Torvacard (20 mg) Atorvastatin
Fomu ya kutulutsidwa kwa Torvacard ndi mapiritsi okhala ndi mafilimu: convex, oval, pafupifupi oyera kapena oyera mbali ziwiri (10 ma PC mu chithuza, matuza atatu kapena 9 mu paketi yamakhadi).
Zogwira pophika: atorvastatin (munthawi ya calcium), piritsi limodzi - 10, 20 kapena 40 mg.
Zigawo zothandiza: malo otsika olowa m'malo mwa hyprolose, lactose monohydrate, magnesium stearate, croscarmellose sodium, magnesium oxide, colloidal silicon dioxide, cellcrystalline cellulose.
Mapangidwe a Shell: macrogol 6000, hypromellose 2910/5, talc, titanium dioxide.
Mlingo
Ambale Mapiritsi 10 mg, 20 mg, 40 mg
Piritsi limodzi lili
ntchito yogwira - atorvastatin 10,00 mg, 2000 mg, 40.00 mg (monga
calcium wa atorvastatin 10,34 mg, 20,68 mg, 41.36 mg, motero)
obwera: magnesium oxide (katundu), microcrystalline cellulose, lactose monohydrate (26.30 mg - - Mapiritsi okhala ndi 10 mg, 52.60 mg - Mapiritsi okhala ndi 20 mg, 105.20 mg - Mapiritsi okhala ndi 40 mg), croscarmellose sodium, otsika-hydroxypropyl cellulose LH 21, madzi osokoneza bongo a colloidal, magnesium stearate
kapangidwe ka chipolopolo: hypromellose 2910/5, macrogol 6000, titanium dioxide E171, talc
Mapiritsi, okutidwa ndi chipolopolo choyera kapena choyera kwambiri, chowona, ndi biconvex malo, pafupifupi 9.0 x 4.5 mm kukula kwake (Mlingo wa 10 mg).
Mapiritsi, okutira ndi chipika cha mtundu woyera kapena pafupifupi woyera, wopaka mawonekedwe, wokhala ndi biconvex, pafupifupi 12.0 x 6.0 mm kukula kwake (Mlingo wa 20 mg).
Mapiritsi, okutira ndi chipolopolo choyera kapena choyera kwambiri, chowona, ndi biconvex malo, pafupifupi 13.9 x 6.9 mm kukula (Mlingo 40 mg).
Mankhwala
Pharmacokinetics
Atorvastatin imalowa mwachangu pambuyo pakukonzekera pakamwa, kuchuluka kwa plasma concentration (Cmax) kumatheka mkati mwa maola 1-2. Mlingo wa mayamwidwe ndi kuchuluka kwa atorvastatin mu madzi a m'magazi kumaonjezera kuchuluka kwa mlingo.
Pambuyo pakukonzekera pakamwa, Torvacard, mapiritsi okhala ndi mbali ali ndi 95% - 99% bioavailability poyerekeza ndi yankho la pakamwa. Mtheradi wa bioavailability wa atorvastatin ndiwotsika (pafupifupi 14%), ndipo kupezeka kwazinthu zakuthupi motsutsana ndi HMG-CoA reductase kuli pafupifupi 30%. Systemic bioavailability yochepa imayamba chifukwa cha kagayidwe kachakudya ka mucous membrane wa m'mimba ndipo / kapena pa "gawo loyambirira" kudzera m'chiwindi. Chakudya chimachepetsa pang'ono komanso kuchuluka kwa mankhwalawa (monga 25% ndi 9%, motsatana, monga zikuwonetsedwa ndi zotsatira za kutsimikiza kwa Cmax ndi AUC), koma kuchepa kwa otsika osalimba a lipoprotein cholesterol (LDL-C) kuli pafupi ndi omwe akamamwa atorvastatin pamimba yopanda kanthu. Pambuyo potenga atorvastatin madzulo, ndende yake ya plasma ndiyotsika (Cmax ndi AUC ndi 30%) kuposa atatha kudya m'mawa. Pali ubale womwe ulipo pakati pa kuchuluka kwa mayamwidwe ndi mlingo wa mankhwalawo.
Kugawidwa kwapakati pa atorvastatin ndi pafupifupi 381 malita. Chiyanjano cha atorvastatin ndi mapuloteni a plasma ndizosachepera 98%. Kupenda
Atorvastatin imapangidwa ndi cytochrome P450 3A4 kwa zotumphukira za ortho- ndi para-hydroxylated ndi zinthu zosiyanasiyana za beta oxidation. Muvitro ortho- ndi para-hydroxylated metabolites imalepheretsa kusintha kwa HMG-CoA, kufananizidwa ndi Torvacard. Kutsika kwapafupifupi 70% kwa ntchito ya HMG-CoA reductase kumachitika chifukwa cha zochita za metabolites zomwe zimagwira.
Atorvastatin imapukusidwa makamaka mu bile pambuyo pa hepatic ndi / kapena metabolism yowonjezera. Komabe, mankhwalawa samayikidwa mobwerezabwereza kwambiri. Pafupifupi theka la moyo wa atorvastatin mwa anthu pafupifupi maola 14. Hafu ya moyo wa inhibitory polemekeza HMG-CoA reductase pafupifupi maola 20-30 chifukwa cha zochita za metabolites. Pambuyo pakukonzekera pakamwa, ochepera 2% ya atorvastatin amapezeka mu mkodzo.
Pharmacokinetics pamagulu apadera a odwala
Odwala okalamba
Kuchuluka kwa atorvastatin ndi metabolites yake yogwira ntchito m'madzi a m'magazi ndi apamwamba mu odwala azaka 65 ndi akulu (Cmax ndi 40%, AUC ndi 30%) kuposa odwala achinyamata, pomwe lipid-kutsitsa mphamvu yachipatala inali yofanana ndi zomwe zimawonetsedwa ndi kuchuluka kwa anthu odwala achichepere.
M'maphunziro azachipatala, chilolezo cha pakamwa cha atorvastatin chawonekera m'matenda a ana chinali chofanana ndi chachikulu mwa akulu omwe ali ndi kuchuluka kwa allometric kulemera kwa thupi. Kudutsa konkera yonse ya atorvastatin ndi o-hydroxyatorvastatin, kutsika kwamphamvu kwa otsika ochepa lipoprotein cholesterol (LDL-C) ndi kuchuluka kwa cholesterol (XC) kumawonedwa.
Kuchulukitsidwa kwa atorvastatin ndi metabolites yake yogwira ntchito mwa akazi kumasiyana (Cmax pafupifupi 20% komanso AUC pafupifupi 10% kutsika) kuchokera kwa amuna, komabe, kusiyana kwakukulu pamalingaliro a mankhwala a lipid metabolism mwa amuna ndi akazi sikunapezeke.
Matenda a impso sasokoneza kukhudzana kwa atorvastatin komanso metabolites yake yogwira m'magazi am'magazi komanso kuchepa kwa lipid yawo, motero, kusintha kwa odwala sikofunikira.
Sizokayikitsa kuti hemodialysis ingayambitse chiwonetsero chachikulu cha atorvastatin, popeza mankhwalawa amagwirizana kwambiri ndi mapuloteni a plasma.
Plasma woipa wa atorvastatin ndi metabolites yake yogwira imachulukirachulukira (Cmax pafupifupi nthawi 16, AUC pafupifupi nthawi 11) mwa odwala omwe ali ndi chiwindi cha chidakwa cha cirrhosis (Gulu Lapamwamba la Mwana).
Zotsatira za gene polymorphism SLCO1B1
Metabolism mu chiwindi cha mitundu yonse ya HMG-CoA reductase inhibitors, kuphatikizapo atorvastatin, imaphatikizira kutenga nawo mapuloteni a OATP1B1 transporter. Odwala omwe ali ndi SLCO1B1 gene polymorphism amawonetsedwa ndi atorvastatin, yomwe imawonjezera chiopsezo cha rhabdomyolysis. Polymorphism mu gene encoding OATP1B1 (SLCO1B1 c.521CC) imayambitsa kuwonekera kwapafupipafupi kwa 2.4 kwa atorvastatin (AUC) poyerekeza ndi anthu omwe alibe izi zapadera za genotype (c.521TT). Odwala otere, kuphwanya kwamtunduwu kwa atorvastatin chifukwa cha majini ndikotheka. Zotsatira zomwe zimachitika chifukwa chodwala mankhwalawa sizikudziwika.
Mankhwala
Torvacard ndi chosankha chopikisana chopikisana ndi HMG-CoA reductase, ma enzyme ofunikira omwe amasintha 3-hydroxy-3-methylglutaryl-CoA kukhala mevalonic acid, poyambira ma steroid, kuphatikizapo cholesterol.
Hepatic triglycerides ndi cholesterol imaphatikizidwa ndi kachulukidwe kochepa kwambiri ka lipoproteins (VLDL), amalowa m'madzi am'magazi ndipo amatengedwa kupita ndi zotumphukira. Low density lipoproteins (LDL) amapangidwa kuchokera ku VLDL, omwe amathandizidwa ndi kulumikizana ndi ma receptors omwe ali ndi mgwirizano wapamwamba wa LDL.
Torvacard imachepetsa plasma cholesterol ndi serum lipoproteins poletsa HMG-CoA reductase ndikuwonjezeranso biosynthesis ya cholesterol mu chiwindi, ndikuwonjezera kuchuluka kwa receptors a hepatic LDL pamaselo a cell, kukulitsa kuwonjezeka ndi kukopa kwa LDL-C.
Torvacard imachepetsa kuchuluka ndi kuchuluka kwa tinthu ta LDL. Torvacard imapangitsa kuchuluka kwakuchulukirachulukira kwa ntchito za LDL zolandila ndikuphatikiza pakusintha kwabwino pamitundu yozungulira ya LDL. Torvacard bwino amachepetsa mulingo wa LDL-C odwala omwe ali ndi homozygous cholowa hypercholesterolemia (mpaka 20%), osagwirizana ndi mankhwala ena okhala ndi lipid-kuchepetsa.
