Ma statins aposachedwa kwambiri: maubwino, mitengo, malingaliro

Mu cardiology, mankhwala ochokera ku kalasi ya statins amagwiritsidwa ntchito nthawi zambiri. Simvastatin kapena Atorvastatin - ndibwino? Izi zitha kutsimikiziridwa ndi dokotala. Ndalamazi zidali zopindulitsa kwenikweni mumakampani opanga mankhwala ndipo zidatha kupulumutsa miyoyo yambiri.

Ma Statin amagwiritsidwa ntchito:

• matenda a mtima
• kutsitsa cholesterol yoyipa m'magazi,
• matenda a kagayidwe.

Zinthu zoterezi zimatha kuwonjezera zakudya, cholinga chake ndikuchotsa lipids zovulaza.

Koma kusankha mankhwalawa kuyenera kusamala kwambiri. Ngakhale kuti mankhwala ambiri amtunduwu ndi othandiza kwambiri, ali ndi zotsutsana zambiri komanso zoyipa, nthawi zambiri odwala amakhala ndi chidwi chofuna kusankha chinthu chabwino komanso chotetezeka.

Mwachitsanzo, ngati mungasankhe pakati pa Atorvastatin kapena Simvastatin, omwe ndi fanizo la mnzake, lingaliro lidzadalira zinthu zambiri. Mwachitsanzo, mankhwala amodzi amatha kukhala ndi zotsatira zowonekera pakanthawi kochepa.

Koma pazomwe amagwiritsa ntchito zoyipa siziphatikizidwa. Zitha kupewedwa ngati mugwiritsa ntchito simvastatin.

Chingakhale cholakwika kupangira mankhwala amtundu wina kapena ena popanda kudziwa chithunzi cha chipatala komanso mbiri ya wodwala. Chifukwa chake, poyambira, ndikofunikira kumvetsetsa momwe thupi lamunthu limazindikirira ndikudziwikitsa moyenera. Pambuyo pokhapokha ngati mankhwala kapena mankhwala ena angalembedwe.

Mawonekedwe a mankhwala ochokera ku gulu la ma statins

Mankhwala onse amtunduwu amatha kugawidwa m'magulu awiri:

• ma statins achilengedwe (simvastatin, lovastatin, pravastatin),
• kapangidwe (Atorvastatin, Fluvastatin, Ceryistatin).

Mankhwala onse omwe ali pamwambawa amatha kuchepetsa cholesterol yoyipa pafupifupi 1/3. Ichi ndi chizindikiro chabwino chomwe chitha kupitilizidwa ndi zakudya zapadera. Koma posachedwa, pafupipafupi, akatswiri amapereka Rosuvastatin kwa odwala. Imalowa mwachangu m'maselo a chiwindi ndipo imakhudza mwachindunji kuchuluka kwa cholesterol yomwe imapangidwa. Zotsatira zake, kuchuluka kwa mapepala kumatsika kangapo. Ngakhale kuti Rosuvastatin ndi wa mankhwala opangidwa, amasiyana kwambiri pakupanga mankhwala kuchokera ku Atorvastatin.

Chizindikiro cha mankhwala ochokera ku gulu la statin ndikuti sangathe kugwiritsidwa ntchito pawokha, chifukwa mankhwalawa amatha kuyambitsa zovuta zambiri, komanso amakumana ndi zotsutsana zambiri. Akatswiri amati akamagwiritsa ntchito ma statin opangidwa mwachitsanzo, Atorvastatin, zovuta zoyipa zosiyanasiyana zimachitika mwa 52% ya odwala. Mankhwala achilengedwe amayambitsa mavuto ochepa. Komabe, samalimbikitsidwanso kuti azigwiritsa ntchito popanda kufunsa adokotala.

Momwe mungagwiritsire ntchito simvastatin?

Mankhwala ndi a gulu la zachilengedwe zachilengedwe. Kugwiritsa ntchito pafupipafupi, kumachepetsa kwambiri cholesterol yoyipa, kuletsa kukula kwa matenda ambiri a mtima ndi mitsempha yamagazi. Kuchita kwa simvastatin sikokwanira kwambiri. Komabe, ngati muphatikiza mankhwalawo ndi zakudya zoyenera ndikuchita masewera olimbitsa thupi, mutha kupeza zotsatira zabwino.

Malangizo onse pazomwe mungamwe mankhwala ndi muyezo wa mankhwala mutha kuwonekera mu malangizo a mankhwalawa. Koma musanayambe chithandizo, ndikofunikira kukaonana ndi dokotala, chifukwa mankhwalawa ali ndi zovuta zambiri. Ndi ochepa kwambiri kuposa Atorvastatin, koma amakhala ndipo amawoneka nthawi zambiri.

Simvastatin ndikulimbikitsidwa osati kokha chifukwa cha cholesterol yapamwamba, komanso ngati njira ya:

• matenda a mtima ndi kupewa sitiroko,
• monga chitetezo ku atherosulinosis ndi mavuto a mtima.

Kugwiritsa ntchito bwino mankhwalawa, zotsatira zabwino zidzaonekera kale sabata lachitatu logwiritsira ntchito. Pakatha miyezi 1.5, cholesterol yovulaza ndi zolembera zam'madzi zizikhala zochepa.

Mbali ya mankhwalawa ndikuti imangokhala ndi kanthawi kochepa chabe. Wodwala atatha kufooka kwa statin sanatsatire zakudya ndikutsatira njira yolondola, ndiye kuti patapita nthawi yochepa cholesterol imadzakhalanso yapamwamba. Pogwiritsa ntchito Simvastatin, ndibwino kusiya madzi a mphesa kuti mupewe mavuto. Mankhwalawa sanatchulidwe kwa ana ochepera zaka 10 ndi amayi apakati.

Ngati kuchuluka kwa Simvastatin sikulondola, zotsatira zoyipa zingachitike. Ndizofunikira kudziwa kuti mankhwalawa, mosiyana ndi ma statin opangidwa, mwachitsanzo, Atorvastatin, kuchuluka kwa zosankha zoyipa ndizochepa kwambiri. Nthawi zambiri, simvastatin amayambitsa:

• mutu
• mavuto am'mimba, mavuto ogona
• kutopa.

Nthawi zina, izi ndizotheka:

• kuwonongeka kwaimpso,
• thupi siligwirizana, mwachitsanzo, zotupa pakhungu,
• mavuto amawonedwe
• zovuta zamanjenje.

Amayi oyembekezera komanso ana osaposa zaka 10 amakhala otsutsana. Kufikira zaka 18, Simvastatin amalembedwa pokhapokha ngati pali umboni wamphamvu.

Zizindikiro ndi contraindication ntchito atorvastatin

Izi zimagwira mwamphamvu kwambiri. Amalembera cholesterol yayikulu, matenda amtima, matenda a shuga komanso ngati prophylactic kuti achepetse vuto la kugunda kwa mtima ndi sitiroko.

Mphamvu yayikulu imalumikizidwa ndi chiwopsezo chachikulu cha zotsatira zoyipa. Makamaka nthawi zambiri amapezeka mwa odwala omwe amaphwanya Mlingo kapena omwe akuphwanya kugwiritsa ntchito mankhwalawa. Simungagwiritse ntchito atorvastatin:

• pa mimba
• ndi matenda akulu a chiwindi,
• kukhalapo kwa uchidakwa wambiri,
• atachitidwa opaleshoni yayikulu.

Ndi kugwiritsa ntchito molakwika kwa Atorvastatin, zoyipa zingapo zimatheka, kuyambira mutu mpaka zilonda zam'magazi. Nthawi zambiri odwala omwe amamwa mankhwalawa amavutika ndi kuphwanya kwam'mimba, kugona komanso chizungulire.

Ndi mankhwala ati omwe ali bwino?

Dokotala wokhayo ndi amene angayankhe molondola funso kuti ndi mankhwala ati othandiza kwambiri pambuyo popenda bwino wodwalayo komanso njira zonse zofunikira zofufuzira. Koma ngati mungayang'ane pamapangidwewo, kusiyana kwake kuli poti Atorvastatin ndi wamphamvu kwambiri, ndipo ndi izi mutha kupeza zotsatira zabwino zamankhwala.

Simvastatin, yomwe ndi statin yachilengedwe, imabweretsa zotsatira zoyipa zochepa. Mukamagwiritsa ntchito, palibe sodium poizoni, yomwe imawonedwa ngati chinthu chowopsa.

Ziwerengero zimawonetsa kuti mankhwalawa amasiyana wina ndi mzake mu Simvastatin amawonetsa mphamvu yakuchepetsa cholesterol yoyipa ndi 20%, pomwe Atorvastatin yokhala ndi nthawi yofananira yogwiritsira ntchito imachepetsa mulingo wa lipids wowopsa ndi pafupifupi 50%. Ngati wodwala akufunika chithandizo chokwanira, amalimbikitsidwa kwambiri atorvastatin. Pazolinga zodzitetezera komanso kupezeka kwa matupi awo sagwirizana ndi zigawo zopangidwa ndi ma statins, Simvastatin akhoza kutchulidwa.

General mankhwala ofanana a statins

Ma statin onse ali m'gulu lamankhwala omwe amakhudza metabolidi ya lipid m'thupi la munthu. Mu gulu la anatomical, achire komanso mankhwala omwe amapangidwa ndi mankhwalawa, amasankhidwa ndi code C10AA ndipo amadziwika kuti HMG-CoA reductase inhibitors. Kuletsa ntchito ya enzyme iyi, amasokoneza kapangidwe ka cholesterol, ndikuchepetsa kwambiri seramu yake. Izi statins amalola kufikira analimbikitsa woipa wa otsika kachulukidwe lipids mu magazi.

