Yini i-Apixaban: Ukusetshenziswa, Umthamo, Imiphumela Eceleni Nokunye

I-Apixaban iyisithambisi segazi esibhalwe ngudokotela esisiza ukuvimbela ukwakheka kwamahlule egazi ayingozi emzimbeni wakho. Ingaphansi kohlobo olusha lwemithi ebizwa ngokuthi ama-anticoagulants aqondile ngomlomo, asebenza ngendlela ehlukile kunezithambisi zegazi ezindala njenge-warfarin. Udokotela wakho angase akubhalele i-apixaban uma unezimo ezithile zenhliziyo noma udinga ukuvikelwa emahuleni abangela unhlangothi.

Yini i-Apixaban?

I-Apixaban ngumuthi oyi-anticoagulant onciphisa ikhono legazi lakho lokwakha amahlule. Cabanga ngayo njengomqaphi wokuphepha ogcina igazi lakho ligeleza kahle emithanjeni yakho. Ngokungafani nezinye izithambisi zegazi ezindala, i-apixaban isebenza ngokuvimba ngokuqondile iphrotheni ethile yokujiya egazi ebizwa nge-Factor Xa egazini lakho.

Lo muthi uza ngesimo samaphilisi futhi uthathwa ngomlomo kabili ngosuku. Yenzelwe ukuhlinzeka ngokuvikeleka okuqhubekayo usuku lonke ngaphandle kokudinga ukuhlolwa kwegazi njalo ukuqapha imiphumela yawo. Lo muthi uye wafundwa kabanzi futhi wabonakala usebenza ngempumelelo ekuvikeleni izinkinga ezingathi sína ezivela emahuleni egazi.

Yini i-Apixaban Esizwa Ngayo?

I-Apixaban iphatha izimo eziningana lapho amahlule egazi eba yingozi enkulu empilweni. Udokotela wakho uyayibhala uma izinzuzo zokuvimbela amahlule zidlula izingozi zokuphuma igazi. Lo muthi ubaluleke kakhulu kubantu abanezinkinga zesigqi senhliziyo noma labo abalulama ezinkingeni ezihlobene nama-clot.

Nawa amakhondishini amakhulu i-apixaban esiza ukuphatha, ngalinye lidinga ukugadwa kwezokwelapha ngokucophelela:

• I-atrial fibrillation (ukushaya kwenhliziyo okungajwayelekile) - ivimbela ukwakheka kwamahlule abangela ukushaywa unhlangothi enhliziyweni
• I-Deep vein thrombosis (DVT) - iphatha amahlule egazi emithanjeni yomlenze futhi iwavimbela ukuthi angabuyi
• I-Pulmonary embolism - iphatha amahlule ayingozi emithanjeni yamaphaphu
• Ukuvimbela amahlule ngemva kokuhlinzwa - ivikela iziguli ngemva kokuhlinzwa kokufakelwa okhalweni noma emadolweni
• Ukuvimbela ukushaywa unhlangothi kwesibili - kunciphisa ingozi yokushaywa unhlangothi okwengeziwe ezigulini ezithile

Isimo ngasinye salezi sidinga izindlela ezihlukene zokulinganisa nokugada. Umhlinzeki wakho wokunakekelwa kwezempilo uzonquma ukusetshenziswa okufanele kakhulu ngokusekelwe esimweni sakho sezokwelapha esithile.

Isebenza Kanjani I-Apixaban?

I-Apixaban isebenza ngokuvimba i-Factor Xa, iphrotheni ebalulekile enqubweni yomzimba wakho yokujiya kwegazi. Lapho le phrotheni ivinjelwa, igazi lakho lithatha isikhathi eside ukwakha amahlule, okunciphisa ingozi yokuvaleka okuyingozi emithanjeni yakho yegazi. Lokhu kwenza i-apixaban ibe yi-anticoagulant enamandla aphakathi nendawo enikeza ukuvikelwa okuthembekile.

Umuthi uqala ukusebenza kungakapheli amahora ngemva komthamo wakho wokuqala, ufinyelela ekusebenzeni okuphezulu ngamahora angu-3-4. Ngokungafani ne-warfarin, i-apixaban ayidingi ukuthi umzimba wakho uhlakaze izici ezikhona zokujiya, ngakho iqala ukukuvikela ngokushesha okukhulu. Igazi lakho lizobuyela emandleni ajwayelekile okujiya kungakapheli amahora angu-24-48 ngemva kokuyeka umuthi.

