Mankhwala Lovastatin: limagwirira ntchito ndi kuwunika

Vuto la cholesterol yayikulu limadetsa nkhawa anthu ambiri. Izi ndichifukwa choti izi zitha kuchititsa kuti mtima usamayende bwino komanso mtima wonse. Kuti muthane ndi hyperlipoproteinemia, ndikofunikira kuti musamadye bwino, komanso kumwa mankhwala ena.

Njira yothandiza kwambiri yochepetsera cholesterol yamagazi imadziwika kuti ndi mankhwala "Lovastatin." Malangizo ogwiritsira ntchito, mtengo, ndemanga, analogi ndi zotsutsana za mankhwalawa adzaperekedwa pansipa. Muphunziranso za zomwe akatswiri akunena za iye komanso mtundu wamawu omwe ogula amasiya.

Fomu, zikuchokera, kulongedza ndi kufotokoza za mankhwala

Mankhwalawa "Lovastatin", malangizo ogwiritsira ntchito omwe adayikidwa mu katoni, amagulitsidwa ngati mapiritsi oyera ndi ozungulira. Chithandizo chophatikizika mu mankhwalawa ndi lovastatin. Ponena za zida zothandizira, zimaphatikizapo lactose monohydrate, starch, cellulose, ascorbic acid, butyl hydroxyanisole, citric acid ndi magnesium stearate.

Mankhwalawa amaperekedwa m'matumba a cell ndi mapaketi a makatoni, motero.

Limagwirira zake ntchito mankhwala

Kodi machitidwe a mankhwala "Lovastatin" ndi ati? Malangizo ogwiritsira ntchito, lipotilo loti ma LP receptors a chiwindi amayang'anira zomwe zili lipoproteins m'magazi. Amachokera kwa iwo kudzera mukulumikizana ndi ma receptors omwe atchulidwa. Zotsatira zake, cholesterol imapangidwa m'maselo a chiwindi.

Mfundo zoyenera kuchita ndi mankhwala omwe amafunsidwa ndi kufotokozera 3-hydroxy-3-methylglutaryl-coenzyme A reductase. Ichi ndi chowonadi ndi kutenga nawo gawo komwe kuphatikiza cholesterol kumachitika.

Kuchepetsa mapangidwe a cholesterol kumafuna kuchuluka kowonjezera a LP receptors pa hepatocytes. Zotsatira zake, njira yochotsa lipoprotein yotsika m'magazi imathamanga, ndipo cholesterol yathunthu, cholesterol yotsika komanso kachulukidwe kachulukidwe kachulukidwe kamachepa.

Zolemba za mankhwala

Kodi mapale a Lovastatin ali ndi zinthu zina ziti? Malangizo ogwiritsira ntchito (mtengo, ndemanga zimaperekedwa kumapeto kwa nkhaniyo) zikuwonetsa kuti chida ichi chitha kuchepetsa zomwe apolipoprotein B ndi triglycerides, komanso zimachulukitsa pang'ono milingo ya lipoproteins yapamwamba.

Zotsatira zochizira pambuyo pakumwa mankhwalawa zimawonekera patatha milungu iwiri, ndipo pazokwanira - patatha pafupifupi mwezi ndi theka. Komabe, limapitirira kwa masabata asanu ndi limodzi atasiya kumwa mankhwalawo.

Kuchita bwino kwa mankhwalawa pogwiritsa ntchito nthawi yayitali sikuchepa. Tiyeneranso kudziwa kuti imachokera ku biocultures ya Aspergillus terreus ndi Monascus ruber.

Katundu wa Kinetic

Lovastatin amatenga nthawi yayitali bwanji? Malangizo ogwiritsira ntchito (mtengo wa mankhwalawo siwokwera kwambiri) akuti kuyamwa kwa mankhwalawa m'mimba kumachitika pang'onopang'ono. Komanso, amachepetsa kudya kwa mapiritsi pamimba yopanda kanthu.

The bioavailability wa mankhwalawa ndi ochepa kwambiri (pafupifupi 30% ya mlingo womwe unatengedwa). Pakadutsa maola pafupifupi anayi, kuchuluka kwambiri kwa mankhwalawa m'magazi kumatheka. Pambuyo tsiku lina amachepetsa ndipo ali pafupifupi 10% ya pazokwanira.

Mankhwala omwe amafunsidwa ali 95% omanga ma protein a plasma. Kutsimikizika kwa mankhwalawa limodzi ndi mlingo umodzi kumawonedwa pa tsiku la 3.

Kodi mankhwala a Lovastatin ndi ati? Malangizo ogwiritsa ntchito akunena kuti ichi ndi chosokoneza bongo. Pambuyo pa gawo loyamba kudzera m'chiwindi, pamatenga mawonekedwe.

Mankhwala amakhathamiritsa kudzera isoenzymes. Hafu yake ya moyo ndi mphindi 180. Chithandizo chogwira mankhwalawo, komanso ma metabolites ake, amathandizidwa ndi impso komanso matumbo.

Zisonyezo zakumwa mapiritsi

Pamaso pa zinthu ziti zomwe odwala amapatsidwa mapiritsi a Lovastatin? Malangizo ogwiritsira ntchito (mafotokozedwe, kapangidwe kake ka mankhwalawa adanenedwa koyambirira kwa nkhaniyo) akuti mankhwalawa ndi othandiza kwambiri kwa hypercholesterolemia (mtundu IIb ndi mtundu IIa lipolipoproteinemia) wokhutira ndi zomwe zili ndi LDL (ngati mankhwala azakudya mwa anthu omwe ali ndi chiwopsezo chotenga matenda a coronary atherosulinosis anali osathandiza) komanso hypertriglyceridemia ndi hypercholesterolemia.

Tiyenera kudziwa kuti mankhwalawa amafunsidwa kawirikawiri atherosulinosis.