Zotsatira zoterezi zimatha kuchepetsa kwambiri chitukuko cha zolembera za atherosulinotic. Komanso, mankhwala amaletsa kuchitika. Ngakhale ndi kukhalapo kwake, ma statins ali ndi phindu lofunikira: amakhazikitsa endothelium pa cholembera cha atherosselotic, chifukwa chake amachepetsa mwayi wa coronary thrombosis, wogwira ntchito mwa njira ina kuposa ma antiplatelet agents. Kuphatikiza apo, kugwiritsa ntchito ndalama izi kumathandizanso kuchepetsa vuto la mtima. Chifukwa chake, mtengo wokhazikitsidwa ndi ma statins ndiwolondola.

Zomwe zimagawidwa ndi ma statins

Pali njira zingapo zogawa mankhwalawa m'magalasi. Zitha kuganiziridwa kuchokera pakuwona kwa mawonekedwe a kaphatikizidwe. Komanso, popeza chithandizo chokhala ndi ma statins osiyanasiyana chimafuna Mlingo wosiyanasiyana, ndikwanzeru kuyambitsa gulu kutengera mitundu yolimbikitsidwa. Kugawa kwa mtundu ndi motere:

• M'badwo: "Simvastatin", "Pravastatin", "Lovastatin".
• Mbadwo wachiwiri: "Fluvastatin."
• M'badwo wachitatu: "Cerivastatin", "Atorvastatin".
• M'badwo wa IV: "Pitavastatin", "Rosuvastatin."

Ma statin onse amagawidwa kukhala opanga, opangidwa kuchokera ku zopangira, komanso zachilengedwe. Omaliza amaphatikizapo Lovastatin, Pravastatin, ndi Simvastatin. Mankhwala ena onse amapangidwa: Fluvastatin, Atorvastatin, Rosuvastatin ndi Pitavastatin.

Gulu la ma statins ndi mlingo

Ndizomveka kugawanitsa mankhwala onse a kalasi, kuphatikiza ma statins a m'badwo wotsiriza, kukhala muyezo wotsika (mpaka 8 mg), mlingo wapakatikati (10-40 mg) ndi mkulu-mlingo (40-80 mg). Makamaka:

• mankhwala oledzera (Atorvastatin, Lovastatin, Fluvastatin),
• mankhwala osokoneza bongo apakatikati ("Simvastatin", "Pravastatin", "Rosuvastatin"),
• Mankhwala ochepa ("Pitavastatin").

Kugawikaku kukuwonetsa mwayi wopanga mankhwala ndi kuperewera kwa mankhwala. Makamaka, mankhwala oledzera omwe ali ndi vutoli amathandizira pazambiri, pomwe amaloledwa bwino. Mankhwala osokoneza bongo apakatikati, kupatula "Rosuvastatin", amalekereka kwambiri muyezo waukulu, koma amakhala ndi zotsatira zabwino.

Mlingo wapakatikati wa mankhwala "Rosuvastatin", ngati pangafunikire kutero, mutha kuwapeza muyezo wokwanira (80 mg), ngakhale chifukwa kuchepa kwathunthu kwa cholesterol ndi kachigawo kakang'ono kwambiri, izi nthawi zambiri sizofunikira. "Pitavastatin" imafunikira kuikidwa kwa anthu ochepa, ndichifukwa chake kuopsa kwake kumachitika kotsika kambiri kotsika kuposa komwe kumachitika kwa kalasi.

Mbiri yakukhazikitsa ndi kukhazikitsa ma statins

Mbiri ya statins ndi yosakanikirana kwambiri. Poyamba, chitukuko chawo chinali cholephereka chifukwa chaumbuli wa cholesterol metabolism komanso mwayi wokhala ndi atherosulinosis kutengera milingo ya magazi lipid. Kuphatikiza apo, othandizira a gopocholesterolemic adapangidwa nthawi yomweyo kuti aletse microflora mu mafangayi a bowa omwe cholinga chake ndi kupanga penicillin. Kupezeka kwa zochita za anticholesterol pazinthu zingapo zopangidwa ndi bowa, ndikupangitsa kuti aphunzire ma statins.

Statin yoyamba inali compactin, yomwe sinayambitsidwe muzochitika zamankhwala chifukwa cha malingaliro ambiri otsutsana pazotsatira zake. Idapatizidwa kuchokera ku chikhalidwe cha Penicillium cetrinium. Kenako, a Monacolin K, wokhala ndi dzina mu February 1979, adzipatula ku chikhalidwe cha Monascus ruber. Mu Juni cha 79, Mevinolin, yemwe pambuyo pake amadziwika kuti Lovastatin, adawerengedwa. Mankhwalawa adagwiritsidwa ntchito pachipatalachi, pomwe ma statins a m'badwo wotsiriza adadzipatula kapena kupangidwa.

Malingaliro ambiri otsutsana adalepheretsa kukula kwa ma statins, pambuyo pake adasankhidwa kuti achite mayeso akuluakulu azachipatala. Mpaka pano, kafukufuku wamkulu komanso wofunikira kwambiri wakhala Phunziro la Kupulumuka kwa Scandinavia Simvastatin. Dzinachepa dzina lake ndi "4S". Imafotokozeranso kuthekera kokhala ndi matenda okhudzana ndi kumwa mankhwala osokoneza bongo, ndikuwonetsa kuti kugwiritsa ntchito kwawo kumachulukitsa kuchuluka kwa moyo komanso kumachepetsa pafupipafupi ma coronary pathologies.

Amanena m'malo mwa ma statins

Ndi koyamba kuchuluka kwa cholesterol ya 7.4 mmol / L, mankhwala a statin ndikufika pamlingo wa 5.4 mmol / L kwambiri kumachepetsa chiopsezo cha choopsa cha mtima ndi 40% muzaka 5 zotsatira. Mu maphunziro ena angapo, zidatsimikiziridwa kuti kuchepa kwa mafuta m'thupi 1mol / l ndi gawo limodzi kumapangitsa kuti magazi azikhala ndi mtima komanso chifukwa cha kugunda kwa mtima.

Kuganizira ma statins, omwe akatswiri ndi odwala ambiri amalankhula motsutsana nawo, munthu amatha kumvetsetsa izi: mutha kupatsa mankhwala omwe ali ndi zaka 40 ndi kupitirira, ndipo kuchepetsa chiopsezo cha matenda a mtima ndi njira yabwino kwambiri yotalikitsira moyo. Ndipo popeza mtengo wa ma statins ndiwotchipa moyenera, mankhwalawa omwe atsimikizira kuti atha kugwiritsidwa ntchito angathe kutengedwa osapereka bajeti yanu. Zowonadi, m'badwo waposachedwa wa ma statins ndi wokwera mtengo kwambiri, ngakhale "Rosuvastatin" yemweyo, pankhaniyi, imakhala yotsika mtengo kwa wodwala. Ndipo mawonekedwe ake otsika mtengo kwambiri ndi mankhwala a Mertenil.

Khalidwe loyerekeza: zabwino ndi mavuto

Mukamaunika ma statin, ndikosavuta kuyankhula motsutsana nawo. Zotsutsana ndizomwe zimapangitsa kuti akhale ochiritsira: kutsitsa cholesterol yamagazi ndi kachigawo kakang'ono kotsika, kupewa zoopsa za zochitika zowopsa komanso kuthandizira. Komabe, mankhwala ngati statins amakhalanso ndi contraindication. Palinso zovuta zoyambitsa kutsutsana pazogwiritsa ntchito.

Ndi mankhwala a statin, pali chiopsezo cha myopathy. Mwinanso imayanjanitsidwa ndi kuletsa kwa cholesterol synthesis, yomwe imafunika minofu. Kukula kwa izi kumakhala kotsika kwambiri, ngakhale kumachulukana mukamamwa pamodzi ndi mankhwala ena ochepetsa lipid. Palinso chiopsezo chokhala ndi khansa ya chiwindi, ngakhale kuti mwayi wa matenda ngati awa, monga kafukufuku waposachedwa, uli wotsika kwambiri. Nthawi yomweyo, mfundo yoti matenda a oncological adakwiya ndi zinthu zina idatsimikiziridwa. Chifukwa chake, kwa mankhwala a "statins" gulu, contraindication iyenera kuletsa kugwiritsidwa ntchito kwa mankhwalawa ndi othandizira ena omwe amathandiza kuchepetsa kuchuluka kwa mafuta m'maselo.

Mtengo wam'badwo waposachedwa kwambiri wama statins

Kwa ma statins a m'badwo waposachedwa, mitengo ndi yosiyana, ngakhale kuti zovuta zake ndizofunikira mtengo. Funso lina ndilakuti zotsatira za zomwe akuchita zitha kuchitika pogwiritsa ntchito njira zotsika mtengo zamibadwo yoyambirira. Makamaka, mtengo wachuma kwambiri wa m'badwo wachinayi "Rosuvastatin" ndiwotsala motere:

• 600 ma ruble a 40 mg mapiritsi,
• 400-450 mapiritsi a 20 mg
• 300-350 pa mapiritsi 10 mg,
• 200 ma ruble a 5 mg.