Lesi senzo esiqondile senza i-apixaban ibe nokuqagela okwengeziwe kunezinye izinciphisi zegazi ezindala. Ngeke udinge ukuhlolwa kwegazi njalo ukuze uhlole ukuthi umuthi uyasebenza yini kahle, nakuba udokotela wakho esazoqhubeka nokugada impilo yakho yonke kanye nokusebenza kwezinso.

Kufanele Ngiyithathe Kanjani I-Apixaban?

Thatha i-apixaban njengoba kunqunyiwe, ngokuvamile kabili ngosuku ngezikhathi ezifanayo nsuku zonke. Ungayithatha nokudla noma ngaphandle kokudla, nakuba ukuyithatha nokudla kungasiza ukunciphisa isisu esibuhlungu. Gwinya amaphilisi wonke ngamanzi - ungaqobi, ungaphuli, noma uhlafune.

Uma unenkinga yokugwinya amaphilisi, ungaqoba bese uwaxuba namanzi, ijusi le-apula, noma i-applesauce. Sebenzisa le ngxube ngokushesha futhi ungayigcini ukuze uyisebenzise kamuva. Ezinye iziguli zikuthola kuwusizo ukuthatha i-apixaban ngesikhathi sasekuseni nakusihlwa ukuze kumiswe umkhuba oqhubekayo.

Ungalokothi uphinde umthamo wakho uma weqa owodwa, futhi ungayeki ukuthatha i-apixaban ngokuzumayo ngaphandle kokukhuluma nodokotela wakho kuqala. Ukuyeka kungazelelwe kungakhuphula ingozi yakho yama-clots egazi, okungase kube yingozi ekuphileni kuye ngesimo sakho.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Apixaban?

Ubude bokwelashwa nge-apixaban buxhomeke ngokuphelele esimweni sakho esithile sezokwelapha kanye nezici eziyingozi. Abanye abantu bayayidinga izinyanga ezimbalwa, kanti abanye bangayithatha iminyaka noma impilo yonke. Udokotela wakho uzohlola njalo ukuthi usayidinga yini ukuvikelwa komuthi.

Ezimweni ezinjenge-deep vein thrombosis noma i-pulmonary embolism, ukwelashwa kuvame ukuthatha izinyanga ezi-3-6 ekuqaleni. Uma une-atrial fibrillation, cishe uzodinga ukwelashwa kwesikhathi eside uma inkinga yesigqi senhliziyo iqhubeka. Iziguli ezingemva kokuhlinzwa zivame ukuyithatha amasonto ama-2-5 kuye ngohlobo lwabo lokuhlinzwa nokululama.

Umhlinzeki wakho wokunakekelwa kwezempilo uzocabangela izici ezinjengengozi yakho yokopha, ukusebenza kwezinso, nempilo yonke lapho enquma ubude bokwelashwa. Ukuqokwa okulandelayo njalo kusiza ukuqinisekisa ukuthi uthola ibhalansi efanele yokuvimbela ama-clot kanye nengozi yokopha.

Yiziphi Imiphumela Eceleni Ye-Apixaban?

Njengazo zonke izinciphisi zegazi, ingozi enkulu ye-apixaban ukwanda kokopha, nakuba izinkinga ezinkulu zokopha zingavamile. Abantu abaningi bayawuthwala kahle umuthi, kodwa kubalulekile ukuqaphela kokubili imiphumela evamile nengavamile. Udokotela wakho unqume i-apixaban ngoba bakholelwa ukuthi izinzuzo zidlula lezi zingozi ezingaba khona.

Imiphumela evamile ongase uyithole ihlanganisa:

• Ukuvuvukala okulula noma imihuzuko evela ngaphandle kwembangela ecacile
• Ukuphuma kwegazi okuncane okuthatha isikhathi eside ukuthi kuyeke (njengokusuka ekusikeni okuncane)
• Ukuphuma kwegazi emakhaleni okungase kube njalo noma kuhlale isikhathi eside
• Izikhathi ezinzima kakhulu kwabesifazane
• Ukuphazamiseka kwesisu okuncane noma isicanucanu
• Isiyezi noma ukukhathala

Le miphumela ejwayelekile ivame ukuthuthuka njengoba umzimba wakho ujwayela umuthi futhi akuvamile ukuthi idinge ukuyeka ukwelashwa.

