Nesiritide ni iki: Ibikoresho, Urutonde rw'imiti, Ingaruka zayo n'ibindi

Nesiritide ni uruvange rw'imiterere y'imisemburo kamere umutima wawe ukora yitwa B-type natriuretic peptide (BNP). Uyu muti ufasha umutima wawe gutera neza kandi ugabanya umuvuduko ku mikorere y'imitsi yawe iyo urimo guhura n'umutima udakora neza cyane.

Muganga wawe ashobora kugusaba nesiritide igihe umutima wawe ukeneye ubufasha bwihuse mugihe uri mu bitaro. Yagenewe by'umwihariko gufasha umubiri wawe gucunga amazi yiyongera no kunoza imikorere y'amaraso iyo izindi nshuti zitanga ubufasha buhagije.

Nesiritide ikoreshwa mu iki?

Nesiritide ivura umutima udakora neza cyane, bivuze ko umutima wawe utabasha gutera amaraso neza. Ibi bikunze kubaho iyo umutima udakora neza by'igihe kirekire birushijeho vuba, akenshi bisaba kwitabwaho mu bitaro byihuse.

Mugihe cyo guhura n'ibibazo by'umutima, umubiri wawe ugumana amazi menshi cyane, bigatuma umutima wawe utabasha gukora neza. Nesiritide ifasha muguhuza imitsi y'amaraso no gushishikariza impyiko zawe gukuramo amazi yarenze urugero binyuze mu kunyara. Iki gikorwa cyombi kigabanya umurimo ku mutima wawe urimo guhura n'ibibazo.

Itsinda ryawe ry'abaganga rizahora rikoresha uyu muti mu bitaro aho bashobora gukurikirana neza imikorere y'umutima wawe n'umuvuduko w'amaraso. Ntabwo ari ikintu wakoresha uri murugo, kuko bisaba ubugenzuzi bw'ubuvuzi bwitondewe mugihe cyose cyo kuvurwa.

Nesiritide ikora ite?

Nesiritide ikora yigana imisemburo umutima wawe ukora mu buryo kamere iyo uri mu bibazo. Iyo umutima wawe uhuye n'ibibazo, ureka BNP kugirango yifashe, ariko rimwe na rimwe ntibikorwa bihagije mugihe cy'ibibazo bikomeye.

Uyu muti ukora ku turemangingo twihariye two mu miyoboro y'amaraso yawe, ukatuma yoroha kandi yaguka. Ibi bituma umutima wawe woroherwa no gutera amaraso mu mubiri wawe. Muri icyo gihe, utuma impyiko zawe zikuramo umunyu mwinshi n'amazi, bikagabanya amazi menshi akaba ariyo akomerera umutima wawe.

Bitekereze nk'ugufasha umutima wawe mu bihe byawo bigoye cyane. Uyu muti ufashwe nk'ufite imbaraga ziringaniye kandi ukora vuba, niyo mpamvu abaganga bawukoresha mu bihe byihutirwa aho kuwukoresha igihe kirekire mu kuvura indwara z'umutima.

Nkwiriye Kufata Nesiritide Nte?

Ntuzifata nesiritide wenyine kuko itangwa gusa binyuze mu muyoboro w'amaraso (IV) mu bitaro. Itsinda ry'abaganga bazashyira agati gato mu urugingo rw'umubiri, akenshi mu kuboko kwawe, hanyuma bagashyira umuti mu maraso yawe.

Ubuvuzi busanzwe butangira n'urugero ruto rwa mbere rukurikizwa n'uruvange rukomeza rushobora kumara amasaha 24 kugeza kuri 48 cyangwa kurenza, bitewe n'uko umutima wawe witwara. Itsinda ry'abaganga bazahindura urugero rwawo bakurikije umuvuduko w'amaraso yawe, umuvuduko w'umutima wawe, n'uko impyiko zawe zikora neza.

Ntabwo ukeneye guhangayika ku gihe cyo kurya cyangwa gufata indi miti hamwe na nesiritide kuko yirengagiza rwose sisitemu yawe yo mu gifu. Ariko, abaganga bawe bazahuza neza n'indi miti y'umutima urimo guhabwa kugirango barebe ko byose bikora neza kandi mu buryo butekanye.

Nkwiriye Kufata Nesiritide Igihe Kingana Gite?

Abantu benshi bahabwa nesiritide mu gihe gito, akenshi amasaha 24 kugeza kuri 48 mu gihe bari mu bitaro. Igihe nyacyo giterwa n'uko ibimenyetso byo kunanirwa k'umutima wawe bikira vuba kandi n'uko umubiri wawe witwara ku buvuzi.