Phukusili limakhala ndi mapiritsi 30, omwe ndi okwanira maphunziro mwezi uliwonse, pomwe mumalandira chithandizo ndi Pitavastatin mitengo yake imakhala yotsatirayi:

• Mapiritsi 1 mg amatenga ruble 700-750,
• Mapiritsi a 2 mg - ma ruble pafupifupi 1000,
• Mapiritsi 4 mg - pafupifupi 1,500 ma ruble.

Kusankhidwa pakati pa Pitavastin ndi Rosuvastatin kumakhazikitsidwa pamiyeso inayi: mtengo wamtengo, kuchuluka kwa kuchepa kwa lipoproteins yotsika kwambiri, kukwaniritsidwa kwa lipoproteins yapamwamba kwambiri, komanso chitetezo. Malinga ndi kuchuluka kwa kuchepetsa cholesterol ndi HDL yowonjezereka, komanso mtengo, "Rosuvastatin" amawoneka bwino kwambiri, pomwe "Pitavastatin" ndiyabwino kwambiri.

Zotsalazo ndizokwera mtengo kawiri poyerekeza ndi Rosuvastatin. Komabe, pali mwayi wogwiritsa ntchito mitundu ina, yotsika mtengo.Zotsika mtengo kwambiri m'mbuyomu zinali Simvastatin. Tsopano adasinthidwa ndi Atorvastatin, yemwe mwachilengedwe amasinthidwa ndi Rosuvastatin (phindu lake lidzatsika). Ndipo ngati mitengo ya ma statins a m'badwo waposachedwa ndi osavomerezeka kwa odwala, ndiye kuti ndiyenera kuganizira mwayi wchithandizo ndi Atorvastatin kapena Simvastatin. Mwa njira, maphunziro ambiri adachitidwa ndi Atorvastatin.

Mlandu wogwiritsira ntchito ma statins ndi okalamba

Madokotala azachipatala kale sankafuna kupereka mankhwala kwa odwala omwe ali ndi zaka zopitilira 75. Zotsatira zake zinali izi:

• kumwa mankhwala angapo amakalasi ena,
• kusafuna kuwonjezera mtundu wina wa mankhwala,
• kusowa kapena kutsata chithandizo chochepa,
• kudandaula kwa wodwala kugula ndi kugwiritsa ntchito ma statin chifukwa chosamvetsetsa zotsatira zake.

Kafukufuku wambiri ndi Simvastatin, Pravastatin, ndi Atorvastatin awonetsa kuchepa kwakukulu kwa kufa kwa odwala okulirapo zaka 75. Komanso, kuchepa kwa chiwerengero chaimfa kunali kwakukulu kwambiri kuposa kwa odwala azaka zapakati pa 55-65 ndi 65-75. Chifukwa chake, pamankhwala omwe ali mgululi (ma statins), kuwunika kwa akatswiri mosakayikira kumatsimikizira chowonadi chimodzi.

Mankhwalawa amatha ndipo ayenera kumwedwa akadali aang'ono, ngakhale mutakhala kuti vuto la mtima limakhalapo. Ndipo odwala omwe amasamala kwenikweni za kuchepetsa chiopsezo cha kufa kwawo kuchokera ku myocardial infarction kapena stroke akuyenera kumvetsetsa kuti ngati mankhwalawo ndi othandiza komanso otetezeka, ndiye kuti ayenera kutengedwa. Kuphatikiza apo, mankhwala a statin afika mosavuta ndipo apitiliza kutero.

Kufotokozera kwamawu kuchokera ku mibadwo yamakono

Kuunika kwa wodwala pakuwunika mtundu wa genin statin sikutanthauza, chifukwa samamva kusintha kulikonse pakutenga mankhwalawo. Kuwongolera mawonekedwe a lipid pamagazi sikuwonekera pa thanzi ndipo sikukhala ndi zizindikiro zakunja. Imadziwika ndi mbiri ya lipid zokha. Chifukwa chake, mukamayang'ana statin, ndizomveka kuwongoleredwa ndi kuwunika kwa akatswiri. Komanso, zokhudzana ndi mankhwala osokoneza bongo omwe ali pitavastatin, akatswiri apakhomo sangayankhe.

Muzochita zamankhwala ku CIS, Pitavastatin sagwiritsidwa ntchito chifukwa cha mtengo wake wapamwamba komanso chifukwa cha kupezeka kwa Rosuvastatin ndi ma genetic ake. Kukonzekera kwa Rosuvastatin, komwe kwatchulidwa pamwambapa, kuchitapo kanthu mwachangu: mbiri ya lipid imakhazikika mu miyezi iwiri. Nthawi ya Atorvastatin ndi nthawi imodzi ndi theka. Komanso ma genetic a "Rosuvastatin" ndi otetezeka, popeza amapangidwa ndi mitundu iwiri ya cytochrome. Pakadali pano, chidziwitsochi, chomwe chatengedwa kuchokera ku kuwunika kwa akatswiri, chimagwira gawo lofunikira pakusankhidwa kwa statin pazinthu zina zamankhwala.

Malingaliro ambiri pazaka zaposachedwa

Mankhwala Pitavastatin ndi Rosuvastatin ndiwotsika kwambiri pakati pa oimira kalasi ya statins, komwe maziko akulu a umboni adasonkhanitsidwa. Zotsatira zawo nthawi zambiri zimakhala zofanana ndi za Atorvastatin, koma pali zosiyana. "Pitavastatin" ndi "Rosuvastatin" amalola cholesterol wambiri, komanso lipoproteins yotsika kwambiri mu mlingo wotsika kuposa "Atorvastatin".

Kuphatikiza pa zabwino zomwe tatchulazi za mibadwo yaposachedwa, gawo lina ndilofunikira. Monga munthawi ya chithandizo ndi Pitavastatin ndi Rosuvastatin, kusintha kwachulukidwe ka magazi ndi ma lipocysteinemia kumachitika. Izi ndizofunikira pokhapokha ngati pali pachimake matenda opatsirana a coricary corcinary atherosulinosis. Chitetezo chogwiritsa ntchito ma statins ndizokwera kuposa mtima wa acetylsalicylic acid. Komabe, kukhalapo kwa ma contraindications kumaletsa kugwiritsidwa ntchito kwawo ndi contingent ya odwala (onani contraindication).

Zitsanzo za Mankhwala Osokoneza bongo

Mankhwala okhala ndi Rosuvastatin amapezeka pansi pa mayina otsatsa awa: Akorta, Rosistark, Rosucard, Rosart, Mertenil, Rosulip, Roxera, Rustor, Tevastor. Mankhwalawa onse ndi generic "Crestor", omwe adakhala rosuvastatin woyamba. Mankhwala, momwe chinthu chogwira pitavastatin, amalembedwa "Livalo". Mitundu yake yopanga ndi Pitavas ndi Pivasta. Samapezeka mu CIS, ngakhale adalembetsedwa mu pharmacopeia.

Malinga ndi zomwe zimachitika chifukwa cha mankhwala osokoneza bongo komanso kuwunika kwa kayendetsedwe ka kayendetsedwe kake, kugwiritsa ntchito ma statins ndikoyenera kukhazikitsa phula la atherosselotic komanso kupewa kupasuka kwake. Amagwiritsidwanso ntchito kuti achepetse kuchuluka kwa atherosulinosis, zomwe zimakhudza mawonekedwe a lipid a seramu yamagazi. Zotsatira zake, gulu ili la mankhwalawa ndilofunikadi mu mtima. Ndipo ma statins apamwamba kwambiri am'badwo waposachedwa amagwira kale ntchito popewa kufa kwa coronary thrombosis.

Zisonyezo za ma statins

Statin ali m'gulu la mankhwala ochepetsa lipid.

Chizindikiro chachikulu pakupangidwako ndikukonzanso kwa metabolidi ya lipid.

Mankhwala oyamba amakupatsani mwayi kusintha kagayidwe kake ka mafuta ndikuchotsa zisonyezo zonse za kuwonongeka kwa mtima wamatenda.

Muzochita zamankhwala, kugwiritsa ntchito ma statins ndikulimbikitsidwa:

• The zovuta mankhwala osakanikirana ndi kudya dosed zolimbitsa thupi odwala omwe ali ndi milingo yayitali ya atherogenic lipids m'magazi,
• kuwonjezera kuchuluka kwa lipoproteins antiatherogenic,
• ntchito odwala omwe sazindikira madandaulo a mtima, koma ali pachiwopsezo (mbiri yakubadwa kwapa makolo, kusuta, matenda oopsa, matenda ashuga),
• Chithandizo cha matenda a mtima, omwe amasonyezedwa ndi angina pectoris,
• kupewa mavuto okhudzana ndi mtima
• Chithandizo cha matenda obadwa nawo omwe amachitika ndi matenda a dyslipidemic.
• mankhwalawa kagayidwe kachakudya matenda.

Momwe mungagwiritsire ntchito mankhwala onsewa ndi lipid metabolism.

Kusankha komwe kungayanjane ndi Atorvastatin kapena Simvastatin, omwe ali m'gulu lomwelo la zinthu, kutengera zinthu zambiri. Mwachitsanzo, statin yoyamba ikhoza kukhala yothandiza kwambiri kupewa, yachiwiri ndi kulandira chithandizo.

Komanso, kusankha kumadalira kupezeka kwa ma contraindication komanso zoletsa kugwiritsa ntchito.

