Liprimar 10 mg - malangizo ogwiritsira ntchito

Mlingo wa Liprimar - mapiritsi: amodzi, ophimbidwa ndi utoto wazithunzi za mtundu woyera, pakupuma - pakati pakhungu loyera:

• Ndi zolemba "10" mbali imodzi ndi PD "155" mbali inayo (ma PC 10. M'matumba, pamatumba atatu a matuza atatu kapena 10),
• Ndi zolemba "20" mbali imodzi ndi PD "156" mbali inayo (ma PC 10. M'matumba, pamakatoni a matuza atatu kapena 10),
• Ndi zolemba "40" mbali imodzi ndi PD "157" mbali inayo (ma PC 10. M'matumba, matuza atatu m'bokosi la makatoni),
• Ndikupanga zolemba "80" mbali imodzi ndi PD "158" mbali inayo (ma PC 10. M'matumba, pamakatoni 3 matuza 3).

Piritsi lililonse lili ndi:

• Zogwira pophika: atorvastatin (mwanjira yamchere wamchere) - 10, 20, 40 kapena 80 mg,
• Zothandiza monga: croscarmellose sodium, magnesium stearate, lactose monohydrate, microcrystalline cellulose, calcium carbonate, hyprolose, polysorbate,
• Kuphatikizidwa kwa chovala cha filimuyi: opadry yoyera YS-1-7040 (candelil wax, titanium dioxide, polyethylene glycol, talc, hypromellose, simethicone emulsion (stearic emulsifier, sorbic acid, simethicone, madzi).

Zizindikiro zogwiritsidwa ntchito

Chithandizo cha matenda otsatirawa:

• Hypercholesterolemia (heterozygous Famer komanso hypercholesterolemia (mtundu IIa malinga ndi gulu la Fredrickson),
• Famical endo native hypertriglyceridemia (mtundu IV malinga ndi gulu la Fredrickson), yogonjetsedwa ndi zakudya,
• Dysbetalipoproteinemia (mtundu wa III malinga ndi gulu la Fredrickson) (kuwonjezera pazakudya),
• Mitundu yophatikiza hyperlipidemia (mitundu ya IIa ndi IIb malinga ndi gulu la Fredrickson),
• Homozygous achiberekero hypercholesterolemia (mankhwalawa amagwiritsidwa ntchito ngati singakwanitse kuphatikiza njira zosaphatikizira zamankhwala, kuphatikizapo mankhwala othandizira pakudya).

Liprimar imalembedwanso njira zodzitetezera:

• Kuteteza koyamba kwa mtima wamavuto odwala osakhala ndi matenda am'matumbo, koma ndi zinthu zingapo zomwe zimapangitsa kuti pakhale zaka zopitilira 55, kusuta, matenda ashuga, matenda oopsa, kusintha kwa chibadwa, kutsika kwakukulu kwa lipoprotein cholesterol (HDL-C) m'madzi a m'magazi,
• Kupewera kwachiwiri kwa matenda amtima wamkati mwa odwala omwe ali ndi matenda amtima kuti achepetse chiopsezo cha angina pectoris, stroko, myocardial infarction, imfa, komanso kufunikira kwa kusinthanso.

Contraindication

• Matenda a chiwindi ogwirira ntchito kapena kuchuluka kwa hepatic transaminases ya komwe sikudziwika (nthawi zopitilira 3 poyerekeza ndi zomwe zimachitika mu adrenal hyperplasia),
• Osakwana zaka 18
• Mimba
• Kuchepetsa (kapena kudyetsa kuyenera kuyimitsidwa),
• Hypersensitivity pamagawo a mankhwala.

Wachibale (chisamaliro chowonjezera chikufunika):

• Mbiri ya matenda a chiwindi,
• Mowa.

Mlingo ndi makonzedwe

Musanayambe Liprimar, ndikofunikira kukwaniritsa kuwongolera kwa hypercholesterolemia mothandizidwa ndi zakudya, zolimbitsa thupi ndi kuchepa thupi kwa odwala omwe ali ndi kunenepa kwambiri, komanso kudzera mu chithandizo cha matenda oyambitsidwa.

Mankhwala ayenera kumwedwa pakamwa 1 nthawi iliyonse tsiku lililonse, kaya kudya.

Mlingo watsiku ndi tsiku umatha kukhala 10 mpaka 80 mg. Dotolo amasankha mlingo poganizira zomwe zikuwonetsa, zomwe zili zoyambirira za otsika osalimba lipoprotein cholesterol (LDL-C) ndi chidziwitso chakuchita bwino kwa Liprimar.

Mu hypercholesterolemia yoyamba ndi kuphatikiza hyperlipidemia, tsiku lililonse mlingo wokwanira kwa odwala ambiri ndi 10 mg. Zotsatira zakuchiritsika zimawonekera mkati mwa masabata awiri, zimafika pakatha pafupifupi masabata anayi.

Ndi homozygous achibale hypercholesterolemia, mankhwala nthawi zambiri mankhwala tsiku lililonse 80 mg.

Odwala omwe ali ndi hepatic osakwanira ayenera kuchepetsa mlingo wa Liprimar kuyang'aniridwa kosalekeza kwa zochitika za alanine aminotransferase (ALT) ndi aspartate aminotransferase (AST).

Wodwala amayenera kutsatira muyezo wa hypocholesterolemic zakudya zomwe dokotala amalimbikitsa nthawi yonse ya chithandizo.

Masabata aliwonse a 2-4 kumayambiriro kwa mankhwalawa komanso kuwonjezeka kulikonse kwa mankhwalawa, ndikofunikira kuwongolera zomwe zili ndi lipids m'magazi ndipo ngati kuli koyenera, sinthani mlingo.

Ngati mankhwala ophatikizidwa ndi cyclosporine ndi ofunika, mlingo wa Liprimar suyenera kupitilira 10 mg.

Zotsatira zoyipa

Kwenikweni, mankhwalawa amalekeredwa bwino. Zotsatira zoyipa, ngati zimachitika, nthawi zambiri zimakhala zowuma pang'ono komanso zimasinthasintha.

Zotheka kuchitidwa:

• Pakati mantha dongosolo: Nthawi zambiri (≥1%) - mutu, kusowa tulo, asthenic syndrome, kawirikawiri (≤1%) - chizungulire, hypesthesia, paresthesia, malaise, zotumphukira neuropathy, amnesia,
• Matumbo: Nthawi zambiri - kupweteka kwam'mimba, kugona, kutsekemera, kutsegula m'mimba, kudzimbidwa, kawirikawiri - kusanza, cholestatic jaundice, kapamba, hepatitis, anorexia,
• Matenda a minofu ndi mafupa: nthawi zambiri - myalgia, kawirikawiri - myositis, minofu kukokana, myopathy, rhabdomyolysis, kupweteka kumbuyo, arthralgia,
• Hematopoietic dongosolo: kawirikawiri - thrombocytopenia,
• Metabolism: kawirikawiri - hyperglycemia, hypoglycemia, kuchuluka kwa serum creatine phosphokinase,
• Thupi lawo siligwirizana: kawirikawiri - kuyabwa, zotupa pakhungu, uritisaria, zidzolo zakumaso, poyizoni wam'mimba, erythema multiforme, anaphylactic reaction,
• Zina: kawirikawiri - kupweteka pachifuwa, kusabala, kuchuluka kwa kutopa, kunenepa kwambiri, tinnitus, alopecia, kulephera kwa impso, edema.

Malangizo apadera

Monga mankhwala ena otsitsa a lipid a kalasi imodzi, Liprimar ikhoza kuthana ndi ntchito ya michere ya chiwindi. Pazifukwa izi, asanakhazikitsidwe, pakadutsa milungu 6 ndi 12 kuchokera nthawi yomwe adayamba kugwiritsa ntchito, kuchuluka kulikonse kwa mankhwalawa, komanso nthawi ndi nthawi yonse ya chithandizo, ndikofunikira kuwunika magawo a chiwindi. Kafukufuku wokhudzana ndi ntchito ya chiwindi ndikofunikira pakachitika zizindikiro zamankhwala kuwonongeka kwake. Ngati kuwonjezeka kwa ntchito za ALT kapena AST kwa nthawi zopitilira 3 kungayerekezeredwe ndi chizindikiro chomwecho cha congenital adrenal hyperplasia, mlingo uyenera kuchepetsedwa kapena mankhwala atha.

Pali malipoti a milandu yachilendo ya rhabdomyolysis, limodzi ndi kulephera kwaimpso chifukwa cha myoglobinuria, mwa odwala omwe akutenga Liprimar. Pachifukwa ichi, ngati pali chiopsezo cha kuperewera kwa impso chifukwa cha matenda a rhabdomyolysis (monga matenda owopsa, kupsinjika, opaleshoni yayikulu, kusokonekera kwa magazi, endocrine, electrolyte ndi kusokonezeka kwa metabolic, kukomoka kosalamulirika) kapena ngati zizindikiro zikuwoneka zomwe zingagwiritsidwe ntchito kukayikira myopathy, Liprimar iyenera kuchotsedwa kwakanthawi kapena kwathunthu.

Odwala onse ayenera kuchenjezedwa kuti ayenera kufunsa dokotala ngati ali ndi vuto la kufooka kapena kufupika kwa minofu, makamaka ngati akupita ndi malungo kapena / kapena kufinya.

Amayi amsinkhu wobereka amatha kukhala ndi Liprimar pokhapokha ngati mwayi wokhala ndi pakati umachepetsedwa, ndipo odwala omwewo akadziwitsidwa za zoopsa zomwe zingachitike. Nthawi yonse ya chithandizo ayenera kugwiritsa ntchito njira zodalirika zakulera.

Zambiri pazokhudzana ndi atorvastatin pa kuchuluka kwa zimachitika ndi kuzunzika sizikupezeka.

Kuyanjana kwa mankhwala osokoneza bongo

Pogwiritsa ntchito munthawi imodzimodzi mafupa, cyclosporins, nicotinic acid mu Mlingo wa hypolipidemic, ufafanuzi wa ethithromycin, erythromycin ndi ma antifungal omwe amachokera ku azole, chiopsezo chokhala ndi myopathy chikuwonjezeka.

Atorvastatin imapangidwa ndi CYP3A4 isoenzyme, chifukwa chake, zoletsa za eyeenzyme (kuphatikizapo ecithromycin, itraconazole ndi erythromycin, diltiazem) zitha kukulitsa kuchuluka kwa atorvastatin m'magazi a magazi.

Tiyenera kukumbukira kuti madzi a mphesa amakhala ndi gawo limodzi lomwe limalepheretsa CYP3A4 isoenzyme, chifukwa chake kumwa kwambiri (oposa 1.2 malita patsiku) kungayambitse kuchuluka kwa atorvastatin m'magazi.