Itsinda ryawe ry’abaganga rizakomeza kugenzura uko umeze kandi rigabanye imiti buhoro buhoro uko imikorere y'umutima wawe izahagarara. Bazashaka ibimenyetso byerekana ko amazi mu mubiri wawe agabanuka, guhumeka kwawe koroshye, kandi umutima wawe ukora neza mbere yo guhagarika imiti.

Umaze guhagarara, abaganga bawe bashobora kukwimurira ku miti yo mu kanwa ivura umutima idashobora gufatirwa mu rugo. Nesiritide yagenewe by'umwihariko nk'ubuvuzi bw'igihe gito kugira ngo igufashe kunyura mu bihe bikomeye, atari nk'umugambi w'ubuvuzi bw'igihe kirekire.

Ni izihe ngaruka ziterwa na Nesiritide?

Ingaruka rusange ushobora guhura nazo ni umuvuduko w'amaraso muke, ushobora gutuma wumva uribwa umutwe cyangwa urumva urimo guta umutwe. Ibi bibaho kuko umuti utuma imitsi yawe y'amaraso iruhuka, kandi rimwe na rimwe umuvuduko w'amaraso yawe urashobora kugabanuka kurusha uko byari byitezwe.

Dore ingaruka ziterwa n'imiti itsinda ryawe ry’abaganga rizakurikirana neza mugihe uvurwa:

• Umuvuduko w'amaraso muke (hypotension) - birashobora gutera isereri cyangwa kumva urimo guta umutwe
• Uburibwe bwo mumutwe - akenshi bworoshye kugeza hagati
• Isesemi - irashobora kuza no gushira mugihe uvurwa
• Uburibwe bwo mu mugongo - akenshi bw'igihe gito
• Isereri - cyane cyane mugihe uhinduye imyanya
• Ukwigunga cyangwa umwuka mubi - birashobora kubaho uko umubiri wawe uhinduka

Itsinda ryawe ryita ku buzima rigenzura izi ngaruka neza kandi rishobora guhindura urugero rw'umuti niba bibaye ngombwa. Ingaruka nyinshi ziterwa n'imiti zirashobora gucungwa kandi zikagenda zikora neza uko imikorere y'umutima wawe ihagarara.

Mu buryo butavugwa cyane, abantu bamwe bashobora guhura n'ingaruka zikomeye zisaba kwitabwaho ako kanya:

• Umuvuduko w'amaraso ugabanuka cyane bisaba guhindura imiti
• Umutima utera nabi cyangwa guhinduka kw'umuvuduko w'umutima
• Guhinduka kw'imikorere y'impyiko - bigenzurwa binyuze mu bizami by'amaraso
• Uko umubiri wabyakiriye (allergies) - birashoboka ariko bidasanzwe hamwe n'imiti iyo ariyo yose

Ahantu hose mu bitaro bituma ibimenyetso icyo ari cyo cyose giteye inkeke bifatwa kandi bigakemurwa vuba, bikaguha uburambe bwiza bwo kuvurwa.

Ninde utagomba gufata Nesiritide?

Nesiritide ntabwo ikwiriye kuri buri wese ufite ibibazo by'umutima. Abaganga bawe bazasuzuma neza amateka yawe y'ubuzima n'uburwayi bwawe bwa none mbere yo gufata icyemezo niba ubu buvuzi bukugirira akamaro.

Ntugomba guhabwa nesiritide niba ufite indwara zimwe na zimwe z'umutima zishobora gutuma ubu buvuzi bugira akaga:

• Umutima utagira imbaraga - iyo umutima wawe udashobora gutera amaraso ahagije mu ngingo z'ingenzi
• Umwuka mubi wo hasi cyane utarasubizwa mu bundi buvuzi
• Indwara z'umutima zibangamiye cyangwa zibangamiye urujya n'uruza rw'amaraso
• Allergies zizwi kuri nesiritide cyangwa imiti isa nayo

Itsinda ryawe ry'ubuvuzi rizakoresha kandi ubushishozi burenzeho niba ufite ibibazo by'impyiko, kuko umuti ugira ingaruka ku buryo impyiko zawe zitunganya amazi. Bazagenzura imikorere y'impyiko zawe hafi y'ubuvuzi kugirango barebe ko bigumana umutekano kuri wewe.

Gusama no konsa bisaba kwitonderwa byihariye, nubwo kunanirwa k'umutima mugihe cyo gutwita ari indwara ikomeye ishobora gusaba ubu buvuzi nubwo hataramenyekana. Abaganga bawe bazagereranya neza ibyago n'inyungu niba utwite cyangwa konsa.

