Rosuvastatin ndi Atorvastatin: zili bwino?

Rosuvastatin kapena Atorvastatin amagwiritsidwa ntchito pochiza matenda ogwirizana ndi hypercholesterolemia. Mankhwalawa onse ali m'gulu la mankhwala othandiza kuchepetsa magazi m'thupi (cholesterol). Akagwiritsidwa ntchito moyenera, sikuti amayambitsa mavuto.

Makhalidwe a rosuvastatin

Rosuvastatin ndi mankhwala othandiza a 4-anticholesterolemic. Piritsi lililonse lili ndi 5 mpaka 40 mg yogwira ya rosuvastatin. Kuphatikizika kwa zigawo zothandizira kumayimiriridwa ndi: colloidal silicon dioxide, lactose monohydrate, kusinthidwa kwowuma kapena chimanga, utoto.

Ma Statin amathandizira kuwonjezeka kwa zochitika zama-low-density lipoprotein receptors, zomwe zimapangitsa kutsika kwawo. Nthawi yomweyo, kuchuluka kwa cholesterol yamagazi kumachepa ndipo kuchuluka kwa lipoproteins okwera kumawonjezeka. Chithandizo cha achire chimayambira pakatha masiku 7 chiyambireni chithandizo. Kuchuluka kwa zotsatira kumawonedwa pakatha mwezi umodzi kuyambira chiyambi cha maphunziro.

Mankhwala amadziwika ndi otsika bioavailability - pafupifupi 20%. Pafupifupi zonse zimatengedwa ndi zinthu izi zimamangidwa kumapuloteni a plasma. Amachotseredwa ndi ndowe zosasinthika. Nthawi yochepetsera mulingo wa rosuvastatin m'mwazi ndi theka ndi maola 19. Amachulukana ndi vuto la chiwindi ndi impso.

Mankhwala akuwonetsedwa zochizira osiyanasiyana hypercholesterolemia odwala zaka 10 zakubadwa. Chida ichi chikulimbikitsidwa monga chowonjezera pa chakudya chochepa cha cholesterol, pomwe mphamvu ya chithandizo chamankhwala imachepetsedwa. Rosuvastatin akulimbikitsidwa kuti amtundu wodziwika bwino wa homozygous hypercholesterolemia.

Rosuvastatin akuwonetsedwa ngati wothandizira popewa matenda ena amtima mwa anthu omwe ali pachiwopsezo.

Rosuvastatin imayendetsedwa pakamwa. Asanayambe chithandizo, wodwalayo amamugulitsa ku chakudya chamafuta ochepa. Mlingo wake umasankhidwa poganizira zomwe akuwonetsa, zomwe zikuchitika paumoyo wa wodwalayo. Mlingo woyambira - kuchokera pa 5 mg. Kuwongolera kuchuluka kwa zinthu zomwe zimatengedwa kumachitika pakadutsa milungu inayi chichitikireni chithandizo (bola sizothandiza mokwanira).

• pa zaka zodwala mpaka zaka 18,
• anthu azaka zopitilira 70
• odwala matenda a impso, chiwindi,
• odwala omwe ali ndi myopathies.

Mankhwala amatengedwa mosamala ngati wodwalayo akuchulukana ndi michere ya chiwindi.

Rosuvastatin amayambitsa zotsatirazi:

• kukula kwa hyperglycemia,
• chizungulire
• kupweteka kwam'mimba
• kutopa,
• mutu
• kudzimbidwa
• kupweteka m'malo olumikizirana mafupa ndi minofu,
• kuchuluka kwa mapuloteni mumkodzo,
• thupi lawo siligwirizana
• kawirikawiri, kukula kwa bere.

Mavuto azomwe zimachitika pakadutsa kuchepa kwa cholesterol zimatengera mlingo. Mankhwala ndi contraindised mu:

• kusalolera kwakanthawi kogwiritsidwa ntchito kapena zinthu zina zothandizira,
• matenda obadwa nawo a mafupa ndi minofu (kuphatikizapo mbiri ya)
• chithokomiro
• uchidakwa wosatha
• wa mtundu wa Mongoloid (mwa anthu ena mankhwalawa samawonetsa ntchito zamankhwala),
• kuwopsa kwa minofu,
• mimba
• yoyamwitsa.

Khalidwe la Atorvastatin

Atorvastatin ndi wothandiza 3 m'badwo anticholesterolemic mankhwala. Zomwe mapiritsi amaphatikizira ndi atorvastatin yogwira kuchokera 10 mpaka 80 mg. Zosakaniza zina zimaphatikizira lactose.

Atorvastatin Mlingo woyenera bwino amachepetsa ntchito za ma enzyme omwe amathandizira kuti azitha kupanga lipoproteins ochepa. Nthawi yomweyo, kuchuluka kwa kachulukidwe kakakulu kolesterol kukuchulukirachulukira.

Kugwiritsa ntchito chida ichi kumathandizira kuchepetsa chiopsezo cha kufa kwa matenda a mtima, kuphatikiza myocardial infaration.

Mankhwalawa amachepetsa ma pafupipafupi a mtima ndi cerebrovascular pathologies.

Pambuyo pa kayendetsedwe ka mkati, imalowa mu m'mimba kwa maola angapo. Kupezeka kwa chinthu yogwira ntchito ngati pakumwa pakamwa kumakhala kotsika. Pafupifupi kuchuluka konse kwa mankhwala omwe amagwiritsidwa ntchito amagwirizana ndi mapuloteni a plasma. Kuti musinthane ndi zimakhala zam chiwindi ndi kapangidwe ka metabolacologic metabolites.