Contraindication chifukwa chotenga mankhwala osokoneza bongo

Ndi nthawi ziti pamene wodwala samalimbikitsidwa kugwiritsa ntchito mapiritsi a Lovastatin? Malangizo ogwiritsira ntchito (mankhwalawa ndi mankhwalawa amayenera kuperekedwa ndi adokotala okha) akuti mankhwala amaphatikizidwa pokhudzana ndi matenda a chiwindi, kutenga pakati kapena kuthekera kwake, ntchito yowonjezera ya transaminase ya chiyambi chosadziwika, komanso panthawi yoyamwitsa, odwala kwambiri chidwi cha lovastatin.

Komanso, mankhwalawa omwe amafunsidwira samayankhidwa ali aang'ono, ndi myopathy ndi cholestasis.

Sizoletsedwa kuphatikiza mankhwala osokoneza bongo ndi mowa. Ndi kusamala kwambiri, imawerengedwa kwa odwala pambuyo poyeserera kugundana kwa mitsempha.

Mankhwala "Lovastatin": malangizo ntchito

Mtengo, fanizo la chida ichi liziwonedwa patsogolo pang'ono.

Malinga ndi malangizo omwe aphatikizidwa, mapiritsi a Lovastatin amayenera kumwa pakamwa kamodzi patsiku.

M'mikhalidwe yodwala monga hyperlipidemia, mankhwalawa amadziwitsidwa mu 10-80 mg kamodzi (mlingo umadalira kuuma kwa matenda).

Kuchiza ndi mankhwala omwe amafunsidwa kumayamba ndi Mlingo wochepa. Kenako imakulitsidwa pang'onopang'ono. Mlingo wapamwamba kwambiri wa tsiku lililonse wa mankhwalawa, wofanana ndi 80 mg, amatha kumwa kamodzi kapena kawiri patsiku (m'mawa komanso asanagone). Kusankhidwa kwa mankhwalawa achire kumachitika limodzi ndi mwezi umodzi.

Kodi Lovastatin amawerengedwa bwanji kuti agwirizane ndi matenda ena? Malangizo ogwiritsira ntchito akuti akuti ngati ali ndi matenda otere, mankhwalawa amapatsidwa mankhwala 20 mg mg. Ngati kuchuluka kwa mankhwalawo sikunathandize, ndiye kuti kumawonjezereka mpaka 60-80 mg.

Mankhwala akaphatikizidwa ndi fibrate kapena nicotinic acid, mlingo wake suyenera kukhala woposa 20 mg patsiku.

Zochitika Zosiyanasiyana

Kodi mankhwala a Lovastatin amayambitsa mavuto? Malangizo ogwiritsira ntchito akuwonetsa zotsatirazi zovuta zotsatirazi:

• amphaka, mutu,
• kuwala kwam'maso, chizungulire,
• kugona, mavuto a kugona, kuda nkhawa, kufooka,
• minofu kukokana, myalgia, myositis
• anthu omwe amamwa nicotinic acid, Cyclosporin kapena Gemfibrozil, amawonjezera chiopsezo cha rhabdomyolysis,
• thrombocytopenia, hemolytic anemia,
• kutentha kwa mtima, biliary cholestasis, nseru, hepatitis, ulemu, kukoma kosokoneza, kudzimbidwa, cholestatic jaundice, kutsegula m'mimba,
• kuchuluka kwa creatine phosphokinase ndi chiwindi transaminases,
• kuchuluka kwa bilirubin ndi zamchere phosphatase,
• Edema ya Quincke, kuzizira, kuyabwa, arthralgia, urticaria,
• alopecia ndi kuchepa potency.

Mankhwala osokoneza bongo

Ndi mwadzidzidzi makonzedwe okwera Mlingo wa mankhwalawa, sizowonekera bwino ndi zomwe zimayambitsa wodwalayo.

Poona matenda a m'magazi, wozunzidwayo amasambitsidwa ndi m'mimba ndikumamwa mankhwala oledzera. Komanso, wodwala amayang'aniridwa kuti azigwira ntchito zofunika, ntchito ya chiwindi ndi ntchito ya phosphokinase.

Kuyanjana kwa mankhwala osokoneza bongo

Kugwiritsa ntchito nthawi imodzimodziyo madzi ambiri a mphesa, komanso Gemfibrozil ndi Fenofibrat, kumabweretsa chiopsezo chotukula myopathies.

Kumwa mankhwalawa ndi nicotinic acid, Clarithromycin, Erythromycin, Cyclosporin, mankhwala antifungal (Itraconazole, Ketoconazole), Nefazodone ndi Ritonavir kumawonjezera kuchuluka kwa mankhwalawa m'magazi, komanso kuwonongeka kwa minofu. minofu ndi chiwopsezo chotenga myopathy.

Kugwirizana kwa "Lovastatin" wokhala ndi "Warfarin" kumawonjezera mwayi wokhetsa magazi.

Mankhwala "Colestyramine" amachepetsa bioavailability wa mankhwala omwe amafunsidwa. Chifukwa chake, nthawi yolumikizana pakati pa kudya imayenera kukhala osachepera maola 2-4.

Mtengo wa mankhwalawo ndi mawonekedwe ake

Pakadali pano, sizotheka kugula mankhwalawa m'masitolo aku Moscow ndi m'mizinda ina ya Russia. Ngati ndi kotheka, imatha kuitanidwa kudzera pa World Wide Web. Mitengo muma pharmaciz opezeka pa intaneti amasiyanasiyana. Mankhwala angagulidwe mumitundu yama ruble 300-600.

Ngati ndi kotheka, ndiye kuti mankhwalawo atha kufunsidwa ndi ena monga Apextatin, Fluvastatin, Cardiostatin, Iinvastin, Vero-Lovastatin, Pravastatin, Holetar, Lovasterol, Mevacor , Mevinacor, Lovacor.

Ndemanga za Mankhwala

Tsopano mukudziwa mapiritsi ngati Lovastatin. Malangizo, kapangidwe, kugwiritsa ntchito, fanizo la mankhwalawa adafotokozedwa m'nkhaniyi.

Malinga ndi akatswiri, mankhwala a lipid-ochepetsa amagwiritsidwa ntchito pazithandizo zovuta, komanso kupewa atherosulinosis ndi zovuta zake.