Kumalangiza mankhwala enaake, osadziwa bwino zamankhwala, ndi cholakwika chosasamala. Kukhazikitsidwa kumafunika kuzindikira kwathunthu kwa odwala.

Makhalidwe ambiri a statins

Malinga ndi gulu lapadziko lonse lapansi, ma statin amagawidwa kukhala mankhwala osakanikirana oyambitsidwa ndipo, pambuyo pake, opangidwa. 4 mibadwo 4 ya mankhwala imasiyananso.

Simvastatin ndi chithunzi chopanga cha m'badwo woyamba. Atorvastatin - njira zopangira m'badwo wachinayi. M'badwo wachinayi wa ma statins amadziwika ndi kukwera kwambiri komanso mawonekedwe ochepa azotsatira.

Hypolipidemic Therapy imapangitsa kuchepetsa kuchuluka kwa atherogenic lipids ndi gawo limodzi mwa magawo atatu.

Molumikizana ndi kudya moyenera komanso kuchita masewera olimbitsa thupi, mankhwalawa amatha kupangitsa matenda a lipid kutulutsa.

Odwala ambiri akudzifunsa kuti pali kusiyana kotani pakati pa mankhwalawa Simvastatin ndi Rosuvastatin wodziwika bwino (dzina lamalonda - Mtanda). Mpaka pano, akatswiri amakonda mankhwala a Rosuvastatin. Chotsirizachi ndi mankhwala amakono azachipatala. Mukamasankha simvastatin kapena rosuvastatin yomwe ili bwinoko, makonda ayenera kupatsidwa rosuvastatin. Kapangidwe ka zochita zake ndiko kuphatikiza mwachangu kwa mamolekyulu omwe amapanga ma hepatocytes, momwe amathandizira pamlingo wa cholesterol yophatikizika. Zotsatira zake, kuchuluka kwa cholesterol ya amkati kumachepa ndipo magulu opanga ma atherosclerotic awonongedwa.

Ndikofunikira kumvetsetsa kuti ndizoletsedwa kugwiritsa ntchito ma statins popanda mankhwala a dokotala. Kuletsa kwamphamvu kotereku kumagwirizanitsidwa ndi zosiyana siyana komanso zoletsa.

Oposa theka la odwala omwe amamwa ma statins adasiya ndemanga zosagwirizana ndi mankhwalawa. Komabe, zoyipa zambiri sizizindikiro kuti pakubwera mankhwala.

Mwambiri, ma statins amatha kuloledwa bwino ndipo amakhala ndi phindu pa metabolidi ya lipid.

Malangizo ogwiritsira ntchito simvastatin

Mankhwalawa ndi woimira wopanga wa m'badwo woyamba wama statins. Kudya kwake pafupipafupi kumathandizira kuchepetsa kuchepa kwa cholesterol ya atherogenic, kuletsa kukula kwa matenda ambiri a mtima.

Tsoka ilo, mphamvu ya Simvastatin poyerekeza ndi mibadwo ina ndiyotsika. Komabe, pofatsa pang'ono zamtundu wa atherosulinosis komanso kuphatikiza zakudya ndi kupsinjika, mankhwalawa ali ndi mphamvu yokwanira yothandizira wodwalayo.

Malinga ndi malangizo olembetsa, malonda amapangidwira kuti azigwiritsa ntchito mkati. Mankhwalawa amapezeka piritsi.

Ndikofunika kumwa kamodzi pa mankhwalawa usiku, popanda kuphwanya umphumphu wa chipolopolo.

Mlingo wa tsiku ndi tsiku umatsimikiziridwa nthawi imodzi. Musanayambe mankhwala ndi simvastatin, tikulimbikitsidwa kuti tikwaniritse kukonzanso kwa metabolidi ya lipid pogwiritsa ntchito masewera olimbitsa thupi komanso kudya mokwanira. Mankhwala atha kutumikiridwa pokhapokha ngati pali zovuta zakudya ndi kupsinjika.

Kutalika kwa maphunziridwe ndi kuchuluka kwa simvastatin kumatsimikiziridwa ndi dokotala wodwala, kutengera kuyambira kwa cholesterol ndi mawonekedwe a thupi.
Mlingo wa tsiku ndi tsiku wa mankhwalawa umasiyana ndi 5 mpaka 80 milligram.
Mlingo sayenera kusinthidwa pasanadutse mwezi umodzi chiyambireni chithandizo.

Sizoletsedwa popanda kusintha komanso kuwonjezera mankhwala.

Kukhazikitsidwa koyenera kwa mankhwalawa kumathandizira kuyambika kwa kuchiritsa kumapeto kwa mwezi woyamba wa mankhwala.

Pakatha mwezi ndi theka, mulingo wa cholesterol ya atherogenic imasinthidwa.

Ma Statin alibe zotsatirapo. Mankhwala amagwira ntchito pokhapokha ngati akukonzekera.

Ngati simutsatira moyo wathanzi mukamaliza kumwa mankhwalawo, pakapita nthawi, kuchuluka kwa mafuta m'thupi kumatha kuwonjezekanso.

Malangizo ogwiritsira ntchito atorvastatin

Mankhwalawa amatha kutanthauzira komanso kuthamanga. Iyenera kuperekedwa kwa cholesterol yayikulu, matenda a mtima, matenda oopsa a shuga komanso kupewa masoka achilengedwe.

Atorvastatin adalandira ndemanga yayikulu kwambiri kuchokera kwa akatswiri azachipatala zokhudzana ndi kugwira ntchito kwake kofunikira.

Atorvastatin ndi mankhwala opangidwa pakamwa. Momwemonso momwe zimakhalira ndi Simvastatin, Atorvastatin iyenera kukhazikitsidwa pokhapokha kulephera kwathunthu kwa mankhwala osagwiritsa ntchito mankhwala.

Mlingo wa tsiku ndi tsiku amasankhidwa poganizira kuopsa kwa matendawa komanso mikhalidwe ya wodwalayo.
Mlingo woyambirira wa mankhwalawa ndi 10 mg. Malangizo amachitika pakatha mwezi umodzi kuyambira chiyambi cha chithandizo.
Kumwa mankhwalawa pafupipafupi kumapereka kuchepa kwa kuchuluka kwa atherogenic lipids oposa theka.

Mbali ya mankhwalawa imakhudza modekha ma nephrons. Pankhaniyi, amavomerezeka kuti agwiritsidwe ntchito ndi odwala omwe ali ndi vuto laimpso. Mlingo wapamwamba wa mankhwalawa ndi 80 mg. Atorvastatin akuwonetsedwa kwa ana muyezo wosaposa 20 mg.
Asanatenge, ndikofunikira kuwunika ma enzymes a chiwindi.

Ndikofunika panthawi ya chithandizo ndikuwunikanso ntchito ya chiwindi.

Zotsatira zoyipa ndi zotsutsana kwa ma statins

Chomwe chimagwiritsidwa ntchito pa Atorvastatin ndi Simvastatin ndikuwunika kosalekeza kwamankhwala ndi machitidwe ofunikira. Mankhwala osokoneza bongo amathandizira kwambiri metabolism yamafuta. Paziphatikazi amaphatikizidwa kuti azisunga thupi.

Ma Statin adanenanso zochita za pharmacological, chifukwa chake, kugwiritsidwa ntchito kwawo kumakhala kochepa pazinthu zina zakuthupi komanso zokhudzana ndi matenda.

Otsatirawa ndi contraindication kugwiritsa ntchito ma statins:

1. Mbiri ya hypersensitivity pamankhwala osankhidwa.
2. Lactose tsankho. Zomwe zimapangidwira zokonzekera zimakhala ndi lactose.
3. Mitundu yosiyanasiyana ya myopathy.
4. Matenda a chiwindi mu mawonekedwe.
5. Ana a zaka mpaka 10.
6. Mowa
7. Matenda opatsirana owopsa.
8. Chiwopsezo chachikulu cha kulephera kwa impso.
9. Chithandizo cha ma immunosuppressants.
10. Kukonzekera opaleshoni yayikulu.
11. Sizoletsedwa kuyendetsa magalimoto ndi magawo omwe amafunikira kwambiri komanso kuyang'anira pamene mukutenga ma statins.
12. Mimba Mankhwala ali wamphamvu teratogenic. Mu mgwirizano uwu, ndizoletsedwa kugwiritsidwa ntchito mwa amayi apakati.
13. Kuchepetsa.

Mukamatenga ma statin opangidwa ndi theka, ndikofunikira kusiya zipatso za zipatso, chifukwa kuphatikiza kwawo kumawonjezera chiopsezo cha mavuto.

Zotsatira zoyipa zimakonda kupezeka chifukwa cha Mlingo wosankhidwa bwino. Komabe, nthawi zina, zotsatira zoyipa sizikugwirizana ndi kuchuluka kwa mankhwalawa.

Zotsatira zotsatirazi ndizofanana ndi ma statins:

• mutu, mpaka kukulitsa ululu wammbuyo ndi migraine,
• zam'mimba dongosolo,
• zosokoneza za kugona ndi magawo,
• kufooka, kutopa,
• kukanika kwa chiwindi
• chifuwa
• Matenda a CNS.

Chochulukitsa kwambiri komanso chotsimikizika cha mankhwala a statin ndikupanga rhabdomyolysis. Izi zimachitika chifukwa cha kuwopsa kwa mankhwalawa paminyewa ya minofu.