Mankhwalawa amachotsedwa m'chiwindi. Hafu ya moyo wa mankhwalawa ndi pafupifupi maola 14. Sichapukusidwa ndi dialysis. Ndi chiwindi chovuta ntchito, pali kuwonjezeka pang'ono mu ndende ya yogwira mankhwala m'magazi.

Zisonyezero zogwiritsidwa ntchito:

• Mankhwalawa ovuta a cholesterol yayikulu m'magazi,
• kukhalapo kwa zinthu zoopsa pakukula kwa matenda a mtima, shuga,
• kukhalapo kwa mbiri yamatsenga a mtima ndi mtsempha wamagazi,
• matenda ashuga
• kukhalapo kwa ana kuphwanya cholesterol kagayidwe mogwirizana ndi heterozygous cholowa hypercholesterolemia.

Asanayambe kumwa mankhwalawa, wodwalayo amapatsidwa chakudya choyenera chokhala ndi cholesterol yotsika. Mlingo wocheperako tsiku lililonse ndi 10 mg, womwe umatengedwa nthawi 1 patsiku, mosasamala nthawi yakudya. Kutalika kwa mankhwalawa, kuchuluka kwa kuchuluka kwa dokotala kumatsimikiziridwa ndi dokotala, kupenda mphamvu ya wodwalayo.

Mlingo waukulu kwambiri kwa akuluakulu ndi 80 mg ya atorvastatin. Ana azaka zapakati pa 10 ndi 10 mankhwala sawerengedwa mopitirira 20 mg ya mankhwalawa. Yemweyo yafupika mlingo ntchito mankhwalawa odwala chiwindi ndi impso. Anthu opitirira 60 safuna kusintha kwa mlingo.

Zotsatira zoyipa ndi zotsutsana ndizofanana mu Rosuvastatin. Nthawi zina erection amasokonezedwa mwa amuna. Mwa ana, zotsatirazi zoyipa ndizotheka:

• kuchuluka kwa magazi
• kunenepa
• nseru komanso nthawi zina kusanza
• kutupa kwa chiwindi
• kusayenda kwa bile
• kupasuka kwa matimu ndi michere,
• chitukuko cha edema.

Kuyerekezera Mankhwala

Kuyerekezera kwa zida izi kumathandizira kusankha njira yothandiza kwambiri yochizira mafuta m'thupi.

Mankhwalawa amagwirizana ndi ma statins. Ali ndi chiyambi chopangidwa. Rosuvastatin ndi Atorvastatin ndi ofanana momwe amagwirira ntchito, zoyipa ndi contraindication, zikuwonetsa.

Mankhwala onsewa amateteza HMG-CoA reductase, yomwe imayang'anira kupanga mafuta a cholesterol. Izi zimakhudzanso wodwalayo.

Kodi pali kusiyana kotani?

Kusiyana kwa njira izi ndikuti Atorvastatin ndi wa statins a mibadwo itatu, ndi Rosuvastatin - omaliza, mibadwo 4.

Kusiyana pakati pawo ndikuti rosuvastatin imafuna mlingo wotsika kwambiri kuti apereke chofunikira chothandizira achire.

Chifukwa chake, zoyipa za mankhwala a statin ndizochepa kwambiri.

Kodi ndizotheka kusintha kuchokera ku Atorvastatin kupita ku Rosuvastatin?

Kusintha kwa mankhwala popanda chilolezo chadokotala kusaloledwa kovomerezeka. Ngakhale mankhwalawa onse amagwirizana ndi ma statins, momwe zimakhalira zimasiyana.

Dokotala amaganiza za kusintha kwa mankhwalawa nthawi zambiri ndi kusalolera kwa chinthu chilichonse. Kuchita bwino kwa mankhwalawa sikusintha.

Ndibwino - rosuvastatin kapena atorvastatin?

Kafukufuku wachipatala awonetsa kuti kutenga theka la rosuvastatin ndiwothandiza kwambiri kuposa kuchuluka kwa atorvastatin. Mafuta a cholesterol am'magazi akamatenga ma statins a m'badwo waposachedwa amachepetsedwa kwambiri.

Rosuvastatin (ndi mawonekedwe ake) imachulukitsa cholesterol yapamwamba kwambiri, chifukwa chake imakhala ndi maubwino akapatsidwa. Izi zikutsimikiziranso malingaliro a ogula.

Rosuvastatin amayamba kuchita zinthu mwachangu. Imavomerezedwa ndi odwala ndipo imayambitsa zovuta zochepa.

Malingaliro a madotolo

Aleksey, wazaka 58, wazachipatala, ku Moscow: “Cholesterol chikadumphira m'magazi kuti alepheretse matenda a ubongo opatsirana, ndimalangiza odwala kuti atenge Rosuvastatin. Mankhwalawa amagwira ntchito bwino ndipo nthawi yomweyo amayambitsa zovuta zingapo. Ndikupangira kuyamba kulandira chithandizo cha 5-10 mg. Pakatha mwezi, ngati vuto la kumwa mankhwalawa, ndikulimbikitsa kulichulukitsa. "Odwala amalola kulandira chithandizo bwino komanso kudya mafuta ochepa a cholesterol, palibe zotsatira zoyipa."