Mfundo zoyenera kuchitira mankhwalawa ndikuchepetsa zomwe zili atherogenic lipoprotein m'magazi

Malinga ndi madotolo, pakadali pano, zochitika zambiri zapezeka pakugwiritsidwa ntchito kwa chipatala ku Lovastatin. Iye ndi imodzi mwamankhwala otetezeka. Mankhwalawa amatha kulekerera nthawi yayitali.

Madandaulo okhudzana ndi zovuta amakhala osowa kwambiri pakuunika kwa wodwala. Nthawi zina mankhwalawa amatha kuyambitsa kusokonezeka, kutsegula m'mimba, kupweteka kwam'mimba, kudzimbidwa, kusowa tulo komanso kupweteka kwa minofu. Nthawi zambiri, izi zimachitika patatha milungu iwiri chichitikireni mankhwala kapena chifukwa cha kuchepetsedwa kwa mlingo.

Mankhwala Lovastatin: limagwirira ntchito ndi kuwunika

Gulu la ma statins (mankhwala ochepetsa mphamvu ya cholesterol) limaphatikizanso Lovastatin yothandiza. Mankhwala amagwiritsidwa ntchito osati mankhwalawa hypercholesterolemia, hyperlipoproteinemia, komanso kupewa matenda a mtima.

Mankhwala ayenera kugwiritsidwa ntchito limodzi ndi zakudya zapadera, masewera olimbitsa thupi komanso kusintha thupi. Munkhaniyi, mutha kuphunzira zambiri za Lovastatin, malangizo ogwiritsira ntchito, mtengo, ndemanga, analogues.

Malangizo ogwiritsira ntchito mankhwalawa

Lovastatin 20 mg kapena 40 mg amapangidwa mwa mawonekedwe a piritsi, chinthu chomwe chimagwira chomwe chimakhala ndi dzina lomweli. Zowonjezera za mankhwalawa ndi lactose monohydrate, starch, cellulose, magnesium stearate, butylhydroxyanisole, citric ndi ascorbic acid.

Mankhwala amagulitsidwa pokhapokha munthu akalandira mankhwala ndi dokotala. Pogula mankhwalawa, wodwalayo ayenera kuyang'anira chidwi chake. Malangizowa ali ndi malingaliro angapo ogwiritsira ntchito mankhwalawa:

• mankhwalawa chachikulu hypercholisterinemia kuphatikiza mtundu IIa ndi IIb,
• hyperlipoproteinemia mankhwala (ovuta ndi matenda a shuga ndi nephrotic),
• mankhwalawa coronary atherosulinosis (palimodzi ndi mavitamini othandizira komanso mafuta osakanizidwa amafuta acid),
• kupewa matenda a mtima,
• hypertriglyceridemia mankhwala.

Kugwiritsa ntchito mapiritsi kuyenera kuchitika nthawi imodzi patsiku la chakudya chamadzulo. Mlingo wa mankhwalawa zimatengera matendawa. Chifukwa chake, ndi hyperlipidemia, mlingo umodzi wa 10-80 mg ndiwo mankhwala.

Chithandizo cha matenda am'mimba chimayambira ndi Mlingo wocheperako, ndikuloledwa ndi dokotala, amatha kuchepa. Ndikulimbikitsidwa kusankha mlingo uliwonse pakatha masabata anayi.

Mlingo wapamwamba kwambiri (80 mg) ungagawidwe pawiri - m'mawa ndi madzulo.

Mankhwala a coronary atherosulinosis, mulingo woyenera kwambiri ndi 20-40 mg. Ngati chithandizo sichitha, kuwonjezeka kwa 60-80 mg ndikotheka. Ngati wodwala akutenga michere kapena nicotinic acid nthawi yomweyo, Lovastatin sayenera kugwiritsidwa ntchito mopitilira 20 mg patsiku. Komanso, mankhwalawa amayenera kuchepetsedwa milandu:

1. Kugwiritsa ntchito ma immunosuppressants.
2. Kugwiritsa ntchito mankhwala othandizira.
3. Chithandizo cha mankhwala antifungal.
4. Chithandizo cha matenda a chiwindi matenda enaake kapena ambiri.
5. Kugwiritsa ntchito mankhwala okhala ndi ma anticoagulants.

Ndikofunika kusunga mankhwalawo pa kutentha kosaposa 25 digiri Celsius.

Pambuyo pa kumaliza ntchito, zomwe ndi zaka 2, ndizoletsedwa kugwiritsa ntchito malonda.

Contraindication ndi zoyipa

Lovastatin ili ndi mndandanda wocheperako wapamwamba. Kugwiritsa ntchito mankhwalawo ndizoletsedwa ngati myopathy (matenda a neuromuscular matenda), pakati, cholestasis, kukanika kwa chiwindi, osakwana zaka 18 ndi Hypersensitivity payekha pazigawo zake.

Mankhwala ayenera kugwiritsidwa ntchito mosamala odwala omwe adutsa pakuthana ndi mtsempha wamagazi. Palibe chifukwa muyenera kumwa mankhwala ndi mowa.

Nthawi zina, mankhwala amatha kuyambitsa mavuto. Pakati pawo, ndikofunikira kufotokoza:

• Zochitika zogwirizana ndi ntchito ya m'mimba thirakiti: kuukira kwa mseru, kutentha pa chifuwa, kuchuluka kwa mpweya, kusintha kukoma, kutsekula m'mimba, kudzimbidwa.
• Zovuta zamkati zamanjenje: kupweteka mutu, kugona tulo, nkhawa, chizungulire, paresthesia, myositis, minofu kukokana ndi myalgia. Mukamagwiritsa ntchito cyclosporine, gemfibrozil kapena nicotinic acid, pamakhala mwayi wa rhabdomyolysis.
• Zimachitika biliary dongosolo: kuchuluka kwa bilirubin, zamchere phosphatase, chiwindi transaminases ndi creatine phosphokinase. Nthawi zina hepatitis, cholestatic jaundice ndi biliary cholestasis ndizotheka.
• Thupi lawo siligwirizana: kuyabwa, zotupa pakhungu, urticaria, angioedema, arthralgia.
• Kusokonezeka kwa nsidze: kukhazikika kwa mitsempha ya optic ndi chitukuko cha ng'ala.
• Zotsatira zina zoyipa: kuchepa kwa potency, malaise wamba, alopecia.

