Simvastatin: malangizo ogwiritsira ntchito, analogi, mitengo ndi malingaliro

Simvastatin ndi mankhwala okhala ndi milomo yotsitsa lipid. Pezani mankhwalawa pogwiritsa ntchito kaphatikizidwe kazinthu zopanga enzymatic metabolism ya Aspergillus terreus.

Kapangidwe ka mankhwala ndi mankhwala ndi mawonekedwe a lactone osagwira. Mwa kusintha kwamitundu iwiri, kuphatikiza cholesterol kumachitika. Kugwiritsa ntchito mankhwalawa kumalepheretsa kudziunjika kwa lipids wambiri m'thupi.

Mamolekyu amomwe amathandizira amachepetsa plasma wozungulira wa triglycerides, atherogenic tizigawo ta lipoproteins, komanso kuchuluka kwa cholesterol yonse. Kuponderezedwa kwa kaphatikizidwe ka liphero la atherogenic kumachitika chifukwa cha kuponderezedwa kwa mapangidwe a cholesterol mu hepatocytes komanso kuchuluka kwa ziwiya zolandila za LDL pa membrane wa cell, zomwe zimatsogolera ku kuyambitsa ndi kugwiritsa ntchito kwa LDL.

Zimawonjezeranso kuchuluka kwa lipoproteins yapamwamba kwambiri, kumachepetsa kuchuluka kwa ma atherogenic lipids kukhala antiatherogenic komanso kuchuluka kwa cholesterol yaulere pamagawo ochepa a antiatherogenic.

Malinga ndi mayesero azachipatala, mankhwalawa sayambitsa masinthidwe a ma cell. Mlingo wa kuyamba kwa achire zotsatira Kuyambika kwa kuwonekera kwa zotsatirazi ndi masiku 12-14, achire kwambiri pazomwe zimachitika mwezi umodzi atayamba kugwiritsa ntchito. Zotsatira zake zimakhala zokhazikika ndi kuchuluka kwa mankhwala. Mukasiya kumwa mankhwalawo, mulingo wa cholesterol amkati umabweranso muyeso wake woyambira.

Kapangidwe ka mankhwala ndikuyimiridwa ndi yogwira Simvastatin ndi zina zothandizira.

Katunduyo ali ndi mayamwidwe ambiri komanso otsika bioavailability. Kulowetsa magazi, kumangiriza ku albin. Wogwira mawonekedwe a mankhwalawa amapangidwira mwachindunji zamkati mwake.

Metabolism ya Simvastatin imapezeka mu hepatocytes. Ili ndi mphamvu ya "poyambira" kudzera m'magazi a chiwindi. Kutaya kumachitika kudzera m'migawo ya m'mimba (mpaka 60%) mwa mawonekedwe a metabolites osagwira. Gawo laling'ono la chinthu limatayidwa ndi impso mu mawonekedwe osakhazikika.

Mawonekedwe ndi kipimo

Simvastatin (INN ya radar - simvastatin) ndi chinthu chogwira ntchito chomwe chimaphatikizidwa mu mankhwala angapo amtundu wa opanga osiyanasiyana ndi chizindikiro pansi pa mayina osiyanasiyana (Zentiva, Vertex, Northern Star ndi ena, kutengera dzikolo). Pulogalamuyi ndi ya m'badwo wachitatu wama statins ndipo ndi othandizira kutsimikizira za lipid.

Patsamba lofufuza mankhwala mutha kupeza mankhwala okhala ndi dzina lofanana ndendende ndi yogwira ntchito - Simvastatin. Njira yotulutsira mankhwalawa ndi piritsi, imakhala ndi mabatani ozungulira a biconvex, wokutira ndi utoto wowonekera kapena yoyera. Kutengera ndi kuchuluka kwa ntchito yogwira, mapiritsi a Simvastatin amapezeka m'mitundu ingapo - 10 ndi 20 mg aliyense.

Cholesterol m'magazi a munthu imangopezeka mwa ma protein okhaokha. Mapangidwe oterewa amatchedwa lipoproteins. Mthupi muli mitundu ingapo ya mamolekyuwo - apamwamba, otsika kwambiri komanso otsika kwambiri (HDL, LDL ndi VLDL, motsatana). Zotsatira zoyipa za cholesterol yayikulu zimayamba kuwoneka ngati zimapezeka mu lipid metabolism. mwayi woonekeratu cha ku LDL, chotchedwa cholesterol choyipa "choyipa".

Zowonjezera zochizira za simvastatin zimatheka makamaka pochepetsa gawo ili la lipoproteins (LDL). Mwa kuletsa enzymatic unyolo wa HMG - Coenzyme A reductase, mankhwala omwe aphunziridwawo amachepetsa kuchuluka kwa mafuta mkati mwa maselo ndikuyambitsa ma receptors a otsopense ndi otsika kwambiri a lipoproteins (LDL ndi VLDL). Chifukwa chake, pathogenesis ya hypercholesterolemia imapangidwa ndi magawo awiri nthawi imodzi - cholesterol imadziwika bwino kwambiri ndi maselo ndipo imachotsedwera mwachangu kuchokera m'magazi ndi thupi lonse.