Irina, wazaka 50, wazachipatala, Saratov: "Pofuna kupewa kufalikira kwamatenda amisala, atherosclerosis ndi stroke mwa odwala omwe ali ndi vuto la lipid metabolism, ndimalimbikitsa Atorvastatin. Ndikukulangizani kuti muyambe kumwa mlingo woyenera (ndimasankha malinga ndi zotsatira za mayeso azachipatala). Ngati kuchuluka kwa cholesterol sikuchepa pakatha mwezi umodzi, onjezani mlingo. Odwala amalola kuthandizidwa bwino, zomwe zimachitika kawirikawiri sizowoneka zokwanira. "

Ndemanga za Odwala a Rosuvastine ndi Atorvastine

Irina, wazaka 50, Tambov: “Mavuto ayamba kukwera pafupipafupi. Kutembenukira kwa adotolo, adayezetsa mayeso onse ofunikira, omwe adawonetsa kuwonjezeka kwa cholesterol yamagazi. Kuti muchepetse chizindikiro, adokotala adalimbikitsa kumwa Rosuvastatin 10 mg, 1 nthawi patsiku. Ndazindikira zotsatira zoyambirira patatha milungu iwiri. Ndinapitiliza kumwa mankhwalawa kwa miyezi itatu, thanzi langa. ”

Olga, wazaka 45, ku Moscow: "Kuyesedwa kwaposachedwa kwa magazi kwawona kuti ndili ndi cholesterol yayikulu m'magazi. Popewa kukula kwa atherosulinosis ndi matenda a mtima, dotolo adapereka 20 mg atorvastatin. Ndikumwa mankhwalawa m'mawa ndikatha kudya. Patatha masabata awiri chiyambireni chithandizo, adazindikira kuti edema yanga yayamba kuchepa, kutopa kumachoka ndikulimbitsa thupi. Pambuyo pa chithandizo cha miyezi iwiri, kuthamanga kwa magazi kunachepa. Ndimatsatira kadyedwe, ine ndinakana zinthu zokhala ndi "cholesterol" yoyipa. "

Kodi pali kusiyana kotani?

Atorvastatin ndi rosuvastatin ndi osiyana:

• mtundu ndi Mlingo wa zinthu zofunikira (mankhwala oyamba ali ndi calcium calcium, wachiwiri uli ndi calcium ya rosuvastatin),
• kuchuluka kwa kuyamwa kwa zigawo zikuluzikulu (Rosuvastatin imalowa mwachangu),
• kuthetsa theka-moyo (mankhwala oyamba amachotsedwa msanga, chifukwa chake ayenera kumwedwa katatu patsiku),
• kagayidwe kake kogwira ntchito (atorvastatin imasinthidwa m'chiwindi ndikuchotseredwa ndi bile, rosuvastatin sizijambulika mumayendedwe a metabolic ndikusiya thupi ndi ndowe).

Yabwino kwambiri ndi iti?

Rosuvastatin mokulira imakhudza kugwira ntchito kwa chiwindi ndi impso, chifukwa chake imawoneka yotetezeka. Kuphatikiza apo, ilinso ndi mawonekedwe owopsa ochepa owoneka ndi mavuto poyerekeza ndi Atorvastatin.

Atorvastatin ali ndi mawonekedwe ambiri azotsatira zoyipa kuposa rosuvastine.

Ndemanga za Odwala a Rosuvastatin ndi Atorvastatin

Elena, wa zaka 58, Kaluga: “Atafufuza anapeza kuti mafuta m'thupi aanthu akula. Dokotala adalimbikitsa atorvastatin kapena rosuvastine kuti asankhe. Ndinaganiza zoyamba ndi mankhwala oyamba, omwe ali ndi mtengo wotsika. Ndinamwa mapiritsi kwa mwezi umodzi, mankhwalawo amayenda ndi maonekedwe a zotupa za pakhungu ndi kuyabwa. Ndinasinthira ku Rosuvastatin, ndipo mavuto awa anatha. Kuchuluka kwa cholesterol m'magazi kwayamba bwino ndipo sikunachulukane kwa miyezi isanu ndi umodzi. ”

Ndemanga ya Atorvastatin ndi Rosuvastatin

Atorvastatin ndi mankhwala omwe ali ndi hypocholesterolemic. Mukadutsa thupi lonse, inhibitor imayang'anira momwe ma molekyulu a enzyme amathandizira kapangidwe ka mevalonic acid. Mevalonate ndiwotsogola kwa ma sterols omwe amapezeka kumapanga otsika kwambiri lipoprotein.

Mapiritsi a 3 a m'badwo wa statin amagwiritsidwa ntchito pochiza mafuta ambiri a cholesterol. Munthawi ya ma atherosulinotic mawonetseredwe, kugwiritsa ntchito mankhwalawa kumawonetsa kukonzekera kwa metabolidi ya lipid, kuchepetsa kuchuluka kwa zigawo za LDL, VLDL ndi triglycerides, zomwe ndizo maziko a mapangidwe a atherosranceotic neoplasms. Mukamagwiritsa ntchito mankhwala, kuchepa kwa cholesterol index kumachitika, mosasamala kanthu za etiology yake.

Mankhwala Rosuvastatin zotchulidwa pa kuchuluka kuchuluka kwa maselo a LDL mu madzi am`magazi. Mankhwalawa ndi a gulu la statins la m'badwo wachinayi (wotsiriza), pomwe chinthu chachikulu chomwe ndi rosuvastatin. Mankhwala a m'badwo waposachedwa kwambiri ndi rosuvastatin ndiye otetezeka kwambiri m'thupi, komanso ali ndi chiwopsezo chachikulu pochiza hypercholesterolemia.

Mfundo zoyenera kugwiritsa ntchito mankhwala osokoneza bongo

Atorvastatin ndi lipophilic mankhwala omwe amasungunuka m'mafuta okha, ndipo Rosuvastatin ndi mankhwala a hydrophilic omwe amasungunuka kwambiri mu plasma ndi seramu yamagazi.

Zochita zamankhwala amakono ndizothandiza kwambiri kwa odwala ambiri njira imodzi ya mankhwala ndikokwanira kutsitsa cholesterol yonse, kachigawo ka LDL ndi VLDL, komanso triglycerides.