Zomwe zimayambitsa cytochrome CYP3A4 isoenzyme (mwachitsanzo, efavirenz ndi rifampicin) zimatha kuchepetsa plasma ndende ya atorvastatin. Ngati ndi kotheka, kugwiritsa ntchito nthawi yomweyo rifampicin, onsewa amatengedwa kuti amwe nthawi yomweyo, kuchedwa kwa liprimar pambuyo pa rifampicin kumabweretsa kuchepa kwakukulu pamlingo wa atorvastatin m'magazi.

OATP1B1 inhibitors (mwachitsanzo, cyclosporine) imatha kuwonjezera bioavailability wa atorvastatin.

Ndi makulidwe amodzi a antacid okhala ndi aluminium kapena magnesium hydroxide, kuchuluka kwa atorvastatin kumatsika pafupifupi 35%, koma izi sizikhudza kuchuluka kwa kuchepa kwa LDL-C.

Colestipol amachepetsa kuchuluka kwa atorvastatin mu plasma ndi 25%, komabe, lipid-yotsitsa mphamvu yogwiritsira ntchito kuphatikiza kotero imaposa zovuta zomwe zimagwiritsidwa ntchito popatula aliyense mankhwala.

Ngati ndi kotheka, kuikidwa kwa Liprimar nthawi yomweyo ndi digoxin kumafuna kuwunika kwamankhwala.

Mukamasankha njira yolerera pakamwa kwa mayi omwe akuchitidwa ndi Liprimar, ziyenera kukumbukiridwa kuti atorvastatin imachulukitsa kuchuluka kwa ethinyl estradiol ndi norethisterone (pafupifupi 20% ndi 30%, motsatana).

Liprimar: malangizo ogwiritsira ntchito

Onaninso vidiyo:

Liprimar: ndemanga

Pa intaneti mungapeze ndemanga zambiri za Liprimar. Mapiritsi awa ndiwotchuka, ngakhale ali okwera mtengo. Anthu akalemba ndemanga pamapiritsi ena a atorvastatin (Atoris, Torvacard), amadandaula kwambiri pazotsatira zawo. Ndemanga za mankhwala a Liprimar ali ndi zodandaula zambiri za mtengo wokwera wa mankhwalawo. Koma pafupifupi onse olemba satchulapo zoyipa zina.

Anthu akutsimikiza kuti popeza akumwa mankhwala okwera mtengo kwambiri mgululi, sizikhala ndi zotsatila. Kusankha zotsika mtengo m'malo mwa Liprimar, ma analogu ake - Atoris, Torvakard kapena ena - odwala amasunga ndalama.Komabe, amakhulupirira pasadakhale kuti mankhwala otsika mtengo amayambitsa zovuta zina. Ngakhale kwenikweni izi siziri choncho. Zotsatira zoyipa zambiri za ma statins omwe anthu amadandaula nazo pakuwunika kwawo zimachitika chifukwa cha zovuta zamaganizidwe, m'malo mwazomwe zimachitika chifukwa cha mankhwalawo.

Ndemanga zambiri zalembedwa ndi anthu omwe amatenga atorvastatin pambuyo poyambitsa myocardial. Popeza tapulumuka vuto la mtima, anthu sakonda kusunga chithandizo chawo. Amagula mwakufuna mankhwala okwera mtengo kwambiri, omwe akuphatikizapo Liprimar. Tsoka ilo, ndi anthu ochepa omwe ali okonzeka kutchera khutu ndikugwiritsa ntchito ndalama pa thanzi lawo panthawi yopewera, pomwe vuto la mtima likhoza kupewedwa kapena kuchedwa. Werengani ndemanga zambiri za odwala omwe amatenga Liprimar.

Mafunso Ofunsidwa Kawirikawiri

Otsatirawa ndi mayankho a mafunso omwe nthawi zambiri amakhala Odwala.

Kodi nditenge Liprimar kuti nditenge nthawi yayitali bwanji?

Monga ma statin ena, Liprimar iyenera kutengedwa kwamuyaya, tsiku lililonse, kwa moyo wanu wonse, ngati muli ndi chiopsezo cha matenda a mtima oyamba kapena obwereza, komanso stroke. Werengani nkhani yayikulu yama statins ndikuwona yemwe akuyenera kumwa mankhwalawa ndi omwe safuna. Simuyenera kupuma mukamamwa mapiritsi a cholesterol omwe mudayikidwa. Tengani tsiku lililonse nthawi yomweyo.

Liprimar, monga ma statin ena, amatha kuyambitsa kutopa, kupweteka kwa minofu ndi mafupa. Kuti mumve zambiri, onani nkhani yakuti "Zotsatira zoyipa za ma statin." Komabe, mankhwalawa amatalikitsa moyo, amachepetsa chiopsezo cha matenda amtima woyamba komanso obwereza. Chifukwa chake, zoyipa zake zoyipa kwambiri mpaka pang'ono zimatha kulekerera. Ngati atorvastatin imabweretsa mavuto akulu, ndiye kuti kupumula kwakanthawi sikungathandize. Mukapuma, mavuto amayambanso kubwereranso. Odwala omwe akukumana ndi zovuta zotsutsana ayenera kukambirana ndi dokotala kuti athandize kuchepetsa, asinthane ndi mankhwala ena, kapena kuthetseratu kwathunthu kwa ma statins.

Liprimar sayenera kumwedwa tsiku lililonse. Dongosolo loterolo silinayesedwe mu maphunziro ena azachipatala. Sizokayikitsa kuti adzakutetezani bwino ku vuto la mtima. Madokotala omwe amapereka kuti atorvastatin kapena ma statin tsiku lililonse tsiku lililonse amachita "zochitika zamankhwala." Ndikwabwino kusintha dokotala kuti akhale katswiri wodziwa bwino. Ngati mukulekerera chithandizo ndi mapiritsi a Liprimar bwino, ndiye kuti mumwa iwo tsiku lililonse. Ndipo ngati zili zoipa, ndiye kuti mukambirane ndi dokotala zoyenera kuchita.

Kodi ndingagawe piritsi pakati?

Mapiritsi a Liprimar sangakhale ogawanika. Palibe mzere wogawanika pa iwo. Mosasamala - mutha kugawana, koma ndibwino osazichita. Chifukwa kunyumba, simungathe kugawanitsa bwino piritsi pakati, ngakhale ndi lumo, ndipo makamaka ndi mpeni. Zotsatira zake, tsiku lililonse mumamwa mankhwala osiyanasiyana omwe amachepetsa cholesterol "yoyipa". Izi zisokoneza zotsatira zamankhwala.

Kumbukirani kuti mlingo wa atorvastatin 5 mg patsiku sunayesedwe mu maphunziro alionse azachipatala. Mwambiri, sichiteteza chokwanira kuchokera ku matenda oyamba obwereza a mtima. Chifukwa chake, simuyenera kugawana piritsi ya 10 mg kuti mutenge 5 mg tsiku lililonse. Anthu ena, poyesa kusunga ndalama, amagula mapiritsi okhala ndi Mlingo wambiri wa Liprimar. Kenako mapiritsiwa amagawika pakati kuti aliyense wa iwo akukwanira masiku awiri. Ndibwino kuti musachite izi kuti mankhwalawa omwe mumamwa akhale omwewo tsiku lililonse.

Onaninso vidiyo ya "Cholesterol Statins: Odwala Odwala."

Kodi mungandipangire kufanana kwa Liprimar komwe kuli kotsika mtengo?

Liprimar ndi mankhwala oyamba a atorvastatin. Amadziwika kuti ndi apamwamba kwambiri, koma okwera mtengo. Ngati mungakwanitse kugula, sankhani mitundu yoyambirira yamankhwala anu osatengera chidwi chawo. Tsoka ilo, mtengo wokwera umapangitsa kukonzekera koyambirira kwamatenda amtundu wa mtima kuthana ndi odwala ambiri. Mwanjira iyi, kusankha koyenera ndizofanizira za mapiritsi a Liprimar, omwe akupezeka ku Eastern Europe. Awa ndi Atoris, Torvakard, Tulip kapena ena.

Ma chequo analogu ndi mapiritsi a atorvastatin opangidwa ku Russia Federation ndi mayiko a CIS. Amapangidwa ndi ALSI Pharma, Canonfarm Production, VERTEX ndi ena. Katswiri wazachipatala wazambiri amalangizidwa kuti mupewe, werengani zambiri apa. Mumakonda mapiritsi a atorvastatin omwe amapangidwa ku Czech Republic, Slovenia ndi maiko ena a Eastern Europe. Sikoyenera kumwa mankhwala a cholesterol omwe amachokera ku India.

Liprimar kapena atorvastatin: ndibwino?

Liprimar ndi mankhwala enieni omwe mankhwala ake ndi atorvastatin, opangidwa ndi Pfizer. Amadziwika kuti ndiwopamwamba kwambiri pakati pa kukonzekera kwa atorvastatin. Mapiritsi ena onse okhala ndi atorvastatin ndi ma analogues ake (majenito). Odwala omwe akufuna kumwa mankhwala abwino kwambiri a atorvastatin ayenera kusankha Liprimar. Pa phukusi lililonse la mapiritsi awa, muyenera kulipira ndalama zambiri. Ngati mukufuna kupulumutsa, ndiye tcherani khutu kukonzekera kwa atorvastatin, komwe kumapezeka ku Eastern Europe. Amafotokozedwa mwatsatanetsatane yankho la funso lapitalo.

Liprimar kapena rosuvastatin: ndibwino?

Monga momwe mumadziwira kale, chinthu chogwira ntchito pamapiritsi a Liprimar ndi atorvastatin. Ndipo rosuvastatin ndi mankhwala atsopano a cholesterol kuposa atorvastatin. Imatsitsa kwambiri cholesterol ya "yoyipa" ya LDL m'magazi a odwala, ngakhale atapatsidwa mankhwala ochepetsa. Koma atorvastatin amaphunziridwa bwino, chifukwa imagwiritsidwa ntchito nthawi yayitali. Werengani nkhani yatsatanetsatane ya rosuvastatin, ulalo womwe waperekedwa pamwambapa. Zindikirani momwe zili zabwinoko - atorvastatin kapena rosuvastatin.

Anthu amagwiritsa ntchito ma statins kuti awonjezere kuchuluka kwa magazi a cholesterol, komanso amachepetsa chiopsezo cha mtima woyamba komanso wachiwiri. Ngati mutenga Liprimar ndipo ikuthandizani, ndiye sizikupanga nzeru kusinthira ku rosuvastatin chifukwa ndi mankhwala atsopano. Komabe, mwa anthu ena, atorvastatin samatsitsa cholesterol yoyipa "yoyipa". Pankhaniyi, muyenera kufunsa dokotala ngati kuli koyenera kusintha ku rosuvastatin, yemwe amakhala wamphamvu. Musasinthe mwa inu nokha mankhwala amafuta ena. Chitani izi pokhapokha ndikuvomerezedwa ndi dokotala.