Torvacard imachepetsa kuchuluka kwama cholesterol ndi 30-46%, LDL cholesterol ndi 41-61%, apolipoprotein B ndi 34-50%, triglycerides ndi 14-33% ndi VLDL odwala heterozygous ndi homozygous Famal hypercholesterolemia, mitundu yosakanikirana ya hypercholesterolemia, komanso odwala omwe samadwala matenda a shuga.
Kuchepetsa cholesterol yathunthu, cholesterol ya LDL ndi apolipoprotein B kumachepetsa chiopsezo chokhala ndi matenda amtima komanso chiwopsezo cha kufa.
Zizindikiro zogwiritsidwa ntchito
- kuphatikiza ndi zakudya zochizira odwala omwe ali ndi cholesterol yokwanira, LDL-C, apolipoprotein B ndi triglycerides ndi kuchuluka kwa HDL-C kwa odwala omwe ali ndi hypercholesterolemia (heterozygous Famal komanso hypercholesterolemia), yophatikizika (yosakanikirana) hyperlipidia IIa ndi IIb malinga ndi Frederickson), okhala ndi triglycerides m'magazi am'magazi (mtundu IV malinga ndi Frederickson) ndi odwala dysbetalipoproteinemia (mtundu wa III malinga ndi Frederickson), pakalibe zotsatira zokwanira ndi di oterapii
- Kuchepetsa kuchuluka kwamadzi am'magazi a cholesterol yathunthu ndi LDL-C odwala omwe ali ndi homozygous Famer hypercholesterolemia osakwanira pakulimbitsa mankhwala
- Kuchepetsa chiopsezo cha zotsatira zakupha za matenda a mtima komanso kuopsa kwa matenda obwera chifukwa cha kuchepa kwa mtima, matenda a angina pectoris, stroko komanso kuchepetsa kufunika kosinthira njira za odwala omwe ali ndi matenda amtima komanso / kapena dyslipidemia, komanso ngati matendawa sanapezeka, koma alipo atatu zinthu zomwe zingayambitse matenda oyamba ndi mtima, monga zaka zopitilira 55, kusuta, matenda oopsa, kuchepa kwa plasma kwa HDL-C, komanso milandu yakukula kwa matenda amtima wapachibale
- kuphatikiza ndi zakudya zochizira ana a zaka zapakati pa 10 mpaka 17 ndi kuchuluka kwa mafuta am'madzi ambiri, LDL-C ndi apolipoprotein B ndi heterozygous Famel hypercholesterolemia, ngati pambuyo poti adye chakudya chokwanira, mulingo wa LDL-C watsala> 190 mg / dl kapena kuchuluka kwa LDL imatsalira> 160 mg / dl, koma pali milandu ya matenda oyambitsidwa ndi mtima mwa abale kapena ziwiri kapena zingapo zomwe zingayambitse matenda a mtima mwa mwana
Mlingo ndi makonzedwe
Musanagwiritse ntchito Torvacard, wodwalayo ayenera kuthandizidwa kuti azidyetsa zakudya zowonjezera lipid, azichita masewera olimbitsa thupi komanso kuwonda. Zakudyazi ziyenera kuchitika nthawi yonse ya mankhwala ndi Torvacard. Mlingo uyenera kusankhidwa payekha kutengera mtundu woyamba wa HDL-C, cholinga chamankhwala komanso mayankho a wodwalayo.
Mlingo woyambira wabwino ndi 10 mg kamodzi tsiku lililonse. Kusintha kwa Mlingo kuyenera kuchitika pakadutsa milungu inayi kapena kupitirira apo. Mlingo waukulu kwambiri ndi 80 mg kamodzi patsiku.
Mlingo wa tsiku ndi tsiku wa Torvacard amatengedwa kamodzi nthawi iliyonse ya tsiku ndi chakudya kapena mosasamala nthawi yakudya. Kutalika kwa mankhwalawa kumatsimikiziridwa ndi dokotala aliyense payekhapayekha.
Hypercholesterolemia yoyambakomanso kuphatikiza(kusakaniza)Hyperlipidemia
Torvacard 10 mg kamodzi tsiku lililonse. The achire zotsatira nthawi zambiri amawona mkati 2 milungu, ndipo pazipita achire zotsatira zambiri zimachitika mkati 4 milungu. Zotsatira zimathandizidwa ndi chithandizo chanthawi zonse.
Heterozygous achibale hypercholesterolemia
Odwala ayenera kuyamba kulandira chithandizo cha 10 mg tsiku la Torvacard. Posankha mlingo, njira ya munthu payekha iyenera kugwiritsidwa ntchito, mankhwalawa amayenera kusintha masabata 4 aliwonse mpaka 40 mg patsiku. Pambuyo pa izi, mlingo wa Torvacard utha kuwonjezereka mpaka 80 mg patsiku kapena 40 mg kamodzi patsiku ungatengedwe limodzi ndi mankhwala omwe amalimbikitsa excretion ya bile acid.
Homozygous achibale hypercholesterolemia
Mlingo wa Torvacard odwala omwe ali ndi homozygous Famer hypercholesterolemia amachokera ku 10 mpaka 80 mg patsiku. Torvacard iyenera kugwiritsidwa ntchito mwa odwalawa ngati zowonjezera zamitundu ina yotsitsa lipid-mwachitsanzo, LDL apheresis), kapena ngati chithandizo chotere sichikupezeka.
Cardio prophylaxis-matenda a mtima
Ndi kupewa kwakukulu, mlingo ndi 10 mg / tsiku. Ndizotheka kuti mlingo waukulu (oposa 10 mg patsiku) ungafunike kuti mukwaniritse zomwe mumafunikira cholesterol (LDL), monga momwe dokotala wakupangirani.
Kusintha kwa Mlingo sikofunikira.
Torvacard iyenera kugwiritsidwa ntchito mosamala odwala omwe ali ndi vuto la chiwindi. Kulandila Torvakard contraindicated odwala omwe akuchita chiwindi matenda.
Odwala okalamba
Malinga ndi zotsatira za kafukufuku wothandiza ndi chitetezo cha mankhwalawa, odwala omwe ali ndi zaka zopitilira 70 amalimbikitsidwa kuti agwiritse ntchito Mlingo wofanana ndi womwe umagwiritsidwa ntchito pamagulu ena onse odwala.
Kugwiritsa ntchito kwa ana
Kugwiritsa ntchito kwa ana kuyenera kuchitika ndi madokotala okhawo omwe ali ndi chidziwitso pochiza matenda a hyperlipidemia, pomwe odwala amayang'aniridwa pafupipafupi kuti awone momwe akupitira patsogolo.
Kwa odwala azaka zapakati pa 10 ndi akulu, mlingo woyambira wa atorvastatin ndi 10 mg pa tsiku ndi kuchepa kwa 20 mg patsiku. Kuitanitsa kuyenera kuchitidwa mogwirizana ndi momwe munthu akumvera komanso kuganizira kulolerana kwa mankhwalawo kwa odwala omwe ali ndi ana. Pakadali pano, pali chidziwitso chochepa cha chitetezo cha mankhwalawa kwa ana omwe adalandira Mlingo wapamwamba 20 mg, womwe ndi wofanana ndi 0,5 mg / kg.
Pali zochepa zomwe mungathe kuchitira ana omwe ali ndi zaka 6 mpaka 10. Atorvastatin sichisonyezedwa kuchitira ana osakwana zaka 10.
Mitundu ina ya Mlingo / zozama zingakhale zoyenera kwambiri pagululi.
Torvacard cholinga chake ndi makomedwe. Mlingo uliwonse wa Torvacard tsiku lililonse umatengedwa kamodzi nthawi ina iliyonse patsiku, mosasamala kanthu za kudya.
Zotsatira zoyipa
Zomwe zimayambitsa zovuta m'mayesero azachipatala omwe atchulidwa pansipa adatsimikiziridwa pogwiritsa ntchito njira zotsatirazi: nthawi zambiri (≥1 / 100 mpaka 1/10), osati kawirikawiri (≥ 1/1000 mpaka 1/100), kawirikawiri (≥ 1/10000 mpaka 1 / 1000), kawirikawiri kwambiri (mpaka 1/10000), ndi ma frequency osadziwika (sangathe kuwerengeka kuchokera ku zomwe zikupezeka).
- kupweteka kwa pharynx ndi larynx, nosebleeds
- kudzimbidwa, kugona mosatulutsa, dyspepsia, nseru, kutsekula m'mimba
- myalgia, arthralgia, kupweteka kwa miyendo, kukokana kwa minofu, kutupa kwa mafupa, kupweteka kumbuyo
- kupatuka kwa magawo a labotale a chiwindi ntchito, kuwonjezeka kwa mlingo wa creatine kinase m'mwazi
- hypoglycemia, kulemera, anorexia
- zoopsa, kugona
- chizungulire, paresthesia, hyposthesia, dysgeusia (kupotoza kukoma), amnesia
- kusanza, kupweteka kumtunda ndi m'munsi kwam'mimba, belching, kapamba
- urticaria, zotupa pakhungu, kuyabwa, alopecia (alopecia)
- kupweteka m'khosi, kutopa kwa minofu
- malaise, kufooka kwathunthu, kupweteka pachifuwa, edema yotupa, kutopa, matenda oopsa
- kukhalapo kwa maselo oyera amkodzo
- Edema ya Quincke, dermatitis yamphongo, kuphatikizapo erythema ya polymorphic, matenda a Steven-Johnson komanso necrolysis yoopsa
- myopathy, myositis, rhabdomyolysis, tendinopathy (kuvulala kwa tendon), nthawi zina kuphatikizidwa ndi kupasuka
Maulendo osadziwika(sizingatheke kudziwa kuchokera ku zomwe zikupezeka)
- Immuno-Mediated necrotizing myopathy
Ndi ma statin
-kugonana
- zochitika zapadera za matenda am'mapapo ochepa, makamaka ndi chithandizo chanthawi yayitali
- shuga mellitus: pafupipafupi zimatengera kupezeka kapena kusapezeka kwa zinthu zoopsa (kusala kudya kwa shuga m'magazi a oposa 5.6 mmol / L, BMI yoposa 30 kg / m2, triglycerides okwera, mbiri ya matenda oopsa).
