Ihe ọmụma
perindopril, angiotensin-converting enzyme inhibitor (ACE), bụ ọgwụ a na-enye n'ọtụtụ ebe maka ọgwụgwọ ọbara mgbali elu na nkụda obi. Otu n'ime ihe dị mkpa maka ndị ọrịa na-ewere perindopril bụ ikpebi oge kacha mma iji were ya maka ịdị irè kachasị yana obere mmetụta. Isiokwu a ga-enyocha oge kachasị mma maka oriri perindopril, ka o si emetụta usoro ọbara mgbali elu, yana atụmatụ maka ijikwa mmetụta ndị nwere ike ime.
Ekwesịrị ị were Perindopril n'ụtụtụ ma ọ bụ mgbede maka uru kacha mma?
Ogologo oge nke oriri perindopril nwere ike inwe mmetụta dị ukwuu na arụmọrụ ya. Ụfọdụ nnyocha na-egosi na ị na-ewere ACE inhibitors na mgbede nwere ike inye aka ịchịkwa ọbara mgbali nke ọma n'ihi ọdịdị nke circadian rhythm nke anụ ahụ. Otú ọ dị, nzaghachi onye ọ bụla nwere ike ịdịgasị iche, ma ekwesịrị ịtụle ihe ndị dị ka usoro onye ọrịa na-eme kwa ụbọchị na usoro ihi ụra.
Nnyocha e bipụtara na Journal of Hypertension chọpụtara na ị theụ ọgwụ mgbede nke ndị na-egbochi ACE, gụnyere perindopril, butere mbelata ọbara mgbali elu nke abalị ma e jiri ya tụnyere ọgwụ ụtụtụ [1]. Nchọpụta a dị mkpa karịsịa n'ihi na ọbara mgbali elu nke abalị na-ejikọta ya na ihe ize ndụ dị ukwuu nke ihe omume obi.
Agbanyeghị, ọ dị mkpa iburu n'uche na ọ bụghị ndị ọrịa niile nwere ike irite uru otu nha site na ị theụ ọgwụ mgbede. Ụzọ ahaziri onwe ya, na-eburu n'uche ihe ndị dị n'otu n'otu, na-adịkarị mkpa. Dịka ọmụmaatụ, ndị ọrịa nwere akụkọ ihe mere eme nke hypotension nke abalị ma ọ bụ ndị na-achọkarị mmamịrị n'abalị nwere ike ịhụ na dose nke ụtụtụ dabara adaba.
The pharmacokinetics nke perindopril na-ekerekwa òkè n'ịchọpụta oge kacha mma. Perindopril nwere ogologo ndụ ọkara ogologo ndụ, yana metabolite na-arụ ọrụ, perindoprilat, na-arụ ọrụ ruo awa 24. Ogologo oge a na-eme ihe na-enye ohere ịme ihe otu ugboro kwa ụbọchị ma na-enye mgbanwe n'ihe gbasara oge.
N'ikpeazụ, a ga-eme mkpebi maka oge ị ga-ewere perindopril na onye na-ahụ maka ahụike. Ihe ndị a ga-atụle gụnyere:
1. Ụdị ọbara mgbali elu nke ọ bụla
2. okirikiri ụra ụra
3. Usoro ọrụ
4. A na-aṅụ ọgwụ ndị ọzọ
5. Ọnụnọ nke comorbidities
Kedu ka oge Perindopril si emetụta njikwa ọbara mgbali elu?
Ọbara mgbali elu adịghị adịgide adịgide n'ụbọchị dum; ọ na-adịkarị elu n'isi ụtụtụ ma na-agbada n'abalị. Ihe omume a, nke a maara dị ka usoro mgbaka ọbara mgbali elu, nwere mmetụta maka oge ọgwụ antihypertensive.
Mmụba ọbara mgbali n'isi ụtụtụ, nke na-emekarị n'etiti 6 AM na ehihie, jikọtara ya na nnukwu ihe ize ndụ nke ihe omume obi [3]. A na-eche na ịwa ahụ a bụ n'ihi ịgbalite sistemu renin-angiotensin-aldosterone (RAAS) yana ịba ụba sistemu ụjọ ụjọ mgbe ọ tetara.
Perindopril, dị ka onye na-egbochi ACE, na-arụ ọrụ site na igbochi ntụgharị nke angiotensin I na angiotensin II, vasoconstrictor nwere ike. Site n'ime nke a, ọ na-enyere aka mee ka arịa ọbara dị jụụ na iwetulata ọbara mgbali. Oge nke
enwere ike ime atụmatụ nhazi usoro iji gbochie mwalite ọbara mgbali n'isi ụtụtụ.
