Torvacard "kapena" Atorvastatin "

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

Torvacard ndi mankhwala osokoneza bongo a statin. Monga othandizira, mankhwala a Torvacard ali ndi Atorvastatin, yemwe amachepetsa mafuta m'thupi. Mankhwalawa amapangidwa ndi kampani yaku Czech "Zentiva" mu mawonekedwe a mapiritsi okhala ndi 10, 20 ndi 40 mg. Atorvastatin bwino amachepetsa mulingo wa lipoproteins ndi cholesterol m'madzi a m'magazi.

• Zizindikiro
• Zakudya Zabwino Kwambiri Cholesterol
• Malangizo popereka mankhwala
• Kodi simuyenera kugwiritsa ntchito liti Torvacard?
• Thorvacard pa mimba ndi mkaka wa m`mawere
• Momwe mungatenge Torvacard?
• Makamaka zoopsa zomwe zimachitika
• Zisonyezo zina za mankhwala a statin
• Mitundu ya Torvacard ndi mtengo wa mankhwala

1. Poyerekeza zakumbuyo chakudya cha hypocholesterol chomwe chimawonjezera kuchuluka kwa cholesterol, mafuta osakanikirana ophatikizika.
2. Ndi kuwonjezeka kwa seramu indices a triglycerides ndi dibetalipoproteinemia.
3. Matenda a mtima ndi mtima mwa odwala omwe ali ndi chiopsezo chokhala ndi zovuta za ischemic - zaka zaka 55, matenda a endocrine, zotumphukira zamitsempha.
4. Popewa yachiwiri mavuto pambuyo pachimake ischemic zinthu.

Atorvastatin

Mankhwalawa ndi a statin ndipo amatanthauza cholesterol yotsika. Kugulitsidwa ku malo ogulitsa mankhwala piritsi. Kuphatikizikako kumakhala ndi gawo lalikulu logwira ntchito atorvastatin kuchuluka kwa 10 kapena 20 mg piritsi limodzi. Kuphatikiza apo, pali magawo othandizira a magnesium stearate, opadra, starch, cellulose, calcium carbonate ndi lactose.

Chipangizocho chikuwonetsedwa pazotsatira za matenda:

• Kuchepetsa cholesterol yamagazi.
• M'malo momwe chithandizo chamankhwala sichithandiza.
• Zochizira limodzi ndi zakudya mankhwala.

Pali zotsutsana zingapo zomwe simungathe kumwa mankhwalawa. Zina mwa izo ndi:

1. Ana osakwana zaka 18.
2. Mimba komanso yoyamwitsa.
3. Amayi omwe samamwa mapiritsi a kulera panthawi yakubereka.
4. Zambiri matenda a chiwindi ndi impso.
5. Lactase akusowa.
6. Kumvera pazigawo.

Mosamala kwambiri, madokotala amatipatsa mankhwala opangira opaleshoni yayikulu komanso pakukonzanso, kuvulala, khunyu, matenda a shuga komanso matenda ena a chithokomiro.

Odwala ena amafotokoza kuwoneka kwa mavuto. Izi zikuphatikiza:

• Kulemera.
• Kukomoka kwa gout.
• Thupi lawo siligwirizana.
• Hypoglycemia.
• Kuchepa chilakolako cha kugonana, kusabala.
• Kupuma.
• Matenda a minofu ndi mafupa.
• Zingwe.
• Kutsekemera kwa mano.
• Matenda a Stool, kupweteka kwam'mimba, kutentha kwa mtima, nseru.
• Anemia
• Kuphwanya kukoma.
• Mutu ndi chizungulire.

Madokotala amati zotsatira zoyipa zikamachitika, pamakhala mwayi wolimba, choncho nthawi zina amachepetsa mlingo, kapena kupereka mtundu wina wa mankhwalawo.

Mankhwala amaperekedwa ndi mankhwala. Mtengo woyenerera wamankhwala ogulitsa mankhwala ndi pafupifupi ma ruble 150 phukusi lililonse la 10 mg.

Kodi pali kusiyana kotani pakati pa mankhwala

Mankhwala amafunikira kuchiza zovuta zomwezo, khalani ndi zomwe zimagwira. Komabe, atorvastatin imagulitsidwa mtundu wa 10 kapena 20 mg piritsi, ndipo Torvacard ikhoza kupezeka yogulitsa mu 10, 20 kapena 40 mg.

Mtengo wawo ndi wosiyana pang'ono. Torvacard ndiokwera mtengo kwambiri, pafupifupi ma ruble 300 pa 10 mg. Atorvastatin ndi wotsika mtengo - pafupifupi ma ruble pafupifupi 150 a mlingo womwewo.

Zomwe ndibwino kusankha

Madokotala nthawi zambiri amapereka mankhwala amodzi kapena amtundu wina malinga ndi zomwe akumana nazo.Ngati munthu m'mbuyomu adakumana ndi zovuta pomwe amamwa chithandizo chamankhwala ena, ndiye kuti sawerengedwa.

Pazonse, onse mankhwalawa ndi ofanana pochita komanso pazinthu zomwe zimagwira pali zosiyana zambiri zomwe angagule, ayi. Nthawi zambiri, odwala amatsogozedwa ndi kupezeka kwa mankhwalawo ku pharmacy pakadali pano. Ngati m'modzi wa iwo palibe, ndiye kuti mutha kuyika china. Komabe, ngati munthu akufuna kusintha mankhwala munthawi ya chithandizo, muyenera kufunsa dokotala.

Atoris: kufotokozera, mawonekedwe, kugwiritsa ntchito

Makampani opanga mafakitala amapereka mankhwala ambiri kuthana ndi atherosulinosis ndi cholesterol yayikulu. Momwe mungasankhire zothandiza kwambiri komanso zotetezeka?

Atoris, mankhwala omwe amachepetsa cholesterol m'thupi, ndi otchuka kwambiri. Ndi m'gulu la ma statins. Zomwe zimagwira ndi atorvastatin. Imalepheretsa kaphatikizidwe ka cholesterol kudzera poletsa HMG CoA reductase, imathandizira kuchepetsa mulingo wake m'magazi. Imachepetsa kuchuluka kwa ma lipoproteins otsika kwambiri a LDL cholesterol zovulaza anthu, ndipo mosemphanitsa, kumawonjezera ndende ya HDL, ndikulimbikitsa anti-atherosclerosis yake. The yogwira mankhwala Atorvastatin amachepetsa ndende ya zinthu zomwe zimapangitsa kukhala ndi adipose minofu m'thupi.

Atoris ndi amodzi a statins a m'badwo wachitatu, ndiye kuti, ndi othandiza kwambiri.

Ikupezeka mapiritsi a 10, 20, 30, 60 ndi 80 ml ndi kampani ya ku Slovenia KRKA.
Atoris amalimbikitsa kugwiritsa ntchito odwala omwe ali ndi atherosulinosis komanso odwala omwe ali ndi cholesterol yambiri m'magazi.

Poyamba, mankhwalawa adapangidwa ngati analogue yotsika mtengo ya liprimar yofufuza komanso yopanga kwambiri ya Liprimar yopangidwa ndi kampani yaku Germany ya Pfizer. Koma, chifukwa cha kuchita bwino, adakhala ndi niche pakati pamapangidwe opanga ma cellins.

Ogonjera A wamba a Atoris

Ma analogues onse ali ndi atorvastatin monga chinthu chachikulu.

• Liprimar - Pfizer, Germany.

Kuchita nawo mayesero azachipatala ambiri. Anadzitsimikizira kuti ndi chida chotetezeka komanso chothandiza. Ili ndi mtengo wokwera.

• Torvacard - Zentiva, Slovenia.

Kupanga kofanana ndi Atoris. Wotchuka ndi odwala ku Russia.

• Atorvastatin - ZAO Biocom, Alsi Pharma, Vertex - onse opanga Russia. Mankhwalawa ndi otchuka kwambiri ku Russia chifukwa cha mtengo wotsika.

Odwala ambiri amafunsa kuti: Atoris kapena Atorvastatin, ndibwino? Yankho la funsoli ndilosiyana. Kapangidwe ka mankhwala onsewa ndi chinthu chimodzi chomwe chimagwira. Izi zimapangitsa machitidwe awo kukhala ofanana. Kusiyana pakati pawo pakampani ndi dziko lakapangidwe.

• Atomax - Hetero Mankhwala Osokoneza bongo, India. Amasiyana ndi Atoris pakakhala mlingo wochepa wa 10-20 mg. Chalangizidwa kupewa matenda a atherosulinosis okalamba odwala.
• Ator - CJSC Vector, Russia.

Adzaperekedwa mu gawo limodzi lokha - 20 mg. Amayenera kugwiritsa ntchito mapiritsi angapo kuti apeze mlingo wofunikira.

Ma analogi ndi zinthu zina zogwira ntchito

Kuphatikizika kwa mankhwalawa kumaphatikizanso statin ina.

Livazo - Pierre Fabre Recordati, France, Italy.

Crestor - Russia, Great Britain, Germany.

Simgal - Czech Republic, Israel.

Simvastatin - Serbia, Russia.

Koma ndikofunikira kukumbukira kuti simvastatin ndi mankhwala a m'badwo woyamba.

Nkhani yoperekedwa ndi Filzor.ru

Kuti muchepetse kuchuluka kwa ndende ndikuwongolera zizindikiro za lipids, cholesterol ndi triglycerides m'magazi, perekani mankhwala omwe ali m'gulu la ma statins. Chitsanzo chochititsa chidwi ndi Atoris ndi Atorvastatin. Mankhwala onse awiriwa ali ndi chinthu chomwecho, piritsi lotulutsidwa. Zachithandizo zawo ndizofanana. Kusiyanitsa kokhako kumakampani opanga mankhwala ndi mitengo.

Dokotala wokhazikika ndi amene angadziwe kuti ndi mankhwala ati omwe angafune komanso othandiza kwa wodwala - Atoris kapena Atorvastatin.

Kutulutsa kwa atoris - mapiritsi okhala ndi mafilimu.Chofunikira chachikulu ndi atorvastatin. Kapisozi imodzi imakhala ndi 10, 20, 30, 40, 60 ndi 80 mg pazinthu izi. Katemera amatenga zidutswa 10, 30, 60 ndi 90.

Mankhwala amaletsa kupanga cholesterol chifukwa kapangidwe ka enzyme yomwe imachepetsa kuchuluka kwake m'madzi a m'magazi. Mlingo wa lipoproteins zovulaza thupi amachepa chifukwa cha mphamvu ya chinthu chomwe chimagwira pa LDL receptors. Pankhaniyi, m'malo mwake, pali kuwonjezeka kwa kuchuluka kwa osachulukitsa lipoproteins (HDL), komwe kumalimbikitsa anti-atherosranceotic. Mankhwalawa amathandizira kuchepetsa kuchuluka kwa mankhwala omwe amapanga mafuta osungira.

Zisonyezo zogwiritsidwa ntchito:

• hyperlipidemia yoyamba,
• hypercholesterolemia,
• hypertriglyceridemia,
• kupewa matenda amitsempha yama mtima ndi magazi, makamaka kwa anthu omwe ali pachiwopsezo (kuyambira azaka 55, kupezeka kwa matenda osokoneza bongo, kuthamanga kwa magazi, zizolowezi zakusuta, kutengera kwa chibadwa),
• kupewa mavuto a matenda a mtima ndi mitsempha, kuphatikizapo sitiroko, matenda a mtima, angina pectoris ndi ena.

Mapiritsi adapangidwa kuti azigwiritsidwa ntchito musanadye kapena mutatha. Poyamba 10 mg imayikidwa, koma ndiye kuchuluka kwake kungakulitse mpaka 80 mg. Kutengera luso la mankhwalawo. Kusintha koyenera kumachitika pambuyo pa milungu iwiri yogwiritsira ntchito mankhwalawa.

Contraindication kuti agwiritse ntchito:

• matenda amisempha
• matenda a chiwindi,
• kulephera kwambiri kwa chiwindi
• matenda a chiwindi ali pachimake (makamaka kwa chiwindi cha etiology zosiyanasiyana),
• kufupika kwa lactase, kusalolera kwa lactose,
• kuchuluka kukhudzidwa kwa mankhwalawa kwa mankhwalawo komanso zida zake.

Kwa ana ochepera zaka 18, komanso azimayi pa nthawi yoyembekezera komanso yoyamwitsa, mankhwalawo sioyenera. Mosamala, iyenera kumwedwa chifukwa cha uchidakwa wambiri, kusakhazikika kwa electrolyte, matenda a endocrine dongosolo ndi metabolism, matenda opatsirana, khunyu, hypotension.

Zofala

Atorvastatin ndiye chofunikira kwambiri popanga mankhwala onse awiri, motero zotsatira zamankhwala ndizofanana. Muli izi:

• kutsitsa cholesterol yamagazi,
• kuchepa kwa kuchuluka kwa lipoproteins m'mwazi,
• kuletsa kukula kwambiri kwa maselo a maselo amitsempha yamagazi,
• kukula kwa lumen ya mtsempha wamagazi,
• kuchepa kwamitsempha yamagazi, kuponderezana kwa zochita za zinthu zina zomwe zimayambitsa kugundika kwake,
• kuchepa kwa mwayi wokhala ndi zovuta zokhudzana ndi matenda a mtima.

Poganizira zamankhwala izi, ma statin onsewa amaperekedwa kwa anthu akuluakulu kapena okalamba, ndipo nthawi zambiri kwa achinyamata. Zizindikiro zogwiritsidwa ntchito ku Atoris ndi Atorvastatin ndizofanana. Mankhwala amalimbikitsidwa pazotsatira zochizira komanso prophylactic.

Chimodzi mwa ma statins onsewo ndi nthawi yomwe amagwiritsa ntchito. M'mayambiriro oyamba, adotolo amakupereka mlingo wochepetsetsa, koma kenako amatha kuwongolera kuti azilamulira mafuta m'thupi. Maphunzirowa amatenga nthawi yayitali, ndipo nthawi zina mankhwalawa amafunikira kuti muzigwiritsa ntchito moyo wanu wonse. Pankhaniyi, kusanthula kwa labotale magawo a magazi kumachitika nthawi ndi nthawi.

Kukhazikitsa zotsatira zoyipa ku Atoris ndi Atorvastatin ndiwofanana chifukwa cha gawo lomweli. Izi zimaphatikizapo zotsatira za mankhwala pa:

• dongosolo lamitsempha - kupweteka mutu, asthenia, mavuto ogona, kusachedwa, dzanzi la miyendo, mavuto a kukumbukira,
• mtima wamagazi - kutsitsa kapena kuthamanga kwa magazi, kuthamanga kwa mtima,
• kugaya chakudya - kuwoneka kwa ululu wosadziwika m'mimba ndi pansi pa nthiti kumanja, kutentha kwa mtima, nseru, kusanza, kupaka, kupangika kwa mpweya, kusinthana kwa m'mimba ndi kudzimbidwa, nthawi zina chiwindi, cholecystitis, kapamba, kulephera kwa chiwindi,
• kwamikodzo ndi njira zoberekera - kulephera kwa impso, kutsika kwa potency, libido,
• musculoskeletal system - kupweteka m'malo, minofu, mafupa, msana,
• hematopoietic dongosolo - thrombocytopenia (nthawi zina),
• khungu - lotupa, kuyabwa, kubowoka chifukwa cha sayanjana,
• ziwalo zam'malingaliro - kusokonezeka kwa malo okhala, mavuto akumva.

Ngati zovuta zosafunikira zikuwoneka chifukwa chotenga Atoris kapena Atorvastatin, ndiye kuti muyenera kusiya kugwiritsa ntchito mankhwalawa ndikupita kuchipatala. Malangizo a Dotolo ndi: kuchepetsa kutsitsa, kusinthanitsa ndi analog kapena kuthetsedwa konse kwa ma statins.

Kodi pali kusiyana kotani?

Kusiyanitsa pakati pa Atoris ndi Atorvastatin ndiko kuzungulira kwa chinthu chogwira ntchito. Zoyambazo zili ndi gawo lonse la 10, 20, 30, 40, 60 ndi 80 mg, pomwe lomaliza limangokhala ndi 10 ndi 20 mg. Ndikusintha kwa Mlingo, Atoris idzakhala yabwino kwambiri.

Kusiyana kwachiwiri ndi komwe amapanga. Atorvastatin amapangidwa ndi Biocom, Vertex, Alsi Pharma, ndiye kuti, makampani aku Russia. Atoris amapangidwa ndi Krka ku Slovenia.

Zomwe zimakhala zotsika mtengo

Atoris ikhoza kugulidwa ku Russia pa ma ruble 400-600 pa paketi iliyonse ndi mapiritsi 30 okhala ndi 10 mg ya chigawo chachikulu. Ngati mungasankhe manambala ofanana ndi makapisozi, koma ndi kuchuluka kwa 20 mg, ndiye kuti mtengo wake udzakhala mpaka ma ruble 1000.

Atorvastatin-teva ku Russia amagulitsidwa pafupifupi ma ruble 150 pachilichonse ndi mapiritsi 10 mg.