Imiphumela emibi kakhulu idinga ukunakekelwa kwezempilo ngokushesha futhi ihlanganisa:

• Izimpawu zokuphuma kwegazi elikhulu - ukuhlanza igazi, izitulo ezimnyama ezinjenge-tar, noma ukukhwehlela igazi
• Ikhanda elibuhlungu kakhulu, ukudideka, noma izinguquko embonweni (ukopha ebuchosheni okungenzeka)
• Ubuthakathaka obungavamile, isikhumba esiphaphathekile, noma ukushaya kwenhliziyo okusheshayo (izimpawu zokulahlekelwa igazi okukhulu)
• Ubuhlungu obuhlangene nokuvuvukala (ukuphuma kwegazi okungavamile emalungeni)
• Ukuphefumula kanzima noma ubuhlungu besifuba

Nakuba le miphumela emibi kakhulu ingavamile, idinga ukunakekelwa kwezempilo eziphuthumayo uma kwenzeka.

Ukuphendula okungavamile kodwa okungase kube kubi kakhulu kufaka phakathi ukusabela komzimba ngokuqubuka kwesikhumba, ukuvuvukala kobuso noma umphimbo, nokuphefumula kanzima. Abanye abantu bangase babe nezinkinga zesibindi, nakuba lokhu kungavamile kakhulu. Xhumana nomhlinzeki wakho wezempilo ngokushesha uma uba nanoma yiziphi izimpawu ezikhathazayo.

Ubani Ongafanele Athole i-Apixaban?

Abantu abathile kufanele bagweme i-apixaban ngenxa yengozi eyengeziwe yezinkinga ezinzima. Udokotela wakho uhlola ngokucophelela umlando wakho wezokwelapha ngaphambi kokukuyalela lo muthi. Uma unesinye salezi zimo, i-apixaban ingase ingakuphephile.

Akufanele uthathe i-apixaban uma une:

• Ukuphuma kwegazi okukhulu okusebenzayo noma umlando wezifo ezinzima zokuphuma kwegazi
• Isifo sezinso esibi esidinga ukuhlanza izinso
• Ama-valve enhliziyo okwenziwa (ama-valve okwenziwa ngomshini)
• Ukungezwani okwaziwayo ne-apixaban noma imithi efanayo
• I-antiphospholipid syndrome (isimo esingavamile sokuzivikela komzimba)

Lezi zimo zombili zikhuphula kakhulu ingozi yokopha noma zenza i-apixaban ingasebenzi kahle ekuvikeleni.

Izixwayiso ezengeziwe ziyasebenza uma unezinkinga eziphakathi nendawo zezinso, izinkinga zesibindi, noma uneminyaka engaphezu kwengama-80 ubudala. Udokotela wakho angase akwazi ukukuchazela i-apixaban kodwa cishe uzosebenzisa umthamo ophansi futhi akuqaphele eduze. Ukukhulelwa nokuncelisa ngamabele nakho kudinga ukucatshangelwa okukhethekile, njengoba idatha yokuphepha kulezi zimo ilinganiselwe.

Amagama Omkhiqizo we-Apixaban

I-Apixaban itholakala kakhulu ngaphansi kwegama lomkhiqizo elithi Eliquis e-United States nakwamanye amazwe amaningi. Lona umkhiqizo wokuqala owenziwe yi-Bristol Myers Squibb kanye ne-Pfizer. Umuthi ungase ube namagama omkhiqizo ahlukene emazweni ahlukene, kodwa isithako esisebenzayo sihlala singashintshi.

Izinhlobo ezivamile ze-apixaban ziya ngokuya zitholakala kwezinye izifunda, ezingase zibize ngaphansi komkhiqizo wegama. Noma ngabe uthola i-apixaban yegama lomkhiqizo noma ejwayelekile, umuthi usebenza ngendlela efanayo futhi unikeza ukuvikelwa okulinganayo ekuqongeleleni kwegazi.

Ezinye izindlela ze-Apixaban

Ezinye izinciphisi zegazi zingasebenza njengezinye izindlela ze-apixaban uma ingakulungele. Udokotela wakho angase acabangele lezi zinketho ngokusekelwe ezidingweni zakho ezithile zezokwelapha, ukusebenza kwezinso, nezinye izinto. Enye indlela ngayinye inezinzuzo zayo kanye nokucatshangelwa kwayo.

