Created at:1/13/2025
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Macitentan na tadalafil ni umuti uvanga ibintu byinshi ufasha kuvura umuvuduko ukabije w'amaraso mu muhogo (PAH), indwara ikomeye aho umuvuduko w'amaraso mu muhogo wawe uba mwinshi cyane. Ubu buryo bwo kuvura buvanga imiti ibiri itandukanye ikorera hamwe kugira ngo ifungure imitsi y'amaraso yo mu muhogo wawe kandi itume amaraso atembera neza.
Iyo ufite PAH, imitsi mito y'amaraso yo mu muhogo wawe iragabanuka kandi igakomera, bigatuma umutima wawe ukora cyane kugira ngo utere amaraso muri yo. Uyu muti uvanga ibintu byinshi ukemura ikibazo ku mpande ebyiri, ukaguha uburyo bwo kuvura burambuye kurusha gukoresha umuti umwe gusa.
Uyu muti uvanga ibintu byinshi birimo ibintu bibiri bikora bifatika bigamije inzira zitandukanye mu mubiri wawe kugira ngo uvure umuvuduko ukabije w'amaraso mu muhogo. Macitentan yugaranisha ibintu byinshi byakira bituma imitsi y'amaraso igabanuka, mugihe tadalafil ifasha koroshya imitsi yoroshye mu nkuta z'imitsi yawe y'amaraso.
Uyu muti uvanga ibintu byinshi uza mu buryo bw'ibinini bifatirwa mu kanwa, akenshi rimwe ku munsi. Muganga wawe arabitanga iyo uburyo bwo kuvura bukoreshwa n'umuti umwe butatanga inyungu zihagije, cyangwa iyo indwara yawe isaba uburyo bwo kuvura bukaze kuva mu ntangiriro.
Ibintu byombi byakoreweho ubushakashatsi bunini ku giti cyabyo no hamwe, bigaragaza ko uruvange rushobora kugira akamaro kurusha umuti umwe ukoreshwa wenyine mu gucunga ibimenyetso bya PAH no gutinda iterambere ry'indwara.
Uyu muti uvanga ibintu byinshi wagenewe by'umwihariko kuvura umuvuduko ukabije w'amaraso mu muhogo, indwara idasanzwe ariko ikomeye igira ingaruka ku mitsi yo mu muhogo wawe. PAH ituma amaraso atembera nabi mu muhogo wawe, bigashyira umutwaro ku ruhande rw'iburyo rw'umutima wawe.
Muganga wawe ashobora kugutegeka gufata uru ruhererekane rw'imiti niba urimo kugira ibimenyetso nk'uguhumeka nabi mu bikorwa bya buri munsi, kubabara mu gituza, umunaniro, cyangwa kubyimba amaguru n'akaboko. Ibi bimenyetso bibaho kuko umutima wawe ukora cyane kugira ngo utere amaraso mu miyoboro y'amaraso y'ibihaha yagabanutse.
Uyu muti ufasha kunoza ubushobozi bwawe bwo gukora imyitozo, bivuze ko ushobora kugenda kure kandi ugakora ibikorwa byinshi utagira umwuka muke. Bifasha kandi kugabanya uko PAH ikomeza, bishobora kugabanya ibyago byo kujyanwa mu bitaro n'izindi ngorane zikomeye.
Uyu muti uvanga ukora ukoresheje uburyo bubiri butandukanye bwo gutanga ubuvuzi bwuzuye bwa hypertension ya pulmonary arterial. Tekereza nk'uko ikemura ikibazo ku mpande nyinshi kugira ngo iguhe ibisubizo byiza.
Macitentan ifunga imiterere ya endothelin mu miyoboro yawe y'amaraso. Endothelin ni ikintu gituma imiyoboro y'amaraso ifunga kandi igabanuka, bityo mu gufunga iyi miterere, macitentan ifasha gukomeza imiyoboro yawe y'ibihaha ifunguye kandi yoroshye.
Tadalafil ikora mu guhagarika enzyme yitwa PDE5, ituma urwego rwo hejuru rw'ikintu gifasha imiyoboro y'amaraso koroha. Ibi bituma amaraso atembera neza mu miyoboro yawe y'ibihaha kandi bigabanya umuvuduko umutima wawe uhura nawo.
Hamwe, iyi miti itanga ingaruka zifatanya, bivuze ko bakora neza hamwe kuruta uko bakora ukwabo. Ubu buryo bwo guhuza bufatwa nk'ubufite imbaraga ziringaniye kandi busanzwe bubikirwa abarwayi bakeneye ubuvuzi bwuzuye.