Kufotokozera kwamachitidwe

Atorvastatin (Atoris) ndi kapangidwe kosankha 3-hydroxy-3-methylglutaryl coenzyme A inhibitor (HMG-CoA), kuletsa kutembenuka kwa HMG-CoA kupita ku mevalonate sterol precursor. Mankhwala amachepetsa kuchuluka kwa cholesterol m'maselo a chiwindi, chifukwa, mawu a LDL receptors (otsika kachulukidwe lipoprotein receptors - "yoyipa" cholesterol) amawonjezeka, omwe amachititsa kuti pakhale zambiri komanso zolimba za LDL, ndipo ma cell a LDL amalowetsedwa. Atorvastatin amachititsa kuchepa kwakukulu kwa cholesterol yathunthu ndi LDL cholesterol. Kuphatikiza apo, VPLL cholesterol (otsika kwambiri lipoproteins), apolipoprotein B ndi triglycerides amachepetsedwa. Atorvastatin amachepetsa chiopsezo cha ischemic episode mkati mwa masabata 16 pambuyo pachimake coronary syndrome, komanso chiopsezo cha zovuta zamtima mwa odwala omwe ali ndi matenda oopsa. 95-99% ya mankhwalawa imatengedwa kuchokera m'matumbo am'mimba, amachotsedwa m'thupi ndi maselo a mucous membrane am'mimba ndi matumbo. Pambuyo poyambirira koyamba, kuphatikiza kwathunthu kwa bioavailability kuli pafupifupi 12%, ntchito ya inhibitory motsutsana ndi HMG-CoA reductase ili pafupifupi 30% (pafupifupi 70% ya ntchitoyi ndi ya metabolites ya Atorvastatin). Nthawi yofika ndende yayikulu ndi maola 1-2. Pafupifupi 98% ya mankhwalawa amamangidwa kumapuloteni a plasma. Atorvastatin imapangidwa mu chiwindi kuti metabolites yogwira. Mu kagayidwe kamankhwala, makamaka CYP3A4 imakhudzidwa. Hafu ya moyo ndi maola 14. Mphamvu ya inhibitory ya HMG-CoA imangokhalira maola 20-30 chifukwa cha metabolites yogwira. Pafupifupi 98% ya mankhwalawa amachotsedwa mu ndulu. Odwala omwe ali ndi matenda osachiritsika a chiwindi, ma pharmacokinetics a Atorvastatin amasintha kwambiri. Kutsika kwa seramu cholesterol kumawonedwa pafupifupi masabata awiri chiyambireni chithandizo, ndipo zotsatira zake zazikulu zimachitika pambuyo pa masabata a 4-6 ndipo zimasungidwa panthawi yopitilira chithandizo. Mukasiya kugwiritsa ntchito mankhwalawa, cholesterol level imabweranso mwakale.

Zabwino kuposa lypimar kapena torvakard

Mu gawo la Matenda, Mankhwala kwa funso: Kodi LIPRIMAR ndi chiani kuposa TORVACARD? yankho labwino kwambiri lopezeka ndi wolemba Ignat ndilotsika mtengo kwambiri kuposa torvacard.

zikuwoneka kuti oimira opanga mapiritsi amagwira ntchito bwino ndi madotolo, motero amapereka kuti ndizokwera mtengo. kutenga torvacard - palibe zoyipa

Gwero lake ndi adotoloyo

Torvakard imatulutsa Zentiva - awa ndi mayiko athu akale a zachikhalidwe cha anthu, ndipo Lypimar ndi kampani yaku Belgian yomwe ili ndi mafakitale ku America ndi Turkey, zina. Osamapusitsa mutu wanu. kodi torvakard ikuthandizani ?? ngati ndi choncho, imwani. komanso za mowa - ngati mumamwa tsiku lililonse, ndiye kuti umboni suyenera kukhala wabwino. mutha kumwa, koma osakwanira ndi malita, ndipo ma gramu zana a vinyo samapweteka, ndipo osati tsiku lililonse

Malangizo ogwiritsira ntchito mankhwalawa

Popeza kuti atherosulinosis ndi matenda akupha, ndikofunika kupita kuchipatala ndiudindo. Muyezo wagolide wothandizira ndi ma statins.

Makina awo ochita chimodzimodzi ndi gulu lonse ndipo ali mu blockade ya HMG-CoA reductase enzymes yomwe imapanga cholesterol m'chiwindi.

Mukamagwiritsa ntchito mankhwala pafupipafupi, odwala amasintha kuchuluka kwa zigawo za lipid, kuphatikiza cholesterol, zigawo zina za m'mimba, triglycerides ndi Alipoprotein B. Mankhwalawa amachepetsa chiopsezo cha zovuta zakupha monga embolism, infaration yokomera pachimake, gangrene ya malekezero, ischemic sitiroko ndi angina pectoris, nthawi yoyamba.

Atorvastatin ndi ma statin ena amapangidwa kuti azigwiritsidwa ntchito pakamwa. Amangotengedwa ndi mankhwala a dokotala, omwe amawerengera mosamalitsa mbiri ya lipid asanapange mankhwala, amalangizidwa pamakhalidwe ndi kusintha kwa zakudya, chifukwa kunenepa kwambiri kumawonjezera mphamvu ya mankhwala ku cholesterol.

Mlingo nthawi zambiri amasankhidwa kuti pakhale kutonthoza kwakukulu kwa wodwala ndipo amapezeka piritsi limodzi, lomwe limatengedwa nthawi iliyonse masana, mosasamala zakudya. Ndikofunikira kuyesa kuyesa kamodzi pamwezi, chifukwa pakalibe chithandizo chamankhwala, mlingo umasinthidwa.

Milandu yayitali ya cholowa, kuchuluka kumakhala mapiritsi anayi patsiku. Odwala okalamba, osachepera mlingo womwe umasinthidwa, chifukwa cha chiwopsezo cha impso. Kwa ana, mlingo sayenera kupitirira mamiligalamu makumi awiri patsiku. Odwala omwe ali ndi matenda a chiwindi, mankhwalawa amatsutsana.

Kukula kotheka kwa zoyipa, monga:

• Mutu, kusokonezeka kwa tulo.
• Kupweteka kwa minofu, kukokana.
• Kusanza, kusanza, kuwawa mkamwa, kusefukira kwam'mimba, kutsekula m'mimba kapena kudzimbidwa.
• Khungu loyenda, urticaria.

Kulowa m'mimba, piritsi limasungunuka mwachangu, ndikulowetsa magazi kudzera mu mucous nembanemba ndikuthamangira kumalo a chilema. Bioavailability ndi 12%, chowonjezera chiwindi, kupatula theka moyo ndi pafupifupi maola 15.

Odwala nthawi zambiri amasokonezeka akagula mankhwala, chifukwa mitengo ya mankhwala imasiyana, pali mayiko ambiri omwe amapanga, mayina ambiri ogulitsa ndipo pamakhala kutsatsa kwachangu pa intaneti komanso pa TV.

Zonsezi zimabweretsa mafunso, pali kusiyana kotani pakati pa kuchuluka kwa mankhwalawa.

Zakudya Zabwino Kwambiri Cholesterol

Pogwiritsa ntchito Torvacard, akatswiri amalimbikitsa kuti azikhala ndi zakudya zapadera, zomwe cholinga chake ndi kuchepetsa mafuta m'thupi. Malamulo oyambira a cholesterol zakudya ndi:

• mchere wolepheretsa kwambiri
• Zakudya za tsiku ndi tsiku zimagawidwa m'magulu a 5-6,
• kuletsa kapena kupatula mafuta a nyama,
• njira zophikira kupatula kukazinga, kusuta, kuphika pa grill,
• kuphika kuyenera kuchitidwa ndi kuphika, kudya popanda kugwiritsa ntchito mafuta, kuwotcha,
• Zakudya ziyenera kukhala ndi masamba, zipatso,
• muyenera kuchepetsa kugwiritsa ntchito mazira, batala,
• ndikofunikira kupatula soseji, makamaka masosefa osuta, zopangidwa zokhomedwa pamsika, zakudya zamzitini, mafuta mkaka.

Chakudya sichikhala ndi zopitilira zopitilira 2700 patsiku. Kutsatira malamulo azakudya amakupatsani mphamvu kusintha cholesterol komanso kupewa misempha.Ngati chithandizo cha zakudya sichokwanira kutsitsa cholesterol, ma statin ndi omwe amapatsidwa.

Malangizo popereka mankhwala

Ngati mankhwala adalandira koyamba, ndikofunikira kusankha mlingo wokwanira wa mankhwalawa. Nthawi zambiri, chithandizo cha hypocholesterolemia chimayamba ndi mlingo wochepa wa 5 kapena 10 mg wa atorvastatin.

Pambuyo pa chithandizo cha masabata atatu ndi ma statins, cholesterol ndi magawo a chiwindi amayang'aniridwa.

Ngati mulingo wa cholesterol sunakhale wosasinthika kapena utachepa pang'ono, mlingo wa mankhwalawo umakulitsidwa. Pankhaniyi, chidwi chiyenera kuperekedwa kwa magawo a chiwindi.

Kodi simuyenera kugwiritsa ntchito liti Torvacard?

Monga mankhwala ambiri a statin, Torvacard ali ndi zotsutsana:

1. Kusagwirizana ndi chimodzi mwazinthu zothandizira kapena chinthu chogwira ntchito.
2. Matenda a chiwindi a mitundu yosiyanasiyana yogwira.
3. Kuwonjezeka kwa kuchuluka kwa michere ya chiwindi yosadziwika kuyambira katatu.
4. Zaka zakubala kwa amayi omwe sagwiritsa ntchito njira zodalirika zakulera.
5. Zaka mpaka 18.

Zotsutsana pamwambapa ndizotsimikizika, koma pali matenda omwe Torvacard ndi yovomerezeka, koma mosamala. Mu malangizo ogwiritsira ntchito Torvacard, mikhalidwe yotereyi ikufotokozedwa:

• kuthamanga kwa magazi
• opaleshoni yayikulu, makamaka m'mimba,
• matenda apadera - sepsis,
• matenda a musculoskeletal system
• kusowa kwa madzi ndi ma elekitirodiya m'thupi,
• matenda a chiwindi m'mbuyomu
• khunyu ndi matenda ena okhala ndi kukomoka kosalamulirika,
• matenda ashuga.

Milandu iyi, kugwiritsidwa ntchito kwa mapiritsi a Torvacard kumayamba ndi kuchuluka kwa mankhwalawa ndikuwonjezera mlingo mosamala, ndikuwona momwe wodwalayo alili.

Thorvacard pa mimba ndi mkaka wa m`mawere

Ngati mimba yachitika pamene mukumwa Atorvastatin, chithandizo ndi mankhwalawa ziyenera kusiyiratu. Kafukufuku wazinyama awonetsa kuti mankhwalawa amatha kukhala ndi poizoni pa mwana wosabadwayo. Kafukufuku wokhudzana ndi zotsatira za atorvastatin pokhudzana ndi anthu panthawi yapakati sanachitike. Kuphatikiza apo, munthawi yoyamwitsa, Torvacard sagwiritsidwa ntchito, chifukwa palibe deta pa kuthekera kwa ma statins omwe angatulutsidwe pamodzi ndi mkaka wa m'mawere. Ngati mayi adatenga ma statins asanabadwe, ndiye kuti kulandila ndalama kuyenera kuthetsedwa nthawi yonse yobereka ndi kuyamwitsa. Atherosulinosis ndi njira yothandizira pang'onopang'ono, chifukwa chake palibe chovuta chomwe chiti chichitike pakapita nthawi yobweretsera mankhwala. Pambuyo atathetsa mkaka wa m`mawere, mankhwala Torvacard akutengedwa yemweyo Mlingo potsatira dokotala.

Momwe mungatenge Torvacard?

Torvacard imatengedwa nthawi iliyonse masana - m'mawa, madzulo kapena usiku, mosasamala kanthu za kudya. Torvacard 10 mg ndiye mlingo woyambirira. Nthawi zina, theka la mapiritsi limasankhidwa ngati koyamba mlingo. Ngati kuchuluka kwa 10 mg sikokwanira, mutatha kuwongolera kuchuluka kwa cholesterol, Torvard 20 mg, kapena Torvacard 40 mg ndi mankhwala.

Mlingo wa mankhwalawa uyenera kusankhidwa ndi dokotala pambuyo pa mayeso ofunikira ndikuwunika. Ndi zoletsedwa mwamphamvu kuwonjezera mlingo wa mankhwalawo!

Zotsatira zoyipa mukamamwa Torvacard zimatha kuchitika mbali zosiyanasiyana za thupi ndi machitidwe a thupi:

1. Pa gawo la kagayidwe, kusinthasintha kwa shuga m'magazi, kunenepa kwambiri, kapena kuchepa thupi kwambiri.
2. Mitsempha yamkati: paresthesia, kusintha kwa kulingalira, kukumbukira kwamisala, neuropathy.
3. Chitetezo cha mthupi - thupi lawo limakumana ndi zotupa pakhungu mpaka pakhungu.
4. Magazi ndi hematopoietic dongosolo: kuchepa kwa maselo a m'magazi.
5. Matenda am'malingaliro amtundu wa zoopsa za usiku ndi mavuto ena ogona.
6. Matumbo dongosolo - dyspeptic zovuta mu mawonekedwe a mseru, kudzimbidwa, kutsegula m'mimba, kupweteka kwam'mimba, kupweteka kwamtima.Mwina kukula kwa njira yotupa mu kapamba.
7. Thupi la minofu ndi mafupa amatha kuyankha kugwiritsidwa ntchito kwa statin mwa kuwoneka kupweteka m'malo, minofu, mafupa, kukokana kwa minofu, kukula kwa myopathy, rhabdomyolysis ndi zovuta zina zamkati mwa musculoskeletal system. Wodwala yemwe adapangidwira ma statins ayenera kuchenjezedwa za kufunika kokawonana ndi dokotala ngati pali kuwawa kwadzidzidzi m'misempha ndi mafupa.
8. Komanso, pakumwa mankhwala ndi ma statins, kukula kwa vuto logonana ndikotheka.

Nthawi zambiri zosafunika zimachitika chifukwa cha mlingo wosankhidwa bwino kapena kupitirira pa Mlingo wa dokotala. Monga lamulo, pambuyo pa kukonza kwa mankhwalawa, mphamvu ya Zizindikiro imachepa kwambiri, kapena zotsatira zosafunika zimazimiririka. Komabe, pali zovuta zina, mawonekedwe ake omwe ayenera kusiya yomweyo chithandizo ndi Torvacard ndikupempha thandizo kuchipatala mwachangu. Kuchita koteroko kumaphatikizapo kupweteka kwa minofu ndi chifuwa.

Makamaka zoopsa zomwe zimachitika

Myopathy imatha kudzetsa kukula kwa aimpso, motero wodwalayo ayenera kuchenjezedwa kuti afunika kusiya mankhwalawo ndikuwona dokotala mwachangu ngati ululu wamankhwala ululu. Thupi lawo siligwirizana amafunikanso kuchotsedwa kwa mankhwalawo. Thupi lomwe siligwirizana ngati lamba ndi ming'oma sichitha kuvulaza kwambiri, ndipo kutupa kwa nkhope ndi khosi kumatha kuyambitsa bronchospasm ndikuvuta kupuma. Mkhalidwe womwe umawopseza kwambiri ndi kugwedezeka kwa anaphylactic. Chifukwa chake, ngati zizindikiro za ziwopsezo zimawonekera, musamwe mapiritsi a Torvacard.

Panthawi imodzi ya mlingo waukulu wa mankhwalawo kapena mwatsatanetsatane wa kuchuluka kwa mlingo woyenera, poyizoni wa atorvastatin amatha. Monga lamulo, bongo wambiri umadziwonetsera ngati chizindikiro cha kugaya kwamphamvu ntchito. Katemera wa mankhwala opezeka pano siliponso, kotero, mankhwala a bongo amakwaniritsidwa.

Zisonyezo zina za mankhwala a statin

• Musanayambe mankhwala ndi mankhwala omwe amachepetsa mafuta a cholesterol, ayenera kuchitapo kanthu pochepetsa mankhwala omwe amachepetsa mphamvu ya cholesterol: zolimbitsa thupi, kuchepa thupi, chithandizo chamankhwala. Ndiye, ngati izi sizinapangitse zotsatira zomwe mukufuna, ma statin ndi omwe amapatsidwa.

• Kuwunika kwawothandizila kutsimikizira zizindikiro za ntchito ya chiwindi kuyenera kuchitika musanayambe chithandizo, ndipo nthawi ndi nthawi, osachepera kawiri pachaka ndi kuwonjezeka kwamtundu uliwonse wa Torvacard.
• Ngati ma hepatic indices adapitilira, wodwalayo ayenera kuyang'aniridwa ndi dokotala mpaka abwerere kwazonse.
• Chenjezo liyenera kuchitidwa popereka mankhwala molumikizana ndi mankhwala ena. Kugwiritsa ntchito mankhwala ena kuyenera kukumbukiridwa, chifukwa Atorvastatin imatha kulumikizana ndi zinthu zina zamankhwala.
• Mukamatenga Torvacard, muyenera kusamala pochita ndi magwero owopsa ndi kuyendetsa.