Liprimar kapena Atoris: ndi mankhwala ati abwinoko?

Liprimar ndi mankhwala oyamba a atorvastatin, ndipo Atoris ndi analogue (generic). Liprimar, monga mankhwala onse apachiyambi, amatengedwa kuti ndi wapamwamba kwambiri m'gulu lake. Komabe, ngati simungathe kulipira, ndiye kuti mverani Atoris. Mapiritsi awa a atorvastatin amapangidwa ndi kampani yotchuka KRKA ku Eastern Europe malinga ndi miyezo ya EU. Atoris ndi kuphatikiza kwa mtengo wololera komanso wapamwamba kwambiri.

Liprimar kapena Torvacard: ndi mankhwala ati abwinoko?

Torvacard ndi mankhwala a Zentiva atorvastatin. Amapikisana ndi mapiritsi a Atoris, omwe amakambidwa poyankha funso lapitalo. Liprimar mwina ndiyabwino kuposa Torvacard. Koma ngati mtengo wa mankhwala oyambawo sungapirire, ndiye kuti Torvacard ndi njira ina yabwino. Mankhwalawa amapezeka ku Czech Republic. Fotokozerani dziko lomwe linachokera ndi barcode pa phukusi. Simungapeze chidziwitso chodalirika kulikonse komwe mankhwalawa ali bwino - Atoris kapena Torvakard. Mankhwalawa onse ndi abwino atorvastatin analogues. Siyani chisankho pakati pawo mwakufuna kwa dokotala.

Dotolo adakulitsa kuchuluka kwanga kwa mapiritsi a Liprimar kuchokera 10 mpaka 40 mg patsiku, chifukwa cholesterol imakhala yokwera. Kuda nkhawa ndi mavuto.

Dziwani kuti mapuloteni omwe ali ndi C-yogwira ndi yani, ndipo yang'anirani chizindikiro ichi mosamala kuposa cholesterol "choyipa" ndi "chabwino". Zitha kuzindikirika kuti mulingo wochepera wama statins ukukwanira.

Kodi atorvastatin angayambitse kukokana kwa mwendo, kugwedezeka, kapena dzanzi kumiyendo, mikono?

Zizindikiro zonsezi zimatha kukhala zoyipa za Liprimar ndi ma statin ena. Choyamba, tengani magazi ndi mkodzo poyesa momwe impso yanu imagwirira ntchito. Zitapezeka kuti zonse ndizabwinobwino ndi impso, tengani magnesium-B6 kuchokera kukokana mwendo. Kugwedezeka kapena kugona m'miyendo, mikono - ikhoza kuwonetsa kuti mukupanga matenda a shuga. Pimani shuga wanu wamafuta mukatha kudya (osati pamimba yopanda kanthu!) Ndi mita ya shuga wamagazi kapena mu labotale. Ngati matenda a shuga atsimikiziridwa, phunzirani momwe mungamulamulire apa. Pankhaniyi, simuyenera kusiya kumwa ma statins popanda kuvomerezedwa ndi dokotala.

Kodi ndingamwe mowa nditamwa Liprimar?

Ngati mukuvutika ndi uchidakwa, simungatenge Liprimar kapena ma statin ena. Ngati ndinu chidakwa "osokoneza bongo", muyenera kusamala - kumwa mankhwalawa, koma nthawi zambiri mumayesa magazi a ma enzymes a chiwindi ndikuwunikira zizindikiro za jaundice. Poyerekeza ndi chithandizo cha mankhwala a atorvastatin, magawo awiri a mowa patsiku amaloledwa kwa amuna azaka zosaposa 65 ndi omwe amawagwiritsa ntchito amuna oposa 65 ndipo azimayi azaka zonse. Imodzi yokha yoperekera zakumwa zoledzeretsa ndi theka la mowa, i.e. mowa, chikho cha vinyo kapena chikho cha mowa wamphamvu wa 40-degree. Ngati simungakhalebe osadziletsa, ndibwino kuti musamamwe mowa.

Werengani mayankho a mafunso ena 22 omwe amafunsidwa kawirikawiri munkhani ya “Statins: FAQ. Mayankho a mafunso a odwala. "

Kugwiritsa ntchito mankhwala Liprimar

Liprimar ndi mankhwala oyamba a atorvastatin, imodzi mwazinthu zatsopano kwambiri. Mankhwalawa amayendetsa mafuta m'thupi. Imachepetsa cholesterol “yoyipa” ya LDL, komanso triglycerides, ndikuwonjezera cholesterol ya "good" HDL. Atorvastatin yatsimikizira kugwira ntchito bwino pakupewa matenda amtima woyamba komanso obwereza, ischemic stroke. Kuti mumve zambiri onani nkhani ya "Liprimar: zaka 15 za umboni wotsimikizika" mu magazini ya "Rational Pharmacotherapy in Cardiology" No. 7/2011. Cholinga cha mankhwalawa chimachepetsa mwayi womwe mungafunike kuchita opareshoni kuti mubwezeretse kutuluka kwa magazi m'mitsempha yomwe yakhudzidwa ndi atherosulinosis.

Mayesero azachipatala a atorvastatin, omwe adachitika mu 1996-2011, adakhudza anthu opitilira 50,000 omwe adapezeka ndi matenda: mtima wamatenda, matenda osokoneza bongo, matenda oopsa, kuchepa kwa magazi. Onse omwe amaphunzira nawo adatenga mankhwala oyamba a Liprimar. Mapiritsiwa atsimikizira kukhala mankhwala othandiza komanso otetezeka, ngakhale kwa anthu achikulire omwe ali ndi chiopsezo chowonjezereka cha zotsatira zoyipa. Ndipo makamaka, kwa odwala azaka zapakati. Kukonzekera kwa Atorvastatin kwa ena opanga kungakhale kotsika mtengo, koma alibe umboni wotsimikiza.

M'mayiko olankhula Chingerezi, kukonzekera koyambirira kwa atorvastatin kulengezedwa pansi pa dzina la Lipitor. Mpaka chaka cha 2012, mpaka patent itatha, idagulitsidwa ndi mtengo wakuda - zopitilira 125 biliyoni. M'mayiko a CIS, mankhwala omwewo amatchedwa Liprimar. Tsopano pamsika wamankhwala pakati pa statins, mpikisano waukulu uli pakati pa atorvastatin ndi mankhwala atsopano - rosuvastatin. Pansipa amafotokozedwa mwatsatanetsatane momwe nthawi zina ndibwino kusankha atorvastatin - mankhwala oyamba kapena mapiritsi ena otsika mtengo.

Statin ndi mankhwala ofunikira kwambiri kwa anthu omwe ali pachiwopsezo cha matenda amtima woyamba komanso wachiwiri, matenda a ischemic. Chifukwa amachepetsa kwambiri ngozi yakumtima, imatenga nthawi yayitali. Umoyo wabwino umathandizanso ngati wodwala sasamala kwambiri za mavuto. Pakugwiritsa ntchito bwino popewa kugunda kwa mtima komanso sitiroko, palibe mapiritsi ena omwe angayerekezedwe ndi ma statins. Atorvastatin ndi m'modzi mwa atsogoleri pakati pa ma statins. Mankhwala oyamba a Liprimar akupitiliza kutchuka, ngakhale mapiritsi otsika mtengo a atorvastatin kuchokera kwa ena opanga amapezekanso m'masitolo ogulitsa mankhwala.

Kuchepetsa Kutsika kwa Cholesterol

Atorvastatin ndi amodzi mwa odziwika kwambiri padziko lapansi ndi mayiko olankhula Russia. Madokotala amatenga liprimar kapena mapiritsi ena a atorvastatin kuti achepetse cholesterol yawo "yoyipa" ya LDL mwa odwala. Komanso, akatswiri akulipira chidwi chochulukirapo pazotsatira zina za mankhwalawa zomwe sizikugwirizana ndi cholesterol. Zotsatira izi zimatchedwa pleiotropic. Chachikulu ndi kuchepa kwa ulesi m'matumbo. Mwina kuchepa kwa vuto la mtima, kugunda, ndi zina mwa zochitika za mtima mwa odwala zimagwirizanitsidwa ndi zotsatira zoyipa za atorvastatin, osati chifukwa cha cholesterol.

Atorvastatin ndi mankhwala Mlingo 10 mpaka 80 mg pa tsiku. Kukula kwakukulu komwe wodwala amamwa, kwambiri kumachepetsa cholesterol ya LDL. Komabe, chifukwa cha kuchuluka kwa Mlingo, zotsatira za zovuta zimakula. Kuchepetsa kwambiri cholesterol ya LDL kumatha kubweretsa mavuto pakuganiza ndi kukumbukira. Chifukwa cholesterol ndiyofunika bongo. Chiwopsezo cha kukhumudwa, ngozi zagalimoto ndipo, mwina, kufa kwa zifukwa zonse kumawonjezeka. Phunzirani cholesterol yamagazi kwa abambo ndi akazi pazaka. Lankhulani ndi dokotala wanu za mulingo woyenera wa Liprimar.

Atorvastatin sikuti amatsitsa LDL zokha, komanso amachulukitsa cholesterol "yabwino" ya HDL. Zotsatira izi sizogwirizana ndi kuchuluka kwa mankhwalawa. Kuwonjezeka kwa tsiku ndi tsiku mlingo wa atorvastatin sikuti kumawonjezera chiwopsezo cha cholesterol ya HDL m'magazi. Kusunga cholesterol, triglycerides, ndi coheroffic yofananira, sinthani zakudya zamafuta ochepa. Izi zimachepetsa tsiku ndi tsiku Mlingo wa Liprimar mpaka 10-20 mg patsiku kapenanso kukana kwathunthu chithandizo ndi ma statins.

Atherosulinosis

Atorvastatin, monga ma statin ena, amalepheretsa kukula kwa atherosulinosis. Chifukwa cha izi, chiwopsezo cha kugunda kwa mtima koyamba komanso kwachiwiri, matenda a ischemic, vuto la mwendo, kufunika kobwezeretsa magazi kudzera m'mitsempha kumachepa. Amakhulupirira kuti mankhwala a Liprimar ndi ma statins ena amathandiza kuthana ndi matenda a matenda a m'mimba, chifukwa amachepetsa cholesterol ya LDL. Kutsika komwe kumakhala cholesterol "yoyipa", imachepetsa pamakoma am'mitsempha.