Rhabdomyolysis ndiowopsa kwambiri komwe kumayambitsa kuwonongeka kwa ma rebu tubules komanso kukulitsa kulephera kwa impso.

Kusankha chamankhwala

Kudziwa mphamvu ya mankhwala ndikotheka pokhapokha ngati mukugwiritsa ntchito wodwala wina. Poyerekeza ndi mankhwala, Atorvastatin ndi chida chamakono komanso champhamvu, ngati titenga maupanga opanga pang'ono poyerekeza. Kusiyana kwakukulu kumakhala pazomwe zimapangidwira komanso pharmacodynamics ya mankhwala.

Kugwiritsidwa ntchito kwa atorvastatin kumaphatikizira kudzikundikira kwa poizoni wa metabolic - sterol, yomwe imayambitsa zotsatira zoyipa pamapangidwe amisempha. Kulandila Simvastatin kumagwirizananso ndi zotsatira za myotoxic, koma pang'ono.

Kusanthula kofananako kwa mankhwala kumawonetsa kuti Atorvastatin imathandizira kuti cholesterol ikhale yofulumira. Ichi ndiye kusiyana kwakukulu pakati pa zida ziwiri.

Malinga ndi kafukufukuyu, kuphatikiza mankhwala othandizira ndi phyto kumathandiza. Kuphatikiza uku kumakhala ndi mwayi wopanga, komanso kumachepetsa mavuto azachuma. Izi sizikutanthauza kuti mankhwala azitsamba, monga Ateroklefit kapena Ravisol, ndi othandiza kwambiri kuposa mtundu wakale wa Atorvastatin, koma ndibwino kuti muwatenge mophatikiza.

Malinga ndi ziwerengero, kugwiritsa ntchito Atorvastatin ndi koyenera kwa mitundu yapamwamba yamatendawa, pomwe Simvastatin imalimbikitsa prophylaxis. Muyenera kugula mankhwalawa m'mankhwala ovomerezeka a pharmacy kapena malo ogulitsa pa intaneti. Mtengo ku Russia ndi CIS zimatengera wopanga.

Ubwino wogwiritsa ntchito ma statins akufotokozedwa mu kanema munkhaniyi.

Khalidwe la Atorvastatin

Atorvastatin amatanthauza mankhwala ochepetsa mphamvu ya lipid kuchokera pagulu la ma statins. Atorvastatin calcium calcium (10,84 mg) ndi chinthu chogwira ntchito chomwe chimakhudzidwa ndi kapangidwe ka cholesterol. Katunduyu amathandizira kuchepetsa kuchuluka kwa otsika osalimba lipoproteins (LDL) ndi kuchuluka kachulukidwe (HDL), potero kuletsa mapangidwe a cholesterol plaques.

Atorvastatin kapena Simvastatin amalembedwa kuti muchepetse cholesterol ndikusintha njira za metabolic.

Pambuyo pakulowetsa, piritsi imalowa m'matumbo aang'ono, momwe imalowera mwachangu kufalikira kwa khoma. The bioavailability wa gawo yogwira ndi 60%. Hepatic michere imapanga gawo la mankhwala, ndipo zotsalazo zimachotsedwa m'thupi ndi ndowe, mkodzo ndi thukuta.

Cholesterol okwera mu atherossteosis, kupezeka kwa malo mu capillaries akuluakulu ndi ang'onoang'ono ndizomwe zikuwonetsa kwambiri pakugwiritsa ntchito Atorvastatin. Ndikofunika kuperekanso mankhwala othandizira kupewa matenda otsatirawa:

• mtundu 2 shuga
• vuto la mtima
• sitiroko
• matenda oopsa
• angina pectoris
• ischemia wamtima.

Atorvastatin amatanthauza mankhwala ochepetsa mphamvu ya lipid kuchokera pagulu la ma statins.

Atorvastatin amatha kudziunjikira m'thupi pogwiritsa ntchito nthawi yayitali komanso ma pathologies ena, mwachitsanzo, ngati ntchito ya chiwindi kapena impso ili ndi vuto. Pankhaniyi, poizoni wa mankhwala amawonedwa. Wodwalayo amatha kudandaula za kutentha thupi, mutu, kufooka, komanso kugwira ntchito mwachangu. Ngati mumanyalanyaza zizindikiro zonsezi, ndiye kuti kuyamwa kwapoizoni wazambiri m'thupi ndikokwera.

Makhalidwe a simvastatin

Mankhwala Simvastatin nawonso ali m'gulu la ma statins. Yogwira pophika mankhwala ndi simvastatin. Opezekapo ndi monga:

• titanium dioxide
• lactose
• povidone
• citric acid
• ascorbic acid
• magnesium stearate ndi ena.

Simvastatin ili ndi mayamwidwe ambiri. Pazipita ndende yogwira ntchito m'magazi imakwaniritsidwa pambuyo maola 1-1,5 pambuyo pa kuperekedwa. Pambuyo maola 12, mulingo uwu umachepetsedwa ndi 90%. Njira yayikulu yakuzembera kudzera m'matumbo, kudzera mu impso, 10-15% yogwira ntchito imachotsedwa.

Cholinga chachikulu cha mankhwalawa ndikuchepetsa cholesterol pamavuto amtima. Mankhwalawa amalembedwa motere:

• chiopsezo chachikulu chotengera atherosulinosis,
• hypercholesterolemia yoyamba (mtundu II ndi ndi II b),
• hypercholesterolemia ndi hypertriglyceridemia,
• kupewa myocardial infarction, sitiroko, ischemic kuukira, atherosulinosis yamitsempha yama mtima.

Cholinga chachikulu chogwiritsira ntchito Simvastatin ndikuchepetsa cholesterol pamavuto amtima.

Kuyerekeza Atorvastatin ndi Simvastatin

Fotokozerani mankhwala ndikusankha mtundu wa mankhwala ayenera kukhala katswiri yemwe samaganizira za matendawa okha, komanso machitidwe a thupi.

Mankhwala onse awiriwa amagwiritsidwa ntchito mwachangu ku mtima ndi matenda a mtima ndi mtima.

Onse a Atorvastatin ndi Simvastatin ndi mankhwala othandiza ndipo ali ndi cholinga chimodzi - kutsitsa cholesterol yamagazi.

Amagwirizananso ndi izi:

1. Mankhwalawa ali ndi zosakaniza zosiyanasiyana, koma lactose ilipo mwa onse awiri. Chifukwa chake, ziyenera kufotokozedwa mosamala ndi kuzindikira kwa gawo lothandizali.
2. Zotsatira zoyipa mu mawonekedwe a chizungulire zimadziwika ndi onse mankhwala. Pachifukwa ichi, munthawi ya chithandizo, muyenera kukana kuyendetsa galimoto ndikugwira ntchito moyenera.
3. Mankhwala amakhudzana ndi mankhwala opatsirana ndi lipid, chifukwa myopathy imayamba. Ngati, motsutsana ndi maziko azachipatala atorvastatin kapena Simvastatin, kutentha kumawuka ndi kupweteka kwa minofu kuwoneka, ndiye kuti mankhwalawo ayenera kusiyidwa, ndikuwachotsa ndi analogues.
4. Mimba ndi mkaka wa m'mawere ndizochita zina zotsutsana. Amayi munthawi ya chithandizo ayenera kugwiritsa ntchito njira zakulera.
5. Pogwiritsa ntchito nthawi yayitali komanso mankhwala osokoneza bongo, mwayi wokhala ndi zotsatirapo zake ndi wokwera. Zikatero, impso ndi chiwindi zimavutika kwambiri. Chifukwa chake, ndizoletsedwa kwambiri kupitirira muyeso womwe dokotala watchulidwa.

Kodi pali kusiyana kotani?

Kusiyana kwakukulu ndikuti kapangidwe kazokonzekerako si chinthu chimodzi chogwira ntchito. Chifukwa chake, atorvastatin amatanthauza ma statin opangidwa, omwe ali ndi mphamvu yayitali yothandizira. Simvastatin ndi statin yachilengedwe yokhala ndi kanthawi kochepa.

The yogwira mankhwala a Atorvastatin ndi wamphamvu kwambiri, chifukwa chake, mankhwalawa ali ndi zotsutsana zambiri. Izi zikuphatikiza:

• Mimba ndi kuyamwa
• zaka mpaka 10
• uchidakwa wambiri,
• kuchuluka kwamankhwala m'magazi,
• thupi lawo siligwirizana
• matenda opatsirana pachimake gawo.

Simvastatin siyikulimbikitsidwa kuti mugwiritse ntchito pazotsatirazi:

• Hypersensitivity pamagawo a mankhwala,
• matenda a chiwindi
• zaka zazing'ono
• Mimba ndi kuyamwa
• mafupa minofu kuwonongeka.

Atorvastatin ndi osayenera kugwiritsidwa ntchito nthawi imodzi ndi antibacterial ndi antimicrobial agents. Simvastatin singathenso kuphatikizidwa ndi ma virus a HIV protease inhibitors ndi anticoagulants. Osamadya zipatso za mphesa kapena kumwa madzi a mphesa pochiritsa ndi mapiritsi. kuphatikiza kumeneku kungadutse kuchuluka kwa zinthu zomwe zili m'magazi.