Mitundu ya Torvacard ndi mtengo wa mankhwala

M'mafakitala, pali mankhwala ambiri okhala ndi Atorvastatin, omwe ndi fanizo la Torvacard. Mwachitsanzo, kukonzekera kwa kampani ya Krka - Atoris, Pfizer - Liprimar ndizodziwika kwambiri pakati pa madokotala. Opanga zapakhomo amatulutsa Atorvastatin mu mitundu yosiyanasiyana - 10, 20, 30, 40 ndi 80 mg. Mtengo wa analogi za Torvakard zimatengera mtengo wamalonda, mayendedwe amagulu onse ogulitsa, komanso ndondomeko yamitengo yamapulogalamu ena. Komabe, kukonzekera kwa Atorvastatin kuli m'gulu la Mankhwala ofunikira ndi ofunikira, chifukwa chake ali ndi mtengo wotsika mtengo womwe mankhwalawo sungagule. Ndalama zodula kwambiri zomwe zimakhala ndi Atorvastatin ndi mankhwala oyamba a Liprimar, opangidwa ndi kampani yaku Germany Pfizer.

Kuchita bwino kwa mankhwala omwe ali ndi Atorvastatin, lero sikukayika, chifukwa chake, ma statins amagwiritsidwa ntchito kwambiri pazachipatala.

Ma statin othandiza kwambiri komanso otetezeka

Tsiku lililonse, vuto la matenda a mtima ndi matenda amtima limakulirakulira, chifukwa ndimatenda a mtima omwe amakhala m'malo oyamba pakati pa omwe amafa. Chimodzi mwazomwe zimatitsogolera komanso ndizofala kwambiri pamenepa ndichakuti, atherosulinosis. Ndipo ndendende zomwe ma statins ndi otetezeka komanso othandiza kwambiri polimbana ndi kuchuluka ndi kupezeka kwa cholesterol ya amkati.

Makhalidwe wamba

Oyimira gulu lino nthawi zambiri amagawika m'magulu awiri: zachilengedwe ndi zopangidwa, zopangidwa mwaluso. Ndiponso kwa mibadwo 4. M'badwo woyamba ndiwachilengedwe womwe umapangidwa kuchokera ku bowa. Mibadwo yotsalayi idapangidwa. Kodi katundu wawo ndi uti:

1. M'badwo woyamba ndi lovastatin, simvastatin. Amakhala ndi mankhwalawa osatchulika kuposa mankhwala amibadwo ina, zotsatira zoyipa zimatha kuchitika.
2. Mbadwo wachiwiri ndi fluvastatin. Poyerekeza ndi ena onse, kugwiritsa ntchito nthawi yayitali kumafunikira, koma pakadali pano, mankhwalawa amakhala ambiri m'magazi.
3. M'badwo wachitatu ndi atorvastatin. Momwe zimachepetsera kwambiri kuchuluka kwa triglycerides (THC) ndi otsika osalimba lipoproteins (LDL), komanso kumachulukitsa lipotroteins yapamwamba kwambiri (HDL) yofunikira kutaya cholesterol yoyipa.
4. Mbadwo wachinayi ndi rosuvastatin. Kuchulukitsa kwambiri komanso chitetezo, poyerekeza ndi ena onse.

Kuphatikiza pa ntchito imodzi yodziwika - cholesterol choletsa, mankhwala aliwonse amakhala ndi mawonekedwe apadera ndi zina zowonjezera. Izi ndichifukwa cha momwe zimachitikira, komanso munthu m'modzi.

Kulongosola Kwachuma

Yankho la funso loti "ndi ma statins ati omwe ali otetezeka komanso othandiza?" Amakhala makamaka pazolimbitsa thupi. Statin imakhudza kapangidwe ka cholesterol m'chiwindi, kudzera mu kuletsa kwake. Izi zimachitika chifukwa cha kutsekeka kwa enzyme yomwe imakhudzana ndi kapangidwe ka cholesterol ya amkati - HMG-CoA reductase. Enzyme iyi imapangitsa (imathandizira) kapangidwe ka mevalonic acid, yomwe imayang'anira mafuta a cholesterol. Kuphatikiza pa tanthauzo lake lalikulu, ma statin ali ndi ena angapo:

• zotsatira za mtima endothelium, pochepetsa kutupa ndi kuchepetsa ngozi ya magazi,
• kukondoweza kwa kapangidwe ka nitric oxide, komwe kumathandizira kukulitsa mitsempha yamagazi ndi kupumula kwawo,
• kuthandizira kukhazikika kwa atherosclerotic plaque.

Kuphatikiza pa kupewa ndi kupewa matenda a atherosulinosis, ma statin amakhalanso ndi zovuta zingapo paz matenda ena:

1. Kupewa kwa myocardial infarction. Poyerekeza ndi mankhwala ena omwe amathandizira pakudwala, ma statin ndi othandiza kwambiri. Mwachitsanzo, kafukufuku wogwiritsa ntchito resuvostatin adawonetsa kuchepetsedwa kwakukulu kwa chiopsezo cha myocardial infaration mwa anthu omwe adatenga zaka ziwiri.
2. Pamodzi ndi kupewa matenda amtima, amachepetsa kwambiri ma stroke ischemic.
3. Panthawi yakukonzanso ndikulakwitsa, ma statin ayenera kumwedwa. Pamodzi ndi chithandizo wamba, amakhala ndi zotsatira zabwino ndikuthandizira kuchira.

Kuwonekera kwakukulu pamachitidwe amtima wapangitsa gulu la ma statins, lotchuka kwambiri komanso lothandiza kwambiri, poyerekeza ndi mankhwala ena.

Contraindication

Popereka mankhwala kuchokera pagululi, dokotala amayenera kukhala osamala kwambiri komanso osamala, popeza pali zovuta zingapo. Mwachitsanzo, atsikana ayenera kupatsidwa mankhwala oletsa kubereka popereka mankhwala, chifukwa ma statins sayenera kutengedwa ndi amayi oyembekezera. Ngati pakufunika kugwiritsa ntchito mankhwalawa ndi mayi wapakati, ndiye kuti ndikofunikira kuganizira nthawi yake, komanso mitundu yonse ya ngozi.

Mwambiri, zotsutsana zazikulu zotsatirazi zimatha kusiyanitsidwa:

• mitundu yosiyanasiyana ya ziwengo, kuphatikiza mankhwala osokoneza bongo,
• mimba
• matenda a impso, endocrine dongosolo, chithokomiro England,
• mavuto mu musculoskeletal system,
• matenda owopsa a chiwindi,
• matenda ashuga.

Contraindication ndichinthu chofunikira kwambiri pakugwiritsa ntchito ma statins. Kulondola kwa zomwe wodwalayo adziwa, kuchuluka kwa mlingo, kupezeka kwa matenda osachiritsika. zonsezi zimakhudza zabwino kapena zoipa za kumwa mankhwala ndi odwala.

Zotsatira zoyipa

Nthawi zambiri, ma statins amatengedwa bwino, popanda mavuto, kwa nthawi yayitali. M'maphunzirowa, zidadziwika kuti 3% yokha mwa omwe anali ndi zotsatirapo zoyipa, koma amapezeka mwa anthu omwe amamwa mankhwalawa kwa zaka zoposa 5.

Pali chiopsezo cha myopathy, koma ndizochepa kwambiri (0.1-0.5%). Kugonjetsedwa kwa myocyte (maselo am'matumbo am'mimba), zimatengera mwachindunji kuchuluka kwa mankhwalawa, zaka (anthu opitilira zaka 70-80 zimatha kutenga matenda a minofu), kuperewera kwa thanzi, komanso zovuta za matenda a shuga.

Komanso, mwina ndi 1%, vuto la CNS limatha kuchitika: mutu, chizungulire, kusokonezeka kwa tulo, kufooka kwathunthu. Zotsatira zoyipa za kupuma zimafotokozedwa ndi rhinitis, kupezeka kwa bronchitis. Madzi ogwiritsira ntchito m'mimba anachitapo kanthu mseru, kusanza, kudzimbidwa. Koma ndikofunikira kudziwa kuti zonse zomwe tafotokozazi zidachitika mwa 1% yokha mwa odwala omwe adalandira.

Pazonse, kugwiritsa ntchito mosamala, mosamala komanso molondola kumabweretsa zotsatira zabwino, komabe, ngati mungagwiritse ntchito mankhwalawa mosasamala komanso kwa nthawi yayitali, zotsatirapo zake zimathandizanso:

• kupweteka m'mimba, matumbo aang'ono, kudzimbidwa, kusanza,
• amnesia, kusowa tulo, paresthesia, chizungulire,
• kutsika kwa maselo othandiza magazi kuundana (thrombocytopenia),
• kutupa, kunenepa kwambiri, kusabereka mwa amuna,
• kukokana kwa minofu, kupweteka kwa msana, nyamakazi, myopathy.

Kuphatikiza ndi mankhwala ena, mwachitsanzo, kutsitsa kwa lipid, zotsatira zoyipa zingachitike.

Mankhwala otetezeka a gululi

Potengera maphunziro angapo, chiphunzitsochi chidapezabe yankho lafunso - ndi ma statins ati omwe ali otetezeka komanso othandiza kwambiri? Choyamba, ndikofunikira kuwunikira atorvastatin, omwe amagwiritsidwa ntchito kwambiri ndikuwonetsa zotsatira zabwino zakafukufuku. Rosuvastatin imagwiritsidwa ntchito pang'ono. Katswiri wachitatu amatulutsa simvastatin, yemwenso ndi wodalirika.

Rosuvastatin

Rosuvastatin ndi mankhwala olengedwa opangidwa ndi gulu la statin, ali ndi hydrophilicity chifukwa chomwe zimapangitsa kuti chiwindi chake chichepetse, komanso zimawonjezera mphamvu yoletsa kupanga mapangidwe otsika a lipoproteins (LDL). LDL ndi cholumikizira chachikulu mu cholesterol synthesis. Rosuvastatin siyipangitsa kuti minyewa ikhale yolakwika, ndiye kuti, mutha kuigwiritsa ntchito osadandaula za kupezeka kwa myopathy ndi minofu kukokana.

Kugwiritsa ntchito mlingo wa 40 mg kumapereka kuchepa kwa LDL mpaka 40%, ndipo nthawi yomweyo, kuwonjezeka kwa lipoproteins yapamwamba kwambiri (HDL - kwambiri kuchepetsa chiopsezo cha atherosulinosis) ndi 10%. Rosuvastatin ndiwothandiza kwambiri kuposa mankhwala ena. Mwachitsanzo, kugwiritsa ntchito mlingo wa 40 mg uli ndi mphamvu kwambiri kuposa kutenga 80 mg ya atorvastatin. Mlingo wa 20 mg ungachepetse kuchuluka kwa LDL, monga 80 mg ya atorvastatin yomweyo.

Zoyenera zimawonekera kale sabata yoyamba yogwiritsira ntchito, mpaka sabata yachiwiri imakhala 90-95%, ndipo yachinayi imafika pazowonjezereka ndipo imasungidwa nthawi zonse, malinga ndi chithandizo chamanthawi zonse.

Simvastatin

Malinga ndi kafukufukuyu, kumwa mankhwalawa kwa zaka 5 kumachepetsa chiopsezo cha matenda amitsempha yama mtima ndi a mtima pambuyo povutitsidwa ndi 10%, komanso kuchuluka komweko kwa odwala omwe ali ndi matenda amtima, matenda a shuga komanso sitiroko.

Zatsimikiziridwa kuti kwa zaka ziwiri, kuchuluka kwa lipoproteins omwe amachititsa kuti mafuta azigwiritsidwa ntchito / kugwiritsidwa ntchito kwa cholesterol kumayenda bwino, chiwopsezo cha kuwundana kwa magazi m'mitsempha yama coronary kumachepetsedwa.

Mwambiri, ma statin ndiotetezeka pamagwiritsidwe ake. Pali chiopsezo cha mavuto, koma ndizochepa. Zonse zimatengera kusamala ndi kuzindikira kwa wodwalayo. Mukamayang'ana momwe wodwalayo aliri, kuchuluka kwa zaka ndi momwe amafotokozera, ndizotheka kudziwa kuti ndi gawo liti lomwe likufunika kuti lipereke zotsatira zabwino.

Momwe mungasankhire mankhwala oyenera?

Mu maunyolo a pharmacy, mutha kupeza mitundu iwiri ya mankhwala. Yoyamba ndi yoyambirira, kakulidwe koyamba ka mankhwala opangira mankhwala omwe ali ndi patent kwa zaka makumi awiri.

Izi zikutanthauza kuti pafupifupi zaka kotala, ndi kampani yokha yomwe imatha kupanga mankhwalawa. Mpaka pomwe patent itatha, kukonzekera kwa analog sikutha kuwonekera pazithunzi. Koma kumapeto kwa nthawi ino, chitetezo chimathetsedwa ndikujambula kwawo. Poterepa, choyambirira chikadali dongosolo la kukwera mtengo kwambiri.

Zomwe zimafotokozedwera mosavuta - popanga chinthu chapadera, asayansi adawononga mabiliyoni a madola kuyesera zazitali zamankhwala ndikutsimikizira kugwira ntchito ndi chitetezo cha anthu ambiri modzifunira. Izi zimatenga zaka zopitilira khumi.

Ma genics (kapena ma jeniki), omwe ali gulu lachiwiri, ndizokonzekera zamayendedwe okhala ndi mawonekedwe ofanana.

Kuti muwapange, muyenera kutenga formula yokonzedwa kale, onjezerani okonda mawonekedwe apakale, mupeze dzina losavuta kukumbukira ndikugulitsa.

Ukadaulo wopanga nthawi zonse umakhala wofanana ndi woyamba mankhwala, motero kupatuka mu zochita za anthu ndizofala.

Mtengo wake umatengera zinthu zambiri: njira yopangira, kuwonjezera pazowonjezera, kuchuluka kwa mayesero azachipatala omwe adadutsa. Kafukufuku akhoza kugawidwa mu:

1. Bioequivalent, ndiko kuti, kuyang'ana machesi ndi Chinsinsi,
2. Mankhwala - kutsimikizira njira yoyenera yochitira,
3. Ndipo achire, kuphunzira momwe mphamvu za anthu zimakhalira.

Mtengo umafanana mwachindunji ndi kuchuluka kwa kafukufuku - ndiko kuti, pomwe alipo ambiri, mtengo wake umakhala wokwera mtengo kwambiri.

Pagulu la mankhwala ochepetsa lipid, atorvastatin ndi achikale. M'mayesero azachipatala omwe amakhala miyezi khumi ndi iwiri, adawonetsa zotsatirazi:

• Kuchuluka kwa otsika osalimba lipoprotein kutsika ndi 55%,
• Chiwerengero cha cholesterol chonse chatsika ndi 46%,
• Mulingo wa lipoprotein wokwera kwambiri umachulukana (ichi ndi cholesterol "chabwino", sichitha zotchingira) ndi 4%.

Mlingo womwe amatengedwa ndi odzipereka anali mamiligalamu 10 patsiku.

Poyerekeza mankhwala omwe ali nawo kale, zidapezeka kuti ma statins ena amafunikira kuthamangitsidwa kuti athe kukwaniritsa izi - kwa Torvacard ndi mamiligirama 20, a Simvastatin - 40, ndi a Fluvastatin pafupifupi 80.

Izi sizikugwirizana ndi makopewo, zomwe zimapangitsa kusiyana kwakukulu.

Torvacard - malangizo, ntchito, ndemanga, mapiritsi, 10 mg ndi 20 mg ndi mankhwala a statin kuti muchepetse cholesterol komanso kupewa matenda a mtima akulu, ana ndi mimba

Munkhaniyi, mutha kuwerengera malangizo ogwiritsira ntchito mankhwalawa Torvard. Ndemanga za alendo pamalowa - ogula mankhwalawa, komanso malingaliro a akatswiri azachipatala pakugwiritsa ntchito Torvacard statin machitidwe awo amaperekedwa.Chopempha chachikulu ndikuti muwonjezere ndemanga zanu za mankhwalawa: mankhwalawo adathandizira kapena sanathandizire kuchotsa matendawa, ndizovuta ziti zomwe zimawoneka ndi zotsatirapo zake, mwina sizinalengezedwe ndi wopanga. Analogs a Torvacard pamaso pa maupangidwe ena apangidwe. Gwiritsani ntchito kuchepetsa mafuta m'thupi komanso kupewa matenda a mtima mwa akulu, ana, komanso panthawi yoyembekezera.