Monga ndi zina za HMG-CoA reductase inhibitors, odwala omwe amalandila atorvastatin adakumana ndikuwonjezeka kwa transaminases. Kusintha uku, monga lamulo, kunali kofooka, kwakanthawi kochepa ndipo sikunafunike kusokonezedwa kwa chithandizo. Kuwonjezeka kwakukulu kwamankhwala (kupitirira katatu kuchulukirapo kuposa kwawonekera) kwa ma seramu transaminases kunachitika mu 0.8% ya odwala omwe amatenga atorvastatin. Kuchuluka kumeneku kunali kodalira mlingo komanso kusintha kwa odwala onse.
Kupitilira kokwana katatu kwa malire obiriwira achilengedwe a serum creatine kinase (CC) anawona mu 2,5% ya odwala omwe amatenga atorvastatin, chizindikiro chofananira chimawonedwa pamayeso azachipatala komanso a HMG-CoA reductase inhibitors. Kuchulukitsa kochulukirapo kopitilira muyeso wabwinobwino kunachitika mu 0.4% ya odwala omwe atorvastatin.
Mbalizochita mwa ana
- kuchuluka kwa ALT, kuchuluka kwa creatine phosphokinase m'mwazi
Kutengera ndi zomwe zilipo, zitha kuganiziridwa kuti kusinthasintha, mtundu ndi zovuta za zochita za ana zomwe zikuchitika atorvastatin ndizofanana ndi akuluakulu. Pakadali pano, pali chidziwitso chochepa cha chitetezo chautali cha mankhwalawa kwa odwala.
Contraindication
- hypersensitivity ku zilizonse za mankhwala
- yogwira chiwindi matenda kapena kuchuluka kwa ntchito za ma seramu transaminases (ochulukirapo katatu poyerekeza ndi malire apamwamba)
- Odwala chiberekero cha lactose tsankho, kuchepa kwa puloteni ya LAPP-lactase, malabsorption wa shuga-galactose
- kutenga pakati ndi kuyamwa, komanso azimayi a zaka zakubala omwe sagwiritsa ntchito njira zoyenera zakulera
- ana osakwana zaka 10
Zochita zamankhwala osokoneza bongo
Zotsatira za kutumikiridwa mankhwala mogwirizana ndi atorvastatin
Atorvastatin imapangidwa ndi cytochrome P4503A4 (CYP3A4) ndipo ndi gawo lapansi la mapuloteni onyamula, mwachitsanzo, transporter ya hepatic - OATP1B1. Kugwiritsa ntchito munthawi yomweyo mankhwala omwe amaletsa CYP3A4 kapena mapuloteni onyamula zinthu kungayambitse kuchuluka kwa atorvastatin m'madzi a m'magazi ndikuchulukitsa chiopsezo cha myopathy.
Komanso, chiwopsezo chitha kuchuluka ndikumamwa atorvastatin ndi mankhwala ena omwe angayambitse myopathy, mwachitsanzo, ndi zotumphukira za fibric acid ndi ezetimibe.
Ma CYP3A4 ma inhibitors amphamvu akuwonetsedwa kuti akuwonjezera kwambiri kuzungulira kwa atorvastatin. Kugwiritsa ntchito munthawi yomweyo ma CYP3A4 zoletsa zamphamvu (mwachitsanzo, cyclosporine, telithromycin, clarithromycin, delavirdine, styripentol, ketoconazole, voriconazole, itraconazole, posaconazole ndi ma protein a zoletsa za HIV, kuphatikizapo ritonavir, lopinavir, pulinavin, lopinavir, lopinavir, lopinavir, lopinavir, lopinavir, lopinavir, lopinavir, lopinavir, lopinavir, lopinavir, lopinavir, lopinavir, lopinavir, lopinavir, lopinavir, lopinavir, lopinavir, lopinavir, . Ngati mothandizidwa ndi mankhwalawa atorvastatin sangapewe, mankhwala oyamba ndi apamwamba a atorvastatin ayenera kuchepetsedwa, ndikuyang'anira kuwunika koyenera kwa odwala.
CYP3A4 Zoletsa Zapakati
Ma CYP3A4 odziletsa (mwachitsanzo, erythromycin, diltiazem, verapamil ndi fluconazole) atha kuyambitsa kuchuluka kwa plasma kwa atorvastatin. Chiwopsezo chowonjezereka cha myopathy chimawonedwa mukamagwiritsa ntchito erythromycin kuphatikiza ndi ma statins. Kafukufuku wokhudzana ndi momwe mankhwalawa amathandizira pophunzira zotsatira za amiodarone kapena verapamil pa atorvastatin sizinachitike. Zinakhazikitsidwa kuti amiodarone ndi verapamil akuletsa ntchito ya CYP3A4, chifukwa chake, kugwiritsidwa ntchito kwawo ndi atorvastatin kungayambitse kuwonjezeka kwa machitidwe ake. Chifukwa chake, ndikofunikira kupereka mankhwala ochepera kwambiri a atorvastatin ndipo tikulimbikitsidwa kuti tizitsogolera odwala moyenera ngati akumamwa mankhwalawo ndi a CYP3A4 inhibitors. Kuwona koyenera kwamankhwala kumalimbikitsidwa pakukhazikitsidwa kwa mankhwala kapena mutatha kusintha kwa inhibitor.
Kukhazikika kwa munthawi yomweyo kwa atorvastatin ndi ma cytochrome P4503A inducers (mwachitsanzo, ndi efavirenz, rifampicin, St. wort wa St.) kungayambitse kuchepa kwakukulu kwa kuchuluka kwa atorvastatin mu plasma. Chifukwa chopanga kawiri-kawiri makina a rifampicin (kulowetsedwa kwa cytochrome P4503A ndi chopinga cha transporter cha mayamwa ndi chiwindi OATP1B1), kugwiritsa ntchito pamodzi kwa atorvastatin ndi rifampicin kwalimbikitsidwa chifukwa cha kuchuluka kwa rifampicin. Komabe, zotsatira za atorvastatin pa kuchuluka kwa ma rifampicin mu hepatocytes sizinakhazikitsidwe, chifukwa chake, ngati kugwiritsidwa ntchito mosavomerezeka sikungalephereke, kuyang'anira odwala kuyenera kuchitika ndi cholinga chakuchita bwino kwa mankhwalawa.
Mapuloteni Oletsa
Mapuloteni oyendetsa mapuloteni (mwachitsanzo, cyclosporine) akhoza kukulitsa zotsatira zonse za atorvastatin. Zomwe zimalepheretsa mayamwidwe aanthu omwe amayendetsa mankhwalawa ndi chiwindi pazowawa za atorvastatin mu hepatocytes sizikudziwika. Ngati chithandizo chogwirizana sichingalephereke, tikulimbikitsidwa kuti muchepetse muyezo ndikuyang'anira kuwunika kwamankhwala moyenera.
Gemfibrozil / fibroic acid zotumphukira
Fibrate monotherapy nthawi zina imayambitsa mavuto mu minofu, kuphatikizapo rhabdomyolysis. Izi zitha kuwonjezeka ndi kugwiritsidwa ntchito palimodzi kwa fibroic acid ndi atorvastatin. Ngati kugwiritsa ntchito mosagwirizana sikungalephereke, kuti mukwaniritse cholinga chamankhwala, ndikofunikira kupereka mankhwala ochepa kwambiri a atorvastatin ndikuwunika odwala moyenera.
Ezetimibe monotherapy imayambitsa mavuto mu minofu, kuphatikizapo rhabdomyolysis. Chifukwa chake, chiwopsezochi chitha kukulira chifukwa cha kugwiritsidwa ntchito kofananira kwa ezetimibe ndi atorvastatin. Kuyang'anira koyenera kwa odwala kotereku ndikulimbikitsidwa.
Kuchuluka kwa atorvastatin ndi metabolites yake yogwira mu plasma inali yotsika (pafupifupi 25%) poyerekeza ndi concomitant mankhwala omwe ali ndi colestipol ndi atorvastatin. Zokhudza milomo ya lipids zinali zokulirapo ndi makonzedwe apakati pa atorvastatin ndi kukonzekera kwa colestipol poyerekeza ndi mlingo wa monotherapy ndi mankhwalawa.
Kafukufuku wokhudzana ndi atorvastatin ndi fusidic acid sanachitike. Monga momwe zimakhalira ndi ma statins ena, panthawi yolembetsa pambuyo polembetsedwa ndi mankhwala a atorvastatin ndi fusidic acid, mavuto a minofu adadziwika, kuphatikizapo rhabdomyolysis. Makina a kulumikizanaku sakudziwika. Odwala ayenera kuyang'aniridwa kwambiri, ndipo nthawi zina, kuyimitsa kwakanthawi makonzedwe a atorvastatin.
Ngakhale kuti palibe kafukufuku wokhudzana ndi atorvastatin ndi colchicine omwe adachitika, milandu ya myopathy idanenedwa ndi chithandizo chofanana ndi atorvastatin ndi colchicine, chifukwa chake kusamala kuyenera kuchitika popereka atorvastatin ndi colchicine.
Zotsatira za atorvastatin pa mankhwala ogawana
Pogwiritsa ntchito mitundu yambiri ya digoxin ndi 10 mg ya atorvastatin, kuchuluka kwa magawo a digoxin kumawonjezeka pang'ono. Odwala omwe amatenga digoxin amayang'aniridwa ndi achipatala.
Kugwiritsa ntchito pamodzi kwa atorvastatin ndi kulera kwapakamwa kumayambitsa kuchuluka kwa plasma kwa norethindrone ndi ethinyl estradiol.
Palibe kuyanjana kwakukulu kwa atorvastatin ndi warfarin komwe kwapezeka.
Adanenedwa milandu yosowa kwambiri mogwirizana kwambiri ndi ma anticoagulants. Musanayambe chithandizo ndi atorvastatin komanso kupitilira pa chithandizo, ndikulimbikitsidwa kudziwa nthawi ya prothrombin mwa odwala omwe akutenga coumarin anticoagulants.