Poyerekeza ndi kuchepa kwa gawo lodetsa mafuta, milomo ya lipid imabwezeretseka ndipo kuchuluka kwa otsutsana, cholesterol yapamwamba, kumakulitsidwa pang'ono. Malinga ndi magwero osiyanasiyana, kuwonjezeka kwa HDL kumapeto kwa njira zamankhwala kudzachokeranso 5 mpaka 14%. Simvastatin samangoletsa cholesterol yoyipa, komanso vasoconstrictor zotsatira. Mankhwalawa amalepheretsa kusokonezeka kwa khoma la mtima, kumawonjezera kusokonekera kwake komanso kamvekedwe chifukwa cha antioxidant.

Chimodzi mwa malingaliro a chitukuko cha atherosulinosis ndi kutupa. Cholinga cha kutupa ndi gawo lofunikira lazoyang'anira zilizonse za endherheli. Simvastatin imakhala ndi antiproliferative athari, poteteza endothelium ku sclerotherapy, scarring ndi stenosis. Magulu angapo asayansi akuwonetsa kuti mankhwala oteteza ku endothelium amapangidwa mwezi umodzi atatha mankhwala.

Cholinga cha mankhwalawa chimachitika pokhapokha malinga ndi mawonekedwe okhwima, kusankha kwa mlingo ndi munthu payekha. Mlingo woyambira Nthawi zambiri 10 mg ndipo, malinga ndi odwala komanso madokotala, amalekeredwa bwino. Mlingo wapamwamba tsiku lililonse ndi 80 mg. Amawerengera zovuta za hyperlipidemic. Kwa odwala omwe ali ndi vuto la chiwindi kapena impso, mlingo waukulu ndi wochepa ndipo ndi 40 mg.

Zizindikiro zogwiritsidwa ntchito

Mankhwala Simvastatin ndi mankhwala ochizira zotsatirazi mikhalidwe ndi matenda:

• Hypercholesterolemia IIA ndi mitundu ya IIB malinga ndi gulu la Fredrickson. Ma Statin amatchulidwa ngati kusintha kwa kadyedwe, momwe mumakhalira ndi zina zomwe sizinabweretse mankhwala sizinabweretse zotsatira zochizira. Amathandizira ndi cholesterol yokhazikika yomwe ili pachiwopsezo chotenga matenda amtima wapamtima motsutsana ndi maziko a atherosulinosis a mitsempha ya mtima ndi mapangidwe.
• Kugwiritsa ntchito kovomerezeka pamiyeso yambiri osati zamagawo a cholesterol okha, komanso triglycerides. Chifukwa chamachitidwe a Simvastatin, ndizotheka kuchepetsa kuchuluka kwa TG (triglycerides) m'magazi pafupifupi 25%.
• Simvastatin ndi mankhwala osokoneza bongo kukonza popewa mtima ndi mtima mavuto - stroko, kugunda kwa mtima, atherosulinosis. Poyerekeza ndi momwe ntchito mankhwalawa imagwiritsidwira ntchito, mafuta a cholesterol pang'onopang'ono abwerera mwakale.

Kukonzekera kwa cholesterol konse kumakhala ndi chiwonetsero chapadera, mndandanda wambiri wazotsatira zoyipa ndi zotsutsana, chifukwa chake zitha kuperekedwa ndi dokotala mu mawonekedwe a mankhwala a Latin.

Contraindication

Monga mankhwala aliwonse, Simvastatin ali ndi zifukwa zingapo zoyeserera, zomwe ziyenera kupewa. Izi ndi monga:

• Gawo lokangalika la pathologies a hepatobiliary system, komanso kuwonjezereka kwa nthawi yayitali, kosawoneka bwino kwa hepatic transaminases yachidziwitso chosadziwika.
• Matenda a Myopathic. Chifukwa cha myotoxicity, simvastatin imatha kukulitsa matenda a minofu, kutsitsa rhabdomyolysis ndi kulephera kwaimpso pambuyo pake.
• Zaka za ana. Muzochita za ana, palibe zinachitikira ndi kugwiritsa ntchito mankhwalawa. Mu sayansi, palibe deta pa mbiri yotsimikizika ndi chitetezo cha Simvastatin kwa odwala ochepera zaka 18.
• Mimba komanso kuyamwitsa - palibe statin yomwe imagwiritsidwa ntchito pa cholesterol nthawi izi.

Mosamala kwambiri, simvastatin imalembedwa kwa anthu omwe amamwa mowa - kuphatikiza mowa mwa ma statins ndikotsika, aimpso ndi hepatic insufficiency amatha kukula mwachangu.