Njira ina yowonera - chachikulu ndi kutsutsa-kutukusira kwa ma statins. Ngati mukuzimitsa kutupa kosatha, ndiye kuti cholesterol sichidzaphatikizidwa ndi ma free radicals. LDL cholesterol, yomwe ili munthawi yabwinobwino, yopanda zamankhwala, siziika m'makoma amitsempha yamagazi, zivute zitani imazungulira m'magazi. Mlingo wa kutupa kosatha kumatsimikiziridwa ndi zotsatira za kuyesa kwa magazi kwa protein yokhala ndi C. Kuti muchepetse cholesterol "yoyipa" ya LDL kukhala yachilendo, mlingo waukulu wa atorvastatin, mpaka 80 mg patsiku, ungafunike. Nthawi yomweyo, kusintha magwiridwe antchito a C-reactive, nthawi zambiri zimakhala zokwanira kumwa mapiritsi a Liprimar mu Mlingo wotsika. Pimayesedwe pafupipafupi kuti mukhale ndi mapuloteni othandizira, osangogwiritsa ntchito cholesterol chabwino kapena chabwino.

Liprimar anali mankhwala oyamba pakati pa ma statins, omwe mwayi wochepetsera kukula kwa zolembera za atherosulinotic unatsimikiziridwa. Pambuyo pake, malo omwewo adapezeka ku rosuvastatin. Zotsatira zofufuzira zisanayambe kufotokozedwa, zimakhulupirira kuti ma statins amatha kuchepetsa kuchepa kwa atherosclerosis, koma sizikuwakhudza malo omwe alipo kale. Kuti kuchuluka kwa ma atherosselotic plaques ayambe kutsika, muyenera kutsitsa cholesterol ya LDL ndi 40% kapena kupitirira. Kuti muchite izi, imwani atorvastatin mu 20 mg patsiku kapena kupitilira.Zolemba m'magazini a zamankhwala nthawi zambiri zimalimbikitsa kuti madokotala azigwiritsa ntchito atorvastatin mankhwala oyamba omwe ali pakatikati komanso okwera kwa odwala, koma osangokhala ndi mlingo wochepa wa 10 mg patsiku, zomwe sizithandiza mokwanira.

Tsoka ilo, ndikugwiritsa ntchito atorvastatin ndi ma statin ena kuchitira atherosermosis, sizonse zili zomveka. Mankhwalawa amachepetsa kuyika kwa cholesterol pamakoma a mitsempha. Nthawi yomweyo, amathandizira kuyika kwa calcium m'mitsempha yamagazi. Mitsempha yamafuta ophatikizika ndi kashiamu imakhala yolimba, osasinthasintha, ngati yabwinobwino. Ichi chimawerengedwa kuti ndi gawo la atherosulinosis. Choyamba, zolembera zofewa za cholesterol zimawonekera, kenako amawonjezera calcium. Liprimar mwina, monga ma statin ena, imafulumira. Werengani nkhani "Statins and Atherosulinosis" mwatsatanetsatane. Phunzirani zamomwe mungapewere kuwongolera khoma la calcium komanso kukalamba pang'onopang'ono.

Matenda a mtima

Anthu omwe adapezeka kuti ali ndi matenda a mtima ndi odwala omwe ali ndi chiwopsezo chachikulu cha mtima. Afunika kumwa Liprimar kapena mapiritsi ena a atorvastatin monga gawo la zovuta zamankhwala zomwe adotolo adzalemba. Phindu la ma statins lidzakhala lokwera kwambiri kuposa chiopsezo chotsatira zoyipa. Monga mukudziwa, chomwe chimayambitsa matenda a mtima ndi coronary arteriosulinosis. Atorvastatin imalepheretsa kukula kwa atherosulinosis kapena kuchepetsa kuchuluka kwa zolembedwa za atherosulinotic. Chifukwa cha izi, mudzachepetsa chiwopsezo cha kugunda kwa mtima ndi sitiroko, komanso kuwonetsa kwa atherosulinosis yamitsempha yamagazi yomwe magazi amayenda kulowa mu ubongo ndi m'munsi mwake.

Mu magazini ya Atherosulinosis ndi Dyslipidemia mu 2013, chidziwitso chinafotokozedwa pazotsatira zamankhwala ndi atorvastatin mwa odwala 25 omwe ali ndi matenda a mtima.

Odwala onse amatenga atorvastatin-Teva 80 mg patsiku. Liprimar choyambirira cha mankhwalawa chimapereka zotsatira zomwezo kapena bwino.

Ndi matenda a mtima okhazikika, simungathamangire kukachita opaleshoni yodutsa kapena yam'mitsempha yama cell, koma choyamba yesani kuthandizidwa ndi mankhwala, kuphatikizapo waukulu Mlingo wa atorvastatin. Kafukufuku wokhudza odwala mazana angapo atsimikizira kuyendera bwino kwa njirayi. Komanso werengani nkhani yoti: “Kuthana ndi Matenda a Mtima Ndi Mikwingwirima” ndikutsatira zomwe zafotokozedwa pamenepo. Atorvastatin mu Mlingo wambiri wapangitsa kuti ambiri omwe atenga nawo mbali pazoyeserera zamankhwala apewe opaleshoni. M'maphunzirowa, Pfizer Liprimar yekhayo woyesedwa. Sizikudziwika ngati mapiritsi a atorvastatin ochokera kwa opanga ena angapereke zofanana.

Kafukufuku wakunja adayerekeza mphamvu ya mankhwala ndi opaleshoni yamatenda a mtima. Zinapezeka kuti mwa odwala okhazikika, opaleshoni samachepetsa kufa ndi chiwopsezo cha ngozi yamtima. Koma chithandizo cha opaleshoni ndichokwera mtengo, ndipo wodwalayo ali ndi chiopsezo chambiri chofuna kufa patebulo yothandizira. Kafukufuku wa AVERT (Atorvastatin VErsus Revascularization Treatment) adawonetsa kuti kumwa mapiritsi a Liprimar a 80 mg patsiku pamodzi ndi mankhwala ena kwa miyezi 18 kunapereka zotsatira zoyipa kwambiri kuposa kuchitira opaleshoni odwala okhazikika a IHD omwe ali ndi chiopsezo chochepa cha matenda a mtima. Ndikupezeka kuti chithandizo cha opaleshoni ndikofunikira pokhapokha ngati mankhwalawo athandizira bwino, komanso ngati pali zovuta. Zotsatira za kafukufuku wa AVERT zidasindikizidwa kale mu 1999 ndikupanga phokoso kwambiri. Komabe, odwala ambiri omwe ali ndi matenda okhazikika m'mitsempha a m'mimba akadali ndi maopareshoni osafunikira.

Pambuyo pa vuto la mtima

Atorvastatin kapena ma statin ena ayenera kuyambika msanga wodwala akakumana ndi vuto la mtima. Izi zikuchepetsa chiwopsezo cha kukonzanso, kukonza zotsatira zakukonzanso. Kukonzekera kwa Atorvastatin amalembedwa kwa odwala omwe akuwonetsedwa pakuchiza matenda a mtima. Mu 2004, zotsatira za kafukufuku wa ARMYDA - Atorvastatin for Reduction of MYocardial Zowonongeka nthawi ya Angioplasty - zidasindikizidwa. Mwa anthu omwe adatenga Liprimar 40 mg patsiku asanafike coronary angioplasty, opaleshoni idatha bwino kuposa odwala omwe sanalandire ma statins. Kafukufuku wina, wotchedwa STATIN STEMI, adawonetsa kuti atorvastatin imatha kutumikiridwa mu Mlingo wa 10 kapena 40 mg patsiku musanalore kwa masiku 7, ndipo sipadzakhala kusiyana.

Mu 2005, zotsatira za kafukufuku wa IDEAL - Kuchulukitsa Kukula kwa Mapeto kudzera mu Aggressive Lipid-kutsitsa - adalembedwa. Zidadziwika kuti pakapita nthawi yayitali, atorvastatin waukulu wa 80 mg tsiku lililonse amathandiza anthu omwe ali ndi vuto la mtima kuposa simvastatin 20 mg patsiku. Odwala 8888 adatenga nawo mbali, omwe adatsatiridwa kwa pafupifupi zaka 5. Atorvastatin ndi simvastatin sanalembedwe kwa odwala nthawi yomweyo, koma patangotha ​​miyezi 3,000 kuchokera vuto la mtima. Mu maora ndi masiku oyamba pambuyo pa vuto la mtima, ndikutheka kuti Mlingo wa Liprimar ukonzanso kuchuluka kwa matendawa kuposa kutsika kwa atorvastatin kapena simvastatin wofooka.

Ischemic stroke

Atorvastatin ndi ma statin ena omwe amakhala ndi chithandizo cha nthawi yayitali amachepetsa chiopsezo cha odwala omwe ali ndi matenda oopsa, matenda a mtima ndi matenda a shuga. M'magazini yamu Januware 2004 ya European Journal of Medical Research, kuwunika kosanthula kwakanthawi kokhudza mphamvu ya ma statins popewa matenda opha ziwonetsero kunasindikizidwa. Amati kumwa mapiritsi a Liprimar kumachepetsa chiopsezo cha sitiroko ndi 41%, ndi chithandizo chamankhwala osakanizidwa ndi simvastatin - mwa 34%. Mitengo yoletsa matenda a sitiroko iyenera kutengedwa ndi anthu omwe ali ndi cholesterol yokhazikika, koma pali zinthu zina zowopsa, makamaka mapuloteni okwanira a C-reactive.

Kuti mudziwe momwe atorvastatin imagwirira ntchito poletsa kukonzanso, kuphunzira kwa SPARCL, Stroke Prevention by Aggressive Reduction mu Cholesterol Level, kunachitika ndi odwala 4371. Odwala omwe ali ndi vuto la ischemic m'miyezi 6 yapitayi adatchulidwa atorvastatin (mankhwala oyamba a Liprimar) pa 80 mg patsiku, kuwonjezera pa chithandizo chamankhwala. Panalinso gulu lowongolera la odwala omwe adatenga placebo m'malo mwa mankhwala enieni. Odwala onse amawawonedwa pafupifupi zaka 5.