Ndikulimbikitsidwa kuti muchepetse koyamba mlingo ndikuwongolera odwala omwe akutenga atorvastatin ndi boceprevir nthawi yomweyo. Mlingo wa tsiku ndi tsiku wa atorvastatin sayenera kupitilira 20 mg pa nthawi yofanana ndi boceprevir.
Maphunziro okhudzana ndi mankhwala osokoneza bongo adachitika ndi akulu okha. Kukula kwa mankhwala osokoneza bongo mwa ana sikudziwika. Zizindikiro za kuyanjana kwa akuluakulu zimafotokozedwera, chifukwa chake, popereka ana, "Malangizo apadera" ayenera kukumbukiridwa.
Kupanga ndi mawonekedwe a kumasulidwa
Mankhwalawa amapezeka mwanjira ya mapiritsi amtundu woyera kapena wapafupi kwambiri ndi utoto woyera, womwe umakhala wokutidwa ndi utoto wamafilimu, ndi biconvex ndi chowulungika.
- Piritsi limodzi lili 40, 20 mg kapena 10 mg ya atorvastatin.
Gulu la zamankhwala ndi mankhwala: lipid-kuchepetsa mankhwala.
Malangizo apadera
Zochita pa chiwindi
Asanalandire chithandizo komanso nthawi yayitali akamaliza, maphunziro a ntchito ya chiwindi amayenera kuchitidwa. Komanso, kuyesa kwa chiwindi kuyenera kuchitidwa mwa odwala omwe ali ndi zizindikiro kapena zizindikiro zowonetsa kuwonongeka kwa chiwindi. Pakuwonjezereka kwa zomwe zili mu hepatic transaminases, mulingo wawo uyenera kuyang'aniridwa mpaka malire azomwe amapezeka. Ngati kuchuluka kwa transaminase kuchulukitsa kuchulukitsa katatu kuposa momwe kumakhalira kwakhazikika, tikulimbikitsidwa kuti muchepetse mankhwalawo kapena tichotseretu mankhwalawo.
Torvacard iyenera kugwiritsidwa ntchito mosamala odwala omwe amamwa mowa wambiri ndi / kapena omwe ali ndi mbiri yodwala matenda a chiwindi.
Odwala omwe ali ndi vuto la hemorrhagic kapena ofulumira ischemic.
Kwa odwala omwe adakumana ndi vuto la hemorrhagic kapena lacunar infarction yaubongo, kuchuluka kwa zoopsa ndi mapindu a 80 mg a atorvastatin ndizosatsimikizika. Odwala otere, asanayambe kulandira chithandizo, chiwopsezo cha hemorrhagic stroke chikuyenera kuganiziridwa mosamala.
Mafupa a minofu
Torvacard, monga zoletsa zina za HMG-CoA reductase, nthawi zina zimatha kukhudza minofu ya m'matumbo ndikupangitsa myalgia, myositis, myopathy, yomwe imatha kupita patsogolo ku rhabdomyolysis, matenda owopsa omwe amadziwika ndi kuchuluka kwakukulu kwa creatine phosphokinase (mu Kuchulukitsa kakhumi kuposa malire apamwamba (VGN), myoglobinemia ndi myoglobinuria, zomwe zingayambitse kulephera kwa aimpso.
Torvacard iyenera kugwiritsidwa ntchito mosamala kwa odwala omwe ali ndi vuto lotsogolera zochitika za rhabdomyolysis. Mlingo wa creatine phosphokinase (CPK) uyenera kuyezedwa musanachitike chithandizo ndi ma statins motere:
zovuta zamagulu obadwa nawo m'mbiri ya munthu kapena banja
mbiri ya poizoni wa minofu chifukwa cha mbiri ya statin kapena fibrate
mbiri yodwala matenda a chiwindi ndi / kapena kumwa kwambiri mowa
- odwala okalamba (zaka zopitilira 70), kufunika kwa izi kuyenera kuganiziridwanso poganizira kupezeka kwa zinthu zina zomwe zikuwonetsa kukonzekera kwa rhabdomyolysis.
- nyengo zomwe kuchuluka kwa zinthu zina zam'magazi zotheka, mwachitsanzo, ndi kulumikizana kwa mankhwala, komanso m'magulu apadera a odwala, kuphatikiza anthu omwe ali ndi matenda obadwa nawo.
Muzochitika zotere, chiopsezo cha chithandizo chikuyenera kuganiziridwa pokhudzana ndi zabwino zomwe zingatheke, ndikuwunika kuyangʻanira kuchipatala. Therapy sayenera kuyambitsidwa ngati milingo ya CPK ndi yokwera kwambiri (kuposa nthawi 5 kuposa VGN) yachibadwa.
Designine Kinase Level Measurement
Mlingo wa creatine phosphokinase (KFK) suyenera kuwerengedwa pambuyo pakuchita zolimbitsa thupi kwambiri kapena pamaso pa chifukwa china chofufutira cha KFK, chifukwa izi zimasokoneza kutanthauzira kwa mfundo zake. Ngati milingo ya CPK iposa kwambiri gawo loyamba (kuposa nthawi 5 kuposa VGN), kuti mutsimikizire zotsatira, bwerezaninso kafukufukuyu patatha masiku 5 mpaka 7.
Zidziwitso Zodwala
Odwala ayenera kuchenjezedwa za kufunika kofotokoza mwadzidzidzi kupweteka kwa minyewa, kukokana kapena kufooka, makamaka ngati akuphatikizidwa ndi malaise kapena malungo. Ngati zizindikirozi zinachitika pamankhwala a Torvacard, ndiye kuti miyezo ya CPK iyenera kuyesedwa. Ngati kuchuluka kwa CPK komwe kwapezeka kuliwonjezeka kwambiri (kuchulukitsa nthawi 5 kuposa malire apamwamba), zizindikiro za minofu ndizovuta ndipo zimayambitsa kusasangalala tsiku ndi tsiku, muyenera kulingalira kusokoneza chithandizo.
Ngati zizindikiro zikucheperachepera ndipo kuchuluka kwa CPK kwabwerera mwakale, kuganiziranso kuyenera kugwiritsidwanso ntchito ngati Torvacard kapena kugwiritsa ntchito mankhwala ena mosaposanso muyezo komanso mosamala.
Atorvastatin iyenera kusiyidwa ngati chiwonetsero chachikulu cha QC chikupezeka (kopitilira 10 times kuposa VGN), kapena ngati rhabdomyolysis kapena kukaikira kwamatenda apezeka.
Zogwirizanamankhwalawaenamankhwalaamatanthauza
Chiwopsezo cha rhabdomyolysis chimawonjezeka ndikugwiritsira ntchito atorvastatin nthawi yomweyo mankhwala ena omwe amatha kuwonjezera kuchuluka kwa atorvastatin m'madzi a m'magazi, mwachitsanzo, ndi ma CYP3A4 inhibitors kapena mapuloteni oyendetsa (monga cyclosporine, telithromycin, clarithromycin, delavirdine, styripentolaz, prriponaz, prriponaz, prriponaz, prriponon, striponaz. ndi ziletso za HIV za protease inhibitors, kuphatikizapo ritonavir, lopinavir, atazanavir, indinavir, darunavir, saquinavir, fosamprenavir, etc.). Kuphatikiza apo, chiwopsezo cha myopathy chitha kuwonjezera ndi kugwiritsa ntchito nthawi imodzi ya gemfibrozil ndi zina zotuluka za fibroic acid, boceprevir, erythromycin, niacin ndi ezetimibe, telaprevir, kapena kuphatikiza kwa tipranavir / ritonavir. M'malo mwa mankhwalawa, ngati zingatheke, lingalirani za kupereka mankhwala ena (osagwirizana).
Osanenedwapo kwambiri immune-mediated necrotic myopathy (IONM) pa nthawi ya mankhwala a statin kapena atatha. IONM nthawi zambiri imadziwika ndi kufooka kwa minofu kosalekeza ndikuwonjezereka kwa ntchito ya serum creatine kinase, yomwe ikupitilira ngakhale kuti imayimitsa mankhwala a statin.
Ngati kugwiritsa ntchito mankhwalawa mogwirizana ndi atorvastatin ndikofunikira, zopindulitsa ndi zoopsa za concomitant therapy ziyenera kuphunziridwa mosamala. Ngati odwala amamwa mankhwala omwe amachulukitsa plasma ndende ya atorvastatin, tikulimbikitsidwa kuti athetse mlingo wapamwamba wa atorvastatin. Pankhani yogwiritsa ntchito ma CYP3A4 inhibitors, ndikofunikira kupatsa mlingo woyambirira wa atorvastatin, ndikulimbikitsidwanso kuti aziwunikira oyang'anira awa.
Kugwiritsa ntchito munthawi yomweyo mankhwala a atorvastatin ndi fusidic acid osavomerezeka, chifukwa chake, atorvastatin mankhwala amatha kuyimitsidwa kwakanthawi pamankhwala a fusidic acid.
Kugwiritsa ntchito kwa ana
Chitetezo cha mankhwalawa komanso zotsatira zake pa chitukuko cha ana sizinakhazikitsidwe.
Matenda am'mapapo
Zochitika zapafupipafupi za matenda am'mapapo a m'mimba zimanenedwapo ndi kugwiritsidwa ntchito kwa nthawi yayitali kwa ma statin ena. Zizindikiro zotsatirazi zidawonedwa: kupuma movutikira, chifuwa chosabereka komanso kuwonongeka mu thanzi (kutopa, kuchepa thupi, komanso kutentha thupi). Ngati mukukayikira kuti wodwalayo ali ndi matenda a m'mapapo ochepa, chithandizo cha statin chiyenera kusiyidwa.
Umboni wina ukusonyeza kuti ma statins monga gulu la mankhwala amawonjezera glucose wamagazi, ndipo mwa odwala ena omwe ali ndi chiopsezo chachikulu cha matenda ashuga, hyperglycemia amatha kufikira momwe angapangire kuti apatsidwe mankhwala a shuga. Komabe, chiwopsezochi chikutha chifukwa cha kuchepa kwa chiwopsezo chotenga matenda amitsempha mothandizidwa ndi ma statins ndipo, chifukwa chake, sichiyenera kukhala chifukwa choletsa kulandira chithandizo ndi ma statins. Kuyang'anira odwala omwe ali pachiwopsezo (kusala kudya glucose wa 5.6-6.9 mmol / l, BMI> 30 kg / m, triglycerides okwera, matenda oopsa) kuyenera kuchitidwa ndi njira zonse zamankhwala komanso zamankhwala amitundumitundu molingana ndi kuyambitsa mayiko.