Amazina ya Nesiritide

Nesiritide izwi cyane n'izina ryayo rya Natrecor muri Leta Zunze Ubumwe z'Amerika. Iyi ni verisiyo ushobora guhura nayo mu bitaro, kuko ni uburyo bwibanze buboneka mukoreshwa ry'ubuvuzi.

Umuti ushobora kwitwa izina ryawo rusange (nesiritide) cyangwa izina ry'ubwoko (Natrecor) mumateka yawe y'ubuvuzi n'impapuro zo gusohoka. Amazina yombi yerekeza kumuti umwe, bityo ntugahungabane niba ubona amagambo atandukanye akoreshwa nabanyamuryango batandukanye b'ikipe yawe y'ubuzima.

Bitandukanye n'imiti myinshi ifite ubwoko bwinshi bw'amazina y'ubucuruzi, nesiritide ifite ubwoko buto bw'amazina y'ubucuruzi kuko ni umuti wihariye ukoreshwa mu bitaro aho kuba umuti usanzwe wandikirwa abarwayi basohoka mu bitaro.

Izindi Miti Ishobora Gusimbura Nesiritide

Hariho indi miti myinshi ishobora kuvura umutima udakora neza, nubwo buri umwe ukora mu buryo butandukanye kandi ushobora gukwera kurushaho bitewe n'uko ubuzima bwawe bumeze. Abaganga bawe bahitamo bashingiye ku mikorere y'umutima wawe, umuvuduko w'amaraso, n'ubuzima bw'impyiko.

Dore izindi miti nyamukuru ikipe yawe y'abaganga ishobora gutekereza:

• Dobutamine - ikomeza imitsi y'umutima ariko ishobora kongera umuvuduko w'umutima
• Milrinone - ituma umutima utera neza kandi ikaruhura imitsi y'amaraso
• Furosemide (Lasix) - ikuraho amazi y'ikirenga binyuze mu kwihagarika cyane
• Nitroglycerin - iruhura imitsi y'amaraso kugira ngo igabanye umurimo w'umutima
• Dopamine - ifasha umuvuduko w'amaraso n'imikorere y'umutima

Buri umwe muri iyi miti ifite imbaraga zitandukanye n'ibyo yitaho. Zimwe zikora neza ku bantu bafite umuvuduko muto w'amaraso, mu gihe izindi zikundwa iyo imikorere y'impyiko ihangayikishije. Ikipe yawe y'ubuzima izahitamo icyo gihuye neza n'ibyo ukeneye n'uko ubuzima bwawe bumeze.

Ese Nesiritide iruta Dobutamine?

Nesiritide na dobutamine bikora mu buryo butandukanye kugira ngo bifashe umutima wawe, bityo "kuruta" biterwa n'uko ubuzima bwawe bumeze. Nesiritide yibanda ku kuruhura imitsi y'amaraso no gukuraho amazi, mu gihe dobutamine ikomeza mu buryo butaziguye imikorere y'umutima wawe.

Abaganga bawe bashobora gukunda nesiritide niba ufite umuvuduko mwinshi w'amaraso hamwe n'umutima udakora neza, kuko ifasha kugabanya umuvuduko w'amaraso mugihe ifasha imikorere y'umutima. Dobutamine ishobora guhitwamo niba umutima wawe ukeneye gushishikarizwa mu buryo butaziguye kugira ngo utere neza, cyane cyane niba umuvuduko wawe w'amaraso umaze kuba muto.

Abantu bamwe bungukirwa no guhabwa imiti yombi icyarimwe, kuko yuzuzanya ingaruka zayo. Itsinda ryawe ry'abaganga rizagena umuvuduko w'amaraso yawe, umuvuduko w'umutima, imikorere y'impyiko, n'ubuzima bwawe muri rusange mu gihe cyo gufata icyemezo cy'uburyo bukora neza mu gufasha koroherwa.

Ibikunze Kubazwa ku bijyanye na Nesiritide

Ese Nesiritide irakwiriye ku bantu barwaye indwara z'impyiko?

Nesiritide isaba gukurikiranwa neza ku bantu bafite ibibazo by'impyiko, ariko iracyakoreshwa neza mu bihe byinshi. Uyu muti ugira ingaruka ku buryo impyiko zawe zikoresha amazi n'umunyu, ibyo bikaba ari bimwe mu bifasha umutima wawe.

Itsinda ryawe ry'abaganga rizasuzuma imikorere y'impyiko zawe hakoreshejwe ibizamini by'amaraso mbere yo gutangira kuvurwa kandi bakomeze gukurikirana mu gihe cyose uzaba urimo kuvurwa. Barashobora guhindura urugero rw'umuti cyangwa bagahitamo undi muti niba impyiko zawe zitagikora neza bihagije kugirango zihangane n'impinduka Nesiritide itera.