Otu nnyocha e bipụtara na American Journal of Hypertension gosiri na mgbede dose nke ACE inhibitors mere ka mbelata ọbara mgbali elu nke ụtụtụ ma e jiri ya tụnyere ọgwụ ụtụtụ [4]. Ekwuru na mmetụta a bụ n'omume kachasị elu nke ọgwụ na-adaba n'isi ụtụtụ mgbe ọbara mgbali elu na-ebili.
Agbanyeghị, ọ dị mkpa iburu n'uche na ịdị irè nke ị theụ ọgwụ mgbede nwere ike ịdabere na nhazi nke perindopril. Emebere ụfọdụ usoro ntọhapụ agbatịgoro iji nye mmetụta mbelata ọbara mgbali elu na-agbanwe agbanwe n'ime oge awa 24, nwere ike ibelata mmetụta nke oge na nrụpụta ọrụ [5].
Maka ndị ọrịa nwere ọbara mgbali elu nke abalị, nke a na-egosi na ọ naghị etinye aka na ọbara mgbali elu n'abalị, ị theụ ọgwụ perindopril na mgbede nwere ike ịba uru. A na-ejikọta ọbara mgbali elu nke abalị na ihe ize ndụ dị ukwuu nke mmebi akụkụ ahụ ezubere iche na ihe omume obi [6].
Chronotherapy, omume nchịkwa ọgwụ oge iji kwekọọ n'ụda okirikiri nke anụ ahụ, bụ mpaghara na-apụta na njikwa ọbara mgbali elu. Ọ bụ ezie na ihe akaebe na-egosi uru nwere ike ịdị na ị theụ ọgwụ mgbede maka ndị na-egbochi ACE dị ka perindopril, ọ dị mkpa ka ọmụmụ ihe buru ibu na ogologo oge iji guzobe ụkpụrụ nduzi.
Kedu ihe mmetụta Perindopril na-emekarị yana kedu ka esi ejikwa ha?
mgbe perindopril A na-anabatakarị ya nke ọma, ọ nwere ike ịkpata mmetụta ndị dị ka isi ọwụwa, ụkwara, na hyperkalemia. Ịghọta otú oge ọgwụ nwere ike isi metụta mmetụta ndị a dị mkpa maka imeziwanye nnabata ndị ọrịa na nkasi obi.
1. Dizziness na hypotension:
Otu n'ime mmetụta ndị na-emekarị nke ndị na-egbochi ACE, gụnyere perindopril, bụ isi ọwụwa n'ihi mbelata ọbara mgbali elu na mberede. Mmetụta a nwere ike ịpụta karịa mgbe a malitere ọgwụ mbụ ma ọ bụ mgbe a na-abawanye dose ahụ. Inweta perindopril n'oge ụra nwere ike inye aka belata mmetụta a n'ihi na ọbara mgbali elu na-agbadata n'oge ụra [7].
Atụmatụ njikwa:
- Malite na obere dose ma jiri nwayọọ nwayọọ na-abawanye ka anabatara
- Nye ndị ọrịa ndụmọdụ ka ha bilie nwayọ site na ọdụ ma ọ bụ dina
- Tụlee usoro ọgwụgwọ mgbede ma ọ bụrụ na isi ọwụwa ụtụtụ bụ nsogbu
2. Ụkwara akọrọ na-adịgide adịgide:
Ụkwara na-egbochi ACE bụ mmetụta a ma ama nke na-emetụta ihe dịka 5-35% nke ndị ọrịa [8]. Oge a na-eri perindopril anaghị emetụta nke ukwuu ohere nke ịmalite ụkwara, n'ihi na ọ metụtara mkpokọta bradykinin kama itinye uche kacha elu nke ọgwụ.
Atụmatụ njikwa:
- Ọ bụrụ na ụkwara ahụ na-enye nsogbu, tụlee ịgafe na angiotensin receptor blocker (ARB)
- Ụfọdụ ndị ọrịa nwere ike nweta ahụ efe site na iji nri were ọgwụ ahụ
3. Hyperkalemia:
Perindopril nwere ike ịbawanye ọkwa potassium n'ime ọbara, ọkachasị ndị ọrịa nwere ọrịa akụrụ ma ọ bụ ndị na-ewere diuretics na-egbochi potassium. Oge nke perindopril oriri anaghị emetụta oke hyperkalemia.
Atụmatụ njikwa:
- Nleba anya mgbe niile maka ọkwa potassium serum
- Nye ndị ọrịa ndụmọdụ ka ha zere nri na mgbakwunye potassium nwere nnukwu
- Tụlee mmezi dose ma ọ bụ ọgwụ ọzọ ma ọ bụrụ na hyperkalemia na-adịgide
4. Ike ọgwụgwụ:
Ụfọdụ ndị ọrịa nwere ike ịnwe ike ọgwụgwụ mgbe ha na-ewere perindopril. Ọ bụrụ na mmetụta a pụtara ìhè, ịṅụ ọgwụ n'oge ụra nwere ike inye aka mee ka ike gwụ ahụ na usoro ihi ụra eke.