Fata uyu muti nk'uko muganga wawe abitegeka, akenshi rimwe ku munsi hamwe n'ibiryo cyangwa utabifite. Urashobora kuwufata n'amazi, kandi ntacyo bitwaye niba urya mbere cyangwa nyuma yo gufata urugero rwawe.
Gerageza gufata imiti yawe ku isaha imwe buri munsi kugira ngo urugero rwayo rukomeze kuba ruringaniye mu maraso yawe. Ibi bifasha kwemeza ko uvurwa neza indwara yawe y’umuvuduko ukabije w’amaraso mu muhogo wawe umunsi wose.
Mimina urupapuro rwose utarukata, uruvuna, cyangwa ururya. Niba ugira ikibazo cyo kumira ibinini, ganira na muganga wawe ku bindi bisubizo cyangwa uburyo bushobora kugufasha.
Ntukareke gufata uyu muti ako kanya, niyo wumva urimo gukira. PAH ni indwara idakira isaba kuvurwa buri gihe, kandi guhagarika ako kanya bishobora gutuma ibimenyetso byawe birushaho kwiyongera vuba.
Ubu ni uburyo bwo kuvura burambye, uzakenera gukomeza igihe cyose bifasha kugenzura neza umuvuduko ukabije w’amaraso mu muhogo wawe. PAH ni indwara idakira itajya yikiza, bityo imiti ikomeza ikunze kuba ngombwa.
Muganga wawe azakurikiza uko witwara ku buvuzi binyuze mu gusuzuma buri gihe, harimo ibizamini byo gupima ubushobozi bwawe bwo gukora imyitozo ngororamubiri n’imikorere y’umutima. Izi gahunda zifasha kumenya niba umuti ukora neza kuri wewe niba hariho impinduka zikenewe.
Abantu bamwe barashobora gukenera gufata iyi mvange imyaka myinshi, mu gihe abandi bashobora guhindukira bakajya ku miti itandukanye bitewe n’uko indwara yabo yitwara. Gahunda yawe yo kuvurwa izaba yihariye bitewe n’ibyo ukeneye byihariye n’uko wihanganira umuti.
Kimwe n’indi miti yose, iyi mvange irashobora gutera ibimenyetso bigaragara, nubwo atari buri wese ubyumva. Ibimenyetso bigaragara byinshi birashobora kugenzurwa kandi bikunda gukira uko umubiri wawe wimenyereza umuti.
Dore ibimenyetso bigaragara bisanzwe ushobora guhura nabyo uko umubiri wawe wimenyereza ubu buvuzi:
Ibi bimenyetso bikunze kugaragara akenshi bigenda bigabanuka uko igihe kigenda gihita, ariko menyesha muganga wawe niba bikomeje cyangwa bikabangamira imirimo yawe ya buri munsi.
Ibimenyetso bimwe bikomeye bisaba ubufasha bwihuse bw'abaganga, nubwo bitajya bibaho kenshi. Vugana n'umuganga wawe ako kanya niba ubonye kimwe muri ibi bimenyetso bikomeye:
Ibi bimenyetso bikomeye ntibibaho kenshi, ariko ni ngombwa kubimenya hakiri kare kugirango ubone ubuvuzi bukwiye niba bibaye ngombwa.
Uyu muti uvanga ntabwo ukwiriye kuri buri wese, kandi muganga wawe azasuzuma neza amateka yawe y'ubuzima mbere yo kuwugusabira. Indwara nyinshi n'imiti bishobora gutuma ubu buvuzi butaba umutekano cyangwa butagira akamaro.
Ntabwo ukwiriye gufata uyu muti niba ukoresha imiti ya nitrate ubu kubera kubabara mu gituza, kuko uyu muti uvanga ushobora gutera igabanuka ry'umuvuduko w'amaraso. Ibi birimo imiti ya nitrate yanditswe na muganga nka nitroglycerin n'ibiyobyabwenge byitwa "poppers."
Abagore batwite cyangwa bagerageza gutwita bagomba kwirinda uyu muti, kuko ushobora gutera ubumuga bukomeye ku mwana. Niba utwite ukoresha uyu muti, vugana n'umuganga wawe ako kanya kugirango muganire ku zindi nzira z'ubuvuzi zifite umutekano.