Limagwirira a zochita za statins

Othandizira onsewo ndi zoletsa za mamolekyulu a HMG-CoA reductase. Reductase ndiye amachititsa kuphatikizika kwa mevalonic acid, yomwe ndi gawo la sterols ndipo ndi gawo la molekyu ya cholesterol. Mamolekyu a cholesterol ndi triglycerides ndi mbali ya ma cell ochepa osachulukitsa a lipoproteins, omwe amaphatikiza panthawi ya maselo a chiwindi.

Mothandizidwa ndi mankhwalawa, kuchuluka kwa cholesterol yomwe imapangidwa imachepetsedwa, yomwe imayambitsa ma LDL receptors, omwe, atayambitsa, amasaka kusaka lipids ochepa, amawagwira ndikuwanyamula kuti awataye.

Chifukwa cha ntchito iyi ya receptors, kuchepa kwakukulu kwa cholesterol yotsika komanso kuchuluka kwa lipids m'magazi kumachitika, zomwe zimalepheretsa kukula kwa systemic pathologies.

Poyerekeza, kuti ayambe kuchitapo kanthu, Rosuvastatin safuna kusinthika m'maselo a chiwindi, ndipo amayamba kuchita mwachangu, koma mankhwalawa samakhudza kuchepa kwa triglycerides. Mosiyana ndi mankhwala a m'badwo wotsiriza, Atorvastatin amasinthika m'chiwindi, koma imagwiranso ntchito kutsitsa index ya TG ndi mamolekyule a cholesterol aulere, chifukwa cha lipophilicity yake.

Zizindikiro ndi contraindication

Mankhwalawa onse ali ndi malangizo omwewo pochotsa cholesterol index yayikulu, ndipo, ngakhale akusiyana ndi kapangidwe ka mankhwala, onse ndi HMG-CoA reductase inhibitors. Mapiritsi a Statin amayenera kutengedwa ndi mavuto amtunduwu wa lipid:

• Hypercholesterolemia osiyanasiyana etiologies (achibale ndi osakanikirana)
• hypertriglyceridemia,
• dyslipidemia,
• zokhudza zonse atherosulinosis.

Komanso, mankhwala amathandizidwa ndi odwala omwe ali pachiwopsezo chotenga mtima ndi mtima:

• matenda oopsa
• angina pectoris
• mtima ischemia
• ischemic ndi hemorrhagic sitiroko,
• myocardial infaration.

Choyambitsa hypercholesterolemia ndikuphwanya metabolism ya lipid, yomwe imakonda kupezeka chifukwa cha wolakwa iye mwini chifukwa cha njira yolakwika ya moyo.

Kulandiridwa kwa ma statins kungakuthandizeni kupewa kukula kwa matenda, ngati mumawatenga pafupipafupi kuti mudziteteze ku zinthu zina:

• chakudya chamafuta ambiri
• mowa ndi chikumbumtima cha bongo,
• mavuto amanjenje ndi kupsinjika kwakanthawi,
• osati moyo wokangalika.

Zoyeserera za mankhwalawa ndizosiyana (Gome 2).

Malangizo ogwiritsira ntchito

Madera akuyenera kutengedwa pakamwa ndi madzi okwanira. Kutafuna piritsi sikuletsedwa, chifukwa amaphimbidwa ndi nembanemba yomwe imasungunuka m'matumbo. Asanayambe njira yothandizira achire ndi ma statins a 3 ndi 4th, wodwalayo ayenera kutsatira zakudya za anticholesterol, ndipo zakudya ziyenera kutsagana ndi maphunziro onse a mankhwala.

Dotoloyo amasankha payekha mlingo ndi mankhwala kwa wodwala aliyense, kutengera zotsatira za mayeso a labotale, komanso kuvomerezedwa kwa thupi ndi zina zomwe zimayenderana ndi matenda osachiritsika. Kusintha kwa Mlingo, komanso kusintha mankhwalawo ndi mankhwala ena, kumachitika osapitirira masabata awiri kuyambira nthawi ya makonzedwe.

Malangizo a Atorvastatin Mlingo

Mlingo woyambirira wa systemic atherosulinosis wa Rosuvastatin ndi 5 mg, Atorvastatin 10 mg. Muyenera kumwa mankhwalawa kamodzi patsiku.

Mlingo wa tsiku lililonse pochiza hypercholesterolemia yamitundu yosiyanasiyana:

• ndi homozygous hypercholesterolemia, mlingo wa Rosuvastatin ndi 20 mg, Atorvastatin ndi 40-80 mg,
• Odwala heterozygous hypercholesterolemia - 10-20 mg wa Atorvastatin, ogaŵikana Mlingo wam'mawa ndi wamadzulo.

Kusiyana kwakukulu ndi kugwira ntchito bwino

Kodi pali kusiyana kotani pakati pa rosuvastatin ndi atorvastatin? Kusiyana pakati pa mankhwala kumawonekera pamlingo wa kuyamwa kwawo kuchokera m'matumbo ang'ono. Rosuvastatin safunikira kuphatikizidwa pakudya pano, ndipo Atorvastatin amayamba kutaya katundu wake ngati mutamwa piritsi pakudya chamadzulo kapena mukangomaliza kudya.

Kugwiritsa ntchito mankhwala ena kumakhudzanso mankhwalawa, chifukwa kusintha kwake kukhala mawonekedwe osagwira kumachitika mothandizidwa ndi ma enzymes a chiwindi. Mankhwala amachotsedwa m'thupi limodzi ndi ma acid a bile.

Rosuvastatin amawachotsa osasinthika ndi ndowe. Musaiwale kuti chithandizo chanthawi yayitali, ndalama zimafunikira. Atorvastatin ndi wotsika mtengo katatu kuposa statin 4 mibadwo, kotero imapezeka m'magulu osiyanasiyana a anthu. Mtengo wa atorvastatin (10 mg) - ma ruble a 125., 20 mg - 150 rubles. Mtengo wa Rosuvastatin (10 mg) - ma ruble 360., 20 mg - 485 rubles.