Zotsatira zoyipa

Kuchokera ku ziwalo zam'mimba thirakiti kumatha kupweteka kwam'mimba, kugwira ntchito kwa dyspeptic syndromes, nseru, kusanza, komanso kusokonezeka kwa chopondapo. Kugwiritsa ntchito mankhwalawa kungakhudze chiwindi mwachangu - malinga ndi malangizo, kuchuluka kwakanthawi kwa ma enzymes a chiwindi (magazi transaminases) ndikotheka.

Pakati ndi potumphukira mantha dongosolo akhoza kuyankha kugwiritsa ntchito simvastatin ndi chitukuko cha astheno-zomwera matenda ndi episode wa cephalgia, kutopa, kufooka, kusinthasintha kwa tulo, kusowa tulo, komanso chizungulire. Zotsatira zina zoyipa za Simvastatin zimaphatikizira kupindika kwa minofu (kupindika), kusokonezeka kwapumaso, kusintha kwa malingaliro.

Ndi chidwi chachikulu pa zinthu zomwe zingagwiritsidwe ntchito ngati mankhwalawa. Pali mitundu yambiri yamawonekedwe awo, koma malinga ndi ziwerengero, urticaria, eosinophilia, nyamakazi yokhala ndi vuto losakanizira, angioedema ndi polymyalgia ya genheis ya rheumatoid nthawi zambiri imatha kukhala.

Mawonekedwe amtundu wa khungu amawonongeka amatha kukhala ngati totupa tating'onoting'ono tating'ono, kuyabwa, komanso mafupa. Othandizira a Hypolipidemic ndi owopsa minofu ya minofu, chifukwa chake, ali ndi mawonekedwe angapo payekha kapena mlingo waukulu, mawonekedwe a myopathies, kupweteka kwa minofu, njira zotupa m'misempha, kufooka kwawo ndi kutopa. Nthawi zina, rhabdomyolysis imayamba.

Mlingo ndi makonzedwe

Kutengera ndi kupezeka kwa mankhwalawa, simvastatin ndi mankhwala omwe adapangidwa ndi dokotala. Amasiyana pakati pa achire ochepera (10 mg) ndi pazokwanira tsiku lililonse (80 mg). Mankhwalawa amayenera kumwedwa musanadye, kamodzi patsiku, makamaka madzulo, kutsukidwa ndi madzi osavuta firiji. Kusintha ndi kusintha kwa mankhwalawa kumachitika ndi nthawi yosakwana mwezi umodzi.

Yankho la funso loti mutenge nthawi yayitali bwanji kutenga Simvastatin kuti mukhale wathanzi lingaperekedwe kokha ndi dokotala wopita. Kutalika kwa maphunzirawa kumatengera matenda, mphamvu za matendawa ndi ma lipid mbiri - LDL, triglycerides, cholesterol yonse.

Pa mimba ndi mkaka wa m`mawere

Simvastatin imakhala ndi teratogenic ndi fetotoxic. Imatha kulowa mu placenta, chifukwa chake, ikaperekedwa nthawi ya pakati, imatha kuyambitsa kukula kwa fetal ndi ma pathologies. Atsikana azaka zakubadwa omwe ayenera kumwa mankhwala kuchokera ku gulu la ma statin pazifukwa zaumoyo ayenera kutsatira njira zokwanira zolerera panthawi yonse ya chithandizo chamankhwala.

Muzochita za ana, mankhwalawa sagwiritsidwa ntchito, chifukwa palibe chidziwitso chachipatala cha Simvastatin cha odwala odwala ana.

Ndi chiwindi ntchito

Ndikofunikira kuthana ndi chiwindi ntchito musanayambe onse chithandizo cha lipid-kuchepetsa komanso panthawi yake. Zizindikiro za ma enzymes a chiwindi (serum transaminases) zimayendera, ndipo kuyesedwa kogwira ntchito kwa chiwindi kumachitidwanso. Ndikusintha kosalekeza muzotsatira zoyeserera, mankhwalawa amayimitsidwa.

Ndi mkhutu aimpso ntchito

Odwala omwe ali ndi vuto lofooka kapena lochepa aimpso amaloledwa kupereka mankhwala, koma tikulimbikitsidwa kuti tisamamwe mlingo waukulu. Woopsa milandu ya PN (aimpso kulephera), creatinine chilolezo zosakwana 30 ml mphindi, kapena kugwiritsa ntchito mankhwala monga cyclosporine, fibrate, dinazole, mlingo waukulu wa mankhwalawa ndi 10 mg patsiku.