Ama-anticoagulants omlomo aqondile afana ne-apixaban afaka:

• Rivaroxaban (Xarelto) - ithathwa kanye ngosuku ezimweni eziningi
• Dabigatran (Pradaxa) - idinga ukulinganiswa kabili ngosuku njenge-apixaban
• Edoxaban (Savaysa) - ngokuvamile ithathwa kanye ngosuku

Le mithi isebenza ngendlela efanayo ne-apixaban kodwa ingase ibe namashejuli ahlukene okulinganiswa noma amaphrofayili emiphumela emibi.

Ama-anticoagulants endabuko afana ne-warfarin (Coumadin) ahlala eyinketho, ikakhulukazi kubantu abanezimo ezithile zamavalvu. Kodwa-ke, i-warfarin idinga ukuhlolwa kwegazi njalo futhi inokudla okuningi nokuxhumana kwemithi kune-apixaban. Imithi ejovwayo efana ne-enoxaparin (Lovenox) ingasetshenziselwa ukwelashwa kwesikhashana noma uma imithi yomlomo ingafanele.

Ingabe i-Apixaban ingcono kune-Warfarin?

I-Apixaban inikeza izinzuzo eziningana ngaphezu kwe-warfarin kubantu abaningi abadinga imithi yokunciphisa igazi. Ucwaningo lubonisa ukuthi i-apixaban okungenani isebenza kahle njenge-warfarin ekuvikeleni amahlule egazi, ngobufakazi obuthile obusikisela ukuthi ingase ibe ngcono ezimweni ezithile. Ukukhetha phakathi kwabo kuncike esimweni sakho sezokwelapha esithile nezintandokazi.

Izinzuzo eziyinhloko ze-Apixaban zihlanganisa ukungadingi ukuhlolwa kwegazi njalo, ukuxhumana okuncane kokudla nemithi, kanye nengozi ephansi yokopha ebuchosheni. Ungadla imifino enamaqabunga aluhlaza futhi ugcine indlela yokuphila ejwayelekile ngaphandle kokukhathazeka ngokuthinta ukusebenza komuthi. Umuthi uqala ukusebenza ngokushesha futhi ususwe ohlelweni lwakho ngokushesha.

Kodwa-ke, i-warfarin iseyona inketho engcono kwabanye abantu, ikakhulukazi labo abanama-valve enhliziyo emishini noma isifo esibi sezinso. I-Warfarin nayo ayibizi kakhulu futhi isetshenziswe ngokuphepha amashumi eminyaka. Uma uba nokopha ngenkathi uthatha i-apixaban, odokotela banolwazi oluningi lokuphatha izinkinga zokopha ezihlobene ne-warfarin.

Umhlinzeki wakho wokunakekelwa kwezempilo uzocabangela izinto ezinjengokusebenza kwezinso zakho, eminye imithi, indlela yokuphila, nezintandokazi zomuntu siqu lapho ekhetha phakathi kwalezi zinketho.

Imibuzo Evame Ukubuzwa Mayelana ne-Apixaban

Ingabe i-Apixaban iphephile kubantu abanesifo sezinso?

I-Apixaban ingasetshenziswa ngokuphepha kubantu abanezifo ezingatheni kuya kweziphakathi zamehlo, kodwa idinga ukulungiswa kwemithamo kanye nokuqapha ngokucophelela. Udokotela wakho uzohlola ukusebenza kwamehlo akho ngaphambi kokuqala ukwelashwa futhi ngezikhathi ezithile ngenkathi usebenzisa umuthi. Abantu abanezifo ezinzima zamehlo ezidinga i-dialysis akufanele bathathe i-apixaban.

Uma ukusebenza kwamehlo akho kuncishiswe ngokulinganiselwe, udokotela wakho cishe uzoqoka umthamo ophansi ukuvimbela umuthi ukuthi ungazitholi emzimbeni wakho. Lokhu kulungiswa kugcina ukusebenza kahle ngenkathi kunciphisa ingozi yokopha. Ukuhlolwa kwegazi okuvamile kusiza ukuqinisekisa ukuthi izinso zakho ziqhubeka nokusebenza kahle ngesikhathi sokwelashwa.

Kufanele Ngenzeni Uma Ngithatha I-Apixaban Eningi Ngengozi?