Mankhwala aliwonse amakhala mthupi la wodwala aliyense mosiyana. Dokotala amasankha mankhwalawa malinga ndi zaka, matenda, magawo ake komanso momwe amasonyezera mawonekedwe a lipid. Atorvastatin kapena Rosuvastatin amatsitsa cholesterol yoyipa pafupifupi chimodzimodzi - mkati mwa 50-54%.

Kugwiritsa ntchito bwino kwa Rosuvastatin ndikokwera pang'ono (mkati mwa 10%), chifukwa chake, malowa amatha kugwiritsidwa ntchito ngati wodwala ali ndi cholesterol yotsika kuposa 9-10 mmol / L. Komanso, mankhwalawa pakanthawi kochepa amatha kuchepetsa OXC, yomwe imachepetsa kuchuluka kwa zoyipa.

Zotsatira zoyipa

Zotsatira zoyipa za mankhwalawa pa thupi ndiye chinthu chachikulu pakusankha mankhwalawa. Statins ndi amodzi mwa mankhwalawa omwe, ngati atamwa mosayenera, amatha kupha. Popewa zovuta zoyipa, mlingo woyenera wa dotolo sayenera kupitilira ndipo malingaliro ake onse akuyenera kutsatiridwa.

Wodwala m'modzi mwa 100 ali ndi zotsatirazi zotsatirazi:

• kugona, komanso kukumbukira zinthu,
• dziko lokhumudwitsa
• mavuto azakugonana.

Wodwala m'modzi mwa 1000, zotsatirapo zoyipa za mankhwalawa zimatha kuchitika:

• kuchepa magazi
• mutu ndi chizungulire zosiyanasiyana.
• paresthesia
• minofu kukokana
• polyneuropathy
• kukomoka
• kapamba
• matenda am'mimba otayika omwe amayambitsa kupweteka m'mimba ndi kusanza,
• kuchuluka kapena kuchepa kwa shuga wamagazi,
• mitundu yosiyanasiyana ya chiwindi,
• zotupa zosafunikira ndi kuyabwa kwambiri,
• urticaria
• alopecia
• myopathy ndi myositis,
• asthenia
• angioedema,
• matenda vasculitis,
• nyamakazi
• polymyalgia wamtundu wotupa,
• thrombocytopenia
• eosinophilia
• hematuria ndi proteinuria,
• kupuma movutikira
• kukula kwa bere lamphongo ndi kusabala.

Mochulukitsa, rhabdomyolysis, chiwindi ndi impso zimatha kukula.

Kuchita ndi mankhwala ena ndi analogi

Ma Statist sangaphatikizidwe ndi mankhwala onse. Nthawi zina kugwiritsa ntchito mitundu iwiri ya mankhwala kungayambitse zotsatira zoyipa:

1. Akaphatikizidwa ndi cyclosporine, zimachitika za myopathy. Myopathy imapezekanso ikaphatikizidwa ndi antibacterial othandizira tetracycline, gulu la ufafanuzi la ecithromycin ndi erythromycin.
2. Zotsatira zoyipa za thupi zimatha kuchitika ngati mukutenga ma statins ndi niacin.
3. Ngati mutenga Digoxin ndi ma statins, palinso kuchuluka kwa Digoxin ndi ma statins. Sitikulimbikitsidwa kuti mutenge mapiritsi a statin ndi madzi a mphesa. Madzi amachepetsa mphamvu ya mankhwala a statin, koma amathandizira pazovuta zake pakhungu ndi mthupi.
4. Kugwiritsanso ntchito kwa mapiritsi a statin ndi ma antacid, ndi magnesium, kumachepetsa kuchuluka kwa statin katatu. Ngati mukugwiritsa ntchito mankhwalawa limodzi ndi maola 2-3, ndiye kuti zotsatira zoyipa zimachepa.
5. Mukaphatikiza kudya mapiritsi ndi proteinase inhibitors (HIV), ndiye kuti AUC0-24 imachulukirachulukira. Kwa anthu omwe ali ndi kachilomboka, kachiromboka ndi kotsutsana ndipo pamakhala zovuta zake.

Atorvastatin ali ndi ma analogu 4, ndi Rozuvastatin - 12. Mofanizira waku Russia waku Atorvastatin-Teva, Atorvastatin SZ, Atorvastatin Canon ndi wotsika mtengo koma wabwino. Mtengo wa mankhwala umachokera ku ma ruble 110 mpaka 130.

Mofanizira kwambiri wa rosuvastatin:

1. Rosucard ndi mankhwala aku Czech omwe amatsitsa cholesterol mwachidule kwachiritsira chochepa.
2. Krestor ndi mankhwala aku America omwe ndi njira yoyambirira ya mibadwo 4. Krestor - adadutsa maphunziro onse azachipatala ndi a labotale. Drawback yokhayo mkati mwake ndi mtengo wa ma ruble 850-1010.
3. Rosulip ndi mankhwala a ku Hungary omwe nthawi zambiri amalamula kuti matenda a atherosulinosis agwiritsidwe ntchito kwa nthawi yayitali.
4. Mankhwala a ku Hungary Mertenil - wolembedwa kuti muchepetse cholesterol yoyipa komanso kupewa matenda a mtima.

Ndemanga za ma statins nthawi zonse zimakhala zosakanikirana, chifukwa akatswiri a zamankhwala amalimbikitsa kumwa mapiritsi a statin, ndipo odwala, akuwopa kuyipa kwa thupi, akutsutsana ndikugwiritsa ntchito kwawo. Ndemanga kuchokera kwa madokotala ndi odwala ithandizanso kudziwa omwe ali atorvastatin kapena rosuvastatin:

Mibadwo ya 3 ndi 4 ya mibadwo imakhala yothandiza kwambiri pochiza matenda a mtima komanso a mtima. Kusankhidwa bwino kwa mapiritsi kumatha kuchitika ndi dokotala kuti mankhwalawa abweretse zabwino zambiri zopanda zotsatirapo zoyipa.