Mapiritsi a Simvastatin: zomwe mankhwalawa amathandizira

Zisonyezo zogwiritsa ntchito mankhwalawa ndi monga:

• chachikulu hypercholesterolemia (mtundu IIa ndi IIb) ndi kusagwira kwa chithandizo chamankhwala chokhala ndi cholesterol yotsika komanso njira zina zosagwiritsa ntchito mankhwala (kuchepa thupi ndi zochitika zolimbitsa thupi) mwa anthu omwe ali ndi chiopsezo chotenga matenda a coronary atherosulinosis,
• kuphatikiza hypertriglyceridemia ndi hypercholesterolemia kosakonzedwa ndi zochitika zolimbitsa thupi komanso zakudya zapadera,
• kuchepetsedwa kwa vuto la mtima (kuvulala kwa ischemic kapena sitiroko),
• kupewa myocardial infarction,
• Kuchepetsa kukula kwa coronary atherosulinosis,
• kuchepetsa chiopsezo cha kusintha kwa njira.

Malangizo ogwiritsira ntchito

"Simvastatin" imatengedwa pakamwa, nthawi yamadzulo 1 patsiku kuphatikiza ndi kuchuluka kwa madzi. Nthawi yakumwa mankhwalawa sifunikira kuyanjana ndi chakudya.

Asanayambe chithandizo, wodwalayo amapatsidwa mankhwala a hypocholesterol, omwe amayenera kuwonedwa panthawi yonse ya chithandizo.

Zochizira hypercholesterolemia, mlingo woyenera wa "Simvastatin" umachokera ku 10 mpaka 80 mg kamodzi patsiku madzulo. Kwa odwala omwe ali ndi vuto losavomerezeka, mlingo woyambirira wa mankhwalawa ndi 10 mg. Mlingo wapamwamba tsiku lililonse ndi 80 mg.

Kusankha (kusintha) kwa mlingo kumafunikira pakadutsa masabata anayi. Odwala ambiri, mankhwalawa amathandizira pakumwa mankhwala mpaka 20 mg / tsiku.

Mankhwalawa odwala matenda a mtima kapena chiwopsezo cha chitukuko, Mlingo wogwira wa mankhwalawa ndi 2040 mg / tsiku. Pankhaniyi, mlingo woyambayo mwa odwala ndi 20 mg / tsiku. Kusankha (kusintha) kwamtengowo kuyenera kuchitika pakadutsa masabata anayi. Ngati ndi kotheka, mlingo utha kuwonjezeka mpaka 40 mg / tsiku.

Kwa odwala omwe akutenga verapamil kapena amiodarone mogwirizana ndi Simvastatin, mlingo wa tsiku ndi tsiku sayenera kupitilira 20 mg.

Odwala omwe ali ndi kuchepa kwapakati kapena pang'ono pang'ono, komanso odwala okalamba, kusintha kwa mankhwalawa sikofunikira.

Mwa anthu omwe ali ndi homozygous cholowa hypercholesterolemia, tsiku lililonse Simvastatin ndi 80 mg mu 3 Mlingo wogawika (20 mg m'mawa, 20 mg masanawa ndi 40 mg madzulo) kapena 40 mg madzulo kamodzi patsiku.

Odwala omwe ali ndi vuto la aimpso kulephera kapena kulandira cyclosporine, gemfibrozil, danazol kapena ma fiber ena (kupatula fenofibrate), komanso nicotinic acid osakanikirana ndi mankhwalawa, mlingo woyenera wa mankhwalawa sayenera kupitirira 10 mg / tsiku.

Zotsatira za pharmacological

"Simvastatin", malangizo ogwiritsira ntchito amadziwitsa izi, - lipid-kuchepetsa wothandizila yemwe adapangidwa kuchokera ku mphamvu yampweya wa Aspergillus terreus ndi lactone wosagwira, amapezeka ndi hydrolysis mu thupi ndikupanga hydroxy acid. Metabolite yogwira inhibits 3-hydroxy-3-methyl-glutaryl-CoA reductase (HMG-CoA reductase), puloteni yomwe imapangitsa mapangidwe oyamba a mevalonate ku HMG-CoA.

Popeza kutembenuka kwa HMG-CoA kukhala mevalonate ndi gawo loyambirira kapangidwe ka cholesterol, kugwiritsidwa ntchito kwa simvastatin sikumapangitsa kudzikundana kwa mankhwala owopsa mthupi. HMG-CoA imapangidwa mosavuta ku acetyl-CoA, yomwe imakhudzidwa ndi njira zambiri zopangira thupi.

"Simvastatin" imayambitsa kutsika kwa plasma of triglycerides (TG), lipoproteins otsika kwambiri (LDL), otsika kwambiri lipoproteins (VLDL) ndi okwana cholesterol (munthawi ya heterozygous mabanja ndi osakhala achibale a hypercholesterolemia, omwe ali ndi vuto laosakanikirana pakati, cholesterol okondemia. chiopsezo) chifukwa cha kuletsa kwa cholesterol synthesis m'chiwindi ndikuwonjezeka kwa zolandilira za LDL pamaselo a cell, zomwe zimapangitsa kuti pakhale zovuta zambiri komanso zowopsa za LDL.