Mwa odwala omwe amathandizidwa ndi atorvastatin, pafupipafupi kubwezeretsanso kunachepa ndi 16% yokha, poyerekeza ndi gulu la placebo. Zikuwoneka kuti zotsatira zake ndizochepa. Koma zidapezeka kuti mfundo ndi kudzipereka kochepa kwa omwe aphunzira nawo. Mu gulu la atorvastatin, odwala ambiri sanamwe mankhwala awo. Kumbali inayi, pagulu la placebo, odwala ambiri amatenga ma statin, omwe amatsogozedwa ndi madokotala m'malo ena azachipatala. Mwa kusintha zizindikiritso za cholesterol m'mwazi, mutha kudziwa ngati wodwala amatenga ma statins kapena ayi. Mwa odwala omwe adathandizidwadi ndi ma statins, ziwonetserozo zochitidwazo zimatsika ndi 31%. ”

Kulephera kwina

Liprimar limodzi ndi mankhwala ena amachepetsa kukula kwa kulephera kwaimpso kwa odwala omwe ali ndi matenda osokoneza bongo. Mu Marichi 2015, magazini ya The Lancet Diabetes & Endocrinology inafalitsa zotsatira za kafukufuku wa PLANET I - kufananiza kwa mphamvu ya atorvastatin ndi rosuvastatin poteteza impso mwa odwala omwe ali ndi matenda amtundu wa 2 komanso a 2. Kafukufukuyu adakhudza odwala 353 omwe adalandira kale mankhwala a ACE inhibitors kapena angiotensin-II receptor blockers. Madokotala adaziyang'ana kwa chaka chimodzi. Zinapezeka kuti rosuvastatin yatsopano ikuchepetsa cholesterol ya LDL mwamphamvu kwambiri, koma imateteza impso kukhala zowopsa kuposa Liprimar wakale - mankhwala oyamba a atorvastatin.

Nthawi zina, kupweteka kwa impso kumatha kukhala zotsatira zoyipa za atorvastatin. Izi zimachitika minofu ya mafupa ikawonongeka. Zinthu zomwe zimawononga impso zimalowa m'magazi. Zotsatira zoyipa izi ndizosowa kwambiri. Chiwopsezo chikuwonjezeka kwa anthu omwe apezeka ndi matenda a impso kapena chithokomiro cha chithokomiro. Kuti mupeze mavuto musanayambe kulephera impso, mutha kuyezetsa magazi kuti mupeze kinase. Liprimar mwina imayambitsa mavuto a impso pafupipafupi kuposa ma statin ena.

Type 2 shuga

Atorvastatin, monga ma statin ena, amawonjezera chiopsezo cha matenda amtundu wa 2 mwa anthu omwe ali ndi chiyembekezo chodwala. Kwa iwo omwe ali ndi matenda ashuga kale, mankhwalawa amachepetsa shuga m'magazi komanso glycated hemoglobin HbA1C. Nthawi yomweyo, kwa anthu omwe ali ndi vuto lalikulu la mtima, mapindu a kumwa mapiritsi a Liprimar kapena ma statin ena ndi apamwamba kwambiri kuposa chiopsezo cha matenda ashuga ndi zina.

Kutenga atorvastatin kumawonjezera chiopsezo cha matenda ashuga mwa anthu onenepa kwambiri, mafuta am'munsi mchiuno, kuthamanga kwa magazi, cholesterol yoyipa komanso triglycerides m'magazi. Pamodzi, zizindikirozi zimatchedwa metabolic syndrome. Phunzirani nkhani yakuti: “Kuletsa Kuthana ndi Mtima ndi Matenda” kuti mudziwe momwe mungapewere matenda osokoneza bongo kuti mudziteteze ku matenda ashuga. Tsatirani malangizowo m'nkhaniyi. Poterepa, pitilizani kutenga Liprimar kapena ma statin ena kuti muchepetse chiopsezo cha mtima wanu. Ndikofunikira kwambiri kuwunika shuga wamagazi kwa azimayi omwe ali ndi vuto loguluka. Chifukwa chakuti amatenga atorvastatin, amawonjezera chiopsezo chawo cha matenda ashuga kwambiri.

Liprimar wa shuga: zabwino ndi mavuto

Kuopsa kwa mtima ndi kudwala kwamtima kwa wodwalayo, kumakhala kopindulitsa kwambiri ndi chithandizo cha atorvastatin kapena ma statin ena. Odwala a shuga a Type 2 ndi omwe ali pachiwopsezo chachikulu cha matenda a mtima, stroke, ndi mavuto ena a mtima. Liprimar imawathandizira, ngakhale kuti imangowonjezera shuga m'magazi komanso glycated hemoglobin. Mwachitsanzo, kafukufuku wa CARDS (Collaborative Atorvastatin Diabetes Study) adawonetsa kuti atorvastatin pa mlingo wa 10 mg okha patsiku amachepetsa chiopsezo cha mtima ndi odwala matenda ashuga pafupifupi 37%. Odwala omwe ali ndi matenda ashuga bwino amatenga ma statins kuposa anthu amsinkhu umodzi omwe ali ndi shuga wabwinobwino. Ndipo musachite mantha ndi Mlingo wambiri wa atorvastatin. Osadziletsa kuti muchepetse 10 mg patsiku ngati mlingo uwu suthandizira wokwanira.

Werengani nkhani yatsatanetsatane "Statins andabetes." Dziwani momwe mungapangire shuga wanu wamagazi, mapuloteni othandizira, komanso zinthu zina zomwe zingayambitse ngozi. Matenda a shuga a Type 2 amatha kuthana ndi vuto popanda kudya "njala", mapiritsi olakwika ndi jakisoni wa insulin. Madokotala amabisa izi kuti asataye makasitomala.

Metabolic syndrome

Metabolic syndrome ndi kuphatikizika kwa zizindikiro za kuchepa mphamvu kwa kagayidwe kazakudya, kuchepa kwa chidwi cha minofu kufikira insulin. Zimaphatikizanso mafuta am'mimba m'mimba (kunenepa kwambiri), matenda oopsa, zotsatira zoyesa za magazi chifukwa cha cholesterol ndi triglycerides. Metabolic syndrome imawonjezera ngozi ya mtima ndi 44%. Chifukwa chake, odwala omwe amapatsidwa izi, madokotala nthawi zambiri amapereka atorvastatin kapena ma statin ena. Malinga ndi kafukufuku wa TNT (Fighting to New Targets), mwa odwala omwe ali ndi metabolic syndrome, atorvastatin (mankhwala oyamba a Liprimar) adachepetsa chiopsezo cha matenda a mtima, sitiroko, kununkha ndi matenda a coronary bypass ndi 29%.

Statins amathandiza odwala omwe ali ndi metabolic syndrome, chifukwa amachepetsa cholesterol "yoyipa" m'magazi, komanso chifukwa cha zotsatira zake zabwino, zomwe tafotokozazi. Komabe, chithandizo chachikulu (control) cha metabolic syndrome ndikusintha kwa moyo wathanzi, osati mankhwala. Atorvastatin, mapiritsi opsinjika ndi mankhwala ena aliwonse amangoonjezera, koma sangathe kusintha chakudya chamagulu komanso maphunziro othandizira olimbitsa thupi. Werengani apa momwe mungamayang'anire matenda a metabolic popanda kudya "njala" komanso kugwira ntchito molimbika. Phunzirani zamomwe mungachepetse kuthamanga kwa magazi pakupereka mapiritsi owononga.

Mankhwala

Chithandizo chophatikizika cha mankhwalawa, atorvastatin, ndi chosankha chofunikira cha puloteni yofunika ya HMG-CoA reductase kukhala mevalonate (moyambirira kwa sterols). Zimathandizira kuchepetsa cholesterol m'magazi mwakuchepetsa kaphatikizidwe kake m'chiwindi ndikukulitsa kuchuluka kwa zolandilira za LDL pamaselo a maselo omwe amachititsa kuti maselo a choleoproteins akhale otsika.

Odwala omwe ali ndi cholowa, a hypercholesterolemia (homo- ndi mitundu ya heterozygous), komanso mitundu yosiyanasiyana ya dyslipidemia, mankhwalawa amachepetsa cholesterol yonse, apolipoprotein B, LDL ndi triglycerides, pomwe akuwonjezera lipoproteins yapamwamba.

Mukamagwiritsa ntchito Liprimar, pamakhala kuchepa kwa pafupipafupi kwa kugunda kwa mtima ndi matenda a mtima, kupweteka kwa mtima, komanso kufunika kwa kusinthanso mtima kwa myocardial kumacheperanso.

Kugwiritsa ntchito bwino kuchepetsa kuchuluka kwa cholesterol yathunthu, B. triglycerides apolipoprotein ndi X-LDL, mankhwalawa samakhudza kwambiri kukula ndi kutha kwa ana ndi achinyamata ndipo sikukulepheretsa kutalika kwa msambo kwa atsikana (zotsatira za maphunziro azachipatala).

Pharmacokinetics

Liprimar, ikamamwa pakamwa, imayendetsedwa bwino ndi chiwindi, ikufika pozungulira kwambiri patatha maola awiri. Plasma ndende ya mankhwalawa imagwirizana ndi mlingo womwe umatengedwa (mndandanda wa 10-20- 40-80 mg). Mtheradi wa bioavailability wa mapiritsi, poyerekeza ndi yankho, ndi 95-99%, kupezeka kwadongosolo ndi 30% (chizindikiro ichi chikugwirizana ndi kutsimikizika kwachidziwitso cha atorvastatin m'matumbo am'mimba komanso momwe magwiridwe ake amayambira kudutsa chiwindi). Mukamamwa mankhwala ndi chakudya, pamakhala kuchepa kwenikweni kwa bioavailability.

Kuyankhulana ndi mapuloteni a plasma - 98%. Mukukonzekera kwa hepatic metabolism, mapangidwe azinthu zomwe zimagwira ntchito zamankhwala zimachitika (pafupifupi 70% ya zochizira zamankhwala zimadziwika chifukwa cha kuzungulira kwa metabolites).

Atorvastatin imachotsedwa makamaka m'matumbo pamodzi ndi bile. Ndi impso - 2% yokha. Komabe, kufalikira kofunikira kwambiri kwa interohepatic sikuwonedwa. Hafu ya moyo wopangira ndi maola 14. Kutalika kwa matenda (chifukwa cha metabolites ozungulira m'magazi) ndi maola 20-30.

Odwala a zaka zapamwamba, poyerekeza ndi azimayi ndi amuna, kuwonjezeka kwa plasma ndende ya atorvastatin kumadziwika.

Matenda amathandizidwe a ntchito yeniyeni samakhudza ma pharmacokinetics a mankhwalawa. Ngati chiwindi chayamba kugwira ntchito m'magazi am'magazi, gawo la chinthu chosasinthika limakula kwambiri.

Liprimar (Atorvastatin) malangizo ogwiritsira ntchito

ntchito: atorvastatin, piritsi 1 lili ndi calcium calcium ya atorvastatin, womwe ndi wofanana ndi 10 mg kapena 20 mg, kapena 40 mg, kapena 80 mg wa atorvastatin,
zokopa: calcium carbonate, microcrystalline cellulose lactose monohydrate, croscarmellose sodium, polysorbate 80 hydroxypropyl cellulose, magnesium stearate film coating material (hydroxypropyl methyl cellulose, polyethylene glycol 8000, titanium dioksidi (E 171), talcic simulsion. acid).