Zizindikiro za mankhwala osokoneza bongo akamagwiritsa ntchito Mlingo waukulu wa mankhwalawa samawonedwa. Maziko othandizira ndikuchotsa Lovastatin, phala lam'mimba, kugwiritsa ntchito ma sorbents (kuyambitsa kaboni, Smecta, Polysorb, Atoxil) kuwongolera kwa ntchito zofunika, ntchito ya chiwindi ndi ntchito ya phosphokinase.

Kuchita ndi njira zina

Lovastatin sayenera kugwiritsidwa ntchito ndi mankhwala onse, chifukwa kulumikizana kwawo kumatha kudzetsa kuyipa kwamthupi. Komanso, mankhwala ena amatha kukulitsa kuchuluka kwa zinthu zomwe zimagwira, ndipo zina zimatha kuchepa.

Chiwopsezo chachikulu cha chiwonongeko cha minofu ndi myopathy, komanso kuwonjezeka kwa zomwe zimagwira ntchitoyo, kumayambitsa kugwiritsidwa ntchito kwa nthawi yomweyo kwa Lovastatin limodzi ndi nicotinic acid, Cyclosporine, Ritonavir, Erythromycin, Nefazodone ndi Clarithromycin.

Kugwiritsa ntchito mankhwala mosokoneza bongo ndi madzi a mphesa, fenofibrate, gemfibrozil kumathandizanso mwayi wa myopathy.

Kuopsa kwa magazi kumawonjezeka ndi kugwiritsa ntchito warfarin. The bioavailability wa lovastatin amachepetsa pogwiritsa ntchito colestyramine. Kuti bioavailability ya mankhwalawa ikhale yokhazikika, ndikofunikira kugwiritsa ntchito mankhwala osokoneza bongo kwa maola 2-4.

Ndi matenda othandizira, wodwalayo ayenera kufunsa dokotala kuti amwe mankhwala.

Zina mwazo sizigwirizana ndi Lovastatin, chifukwa chake, kugwiritsa ntchito mankhwala mosaloledwa nkoletsedwa.

Mtengo, analogi ndi kuwunika kwa wodwala

Tsoka ilo, sizotheka kugula Lovastatin chifukwa Sipangidwa ku Russia.

Makampani opanga mankhwala monga Lekpharm (Belarus), Replekpharm AD (Macedonia) ndi Kievmedpreparat (Ukraine) ndi omwe amapanga mankhwalawa.

Pankhani imeneyi, adotolo atha kukulemberani analog ya Lovastatin, yomwe ili ndi zofanana zochizira.

Mankhwala odziwika bwino ndi awa:

1. Holetar. Ili ndi gawo lomwe limagwira - lovastatin, chifukwa chake ndi lofanana ndi Lovastatin. Mankhwala ali ndi zofanana, contraindication ndi zolakwika zimachitikira monga Lovastatin.
2. Cardiostatin. Mankhwala ena odziwika bwino ndi ofanana ndi Lovastatin, chifukwa ili ndi zomwe zimapangitsa. Mukamamwa Cardiostatin, njira yochizira yodziwikiratu imawonekera kwa milungu iwiri, ndipo pazabwino pambuyo pa masabata 4-6 atamwa mankhwalawo. Mtengo wapakati ndi ma ruble 290 (phukusi la mapiritsi 30 a 20 mg).
3. Pravastatin. Ili ndi mitundu yambiri yochitira. Chosakaniza chophatikizacho ndi pravastatin. Mankhwalawa amagwiritsidwa ntchito popanga hypercholesterolemia ndi dyslipidemia, komanso kupewa matenda a mtima a ischemic. Kugwiritsidwa ntchito kwa Pravastatin ndikotheka ngati njira yachiwiri yopewera kulowetsedwa kwa myocardial infarction, angina pectoris ndi post-transplant hyperlipidemia.
4. Zokor. Mphamvu yogwira ya mankhwala ndi simvastatin. Chizindikiro chachikulu cha mankhwalawa ndi chithandizo cha hypercholesterolemia. Zokor imagwiritsidwanso ntchito ngati prophylactic popewa kukula kwa mtima wamitsempha yamagazi. Mtengo wapakati ndi ma ruble 380 (mapiritsi 28 a 10 mg) ndi 690 ruble (mapiritsi 28 a 20 mg).

Malinga ndi Vyshkovsky Index, atsogoleri pamsika wazaka za Russia ndi Cardiostatin, Mevacor, Holetar ndi Rovacor.

Mayankho ku Lovastatin, ochokera kwa odwala komanso madokotala, ndi abwino. Mankhwalawa ndi otetezedwa komanso odwala bwino, ngakhale atakhala kwa nthawi yayitali.

Zochitika zokhudzana ndi matenda a dyspeptic nthawi zina zimawonekera kumayambiriro kwa mankhwala. Pakatha milungu iwiri, thupi likagwiritsidwa ntchito pokopa chinthu, ziwalo zimasiya. Nthawi zina, milingo ya ALT ndi AST imachuluka, motero ndikofunikira kuwongolera zomwe zili.

Pambuyo pa miyezi 1.5 kuyambira pachiyambireni chamankhwala, kufufuza koyeserera kumachitika. Monga lamulo, pali mawonekedwe abwino pazowunikira, i.e. ndende ya lipid yafupika.

Momwe mungachepetse cholesterol akufotokozedwa mu kanema m'nkhaniyi.

Sonyezani shuga lanu kapena sankhani jenda pamayendedwe Kusaka OsapezekaKusaka Kuyang'ana kosapezeka

Kutulutsa mawonekedwe ndi kapangidwe kake

Mlingo wa kutulutsidwa kwa Lovastatin ndi mapiritsi: wozungulira wozungulira, woyera ndi wachikasu, wokhala ndi bevel (pamakatoni olembetsedwa mapepala atatu a matanda 10, 15 kapena 20).