Zotsatira zoyipa izi zitha kuchitika mukamatenga Simvastatin:

• zovuta m'mimba
• kusowa tulo
• mutu
• kuphwanya kukoma ndi mawonekedwe (kawirikawiri),
• kuchuluka kwa ESR, kuchepa kwa maselo am'magazi ndi maselo ofiira amwazi.

Pochita mankhwala ndi Atorvastatin, odwala amatha kupeza tinnitus, mavuto a kukumbukira, komanso kumva kutopa kosalekeza.

Poyerekeza ndi kumbuyo kwa kutenga Simvastatin, kupweteka kwa mutu kumatha kuchitika.

Hemodialysis akuwonetsedwa milandu bongo wa simvastatin. Kuchita kotereku sikungakhale kwaphindu pamikhalidwe yofananayo ndi Atorvastatin.

Zomwe zimakhala zotsika mtengo

Mtengo wa mankhwala umatengera dziko lomwe amapanga komanso mlingo.

Simvastatin imapangidwa m'maiko ambiri, kuphatikizapo Russia, France, Serbia, Hungary, ndi Czech Republic. Mtengo wa phukusi la mapiritsi 30 a 20 mg udzakhala 50-100 rubles. Mtengo wonyamula mankhwala (ma PC 20. Kwa 20 mg) wopangidwa ku Czech Republic ndi pafupifupi ma ruble 230-270.

Atorvastatin wopanga Russian ungagulidwe muma pharmacies pamtengo uwu:

• 110 rub - 30 ma PC. 10 mg aliyense
• 190 rub - 30 ma PC. 20 mg aliyense
• 610 rub - 90 ma PC. 20 mg aliyense.

Zomwe zili bwino - atorvastatin kapena simvastatin

Dokotala wokhazikika ndi amene angadziwe za mankhwala omwe ali bwino mutapenda wodwalayo, koma pali zinthu zina zofunika kwambiri:

1. Zotsatira zabwino zachangu zingatheke ndi Atorvastatin, monga ili ndi chinthu chogwira ndi mphamvu zambiri.
2. Simvastatin imayambitsa mavuto ochepa, omwe ndi mwayi wa mankhwalawa. Ikagwiritsidwa ntchito moyenera, zinthu zapoizoni sizidziunjikira m'thupi.
3. Zotsatira zofufuza zamankhwala zamankhwala, zimatsimikiziridwa kuti Simvastatin amachepetsa cholesterol yoyipa ndi 25%, ndi Atorvastatin - ndi 50%.

Chifukwa chake, pakudya kwa nthawi yayitali a pathologies, Atorvastatin iyenera kukondedwa, komanso pofuna kupewa matenda amitsempha, ndibwino kugwiritsa ntchito Simvastatin.

Ma Statin - ndi chiyani?

Mankhwalawa amatenga malo oyamba mwa kuchuluka kwa odwala omwe amamwa. Mphamvu yogwiritsira ntchito mankhwala ochepetsa lipid imakhazikitsidwa chifukwa cha kuletsa kwa ma enzymes okhala ndi dzina lovuta "HMG-CoA reductase", lomwe limapangitsa kupanga cholesterol yatsopano mu chiwindi.

Statins kukonza ziwiya zowonongeka pamene atherosulinosis sichinadziwikebe, koma cholesterol "yoyipa" ikupezeka kale m'makoma. Amasintha mankhwala ndikusintha kwamitsempha yamagazi: kuchepa kwamitsempha, kupewa mawonekedwe a magazi.

Mankhwala othandiza kwambiri kwa cholesterol ndi m'badwo watsopano wa atorvastatin, cerivastatin, rosuvastatin ndi pitavastatin.

Ma boma samangoletsa kuchuluka kwa cholesterol yoyipa, komanso kuwonjezera zomwe zili zopindulitsa. Zotsatira zakugwiritsa ntchito mankhwala a gululi zitha kuwonekera patatha mwezi umodzi atagwiritsidwa ntchito nthawi zonse. Statin amalembedwa kamodzi patsiku, usiku, kuphatikiza piritsi limodzi ndi mtima wololeza ndikuloledwa.

Kudzichita nokha ndi ma statins ndikosavomerezeka, popeza malingaliro a dokotala ali pazotsatira zakuwunika kwa magazi, makamaka, pazisonyezo za LDL. Ndalamayi ikapanda kupitirira 6.5 mmol / l, imachepetsedwa ndikusintha zakudya komanso moyo. Ngati izi sizili zokwanira, patatha miyezi isanu ndi umodzi dokotala amamulembera ma statins.

Sizovuta kwa ogula osamvetsetsa kuti amvetsetse: rosuvastatin ndi atorvastatin - pali kusiyana kotani pakati pa izi ndi mankhwala ena-omwe omwe amaletsa ma enzyme omwe amapanga cholesterol? Rosuvastatin ndi mankhwala obwera kumene omwe amafanizidwa bwino ndi omwe adalipo kale.

Mlingo wofanana ndi atorvastatin, umakhala ndi tanthauzo. Mtsutso wofunikira udzakhala chiopsezo chake chotsika.

Mutha kuphunzira zambiri za momwe mungatenge ma statins molondola kuchokera pa vidiyo.

Mankhwala Opatsa Moyo

Ngati mankhwala osagwiritsa ntchito mankhwala atakhala kuti sangathe, mwachikhalidwe chizindikiritso chachikulu cha kusankha kwa zoletsa chinali hypercholesterolemia (kuphatikiza cholesterol yayikulu mwachilengedwe).

Masiku ano, ma statin amadziwika ngakhale ndi cholesterol wamba:

1. Odwala omwe ali ndi matenda a mtima a ischemic,
2. Pambuyo pathupi lakumaso,
3. Pambuyo pa opaleshoni yamitsempha yama coronary (stenting, bypass surge),
4. Wodwala akavulala kwambiri,
5. Ndi matenda a shuga omwe ali ndi LDL yayikulu.

Machitidwe a statins ndi ochulukirapo kuposa kusintha kwachilengedwe kwa cholesterol, padziko lonse lapansi - awa ndi mankhwala omwe amakhala ndi moyo nthawi yayitali. Chofunikira kwambiri pakuika kwa ma statins ndi atherosulinosis yomwe ikukula pang'onopang'ono. Izi zonsezi, komanso cholowa chamtsogolo, zimapereka chiopsezo chowonongeka cha mtima.

Gululi lamankhwala limapangidwa mu hepatitis, cirrhosis ndi zina za chiwindi. Statin salimbikitsidwa pa nthawi yoyembekezera komanso nthawi yoyamwitsa. Amayi azaka zoyambira kubereka sayenera kutengedwa ngati satetezedwa ndi njira zodalirika zakulera. Osakupatsani mankhwala opezeka ndi mankhwalawa ngati mwapezeka.

Ma Statin sakhala ndi vuto lililonse panjira zina - kusinthana kwa mapuloteni, chakudya, purines, kotero, amatha kugwiritsidwa ntchito mosamala ndi odwala matenda ashuga, odwala matendawa ndi matenda ena.

Zotsatira zoyipa

Mankhwala oterewa popanga amapangidwa m'manja mwamphamvu kwambiri pazotsatira zoyipa. Mwachitsanzo, Rosuvastatin, adaphunzira zaka ziwiri, atorvasin, lovastatin ndi simvastatin kwa zaka 3-5. Kuphatikiza pa ziwerengero zotsimikizika popewa kugunda kwa mtima, palinso ma pluses ena.

Chiwopsezo cha zovuta zoyipa ndi chithandizo cha nthawi yayitali ndi ma statins sichidutsa 1%. Zina mwazinthu izi:

• Vuto la kugona
• Kumva kuwonongeka
• Kufooka ndi kupweteka kwa minofu ndi mafupa,
• Kusweka kwa minofu
• Sinthani kaonedwe ka kukoma,
• Tachycardia,
• Madontho a kuthamanga kwa magazi,
• Kuchepa kwa ndende,
• Zamphuno
• Matenda a Dyspeptic
• Kuphwanya phokoso la kayendedwe ka matumbo ndi kukodza,
• Kuchepetsa kugonana,
• Kuchulukitsa thukuta
• Ziwengo

Oposa 1% odwala amatha kumva chizungulire, kupweteka pachifuwa, kutsokomola, kutupa, mphamvu yayikulu pozungulira poizoni, kuyatsidwa khungu (kuyambira redness mpaka eczema).

Werengani zambiri za ngati pamakhala kufunikira kotenga ma statins - kanemayu

Kugwirizana kwina ndi mankhwala ena

WHO ndi American Heart Association amalimbikitsa ma statins ngati gawo lofunikira pothandizira matenda am'mitsempha yamagazi ngati chiwopsezo cha zovuta chikukwana. Kukhazikitsidwa kwa gulu ili la odwala kumangotanthauza kuti cholesterol yotsika sikokwanira.

Chithandizo chokwanira chimaphatikizapo:

• B-blockers (monga bisoprolol, atenolol, metoprolol),
• Ma antiplatelet othandizira (mawonekedwe a aspirin, aspirin, bulu wa thrombosis),
• ACE zoletsa (perindopril, quadripril, enalapril),
• Madera

Kafukufuku wambiri amatsimikizira chitetezo cha kugwiritsa ntchito mankhwalawa mophatikiza.

Nthawi zina, kuphatikiza kwa mankhwala osiyanasiyana piritsi limodzi (mwachitsanzo, pravastatin + aspirin) kumachepetsa vuto la mtima (7,6%) yokha poyerekeza ndi kugwiritsa ntchito mankhwalawa (9% ya pravastatin ndi 11% ya aspirin).