Kuchulukitsa zomwe zili ndi lipoproteins yapamwamba kwambiri (HDL) ndikuchepetsa kuchuluka kwa LDL / HDL ndi cholesterol yonse / HDL. Zilibe mutagenic. Kukhazikika kwa kuwonekera kwa mavutowo ndi masabata awiri pambuyo poyambira kukhazikitsa, njira yayitali yothandizira imatheka pambuyo pa masabata a 4-6.

Zotsatira zake zimapitiliza ndi chithandizo chopitilira, pakutha kwa mankhwala, cholesterol pang'onopang'ono imabweza msanga.

Zotsatira zoyipa

Kuchiza kumayambitsa kukula kwa zovuta monga:

• kuchepa magazi
• palpitations
• dyspepsia
• alopecia
• zotupa pakhungu
• kuyabwa
• kusowa tulo
• paresthesia
• kusokonezeka kwa kukumbukira
• minofu kukokana
• chizungulire
• mutu
• zotumphukira neuropathy
• kulephera kwa impso (chifukwa cha rhabdomyolysis),
• kapamba
• chiwindi
• utachepa potency
• kufooka
• kupweteka m'mimba
• kutsegula m'mimba
• kusanza, kusanza,
• chisangalalo
• kudzimbidwa
• chiwindi ntchito,
• myasthenia gravis
• asthenia
• myalgia
• myopathy
• cholestatic jaundice,
• minofu kukokana
• khalokuz
• kuphwanya kukoma
• malingaliro owoneka bwino,
• khateyo hypersensitivity syndrome (angioedema, lupus-like syndrome, polymyalgia rheumatism, vasculitis, dermatomyositis, thrombocytopenia, eosinophilia, kuchuluka kwa ESR, nyamakazi, arthralgia, urticaria, photosensitivity, kufinya kwa nkhope, kupuma movutikira.

Mndandanda wa mankhwala "Simvastatin"

Zofananira zonse pazogwira:

1. Simlo.
2. Chinyengo.
3. Holvasim.
4. Simvacol.
5. Simvalimite.
6. Zorstat.
7. Aries
8. Simvor.
9. Simgal.
10. Zokor forte.
11. Simvakard.
12. Simvastatin Chaikafarma.
13. Simvastol.
14. Zokor.
15. Simvastatin Zentiva.
16. Machitidwe.
17. Vasilip.
18. Vero Simvastatin.
19. Simvastatin Pfizer.
20. Atherostat.
21. Simvastatin Fereyn.

Gulu la statins limaphatikizapo mankhwala:

1. Tulip.
2. Holvasim.
3. Holetar.
4. Atomax
5. Leskol forte.
6. Mertenil.
7. Aries
8. Pravastatin.
9. Rovacor.
10. Liptonorm.
11. Lovacor.
12. Vasilip.
13. Atoris.
14. Vazator.
15. Zorstat.
16. Cardiostatin.
17. Lovasterol.
18. Mevacor.
19. Roxer.
20. Lipobay.
21. Lipona.
22. Rosulip.
23. Tevastor
24. Atorvox.
25. Crestor.
26. Lovastatin.
27. Medostatin.
28. Atorvastatin.
29. Leskol.
30. Liprimar.
31. Rosuvastatin.
32. Akorta.
33. Lipostat.
34. Lipoford.
35. Rosucard.
36. Anvistat.
37. Torvazin.
38. Apextatin.
39. Torvakard.
40. Atherostat.
41. Atocord.

Maholide ndi mtengo

Mtengo wamba wa Simvastatin (mapiritsi 10 mg No. 30) ku Moscow ndi 44 rubles. Ku Kiev, mutha kugula mankhwala (20 mg No. 28) kwa 90 h scrollnias. Ku Kazakhstan, malo ogulitsa mankhwala amapereka analogue ya Vazilip (10 mg No. 28) kwa 2060 tenge. Zimakhala zovuta kupeza mankhwala ku Minsk. Imapezeka ku pharmacies ndi mankhwala.

About "Simvastatin" ndemanga za odwala zimasiyana. Ogwiritsa ntchito ena amatsimikizira kuti mankhwalawa amachepetsa cholesterol, koma panthawi imodzimodziyo amafotokoza zovuta zosiyanasiyana zotsutsana ndi maziko onse a hypocholesterol. Odwala odwala ndi kapamba, onani kuwonjezeka kwa pafupipafupi mankhwala. Ndi chithandizo chathanzi, pali kusintha kwa lipid kukhala kwabwinoko.

Malingaliro a madotolo amagawanidwanso. Ena amazindikira kuti mankhwalawo amatsitsa cholesterol bwino ndipo ndi njira yabwino kwambiri yolepheretsera matenda a atherosulinosis. Ena amakhulupirira kuti mankhwalawo adatha, chifukwa cha zovuta zoyipa, komanso mawonekedwe pamsika wazipatala wa Atorvastatin ndi Rosuvastatin, omwe ndi mankhwala atsopano.