Kugwiritsa ntchito msuzi wamphesa yambiri mutamwa atorvastatin sikulimbikitsidwa.
Torvacard muli lactose monohydrate. Odwala omwe ali ndi chibadwa cha galactose osagwirizana, kuperewera kwa lappase kapena glucose-galactose malabsorption sayenera kumwa mankhwalawa.
Torvacard imaphatikizidwa ndi pakati. Amayi a msinkhu wobereka ayenera kutenga njira zoyenera zolerera panthawi ya mankhwala a Torvacard. Palibe kafukufuku wazachipatala wa atorvastatin mwa amayi apakati omwe adachitapo. Pali malipoti ochepa okhalitsa obwera pambuyo pakuwonekera kwa intrauterine ku HMG-CoA reductase inhibitors. Kafukufuku wazinyama awonetsa kuti mankhwalawa ali ndi poizoni pakubala.
Kuthandizira kwa amayi ndi atorvastatin kungachepetse kuchuluka kwa mealonate mwana wosabadwayo, komwe kumayambira kolesterol biosynthesis. Popeza atherosulinosis ndi njira yokhazikika, kuthetseka kwa lipid-kuchepetsa mankhwala panthawi yomwe ali ndi pakati sikungathandize pachiwopsezo chotenga nthawi yayitali chokhudzana ndi hypercholesterolemia. Chifukwa chake, Torvacard sayenera kumwedwa ndi amayi apakati, amayi omwe akukonzekera kukhala ndi pakati kapena akuganiza kuti ali ndi pakati. Kuchiza kwa Torvacard kuyenera kutha panthawi yovomerezeka, kapena mpaka kukhazikike bwino kuti mkaziyo alibe pakati.
Zambiri zakuti atorvastatin adachotsedwa mkaka wa munthu sizikupezeka. Mu makoswe, kuchuluka kwa atorvastatin ndi metabolites yake yogwira mu plasma ndi ofanana ndi kukhazikika kwawo mkaka. Chifukwa chazovuta zoyipa, azimayi omwe amatenga Torvacard sayenera kuyamwitsa. Atorvastatin ndi contraindicated pa mkaka wa m`mawere.
Zomwe zimachitika chifukwa cha mankhwalawa amatha kuyendetsa galimoto komanso njira zoopsa
Poganizira zovuta za mankhwalawa, kusamala kuyenera kugwiritsidwa ntchito poyendetsa magalimoto ndi njira zina zowopsa.
Zotsatira za pharmacological
Mankhwala a Torvacard, kukhala mpikisano wosankha wa HMG-CoA reductase, kumabweretsa kuchepa kwa cholesterol yamagazi. Torvacard imathandiza poyerekeza ndi maziko a homozygous Famer hypercholesterolemia, omwe nthawi zambiri samatha kuchiritsidwa ndi mankhwala ena.
Njira yodziwika yochizira imawonedwa pambuyo pa masabata 1.5-2, ndipo pazofunikira - pambuyo mwezi umodzi. Komanso, mtsogolomo, zotsatira za mankhwalawa zimasungidwa.
Malangizo ogwiritsira ntchito
Torvacard iyenera kumwedwa pakamwa nthawi iliyonse yabwino masana, mosasamala chakudya. Asanapange mankhwala, wodwalayo amalimbikitsidwa kuti azidyetsa zakudya zochepetsa lipid, zomwe ayenera kutsatira nthawi yonse ya chithandizo.
Mlingo umasankhidwa payekhapayekha, poganizira zisonyezo zoyambirira za LDL-C, cholinga cha chithandizo ndi zomwe wodwalayo amayankha.
- Mlingo woyambirira ndi pafupifupi 10 mg 1 nthawi / tsiku. Mlingo umasiyana 10 mpaka 80 mg 1 nthawi / tsiku. Mankhwala amatha kumwa nthawi iliyonse masana, mosasamala nthawi yakudya. Mlingo umasankhidwa poganizira magawo angapo a LDL-C, cholinga cha mankhwala ndi zotsatira zake. Kumayambiriro kwa chithandizo chamankhwala ndi / kapena pakuwonjezeka kwa mlingo wa Torvacard, ndikofunikira kuyang'anira kuchuluka kwa plasma lipid masabata onse a 2-4 ndikusintha mlingo moyenerera. Pazipita tsiku lililonse 80 mg mu 1 mlingo.
- Ndi hyperlipidemia yosakanikirana ndi hypercholesterolemia yoyamba, monga lamulo, mlingo wa 10 mg kamodzi patsiku wokwanira, phindu lalikulu la chithandizo limawonedwa pambuyo pa masabata awiri. Pambuyo pa milungu 4, chithandizo chokwanira kwambiri chimawonetsedwa, chomwe chimapitirira ndi chithandizo cha nthawi yayitali.
A kutchulidwa achire zotsatira zimachitika pokhapokha masabata awiri amtundu wa chithandizo cha Torvacard, ndipo pazofunikira - patatha mwezi umodzi. Malinga ndi ndemanga ya Torvacard kuchokera kwa odwala, kugwiritsa ntchito mankhwalawa kwa nthawi yayitali, zotsatira zake achire zimasungidwa.
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| Pafupifupi kupezeka kwa mphutsi akuti KUDULA mkamwa! Kamodzi patsiku, kumwa madzi ndi dontho .. Zambiri zaukadauloZomwe zimapangidwira pafomu yotulutsidwa zafotokozedwa mwatsatanetsatane mu malangizo apalendala a Torvacard. Kuchokera pamenepo mutha kudziwa kuti mankhwalawa ali piritsi la piritsi, piritsi limakhala lakutidwa ndi kanema wochepa thupi wa chakudya. Nthawi zambiri, mawonekedwe ake ndi oyera kapena pafupi kwambiri ndi utoto uwu. Chigawo chapadera chimakhala ndi mawonekedwe ozungulira, mawonekedwe a mbali zonse ziwiri. Chofunikira chachikulu chopezeka piritsi lililonse ndi molekyulu ya calcium ya atorvastatin. Potengera statin yoyera, mwachitsanzo muli 10, 20 kapena 40 mg ya yogwira ntchito. Mlingo weniweniwo sunangotchulidwa m'zolemba zokha, komanso kunja kwa phukusi. Inalembanso kuchuluka kwa mapiritsi omwe ali mkati.
BongoZizindikiro zotsatira zoyipa. Chithandizo: palibe mankhwala apadera. Ngati bongo wa Torvacard wapezeka, chithandizo cha wodwalayo chikuyenera kukhala chazizindikiro, kuyesa kwa chiwindi chogwira ntchito kuyeneranso kuchitidwa ndipo milingo ya serum CPK iyenera kuyang'aniridwa. Popeza atorvastatin imamangilira mapuloteni a plasma, hemodialysis siyothandiza. Analogs TorvakardZofanana muzochitika zamagulu:
Chidwi: kugwiritsa ntchito ma fanizo kuyenera kuvomerezana ndi adokotala. Mtengo wapakati wa mapiritsi a TORVACARD m'masitolo ogulitsa mankhwala (Moscow) ndi ma ruble 300. Mlingo ndi makonzedweAsanalandire chithandizo, wodwala amakulimbikitsidwa kuti azitsatira zakudya zomwe zimachepetsa lipid, ndipo nthawi yonse ya chithandizo iyenera kutsatiridwa. Torvacard iyenera kumwedwa pakumwa nthawi iliyonse masana, osanenapo chakudya. Dokotala amasankha mlingo wogwira ntchito malinga ndi zomwe akuwonetsa, momwe muliri wa LDL-C ndi mtundu wa mankhwalawo. Mlingo woyamba, monga lamulo, ndi 10 mg kamodzi patsiku. Achire achire atha kusiyana 10 mpaka 80 mg mu 1 mlingo. Mlingo wovomerezeka kwambiri ndi 80 mg / tsiku. Kumayambiriro kwamankhwala, masabata awiri aliwonse a 2 ndi / kapena kuchuluka kulikonse, ndikofunikira kuwongolera kuchuluka kwa plasma ndipo, kutengera zotsatira zake, sinthani mlingo wa atorvastatin ngati kuli kofunikira. Ndi hypercholesterolemia yoyamba ndi hyperlipidemia yosakanikirana, odwala ambiri amafunikira 10 mg kamodzi patsiku. Mphamvu yotchulidwa ikuwonekera pakutha kwa sabata lachiwiri la chithandizo, pazofunikira - pambuyo pa masabata anayi. Ndi chithandizo cha nthawi yayitali, izi zimapitirira. Ndi homozygous achibale hypercholesterolemia, mlingo wokwanira tsiku lililonse wa 80 mg nthawi zambiri umafunika. Kuyanjana kwa mankhwala osokoneza bongoNdi munthawi yomweyo makonzedwe omwe amakhala ndi aluminium hydroxide kapena magnesium hydroxide, kuchuluka kwa atorvastatin m'madzi a m'magazi kumatha kuchepa, komabe, kuchepa kwa milingo ya LDL-C sikusintha. Torvacard imawonjezera mphamvu ya mankhwala omwe amachepetsa kuchuluka kwa mahomoni amkati, kuphatikizapo ketoconazole, cimetidine, spironolactone, motero ayenera kusamala popereka mankhwala. Atorvastatin imakulitsa kuchuluka kwa njira zakulera zamkamwa zomwe zimakhala ndi ethinyl estradiol ndi norethindrone (pofika 20% ndi 30%, motsatana), zomwe ziyenera kuganiziridwa posankha njira zakulera za akazi. Pamene atorvastatin imagwiritsidwa ntchito limodzi ndi colestipol, ndende ya plasma yam'mbuyo imachepa pafupifupi 25%, komabe, lipid-yotsitsa kuphatikiza kumeneku kumakhala kwakukulu kuposa komwe mukamamwa mankhwalawa mosiyana. Mankhwala omwe amalepheretsa kagayidwe koyendetsedwa ndi CYP450 isoenzyme 3A4 ndi / kapena kayendedwe ka mankhwala, mankhwala antifungal kuchokera ku gulu la azole, fibrate, erythromycin, nicotinamide, nicotinic acid, clarithromycin, cyclosporine, mankhwala a immunosuppressive amachititsa kuchuluka kwa atorvastatin chifukwa cha plasma, plasma, plasma, plasma chifukwa cha plasma. mwayi wokhala ndi myopathy ukuwonjezeka. Kugwiritsa ntchito nthawi yomweyo kuphatikiza kotereku ndizotheka pokhapokha kuwunika zoopsa zomwe zingachitike. Kuchiza kuyenera kuchitika moyang'anitsitsa matendawo kuti muzindikire ululu kapena kufooka m'misempha yake munthawi. Ndikofunikira kudziwa nthawi ndi nthawi ntchito ya CPK. Tiyenera kukumbukira kuti kuwongolera kotereku sikulepheretsa kukula kwa myopathy yayikulu. Ndi kuwonjezeka kutchulidwa mu ntchito za CPK, kukayikira kwa myopathy, Torvacard yathetsedwa. Mukamagwiritsa ntchito atorvastatin tsiku lililonse 10 mg imodzi ndi digoxin, plasma ndende yomaliza siyisintha. Komabe, ngati atorvastatin amatengedwa mu mlingo wa tsiku ndi tsiku wa 80 mg, mlingo wa digoxin ukuwonjezeka pafupifupi 20%. Chifukwa chake, kuphatikiza koteroko kungathe kufotokozedwa pokhapokha ngati pakuyang'anitsitsa momwe wodwalayo alili. Ma Analogs a Torvacard ndi awa: Atoris, Liprimar, Atorvastatin, Atorvastatin-Teva. Kutenga?Asanayambe kumwa mankhwalawa, wodwalayo ayenera kuyamba kutsatira zakudya zotsitsa lipid. Mankhwalawa amatha kuyamba ndi mlingo wa 10 mg ya mankhwalawa kamodzi patsiku. Mlingo umatha kusinthidwa mkati mwa 10-80 mg / tsiku. Mankhwalawa amatha kugwiritsidwa ntchito nthawi iliyonse masana, mosasamala chakudya. Pakati pa mankhwalawa hyperlipidemia ndi 10 mg / tsiku. The achire zotsatira kumwa mankhwala amadziwika pambuyo 1.5-2 milungu. Pazipita ntchito ya mankhwalawa zimawonedwa pakatha milungu 4. Ndi chithandizo cha nthawi yayitali, zotsatira zake sizikutayika.