Atụmatụ njikwa:
- Nnwale na usoro onunu ogwu mgbede ma ọ bụrụ na ike ọgwụgwụ ụbọchị nwere nsogbu
- Gbaa mbọ hụ na ihi ụra zuru oke ma debe usoro ihi ụra na-agbanwe agbanwe
5. Mmebi gbasara akụrụ:
Ndị na-egbochi ACE nwere ike imetụta ọrụ akụrụ, karịsịa na ndị ọrịa nwere ọrịa akụrụ dị adịbu ma ọ bụ ndị na-aṅụ ọgwụ ndị ọzọ na-emetụta akụrụ. Ogologo oge iji perindopril anaghị emetụta ihe egwu a.
Atụmatụ njikwa:
- Nleba anya nke ọrụ gbasara akụrụ mgbe niile
- Gbanwee usoro onunu ogwu dabere na mkpochapụ creatinine
- Gbaa mbọ hụ na hydration zuru oke
Ọ dị mkpa iburu n'uche na ka ịhazigharị oge nke oriri perindopril nwere ike inye aka ijikwa mmetụta ụfọdụ, mgbanwe ọ bụla kwesịrị ime n'okpuru nduzi nke onye na-ahụ maka ahụike. Na mgbakwunye, ekwesịrị ka a kụziere ndị ọrịa gbasara mmetụta ndị nwere ike ime ma gbaa ha ume ka ha kọọ nsogbu ọ bụla ozugbo.
mmechi
Na-ekpebi oge kacha mma iji were perindopril na-agụnye imeziwanye ihe ndị na-emepụta ọgwụ na-emepụta ọgwụ, usoro ihe na-eme gburugburu ahụ, na mkpa onye ọrịa. Ọ bụ ezie na ihe akaebe na-egosi uru ndị nwere ike ịdị na ịdoụ ọgwụ mgbede maka njikwa ọbara mgbali elu, ọkachasị n'ịchịkwa mgbawa n'isi ụtụtụ na ọbara mgbali elu nke abalị, ụzọ otu nha dabara adabaghị adabara.
Ndị ọrịa na ndị na-ahụ maka ahụike kwesịrị ịrụkọ ọrụ ọnụ iji chọta oge kacha mma maka nchịkwa perindopril, na-eburu n'uche ihe ndị dị ka usoro ọbara mgbali elu nke onye ọ bụla, ụdị ndụ, yana ọnụnọ nke nsonaazụ ya. Nleba anya na nleba anya mgbe niile dị mkpa iji hụ na usoro a họọrọ na-enye njikwa ọbara mgbali elu dị irè ma na-ebelata mmetụta ọjọọ.
Ka nyocha na chronotherapy na-aga n'ihu na-etolite, ọmụmụ ihe n'ọdịnihu nwere ike ịnye ntụzịaka doro anya na oge kachasị mma nke nchịkwa ACE inhibitor. Ka ọ dị ugbu a, usoro ahaziri onwe ya, nke mkpebi ụlọ ọgwụ na mmasị ndị ọrịa na-eduzi, ka bụ atụmatụ kachasị mma maka ịkwalite ọgwụgwọ perindopril.
Ọ bụrụ na ị nwekwara mmasị na ngwaahịa a ma chọọ ịmatakwu nkọwa ngwaahịa, ma ọ bụ chọọ ịmata maka ngwaahịa ndị ọzọ metụtara, biko nweere onwe gị ịkpọtụrụ. iceyqiang@gmail.com.
References:
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2. Todd, PA, & Fitton, A. (1991). Ọgwụ ọjọọ, 42 (1), 90-114.
3. Kario, K. (2010). Akwụkwọ akụkọ America nke ọbara mgbali elu, 23 (10), 1059-1067.
4. Hermida, RC, et al. (2005). Akwụkwọ akụkọ American nke Ọbara mgbali elu, 18 (3), 364-371.
5. Meredith, PA (1994). Akwụkwọ akụkọ nke Cardiovascular Pharmacology, 23, S44-S47.
6. Birkenhäger, AM, & van den Meiracker, AH (2007). Akwụkwọ akụkọ ọbara mgbali elu, 25 (5), 935-946.
7. Sica, DA (2005). Akwụkwọ akụkọ ọbara mgbali elu, 7 (4), 238-242.
8. Dicpinigaitis, PV (2006). Igbe, 129 (1), 169S-173S.