Kuchita ndi mankhwala ena

Kugwiritsa ntchito munthawi yomweyo mankhwala a antimycotic ngati ketoconazole, itraconazole, kugwiritsa ntchito erythromycin, cytostatics, Mlingo waukulu wa Vitamin PP (nicotinic acid) ndikutsutsana ndi Simvastatin. Mankhwalawa ali ndi vuto lalikulu la myopathies ndi minofu ina pamavuto. Akaperekedwa nthawi yomweyo, minyewa yawo imawonjezeredwa, motero imawirikiza kawiri magawo a zochitika za rhabdomyolysis.

Ndi kufanana kwa Simvastatin ndi mankhwala a anticoagulant (warfarin, fenprocoumone), ndikofunikira kuwunika nthawi zonse magazi a coagulogram, popeza ma statins amawonjezera mphamvu ya anticoagulants. Kusintha kwa mlingo kapena kusiya mankhwala kumachitika pambuyo pa ulamuliro wa INR.

Iwo ali osavomerezeka kuti agwiritse ntchito madzi a mphesa munthawi ya lipid-kutsitsa chithandizo ndi ma statins. Mulingo wololedwa uli mpaka 250 ml patsiku. Zakumwa zatsopanozi zimakhala ndi mapuloteni a CYP3A4 inhibitor, omwe amasintha pharmacodynamics ndi pharmacokinetics a Simvastatin.

Zolemba zogwiritsira ntchito

Simvastatin ndi mankhwala omwe ali ndi zotsatirapo zosiyanasiyana zaumoyo komanso mavuto, chifukwa chake amalembedwa ndi adokotala, malinga ndi ziwonetsero zovuta, ndipo amawagawa m'mafakitala pokhapokha ngati mumalandira mankhwala. Panthawi yamankhwala, mawonekedwe a coagulation system (INR, APTT, nthawi yowundana), mbiri ya lipid, ntchito ya chiwindi (ALT, michere ya AST) ndi ntchito ya impso (creatinine clearance, CPK) imayang'aniridwa.

Mtengo wa mankhwala

Mtengo wa simvastatin ndiwofatsa komanso wokwera mtengo kwa wodwala aliyense. Kutengera ndi dera komanso ndondomeko zamakampani ogulitsa mankhwala, mtengo wake ungasiyane. Pafupifupi, mtengo wa mankhwala ku Russia ndi:

• Mlingo 10 mg, zidutswa 30 pa paketi iliyonse - kuchokera 40 mpaka 70 ma ruble.
• Mlingo 20 mg, zidutswa 30 pa paketi iliyonse - kuchokera ku 90 ma ruble.

Muzipatala za ku Ukraine, mtengo wa Simvastatin ndi 20-25 UAH ndi 40 UAH pa Mlingo wa 10 ndi 20 mg, motero.

Analogs a simvastatin

Simvastatin ali ndi gulu lonse pamsika wamankhwala zotengera zonse - zida zamagulu pansi pa mayina ena ogulitsa. Izi zikuphatikizapo Vasilip, Aries, Alkaloid, Simlo, Simvastatin C3, Simgal, Vertex, Simvastol, Zokor. Mankhwalawa ndi ma synonyms ndipo amatha kutumizidwa molingana ndi zomwe dokotala amakonda, kuchuluka kwa zachuma kwa wodwalayo komanso zomwe munthu akudziwa chifukwa cha mankhwalawa.

Kodi bwino simvastatin kapena atorvastatin

Simvastatin ndi Atorvastatin sizofanana. Mankhwalawa ndi amibadwo yosiyanasiyana yama statins: Atorvastatin - woyamba, Simvastatin - wachitatu. Amasiyana mu zinthu zogwiritsidwa ntchito, zikuwonetsa, contraindication, kuphatikizika kwa mgwirizano ndi zida zina zamankhwala.

Mankhwala aliwonse amakhala ndi mankhwala ake ochizira komanso omwe amapindulitsa, motero sikoyenera kuzifanizira. Atorvastatin ndi wogwira ntchito komanso wogwira ntchito mwachangu komanso wolimbikira. Chifukwa chake, ngati kuli kotheka, kuti musinthe mwachangu, mwayi umapatsidwa kwa iye. Komabe, simvastatin, ndi mankhwala ofatsa omwe amapereka mavuto ochepa ndipo amavomerezeka kuti agwiritsidwe ntchito magawo a impso ndi chiwindi, mosiyana ndi Atorvastatin.

Kodi pali kusiyana kotani pakati pa simvastatin ndi rosuvastatin

Pakati pa simvastatin ndi rosuvastatin pali kusiyana pakati pa zinthu zomwe zikugwira, mbiri ya magwiridwe antchito, zikuwonetsa, zotsutsana, zovuta komanso mtengo wamitundu. Rosuvastatin amagwiritsidwa ntchito pafupipafupi kuchoka pa njira yopewera kuwona kwa odwala omwe ali ndi mbiri yodwala yamtima.