Torvacard ndi mankhwala a hypolipidemic ochokera ku gulu la ma statins. Kusankha mpikisano wosankha wa HMG-CoA reductase, enzyme yomwe imatembenuza 3-hydroxy-3-methylglutaryl-coenzyme A mpaka mevalonic acid, yomwe imatsogolera sodiumids, kuphatikiza cholesterol. Mu chiwindi, triglycerides ndi cholesterol imaphatikizidwa mu VLDL, imalowa m'magazi am'magazi ndipo imatengedwa kupita ku zotumphukira. Kuchokera ku VLDL, LDL imapangidwa panthawi yolumikizirana ndi LDL receptors. Atorvastatin (zomwe zimagwiritsidwa ntchito ndi mankhwala a Torvard) amachepetsa plasma cholesterol (Ch) ndi lipoproteins poletsa HMG-CoA reductase, kupanga cholesterol m'chiwindi ndikuwonjezera kuchuluka kwa zolandila za LDL m'chiwindi pamaselo a khungu, zomwe zimapangitsa kuti pakhale kuchuluka ndi chidwi chachikulu cha LDL .

Atorvastatin imachepetsa mapangidwe a LDL, imayambitsa kuwonjezereka komanso kulimbikira mu zochitika za LDL receptors. Torvacard amachepetsa LDL odwala omwe ali ndi homozygous Famer hypercholesterolemia, yomwe nthawi zambiri siziwathandiza kuchiza ndi ena othandizira a hypolipidemic.

Amachepetsa kuchuluka kwa cholesterol yonse ndi 30-46%, LDL - mwa 41-61%, apolipoprotein B - ndi 34-50% ndi triglycerides - pofika 14-33%, amachititsa kuchuluka kwa HDL-C ndi apolipoprotein A. Dose-modalira kumachepetsa mulingo wa LDL mu odwala homozygous cholowa hypercholesterolemia, kugonjetsedwa ndi mankhwala ndi lipid-kuchepetsa mankhwala.

Calcium a Atorvastatin.

Mafuta ndi okwera. Kudya pang'ono kumachepetsa kuthamanga ndi kutalika kwa mankhwalawa (mwa 25% ndi 9%, motsatana), koma kuchepa kwa cholesterol ya LDL ndikofanana ndi kugwiritsidwa ntchito kwa atorvastatin popanda chakudya. Kuchulukitsidwa kwa atorvastatin pamene ntchito madzulo kumatsika kuposa m'mawa (pafupifupi 30%). Ubale wapakati pakati pa kuchuluka kwa mayamwidwe ndi mlingo wa mankhwalawo unawululidwa. Zimapangidwa makamaka m'chiwindi. Imafufutidwa m'matumbo ndi bile pambuyo pa hepatic ndi / kapena extrahepatic metabolism (siyimatchulidwa kuti enterohepatic recirculation). Ntchito yoletsa kutsutsana ndi HMG-CoA reductase imasungidwa ndi kukhalapo kwa metabolites yogwira. Osakwana 2% ya mlingo wa pakamwa amadziwika mu mkodzo. Sichotsetsedweratu pa hemodialysis.

• kuphatikiza ndi zakudya kuti muchepetse kuchuluka kwa cholesterol okwanira, cholesterol-LDL, apolipoprotein B ndi triglycerides ndikuwonjezera cholesterol-HDL kwa odwala omwe ali ndi hypercholesterolemia, heterozygous mabanja ndi osagwirizana ndi hyperlipidemia (mitundu 2a ndi 2a ndi 2a ,
• kuphatikiza ndi zakudya zochizira odwala omwe ali ndi serum triglycerides (mtundu 4 malinga ndi Fredrickson) ndi odwala dysbetalipoproteinemia (mtundu 3 malinga ndi Fredrickson), yemwe mankhwalawa amadya.
• Kuchepetsa kuchuluka kwa cholesterol yathunthu ndi LDL-C odwala omwe ali ndi homozygous Famer hypercholesterolemia, pamene chithandizo chamankhwala ndi njira zina zosagwiritsa ntchito mankhwalawa sizigwira ntchito mokwanira (monga njira yolumikizira kuchepa kwa lipid-kupatula magazi, kuphatikizapo autohemotransfusion ya magazi-oyeretsedwa a LDL),
• matenda a mtima dongosolo (odwala omwe ali ndi chiopsezo cha matenda a mtima - okalamba wazaka zopitilira 55, kusuta, matenda oopsa, matenda ashuga, matenda amitsempha yam'mimba, sitiroko, lamitsempha yamagazi kwamitsempha, protein / albuminuria, matenda amitsempha yamagazi ), kuphatikizapomotsutsana ndi maziko a dyslipidemia - yachiwiri prophylaxis ndi cholinga chochepetsera chiopsezo chonse cha kufa, kulowerera m'mitsempha, matenda opha ziwalo, kuyambiranso kuchipatala kwa angina pectoris ndi kufunika kosinthanso.

10 mg, 20 mg ndi 40 mg mapiritsi okhala ndi mafilimu.

Malangizo ogwiritsira ntchito ndi regimen

Torvacard asanaikidwe, wodwalayo ayenera kulimbikitsa zakudya zochepetsa lipid, zomwe ayenera kupitiriza kuzitsatira panthawi yonse ya chithandizo.

Mlingo woyambirira ndi pafupifupi 10 mg kamodzi patsiku. Mlingo umasiyanasiyana 10 mpaka 80 mg kamodzi patsiku. Mankhwala amatha kumwa nthawi iliyonse masana, mosasamala nthawi yakudya. Mlingo umasankhidwa poganizira magawo angapo a LDL-C, cholinga cha mankhwala ndi zotsatira zake. Kumayambiriro kwa chithandizo chamankhwala ndi / kapena pakuwonjezeka kwa mlingo wa Torvacard, ndikofunikira kuyang'anira kuchuluka kwa plasma lipid masabata onse a 2-4 ndikusintha mlingo moyenerera. Pazipita tsiku lililonse 80 mg mu 1 mlingo.

Mu chachikulu hypercholesterolemia ndi hyperlipidemia wosakanikirana, nthawi zambiri, mlingo wa 10 mg wa Torvacard kamodzi patsiku wokwanira. A achire kwambiri zimachitika pambuyo 2 milungu, monga lamulo, ndipo pazipita achire zotsatira zambiri zimawonedwa pambuyo 4 milungu. Ndi chithandizo cha nthawi yayitali, izi zimapitirira.

• mutu
• asthenia
• kusowa tulo
• chizungulire
• kugona
• zolota
• amnesia
• kukhumudwa
• zotumphukira neuropathy,
• ataxia
• paresthesia
• kusanza, kusanza,
• kudzimbidwa kapena kutsegula m'mimba
• chisangalalo
• kupweteka m'mimba
• kukwiya kapena kulakalaka kudya,
• myalgia
• arthralgia,
• myopathy
• myositis
• kupweteka kumbuyo
• kukhathamira m'matumbo amiyendo,
• Khungu
• zotupa
• urticaria
• angioedema,
• anaphylactic shock,
• zotupa zambiri
• polymorphic exudative erythema, kuphatikizapo Matenda a Stevens-Johnson
• toxic epidermal necrolysis (matenda a Lyell),
• hyperglycemia
• achina,
• kupweteka pachifuwa
• zotumphukira edema,
• kusabala
• alopecia
• tinnitus
• kunenepa
• malaise
• kufooka
• thrombocytopenia
• kulephera kwachiwiri kwaimpso.

• odwala matenda a chiwindi kapena kuwonjezeka kwa zochitika za transaminases mu seramu yamagazi (koposa nthawi 3 poyerekeza ndi VGN) yosachokera,
• Kulephera kwa chiwindi (kuopsa kwa A ndi B pamawonekedwe a Mwana-Pugh),
• matenda obadwa nawo, monga lactose tsankho, kuchepa kwa lactase kapena malabsorption a glucose (chifukwa cha kupezeka kwa lactose mu kapangidwe kake),
• mimba
• kuyamwa
• azimayi amsinkhu wobereka omwe sagwiritsa ntchito njira zokwanira zakulera,
• ana ndi achinyamata ochepera zaka 18 (mphamvu ndi chitetezo sizinakhazikitsidwe),

Mimba komanso kuyamwa

Torvacard imakhudzana ndi pakati komanso kuyamwa.

Popeza cholesterol ndi zinthu zopangidwa kuchokera ku cholesterol ndizofunikira pakukula kwa mwana wosabadwayo, chiwopsezo choteteza HMG-CoA reductase chimaposa phindu logwiritsa ntchito mankhwalawa panthawi yapakati. Mukamagwiritsa ntchito lovastatin (inhibitor ya HMG-CoA reductase) yokhala ndi dextroamphetamine mu trimester yoyamba ya mimba, kubadwa kwa ana omwe ali ndi mafupa osakanikirana, tracheo-esophageal fistula, ndi anus atresia amadziwika. Ngati amayi apezeka ndi pakati pa mankhwala ndi Torvacard, mankhwalawa amayenera kuyimitsidwa nthawi yomweyo, ndipo odwala ayenera kuchenjezedwa za chiwopsezo chomwe chingakhalepo kwa mwana wosabadwayo.

Ngati ndi kotheka kugwiritsa ntchito mankhwalawa panthawi yoyamwitsa, chifukwa cha zovuta za makanda, nkhani yoletsa kuyamwitsa iyenera kuthetsedwa.

Kugwiritsira ntchito kwa akazi amisinkhu yakubereka ndikotheka kokha ngati njira zodalirika zakulera zikugwiritsidwa ntchito. Wodwala ayenera kudziwitsidwa za chiopsezo cha chithandizo cha mwana wosabadwayo.

Mankhwalawa amaletsedwa kugwiritsidwa ntchito mwa ana ndi achinyamata osakwana zaka 18 (zoyenera ndi chitetezo sizinakhazikitsidwe).

Musanayambe mankhwala a Torvacard, ndikofunikira kuyesa kuthana ndi hypercholesterolemia mwa kudya mokwanira mankhwala, zolimbitsa thupi, kuchepa thupi kwa odwala omwe ali ndi kunenepa kwambiri komanso kuthandizira zina.

Kugwiritsa ntchito ma HMG-CoA reductase inhibitors kuti muchepetse lipids zamagazi kungapangitse kusintha kwa magawo amomwe amomwe amachititsa ntchito ya chiwindi. Kuchita kwa chiwindi kuyenera kuyang'aniridwa musanayambe mankhwala, masabata 6, masabata 12 mutayamba kumwa Torvacard pambuyo poti kuchuluka kulikonse kwa mankhwalawa, komanso nthawi ndi nthawi (mwachitsanzo, miyezi isanu ndi umodzi iliyonse). Kuwonjezeka kwa ntchito ya hepatic michere mu seramu yamagazi imatha kuwonedwa pa nthawi ya chithandizo cha Torvard (nthawi zambiri m'miyezi itatu yoyambirira). Odwala omwe ali ndi kuchuluka kwa transaminase ayenera kuwunikidwa mpaka milingo ya enzyme ibwerere ku yachilendo. Ngati malingaliro a ALT kapena AST apamwamba kwambiri kuposa katatu kwa VGN, tikulimbikitsidwa kuti muchepetse mlingo wa Torvacard kapena kusiya chithandizo.

Kuchiza ndi Torvacard kungayambitse myopathy (kupweteka kwa minofu ndi kufooka kophatikiza ndi kuwonjezeka kwa ntchito za CPK ndi nthawi zopitilira 10 poyerekeza ndi VGN). Torvacardum ikhoza kuyambitsa kuchuluka kwa serum CPK, yomwe iyenera kukumbukiridwa pakuwonetsetsa kusiyanasiyana kwa kupweteka pachifuwa. Odwala akuyenera kuchenjezedwa kuti ayenera kupita kwa dokotala ngati vuto lopanda kufooka kapena kufooka kwa minofu kumachitika, makamaka ngati akuphatikizidwa ndi malaise kapena malungo. Kuchiza kwa Torvard kuyenera kusiyidwa kwakanthawi kapena kulekeka kwathunthu ngati pali chizindikiro cha myopathy kapena choopsa chokhala ndi kulephera kwa impso chifukwa cha rhabdomyolysis (mwachitsanzo, matenda opweteka kwambiri, kusokonekera kwa hypotension, opaleshoni yayikulu, kuvulala kwambiri, kupweteka kwa metabolic, endocrine ndi electrolyte )

Kukopa pa kuyendetsa galimoto ndikugwira ntchito ndi zinthu

Zotsatira zoyipa za Torvacard pakutha kuyendetsa magalimoto ndi kuchita zinthu zina zomwe zimafunikira chidwi ndi kuthamanga kwa zochitika zama psychomotor sizinanenedwe.

Pogwiritsa ntchito munthawi yomweyo cyclosporine, fibrate, erythromycin, clarithromycin, mankhwala a immunosuppressive ndi antifungal a gulu la azole, nicotinic acid ndi nicotinamide, mankhwala omwe amalepheretsa kagayidwe kosungidwa ndi CYP450 isoenzyme 3A4, ndi / kapena mankhwala a plastma amadzuka. Popereka mankhwala awa, phindu lomwe likuyembekezeredwa komanso chiopsezo chamankhwala liyenera kuyesedwa mosamala, odwala ayenera kuwunikidwa pafupipafupi kuti adziwe kupweteka kwa minofu kapena kufooka, makamaka m'miyezi yoyambirira ya chithandizo komanso panthawi yowonjezera mlingo wa mankhwala aliwonse, nthawi ndi nthawi muzindikire ntchito ya KFK, ngakhale izi kupewa kukula kwa myopathy. Mankhwala a Torvard amayenera kusiyidwa ngati pali kuwonjezeka kwodziwika kwa zochitika za CPK kapena kukhalapo kwa myopathy yotsimikizika kapena yotsimikizika.

Torvacard sanakhale ndi vuto lililonse pakumanga kwa terfenadine m'magazi am'magazi, omwe amapangika makamaka ndi 3A4 CYP450 isoenzyme, chifukwa chake atrvastatin ingakhudze kwambiri magawo a pharmacokinetic a magawo ena a 3A4 CYP450 isoenzyme. Ndi munthawi yomweyo kugwiritsa ntchito atorvastatin (10 mg kamodzi patsiku) ndi azithromycin (500 mg kamodzi patsiku), kuchuluka kwa atorvastatin m'madzi a m'magazi sikusintha.

Ndi kuyambitsa munthawi yomweyo kwa atorvastatin ndi kukonzekera komwe kumakhala ndi magnesium ndi aluminium hydroxides, kuchuluka kwa atorvastatin m'madzi a m'magazi kunatsika pafupifupi 35%, komabe, kuchepa kwa mulingo wa LDL-C sikunasinthe.

Pogwiritsa ntchito nthawi yomweyo colestipol, kuchuluka kwa ma atorvastatin kutsika ndi 25%. Komabe, lipid-kutsitsa mphamvu ya kuphatikiza kwa atorvastatin ndi colestipol imaposa ya aliyense mankhwala payekhapayekha.

Kugwiritsa ntchito pamodzi kwa Torvacard sikukhudza ma pharmacokinetics a phenazone, chifukwa chake, kuyanjana ndi mankhwala ena omwe amapangidwa ndi CYP450 isoenzymes yomwe siyikuyembekezeredwa.

Mukamaphunzira kuyanjana kwa atorvastatin ndi warfarin, cimetidine, phenazone, palibe zizindikiritso zofunika kwambiri zamankhwala zomwe zapezeka.

Kugwiritsa ntchito munthawi yomweyo mankhwala omwe amachepetsa kuchuluka kwa mahomoni amkati (kuphatikizapo cimetidine, ketoconazole, spironolactone) kumawonjezera chiopsezo chochepetsa mahomoni amtundu wa antioxidosis (kusamala kuyenera kuchitidwa).

Palibe zochitika zamatenda zofunikira za atorvastatin zomwe zimagwiritsidwa ntchito ndi antihypertensive mankhwala, komanso estrogens.

Ndi kugwiritsa ntchito pamodzi kwa Torvacard pa mlingo wa 80 mg patsiku ndi njira zakulera zamkati zomwe zimakhala ndi norethindrone ndi ethinyl estradiol, kuchuluka kwakukulu kwa kuchuluka kwa norethindrone ndi ethinyl estradiol kumawonedwa ndi pafupifupi 30% ndi 20%, motero. Izi ziyenera kuganiziridwa posankha njira yolerera pakamwa ya azimayi omwe amalandila Torvacard.

Ndi munthawi yomweyo kugwiritsa ntchito atorvastatin pa mlingo wa 80 mg ndi amlodipine pa 10 mg, ma pharmacokinetics a atorvastatin m'chigawo chofanana sanasinthe.

Mobwerezabwereza makonzedwe a digoxin ndi atorvastatin pa 10 mg, kuchuluka kwa ndende ya digoxin m'madzi a m'magazi sikunasinthe. Komabe, pamene digoxin imagwiritsidwa ntchito limodzi ndi atorvastatin pa mlingo wa 80 mg patsiku, kuchuluka kwa digoxin kumawonjezeka pafupifupi 20%. Odwala omwe amalandira digoxin osakanikirana ndi atorvastatin amafunikira kuyang'aniridwa.