Kodi ma statins ndi ati?

Statin ndi gulu losiyana la mankhwala a lipid-lowering (lipid-lowering) omwe amagwiritsidwa ntchito pochiza hypercholesterolemia, i.e., okwera kwambiri a cholesterol (XC, Chol) m'magazi, omwe sangachepetsedwe pogwiritsa ntchito njira zosagwiritsa ntchito mankhwala: moyo wathanzi, masewera ndi zakudya.

Kuphatikiza pa ntchito yayikulu, ma statin ali ndi zinthu zina zofunikira zomwe zimalepheretsa zovuta zamtima:

• kukhalabe ndi kukula kwa malo omwe atherosselotic malo okhazikika,
• magazi kuwonda ndi kuchepetsa kupatsidwa zinthu za m'magazi ndi erythrocyte,
• kuyimitsa kutupa kwa endothelium ndikubwezeretsa magwiridwe ake,
• kukondoweza kwa kapangidwe ka nitric oxide, kofunikira popuma.

Mwachizolowezi, ma statins amatengedwa ndi kuchuluka kwakukulu kwa cholesterol yovomerezeka - kuchokera ku 6.5 mmol / l, komabe, ngati wodwalayo ali ndi zifukwa zoyipa (majini amtundu wa dyslipidemia, atherosulinosis, kugunda kwa mtima kapena mbiri ya sitiroko), ndiye kuti amalembedwa pamiyeso yotsika - kuyambira 5 8 mmol / L.

Kapangidwe ndi mfundo zoyenera kuchitapo

Kuphatikizika kwa mankhwalawa Atorvastatin (Atorvastatin) ndi Rosuvastatin (Rosuvastatin) kumaphatikizapo zinthu zopangidwa kuchokera ku mibadwo yaposachedwa ya statins mu mawonekedwe a calcium calcium - m'badwo wa calcium (III m'badwo) ndi calcium rosuvastatin (IV m'badwo) + mbali zothandizira, kuphatikiza mkaka wochokera ku lactose monohydrate )

Kuchita kwa ma statins kumakhazikitsidwa ndi cholepheretsa enzyme, yomwe imayang'anira kupanga cholesterol ndi chiwindi (gwero la pafupifupi 80% ya chinthucho).

Makina a zochita za onse a mankhwalawa cholinga chake ndi kuphatikiza mphamvu ya kolesterol yomwe imapangidwira: mwa kuletsa (kuletsa) kapangidwe ka HMG-KoA reductase (HMG-CoA reductase) m'chiwindi, amachepetsa kupanga mevalonic acid, patsogolo pa cholesterol yamkati (endo native).

Kuphatikiza apo, ma statins amalimbikitsa mapangidwe a ma receptor omwe amayang'anira kayendedwe ka lipoproteins yotsika (LDL, LDL), makamaka kachulukidwe kochepa (VLDL, VLDL) ndi triglycerides (TG, TG) pachiwindi kutaya, komwe kumayambitsa kuchepa kwambiri kwa zigawo za "cholesterol" zoyipa " mu seramu yamagazi.

Chachilendo cha statins statins zatsopano ndikuti sizikhudza kagayidwe kazakudya, i.e., Atorvastatin ndi Rosuvastatin amangochulukitsa kuchuluka kwa glucose, komwe kumathandizira ngakhale anthu omwe samadalira insulin mtundu wamtundu wa II kuti awatenge.

Atorvastatin kapena Rosuvastatin: ndibwino bwanji?

Mtundu uliwonse wotsatira wa mankhwala omwe amapezeka amachititsa kuti ma cell ena apangidwe akhale momwemo, Rosuvastatin wamtunduwu amasiyana ndi Atorvastatin pazinthu zatsopano zomwe zimapangitsa kuti mankhwalawa azidalira.

Kuyerekezera kwa Atorvastatin ndi Rosuvastastinn (patebulo):

Kugwiritsa ntchito mankhwala a Atorvastatin ndi Rosuvastatin pakati kungakhale bwino kumachepetsa cholesterol "yoyipa" - mwa 48-54% ndi 52-63%, motero, kusankha komaliza kwa mankhwalawa kumatengera mtundu wa thupi la wodwalayo:

• jenda, zaka, cholowa komanso kupezeka kwa mawonekedwe,
• matenda am'mimba ndi kwamikodzo dongosolo,
• mankhwala omwe amamwa limodzi, zakudya komanso moyo,
• zotsatira za zasayansi yantchito ndi zothandizira.

Rosuvastatin ndi bwino kuchiza hypercholesterolemia mwa anthu omwe ali ndi mavuto a chiwindi ndi kapamba. Mosiyana ndi ma statins akale, sizifunikira kutembenuka, koma nthawi yomweyo mumalowa m'magazi. Amadzipukusanso makamaka m'matumbo, omwe amachepetsa magwiridwe antchito pa ziwalo izi.

Ngati munthu amene ali ndi cholesterol yambiri ali ndi vuto la kunenepa kwambiri, ndiye kuti atorvastatin ayenera kukondedwa. Chifukwa cha kusungunuka kwamafuta, imagwira ntchito mwachangu pakuphulika kwa lipids yosavuta ndikuletsa kutembenuka kwa cholesterol pamafuta a thupi omwe alipo.