Kugwiritsa Ntchito

Ndemanga za madokotala ndi odwala omwe amatenga Simvastatin salowerera nawo. Madokotala amazindikira kufewa kwa mankhwalawa - zovuta zoyipa zomwe sizipezeka kawirikawiri, zimagwirizana ndi mankhwala ena. Ubwino wabwino wa mankhwalawa ndi mwayi wokhazikitsidwa ndi matenda a impso kapena chiwindi mu mawonekedwe awo ofatsa kapena olimbitsa. Komabe, pogwira simvastatin ndiwotsika pang'ono poyerekeza ndi mibadwo ina ya ma statins, chifukwa chake, sichidagwiritsira ntchito mankhwala othandizira.

Pharmacodynamics ndi pharmacokinetics

Simvastatin ili ndi mayamwidwe ambiri. Kuzindikira kwakukulu kumachitika pambuyo pa maola 1.5-2.5, koma maola 12 pambuyo pake amatsika ndi 90%. M'mapuloteni a plasma, gawo lomwe limagwira limatha kumanga mpaka 95%. Kwa simvastatin ndi kagayidwe zotsatira zachilendo za "woyamba" zimadziwika mu hepatic system, pomwe, chifukwa cha hydrolysis, mankhwala othandizira ofanana, a beta-hydroxy acid, amapangidwa. Njira yayikulu yakuzembera kudzera m'matumbo. Mwa mawonekedwe osagwira, 10-15% yogwira ntchito imachotsedwa kudzera mu impso.

Momwe mungatenge simvastatin?

Mlingo wa tsiku lililonse wa mankhwalawa kwa akulu ndi 1 t. (20-40 mg.) 1 p. patsiku kwa mphindi 30 mpaka 40. musanagone, kumwa madzi ambiri.

Mlingo wambiri watsiku ndi tsiku sayenera kupitirira 80 mg. (2 t.), Popeza izi zitha kusokoneza thanzi lathunthu.

Njira ya mankhwala ndi mlingo wa mankhwala zimatsimikiziridwa ndi kupezeka kwa dokotala aliyense payekhapayekha kwa wodwala aliyense, kutengera kutha kwa njira ya matenda ena amthupi.

Kupanga ndi mawonekedwe a kumasulidwa

Zabwino, mg

10/20/40 mg mapiritsi

simvastatin 10/20/40 mg

ma cellcose a microcrystalline 70/140/210

ascorbic acid 2.5 / 5 / 7.5

gelatinized wowuma 33.73 / 67.46 / 101.19

stearic acid 1.25 / 2.5 / 3.75

lactose monohydrate 21/42/63

mowa wa polyvinyl 2.33 / 4.66 / 6.99

silicon dioxide 0,75 / 1.50 / 2.25

titaniyumu dioxide 0,97 / 1.94 / 2.91

Yellow iron oxide 0,28 / 0.56 / 0.84

oxide wofiira wachitsulo 0,19 / 0.38 / 057

Mlingo ndi makonzedwe

Musanayambe mankhwala, zakudya za hypocholesterol ndizovomerezeka. Simvastatin amatengedwa pakamwa nthawi 1 madzulo, kutsukidwa ndi madzi, mosasamala kanthu za chakudya. Mlingo wake umatengera chifukwa chomwe mapiritsi amaikidwa:

• Hypercholesterolemia - mlingo woyamba ndi 10 mg, pazomwe 80 ndi. Kusintha kwa Mlingo kumachitika nthawi 1 pamwezi.
• Ischemia, chiwopsezo cha chitukuko chake ndi 20-40 mg.
• Homozygous cholowa cha hypercholesterolemia - 20 mg katatu patsiku.
• Matenda a impso - osapitirira 10 mg patsiku ndi a mtundu wa creatinine (3 0,31 ml / min akhoza kutchulidwa).
• Kwa odwala omwe akutenga Verapamil, Amiodarone - tsiku lililonse 20 mg.

Malangizo apadera

Masiku atatu oyambirira otenga Simvastatin, kuwonjezeka kwa bilirubin m'magazi komanso milingo ya AST ndi ALT ikhoza kuonedwa. Pachifukwa ichi, ndikofunikira kuchita kafukufuku wa ultrasound miyezi itatu iliyonse (mutatenga 80 mg kapena kupitilira). Chithandizo chimayimitsidwa pakangodutsa ma enzymes a chiwindi pakadutsa masiku atatu. Hypertriglyceridemia ya 1.4, mitundu 5 ndiyo kuphwanya kugwiritsa ntchito mankhwalawa.