Mu bihe bimwe na bimwe, indwara y'umutima ubwayo ishyira igitutu ku mpyiko zawe, kandi kuvura indwara y'umutima na Nesiritide bishobora gufasha kurengera imikorere y'impyiko zawe mu gihe kirekire.

Nigute nzakora niba ngize ingaruka ziterwa n'uyu muti mu gihe ndimo kuvurwa?

Kubera ko uzaba uri mu bitaro mu gihe urimo guhabwa Nesiritide, ugomba kubwira umuforomo wawe cyangwa muganga wawe ako kanya ku bijyanye n'ibimenyetso byose bitakoroheye. Ntukegere cyangwa ngo wibeshye ko ibimenyetso bizagenda byonyine.

Itsinda ryawe ry'abaganga riteganya kugukurikirana neza mu gihe uvurwa kandi barashaka kumenya impinduka zose zigaragara ku buryo wumva. Barashobora guhindura vuba urugero rw'umuti wawe, kuguha imiti yiyongera kugirango bagufashe guhangana n'ingaruka ziterwa n'uyu muti, cyangwa guhindura bakaguha undi muti niba bibaye ngombwa.

Ibimenyetso bisanzwe nk'izunguzanye ryoroheje cyangwa kubabara umutwe akenshi birashobora gucungwa n'uburyo bworoshye, mu gihe ibimenyetso bikomeye bishobora gusaba guhindura imiti ako kanya kugirango ugumane umutekano.

Ese nshobora gufata imiti yanjye isanzwe y'umutima mu gihe ndimo guhabwa Nesiritide?

Abaganga bawe bazasuzuma neza imiti yose usanzwe ufata, bagafata icyemezo cyo gukomeza, guhagarika, cyangwa guhindura imiti iyo uri guhabwa nesiritide. Imwe mu miti y'umutima ikora neza hamwe na nesiritide, mu gihe indi ishobora gukenera impinduka z'igihe gito.

Imiti igabanya umuvuduko w'amaraso akenshi ikenera guhindurwa kuko nesiritide ishobora kugabanya umuvuduko w'amaraso. Itsinda ry'abaganga bazakurikirana umuvuduko w'amaraso yawe neza, bagahindura indi miti uko bikwiye kugira ngo bagumane urwego rw'umutekano.

Ntuzigere uhagarika cyangwa utangira imiti iyo ari yo yose wenyine igihe uri guhabwa nesiritide. Buri gihe ujye uganira ku mpungenge zose ufite ku miti yawe n'itsinda ry'abaganga, kuko bagomba guhuza ibintu byose neza ku bw'umutekano wawe.

Nshobora gutaha ryari nyuma yo kuvurwa na Nesiritide?

Abantu benshi bashobora gutaha nyuma y'amasaha 24 kugeza kuri 48 nyuma yo kurangiza kuvurwa na nesiritide, ariko ibi biterwa n'uko umutima wawe wifashe neza n'uko wifashe neza ku miti mishya ufata.

Abaganga bawe bazashaka kureba ko amazi mu mubiri wawe yagabanutse, guhumeka kwawe byoroshye, kandi imikorere y'umutima wawe yihagaze mbere yo kuguha uruhushya rwo gutaha. Bazanasuzuma ko wumva umeze neza ku miti mishya uzaba ufata mu rugo.

Kuvana mu bitaro ukajya mu rugo bikubiyemo gutegura neza kugira ngo umutima wawe ukomeze kugenzurwa neza. Itsinda ry'abaganga bazategura gahunda yo gusuzumwa nyuma yo gutaha, kandi bazatanga amabwiriza asobanutse yo gucunga uburwayi bwawe uri mu rugo.

Ese nzongera gukenera Nesiritide mu gihe kizaza?

Niba uzongera gukenera nesiritide biterwa n'uko umutima wawe ukora neza ku miti ukomeza gufata n'imibereho yawe. Abantu bamwe bagira igihe kimwe gikeneye nesiritide hanyuma bakamera neza ku miti yo kunywa igihe kirekire.

Abandi bafite uburwayi bw'umutima bukomeye bashobora gukenera kujya kwa muganga kenshi kandi bashobora kongera guhabwa nesiritide mu gihe kizaza. Umuganga w'umutima wawe azakorana nawe kugira ngo ategure neza gahunda yawe y'ubuvuzi bw'igihe kirekire kugira ngo agabanye amahirwe yo gukenera ubuvuzi bushingiye ku bitaro.

Intego ni ukugumisha uburwayi bw'umutima wawe bugenzurwa neza mu rugo ukoresheje imiti ushobora kunywa, kugenzura buri gihe, no guhindura imibereho ishyigikira ubuzima bw'umutima wawe.