Piritsi 1:

• yogwira mankhwala: lovastatin - 20 kapena 40 mg (malingana ndi 100% youma),
• othandizira zigawo zikuluzikulu: colloidal silicon dioxide, magnesium stearate, wowuma chimanga, butylhydroxyanisole, cellcrystalline cellulose, mkaka wa mkaka.

Mankhwala

Lovastatin ndi cholepheretsa kuphatika kwa cholesterol amkati mu chiwindi. Thupi lomwe lili mthupi mwanjira ya lactone yolumikizika imatulutsidwa mwachindunji ku mawonekedwe othandizira othandizira, omwe amakhala ngati mpikisano wa 3-hydroxy-3-methylglutaryl-coenzyme-A reductase (HMG-CoA reductase). Ili ndiye puloteni yomwe imathandizira kusintha kwa HMG-CoA kukhala mevalonate, komwe ndi gawo loyamba la cholesterol biosynthesis.

Zotsatira zazikulu za lovastatin:

• Kuchepa kwa cholesterol yamagazi kwathunthu ndi cholesterol ku LDL ndi VLDL (lipoproteins otsika kwambiri ndi lipoproteins otsika kwambiri),
• kufooketsa kuchepa kwa zomwe zili apolipoprotein B, kuchuluka kwa triglycerides m'madzi a m'magazi komanso kuwonjezeka kwapakati pa ndende ya HDL (high density lipoproteins),
• kukhazikika kwa zolengeza, kusintha kwa ntchito ya endothelial, antithrombogenic ndi anti-kutupa kwenikweni (zimathandizira antiatherosranceotic).

The kutchulidwa achire zotsatira za lovastatin limawonekera mkati 14 masiku, ndipo pazabwino pambuyo 1-1.5 miyezi mwatsatanetsatane makonzedwe. Nthawi yomweyo atasiya kulandira chithandizo, zotsatira zake zimapitirira. Pogwiritsa ntchito nthawi yayitali (mpaka zaka 5), ​​mphamvu ya lovastatin sichitha.

Pharmacokinetics

Lovastatin imalowetsedwa m'matumbo am'mimba (m'mimba thirakiti) pang'onopang'ono komanso osakwanira - pafupifupi 30% ya mlingo. Mukamwa pamimba yopanda kanthu, mayamwidwe amachepetsedwa ndi 1/3 poyerekeza ndi kugwiritsa ntchito chakudya.

Tmax (nthawi yofika ndende yayitali) imachokera ku 2 mpaka maola 4, Cmax (ndende yozama) ndi 7.8 ndi 11.9 ng / ml (ya lovastatin ndi beta-hydroxyacids), ndiye kuti plasma concentration ikucheperachepera. Pambuyo pa maola 24, ndi 10% ya pazokwanira. Kuyankhulana ndi mapuloteni am'madzi am'magazi - 95%. Ndi gawo limodzi usiku, chilolezo cha lovastatin ndi metabolites yake yogwira chimafikira maola 48-72.

Imalowa m'magazi muubongo ndi mu zotchinga zina.

Mukadutsa chiwindi koyamba, lovastatin imakhala ndi metabolism yowonjezera, imapukusira kwa beta-hydroxy acid, 6-hydroxy derivative ndi ma metabolites ena, ena a iwo amawonetsa zochitika za pharmacological (amatchinga HMG-CoA reductase). Ma isoenzymes a CYP3A4, CYP3A7 ndi CYP3A5 akukhudzidwa ndi metabolism ya lovastatin.

T_1/2 (theka-moyo) ndi maola atatu. 83% ya mankhwala amatulutsidwa m'matumbo, 10% - impso.

Zizindikiro zogwiritsidwa ntchito

• kukwezeka seramu kuchuluka kwathunthu cholesterol, LDL cholesterol ndi triglycerides mu magazi seramu mwa odwala matenda oopsa hypercholesterolemia (malinga Fredrickson mitundu IIa ndi IIb), kuphatikizapo achibale zosakanikirana hyperlipidemia, polygenic hypercholesterolemia ndi heterozygous hypercholesterolemia chifukwa cha kuchuluka kwa infatin. njira zina zopanda mankhwala
• coronary atherosulinosis odwala matenda a mtima matenda (mtima wamtima): mankhwala amachitika kuti achepetse kukula kwake.

Hyperlipidemia

Mlingo wa Lovastatin womwe amalimbikitsidwa tsiku lililonse ndi 10-80 mg kamodzi patsiku.

Odwala omwe ali ndi Hypercholesterolemia woyenera, mlingo woyambira nthawi zambiri umakhala 20 mg kamodzi patsiku, ndimatchulidwe a matendawa (plasma okwana cholesterol m'magazi - kuyambira 7.8 mmol / l) - 40 mg. Kuti tikwaniritse milingo ya cholesterol yomwe mukufuna, mankhwalawa amatha kuwonjezeredwa mpaka 80 mg (pazambiri) mu waukulu kapena umodzi (m'mawa ndi madzulo).

Sinthani mlingo ndi zosokoneza kwa milungu inayi. Ngati kuchuluka kwa cholesterol yathunthu m'madzi a m'magazi kutsikira ku 140 mg / 100 ml kapena LDL cholesterol mpaka 75 mg / 100 ml, mlingo wa Lovastatin ungachepe. Mukaphatikizidwa ndi cyclosporine, fibrate kapena nicotinic acid (kuyambira 1000 mg patsiku), mlingo sayenera kupitirira 20 mg patsiku. Odwala kwambiri aimpso kulephera ndi creatinine chilolezo zosakwana 30 ml / mphindi, mankhwala zotchulidwa kuyangʻaniridwa ndi achipatala (pazipita mlingo - 20 mg patsiku).

Lovasterol - malangizo ogwiritsira ntchito

Owerenga athu adagwiritsa ntchito bwino Aterol kutsitsa cholesterol. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Patsamba lino: kufotokozera kwa mankhwala Lovasterol, mavuto onse, contraindication ndi malangizo ogwiritsira ntchito mankhwala Lovasterol amawaganizira.