Pachikhalidwe, ma statin anali kutumizidwa usiku wonse, mosiyana ndi mitundu ina yamankhwala. Masiku ano, akatswiri a zamankhwala amapereka kuphatikiza kwa mitundu ingapo ya mankhwala piritsi limodzi, ndilo njira yomwe madokotala angafune. Mwa zina mwa mankhwalawa ndi duplexor, caduet, kuphatikiza atorvastatin ndi amlodipine piritsi limodzi.

Amadutsa mayeso ndi chida chatsopano chazovuta - Polypill.

Ngati mfundo za cholesterol zikuposa 7.4 mmol / l, ma statin amaphatikizidwa ndi fibrate (gulu lina la mankhwala ochepetsa cholesterol). Ndi ma statins omwe ndi othandiza kwambiri komanso otetezeka pankhani inayake, dokotala amasankha, kupenda zoopsa zonse zomwe zingatheke.

Sizovomerezeka kutenga ma statins ndi piritsi ya madzi a mphesa, chifukwa imakhala ndi zinthu zomwe zimalepheretsa kuyamwa kwa ma statins. Kuchulukitsa magazi awo ndizowopsa chifukwa cha kuchuluka kwa poizoni.

Chithandizo chosagwirizana ndi gulu ili la anthu omwe ali ndi zakumwa zoledzeretsa ndi maantibayotiki ena: monga clarithromycin ndi erythromycin, omwe amachititsa kuti chiwindi chiwonjezeke.

Maantibayotiki ena amagwirizana kwambiri ndi mankhwala omwe amachepetsa cholesterol. Mkhalidwe wa chiwindi uyenera kuyang'aniridwa miyezi itatu iliyonse, kutchulira m'magazi kuyesa chizindikiro cha michere ya chiwindi.

Phindu ndi zovuta za ma statins

Kuwerenga maphikidwe, wodwala aliyense woganiza bwino amaganiza za kugwiritsa ntchito mankhwala: Kodi phindu la ma statins limaposa bwanji kuvulaza komwe kumayankhulidwa kwambiri? Zambiri zokhudzana ndi mankhwala atsopano okhala ndi zovuta zochepa zosathandizira zimathandizira kuthetsa kukayikira.

Izi zotsatirazi zimayankhula m'malo mochita bwino kwawo:

• Kuchepetsa 40% kwa odwala matenda amtima opitilira zaka 5.
• Chepetsani mwayi wokhala ndi vuto la mtima komanso stroke 30%.
• Kuchepa kwa mafuta m'thupi ndi 45-55% (pogwiritsa ntchito nthawi yayitali komanso kwanthawi yayitali). Kuti muwone zamphamvuzi, muyenera kupenda magazi mwezi uliwonse ngati cholesterol.
• Kugwiritsa ntchito mankhwalawa kwa mtundu waposachedwa kwama statins sikukutulutsa koopsa. Kwa nthawi yayitali ankakhulupirira kuti ma statins amatha kuwonjezera chiopsezo chokhala ndi khansa ya chiwindi, mtundu wachiwiri wa matenda ashuga, matenda amkati, matenda a dementia. Kafukufuku wamakono atsimikizira izi kuti izi zachitika komanso kuti zotsatirapo zake zimachitika. Kuyambira 1996, Denmark yakhala ikuwunika anthu odwala matenda ashuga. Kuwonongeka kwa matenda ashuga monga retinopathy, polyneuropathy kunachepa ndi 40 ndi 34%.
• Kusankha kofananako kwa mankhwala ofananirako osiyanasiyana ophatikizidwa ndi mankhwala wamba. Mitu yamutu nthawi zambiri imafunsa: simvastatin kapena atorvastatin - ndibwino? Njira yoyamba ndi yoyimira ma statins achilengedwe, yachiwiri ndi yamakono yopanga. Ndi zosiyana zonse pakapangidwe kake ndi kagayidwe kachakudya, mankhwalawa ali ndi mankhwala ofanana. Amasiyana kwambiri pamtengo: simvostatin ndi wotsika mtengo kwambiri kuposa atorvastatin.

Mwa zoperewera, munthu amatha kuwona mtengo wokwera wamtanda, rosucard, leskol forte ndi ma statin ena apoyamba a m'badwo waposachedwa, pa dzina lililonse la mankhwalawo omwe mungatchule mungasankhe generic ndi mtengo wotsika mtengo.

Kuwona koyambirira kwa pulofesa wa ku France, Debreu pankhani yovuta "yochitira ndi matenda a statin" onerani vidiyo

Kubwereza kwa Statins

Mndandanda wa ma statins - mankhwala omwe mayina awo nthawi zambiri amapezeka pazamankhwala, amaperekedwa patebulopo.

Mayina ndi kuzungulira kwa maziko

Mankhwala oyamba a m'badwo woyamba

Mankhwala achibadwa chachiwiri

Mankhwala a m'badwo wachitatu

Mankhwala a m'badwo wachinayi

Chogwira ntchito	Kodi amapanga kuti	Mtengo wapakatikati, opaka.
Simvastatin	Vasilip (10, 20, 40 mg)	Ku Slovenia	444
Simgal (10, 20 kapena 40)	Ku Israel ndi Czech Republic	461
Simvakard (10, 20, 40)	Ku Czech Republic	332
Simlo (10, 20, 40)	Mwa India	302
Simvastatin (10, 20.40)	Mu Russian Federation, Serbia	125
Pravastatin	Lipostat (10, 20)	Ku Russian Federation, Italy, USA	170
Lovastatin	Holletar (20)	Ku Slovenia	323
Cardiostatin (20, 40)	Ku Russian Federation	306
Fluvastatin	Leskol Forte (80)	Ku Switzerland, Spain	2315
Atorvastatin	Liptonorm (20)	Ku India, RF	344
Liprimar (10, 20, 40, 80)	Ku Germany, USA, Ireland	944
Tulip (10, 20, 40)	Ku Slovenia, Sweden	772
Torvacard (10, 40)	Ku Czech Republic	852
Atoris (10, 20, 30, 40)	Ku Slovenia, Russian Federation	859
Rosuvastatin	Crestor (5, 10, 20, 40)	Mu Russian Federation, England, Germany	1367
Rosucard (10, 20, 40)	Ku Czech Republic	1400
Rosulip (10, 20)	Ku Hungary	771
Tevastor (5, 10, 20)	Ku Israel	531
Pitavastatin	Livazo (1, 2, 4 mg)	Ku Italy	2350

Mtengo wama statins ndiwopatsa chidwi, koma mankhwala opangidwa generic sakhala otsika poyerekeza ndi mankhwala oyambira pamndandanda, kotero aliyense angathe kudzisankhira analogi malinga ndi bajeti.

Njira zakonzanso cholesterol level

Ngati cholesterol ikuchulukirachulukira ndipo mulibe vuto lililonse loti mulephera kutaya mtima, yesetsani kusintha kadyedwe. Chozizwitsa, zakudya zina zam'mera zimakhala ndi zolengedwa zachilengedwe. Zophunziridwa kwambiri pankhaniyi ndizotheka kwa adyo ndi turmeric.

Kuphatikiza pa iwo, zakudya zoyenera zimaphatikizapo chithandizo chofatsa cha zinthu (kuwonjezera, kuwotcha, kuphika kapena kuwiritsa). Zakudya zamafuta ndi zokazinga siziyikidwa kunja, pali zoletsa pa kuchuluka kwa mazira, mkaka ndi offal.

Cholesterol ndiyofunikira kwa thupi monga zinthu zomanga maselo, motero ndikofunikira kuti musatenge, koma kuti muchepetse kugwiritsidwa ntchito kwa mitundu yina ya zinthu.

CHIKWANGWANI chamasamba (masamba, chimanga, ma legamu) ndi mafuta a asidi Щ-3 (nsomba zofiira, mafuta amafuta), zomwe zimapangitsa kuti kagayidwe ka cholesterol, ndizothandiza.

Ngati njira zomwe zili pamwambazi sizipereka zotsatira zomwe zimafunikira, mankhwala ochepetsa lipid ndi omwe amapatsidwa.

Pomaliza, ndikofunikira kutsindika kuti, ndi nkhawa zonse za odwala zomwe zimatenga ma statins - mankhwala ochepetsa cholesterol - komanso malingaliro ofala okhudzana ndi zovulaza zamankhwala otere, cholinga chawo chimakhala chokwanira ngati atherosulinosis yayikulu ikhoza kukhala ndi zotsatirapo zovuta, chifukwa mankhwalawa amatha kutalikitsa moyo komanso kusintha mtundu wake.

Inde, piritsi ndi yosavuta kumwa, koma ndi cholesterol yokwezeka pang'ono popanda chizindikiro chochepa kwambiri cha kuwonongeka kwa mtima, ndikwabwino kungokhalira ndi moyo wathanzi ndikuwunikira cholesterol nthawi ndi nthawi.

Pulofesa E. Malysheva amalankhula motsimikiza za ma statins omwe amatalikitsa moyo

Atorvastatin Action Tebulo

Zotsatira zamatenda a atorvastatin
Gulu la odwala	Thanzi
Akuluakulu opanda matenda amtima oyamba komanso ophatikizika ndi ziopsezo (mbiri yakale ya matenda oyamba m'mitsempha, kudalira kwa fodya, uchidakwa, hyperlipidemia, matenda oopsa, msinkhu)	Kuchepetsa Ziwopsezo:

• Kukula kwa angina pectoris ndi kufunika kwa kusinthanso.
• Stroko.
• Myocardial infaration.