Kafukufuku wokhudzana ndi mankhwala ena sanachitike.

Mndandanda wa mankhwala Torvacard

Zofanana muzochitika zamagulu:

Ma Analogs mu pharmacological group (ma statins):

Liprimar: Zizindikiro zogwiritsidwa ntchito

Mankhwala amathandizidwa ndi matenda otsatirawa:

• hypercholesterolemia,
• kuphatikiza mtundu wophatikizira,
• dysbetalipoproteinemia,
• hypertriglyceridemia,
• magulu omwe ali pachiwopsezo chotenga matenda a mtima (anthu opitirira 55, osuta, odwala matenda a shuga, matenda obadwa nawo, matenda oopsa ndi ena),
• matenda a mtima.

Mutha kutsitsa cholesterol, kuwona kadyedwe, maphunziro olimbitsa thupi, kunenepa kwambiri mwa kutaya thupi owonjezera, ngati izi sizipereka zotsatira, perekani mankhwala omwe amachepetsa cholesterol.

Ndikofunikira kutsatira malangizo ogwiritsira ntchito Liprimar. Palibe malire a nthawi oti amwe mapiritsiwo. Kutengera ndi zomwe zikuwonetsa LDLP (cholesterol yoyipa), mlingo wa tsiku ndi tsiku wa mankhwalawa (nthawi zambiri 10-80 mg) umawerengeredwa. Wodwala wokhala ndi mawonekedwe oyamba a hypercholesterolemia kapena kuphatikiza hyperlipidemia ndi mankhwala 10 mg, omwe amatengedwa tsiku lililonse kwa masabata 2-4. Odwala akudwala cholowa hypercholesterolemia ndi mankhwala okwanira 80 mg.

Sankhani Mlingo wa mankhwala omwe amakhudza metabolism yamafuta ayenera kuyang'aniridwa ndi milingo ya lipid m'magazi.

Mochenjera, mankhwalawa amalembedwa kwa odwala omwe ali ndi vuto la chiwindi kapena chikugwirizana ndi cyclosparin (osapitirira 10 mg patsiku), akuvutika ndi matenda a impso, odwala omwe ali ndi zaka zochepetsedwa Mlingo safunika.

Kupanga ndi mawonekedwe a kumasulidwa

Wopezeka mu mawonekedwe a mapiritsi, m'matumba a zidutswa za 7-10, kuchuluka kwa matuza mu phukusi ndilosiyana, kuyambira pa 2 mpaka 10.Zomwe zimagwira ndi mchere wa calcium (atorvastatin) ndi zina zowonjezera: croscarmellose sodium, calcium carbonate, candelila wax, makhiristo ang'onoang'ono a cellulose, hyprolose, lactose monohydrate, polysorbate-80, opadra yoyera, magnesium stearate, simethicone emulsion.

Mapiritsi a Elliptical Liprimar omwe amapangidwa ndi chipolopolo choyera, kutengera mlingo wa milligram, ali ndi zolemba za 10, 20, 40 kapena 80.

Zothandiza katundu

Chuma chachikulu cha Liprimar ndi hypolipidemia. Mankhwala amathandizira kuchepetsa kupanga ma enzyme omwe amachititsa kuti mafuta azigwiritsa ntchito cholesterol. Izi zimabweretsa kuchepa pakupanga cholesterol ndi chiwindi, motero, mulingo wake m'magazi umachepa, ndipo ntchito yamtima imayenda bwino.

Mankhwalawa amalembedwa kwa anthu omwe ali ndi hypercholesterolemia, zakudya zosachiritsika komanso mankhwala ena ochepetsa mafuta m'thupi. Pambuyo popita kuthandizira, kuchuluka kwa cholesterol kumatsika ndi 30-45%, ndi LDL - ndi 40-60%, ndipo kuchuluka kwa lipoprotein m'magazi kumachuluka.

Kugwiritsa ntchito Liprimar kumathandizira kuchepetsa kukulitsa kwa matenda a mtima a coronary ndi 15%, kufa kwa mtima kuchokera ku mtima kumachepa, ndipo chiwopsezo cha kugunda kwamtima ndi kuwopsa kwa angina chikuchepera ndi 25%. Katundu wa Mutagenic ndi carcinogenic sanapezeka.

Zotsatira zoyipa za Liprimara

Monga mankhwala aliwonse, awa imakhala ndi mavuto. Kwa Liprimar, malangizo ogwiritsira ntchito akuwonetsa kuti nthawi zambiri amalekeredwa bwino. Komabe, pali zovuta zingapo zomwe zadziwika: kusowa tulo, matenda a kutopa kwambiri (asthenia), kupweteka m'mimba, kutsegula m'mimba ndi matenda osokoneza bongo, kutulutsa magazi (flatulence) ndi kudzimbidwa, myalgia, nseru.

Zizindikiro za anaphylaxis, anorexia, arthralgia, kupweteka kwa minofu ndi kukokana, hypo- kapena hyperglycemia, chizungulire, jaundice, zotupa pakhungu, kuchepa kwa magazi, kuchepa kwa magazi, kuchepa kwa chikumbumtima, kuchepa mphamvu, kusanza sikunachitike. thrombocytopenia.

Zotsatira zoyipa za Liprimar zimawonedwanso, monga kufupika kwa malekezero, kunenepa kwambiri, kupweteka pachifuwa, alopecia, tinnitus, ndi chitukuko cha kulephera kwachiwiri kwa impso.

Mbale

Atorvastatin - analogue ya Liprimar - ndi amodzi mwa mankhwala odziwika kwambiri ochepetsa kupsinjika kwa lipoproteins. Kuyesedwa kochitidwa ndi Grace ndi 4S kunawonetsa kukula kwa atorvastatin kupitilira simvastatin poletsa kukula kwa ngozi ya mtima wamatenda komanso sitiroko. Pansipa timaganizira za mankhwala a gulu la statin.

Zinthu zopangidwa ndi Atorvastatin

Analogue yaku Russia ya Liprimar, Atorvastatin, imapangidwa ndi makampani opanga mankhwala: Kanofarma Production, ALSI Pharma, Vertex. Mapiritsi amlomo wokhala ndi mulingo wa 10, 20, 40 kapena 80 mg. Tengani kamodzi patsiku pafupifupi nthawi yomweyo, osadya.

Nthawi zambiri makasitomala amadzifunsa - Atorvastatin kapena Liprimar - ndibwino?

Mankhwala at "Atorvastatin" ali ofanana ndi machitidwe a "Liprimar", chifukwa mankhwalawo ali ndi maziko ofanana. Limagwirira ntchito cha woyamba mankhwala umalimbana kusokoneza kapangidwe kolesterol ndi atherogenic lipoproteins ndi maselo a thupi. Kugwiritsa ntchito kwa LDL m'maselo a chiwindi kumawonjezeka, ndipo kuchuluka kwa kupanga ma anti-atherogenic high-density lipoproteins kumakulanso pang'ono.

Atorvastatin asanaikidwe, wodwalayo amasinthidwa kukhala chakudya ndikumupatsa njira yochitira masewera olimbitsa thupi, zimachitika kuti izi zimabweretsa kale zotsatira zabwino, ndiye kuti mankhwala a statins amakhala osafunikira.

Ngati sizotheka kusintha mtundu wa cholesterol osakhala mankhwala, mankhwala a gulu lalikulu la statins ndi omwe amaperekedwa, omwe akuphatikizapo Atorvastatin.

Pa gawo loyamba la mankhwalawa, Atorvastatin amayikidwa 10 mg kamodzi patsiku. Pambuyo pa masabata 3-4, ngati mulingo wosankhidwa bwino, kusintha kwa mawonekedwe a lipid kumaonekera.Mu mbiri ya lipid, kuchepa kwa cholesterol yathunthu kumadziwika, kuchuluka kwa lipoproteins yotsika komanso yotsika kwambiri kumachepa, kuchuluka kwa triglycerides kumachepa.

Ngati mulingo wa zinthu izi sunasinthe kapena ngakhale kuchuluka, ndikofunikira kusintha mlingo wa Atorvastatin. Popeza mankhwalawa amapezeka pamiyeso ingapo, ndikofunikira kwa odwala kuti asinthe. Pakatha masabata 4 mutachulukitsa mlingo, kusanthula kwa lipid mobwerezabwereza, ngati kuli kotheka, mlingo umakulanso, mlingo waukulu tsiku lililonse ndi 80 mg.

Makina ochitira, Mlingo ndi zoyipa za Liprimar ndi mnzake waku Russia ndizofanana. Ubwino wa Atorvastatin umaphatikizapo mtengo wake wotsika mtengo. Malinga ndi ndemanga, mankhwala a ku Russia nthawi zambiri amayambitsa zovuta komanso chifuwa poyerekeza ndi Liprimar. Chosangalatsa china ndi chithandizo cha nthawi yayitali.

Zina m'malo mwa Liprimar

Atoris - analogue of Liprimar - mankhwala opangidwa ndi kampani yopanga mankhwala ku Slovenia KRKA. Ndiwonso mankhwala ofanana mu mankhwala ake a Liprimaru. Atoris imapezeka ndi mulingo wambiri poyerekeza Liprimar. Izi zimathandizira adokotala kuti athe kuwerengera mosamala mankhwalawo, ndipo wodwalayo atha kumwa mankhwalawo mosavuta.

Atoris ndi mankhwala okhawo a generic (Liprimara generic) omwe adakumana ndi mayesero ambiri azachipatala ndipo adawatsimikizira kuti amagwira ntchito bwino. Odzipereka ochokera kumayiko ambiri anachita nawo kafukufukuyu. Kafukufukuyu adachitika pamaziko a zipatala ndi zipatala. Zotsatira zamaphunziro mu maphunziro 7000 omwe atenga Atoris 10 mg kwa miyezi iwiri, kuchepa kwa atherogenic ndi cholesterol yathunthu ndi 20-25% idadziwika. Kupezeka kwa zoyipa ku Atoris ndizochepa.

Liptonorm ndi mankhwala a ku Russia omwe amateteza kagayidwe ka mafuta m'thupi. Chomwe chimagwira ntchito yake ndi atorvastine, chinthu chomwe chili ndi hypolipidemic ndi hypocholesterolemic kanthu. Liptonorm imakhala ndi zofanana pakugwiritsa ntchito komanso kumwa ndi Liprimar, komanso zovuta zina.

Mankhwalawa amapezeka mu mitundu iwiri yokha ya 10 ndi 20 mg. Izi zimapangitsa kuti ikhale yovuta kugwiritsidwa ntchito ndi odwala omwe ali ndi vuto lochiritsika la atherosulinosis, heterozygous Famer hypercholesterolemia, ayenera kumwa mapiritsi a 4-8 patsiku, popeza tsiku lililonse ndi 80 mg.

Torvacard ndiye analogue wodziwika kwambiri wa Liprimar. Kupanga kampani ya mankhwala ku Slovak "Zentiva". "Torvacard" yakhazikitsa bwino kukonzanso kwa cholesterol kwa odwala omwe ali ndi matenda a mtima. Imagwiritsidwa ntchito bwino pochiza odwala omwe ali ndi vuto la kuchepa kwa magazi m'thupi komanso kuchepa kwa mtima, komanso kupewa zovuta monga kugwidwa ndi matenda a mtima. Mankhwala amathandizira kuchepetsa kuchuluka kwa triglycerides m'mwazi. Imagwiritsidwa ntchito bwino pochiza matenda amtundu wa dyslipidemia, mwachitsanzo, kuonjezera milingo ya "othandiza" yapamwamba kwambiri ya lipoprotein.

Mitundu yotulutsidwa kwa "Torvokard" 10, 20 ndi 40 mg. Mankhwala a atherosulinosis amayamba, nthawi zambiri amakhala ndi 10 mg, atatha kukhazikitsa mlingo wa triglycerides, cholesterol, lipoproteins wotsika. Pambuyo 2-4 milungu kuchita kusanthula kwa lipid sipekitiramu. Ndi chithandizo cha mankhwala, onjezani mlingo. Mlingo waukulu patsiku ndi 80 mg.

Mosiyana ndi Liprimar, Torvacard imathandiza kwambiri odwala omwe ali ndi matenda a mtima.

Zinthu zopangidwa ndi Rosuvastatin

"Rosuvastatin" ndi wothandizira m'badwo wachitatu womwe umapangitsa kuchepa kwa lipid. Kukonzekera komwe kumapangidwa pamaziko ake kumatha kusungunuka bwino m'magazi amadzi. Zotsatira zawo zazikulu ndikuchepetsa kolesterol yathunthu ndi lipoprotein atherogenic. Mfundo ina yabwino, "Rosuvastatin" ilibe vuto lililonse m'maselo a chiwindi ndipo siziwononga minofu ya minofu.Chifukwa chake, ma statins omwe amachokera ku rosuvastatin sakonda kuyambitsa zovuta mu chiwindi, kulephera kwa transaminase, myositis, ndi myalgia.

Chachikulu pharmacological kanthu umalimbana kuphatikiza kaphatikizidwe ndikuwonjezera kuchulukana kwa zigawo za mafuta a atherogenic. Zotsatira zamankhwala zimachitika mwachangu kwambiri kuposa chithandizo cha Atorvastatin, zotsatira zoyambirira zimapezeka kumapeto kwa sabata loyamba, mphamvu yayitali imatha kuonedwa pakadutsa masabata atatu.

Mankhwala otsatirawa amachokera ku rosuvastatin:

• "Crestor" (kupanga Great Britain),
• Mertenil (wopangidwa ku Hungary),
• "Tevastor" (wopangidwa ku Israeli).

"Crestor" kapena "Liprimar" choti musankhe? Kukonzekera kuyenera kusankhidwa ndi adokotala.

Zogwiritsa ntchito Simvastatin

Chithandizo china chodziwika chotsitsa lipid ndi Simvastatin. Kutengera ndi ichi, mankhwala angapo apangidwa omwe amagwiritsidwa ntchito bwino pochiza matenda a atherosulinosis. Kuyesedwa kwachipatala kwa mankhwalawa, komwe kwachitika zaka zoposa zisanu ndikuphatikizira anthu opitilira 20,000, kwathandizira kunena kuti mankhwala opangidwa ndi simvastatin amachepetsa chiopsezo cha kugunda kwamtima ndi stroke chifukwa cha odwala omwe ali ndi matenda amtima komanso a cerebrovascular pathologies.

Analogs of Liprimar on simvastatin:

• Vasilip (wopangidwa ku Slovenia),
• Zokor (kupanga - Netherlands).

Chimodzi mwazinthu zodziwitsa zomwe zimakhudza kugulidwa kwa mankhwala enaake ndi mtengo wake. Izi zimagwiranso ntchito kwa mankhwala omwe amabwezeretsa zovuta zama metabolism yamafuta. Chithandizo cha matenda ngati amenewa chimapangidwa kwa miyezi yambiri, ndipo nthawi zina zaka. Mitengo yamankhwala ofanana mu zamankhwala amasiyana pamakampani opanga mankhwala nthawi zina chifukwa cha mitengo yamitengo yosiyanasiyana yamakampani awa. Poika mankhwala ndi kusankha kwa mankhwalawa kuyenera kuchitika ndi adotolo, komabe, wodwalayo ali ndi kusankha kwa mankhwala kuchokera ku gulu limodzi lama pharmacological, lomwe limasiyana mu wopanga ndi mtengo.

Mankhwala onse omwe ali pamwambapa komanso akunja, omwe amalowa m'malo mwa Liprimar, adutsa mayeso azachipatala ndipo adziyambitsa okha ngati othandizira omwe amachepetsa mafuta. Zabwino mwa njira yochepetsera cholesterol zimawonedwa mu 89% ya odwala mwezi woyamba wa chithandizo.

Kuopsa kwa cholesterol yayikulu kukuwonekera kwake. Zowerengeka zochepa za cholesterol zolembera zimatha kupezeka zaka 20 zitatha. Ndipo zizindikilo zikaoneka - pa 40, 50, zaka 60 - malembawa ali ndi zaka zopitilira khumi ndi ziwiri. Koma munthu yemwe wapeza vuto - matenda a mtima kapena cholembera m'mitsempha ya khosi, amadabwa mowona mtima - pambuyo pake, palibe chomwe chidamuvutitsa kale! Sankaganiza kuti ali ndi cholesterol yayitali kwa nthawi yayitali.

Chimodzi mwazinthu zabwino kwambiri zotsitsa mafuta m'thupi ndi ma statins. Kugwiritsa ntchito, kuphatikiza pa zotsatira zabwino, kumayendera limodzi ndi zovuta zina, motero ndikofunikira kudziwa momwe mungatenge ma statins molondola.

Momwe ma statins amagwirira ntchito

Mu pharmacology, mankhwalawa amatchedwa HMG-Co-A reductase inhibitors. Izi zikutanthauza kuti molekyu ya statin imalepheretsa enzyme. Izi zimayambitsa kuchepa kwa cholesterol yomwe ili mkati mwa khungu ndikupititsa patsogolo kwambiri mafuta a cholesterol otsika kwambiri (owopsa kwambiri). Zotsatira zake: cholesterol yamagazi imachepetsedwa. Statins amachita mwachindunji m'chiwindi.