Dzina losagwirizana ndi mayiko ena onse pazomwe limagwira ndi chinthu chofunikira chokhudza mankhwalawa. Chowonadi ndi chakuti, monga lamulo, mankhwala omwe ali ndi ntchito yomweyo amapangidwa pansi pa mayina osiyanasiyana ogulitsa, ndiye kuti, awa ndi omwewa, koma opangidwa ndi makampani osiyanasiyana. Ndi INN yomwe imathandiza madokotala kusankha chida choyenera kuchokera ku kuchuluka kwakukulu kwa mankhwala omwe amapezeka pamsika wamankhwala.

Kutulutsa Fomu:

Mapiritsi
1 tabu
lovastatin
20 mg
Ma PC 10 - matumba otumphukira (3) - mapaketi a makatoni.

Mapiritsi
1 tabu
lovastatin
10 mg
Ma PC 10 - matumba otumphukira (3) - mapaketi a makatoni.

Mapiritsi
1 tabu
lovastatin
40 mg
Ma PC 10 - matumba otumphukira (3) - mapaketi a makatoni.

tabu. 20 mg: 30 ma PC.

tabu. 10 mg: 30 ma PC.

tabu. 40 mg: 30 ma PC.

Cerebrovascular matenda: mitundu, zimayambitsa, Zizindikiro, matenda, momwe mungachitire

Cerebrovascular matenda (CVB) ndi matenda amitsempha yama ziwongo, yomwe imatsogolera ku ischemia, hypoxia ndi kuphwanya ntchito zosiyanasiyana za thupi. Mothandizidwa ndi zoyipa zakunyumba ndi zamkati, zotengera zamkati zimawonongeka, ndipo kufalikira kwa ziwalo kumasokonekera.

Cerebrovascular matenda kumabweretsa chitukuko cha discirculatory encephalopathy - matenda omwe akupita pang'onopang'ono bongo chotupa chifukwa cha kuperewera kwa mtima. Izi zimawonedwa kale ngati vuto la okalamba. Pakadali pano, kuchepa kwa matenda a "cerebrovascular" ndi "achichepere": matendawa amapezeka kwambiri mwa anthu ochepera zaka 40. Izi zimachitika chifukwa cha moyo wopanda thanzi, zachilengedwe, kusowa bwino kwa zakudya.

Matenda a Cerebrovascular pano ndivuto lalikulu lazachipatala. Amakhala wachitatu pamagawo onse omwalira pambuyo pamatenda a mtima komanso a oncopathology. CVI ndi yomwe imayambitsa matenda opha ziwalo komanso kulumala kwanthawi yayitali.

Gulu

Matenda a Cerebrovascular - matenda am'magazi, omwe ndi monga:

• Hemorrhagic ndi ischemic stroke.
• Matenda a discirculatory matenda aubongo - ma occlusion ndi vasospasm, arteritis, aneurysm.
• Intracranial hemorrhage.
• Hypertensive cerebrovascular matenda - atherosulinotic ndi hypertgency encephalopathy.

Mfundo zazikuluzikulu za matenda:

1. Zilonda zam'mimba za chotupa cha chotupa chimayambitsa kupezeka kwa cholesterol, mapangidwe a zolembera, kuchepa kwake ndi kufalikira, ndipo kenako kuphwanya kwamitsempha yamagazi, ubongo wamatumbo ndi malingaliro.
2. Kuwonongeka kwa magazi pakupanga magazi, thrombosis ndi thromboembolism nthawi zambiri kumayambitsa kusokonezeka kwa ubongo.
3. Kuphipha kwa khoma lakunja chifukwa cha matenda oopsa amachepetsa magazi.
4. Vasculitis imasokoneza magazi kupita ku ubongo.
5. Osteochondrosis imatha kubweretsa kusowa kwa vertebro-basilar komanso kusokonezeka kwakanthawi kwamatenda amitsempha yamagazi.

Zomwe zimayambitsa kukula kwa matenda:

Owerenga athu adagwiritsa ntchito bwino Aterol kutsitsa cholesterol. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

• Matenda a shuga
• Ukalamba
• Hypercholesterolemia, dyslipidemia,
• Kunenepa kwambiri
• Matenda oopsa
• Matenda a mtima wa Ischemic,
• Kupsinjika
• Kuvulala kwam'mutu
• Kugwiritsa ntchito kwa nthawi yayitali njira zakulera zamkamwa,
• Kusuta
• Khalidwe labwino
• Khalidweli.

Zizindikiro

Cerebrovascular matenda koyambirira kwa kukula kwake kumawonetsedwa ndi zizindikiro zotsatila zamankhwala:

1. Kuchepa kwa ntchito, kuchuluka kwa kutopa,
2. Kusakwiya, kusintha kwa mtima, kusakhazikika pamtima,
3. Kukangana kwambiri
4. Kusowa tulo
5. Kumva kutentha
6. Pakamwa pakamwa
7. Asthenia
8. Zosangalatsa pamtima.

M'tsogolomo, pamene ubongo hypoxia ukuwonjezeka, zovuta zowopsa zimayamba ndikuwonekera kwambiri: kufooka kwa chidwi, kusokonezeka kukumbukira, kusokonezeka kwa malingaliro, kulingalira, kulumikizana, kupweteka mutu kosachepera, kuchepa kwa ntchito m'maganizo.

Odwala, kupsinjika kumachitika, nzeru zimachepa, ma neuroses ndi psychoses amakula, phobias ndi mantha, egocentrism, kuphulika, kufooka kwa mtima kumawonekera. Odwala amakhala hypochondriacal komanso osatetezeka. Milandu yayikulu, kugwedezeka, kunjenjemera, kugwedezeka kwamkati, kulankhula mkatikati, kusunthika ndi mphamvu mu malekezero zimakhazikika, kuzungulira kwa thupi kumatha, ndipo ziwalo zamawonedwe zimakhudzidwa.