Mankhwala

Liprimar ndi mankhwala opanga a lipid ochepetsa. Atorvastatin ndi choletsa wa 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase.Ma enzyme amenewa amathandizira kusintha kwa HMG-CoA kukhala mevalonate - gawo loyambirira la cholesterol biosynthesis yomwe imalepheretsa kukula kwake.

Liprimar ndi mpikisano wosankha wa HMG-CoA reductase, enzyme yomwe imatsimikiza kusintha kwa 3-hydroxy-3-methylglutaryl coenzyme A to mevalonate, chinthu choyambirira cha sterols, kuphatikiza cholesterol. Cholesterol ndi triglycerides amayendayenda m'magazi ndikuphatikizana ndi lipoproteins. Maofesi amenewa amalekanitsidwa ndi ma ultracentrifugation m'magawo a HDL (lipensitroteins apamwamba), HDL (lipoproteins yapakatikati.), LDL (lipoproteins low). Triglycerides (TG) ndi cholesterol m'chiwindi chimaphatikizidwa mu VLDL ndikutulutsidwa m'madzi a m'magazi kuti azinyamula. LDL imapangidwa ndi VLDL ndipo imapangidwa ndi kuyanjana ndi ma receptors apamwamba a LDL. Kafukufuku wokhudzana ndi zamankhwala ndi matenda am'mimba akuwonetsa kuti kuchuluka kwa cholesterol kwathunthu (OX), LDL cholesterol (LDL-C) ndi apolipoprotein B (pomwe B) m'magazi amathandizira kukulitsa kwa atherosclerosis mwa anthu ndipo ndi zinthu zomwe zimayambitsa chitukuko cha matenda amtima. pomwe ma cholesterol a HDL okwera amaphatikizidwa ndi chiopsezo chochepetsa matenda a mtima.

Pazoyeserera nyama, lyprimar imachepetsa cholesterol ya plasma ndi lipoprotein mwa kuletsa kuchepa kwa HMG-CoA m'chiwindi ndi cholesterol komanso mwakuwonjezera kuchuluka kwa zolandilira kwa LDL pamaselo a cell kuti zithetse kuyamwa ndi kukopa kwa LDL komanso liprimar kumachepetsa kupanga LDL komanso kuchuluka kwa izi tinthu tosiyanasiyana. Liprimar amachepetsa cholesterol ya LDL mwa odwala ena omwe ali ndi homozygous Famer hypercholesterolemia, ndiko kuti, magulu a anthu omwe samakonda kulandira chithandizo ndi mankhwala ena a hypolipidemic.

Kafukufuku wambiri wazaka awonetsa kuti kuchuluka kwambiri kwa cholesterol, LDL cholesterol ndi apo B (mawonekedwe a membrane a LDL cholesterol) kumayambitsa chitukuko cha atherosulinosis. Momwemonso, kutsika kwa HDL cholesterol (ndi kayendedwe kake - ndi A) kumalumikizidwa ndi chitukuko cha atherosulinosis. Kafukufuku wa Epidemiological apeza kuti kuchepa kwa mtima ndi kufa kwa mtima zimasiyana molingana ndi kuchuluka kwa cholesterol yathunthu ndi cholesterol cha LDL komanso mochuluka mpaka muyeso wa cholesterol ya HDL.

Liprimar amachepetsa cholesterol yonse, LDL cholesterol ndi apo B odwala homozygous ndi heterozygous achibale hypercholesterolemia, omwe siabanja mitundu ya hypercholesterolemia ndi dyslipidemia wosakanikirana. Liprimar imatsitsanso cholesterol ya VLDL ndi TG, komanso imayambitsa kuwonjezeka kosagwedezeka kwa HDL cholesterol ndi A-1 apolipoprotein. Liprimar amachepetsa cholesterol yonse, LDL cholesterol, VLDL cholesterol, apo B, triglycerides ndi HDL cholesterol, komanso imakulitsa cholesterol ya HDL kwa odwala omwe ali ndi hypertriglyceridemia. Liprimar amachepetsa ma cholesterol omwe amachepetsa kwambiri odwala omwe ali ndi dysbetalipoproteinemia.

Monga LDL, lipoprotein olemeretsedwa mu cholesterol ndi triglycerides, kuphatikizapo VLDL, STDs ndi zotsalira, zingathandizenso kukulitsa kwa atherosulinosis. Ma pligma triglycerides okwera nthawi zambiri amakhala m'magulu atatu okhala ndi cholesterol ya HDL ndi magawo ang'onoang'ono a LDL, komanso kuphatikiza zomwe sizikhala ndi lipid metabolic pachiwopsezo cha matenda a mtima. Sizinatsimikiziridwe kuti kuchuluka konse kwa plasma triglycerides motero ndi njira yodziyimira payokha pakukula kwa matenda a mtima. Kuphatikiza apo, zotsatira zodziyimira zowonjezera kuchuluka kwa HDL kapena kuchepetsa triglycerides pachiwopsezo cha coronary ndi mtima morbidity ndi kufa zimakhazikitsidwa.

Liprimar, monga ena mwa ma metabolites ake, amagwira ntchito mwa mankhwala. Malo akuluakulu a atorvastatin ndi chiwindi, chomwe chimagwira gawo lalikulu pakuphatikizidwa kwa cholesterol ndi chilolezo cha LDL. Mlingo wa mankhwalawa, mosiyana ndi kuchuluka kwa mankhwalawa, amaphatikizidwa bwino ndi kuchepa kwa cholesterol ya LDL. Kusankha kwa munthu payekhapayekha kuyenera kuchitidwa kutengera kuthekera kwachithandizo (onani Gawo "Mlingo ndi Ulamuliro").

Zogulitsa. Liprimar imatengeka mwachangu pambuyo pakukonzekera pakamwa ndipo ndende yake yayikulu ya plasma imafikiridwa mkati mwa maola 1-2. Mlingo wa mayamwidwe umawonjezeka molingana ndi kuchuluka kwa mankhwala a lymprim. The bioavailability wa atorvastatin (kholo kholo) pafupifupi 14%, ndipo zokhudza zonse bioavailability wa zoletsa ntchito motsutsana HMG-CoA reductase pafupifupi 30%. Kupezeka kwadongosolo lokhazikika kwa mankhwalawa kumalumikizidwa ndi kutsimikizika kwazomwe zimayambira mucous membrane wam'mimba komanso / kapena dongosolo la biotransformation mu chiwindi. Ngakhale chakudya chimachepetsa kuchuluka ndi kufalikira kwa mankhwalawa pafupifupi 25% ndi 9%, motero, kutengera C max ndi AUC, kutsitsa cholesterol ya LDL kuli kofanana ngakhale lypimar imatengedwa ndi chakudya kapena chokha. Mukamagwiritsa ntchito atorvastatin madzulo, kuyika kwake m'magazi kumachepa (pafupifupi 30% kwa C max ndi AUC) kuposa m'mawa. Komabe, kuchepa kwa cholesterol ya LDL ndi chimodzimodzi ngakhale nthawi yakumwa mankhwalawa (onani Gawo "Mlingo ndi Ulamuliro").

Kugawa. Pafupifupi kuchuluka kwa kagawidwe ka mankhwala lyprimar ndi pafupifupi 381 malita. Kuposa 98% ya mankhwalawa amamangidwa kumapuloteni a plasma. Chiwerengero cha magazi / madzi a m'magazi pafupifupi 0,25, zomwe zikusonyeza kuti malowedwe osayenera a mankhwalawo m'maselo ofiira a magazi. Kutengera ndi zomwe apenya m'makoswe, amakhulupirira kuti lypimar imatha kulowa mkaka wa m'mawere (onani Magawo "Contraindication", "Gwiritsani ntchito Pakateni kapena Pakupatsa" ndi "Makhalidwe Ogwiritsira Ntchito").

Kupenda. Liprimar imapangidwira kwambiri mu zotulutsa za ortho ndi para-hydroxylated ndi zinthu zosiyanasiyana za beta oxidation. Mu maphunziro a in vitro, kuletsa kwa HMG-CoA reductase ortho ndi parahydroxylated metabolites kuli kofanana ndi kuletsa kwa mankhwala a lympar. Pafupifupi 70% ya zozungulira zoletsa zotsutsana ndi HMG-CoA reductase zimagwirizanitsidwa ndi metabolites yogwira. Kafukufuku wa in vitro akuwonetsa kufunikira kwa kagayidwe ka mankhwala a lyprimar cytochrome P450 3A4, omwe amagwirizana ndi kuchuluka kwa mankhwala a lypimar m'magazi amunthu pambuyo pakugwiritsa ntchito pamodzi ndi erythromycin, odziwika odziwika ndi enzyme iyi (onani gawo "Kuyanjana ndi mankhwala ena").

Kupatula. Liprimar ndi metabolites ake amachotseredwa ndi bile pambuyo pa hepatic ndi / kapena metabolism yowonjezera, komabe, mankhwalawa, mwachiwonekere, samakumana ndi gastrohepatic recirculation. Hafu ya moyo wa lypimar kuchokera ku madzi a m'magazi a anthu ndi pafupifupi maola 14, koma nthawi yotsika ya zochita zoletsa kutsutsana ndi HMG-CoA reductase imachokera maola 20 mpaka 30 popereka ma metabolites. Pambuyo kumwa mankhwalawa ndi mkodzo, osakwana 2% ya mankhwalawa amachotsedwanso.

Odwala okalamba. Kuchuluka kwa plasma ya lyprimar ndikokwera (pafupifupi 40% ya C max ndi 30% kwa AUC) mwa odwala okalamba athanzi (opitilira zaka 65) kuposa akulu akulu. Zambiri zamankhwala zimawonetsa kuchepa kwakukulu kwa LDL mukamagwiritsa ntchito mtundu uliwonse wa mankhwalawa odwala okalamba poyerekeza ndi achinyamata (onani gawo "Zogwiritsira ntchito").

Ana. Palibe data ya pharmacokinetic ya gulu la odwala.

Paulo The kuchuluka kwa mankhwalawa lymprim mu madzi am`magazi azimayi amasiyana ndi kuchuluka kwa ndende yamagazi a u (pafupifupi 20% kuposa C max ndi 10% kutsika kwa AUC). Komabe, palibe kusiyana kwakukulu kachipatala pakuchepetsa cholesterol ya LDL mukamagwiritsa ntchito lypimar mwa amuna ndi akazi.

Matenda aimpso. Matenda amkati samakhudzanso kuchuluka kwa mankhwalawa a lymprim mu madzi a m'magazi kapena kuchepa kwa LDL cholesterol, motero, kusintha kwa odwala omwe ali ndi vuto laimpso sikofunikira (onani magawo "Mlingo ndi makonzedwe", "tsatanetsatane wa ntchito").