Uma ngengozi uthatha i-apixaban eningi kunaleyo ebekiwe, xhumana nodokotela wakho noma isikhungo sokulawula ubuthi ngokushesha, ngisho noma uzizwa ulungile. Ukuthatha okuningi kwandisa ingozi yakho yokopha okukhulu, okungenzeka kungabonakali ngokushesha. Ungalindi ukuthi izimpawu zivele ngaphambi kokufuna usizo.

Ngenkathi ulinde iseluleko sezokwelapha, qaphela izimpawu zokopha njengokulimala okungavamile, ukuphuma kwegazi emakhaleni, noma igazi emchameni noma esitulweni. Gwema imisebenzi engabangela ukulimala, futhi ungathathi eminye imithamo ngaphandle kokuthi ukhulume nomhlinzeki wezempilo. Ezimweni ezinzima, ukwelashwa okuphuthumayo kungase kudingeke ukuguqula imiphumela yomuthi.

Kufanele Ngenzeni Uma Ngiphuthelwa Umthamo We-Apixaban?

Thatha umthamo wakho ophuthelwe ngokushesha lapho ukhumbula, kodwa kuphela uma sekudlule amahora angaphansi kwama-6 kusukela ngesikhathi sakho esihleliwe. Uma sekudlule amahora angaphezu kwama-6, weqa umthamo ophuthelwe bese uthatha umthamo wakho olandelayo ngesikhathi esijwayelekile. Ungalokothi uthathe imithamo emibili ngesikhathi esisodwa ukuze ulungise umthamo ophuthelwe.

Ukuphuthelwa imithamo ngezikhathi ezithile ngokuvamile akuyona ingozi, kodwa zama ukugcina isimiso esiqhubekayo ukuze uthole ukuvikelwa okungcono kakhulu. Cabangela ukusetha ama-alamu ocingo noma ukusebenzisa umhleli wamaphilisi ukusiza ukukhumbula imithamo yakho. Uma uvame ukukhohlwa imithamo, khuluma nodokotela wakho mayelana namaqhinga okuthuthukisa ukunamathela emithini.

Ngingayeka nini ukuthatha i-Apixaban?

Ungayeki ukuthatha i-apixaban ngokuzumayo ngaphandle kokubonisana nodokotela wakho kuqala, ngoba lokhu kungakhuphula kakhulu ingozi yakho yamaqhubu egazi. Umhlinzeki wakho wezempilo uzonquma ukuthi kuphephile nini ukuyeka umuthi ngokusekelwe esimweni sakho esingaphansi kanye nesimo sempilo yakho yamanje. Abanye abantu badinga ukwelashwa impilo yabo yonke, kanti abanye bangayeka ngemva kwesikhathi esithile.

Uma udinga ukuyeka i-apixaban ngenxa yokuhlinzwa noma ezinye izinqubo zezokwelapha, udokotela wakho uzohlinzeka ngemiyalelo ethile mayelana nesikhathi. Bangase batusa ukuxhumana nezinciphisi zegazi ezinjovwayo noma ukuyeka nje isikhathi esifushane kuye ngengozi yakho yegazi kanye nenqubo eyenziwayo.

Ngingakwazi yini ukuphuza utshwala ngenkathi ngithatha i-Apixaban?

Ukuphuza utshwala ngokulinganisela kuvamile ukwamukeleka ngenkathi uthatha i-apixaban, kodwa ukuphuza ngokweqile kungakhuphula ingozi yakho yokopha. Utshwala bungathinta ikhono lesibindi sakho lokucubungula umuthi futhi bungakwenza ukuthi uthambekele ekuweni noma ukuzilimaza. Xoxa ngokwethembeka ngokusetshenziswa kotshwala nodokotela wakho ukuze unqume ukuthi yini ephephile kuwe.

Uma ukhetha ukuphuza, zilinganisele kungabi ngaphezu kwesisodwa ngosuku kwabesifazane noma iziphuzo ezimbili ngosuku kwabesilisa. Qaphela ukulimala okukhulu noma ukopha ngemva kokuphuza, futhi gwema ukuphuza ngokweqile ngokuphelele. Abanye abantu bathola ukuthi utshwala bubenza bazizwe benesiyezi noma bengaqinile, okungakhuphula ingozi yokulimala ngenkathi bethatha izinciphisi zegazi.