Mankhwala Okhala Pamalo a PharmacyMutha kugula mankhwala kokha mwa mankhwala. M'malo ogulitsa mankhwala achi Russia, mtengo wa cholesterol regule umayamba pa ma ruble 299. pa paketi 30 yamapiritsi. Monga cholowa mmalo mwa mankhwalawa, mutha kusankha zida izi:
Olga Alekseeva (wochiritsa), wazaka 43, Pervouralsk. Mankhwala a hypolipidemic akhazikika bwino mafuta a cholesterol ndi LDL. Kwa nthawi yonse yomwe ndimapereka mankhwala kwa odwala anga, sindinawone zomwe zimachitika. M'pofunika kugwiritsa ntchito mapiritsi nthawi zonse kuyambira milungu inayi mpaka isanu ndi umodzi. Kugwiritsa ntchito kwakanthawi kochepa sikothandiza. Ndi kusankha kwa mankhwalawa palibe mavuto. Ndikwabwino kumwa mankhwalawa. Mtengo wa mankhwalawo umavomerezeka mokwanira ndi kukhathamiritsa kwake kwakukulu. Irina Gorbunkova, wazaka 39, Salsk. Pafupifupi ochepa, "ndatsitsidwa" ndi cholesterol yotsitsidwa. Posachedwa ndidaganiza zoyamba kuthetsa vutoli polumikizana ndi dokotala. Katswiri wodziwika ndi amene adapereka mapiritsiwo. Adatenga molingana ndi Mlingo woyenera, adayesetsa kuti asaphonye phwando. M'milungu iwiri yoyambirira tulo tanga tinabwinobwino, ndipo chifukwa chake, ndinasintha. Mankhwalawa amagwira ntchito. Sindikudandaula ndalama zomwe zawonongeka. Nikolai Kozhevnikov, wazaka 51, Taganrog. Ndinapita kwa adotolo ndikudandaula za kuwawa mtima. Pambuyo pa kufufuza, kunapezeka kuti mulingo wa cholesterol m'thupi mwanga ndi wabwinobwino. Adotolo adauza mankhwalawa. M'masiku oyambilira, kupanikizika kudumpha pang'ono, koma zonse zidatha. Cholesterol pang'onopang'ono idabwezeretseka. Kutalika kwa njira ya achire anali 4,5 miyezi. Zinaida Chistyakova, wazaka 50, Togliatti. Ndinapita kuchipatala, komwe ndinapezeka kuti anali ndi cholesterol yayikulu (pafupifupi 6.8). Adotolo adandipatsa mankhwalawa. Patatha mwezi umodzi, cholesterol inabweranso mwakale. Mtengo wa chinthucho umandikwanira, chifukwa ndi wofulumira komanso wokhalitsa. Igor Zemlyakov, wazaka 47, Syzran. Ndidagwiritsa ntchito mapiritsi kupewa myocardial infarction molimbikitsidwa ndi dokotala. Ngati sichinali cha mankhwalawa, ndiye kuti chithandizo changa chachedwa kwa nthawi yayitali, motero ndidamwa kwa milungu itatu yokha. About zikuchokera zambiriPopanga chinthu, wopanga amapaka zina zowonjezera. Ndikofunikira kwambiri kwa anthu omwe ali ndi vuto la kusalolera kapena sayanjana ndi zinthu zilizonse zomwe zimapezeka mumafakitale azamankhwala kuti adziwe mndandanda wonse. Wopanga amatha kusintha mawonekedwe ake molingana ndi zowonjezera zina, chifukwa chake, ndikofunikira kuti muwerenge gawo ili mwatsatanetsatane pogula phukusi lililonse latsopano, ngati pali chifukwa choopera kuwonetsa kusakhudzidwa. Nthawi zambiri, mapiritsi a Torvacard amakhala ndi wowuma ndi talc, mapadi ndi lactose, komanso mankhwala a sodium ndi magnesium monga zida zothandizira. Wopanga amagwiritsa ntchito carmellose, hyprolose, silicon mankhwala. Kupanga chipolopolo, ma molekyulu a titaniyamu, hypromellose ndi macrogol adagwiritsidwa ntchito. PharmacologyKufotokozera kwamomwe zochita zamankhwala zimathandizira kudziwa chifukwa chake mapiritsiwa amathandizira. "Torvacard" ndi m'gulu la zipid zotsitsa lipid. Amasankha zoletsa za GMG-CoA mosankha. Enzyme yomwe yatchulidwa imakhudzidwa pakusintha kwa coenzyme A kukhala acidic acid yoyamba ya mankhwala omwe amaphatikiza cholesterol. Kuphatikizika kwake kumapanikizidwa, ndipo izi zimalepheretsa mapangidwe a atherosulinotic malo m'makoma a mitsempha. Chiwindi cha munthu ndi gawo lachitukuko cha zamankhwala am'madzi am'mitima ya magazi zomwe zimachitika panthawi yomwe cholesterol, triglycerides imakhala gawo la lipoprotein otsika kwambiri. Kenako amalowa mkati mwa ziwalo zozungulira ndipo amayenda kudutsa zotumphukira. Zinthu zochepetsetsa kwambiri zimasinthidwa kukhala lipoprotein panthawi yomwe ikukhudzana ndi ma receptor. Kugwiritsa ntchito atorvastatin kumathandizira kuchepetsa zomwe zimakhala m'mafuta a cholesterol ndi lipoprotein mu seramu yamagazi, chifukwa ma molekyulu a enzyme amalepheretsa, m'badwo wazinthu zoyipazi ndi ma cell a chiwindi umaletsedwa. Nthawi yomweyo, kuchuluka kwa zolimba kwambiri za lipoprotein zolandila pamalo owonekera maselo kukukulira. Kugwidwa ndi catabolism yotsatira ya lipoproteins ndiyabwino kwambiri komanso mwachangu.
Atorvastatin: pharmacological nuancesKupezeka kwa atorvastatin mumankhwala kumakupatsani mwayi wofotokoza zingapo momwe "Torvacard" imalembedwa. Kodi mapiritsiwa amathandizira bwanji? Pochepetsa kuchuluka kwa cholesterol, mankhwalawa nthawi yomweyo amachepetsa chiopsezo cha kugunda kwa mtima, sitiroko ndi zina zambiri zoopsa. Zotsatira za atorvastatin zimafooketsa m'badwo wa lipoproteins wotsika. Pakadali pano, zochitika za ma receptor pamtunda wam'manja zikuchulukirachulukira ndipo zimakhazikika. Zomwe zili m'mapangidwe ocheperako amachepera ndi homozygous hypercholesterolemia, ngati wina wapanga m'mabanja.Zadziwika kuti matenda amtunduwu ndi ovuta kuwongolera kudzera pazinthu zina zomwe zimapangitsa kuchepetsa mankhwala a lipid. Kugwiritsa ntchito mankhwalawa kumathandizira kuchepetsa kuchuluka kwa cholesterol ndi wachitatu, nthawi zina kuchepa kumafika 46%. Zida zotsika kwambiri zimakhala 40-60% zochepa. Monga momwe gulu loyesera lidawonetsera, mtundu wa B-apolipoprotein m'madongosolo ozungulira umapezeka mu ndende imodzi kapena theka kwambiri kuposa oyambayo. Triglycerides voliyumu imachepetsedwa ndi 14-33%. Mapiritsi a Torvakard amachititsa kuti zigawo za cholesterol zikuluzikulu. Kuwonjezeka kwa zomwe zili pa A-mtundu apolipoprotein kumawonedwa. Ndi chibadwa chodziwikiratu cha hypercholesterolemia cha mtundu wina wa homozygous, kugundika kwa zigawo zochepa kumatsika molingana ndi mlingo womwe umagwiritsidwa ntchito.