Abantu barwaye indwara ikomeye y'umwijima cyangwa indwara zimwe na zimwe z'umutima ntibashobora kuba bakwiriye ubu buvuzi. Muganga wawe azasuzuma imikorere y'umwijima wawe n'ubuzima bw'umutima wawe mbere yo gutangira kukuvura n'uyu muti.
Niba ufite amateka y'ibibazo by'amaso, kutumva neza, cyangwa umuvuduko muke w'amaraso, muganga wawe azagomba gupima neza inyungu n'ibibazo mbere yo kugusaba uyu muti uvanga.
Uyu muti uvanga uboneka munsi y'izina ry'ubwoko rya Opsynvi, rikaba ari ryo ryibanze ryemewe mu bucuruzi bwo kuvura umuvuduko ukabije w'amaraso mu muhogo. Izina ry'ubwoko rifasha gutandukanya n'indi miti irimo ibi bice bitandukanye.
Urashobora kandi guhura n'ibice bya buri kimwe bigurishwa bitandukanye munsi y'amazina y'ubwoko atandukanye. Macitentan iboneka nka Opsumit, naho tadalafil izwi n'amazina menshi y'ubwoko arimo Cialis na Adcirca.
Jya ukoresha buri gihe ubwoko bwihariye n'uburyo muganga wawe aguteye, kuko uburyo butandukanye bushobora kugira imbaraga zitandukanye cyangwa uburyo bwo kurekura bituma umuti ukora neza ku ndwara yawe.
Ubuvuzi butandukanye burahari bwo kuvura umuvuduko ukabije w'amaraso mu muhogo niba uyu muti uvanga utagukwiriye cyangwa utatanga uburyo bwo kugenzura ibimenyetso bihagije. Muganga wawe ashobora gufasha kumenya uburyo bushobora gukora neza ku miterere yawe yihariye.
Izindi miti yo kunywa yo kuvura PAH harimo bosentan, ambrisentan, sildenafil, na riociguat. Buri kimwe muri ibi gikora mu nzira zitandukanye kugira ngo gifashe gufungura imitsi y'amaraso yo mu muhogo wawe no kugabanya umuvuduko wo mu muhogo.
Ku byerekeye ibibazo bikomeye, muganga wawe ashobora gutekereza ku miti ihumeka cyangwa yo mu maraso nka epoprostenol, treprostinil, cyangwa iloprost. Ubu buvuzi busanzwe bubikirwa abarwayi bafite indwara ikomeye cyangwa abatazira neza imiti yo kunywa.
Abantu bamwe barushaho kumera neza bakoresheje imiti ivuye mu byiciro bitandukanye, abandi bakaba barushaho kumera neza bakoresheje imiti yongerwa buhoro buhoro bitewe n'uko umubiri wabo uyakira.
Uburyo bwombi bwo kuvura burimo imbaraga zabyo, kandi guhitamo hagati yabyo biterwa n'uburwayi bwawe bwihariye n'intego z'ubuvuzi. Macitentan na tadalafil byombi bikoreshwa mu kuvura inzira ebyiri, naho sildenafil ikora mu buryo bumwe nkuko tadalafil ikora.
Uburyo bwo kuvura hakoreshejwe imiti ibiri bushobora gutanga ubuvuzi bwuzuye kuko buvura inzira nyinshi zifite uruhare muri PAH. Ubushakashatsi bumwe buvuga ko ubuvuzi bukoresha imiti ibiri bushobora kugira akamaro kurusha kuvura hakoreshejwe umuti umwe ku barwayi bamwe.
Ariko, sildenafil imaze igihe kinini ikoreshwa mu kuvura PAH kandi ifite amakuru menshi yerekeye umutekano wayo. Ishobora gukundwa ku barwayi bakeneye uburyo bworoshye bwo kuvurwa cyangwa bafite uburwayi bwihariye butuma kuvura hakoreshejwe imiti ibiri bidakwiriye.
Muganga wawe azatekereza ku bintu nk'uburemere bw'uburwayi bwawe, izindi ndwara, imiti urimo gufata, n'intego z'ubuvuzi mu gufata icyemezo cy'uburyo bwiza kuri wowe.
Ubu buryo bwo kuvura hakoreshejwe imiti ibiri bushobora gukoreshwa ku bantu bafite ubwoko bumwe bw'indwara z'umutima, ariko bisaba gukurikiranwa neza no gusuzumwa na muganga wawe. Kubera ko PAH ubwayo igira ingaruka ku mutima, kuvura indwara yihishe inyuma yabyo akenshi bifasha kunoza imikorere y'umutima.