Kuphatikiza apo, ma statins ali ndi anti-yotupa komanso antioxidant - izi zikutanthauza kuti malo omwe adapangidwa kale azikhala osasunthika komanso osayambitsa matenda a thrombosis (omwe ndi omwe amachititsa kugunda kwa mtima kapena stroko).

Dokotala wokhayo yemwe ayenera kupezeka kuti akupatseni mankhwala a statin: zotsatira zoyipa za ma statin ndi zakupha. Asanawalimbikitse, adokotala amawunika zonse zomwe zikuwonetsa kuyesedwa kwa magazi ndi matenda omwe alipo.

Mlingo wa mankhwala ndi zitsanzo za mapiritsi

• Simvastatin ndi mankhwala ofooka kwambiri.Ndizomveka kuzigwiritsa ntchito kwa anthu okhawo omwe cholesterol yawo imachulukirachulukira. Awa ndi mapiritsi monga Zokor, Vasilip, Simvakard, Sivageksal, Simvastol. Amapezeka mu Mlingo wa 10, 20 ndi 40 mg.
• Atorvastatin ndi wamphamvu kale. Itha kugwiritsidwa ntchito ngati mulingo wa cholesterol kwambiri. Awa ndi magome ochokera ku cholesterol Liprimar, Atoris, Torvakard, Novostat, Liptonorm. Mlingo ukhoza kukhala 10, 20, 30, 40 ndi 80 mg.
• Rosuvostatin ndiye wolimba kwambiri. Madokotala amamulembera cholesterol kwambiri, mukafuna kuchitsitsa. Awa ndi mapiritsi Krestor, Roxer, Mertenil, Rosulip, Tevastor. Rosucard. Ili ndi Mlingo wotsatira: 5, 10, 20 ndi 40 mg.
• Lovastatin imapezeka ku Cardiostatin, Choletar, Mevacor. Mankhwalawa ali muyezo wa 20 mg piritsi limodzi.
• Fluvastatin pakadali pano ali ndi mtundu umodzi wokha wamapiritsi - awa ndi Lescor (20 kapena 40 mg aliyense)

Monga mukuwonera, mulingo wa mankhwalawa ndiwofanana. Koma chifukwa cha kusiyana pakukhudzika, 10 mg ya rosuvostatin yotsika cholesterol mofulumira kuposa 10 mg ya atorvastatin. Ndipo 10 mg ya Atoris ndiyothandiza kwambiri kuposa 10 mg ya Vasilip. Chifukwa chake, ndi dokotala wokhazikika amene angadziwike ma statin, kuwunika zonse, zotsutsana ndi zovuta zina.

Momwe mungatenge ma statins?

Kutsitsa cholesterol, ma statin amatengedwa kamodzi patsiku. Ndikwabwino ngati kukhale madzulo - popeza lipids zimapangidwa mwachangu madzulo. Koma kwa atorvastatin ndi rosuvostatin, izi sizowona: amagwira ntchito molingana tsiku lonse.

Simungaganize kuti ngati munthu amamwa mankhwala omwe amachepetsa cholesterol, ndiye kuti kudya sikofunikira. Ngati palibe chilichonse m'moyo wa munthu chitasintha, kulandira chithandizo ndi ma statins kulibe ntchito. Zakudya ziyenera kuphatikizapo kusiya kusuta fodya ndi mowa, kuchepetsa kuchuluka kwa mchere pazakudya. Chakudya chimayenera kukhala chosiyanasiyana, chokhala ndi nsomba zitatu zokha pa sabata ndi 400 g zamasamba kapena zipatso patsiku. Nthawi zambiri zimavomerezedwa kuti palibe chifukwa chochepetsera zopatsa mphamvu za calorie ngati palibe cholemera.

Kuchita masewera olimbitsa thupi mlengalenga kumathandiza kwambiri: zimapangitsa kuti mitsempha ya magazi ikhale yabwino. Kwa 30 305 mphindi 3-4 kawiri pa sabata zidzakhala zokwanira.

Mlingo wa ma statins ndi munthu payekha, ndi adokotala okha omwe ayenera kumwa mankhwala. Zimangotengera cholesterol, komanso matenda a anthu.

Mwachitsanzo, adotolo adakugulirani 20 mg ya Atoris kwa inu, komanso mnansi wokhala ndi cholesterol yomweyo - 10 mg. Izi sizikusonyeza kuti palibe katswiri wosaphunzira. Zimangotanthauza kuti muli ndi matenda osiyanasiyana, ndiye kuti kuchuluka kwa ma statins ndi kosiyana.

Zotsutsana

Ma Statin amagwiritsidwa ntchito mosamala:

• Ndi matenda a chiwindi omwe kale anali.
• Ndi mafuta hepatosis ndi kuchuluka pang'ono kwa michere.
• Mtundu 2 wa shuga mellitus, wowonongeka pomwe shuga sangasungidwe.
• Amuna ochepera zaka 65 omwe akumamwa mankhwala ambiri kale.

Komabe, mosamala - sizitanthauza kuti sanasankhe.

Kupatula apo, kugwiritsa ntchito ma statins kuchokera ku cholesterol ndikuti amateteza munthu ku matenda monga myocardial infarction, kusokonezeka kwa miyendo (zomwe zingayambitse kumangidwa kwamtima), matenda am'mimba, matenda a thrombosis. Izi zoyambitsa matenda tsiku ndi tsiku zimabweretsa kufa kwa anthu masauzande ndipo zimawerengedwa kuti ndi chimodzi mwazomwe zimayambitsa imfa. Koma chiopsezo chofa ndi mafuta a hepatosis ndi ochepa.

Chifukwa chake, musachite mantha ngati kale mudadwala matenda a chiwindi, ndipo tsopano ma statins adayikidwa. Dokotala azikulangizani kuti mukaayezetseni magazi musanatenge mafuta a cholesterol komanso patatha mwezi umodzi. Ngati mulingo wa ma enzymes a chiwindi uli mu dongosolo, ndiye kuti umagwirizana ndi katunduyo moyenera, ndipo cholesterol imachepa.

Kuphatikiza ndi mankhwala ena

Kuvulaza kuchokera ku ma statins kumawonjezera ngati atengedwa nthawi yomweyo monga mankhwala ena: thiazide diaretics (hypothiazide), macrolides (azithromycin), calcium antagonists (amlodipine). Muyenera kupewa kudziyang'anira nokha malamulo a kolesterol - adotolo ayenera kuwunika mankhwala onse omwe munthu amamwa. Adzaona kuti kuphatikiza koteroko ndikotsutsana.

Nditenga ma statins nthawi yayitali bwanji?

Nthawi zambiri pamachitika munthu akamamwa paketi ya Krestor ndikuganiza kuti tsopano ali wathanzi. Awa ndi malingaliro olakwika. Kuchuluka kwa cholesterol (atherosulinosis) ndi matenda osachiritsika, ndizosatheka kuchiritsa ndi mapiritsi amodzi.

Koma ndizowona kusungabe cholesterol mwanjira yoti zolembedwa zatsopano sizipanga, ndipo zakale zidzasungunuka. Kuti muchite izi, ndikofunikira kutsatira zakudya ndikumwa ma statin kwa nthawi yayitali.

Koma mlingo womwe unayambira - pakapita nthawi, ungathe kuchepa kwambiri.

Zomwe muyenera kuwongolera ngati mumamwa ma statins

Pa chithandizo musanayambe, mulingo wa lipids amayeza: cholesterol yathunthu, triglycerides ndi lipids yayitali komanso yotsika. Ngati mulingo wa cholesterol suchepa, ndiye kuti mwina mlingo wake ndi wocheperako. Dokotala angakulangizeni kuti muukulitse kapena dikirani.

Popeza mankhwala omwe amachepetsa cholesterol amakhudza chiwindi, muyenera kupimidwa magazi pafupipafupi kuti muwone kuchuluka kwa ma enzyme. Dokotala wopezeka akuwunika izi.

• Asanakhazikitsidwe ma statins: AST, ALT, KFK.
• Masabata a 4-6 atayamba kuvomerezedwa: AST, ALT.

Ndi kuwonjezeka kwa muyezo wa AST ndi ALT kuchulukitsa katatu, kuyezetsa magazi kumabwerezedwa. Ngati zotsatira zomwezo zimapezeka pakubwereza magazi mobwerezabwereza, ndiye kuti ma statins amalephera mpaka mulingowo ukhale womwewo. Mwina adokotala angaganize kuti ma statins amatha kusintha ndi mankhwala ena a cholesterol.

Cholesterol ndi chinthu chofunikira m'thupi. Koma ndi kuchuluka kwake, matenda owopsa amatuluka. Sikoyenera kuchita mopepuka kuyezetsa magazi kwa cholesterol yonse. Ngati, malinga ndi zotsatira zake, dokotala akulangizani kuti mutenge ma statins, ndiye kuti ndi ofunikira. Mankhwalawa a cholesterol ali ndi zotsatira zabwino, koma pali zovuta zambiri. Chifukwa chake, ndizoletsedwa kumwa iwo osavomerezeka ndi dokotala.

Ma Status: momwe amathandizira, zikuwonetsa komanso kuphwanya, kuwunika kwa mankhwala, zomwe zingachitike

Cholesterol, kapena cholesterol, ndi chinthu chomwe chimagwira ntchito zofunika mthupi la munthu. Izi zikuphatikiza:

• Kutengapo gawo ngati chida chomanga cha pafupifupi maselo onse amthupi, popeza mamolekyu a cholesterol amaphatikizidwa ndi membrane wa cell ndikupatsa mphamvu, kusinthasintha ndi "fluidity",
• Kutenga nawo gawo pa chimbudzi ndi mapangidwe a bile acids wofunikira pakuwonongeka ndikufinya kwa mafuta m'matumbo am'mimba,
• Kutenga nawo gawo pakapangidwe kwamahomoni m'thupi - mahomoni a adidal a gren ndi ma mahomoni ogonana.

Kuchuluka kwa cholesterol m'magazi kumabweretsa kuti ma molekyulu ake owonjezera amatha kumuyika pazenera za mitsempha yamagazi (makamaka mitsempha). Mapangidwe a atherosulinotic amapangidwa omwe amasokoneza magazi oyenda kudzera mu mtsempha wamagazi ndipo nthawi zina, pamodzi ndi zigawo za magazi zomwe zimamangiriridwa, zimatseka lumen ya chotengera, zomwe zimathandizira kukulitsa kugunda kwa mtima komanso sitiroko.

Muyezo wa cholesterol yathunthu m'magazi a munthu wamkulu sayenera kupitirira 5.0 mmol / l, mwa odwala omwe ali ndi matenda a mtima osaposa 4.5 mmol / l, komanso kwa odwala omwe ali ndi infration ya myocardial osaposa 4.0 mmol / l.

Kodi ma statins ndi chiyani ndipo amagwira ntchito bwanji?

Muzochitika zomwe wodwalayo ali ndi chiwopsezo chambiri chotenga myocardial infarction chifukwa cha atherosulinosis ndi cholesterol metabolism, amamuwonetsa kugwiritsa ntchito mankhwala ochepetsa lipid ochepetsa nthawi yayitali.

Statins ndi hypolipidemic (lipid-kutsitsa) mankhwala, limagwirira zake zomwe tikulepheretsa enzyme yomwe imalimbikitsa kupanga cholesterol. Amagwiritsa ntchito mfundo ya "palibe enzyme - palibe cholesterol." Kuphatikiza apo, chifukwa cha njira zosadziwika, amathandizira kusintha kwa mitsempha yamkati yowonongeka pamitsempha pomwe atherosulinosis ikadali yosatheka kuzindikira, koma mawonekedwe a cholesterol pamakoma ayamba kale - kumayambiriro kwa atherossteosis.Amathandizanso pakutsata magazi a magazi, kutsitsa mamasukidwe akayendedwe, chomwe ndichinthu chofunikira chomwe chimalepheretsa mapangidwe amwazi ndi kudziphatika kwawo pamapepala.

Zothandiza kwambiri pano ndizodziwika bwino monga m'badwo waposachedwa kwambiri wama statins, okhala ndi atorvastatin, cerivastatin, rosuvastatin ndi pitavastatin ngati chinthu chogwira ntchito. Mankhwala a m'badwo waposachedwa samangoletsa kuchuluka kwa cholesterol "yoyipa", komanso kuwonjezera "zabwino" m'magazi. Awa ndiwo ma statin abwino kwambiri mpaka pano, ndipo momwe amagwiritsidwira ntchito amapezeka kale mwezi woyamba wogwiritsidwa ntchito mosalekeza. Statin amalembedwa kamodzi patsiku usiku, kuphatikiza kwa iwo piritsi limodzi ndi mankhwala ena a mtima ndikotheka.

Kugwiritsira ntchito mwaulere kwa ma statins popanda kufunsa dokotala sikovomerezeka, popeza musanamwe mankhwalawa, ndikofunikira kudziwa kuchuluka kwa cholesterol m'magazi. Kuphatikiza apo, ngati cholesterol yotsika kuposa 6.5 mmol / l, pakatha miyezi isanu ndi umodzi muyenera kuyesa kutsitsa ndi zakudya, moyo wathanzi, ndipo pokhapokha ngati izi sizikuyenda bwino, dokotalayo amasankha kukhazikitsidwa kwa ma statins.

Kuchokera pazomwe mungagwiritse ntchito ma statins, mutha kuwunikira mfundo zazikulu:

Zisonyezo za ma statins

Chizindikiro chachikulu ndi hypercholesterolemia (cholesterol yayikulu) ndi kusachita bwino kwa njira zosagwiritsa ntchito mankhwala osokoneza bongo komanso cholowa chamagulu (cholowa) hypercholesterolemia ndi kusagwira bwino kwa zakudya.

Kukhazikitsa ma statins ndikofunikira kwa anthu omwe ali ndi hypercholesterolemia yomwe imakhudzana ndi matenda otsatirawa, chifukwa kugwiritsa ntchito kwawo limodzi ndi mankhwala ena omwe adalembedwa ndi adokotala kumachepetsa chiopsezo cha kufa mwadzidzidzi kwamtima:

• Anthu opitirira 40 omwe ali ndi chiwopsezo chachikulu cha matenda amtima,
• Matenda a mtima, angina pectoris,
• Myocardial infaration
• Opaleshoni ya aorto-coronary bypass kapena stent yokhazikitsidwa kwa myocardial ischemia,
• Stroko
• Kunenepa kwambiri
• Matenda a shuga
• Milandu yakufa mwadzidzidzi kwamtima wa pachibale pafupi ndi zaka 50.

Kodi ma statins amatha kuphatikizidwa ndi mankhwala ena?

Malinga ndi malingaliro a WHO ndi American Mtima Association, ma statins ndi mankhwala ofunikira pakuthandizira matenda a mtima omwe ali ndi chiwopsezo chachikulu cha zovuta komanso kuphwanya kwa myocardial. Kukhazikitsa mankhwala okha kuti muchepetse cholesterol sikokwanira, chifukwa chake mankhwala ofunika amaphatikizidwa muzoyimira - awa ndi beta - blockers (bisoprolol, atenolol, metoprolol, etc.), antiplatelet agents (aspirin, aspirin Cardio, aspicor, thrombo Ass, etc.), ACE inhibitors ( enalapril, perindopril, quadripril, etc.) ndi ma statins. Kafukufuku wambiri wachitika omwe amatsimikizira kuti kugwiritsa ntchito mankhwalawa mophatikiza ndi kwabwino. Komanso, kuphatikiza kwa, mwachitsanzo, pravastatin ndi aspirin piritsi limodzi, chiopsezo chotenga myocardial infarction (7.6%) chimachepetsedwa kwambiri poyerekeza ndi kumwa mankhwala okha (pafupifupi 9% ndi 11% mukamamwa pravastatin ndi aspirin, motsatana).

Chifukwa chake, ngati ma statin adayikidwa usiku pamaso, ndiye kuti, panthawi yokhapokha kuti asamwe mankhwalawa, gulu lachipatala padziko lonse lapansi pano likumaliza kuti kumwa mankhwala ophatikizidwa piritsi limodzi ndikwabwino. Mwa zophatikiza izi, mankhwala omwe amatchedwa polypill pano akuyesedwa, koma ntchito yawo yochulukirapo idakali ochepa. Mankhwala omwe agwiritsidwa kale ntchito mosakaniza ndi atorvastatin ndi amlodipine - caduet, duplexor.

Ndi cholesterol yochuluka kwambiri (yoposa 7.4 mmol / l), kugwiritsa ntchito ma statin osakanikirana ndi mankhwala ndikotheka kuti kuichepetse kuchokera ku gulu lina - fibrate. Kusankhidwa kumeneku kuyenera kuchitidwa ndi dokotala, kuwunika mosamala kuopsa kwa zotsatirapo zake.