WogulitsaMutatha kumwa mapiritsi a Torvakard, chinthu chachikulu chimamwidwa ndi magwiridwe antchito ambiri. Kuchuluka kwa ndende kuzungulira kwadongosolo kumalembedwa ola limodzi kapena awiri pambuyo pa utsogoleri. Mwa amayi, zimaposa zomwe zimachitika ndi wachisanu. Ngati munthu amamwa mowa mopitirira muyeso ndipo izi zimayambitsa matenda amitsempha yamagazi, kuchuluka kwambiri kwa mankhwala othandizira omwe amapezeka mu seramu yamagazi ndi kokwirikiza 16 kuposa muyezo. Gawo lalikulu la mapiritsi "Torvakard" 20 mg (ndi mitundu ina yotulutsira) chibadwa cha bioavailability pafupifupi 12%. Zosakhazikika zokhala ndi zoletsa zochitika zimafika 30%. Zizindikiro zazing'ono zoterezi zimachitika chifukwa cha zochita za pang'onopang'ono kagayidwe kake m'matumbo ndi matumbo a mucous ndi gawo lalikulu la hepatic. Kodi chikuchitika ndi chiani mthupi?Kugwiritsa ntchito mapiritsi a Torvacard kumaphatikizidwa ndikumangiriza kwa yogwira pophika ndi mapuloteni a Whey. Mwachidziwikire, luso la njirayi likufika 98%. Voliyumu yapakati yogawa atorvastatin ndi 381 malita. Njira zosinthira zomwe zimagwira zimapangidwira m'chiwindi. Zimachitikira ndikupanga nawo ma enzymes CYP3A4, CYP3A5, CYP3A7. Zotsatira zake, zinthu zomwe zimapangidwa zimapangidwa zomwe zimadziwika ndi ntchito ya pharmacological. M'malo olembetsera, mphamvu ya metabolites ya HMG-COA idapezeka kuti ili pafupi ndi zomwe zasonyezedwa ndi statin yoyambayo. The inhibitory reductase pafupifupi 70% imachitika makamaka pazinthu zomwe zimapangidwa nthawi ya metabolin ya statin. Zinthu izi zimazungulira kwa nthawi yayitali mthupi.
KuthetsaAtorvastatin wopezeka 40 mg, 20 mg kapena 10 mg mapiritsi a Torvard amachotsedwa ndi matumbo a chikhodzodzo. M'mbuyomu, zinthu zimachitika mu chiwindi kapena kunja kwa chiwalo. Statin ilibe kuzindikirika kwamatumbo kapena chiwindi. Mphamvu yoletsa kupumira kwa GMG-COA imakhazikitsidwa kwa maola 20-30. Kutalika kumachitika chifukwa cha zochita zama metabolic. Osapitirira 2% ya zinthu zazikulu zomwe adalandira amapezeka mkodzo. Kuyika magazi m'magazi sikugwira ntchito pakufukula kwa atorvastatin kapena zinthu zosintha m'thupi la munthu. Zithandiza liti?10, 20 kapena 40 mg mapiritsi a Torvacard okhala ndi kantheya kameneka amagwiritsidwa ntchito pochizira anthu omwe ali ndi cholesterol yambiri mthupi. Mankhwala amatchulidwa kuti ndi imodzi mwazomwe zimapangidwira m'njira zambiri. Ndikofunikira kuphatikiza mankhwala ogulitsa mankhwala ndi zakudya zapadera. Cholinga cha mankhwalawa ndikuchepetsa kuchuluka kwa cholesterol yokwanira komanso yotsika, komanso B-mtundu apolipoprotein. Mankhwalawa amathandizira kuchepetsa seramu triglycerides. Chizindikiro china cha chithandizo ndikuwonjezera zomwe zili pachiwopsezo cha tizigawo ting'onoting'ono ta cholesterol. Pachifukwa ichi, mankhwala opangira mankhwala amalembedwa kwa anthu omwe ali ndi mtundu wosakanikirana wa hyperlipidemia. Komanso, akuvutika ndi matenda a mtundu woyamba hypercholesterolemia, mabanja a heterozygous osati otere. Mutha kugwiritsa ntchito kapangidwe ka matenda malinga ndi gulu la Fredrickson agulu la 2a, 2b. Mtundu wachinayi wa hyperlipidemia wa gulu lomweli, limodzi ndi kuchuluka kwa zinthu zomwe zimachitika mu triglycerides m'magazi amwazi, ndi chisonyezo chokhazikitsidwa ndi mapiritsi a Torvakard kuphatikiza zakudya zamagulu. Amaloledwa kugwiritsa ntchito mankhwalawa chifukwa cha dysbetalipoproteinemia, ndiko kuti, mtundu wachitatu wa matenda awa. Ndi matenda awa, atorvastatin ndikulimbikitsidwa pokhapokha ngati zakudya zokhazokha sizilola kuti zitheke. Monga mukumaliza kuchokera ku malangizo ogwiritsira ntchito mapiritsi a "Torvakard", mankhwalawa amayenera kugwiritsidwa ntchito ngati matenda a mtima ndi mitsempha yamagazi, komanso chifukwa cha zinthu zomwe zikuwonetsa kuchuluka kwa ischemia. Zizindikiro zimaphatikizapo:
"Torvacard" imagwiritsidwa ntchito kwa dyslipidemia. Mankhwalawa ndi chenjezo lachiwiri, amalembedwa kuti achepetse chiopsezo cha kufa, kugunda kwa mtima, sitiroko, kuchipatala chifukwa cha angina pectoris. Mankhwala othandizira amathandizira kuchepetsa mwayi wopatsanso mphamvu. Malangizo ogwiritsira ntchito mapiritsi a Torvacard tikulimbikitsidwa kuti muwagwiritse ntchito kuti muchepetse zomwe zimakhala ndi cholesterol yokwanira komanso yotsika mu mawonekedwe a banja. Zochizira homozygous hypercholesterolemia. Mankhwala amaperekedwa ngati pulogalamu ya zakudya ndi mankhwala ena sakusonyeza zotsatira zomwe mukufuna. Mankhwala ogulitsa mankhwala amagwira ntchito ngati njira yowonjezerapo yochepetsa lipid. Mutha kugwiritsa ntchito ngati wodwala akuwonetsedwa wa autohemotransfusion yamagazi komwe ma lipoprotein inclusions amachotsedwa. Mukufuna zochuluka motani?Asanapereke mapiritsi a Torvacard (20 mg kapena mtundu wina wa mankhwala), dokotala amapanga pulogalamu yamakudya. Cholinga chake ndikuchepetsa mafuta a nyama muzakudya. Ndikofunika kuti ndiyiyambitse masiku angapo isanayambike mankhwala. Ngati zakudya wamba sizigwira ntchito, zimaphatikizidwa ndi mankhwala opangira mankhwala. Nthawi yonse ya kumwa mankhwalawa iyenera kutsatira zoletsa zopatsa thanzi. Nthawi zambiri, chithandizo chimayamba ndi 10 mg amatengedwa kamodzi patsiku. Kenako, mlingo umakulitsidwa mpaka zitheke kusankha woyenera kwambiri kwa wodwala. Zomwe zimachitika tsiku ndi tsiku zili mgulu la 10-80 mg. Mavoliyumu onse omwe amaikidwa patsikuli ayenera kumamwa nthawi imodzi. Amaloledwa kugwiritsa ntchito nthawi iliyonse tsiku. Kulandila sikudalira chakudya. Kuti adziwe mlingo woyenera, dokotalayo amaganizira kuchuluka kwa kachulukidwe kakang'ono ka mafuta a kolesterol, kutsimikizira, zolinga zamankhwala komanso chiwopsezo cha thupi ku pulogalamu ya chithandizo. Nthawi zina kwa wodwala kwa miyezi itatu, phukusi limodzi lokhala ndi mapiritsi 90 a "Torvacard" (10 mg) ndi lokwanira. Pali nthawi zina pamene muyenera kugula kutulutsa kokwanira kwambiri (40 mg) ndi kumwa mapiritsi awiri kamodzi patsiku. Kuyamba kwa pulogalamu ya chithandizo ndi kuchuluka kwa mankhwalawa kuyenera kumayendera limodzi ndikuwunika pafupipafupi ma sabata angapo kapena mwezi. Dokotala amayang'ana mulingo wa lipids ndikuwongoletsa. Pamwamba 80 mg limaloledwa patsiku. Kupeza malamulo ndi malamuloKuti mankhwala azachipatala apereke zotsatira zabwino, ndikofunikira kuzigwiritsa ntchito moyenera. Ngati mukufuna kudziwa ngati zingatheke kugawa piritsi la "Torvakard" pakati, ndiye kuti wopanga savomereza izi. Osaphwanya umphumphu wa chipolopolo, popeza zomwe mkati mwake zimawonongeka mothandizidwa ndi hydrochloric acid omwe amapezeka m'matumbo am'mimba. Pazifukwa izi, kunja kwa piritsi sikukukhala pachiwopsezo. Pali mankhwala omwe ali ndi Mlingo wocheperako wogulitsa. Ndi omwe amafunikira kugwiritsidwa ntchito ngati njira yofooka ya pulogalamu ya mankhwala ikufunika. Pankhani ya hypercholesterolemia ya pulayimale komanso kuphatikiza hyperlipidemia, odwala ambiri amafunikira 10 mg kamodzi patsiku. Zotsatira zowunikira pulogalamuyi zitha kujambulidwa patatha milungu ingapo. Tikuwona zotsatira zabwino patadutsa mwezi umodzi chichitikireni pulogalamuyi. Zimapitirira ngati wodwala agwiritsa ntchito mankhwalawo kwa nthawi yayitali.