Hemodialysis Ngakhale kuti pakhala kuti palibe kafukufuku yemwe wachitika pakati pa odwala omwe ali ndi vuto la impso, amakhulupilira kuti hemodialysis sikuwonjezera chilolezo cha lymprim, popeza mankhwalawa amamangidwa kwambiri ndi mapuloteni a plasma.

Kulephera kwa chiwindi. The kuchuluka kwa mankhwalawa lymprim mu madzi am`magazi limachulukirachulukira odwala kwambiri matenda a chiwindi matenda. Makhalidwe a C max ndi AUC ndi ochulukirapo ma 4 kwa odwala omwe ali ndi matenda A chiwindi monga kalasi la Mwana-Pugh. Odwala omwe ali ndi matenda a chiwindi a ana-Pugh, zomwe C max ndi AUC zimachulukitsa pafupifupi 16 komanso 11, khosi, onani (onani gawo "Contraindication").

Zotsatira zomwe zimagwiritsidwa ntchito nthawi yomweyo pa pharmacokinetics ya atorvastatin

Liprimar kwa okalamba

Liprimar, monga ma statin ena, amalembedwa kwa anthu achikulire omwe adapezeka ndi matenda a mtima. Mankhwalawa amachepetsa chiopsezo cha kugunda kwamtima, kugwidwa, kufunika kwa kununkha kapena kukokoloka kwa mitsempha. Zolemba m'magazini azachipatala akunja zimalimbikitsa kuti atorvastatin ipatsidwe kwa anthu achikulire omwe ali ndi Mlingo wambiri komanso wapamwamba, osati ochepa. Malangizowa akugwira ntchito kwa odwala azaka 65-78 omwe ali ndi chiwopsezo chamtima kwambiri - ndi matenda a angina pectoris, atherosclerosis a m'munsi omwe akumana ndi vuto la mtima, sitiroko kapena opaleshoni kuti abwezeretse magazi m'mitsempha. Ngati atorvastatin 10 mg patsiku sizithandiza mokwanira, ndiye kuti muyenera kuwonjezera kuchuluka kwake. Zotsatira zoyipa sizoyipa kwenikweni kuposa kufa kapena kulemala chifukwa cha vuto la mtima.

Mu 2009, nyuzipepala yotchedwa Clinical Cardiology ya nyuzipepala inafalitsa zotsatira za kafukufuku yemwe odwala okalamba 2442 omwe ali ndi matenda a mtima adatenga nawo mbali. Theka laiwo adayikidwa Liprimar muyezo waukulu, mpaka 80 mg patsiku, ndipo gulu lachiwiri linapatsidwa atorvastatin kapena ma statin ena omwe ali mumtundu wotsika komanso wapakati. Madotolo adawona omwe adatenga nawo mbali pa kafukufukuyu zaka 4,5. Odwala omwe amatenga Mlingo wambiri wa atorvastatin, chiwopsezo cha mtima chatsika ndi 27% poyerekeza ndi gulu lachiwiri. Zotsatira zoyipa za kutenga ma statins nthawi zambiri zimawonedwa mwa odwala okalamba kuposa ana. Koma kuchuluka kwawo m'magulu onsewa sikunasinthe kwambiri.

Cholesterol Wokwezedwa mwa Ana

Kunja, mankhwalawa ndiwo mankhwala enieni a atorvastatin omwe amaperekedwa kwa achinyamata omwe amapezeka kuti ali ndi matenda achilendo - heterozygous Famer hypercholesterolemia. Itha kuthandizidwa ndi chida ichi, monga ma statin ena, kuyambira wazaka 10. Atsikana amatha kutenga ma statin patatha chaka chimodzi atatha kusamba.

Liprimar zochizira mabanja hypercholesterolemia samayambitsa zotsatira zoyipa nthawi zambiri kuposa placebo. Palibe chidziwitso pakugwiritsa ntchito mankhwalawa kwa ana ochepera zaka 10. M'mayesero azachipatala, atorvastatin adalembedwa kwa ana ndi achinyamata pamankhwala osaposa 20 mg patsiku. Chifukwa chake, palibe chidziwitso cha momwe milingo yapamwamba ingagwire ntchito. M'mayiko olankhula Chirasha, zaka 18 ndi kuphwanya kwapadera kukhazikitsidwa kwa atorvastatin.

Nkhaniyi ikufotokozera zonse zomwe odwala amafunikira kudziwa pakugwiritsa ntchito atorvastatin. Makamaka, zoyipa zimafotokozedwa mwatsatanetsatane - funso lomwe limavutitsa aliyense. Madotolo adzipezanso zambiri zothandiza pazokha. Atorvastatin amatsitsa cholesterol "yoyipa" m'magazi kuposa ma preins am'badwo wam'mbuyomu - lovastatin ndi simvastatin. Zimangolepheretsa kukula kwa atherosulinosis, komanso kumachepetsa makulidwe amtundu wa atherosrance. Mankhwala achikulire samakhudza ma cholesterol amana, omwe awonekera kale pazitseko za mitsempha. Liprimar - mankhwala oyamba a atorvastatin, omwe amadziwika kuti ndi apamwamba kwambiri. Ngati ndalama zilola, tengani. Ngati mukufuna kupulumutsa ndalama, funsani dokotala wanu kuti musinthe mapiritsi a atorvastatin kuchokera kwa ena opanga.

Rosuvastatin ndi mankhwala atsopano kuposa atorvastatin. Tsopano pamsika wamankhwala pakati pa statins pali mpikisano waukulu pakati pa mankhwalawa. Atorvastatin sikuti amaganiza kuwonjezera chiwopsezo cha matenda ashuga monga rosuvastatin. Atorvastatin ikhoza kukhala yabwino kwa odwala omwe ali ndi vuto la mtima. Liprimar choyambirira cha mankhwala amateteza impso mwa odwala omwe ali ndi mtundu woyamba wa 2 ndi mtundu wa 2 kuposa matenda a rosuvastatin. Koma sizikudziwika ngati mapiritsi otsika mtengo a atorvastatin amathandizanso odwala matenda ashuga. Kusankha kwa mankhwala enaake kuyenera kuchitidwa ndi adokotala. Osadzisilira.

Ndi chisamaliro

Odwala omwe amamwa mowa kwambiri, odwala omwe ali ndi mbiri ya matenda a chiwindi.

Odwala omwe ali pachiwopsezo cha matenda a rhabdomyolysis (vuto la impso, hypothyroidism, minofu yolowa mu mbiri ya wodwalayo kapena mbiri ya banja, zotsatira zoyipa za HMG-CoA reductase inhibitors (ma statins) kapena mafinya pamatumbo amisempha, mbiri yamatenda a chiwindi ndi / kapena odwala omwe amamwa mowa wambiri, wopitilira zaka 70, mikhalidwe yomwe kuchuluka kwa atorvastatin ikuyembekezeka kuwonjezeka (mwachitsanzo, kuchita ndi mankhwala ena amatanthauza)).

Heterozygous achibale hypercholesterolemia

Mlingo woyambirira ndi 10 mg patsiku. Mlingo uyenera kusankhidwa payekhapayekha ndikuwunika kuyeneranso kumwa kwa masabata anayi alionse ndikuwonjezereka kwa 40 mg patsiku. Kenako, mwina mlingo utha kuwonjezereka mpaka 80 mg tsiku lililonse, kapena n`zotheka kuphatikiza olowa ndi michere ya bile pogwiritsa ntchito atorvastatin pa mlingo wa 40 mg patsiku.

Mtima Kupewa matenda

Mu maphunziro a kupewera koyambirira, mlingo wa atorvastatin anali 10 mg patsiku. Kuchulukitsa kwa mankhwalawa kungakhale kofunikira kuti mukwaniritse zofunika za LDL-C zogwirizana ndi malangizo apano.

Gwiritsani ntchito ana kuyambira zaka 10 mpaka 18 ndi heterozygous Famer hypercholesterolemia

Mlingo woyambira wabwino ndi 10 mg kamodzi patsiku. Mlingo utha kuwonjezeka mpaka 20 mg patsiku, kutengera zovuta zamatenda. Zochitika ndi mlingo wopitilira 20 mg (wofanana ndi 0,5 mg / kg) ndizochepa.

Mlingo wa mankhwalawa uyenera kukhala wokhudza mankhwalawa kutengera cholinga cha kutsitsa kwa lipid. Kusintha kwa Mlingo kuyenera kuchitika mosiyanasiyana nthawi 1 m'milungu inayi kapena kupitilira.

Gwiritsani ntchito limodzi ndi mankhwala ena

Ngati ndi kotheka, kuphatikiza kwa cyclosporine, telaprevir kapena kuphatikiza kwa tipranavir / ritonavir, mlingo wa Liprimar suyenera kupitilira 10 mg / tsiku.

Muyenera kusamala ndikuwonetsetsa kuti mankhwala ochepetsa mphamvu ya atorvastatin azigwiritsidwa ntchito ngati agwiritsidwa ntchito ndi kachilombo ka HIV proteinase inhibitors, hepatitis C proteinase inhibitors (boceprevir), clarithromycin ndi itraconazole.

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere

Liprimar imakhudzana ndi pakati.

Amayi a msinkhu wobereka ayenera kugwiritsa ntchito njira zokwanira zolerera panthawi ya chithandizo. Kugwiritsa ntchito Liprimar kumayesedwa pakati pa azimayi amiseche omwe sagwiritsa ntchito njira zoyenera zakulera.

Zochitika zosawerengeka zamalingaliro obadwa nazo zadziwika pambuyo podziwikiridwa kwa fetus mu chiberekero pambuyo pa HMG-CoA reductase inhibitors (statins). Kafukufuku wazinyama adawonetsa poyipa pakubala. Liprimar imakhudzana ndi mkaka wa mkaka. Sizikudziwika ngati atorvastatin amachotsedwa mkaka wa m'mawere. Ngati ndi kotheka kuti mupeze mankhwalawa panthawi yoyamwitsa, yoyamwitsa iyenera kuyimitsidwa kuti ipewe chiopsezo cha zovuta za ana.

Zokhudza chiwindi

Momwemonso kugwiritsa ntchito mankhwala ena otsitsa a lipid a mkalasi imeneyi, ndi kugwiritsa ntchito mankhwala a Liprimar, kuchuluka kwapakati (kangapo katatu poyerekeza ndi VGN) pa zochitika za hepatic transaminases AST ndi ALT. Kukula kosalekeza kwa ntchito ya seramu ya hepatic transaminases (nthawi zopitilira 3 poyerekeza ndi VGN) idawonedwa mu 0.7% ya odwala omwe amalandira Liprimar. Pafupipafupi kusintha koteroko kugwiritsa ntchito mankhwala Mlingo wa 10 mg, 20 mg, 40 mg ndi 80 mg anali 0,2%, 0,2%, 0,6% ndi 2.3%. Kuwonjezeka kwa hepatic transaminase ntchito nthawi zambiri sikumayendetsedwa ndi jaundice kapena mawonekedwe ena achipatala. Ndi kuchepa kwa mlingo wa Liprimar, kusiya kwakanthawi kapena kwathunthu kwa mankhwalawo, zochitika za hepatic transaminases zidabwerera momwe zidakhalira. Odwala ambiri anapitiliza kumwa Liprimar muyezo wochepetsera popanda zotsatira zoyipa.