Ariko, niba ufite umutima udakora neza cyane, watewe n'umutima vuba aha, cyangwa ibibazo bimwe na bimwe by'umutima, muganga wawe ashobora gukenera guhindura gahunda yawe y'ubuvuzi cyangwa agatekereza ku zindi nzira zo kuvura. Uyu muti ushobora kugira ingaruka ku mitsi y'amaraso n'umuvuduko w'umutima, bityo gukurikiranwa kwa kenshi kw'umutima ni ingenzi.
Umuvuzi w'umutima wawe n'inzobere mu kuvura PAH bazakorana kugira ngo barebe ko gahunda yawe yo kuvurwa ikemura umuvuduko mwinshi w'amaraso mu muhogo ndetse n'izindi ndwara z'umutima zishobora kuba zihari mu buryo bwizewe.
Niba unyweye umuti mwinshi kuruta urugero rwanditswe, vugana n'umuganga wawe cyangwa ikigo gishinzwe ubumara ako kanya, kabone n'iyo wumva umeze neza. Kunywa umuti mwinshi bishobora gutera igabanuka ry'amaraso rishobora guteza akaga n'izindi ngorane zikomeye.
Ibimenyetso byo kunywa umuti mwinshi bishobora kuba harimo isereri rikomeye, kuruka, isesemi, cyangwa impinduka mu mbono. Ntukagerageze kwivuza wenyine ibi bimenyetso, kandi ntukagire icyo utegereza ngo urebe niba byikiza.
Igihe uhamagaye usaba ubufasha, gira urupapuro rw'umuti wawe kugira ngo ushobore gutanga amakuru yihariye ku byo wanyoye n'ingano yabyo. Ibi bifasha abaganga kuguha inama zikwiriye.
Niba wirengagije kunywa urugero rw'umuti, unywe ako kanya wibukije, keretse igihe cyo kunywa urugero rukurikira kigeze. Muri icyo gihe, reka urugero wirengagije hanyuma ukomeze gahunda yawe isanzwe yo kunywa imiti.
Ntuzigere unywa imiti irenze urugero rumwe kugira ngo wuzuze urugero wirengagije, kuko ibi bishobora kongera ibyago byo kugira ingaruka ziterwa n'imiti n'ingorane. Kunywa imiti irenze urugero rumwe bishobora gutera igabanuka ry'amaraso rishobora guteza akaga.
Niba ukunda kwibagirwa kunywa imiti, tekereza gushyiraho ibyibutso kuri terefone cyangwa ukoreshe igikoresho gifasha gutegura imiti kugira ngo bigufashe gukurikiza gahunda yawe yo kuvurwa.
Ugomba kureka kunywa uyu muti gusa uyobowe n'umuganga wawe, kuko PAH ni indwara idakira isaba kuvurwa buri gihe. Guhagarika ako kanya bishobora gutuma ibimenyetso byawe bisubira cyangwa bikiyongera vuba.
Muganga wawe ashobora gutekereza kugabanya cyangwa guhagarika imiti niba ubonye ingaruka zikomeye zitashobora gucungwa, cyangwa niba uburwayi bwawe buhinduka cyane. Impinduka zose kuri gahunda yawe y'imiti zigomba gukorwa buhoro buhoro kandi hakurikiranwa cyane.
N'ubwo wumva umeze neza cyane, komeza gufata imiti yawe nk'uko byategetswe. Uburyo ibimenyetso byawe bigenda birushaho kugaragaza ko imiti ikora, atari uko utakiyikeneye.
Ugomba kugabanya kunywa inzoga mugihe ufata iyi miti, kuko inzoga n'imiti byombi bishobora kugabanya umuvuduko w'amaraso. Kubihuza bishobora kongera ibyago byo kuribwa umutwe, kuruka, cyangwa izindi ngaruka.
Niba uhisemo kunywa rimwe na rimwe, bikore mu rugero ruciriritse kandi witondere uko wumva. Tangira n'utuntu duto kugirango urebe uko umubiri wawe witwara, kandi wirinde kunywa niba umaze kuribwa umutwe cyangwa umuvuduko w'amaraso uri hasi.
Ganira na muganga wawe ku rwego rwo kunywa inzoga, niba ruriho, rukwiriye kuri wowe hashingiwe ku buzima bwawe muri rusange no ku buryo witwara ku miti.