Malangizo onsePopeza madotolo, akufotokozera ngati kuli kotheka kugawa piritsi la "Torvacard" pakati, akulangizidwa kuti musapusitsidwe, muyenera kupenda malingaliro awo zokhudzana ndi chithandizo chamankhwala musanachitike ndikusankha mankhwalawo ndi mulingo woyenera wopezeka mu mankhwala. Tifunikira ndendende mtundu wa kumasulidwa koyenera pamlandu wina. Mukamasankha mlingo, dokotala adzakhazikika pamikhalidwe yomwe ilipo komanso magawo azofunikira zamagawo a cholesterol. Makamaka, ndi atherosulinosis, yomwe imatsagana ndi matenda ena, ndikofunikira kukwaniritsa zomwe zili ndi zigawo za 100. Pamaso pa zinthu zoopsa popanda atherosclerosis, mulingo woyenera kwambiri ndi magawo 130 kapena kuchepera. Pokhapokha pali matenda omwe atchulidwa komanso omwe ali pachiwopsezo, mtengo wolondola ndi magawo 160 kapena kuchepera. "Torvakard" imafotokozedwa ngati magawo oyambira ali akulu (motsatana) pamikhalidwe iyi: 130, 160, 190 magawo. Mdziko lathu, maphunziro adachitika ndi anthu omwe adapezeka kuti ali ndi mtundu wina wa hypercholesterolemia wa mtundu wa homozygous. Ngati odwala oterewa amalamula 80 mg ya atorvastatin tsiku ndi tsiku, zomwe zimakhala zamagawo ochepa a cholesterol zimatsika ndi 18-45%. Ndikofunikira kuyang'ana pazotsatira izi, kusankha mawonekedwe a pulogalamu ya achire. Tidasanthula kugwiritsa ntchito mapiritsi a Torvacard. Malangizowo akuwonetsa kuti chipangizocho chikuyenera kugwiritsidwa ntchito mkati, kunja kwa chakudya. Mwambo wapaderaAmaloledwa kugwiritsa ntchito mankhwalawa chifukwa cha kulephera kwa impso kapena ma pathologies apadera a chiwalochi. Zowonekera mwapadera, kusintha kwamalamulo ovomerezeka kapena mlingo sikufunika kwa anthu otere. Zovuta za impso sizimakhudza zomwe atorvastatin mu seramu yamagazi. Palibe kudalira mankhwala ndipo mavuto azaumoyo awa adadziwika. Palibe tanthauzo lenileni la mankhwalawo pakukalamba lomwe sanapezeke. Mapiritsi ochokera ku cholesterol "Torvakard" amatha kuperekedwa kwa anthu otero malinga ndi malamulo apadera. Palibe mulingo wodziwikiratu wogwira ntchito; zolinga zakuchiritsa zimakwaniritsidwa chimodzimodzi. Zotsatira sizimadalira zaka. Kodi zingandithandizire? NdemangaMalinga ndi ndemanga ndi malangizo ogwiritsira ntchito mapiritsi a "Torvakard" (chithunzi cha mankhwalawa chili munkhaniyi), mankhwalawa amaperekedwa nthawi zambiri. Inde, ambiri mwa anthu omwe timathandizira nawo amakumana ndi mavuto okhala ndi tizigawo ting'onoting'ono ta cholesterol m'thupi. Anthu omwe amagwiritsa ntchito ma statins moyang'aniridwa ndi dokotala wowachiritsa adawona kusintha kwabwino. Chokhacho chomwe chinayambitsa kusakhutira kwina chinali kufunika kwa kugwiritsa ntchito mankhwalawa kwa nthawi yayitali, nthawi zambiri. Ndemanga za mapiritsi "Torvakard" ochokera kwa anthu omwe amangokakamira kudya ma statins siabwino. Gululi la anthu nthawi zambiri limakumana ndi zovuta, kuphatikizapo zovuta kwambiri. Kuti musakhale pakati pawo, muyenera kugwiritsa ntchito mankhwalawa moyang'aniridwa ndi katswiri pofufuza pafupipafupi milingo yamagazi a lipid. Izi zikuthandizani kusankha mlingo woyenera komanso wotetezeka ndikuwonetsetsa kuti zotsatira zabwino za pulogalamuyi ndi zamankhwala. Zotsatira zoyipaMonga mungaphunzirire pa malingaliro ndi malangizo ogwiritsira ntchito mapiritsi a Torvakard, mankhwalawa amadzetsa mavuto. Ndiwosowa, komabe, pali mwayi wopanga, makamaka osagwiritsidwa ntchito molakwika komanso popanda kuwunika mwatsatanetsatane ndi katswiri. Anthu ambiri omwe amamwa mankhwalawa akuti amamva kupweteka mutu, kusanza, kusanza, komanso kupweteka. Kuwonongeka kapena kuchitika kwa chilakolako cha thupi, kupweteka ndi minofu kukokana. Pali ngozi yakuyiwalika. Nthawi zina pamakhala mavuto ena. Nthawi zina, odwala anali ndi kuwonjezeka kapena kuchepa kwa shuga m'magazi, kuwonjezeka kwa ntchito za CPK mu seramu ya madzi obwera. Ena amadandaula za kupweteka pachifuwa, kutupa kwa minofu. Kuwonongeka komwe kungachitike, kuchepa tsitsi, kuwonda kwambiri ndizotheka. Ena anazindikira kuti matenda ofooka amakhala osakwanira.
Nthawi zina simungatheKuphwanya lamulo polandila mankhwala omwe amapezeka pamwambapa ndi ntchito yayikulu ya ma enzymes a chiwindi mu madzi am'magazi popanda kudziwa zomwe zimapangitsa. Simungagwiritse ntchito "Torvakard" ngati matenda akulu a chiwindi akhazikitsidwa, kusakwanira kwa chiwalo ichi - milingo A kapena B malinga ndi dongosolo la Mwana-Pugh. Chida sichikugwiritsidwa ntchito pokhudzana ndi zovuta zingapo za pathological chifukwa cha chibadwa cha wodwalayo. Makamaka, Torvacard silingatengedwe ndi lactose tsankho kapena kusowa kwa lactase, malabsorption syndrome. Mankhwalawa sanapangidwire zochizira amayi apakati komanso oyamwa. Ngati mayi wa zaka zobereka akufunika mankhwala, "Torvacard" imangotchulidwa pokhapokha wodwala atagwiritsa ntchito njira zodalirika zolerera. Kuchita bwino komanso chitetezo popereka mankhwala kwa ana sichinadziwike, chifukwa chake, mankhwalawa sagwiritsidwa ntchito m'gulu lino. Contraindication ndi tsankho kwa chinthu chilichonse, kuphatikizapo zothandiza zomwe zimapezeka pamapiritsi. Zinthu zofunika kusamalaNdikofunikira kugwiritsa ntchito mosamala mankhwala ngati wodwala ali chidakwa. Nthawi zina anthu amafunsira dokotala ngati angathe kumwa mapiritsi a Haloperidol ndi mapiritsi a Torvakard. Mwambiri, mankhwalawa samalumikizana, koma njira yophatikiza ya mankhwala nthawi zonse imafunikira chidwi chowonjezera pamlingo wa wodwala. Ndikofunikira kuwunika nthawi zonse ntchito ya thupi la munthu, wokakamizidwa kutenga "Torvakard", ngati akudwala matenda a chiwindi m'mbuyomu, adakumana ndi kusowa kwamphamvu kwa mchere komanso kuthamanga kwamadzi m'thupi. Odwala omwe ali ndi kusokonezeka kwa metabolic ndi endocrine amafuna chidwi chochulukirapo. Mosamala, "Torvacard" imagwiritsidwa ntchito motsutsana ndi maziko a kuthamanga kwa magazi, sepsis, ndi matenda osakhazikika a khunyu. Makamaka olondola ayenera kukhala omwe akuchitidwa opaleshoni yayikulu, omwe alandidwa kuvulala kwambiri kapena omwe ali ndi matenda a shuga. Zowopsa zimagwirizanitsidwa ndi ma pathologies a minofu minofu yothandizira mafupa. Mimba komanso KuyamwitsaMonga tafotokozera pamwambapa, kutenga pakati, kuyamwa ndi njira zotsutsana zogwiritsira ntchito mapiritsi a Torvacard. Atorvastatin ndi yoletsedwa azimayi munthawi imeneyi, chifukwa cholesterol ndi mankhwala omwe amapangidwamo ndikofunikira kuti apangidwe mluza. Kuletsa kwa reductase HMG-COA kuli ndi zoopsa zambiri, osayeneranso phindu la kumwa mankhwalawo. Kugwiritsa ntchito lovastatin, komwe kumayandikira atorvastatin mikhalidwe ndi mawonekedwe ake, gawo lachitatu lokhalo, monga limadziwika, linatsagana ndi kubadwa kwa ana omwe ali ndi vuto la mafupa, fistulas, anus atresia. Ngati mimbayo ikawululidwa panthawi yomwe mukugwiritsa ntchito mapiritsi a Torvacard, muyenera kusiya kugwiritsa ntchito mankhwala omwe amapezeka monga mankhwala.Adotolo ayenera kukakamiza mayiyo za zoopsa zonse zomwe zingachitike chifukwa cha vutoli.
Kodi pali njira ina?Monga fanizo la mapiritsi a Torvakard, mankhwala omwe ali ndi gawo lomweli angagwiritsidwe ntchito. Pafupifupi mankhwala aliwonse am'nyumba, mungapeze mankhwala otsika mtengo a Atorvastatin. Ndi mankhwala ena okwera mtengo kwambiri kwa anthu wamba omwe ali ndi vuto lofananalo. Komabe, musanalowetse mankhwalawa, muyenera kaye kukambirana ndi dokotala. Kusintha kwodziyimira kwina pazamankhwala kungayambitse zosafunikira. Torvakard ili ndi mitundu yambiri. Monga njira ina yothandizira mankhwalawa, mutha kuganizira za kukonzekera "Atoris" ndi "Atomax", zofanana mu katundu komanso mphamvu yogwira thupi la munthu. Siyanitsani "Anvistat" ndi "Liptonorm." Nthawi zina Torvakard imaloledwa m'malo mwake ndi Liprimar kapena Lipoford. Kufikira pang'ono, mankhwalawa Tulip ndi Lipona ali ndi magawo ofanana.
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