Mankhwala angayambitse kukula kwa myopathy, zomwe zimachitika chifukwa cha rhabdomyolysis, matenda aimpso. Mapiritsi amathandizika onse mu zovuta mankhwala othandizira omwe ali ndi sequine of bile acid, ndi monotherapy. Kuchita bwino kwa mapiritsi kumatha kupitilizidwa pogwiritsa ntchito njira ya hypocholesterol. Kugwiritsa ntchito madzi a mphesa nthawi yamankhwala ndikosayenera.

Kuyanjana kwa mankhwala osokoneza bongo

Mlingo wokwera wa simvastatin ndi kutenga cyclosporine, danazole imatha kuyambitsa rhabdomyolysis. Statin imawonjezera mphamvu ya ma anticoagulants - Warfarin, Fenprokumon, yomwe imatha kuwonjezera magazi. Kuzunza kwa Digoxin kumawonjezera kuphatikiza ndi kudya kwa statin. Ndizoletsedwa kumwa mapiritsi ndi gemfibrozil. Kuopsa kwa myopathy kumachitika chifukwa cha kuphatikiza ndi mankhwala otsatirawa:

• Nefazodon.
• Erythromycin.
• Clarithromycin
• Machirowa.
• Ketoconazole, Itraconazole.
• Fibates.
• Nicotinic acid waukulu.
• HIV protease zoletsa.

Bongo

Zizindikiro za kuchuluka kwa mulingo sizachilendo. Mankhwala, ndikofunikira kusanza, kutsuka m'mimba. Otsatirawa ndi syndromic chithandizo chowunikira magawo a hepatic. Ndi aimpso zovuta, ntchito diuretic mankhwala, mtsempha wa magazi makonzedwe a sodium bicarbonate tikulimbikitsidwa. Hemodialysis siyothandiza, koma imatha kuchitika ngati pakufunika. Ndi rhabdomyolysis, hyperkalemia imayamba, yomwe imafuna kulowetsedwa kwa calcium chloride ndi gluconate, insulin yokhala ndi shuga.

Migwirizano yogulitsa ndikusunga

Mankhwala a statin ndi mankhwala omwe mumalandira. M'mafakitala ena, mankhwala othandizira sangafunike. Wopanga mapiritsiwa amalimbikitsa kuti azisunga mankhwalawo pamalo amdima, ozizira pa kutentha kwa madigiri 15 mpaka 25. Malonda ayenera kutetezedwa makamaka kuchokera kwa ana. Alumali moyo wa chinthu ndi miyezi 24 kuyambira tsiku lotulutsidwa.

Analogs ndi choloweza m'malo mankhwala Simvastatin

Pali mndandanda wamankhwala omwe ali ofanana pakupanga ndi kuchitira simvastine. Mankhwalawa akuphatikizapo:

1. Vasilip ndi analogue yathunthu yopanga. Amagwiritsidwa ntchito pochiza hypercholesterolemia, kupewa ischemia.
2. Simgal - imagwiritsidwa ntchito pofuna kupewa chitukuko cha atherosulinosis, myocardial infarction.
3. Zokor - adalembedwa kuti achepetse cholesterol ya plasma.
4. Holvasim - analimbikitsa zochizira zosakanizira hyperlipidemia, ischemia aakulu.
5. Sinkard - omwe amagwiritsidwa ntchito kukhazikitsa kufalikira kwa ziwalo, kuchepetsa mwayi wa kufa.

Mimba (ndi mkaka wa m'mawere)

Simvastatin imatsutsana mu gestation mimbachifukwa wokhoza kuyambitsa zovuta zina zapakhomo zatsopano. Pa chithandizo, kugwiritsa ntchito kulera. Palibe chidziwitso pakulanda kwa zinthu zomwe zimagwira mkaka wa m'mawere. Komabe, ndikofunikira kukumbukira kuti pali chiopsezo chachikulu cha zotsatira za simvastatin pa thanzi la mwana.

Ndemanga za Simvastatin (malingaliro a madokotala, odwala)

Ndemanga za Simvastatin pamaforamu ndizosiyana. Odwala amatsimikizira kuti mankhwalawa amachepetsa cholesterol, koma nthawi yomweyo amafotokoza zovuta zosiyanasiyana zotsutsana ndi maziko onse a hypocholesterol. Odwala omwe ali ndi vuto losatha la kapamba amawona kuchuluka kwa kuchuluka kwa nthawi ya mankhwala. Ndi chithandizo chathanzi, pali kusintha kwa lipid kukhala kwabwinoko.

Malingaliro a madokotala amagawidwa. Ena amakhulupirira kuti mankhwalawo ndi a "gulu lakale lakale" ndipo ladziphika lokha, chifukwa cha zovuta zoyipa, komanso mawonekedwe pamsika wamankhwala Atorvastatin ndi Rosuvastatinzomwe zimagwirizana ndi mankhwala a m'badwo watsopano. Ena amazindikira kuti mankhwalawo amatsitsa cholesterol bwino ndipo ndi njira yabwino kwambiri yolepheretsera matenda a atherosclerosis.