Odwala odwala matenda ashuga amtundu wa 2 omwe alibe matenda oopsa a m'mitsempha pamodzi ndi zinthu zoopsa (matenda oopsa, kusuta, uchidakwa, albinuria, retinopathy)Kuchepetsa Ziwopsezo:

• Stroko.
• Myocardial infaration.

Odwala omwe ali ndi vuto lalikulu la mtimaKuchepetsa Ziwopsezo:

• Kugonekedwa m'chipatala chifukwa cha mtima walephera.
• Kufa koopsa komanso kosavulaza.
• Nonfatal myocardial infaration.
• Kukula kwa angina pectoris ndi kufunika kwa kusinthanso.

Rosuvastatin

Ichi ndi chinthu chopangidwa ndi mankhwala othandizira, omwe amawerengedwa ngati opeza bwino kwambiri pakugwiritsa ntchito nthawi yayitali. Rosuvastatin akuwonetsedwa kuti agwiritsidwe ntchito kwa odwala omwe ali ndi vuto lalikulu la kuchepa kwa magazi, matenda oopsa, matenda opha ziwalo, matenda a atherosulinosis. Statin imawonedwanso kuti ndi yotetezeka, koma yothandiza kuposa atorvastatin.

Kapangidwe kake kamafanana kwa gulu la mankhwala. Pa gawo loyamba, mankhwala amatengedwa mpaka 10 mg patsiku. Popanda mavuto, mlingo wa tsiku ndi tsiku umatha kuchuluka mpaka 40 mg. Mulingo wofanana ndi wotetezedwa woterewu umalimbikitsidwa kwa odwala omwe ali ndi cholesterol yambiri yam magazi, yotsimikizika chibadwa, komanso cholowa cholandilira hypercholesterolemia.

Rosuvastatin amayimitsa bwino kuchuluka kwa LDL. Kutha kwake kusungunuka msanga m'madzi kwenikweni sikukhudza magwiridwe antchito a maselo a chiwindi. Kuyesa kambiri kwatsimikizira kutetezeka kwa kugwiritsa ntchito mankhwalawa kwa chiwindi ntchito. Poyerekeza ndi lipophilic statins, Rosuvastatin amaonedwa ngati mankhwala ofatsa komanso otetezeka. Kuphatikiza apo, siziwononga ulusi wa minofu.

Mphamvu zoyenera kuchokera ku mankhwala a rosuvastatin zimawonedwa kale kumayambiriro kwa chithandizo. Pakatha mwezi wokhazikika wogwiritsa ntchito, mankhwalawa amayamba kugwira ntchito bwino. Malinga ndi STELLAR, pa tsiku lililonse 40 mg, kuchepa kwa LDL kopitilira theka kudalembedwa, limodzi ndi kuwonjezeka kwa HDL ndi 10%.

Maphunziro oyerekeza a LUNAR adawonetsa kukwera pang'ono kwa Rosuvastatin, amatengedwa pa 40 mg patsiku, kupitilira Atorvastatin ndi chizolowezi cha tsiku ndi tsiku cha 80 mg. Zizindikiro zochepa za kuchepa kwa LDL zinali 47 ndi 43%, motsatana. Ponena za cholesterol "yabwino", kudya kwa 40 mg kwa Rosuvastatin kumawonjezera HDL ndi 12%, pomwe kuchuluka kwa lipoprotein kuchokera 80 mg wa Atorvastatin sikunapose 6%.

Buku lotchuka lazachilendo lotulutsa zakunja linasindikiza zotsatira za zomwe zapezeka posachedwa zamankhwala, malinga ndi zomwe mankhwalawa ali pamwambapa zimakhudza kugwira ntchito kwa impso.

Pali mankhwala angapo omwe ali ndi zinthu zomwezi monga Rosuvastatin, chifukwa chake amatha kugwiritsidwa ntchito mwanjira ina. Musanagwiritse ntchito, ndikofunikira kuti mufunsane ndi dokotala. Njira zina ndi izi:

Simvastatin Substitutes

Zofanana mu mawonekedwe a statin:

Kodi ndizotheka kuchepetsa zoopsa za matenda amtima komanso cholesterol yayikulu, osamwa mankhwala omwe ali ndi mavuto? Yankho ndi lothandizika ndipo limakhala m'makalasi olimbitsa thupi, komanso zakudya zoyenera. Munthu amazolowera kuthana ndi mavuto azachipatala mpaka kuiwala za mphamvu ya thupi lake. Kusintha kusaka kwa piritsi mu mawonekedwe a piritsi kumatha kukhala ndi thanzi labwino.

Yang'anani! Mankhwala onse ndi pafupifupi, ndipo kwa munthu aliyense payekha, chifukwa musanayambe kumwa mankhwala aliwonse, muyenera kufunsa dokotala.

Ma Statin a chiwindi, kapena, kayendetsedwe kake kamaletsa kuperewera kwa chiwindi. Nthawi yomweyo, amachepetsa chiopsezo chamitsempha yamagazi.

Matenda a matenda a shuga a mtundu wachiwiri amalimbikitsidwa kupewa matenda oyenda ndi kuzungulira kwamtima komanso kugwira ntchito bwino kwa mtima. Mankhwala osokoneza bongo amathandizira kutsitsa cholesterol yamagazi.

Ma Status samangotsitsa ma lipoproteins otsika kwambiri m'magazi. Kugwiritsa ntchito mankhwalawa moyenera komanso moyenera, njira yotupa m'mitsempha yomwe ikukhudzidwa ndi cholesterol plaques inayima.

Mbadwo waposachedwa wa ma statins umathandiza thupi kuchotsa cholesterol yoyipa. Izi zimachitika chifukwa cha kufalikira kwa chiwindi, chomwe chimapangidwa kuti chizipanga.

Ndemanga za Odwala

Olga, wazaka 37, Veliky Novgorod

Pambuyo pa vuto la mtima, bambo adasankhidwa Simvastatin kuti achepetse cholesterol. Mankhwalawa adatha miyezi 4 ndipo munthawi imeneyi padalibe zotsatirapo zake. Kuphatikiza kosasinthika kwa mankhwalawo ndi mtengo, opanda - mphamvu zochepa. Kuwunikiranso mobwerezabwereza kunawonetsa kuti kuchuluka kwa cholesterol yoyipa kunachepa pang'ono. Abambo anakwiya, chifukwa anali ndi chiyembekezo chachikulu chamankhwala. Ndikhulupirira kuti simvastatin imathandizira pofatsa, osati mwa otsogola. Tsopano tikuthandizidwa ndi mankhwala ena.

Maria Vasilievna, wazaka 57, Murmansk

Potsatira mayeso otsatira, adotolo adati cholesterol idakwera pang'ono ndikulimbikitsa kumwa ma statins. Anatenga Simvastatin, adatsata zakudya ndikutsatira pang'ono zolimbitsa thupi. Pambuyo pa miyezi iwiri ndidadutsa kuwunikanso kwachiwiri, komwe zizindikiro zonse zidabwezereredwa. Sindikudandaula kuti ndinamwa mankhwalawa, ngakhale ambiri adachenjeza za kuvulaza kwake ndi zopanda pake ndi mtundu wamagazi anga. Ndine wokondwa kuti zotsatira zake zakwaniritsidwa. Ndikupangira!

Galina, wazaka 50, Moscow

Ndidachita mantha nditamva kuchokera kwa dokotala kuti panali cholesterol yoposa 8. Ndimaganiza kuti mankhwalawa atenga nthawi yayitali komanso ovuta. Atorvastatin adalembedwa. Ndinalibe chiyembekezo chachikulu pa mankhwalawa, koma sizinachitike. Pambuyo pakuthandizidwa miyezi iwiri, cholesterol idatsikira ku 6. Sindimayembekezera kuti mankhwalawa athandiza. Ndikufuna kudziwa kuti ndimamwa mosamalitsa adokotala ndipo palibe zotsatira zoyipa.

Mankhwala onse awiriwa amagwiritsidwa ntchito mwachangu ku mtima ndi matenda a mtima ndi mtima.

Madokotala amawunika za Atorvastatin ndi Simvastatin

Egor Alexandrovich, wazaka 44, Moscow

Sindimakonda kulemba Simvastatin, chifukwa Ndimaona ngati mankhwala a m'zaka zapitazi. Tsopano pali ma statin amakono omwe ndi othandiza komanso otetezeka. Mwachitsanzo, atorvastatin. Mankhwalawa sangathe kutsitsa cholesterol yoyipa, komanso amachepetsa chiopsezo cha matenda a mtima ndi sitiroko. Fomu yabwino yotulutsidwa.

Lyubov Alekseevna, wazaka 50, Khabarovsk

Muzochita zamankhwala, ndimayesetsa kupereka Atorvastatin kwa odwala ngati palibe contraindication. Ndikukhulupirira kuti mankhwalawa amagwira ntchito modekha, osasokoneza kugwira ntchito kwamkati ndi ziwalo zamthupi. Odwala nthawi zambiri samadandaula za mavuto, zomwe ndizofunikira. Kupatula apo, ambiri omwe amapuma pantchito amabwera ndi vuto lofananalo, omwe ali kale ndi matenda osachiritsika.