Kuchulukanso kwa kusintha kwa morphological mu minyewa ya muubongo kumabweretsa kuwonekera kwa ma syndromes ambiri otchuka ndi owoneka - ma ubongo ndi mikwingwirima, maresi ndi ziwalo zamiyendo, matenda am'matumbo, dysphagia, kuseka kwachiwawa ndikulira.

Zizindikiro zamankhwala zomwe zimapezeka mwa odwala tsiku lonse zimawonetsa kuphwanya kwamitsempha yamagazi - matenda amitsempha. Akazimiririka kwakanthawi kochepa, amakayikira kwa kanthawi kochepa.

3 madigiri a cerebrovascular matenda amadziwika:

• CVB ya digiri yoyamba ipezeka osadziwika. Zizindikiro zake zili m'njira zambiri zofanana ndi zizindikiro za matenda ena kapena kuvulala.
• Digiri yachiwiri imawonetsedwa ndi kusokonezeka kwa malingaliro. Matendawa ndi chisonyezo chofotokoza kupunduka, koma wodwala amadzipereka.
• Digiri yachitatu ndikusinthidwa kwa matenda kukhala gawo la mtima wofatsa. Wodwala sangathe kuyendayenda ndikuyenda m'malo; amafunika thandizo ndi chisamaliro cha anthu omuzungulira. Khalidwe la odwala otere liyenera kuwongoleredwa.

Mavuto ambiri a CVB ndi: stroke, kusokonezeka kwapang'onopang'ono, kuchepa kwa magazi, kuchepa kwa magazi.

Zizindikiro

Kuzindikira ndi kuchiza matenda amitsempha yamagazi okhudzana ndi opaleshoni ya mtima komanso opaleshoni ya mtima. Amasankha njira zamankhwala mogwirizana ndi machitidwe a matendawa, momwe wodwalayo alili komanso kupezeka kwa zovuta zodwala.

Kuyesedwa kwathunthu kwa odwala omwe ali ndi CVI akuphatikizapo:

1. Kuyesedwa kwa magazi
2. Mapazi amwazi
3. Kudziwitsa kwa index ya prothrombin,
4. Machitidwe a serological pa syphilis,
5. ECG
6. Urinalysis
7. Pesi x-ray.

Njira zomwe zimapangidwira kuti tidziwe matenda amitsempha yathunthu:

• Duplex kapena triplex angioscanning amapangira matenda oyamba a CVB. Ndiwotetezeka kwambiri, mwachangu komanso wotsika mtengo. Mwanjira imeneyi, zotengera zomwe zingakhudzidwe zimatha kuyesedwa mobwerezabwereza komanso popanda kuvulaza thanzi.
• Angiography ndi njira yosiyanitsa ndi ma x-ray a mitsempha yamagazi, yomwe imalola kudziwa momwe zimagwirira ntchito, kupezeka kwa njira yothandizira komanso kutalika kwake. Cerebral angiography amachitika pambuyo pa kuphatikiza kosiyana naye magazi. Zimakuthandizani kudziwa wodwala kukhalapo kwa thrombosis, zotupa za atherosselotic komanso kuchepetsedwa kwamitsempha yamagazi, oncopathology, hematoma ndi aneurysm.
• Binti scintigraphy ndi njira yosavuta yofufuzira komanso yopanda chitetezo yomwe ilibe zotsutsana ndipo sizimayambitsa zovuta. Kuunika kwa nyukiliya ndi njira yothandiza kwambiri komanso yodziwitsa anthu za ngozi ya matenda a mtima. Mankhwala okhala pama radioase amachokera mu mtsempha, ndipo pakatha mphindi 15 amangojambula. Ino ndi yokwanira kuti wayilesi yayala kufalikira thupi lonse ndikudziunjikira minofu yosinthika. Chizindikirochi chili ndi muyeso wa radiation womwe suvulaza thupi.
• Transcranial Doppler ultrasound ndi kuwunika kwa mitsempha yamagazi yomwe imawunika kuthamanga kwa magazi ndikuwonetsa zosokoneza za hemodynamic.
• Zosafunikira kwenikweni pa kuzindikira kwa CVB ndi MRI ndi CT.

Ndikosatheka kudziyimira pawokha komanso kuchiza matenda amisempha. Katswiri wodziwa bwino, wodziwa bwino kwambiri, yemwe adaphunzira madandaulo a wodwala ndikumufufuza kwathunthu, ndi omwe angamupatse chithandizo choyenera. Chithandizo chokwanira komanso chapanthawi yake chidzasintha moyo wa wodwala ndikuchepetsa chiopsezo chokhala ndi chiopsezo cha moyo - sitiroko.

Cholinga chachikulu cha mankhwalawa ndikuchotsa kusokonezeka kwa ntchito za ubongo. Kuti tichotse kwathunthu matenda a cerebrovascular path, ndikofunikira kudziwa ndikuchotsa zomwe zimayambitsa. Kuphatikiza pa kupereka mankhwala, akatswiri amapatsa odwala malangizo oyenera: sinthani moyo wawo, muchepetse thupi, musasute fodya kapena kumwa mowa, idyani moyenera komanso moyenera.

Mankhwala

Chithandizo chokwanira cha matenda amisempha nthawi zambiri chimachitika mu dipatimenti yamitsempha. Akatswiri amathandizira makamaka kupewa zinthu zoika pachiwopsezo: mankhwala antisulinotic, hypotensive, hypoglycemic. Pambuyo pokhazikitsa kukonzanso kwa kagayidwe kake kamomwe amapita ku chithandizo chachindunji cha matenda.