Pamaso pa mafuta a hepatosis kapena cirrhosis ya chiwindi, kutenga Atorvastatin nthawi zambiri kumafuna kuyang'ana kuchuluka kwa michere ya hepatic m'magazi, chifukwa chake, pakalibe kunenepa kwambiri, pakulipira kwakanthawi ndikulimbikitsidwa kusankha statin yokhala ndi mlingo wotsika wa chinthu chogwira ntchito komanso chiopsezo cha "zovuta", ndiye kuti Rosuvastatin.

Zotsatira zoyipa Poyerekeza Tchati

Ngati mumadalira njira zamankhwala ndikuwunika kwa odwala omwe akutenga maulalo kwa nthawi yayitali, mukamagwiritsa ntchito Mlingo wa mankhwala omwe aliwonse a III ndi IV, osawerengeka (mpaka 3%), mavuto obwera mosiyanasiyana pamagulu ena amthupi amatha kuonedwa.

Kuyerekeza "zoyipa" za Atorvastatin ndi Rosuvastatin (tebulo):

Kodi ndingathe kulowetsa Atorvastatin ndi Rosuvastatin?

Ngati mankhwalawa salekerera bwino, omwe akuwoneka ndi zotsatira zoyipa za chiwindi, akutsimikiziridwa ndi kuwonongeka kwa magawo a labotale, ndikofunikira kusintha mlingo wa atorvastatin: kuletsa kwakanthawi, kuchepetsa mlingo kapena mutha kusintha m'malo mwake ndi Rosuvastatin waposachedwa.

Simungathe kuchita izi nokha, chifukwa nthawi zambiri pakatha milungu iwiri mpaka itatha mankhwala atayimitsidwa, milomo ya lipids m'magazi imabweranso pamtengo wake woyambira, womwe ungawononge thanzi la wodwalayo. Chifukwa chake, lingaliro la kuthekera kwatsopano liyenera kuchitika limodzi ndi adokotala.

Mankhwala abwino kwambiri a mibadwo ya 3 ndi 4

Pamsika wamankhwala, ma statin a m'badwo wa III ndi IV amaimiridwa ndi mankhwala oyamba - Liprimar (atorvastatin) ndi Krestor (rosuvastatin), ndi makope ofanana, otchedwa. zamagetsi zomwe zimapangidwa kuchokera ku chinthu chomwechi, koma pansi pa dzina lina (INN):

• atorvastatin - Tulip, Atomax, Liptonorm, Torvakard, Atoris, Atorvastatin,
• rosuvastatin - Roxer, Rosucard, Mertenil, Rosulip, Lipoprime, Rosart.

Zochita zamagetsi zimakhala zofanana ndendende ndi zoyambirira, choncho munthu ali ndi ufulu wosankha izi payekha, kutengera zomwe amakonda.

Ndikofunika kumvetsetsa kuti ngakhale atorvastatin ndi Rosuvastatin sizinthu zomwezo, kudya kwawo kuyenera kutengedwa chimodzimodzi: pendani mosamala mkhalidwe waumoyo wa chiwindi ndi impso, m'mbuyomu komanso mtsogolo, komanso mosamalitsa makulidwe othandizidwa ndi adotolo, zakudya ndi zakudya zolimbitsa thupi.

About ma statins

Mosasamala dzina lake (simvastatin, rosuvastatin, atorvastatin), ma statin onse ali ndi magwiritsidwe ofanana pa thupi la munthu.Mankhwalawa amalepheretsa enzyme HMG-CoA reductase, yomwe imapezeka m'matumbo a chiwindi ndikuchita nawo kaphatikizidwe wa cholesterol. Komanso, kutsekereza kwa enzyme kumeneku sikuti kumangoyambitsa kuchepa kwa mafuta m'thupi, komanso kumachepetsa kuchuluka kwa ma lipoprotein otsika komanso otsika kwambiri, omwe amathandiza kwambiri pakukula kwa mitsempha ya mitsempha.

Nthawi yomweyo, zomwe zili m'magazi akuluakulu a magazi (HDL) m'magazi zimachulukana, zomwe zimachotsa ma lipids ku malo ophatikizika ndi ma chiwindi, zomwe zimayambitsa kuchepa kwa zovuta za atherosclerosis komanso kusintha kwa thanzi la wodwalayo.

Pali ma statin atatu apamwamba muzochitika zamankhwala zamakono: rosuvastatin, atorvastatin ndi simvastatin.

Kuphatikiza pa kukhudzika kwake kwa cholesterol metabolism m'thupi, ma statin onse ali ndi chinthu chimodzi chofanana: amasintha mawonekedwe amkati wamitsempha yamagazi, potero amachepetsa mwayi wa kuyambika kwa njira ya atherosulinotic mwa iwo.

Atorvastatin - wothandizira lipid-kutsitsa

Atorvastatin ndi rosuvastatin amagwiritsidwa ntchito pofuna kuthana ndi vuto lililonse lomwe lingagwirizane ndi hypercholesterolemia (cholowa ndi kutengera), komanso kupewa matenda monga myocardial infarction ndi ischemic stroke. Komabe, odwala ambiri ndi madokotala amafunsa funso lofunika, koma ndibwino - rosuvastatin kapena atorvastatin? Kuti mupereke yankho lolondola, ndikofunikira kukambirana zakusiyana pakati pawo.

Kapangidwe ka mankhwala ndi chikhalidwe cha mankhwala

Ma statins osiyanasiyana amakhala ndi magawo osiyanasiyana - zachilengedwe kapena zopangidwa, zomwe zimatha kukhudza zochitika zawo zamankhwala komanso kuchita bwino kwa wodwalayo. Mankhwala omwe amapezeka mwachilengedwe, monga simvastatin, amasiyana ndi mapangidwe awo ophatikizika mu ntchito yochepetsedwa ndipo nthawi zambiri amayambitsa zovuta. Kupatula apo, kuchuluka kwa kuyeretsa kwazowetazo kungakhale kosakwanira bwino.