Asanayambe, milungu isanu ndi umodzi ndi milungu 12 atatha mankhwalawa kapena atakulitsa mlingo, ndikofunikira kuwunikira zizindikiro za chiwindi. Kugwiritsidwa ntchito kwa chiwindi kuyeneranso kuyesedwa ngati zizindikiro zakuchipatala za kuwonongeka kwa chiwindi zikuwonekera. Ngati chiwopsezo cha ntchito ya hepatic transaminases, ntchito zawo ziyenera kuyang'aniridwa mpaka zitasintha. Ngati kuchuluka kwa ntchito ya AST kapena ALT mwa kuchulukitsa katatu poyerekeza ndi VGN ndikulimbikira, ndikulimbikitsidwa kuti muchepetse mlingo kapena kusiya Liprimar.

Liprimar iyenera kugwiritsidwa ntchito mosamala odwala omwe amamwa mowa wambiri ndi / kapena omwe ali ndi mbiri yodwala matenda a chiwindi. Matenda a chiwindi omwe amagwira ntchito kapena kuwonjezereka kwa hepatic transaminase yamagazi a osadziwikiratu ndikutsutsana ndi Liprimar.

Zotsatira pa minofu ya mafupa

Myalgia adadziwika mu odwala omwe amalandira Liprimar. Kuzindikiritsa kwa myopathy kuyenera kuganiziridwa kwa odwala omwe akuphwanya myalgia, kupweteka kwa minofu kapena kufooka komanso / kapena kuwonjezeka kodziwika mu ntchito ya KFK (koposa nthawi 10 poyerekeza ndi VGN). Mankhwala a Liprimar amayenera kusiyidwa ngati pakuwoneka kuwonjezeka kwa zochitika za CPK, pamaso pa myopathy yotsimikizika. Chiwopsezo cha myopathy akamagwiritsidwa ntchito ndi mankhwala ena mkalasiyi chikuwonjezeka ndikugwiritsira ntchito munthawi yomweyo zoletsa zamphamvu za CYP3A isoenzyme (mwachitsanzo, cyclosporine, telithromycin, clarithromycin, delavirdine, styripentol, ketoconazole, voriconazole, itraconazole, posraconazole, posraconazole, posraconazole. darunavir), gemfibrozil kapena mafupa ena, boceprevir, erythromycin, nicotinic acid mu lipid kutsitsa Mlingo (woposa 1 g / tsiku), ezetimibe, azole antifungal agents, colchicine, telaprevir, boceprevir, kapena kuphatikiza kwa tipranavir / ritonavir. Ambiri mwa mankhwalawa amalepheretsa CYP3A4 isoenzyme metabolism ndi / kapena kayendedwe ka mankhwala. Amadziwika kuti cytochrome CYP3A4 isoenzyme ndiye chiwindi chachikulu cha isoenzyme chomwe chimakhudzidwa ndi biotransfform ya atorvastatin. Kulemba Liprimar molumikizana ndi ma fibrate, erythromycin, immunosuppressants, mankhwala antifungal (azole derivatives) kapena nicotinic acid mu Mlingo wa hypolipidemic (wopitilira 1 g / tsiku), mwayi woyembekezeredwa ndi chiopsezo chamankhwala ziyenera kuyesedwa. Odwala amayenera kuyang'aniridwa pafupipafupi kuti awone kupweteka kwa minofu kapena kufooka, makamaka m'miyezi yoyambirira ya chithandizo komanso panthawi yowonjezera Mlingo wa mankhwala aliwonse. Ngati ndi kotheka, kuphatikiza mankhwalawa kuyenera kuganiziranso za kugwiritsa ntchito mankhwalawa pang'onopang'ono ndikukonzanso Mlingo. Kugwiritsa ntchito munthawi yomweyo mankhwala a atorvastatin ndi fusidic acid osavomerezeka, chifukwa chake, kuchoka kwa atorvastatin ndikulimbikitsidwa panthawi ya mankhwala a fusidic acid. Muzochitika zotere, kutsimikiza kwakanthawi kantchito ya CPK kungalimbikitsidwe, ngakhale kuwunika koteroko sikumalepheretsa kukula kwa myopathy.

Pamaso mankhwala

Liprimar iyenera kugwiritsidwa ntchito mosamala mu odwala omwe ali ndi vuto la rhabdomyolysis. Kuwongolera kwa ntchito za CPK kuyenera kuchitika pazochitika zotsatirazi musanayambe chithandizo cha atorvastatin:

• kuwonongeka kwaimpso,
• hypothyroidism
• zovuta zam'badwa zamavuto m'mbiri ya wodwalayo kapena mbiri ya banja,
• anasamutsa kale poizoni wa HMG-CoA reductase inhibitors (ma statins) kapena ma fiber pamisempha minofu,
• mbiri yodwala matenda a chiwindi ndi / kapena odwala omwe amamwa mowa wambiri,
• mwa odwala omwe ali ndi zaka zopitilira 70, kuwunika kwa CPK kuyenera kuwunikiridwa, popeza kuti odwalawa ali ndi zinthu zomwe zikuwonetseratu kukula kwa rhabdomyolysis,
• nthawi yomwe kuchuluka kwa plasma wozungulira atorvastatin amayembekezeredwa, monga kuchita ndi mankhwala ena. Zikatero, chiwopsezo / phindu limayenera kuwunikidwa ndikuwunika momwe wodwalayo alili. Pankhani yakuwonjezereka kwa ntchito za CPK (zochulukirapo ka 5 kuposa VGN), chithandizo cha atorvastatin sichiyenera kuyamba.

Mukamagwiritsa ntchito mankhwala a Liprimar, komanso zoletsa zina za HMG-CoA reductase, kawirikawiri milandu ya rhabdomyolysis yolephera pachaka chifukwa cha myoglobinuria imafotokozedwa. Chiwopsezo cha rhabdomyolysis chitha kukhala choperewera chaimpso. Odwala otere ayenera kuperekedwa mosamala kwambiri kuti adziwe kuti matenda a musculoskeletal system. Ngati zizindikiro za myopathy zotheka zikuwoneka kapena pali zovuta zomwe zingayambike chifukwa cha kulephera kwa impso chifukwa cha rhabdomyolysis (mwachitsanzo, kupweteka kwambiri pachimake, hypotension ya arterial, opaleshoni yayikulu, kuvulala, metabolic, endocrine ndi kusokonezeka kwa madzi-electrolyte, kugwirira mosagwirizana), Liprimar iyenera kutha kwakanthawi kapena kuletsa kwathunthu.

Odwala akuyenera kuchenjezedwa kuti ayenera kupita kwa dokotala ngati vuto lopanda kufooka kapena kufooka kwa minofu kumachitika, makamaka ngati akuphatikizidwa ndi malaise kapena malungo.

Kuteteza kwa Stroko kudzera Kuchepetsa kwa Cholesterol

Mukuwunikanso mozama ma subtypes a odwala omwe alibe matenda am'mitsempha, omwe adangokhala ndi stroke kapena kuvulala kwa ischemic, poyambira gawo lomwe adalandira atorvastatin pa mlingo wa 80 mg, chiwopsezo chachikulu cha hemorrhagic stroke chidadziwika poyerekeza ndi odwala omwe akulandira placebo. Chiwopsezo chowonjezeka chinali chowonekera kwambiri mwa odwala omwe ali ndi mbiri ya kukomoka kwa hemorrhagic kapena infarction ya lacunar koyambirira kwamaphunziro. Mu gululi la odwala, phindu / chiopsezo cha kumwa atorvastatin muyezo wa 80 mg sichinafotokozedwe bwino, pankhaniyi, musanayambe chithandizo, chiopsezo chokhala ndi matenda a hemorrhagic mwa odwalawa amayenera kuwunikira mosamala.

Pambuyo pa kusanthula kwapadera kwa kafukufuku wamankhwala okhudzana ndi odwala 4731 opanda matenda amitsempha yamagazi omwe anali ndi stroke kapena ofulumira ischemic attack (TIA) m'miyezi 6 yapitayi omwe adalembedwa atorvastatin 80 mg / tsiku, zochitika zapamwamba za hemorrhagic stroke ku gulu la atorvastatin la 80 mg poyerekeza ndi gulu la placebo (55 pagulu la atorvastatin motsutsana ndi 33 pagulu la placebo). Odwala omwe ali ndi vuto la hemorrhagic panthawi yophatikizidwa phunziroli anali ndi chiopsezo chobwereza hemorrhagic pafupipafupi (7 pagulu la atorvastatin motsutsana ndi 2 mgulu la placebo). Komabe, odwala omwe amalandira atorvastatin 80 mg / tsiku anali ndi mikwingwirima yocheperako yamtundu uliwonse (265 motsutsana 311) komanso zochitika zochepa zamtima (123 motsutsana 204).

Matenda am'mapapo

Pochita mankhwala ndi ena a HMG-CoA reductase inhibitors (ma statins), makamaka panthawi yayitali, milandu yokhazikika yamatenda a m'mapapo imanenedwapo. Kupuma pang'ono, chifuwa chosabereka, komanso thanzi lofooka (kutopa, kuchepa thupi, komanso kutentha thupi) kumatha kuchitika. Ngati wodwala akuganiza kuti matenda am'mapapo apakati, chithandizo cha atorvastatin ziyenera kusiyidwa.

Ntchito ya endocrine

Mukamagwiritsa ntchito zoletsa za HMG-CoA reductase (statins), kuphatikizapo atorvastatin, pakhala pali kuchuluka kwa glycosylated hemoglobin (HbA1) ndi kusala kwama protein glucose. Komabe, chiopsezo cha hyperglycemia ndi chotsika poyerekeza ndi kuchepetsedwa kwa chiwopsezo cha zovuta zam'mimba mutatenga HMG-CoA reductase inhibitors (ma statins).

Zokhudza mphamvu pakuyendetsa magalimoto

Palibe deta pazokhudza Liprimar pa kuyendetsa magalimoto ndi kuchita zoopsa zomwe zimafunikira chidwi chochulukirapo komanso kuthamanga kwa zochitika zama psychomotor. Komabe, poganizira kuti mungakulitse chizungulire, muyenera kusamala pochita izi