Chithandizo chapadera

Magulu akuluakulu a mankhwala omwe amasinthira kufalikira kwa matenda a ziwongo ndipo cholinga chake ndikuchiritsa matenda osachepera ubongo:

1. Ma calcium calcium blockers amawongolera magazi, magazi am'munsi, kuthamanga kwa mapapo, kuchepetsa maphatikizidwe am'magazi ndikusintha kapangidwe ka magazi. Mankhwala ozikidwa pa nifedipine amachepetsa ziwiya zaubongo - Corinfar, Kardipin, mankhwala ochokera ku gulu la diltiazem Dilzem, Kardil. Cinnarizine ndi zotumphukira zake, Verapamil, amakhalanso a calcium blockers.
2. Ma antioxidants. A antioxidant wamphamvu wolembedwa kwa matenda a cerebrovascular matenda, stroke ndi encephalopathy ndi Cerebrolysin. Kuphatikiza apo, Cerebrocurin ndi Actovegin amagwiritsidwa ntchito nthawi zambiri.
3. Ma antihypoxants amalembedwa chifukwa cha matenda a cerebrovascular matenda - Ketoprofen, Imidazole, Mekaprin.
4. Ma metabolism - "Cavinton", "Sermion", "Vinpocetine", "Tanakan".
5. Direct anticoagulants - "Heparin", "Fraxiparin" komanso osadziwika - "Phenilin", "Sincumar", "Warfarin".
6. Mankhwala othandizira antiplatelet - "Acetylsalicylic acid", "Curantyl".
7. Mankhwala okhala ndi hypocholesterolemic kanthu, ma statins - "Lovastatin", "Lipostat", "Probucol", "Tykveol".
8. Mankhwala a nootropic - Omaron, Piracetam, Pantogam, Glycine, Phenibut.
9. Mankhwala omwe amachepetsa ziwiya zaubongo - Pentoxifylline, Trental, Agapurin.
10. Antispasmodics - "Papaverine", "Eufillin", "Dibazol."

Chithandizo chachikulu

Chithandizo chachikulu cha CVB ndikutanthauza kusintha kwamphamvu kupuma, mtima ndi mtima, kusunga homeostasis, komanso neuroprotection.

• Kuti muchite izi, santhani mlengalenga, lowetsani trachea, ndikupereka mpweya wabwino wam'mapapo.
• PZizindikiro zakulephera kwa mtima ndi edema ya m'mapapo zikupezeka, "Lasix" ndi "Pentamine" amagwiritsidwa ntchito.
• Mankhwala othandizira antiarrhythmic amawonetsedwa kwa odwala omwe ali ndi mtima wa arrhythmias. Nthawi zambiri zotchulidwa antianginal mankhwala, mtima glycosides - Strofantin, Korglikon, antioxidants.
• "Seduxen", "Haloperidol", "diphenhydramine", "Sodium oxybutyrate" ithandizanso kuyimitsa ntchito zamasamba.
• Pofuna kuthana ndi edema yam'mimba, osmotic diuretics amagwiritsidwa ntchito - Mannitol, Furosemide.
• Kuti khazikitse kuthamanga kwa magazi, Atenolol, Enalapril, Nifedipine, Dibazol ndi mankhwala.
• Kuwongolera zovuta zama metabolic kumachitika ndi kubwezeretsanso kuchuluka kwa madzi amadzimadzi a extracellular ndi mayankho a Ringer, plasma, glucose.
• Chithandizo cha Sy Symbomatic chimaphatikizapo anticonvulsant ndi psychotropic mankhwala, othandizira minofu, analgesics - "Analgin", "Ketorol", "Promedol".

Hyperbaric oxygenation ndi njira yochiritsira yopatsa thupi yomwe imapereka magazi m'magazi komanso kulowa kwake mu minyewa ya ubongo. Wodwalayo ali m'chipinda chapadera ndipo amapumira mpweya wabwino. Hyperbaric oxygenation imachotsa ngongole ya oksijeni ndikuyambiranso aerobic glycolysis. Njirayi imawongolera moyo wa odwala, imachepetsa zizindikiro za matenda a m'mitsempha ndikulepheretsa kukula kwa zovuta zovuta.

Mankhwala othandizira

Mitundu yambiri yamatenda, omwe sangathe kuwongolera kuchipatala, amafunikira opaleshoni. Odwala amachotsedwa magazi ndikuwakhomera pamatumbo, kumakulitsa lumen kwa ziwiya pogwiritsa ntchito catheter ndi balloon, ndipo zokhazikitsidwa zimayikidwa mumitsempha yama cell yomwe imapangitsa kuti chimbudzi chikhale chotseguka.

Matenda a Cerebrovascular akuyenera kuchitidwa opaleshoni: ochepa aneurysms ndi intracerebral hemorrhages.

Chithandizo cha anthu

Chithandizo chofala kwambiri chomwe chimagwiritsidwa ntchito pochiza matenda a mtima:

• Muzu wa peony ndi wouma, pansi ndikuthira madzi otentha. Kuumirira yankho la ola limodzi, firiji ndi kutenga 5 pa tsiku supuni.
• Mu chopukusira nyama, malalanje awiri ndi mandimu awiri amaphwanyidwa, misa ndikuphatikizidwa ndi uchi wamadzi ndikusakanizidwa. Kuumirira pa tsiku lozizira, ndipo kenako supuni katatu pa tsiku.
• Ma singano a paini amathiridwa ndi madzi otentha, onjezerani ndikuwonjezera msuzi wa theka la ndimu ku msuzi. Tengani mankhwalawa pamimba yopanda kanthu kwa miyezi itatu.
• Celandine tincture imatengedwa pamimba yopanda kanthu katatu patsiku kwa masabata awiri.

Mankhwala achikhalidwe ndiwowonjezera pazabwino zazikulu za matenda.

Kupewa komanso kudwala

Njira zopewera kukula kwa matenda osokoneza bongo:

1. Matenda a kuthamanga kwa magazi
2. Mankhwala a panthawi yake a concomitant pathologies,
3. Kulimbana ndi zizolowezi zoipa
4. Masewera olimbitsa thupi
5. Zakudya zoyenera
6. Kukhathamiritsa kwa ntchito ndikupuma
7. Kunenepa.

Pazolinga za prophylactic, odwala amalembedwa mankhwala omwe amasintha kufalitsa kwa magazi ndi kuthana ndi magazi.

Ngati matendawa amathandizidwa mwachangu komanso molondola, sizotheka kungosintha moyo wa wodwalayo, komanso kuchepetsa chiopsezo cha matenda a sitiroko ndi zovuta zina zazikulu.