Simungathe kuphatikiza kutenga ma statins ndi madzi a mphesa, chifukwa zimakhala ndi zinthu zomwe zimachepetsa kagayidwe kazomwe zimapanga thupi ndikuwonjezera kuchuluka kwake m'magazi, omwe amadzala ndi kukula kwa poyipa wamavuto.

Komanso, musamamwe mankhwalawa ndi mowa, maantibayotiki, makamaka ufafanuzi wa hemithromycin ndi erythromycin, chifukwa izi zimatha kuyambitsa chiwindi. Maantibayotiki ena ophatikizidwa ndi mankhwala ochepetsa cholesterol ndi otetezeka. Kuti muwone ntchito ya chiwindi, ndikofunikira kuyesa magazi a biochemical miyezi itatu iliyonse ndikuwona kuchuluka kwa ma enzymes a chiwindi (AlAT, AsAT).

Zowopsa ndi Zabwino - Zabwino ndi Zabwino

Mukamamwa mankhwala omwe dokotala wamupatsa, wodwala aliyense amalingalira za momwe mankhwalawo alondola. Kutenga ma statins kulinso chimodzimodzi, makamaka chifukwa nthawi zambiri mumatha kumva za kuwopsa kwa mankhwalawa. Malingaliro awa amatha kusintha, chifukwa m'zaka zaposachedwa mankhwala aposachedwa amapangidwa omwe amapindulitsa kwambiri kuposa kuvulaza.

Kusankha pakati pa generic ndi choyambirira

Mankhwala a Torvakard ndi amodzi mwa omwe amapikisana kwambiri ndi Atorvastatin.

Mtengo wake ndendende ndi theka womwe umakopa anthu ambiri, chifukwa ndalama zomwe amasunga ndi 50%. Imalengezedwa bwino, pali ndemanga zabwino za izi, kotero anthu amatenga nazo chisangalalo.

Mankhwalawa ndi osiyana kwambiri ndi mawonekedwe ake, ngati mu maphikidwe oyambawo pali zinthu zoyambirira za atorvastatin ndi chinthu chothandizira mu mawonekedwe a lactose, ndiye ku Torvakard palinso mankhwala ena othandizira.

Kapangidwe ka mankhwala akuphatikiza:

1. Mchere wamchere wa Atorvastatin, mamiligalamu 10 - yogwira ntchito,
2. Croscarmellose sodium - chosagawika chomwe chimapereka kuwonongeka kwa mapiritsi m'mimba,
3. Magnesium oxide amalepheretsa kupindika,
4. Lactose monohydrate - chojambula chowonjezera chochuluka,
5. Glucose wa monocrystalline ndi kununkhira ndi kununkhira,
6. Magnesium stearate ndi zinthu zotsutsana ndi ndodo kuti muchepetse kupanga ndi kulongedza.

Mapangidwe a chipolopolocho ndi:

• titanium dioxide - utoto wamamineral mu ufa wabwino,
• talc ndi chinthu chosunthira chomwe chimachepetsa kukwiya chifukwa cha adsorption pansi pa granules.

Monga tikuwonera kuchokera pamwambapa, mankhwala a Torvakard ali ndi zinthu zambiri zowola zomwe zimawonjezera kulemera kwake komanso zolimbitsa thupi. Kwa ambiri mwa zinthuzi, odwala matendawa amatha kuyamba kusalolera kapena kuyambika chifukwa cha kuyamwa, kuyambira kuyabwa pakhungu mpaka edema la Quincke, choncho sakulimbikitsidwa kugwiritsa ntchito mankhwalawa. Kapena, tengani mayeso ndi mayeso a allergenic pazinthu izi kuti muwonetsetse kuti kumwa mankhwalawo ndikotetezeka kwa thanzi.

Anthu omwe ali ndi tsankho lactose saloledwa kutenga mitundu yonse ya ma statins.

Ndiye pali kusiyana kotani pakati pa Atorvastatin ndi Torvacard?

Monga tikuwonera kuchokera ku maphunziro azachipatala, kuwunika kwa maselo ndi ngozi ya matupi awo, Torvacard ndiwotsika kwambiri ku Atorvastatin. Izi ndizosadabwitsa, chifukwa tekinoloje yopanga zinthu zamagetsi ndi yosiyana ndi yoyambayo, chifukwa chake, chithandizo chamankhwala chimakhala chotsika kwambiri, ndipo mulingo wofunikira umakhala wokwera. Ubwino wake waukulu ndi mtengo, koma muyenera kukumbukira kuti owonetsa zowawa amalipira kawiri, ndipo simuyenera kupulumutsa pa thanzi lanu.

Kodi ndichabwino kutenga ma statins akatswiri akuuza mu kanema munkhaniyi.

• Imakhazikika pamisempha ya shuga kwa nthawi yayitali
• Imabwezeretsa kapangidwe ka insulin

Ubwino wotenga ma statins

1. Kuchepetsa 40% yaimfa yamtima m'zaka zisanu zoyambirira,
2. 30% Kuchepetsa chiopsezo cha matenda a sitiroko ndi mtima,
3. Kuchita bwino - kutsitsa cholesterol ndikugwiritsidwa ntchito mosalekeza ndi 45 - 55% ya oyamba kwambiri. Kuti muwone kuyendetsa bwino, wodwalayo amayenera kuwezetsa magazi mwezi uliwonse chifukwa cha cholesterol,
4. Chitetezo - kutenga mbadwo waposachedwa wa ma statins mu mankhwala othandizira alibe mphamvu yakuopsa m'thupi la wodwalayo, ndipo chiopsezo cha zotsatirapo chake ndichotsika kwambiri. Kafukufuku angapo omwe achita kuwunikira kwakanthawi kwa odwala omwe akhala akutenga ma statins kwa nthawi yayitali akuwonetsa kuti kugwiritsa ntchito kwawo kungapangitse kukulira kwa mtundu wa 2 matenda a shuga, khansa ya chiwindi, matenda amkati, komanso kuwonongeka kwa malingaliro. Komabe, izi zatsimikiziridwa ndikuwonetsa kuti matendawa amatenga chifukwa cha zina. Kuphatikiza apo, ku Spain kwa odwala omwe ali ndi mtundu wachiwiri wa matenda ashuga omwe alipo kale kuyambira mu 1996, awonetsa kuti chiopsezo chotenga matenda a shuga monga matenda ashuga polyneuropathy, retinopathy amachepetsa ndi 34% ndi 40%, motero.
5. Chiyerekezo chochulukirapo chomwe chimagwira ntchito imodzi m'magulu osiyanasiyana amtengo, zomwe zimathandiza kusankha mankhwala poganizira mphamvu zomwe wodwalayo ali nazo.

Zoyipa zovuta kutenga ma statins

• Mtengo wokwera wa zokonzekera zina zoyambirira (mtanda, rosucard, leskol forte). Mwamwayi, drawback iyi imachotsedwa mosavuta pakusintha mankhwala pogwiritsa ntchito zomwezo ndi analogue yotsika mtengo.

Inde, zabwino ndi mapindu osayerekezekawa ayenera kukumbukiridwa ndi wodwala yemwe akuwonetsa kuti akuvomera, ngati akukayika ngati kuli koyenera kutenga ma statins ndikuyesa mosamala zabwino ndi zoipa zake.

Mwachidule

Mndandanda wa mankhwala omwe nthawi zambiri amaperekedwa kwa odwala amaperekedwa patebulo:

Dzina la mankhwalawa, zomwe zimapezeka mu mankhwala (mg)

Mtengo woyerekeza, rub

Ine m'badwo SimvastatinVasilip (10, 20 kapena 40)Slovenia355 — 533 Simgal (10, 20 kapena 40)Czech Republic, Israel311 — 611 Simvakard (10, 20, 40)Czech Republic262 — 402 Simlo (10, 20, 40)India256 — 348 Simvastatin (10, 20 kapena 40)Serbia, Russia72 — 177 PravastatinLipostat (10, 20)Russia, USA, Italy143 — 198 LovastatinHolletar (20)Slovenia323 Cardiostatin (20, 40)Russia244 — 368 M'badwo wachiwiri FluvastatinLeskol Forte (80)Switzerland, Spain2315 M'badwo wa III AtorvastatinLiptonorm (20)India, Russia344 Liprimar (10, 20, 40, 80)Germany, USA, Ireland727 — 1160 Torvacard (10, 40)Czech Republic316 — 536 Atoris (10, 20, 30, 40)Slovenia, Russia318 — 541 Tulip (10, 20, 40)Slovenia, Sweden223 — 549 M'badwo wa IV RosuvastatinCrestor (5, 10, 20, 40)Russia, Great Britain, Germany1134 – 1600 Rosucard (10, 20, 40)Czech Republic1200 — 1600 Rosulip (10, 20)Hungary629 – 913 Tevastor (5, 10, 20)Israeli383 – 679 PitavastatinLivazo (1, 2, 4 mg)Italy2350

Ngakhale kufalikira kotereku pamitengo yama statins, ma analogi otsika mtengo samakhala otsika kwambiri pamankhwala okwera mtengo. Chifukwa chake, ngati wodwalayo sangathe kugula mankhwalawo, ndikotheka kusintha m'malo mwake monga momwe adanenera adotolo ndi omwe ali ndi ndalama zambiri.

Kodi ndingachepetse cholesterol yanga popanda mapiritsi?

Mankhwala a atherosulinosis monga mawonekedwe a cholesterol yoipa “yambiri” m'thupi, mankhwala oyamba ayenera kukhala olimbikitsa kusintha kwa moyo, chifukwa ngati cholesterol mulibe kwambiri (5.0 - 6.5 mmol / l), ndipo chiopsezo cha zovuta zamtima ndi chochepa kwambiri, mutha kuyesa sinthani izi mothandizidwa ndi izi:

Zakudya zina zimakhala ndi zotchedwa zachilengedwe. Mwa zinthu izi, adyo ndi turmeric ndizophunziridwa kwambiri. Kukonzekera kwa mafuta a nsomba kumakhala ndi omega 3 mafuta acids, omwe amathandizira kagayidwe ka cholesterol m'thupi. Mutha kumwa mafuta a nsomba omwe amagulidwa ku malo ogulitsa mankhwala, kapena mutha kuphika mbale zam'madzi (trout, nsomba, nsomba, etc.) kangapo pa sabata. Mitengo yokwanira ya masamba, yomwe imapezeka muma maapulo, kaloti, phala (oatmeal, barele) ndi nyemba, ndilolandiridwa.

Pokhapokha pakuchitika njira zosagwiritsa ntchito mankhwala osokoneza bongo, adokotala amatulutsa imodzi mwazomwe zimachepetsa mankhwala a lipid.

Pomaliza, ndikufuna kudziwa kuti, ngakhale ali ndi mantha a odwala komanso lingaliro la zoopsa za ma statins, cholinga chawo ndicholondola pakufikira kwa atherosclerosis ndi kuwonongeka kwamitsempha yama coronary, popeza mankhwalawa amatalikitsa moyo. Ngati muli ndi cholesterol yayikulu popanda chizindikiro choyambirira cha kuwonongeka kwa mtima, ndiye kuti muyenera kudya moyenera, kusunthika, kukhala ndi moyo wathanzi, kenako mudzaganiza kuti mutenge ma protein.

Kodi mapiritsi a Atoris angatengedwe kwa nthawi yayitali?

Inde, ma statin onse amapangidwa kuti azikhala ndi nthawi yayitali (kuphatikizapo nthawi yayitali). Ngati iye makamaka wodwala amachepetsa cholesterol ndipo sayambitsa kuwonjezeka kwa ALT ndi AST (ma enzymes a chiwindi poyesa magazi), mutha kupitiliza kumwa. Kuphatikiza apo, kamodzi miyezi isanu ndi umodzi, muyenera kubwereza kuyesedwa kwa magazi kwa lipid mbiri (cholesterol), ALT, AST.

Kanema: kodi ndiyabwino kutenga ma statins nthawi zonse?

Gawo 2: mutalipira, funsani funso lanu mu fomu ili m'munsiyi. Gawo 3: Muthokozanso katswiriyo pomulipiritsa ndalama zowonjezera

Mankhwala apamwamba kwambiri a ku Switzerland omwe amatha kuchepetsa LDL ndi 50%, ndi cholesterol - ndi 40%. Zotsatira zake zikuwoneka kale masabata atatu mutatha kugwiritsa ntchito, ndipo zotsatira zake zimakhala patadutsa mwezi umodzi.

Kuchiza kumayamba ndi gawo yaying'ono la 10 mg yogwira ntchito patsiku, ngati kuli kofunikira kuonjezera pambuyo pa masabata 3-4, potengera kuwunika kwa magazi. Monga ma statin ena, odwala nthawi zambiri amakhala ndi zovuta monga kusowa tulo, kuponderezana kwamphamvu, ndi kufooka kwa minofu. Mitengo ya Swiss Swip imayamba kuchokera ku 255 ma ruble a mapiritsi 30 ndi mulingo wa 10 mg.

Njira yotsika mtengo kwambiri komanso yotsika mtengo kwambiri ya Atoris kuchokera ku Russia wopanga ATOLL. Imapezeka mu mawonekedwe a makapisozi ndipo ilinso ndi zina zingapo zothandizira, zomwe zimakuthandizani kuti mukwaniritse mwachangu komanso moonekera kwambiri momwe mumathandizira.

Mlingo woyambirira amakhalabe osasinthika - 10 mg / tsiku. Komabe, musanagwiritse ntchito mankhwalawa, ndikulimbikitsidwa kusinthana ndi zakudya zopezeka mu hypocholesterol, zomwe zimayenera kuchitika nthawi yonse ya chithandizo. Mitengo ya novostatin imayamba kuchokera ku ruble 330.

Osotsika mtengo kwambiri, koma otetezeka kwambiri komanso ogwira ntchito kwambiri, okhala ndi zotsatirapo zochepa zoyipa, mnzake waku Ireland. M'malo mwake, iyi ndi mankhwala omwewo a hypolipidemic ndi hypocholesterolemic a kampani yopanga mankhwala Pfizer, yodziwika chifukwa chaukadaulo wake wapamwamba komanso kugwiritsa ntchito mankhwala omwe ali ofatsa momwe angathere thupi, zomwe ndizofunikira kwambiri pakulandira chithandizo kwa nthawi yayitali. Pankhani ya cholesterol yayikulu, mankhwala a statin amatha kuyambira miyezi ingapo kupitirira chaka chimodzi.

Nthawi yomweyo, pali zovuta zowoneka zakukonzekera iyi, yomwe mtengo wake ndi wokwera mtengo. Mitengo ya Liprimar ku malo ogulitsa mankhwala ku Russia imayamba pa ma ruble 700 pa mapiritsi 10 a mlingo wochepera.

Komanso mndandanda wamtengo wotsika mtengo wa Atoris ukhoza kubwezeretsedwanso ndi mankhwala omwe sakudziwika bwino, koma alipo pamsika, monga: Ator, Atomax, Amvastan, Lipoford, Torvalip, Torvas. Ndikofunikira kukumbukira za contraindication, zomwe ndizofanana ndi zamankhwala onse omwe ali pamwambapa.

Mtengo Wophatikiza Mtengo

Mavuto a mankhwala aliwonse ndi njira zamakono zothandizira. Owerenga amalimbikitsa mankhwala achilengedwe, omwe, kuphatikizapo zakudya komanso ntchito, amachepetsa kwambiri mafuta m'thupi pambuyo masabata 3-4 . Maganizo a madotolo >>

Mosasamala wopanga ndi wopaka, mankhwala onse omwe ali pamwambapa amatengera atorvastatin ndipo amachitanso chimodzimodzi (kupatula kusiyanasiyana kakang'ono pazotsatira zoyipa, chitetezo ndi liwiro lolowera m'magazi) - izi ndi zowona.

Kusiyanitsa kwakukulu kotereku kumatha kufotokozedwa ndi mtengo wopanga (kuchuluka kwa malipiro a ogwira ntchito, mtengo wa zida), kayendedwe ka kayendedwe ka mtengo ndi mtengo wa kampani yopanga mankhwala pazotsatsa. Komabe, zimakhulupililidwa kuti makampani akuluakulu komanso odziwika bwino amagwiritsa ntchito zida zamakono kwambiri ndikupanga zofunikira kwambiri pakupanga, chifukwa chomwe amapeza bwino.

Malinga ndi kuchuluka kwa 10 mg / tsiku, phukusi la mapiritsi 30 lidzakwanira mwezi umodzi wowerengeka. Ngati, mwezi woyamba wa chithandizo, madokotala akupangirani maphunziro a statin kwa miyezi yopitilira 2, kukhala kopindulitsa kwambiri kugula phukusi la mapiritsi 90 kapena 100, popeza mtengo wa piritsi limodzi m'mapaketi akuluakulu ndi wocheperako.

Zotsatira za pharmacological

Zopangira lipid-kutsitsa mankhwala. Atorvastatin ndi mpikisano wosankha wa HMG-CoA reductase, ma enzyme ofunikira omwe amasintha 3-hydroxy-3-methylglutaryl-CoA kukhala mevalonate, choyambirira kwa ma steroid, kuphatikiza cholesterol.