Rosuvastatin amatsutsana ndi odwala omwe ali ndi matenda a chiwindi

Ma synthetiki ophatikizika (mertenyl - dzina lamalonda la rosuvastatin ndi atorvastatin) amalandiridwa ndikupanga chinthu chomwe chikugwirika pantchito zapadera za fungus. Komanso, zomwe zimapangidwazo zimadziwika ndi chiyero chambiri, chomwe chimapangitsa kukhala chothandiza kwambiri kuposa anzawo achilengedwe.

Palibe chifukwa chomwe mungatengere nokha, chifukwa cha chiwopsezo chachikulu cha zotsatira zoyipa ndi mulingo woyenera.

Kusiyana kofunikira kwambiri poyerekeza rosuvastatin ndi atorvastatin ndizinthu zawo zachilengedwe, zomwe ndi solubility m'mafuta ndi madzi. Rosuvastatin ndi hydrophilic ndipo imasungunuka mosavuta m'madzi amadzi ndi madzi ena aliwonse. Atorvastatin, m'malo mwake, ndi lipophilic, i.e. amawonetsa solubility yowonjezereka m'mafuta. Kusiyana kwazinthu izi kumayambitsa kusiyana kwakanayambitsa. Rosuvastatin imakhudzanso kwambiri maselo a chiwindi, ndi mnzake wa lipophilic, pa ubongo.

Kutengera kapangidwe ndi mankhwalawa, ndiye kuti sizotheka kudziwa omwe ali othandiza kwambiri. Pamenepa, ndikofunikira kulabadira momwe amasiyana wina ndi mnzake mu mawonekedwe a mayamwidwe ndi magawidwe m'thupi, komanso pogwira ntchito yawo pa cholesterol ndi lipoproteins yamitundu yosiyanasiyana.

Kusiyana mu njira zoperewera, kugawa ndi kupukusa thupi

Kusiyana pakati pa mankhwalawa kumayambira pakulowa kwa matumbo. Atorvastatin sayenera kumwedwa nthawi yomweyo ndi chakudya, chifukwa kuchuluka kwake kumachepetsedwa kwambiri. Nawonso, rosuvastatin amamezedwa pafupipafupi, osagwiritsa ntchito zinthu zosiyanasiyana.

Kusiyana pakati pa mankhwala kumakhudza zomwe zikuwonetsa ndi zotsutsana ndi zomwe amapeza.

Mfundo yofunika kwambiri yomwe mankhwalawa amasiyanasiyana ndi kagayidwe kake, i.e. Kusintha mthupi la munthu. Atorvastatin imasinthidwa kukhala mawonekedwe osagwira ndi ma enzymes apadera m'chiwindi kuchokera ku banja la CYP. Motere, kusintha kwakukulu muzochitika zake kumalumikizidwa ndi mkhalidwe wa hepatic dongosolo lino komanso kugwiritsa ntchito munthawi yomweyo mankhwala ena omwe amakhudzapo. Pankhaniyi, njira yayikulu ya supretion ya mankhwala imakhudzana ndi excretion pamodzi ndi bile. Rosuvastatin kapena mertenyl, m'malo mwake, amawapaka ndi ndowe mu mawonekedwe osasinthika.

Mankhwalawa ndi chisankho chabwino kwa chithandizo cha nthawi yayitali cha hypercholesterolemia, chifukwa kukhazikika kwawo m'magazi kumakupatsani mwayi woti muzitha kumwa mankhwala kamodzi patsiku.

Kusiyanitsa Kachitidwe

Mfundo yofunika kwambiri posankha mankhwala enaake ndi kuyesetsa kwake, i.e. kuchuluka kwa kuchepa kwa kuchuluka kwa cholesterol ndi otsika kachulukidwe lipoproteins (LDL) ndi kuchuluka kwa osaluka kwambiri lipoproteins (HDL).

Mertenil - mankhwala opangira

Poyerekeza rosuvastatin ndi atorvastatin m'mayesero azachipatala, zakale ndizothandiza kwambiri. Tisanthula zotsatira mwatsatanetsatane:

• Rosuvastatin amachepetsa LDL ndi 10% yothandiza kwambiri kuposa inzake pamlingo wofanana, womwe ungagwiritsidwe ntchito pochiza odwala omwe ali ndi cholesterol yowonjezereka.
• Kuperewera kwapakati ndi kufa pakati pa odwala omwe amamwa mankhwalawa ndikofunikira - kuchuluka kwa mtima ndi matenda amitsempha, komanso kufa kumatsika mwa anthu omwe amagwiritsa ntchito mertenyl.
• Zomwe zimayambitsa mavuto pakati pa mankhwalawa sizosiyana.

Zambiri zomwe zikupezeka zikuwonetsa kuti rosuvastatin bwino imalepheretsanso kuchepa kwa HMG-CoA m'magazi a chiwindi, zomwe zimapangitsa kuti azikhala ndi kuthekera kwakukulu poyerekeza ndi atorvastatin. Komabe, mtengo wake ukhoza kuchita mbali yayikulu pakusankha mankhwala ena, omwe ayenera kuthandizidwa ndi adokotala.

Atorvastatin ndi rosuvastatin amasiyana pang'ono, komabe, otsirizawa adalinso ndi kutchulidwa kwakanthawi kachipatala komanso kusiyana kwakanthawi, komwe kuyenera kuganiziridwa popereka mankhwala kwa wodwala wina. Kumvetsetsa kwa madokotala omwe akupita komanso wodwala kusiyana kwa ma statins kungakulitse mphamvu ndi chitetezo cha hypocholesterolemic mankhwala.