Odwala omwe ali ndi homozygous ndi heterozygous Famer hypercholesterolemia, osakhala a mabanja a hypercholesterolemia ndi dyslipidemia, atorvastatin otsika okwana cholesterol (Ch) mu plasma, cholesterol-LDL ndi apolipoprotein B (apo-B), komanso Cuc C. kuchuluka kosasunthika pamlingo wa HDL-C.

Atorvastatin amachepetsa kuchuluka kwa cholesterol ndi lipoproteins m'magazi am'magazi, kuletsa HMG-CoA reductase ndi kaphatikizidwe kolesterol mu chiwindi ndikuwonjezera kuchuluka kwa hepatic LDL receptors pamaselo a cell, zomwe zimayambitsa kuwonjezeka ndikuwonetsa kwa LDL-C.

Atorvastatin amachepetsa kupangika kwa LDL-C ndi kuchuluka kwa tinthu ta LDL. Zimayambitsa kuwonjezeka kosalekeza kwa zochitika za LDL receptors, kuphatikiza pakusintha koyenera mu zinthu za LDL. Amachepetsa mulingo wa LDL-C odwala omwe ali ndi homozygous cholowa hypercholesterolemia, osagwirizana ndi mankhwala ena okhala ndi lipid-kuchepetsa.

Atorvastatin mu Mlingo wa mg amachepetsa cholesterol yonse ndi 30-46%, LDL-C ndi 41-61%, apo-B ndi 34-50% ndi TG ndi 14-33%. Zotsatira zamankhwala ndizofanana kwa odwala omwe ali ndi heterozygous Famer hypercholesterolemia, omwe siabanja mitundu ya hypercholesterolemia ndi hyperlipidemia kuphatikizapo Odwala odwala matenda a shuga omwe amadalira insulin.

Odwala omwe ali ndi hypertriglyceridemia yotsala, ma atorvastatin amatsitsa cholesterol yonse, Chs-LDL, Chs-VLDL, apo-B ndi TG ndikuwonjezera kuchuluka kwa Chs-HDL. Odwala omwe ali ndi dysbetalipoproteinemia, amachepetsa mulingo wa ChS-STD.

Odwala omwe ali ndi mtundu wa IIa ndi IIb hyperlipoproteinemia malinga ndi gulu la Fredrickson, mtengo wowonjezereka wa HDL-C panthawi ya chithandizo ndi atorvastatin (10-80 mg), poyerekeza ndi mtengo woyambira, ndi 5.1-8.7% ndipo sizimatengera mlingo. Pali kuchepa kwakukulu kosadalira mlingo: cholesterol / Chs-HDL ndi Chs-LDL / Chs-HDL ndi 29-44% ndi 37-55%, motsatana.

Atorvastatin pa mlingo wa 80 mg kwambiri amachepetsa chiopsezo cha ischemic zovuta ndi kufa ndi 16% pambuyo pa maphunziro a sabata 16, ndi chiopsezo chokhazikitsidwanso kuchipatala cha angina pectoris, chotsatira ndi zizindikiro za myocardial ischemia, ndi 26%. Odwala omwe ali ndi misinkhu yosiyanasiyana ya LDL-C, atorvastatin amachititsa kuchepa kwa vuto la ischemic ndi kufa (mwa odwala omwe ali ndi vuto la myocardial infarction opanda Q wave ndi angina osakhazikika, amuna ndi akazi, odwala omwe ali ndi zaka 65!

The achire zotsatira zimatheka patatha masabata awiri chiyambireni kuyambika kwa mankhwalawa, chimafika pakatha masabata 4 ndipo chimapitilira nthawi yonse ya chithandizo.

Mtima Kupewa matenda

Mu kafukufuku wa Anglo-Scandinavia wazotsatira zamtima, lipid-lowering nthambi (ASCOT-LLA), zotsatira za atorvastatin pa matenda oopsa a mtima komanso osapatsa mphamvu, zinapezeka kuti zotsatira za chithandizo cha atorvastatin pamlingo wa 10 mg kwambiri zimadutsa zotsatira za placebo, motero lingaliro linapangidwa kuti lithe msanga amaphunzira pambuyo pa zaka 3.3 m'malo mwa zaka zisanu.

Atorvastatin kwambiri adachepetsa kukula kwa zovuta zotsatirazi:

Panalibe kuchepa kwakukulu muimfa yathunthu ndi yamtima, ngakhale panali zochitika zabwino.

Pa kafukufuku wophatikizidwa wokhudzana ndi zotsatira za atorvastatin mwa odwala omwe ali ndi mtundu wa 2 shuga mellitus (CARDS) pazotsatira zakupha komanso zopanda pake zamatenda amtima, zidawonetsedwa kuti chithandizo chamankhwala atorvastatin, mosasamala za jenda la wodwala, zaka, kapena msambo wa LDL-C, idachepetsa chiopsezo chokhala ndi zovuta zamtima zotsatirazi :

Pakufufuza kwakukonzanso kwa kusintha kwa coronary atherosulinosis ndi hypolipidemic tiba (REVersAL) ndi atorvastatin pa mlingo wa 80 mg mwa odwala omwe ali ndi matenda amitsempha yamagazi, tapezeka kuti kuchepa kwapakati pa voliyumu yonse ya atheroma (gawo lalikulu la chidziwitso) kuyambira pachiyambire kafukufukuyo panali 0.4%.

Intensive Cholesterol Reduction Programme (SPARCL) idapeza kuti atorvastatin pa mlingo wa 80 mg patsiku amachepetsa chiopsezo chobwereza kapena kusaphedwa kwa odwala omwe anali ndi mbiri ya kuwonongeka kapena kusakhalitsa kwa ischemic matenda opanda ischemic matenda a mtima ndi 15%, poyerekeza ndi placebo. Nthawi yomweyo, chiopsezo cha zovuta zazikuluzikulu za mtima ndi njira zotsitsimutsira magazi zinachepetsedwa kwambiri. Kuchepetsa chiopsezo cha matenda amkati pamtima pa atorvastatin adawonedwa m'magulu onse kupatula okhawo omwe amaphatikiza odwala omwe ali ndi vuto loyambira kapena lozungulira hemorrhagic stroke (7 pagulu la atorvastatin motsutsana ndi 2 mu gulu la placebo).

Odwala omwe amathandizidwa ndi atorvastatin mankhwala pa mlingo wa 80 mg, kuchuluka kwa hemorrhagic kapena ischemic stroke (265 motsutsana 311) kapena IHD (123 motsutsana 204) kunali kochepa poyerekeza ndi gulu lolamulira.

Kupewa kwachiwiri kwa mtima wamavuto

Malinga ndi New Target Study (TNT), zotsatira za atorvastatin pamiyeso ya 80 mg patsiku ndi 10 mg patsiku pachiwopsezo chokhala ndi zovuta zamtima mwa odwala omwe ali ndi matenda amitsempha yamagetsi otsimikizika.

Atorvastatin pa mlingo wa 80 mg kwambiri adachepetsa kukula kwa zovuta zotsatirazi:

Analogs kutengera rosuvastatin - chinthu china chogwira ntchito

Atoris ndi a gulu la statins a m'badwo wachitatu ndipo, mosiyana ndi mibadwo yam'mbuyomu, ali ndi chiopsezo chotsika kwambiri chotsatira zoyipa ndi kuchuluka kwake. Komabe, lero m'badwo wachinayi ulipo kale, womwe ukukula kwambiri ndipo m'tsogolo, ndizotheka kusintha chachitatu.

Zomwe zimagwira ndi rosuvastatin. Zikomo kwa iye, ngakhale ndi mlingo wa tsiku lililonse wa 5 mg, ndizotheka kukwaniritsa zomwezo, ndipo nthawi zina, zimachitika mwachangu. Mwachidziwikire, mlingo wocheperako umakhudzanso chiwindi, umayambitsa zotsatira zoyipa zochepa, zomwe zimadziwika kwambiri ndi chithandizo cha nthawi yayitali.

Komabe, samalani, chifukwa ngakhale kuti mibadwo yonse yamankhwala imapangidwa kuti muchepetse kupanga mafuta a cholesterol ndipo ndioyenera kwa odwala omwe ali ndi hypocholesterolemia, momwe amagwirira ntchito pa thupi ndizosiyana pang'ono, zomwe zimakhudza osati kungogwira ntchito bwino kwamankhwala, komanso mkhalidwe wamagetsi ambiri amthupi.

Kodi mukuganizabe kuti kuthana ndi cholesterol yamagazi ndikosatheka?

Poona kuti mukuwerenga izi tsopano - vuto la cholesterol yayikulu mwina likukuvutitsani kwakanthawi. Koma izi sizolankhula nthabwala ayi: kupatuka kotereku kumakulitsa magazi ndipo ngati sichingachitike, kumatha kutha kwambiri.

Koma ndikofunikira kumvetsetsa kuti ndikofunikira kusamalira osati zovuta za kukakamizidwa kapena kukumbukira, koma zomwe zimayambitsa. Mwina muyenera kuzolowera zida zonse pamsika, osati kungotsatsa? Inde, nthawi zambiri, mukamagwiritsa ntchito mankhwala opangira mankhwala omwe ali ndi zotsatira zoyipa, zimachitika zomwe zimadziwika kuti "chimodzi chimagwira ndi zolakwika zina". M'modzi mwa mapulogalamu ake, a Elena Malysheva adakhudza mutu wa cholesterol yayikulu ndipo adalankhula za mankhwala omwe amapangidwa kuchokera kuzomera zachilengedwe ...

Pharmacokinetics

Atorvastatin imalowa mwachangu pambuyo pakumwa pakamwa, Cmax imatheka pambuyo pa maola 1-2. Mlingo wa mayamwidwe ndi kuchuluka kwa atorvastatin mu plasma yamagazi ukuwonjezeka molingana ndi mlingo. Mtheradi wa bioavailability wa atorvastatin ndi pafupifupi 14%, ndipo dongosolo la bioavailability la inhibitory zochita motsutsana ndi HMG-CoA reductase lili pafupifupi 30%. Kuperewera kwachilengedwe kwachilengedwe kumachitika chifukwa cha kagayidwe kachakudya komwe kamakhala m'matumbo komanso / kapena mu "gawo loyambira" kudzera m'chiwindi. Chakudya chimachepetsa kuchuluka kwake komanso kuchuluka kwa mayamwidwe ndi 25% ndi 9%, motsatana (monga zikuwonetsedwa ndi zotsatira za kutsimikiza kwa Cmax ndi AUC), koma mulingo wa LDL-C mukamamwa atorvastatin pamimba yopanda kanthu komanso panthawi ya chakudya imatsika pafupifupi ofanana. Ngakhale kuti atamwa atorvastatin madzulo, milingo yake ya plasma ndiyotsika (Cmax ndi AUC ndi 30%) kuposa atatha kumwa m'mawa, kuchepa kwa LDL-C sikudalira nthawi yamasiku omwe mankhwalawa amwedwa.

Vd wamba wa atorvastatin pafupifupi 381 L. Kumangidwa kwa mapuloteni a atorvastatin kupita ku mapuloteni a plasma kuli pafupifupi 98%. Chiwerengero cha milingo ya atorvastatin m'magazi ofiira a magazi / madzi am'magazi ndi pafupifupi 0,25, i.e. atorvastatin simalowa m'magazi ofiira magazi.

Atorvastatin imapangidwa kwakukulu kuti ipange ma ortho- ndi para-hydroxylated exivatives ndi zinthu zingapo za beta-oxidation. In vitro, ortho- ndi para-hydroxylated metabolites imalepheretsa kusintha kwa HMG-CoA, kufananizidwa ndi atorvastatin. Ntchito zoletsa kutsutsana ndi HMG-CoA reductase ndi pafupifupi 70% chifukwa cha zochita zama metabolites. Kafukufuku wa in vitro akuwonetsa kuti CYP3A4 isoenzyme imachita mbali yofunika kwambiri pakukula kwa atorvastatin. Izi zikutsimikiziridwa ndikuwonjezereka kwa kuchuluka kwa atorvastatin mu plasma ya anthu pamene akutenga erythromycin, yomwe imalepheretsa iyi isoenzyme.

Kafukufuku wa in vitro awonetsanso kuti atorvastatin ndi choletsa chofooka cha CYP3A4 isoenzyme. Atorvastatin analibe zovuta zowonekera pamatenda a terfenadine mu plasma, omwe amakonzedwa makamaka ndi isoenzyme CYP3A4, motere, mphamvu yayikulu ya atorvastatin pa pharmacokinetics ya magawo ena a isoenzyme CYP3A4 ndiyokayikitsa.

Atorvastatin ndi ma metabolites ake amachotseredwa ndi bile pambuyo pa hepatic ndi / kapena metabolism yowonjezera (atorvastatin sakhala ndikuchitika mobwerezabwereza kwambiri). T1 / 2 ili pafupifupi maola 14, pomwe mphamvu yoletsa kukhudzana ndi HMG-CoA reductase imakhala pafupifupi 70% yotsimikizika ndi ntchito yozungulira metabolites ndipo mphete imasungidwa chifukwa cha kupezeka kwawo. Pambuyo pakamwa, osachepera 2% ya mlingo wa atorvastatin wapezeka mu mkodzo.

Pharmacokinetics mu milandu yapadera yamankhwala

Kuchulukitsa kwa plasma kwa atorvastatin okalamba (wazaka? 65 zaka) ndiwokwera kwambiri (Cmax ndi 40%, AUC pafupi 30%) kuposa kwa odwala achikulire. Panalibe kusiyana pakukhwimitsa chitetezo, kugwira ntchito mwamphamvu, kapena kukwaniritsa zolinga zamankhwala ochepetsa lipid mu okalamba poyerekeza ndi ambiri.

Maphunziro a pharmacokinetics a mankhwalawa mu ana sanachitike.

Kuzama kwa plasma ya Atorvastatin mwa akazi ndi kosiyana (Cmax pafupifupi 20% kuposa, ndi AUC 10% kutsika) kuchokera kwa iwo mwa amuna.Komabe, kusiyana kwakukulu mwakuthupi kwa mankhwala a lipid metabolism mwa amuna ndi akazi sikunapezeke.

Kuwonongeka kwa impso sikukhudza kuchuluka kwa atorvastatin m'madzi a m'magazi kapena kukhudzana ndi metabolid ya lipid. Pankhani iyi, kusintha kwa odwala omwe ali ndi vuto laimpso sikofunikira.

Atorvastatin samachotsedwa pa hemodialysis chifukwa chomangirira mapuloteni a plasma.

Kuzungulira kwa Atorvastatin kumawonjezeka kwambiri (Cmax ndi AUC pafupi ndi 16 ndi 11 nthawi, motero) mwa odwala omwe ali ndi vuto la zakumwa zoledzeretsa (kalasi B pamulingo wa Mwana-Pugh).

Zisonyezero zamankhwala LIPRIMAR®

• chachikulu hypercholesterolemia (heterozygous achibale komanso osakhala achibale hypercholesterolemia (mtundu IIa malinga ndi gulu la Fredrickson),
• kuphatikiza (kusakaniza) hyperlipidemia (mitundu IIa ndi IIb malinga ndi gulu la Fredrickson),
• dibetalipoproteinemia (mtundu wa III malinga ndi gulu la Fredrickson) (monga zakudya)
• mabanja amkati hypertriglyceridemia (mtundu IV malinga ndi gulu la Fredrickson), yogonjetsedwa ndi zakudya,
• homozygous achibale hypercholesterolemia osakwanira kudya mankhwala ndi njira zina sanali mankhwala
• kupewa kwakukulu kwa zovuta zamtima mu mtima mwa odwala osakhala ndi matenda am'matumbo, koma ndi zinthu zingapo zomwe zingayambitse kukula kwake - msinkhu woposa zaka 55, kusuta kwa chikonga, matenda oopsa, matenda ashuga, kutsika kwa HDL-C mu plasma, kuperewera kwa majini, etc. maola motsutsana ndi maziko a dyslipidemia,
• kupewa kwachiwiri kwamtima wamavuto omwe ali ndi matenda amtima kuti achepetse kuchuluka kwa anthu omwe amwalira, matenda amitsempha yam'mimba, sitiroko, kuyambiranso kuchipatala kwa angina pectoris ndi kufunika kosinthanso.

Mlingo ndi makonzedwe

Asanayambe chithandizo ndi Liprimar, ayenera kuyesa kupeza mphamvu ya hypercholesterolemia kudzera mu chakudya, masewera olimbitsa thupi komanso kuchepa thupi kwa odwala omwe ali ndi kunenepa kwambiri, komanso chithandizo cha matenda oyambitsidwa.

Popereka mankhwala, wodwalayo ayenera kulimbikitsa mtundu wa zakudya zomwe ayenera kutsatira pakumwa.

Mankhwala amatengedwa pakamwa nthawi iliyonse ya tsiku, mosasamala kanthu za kudya. Mlingo wa mankhwalawa umasiyana 10 mg mpaka 80 mg kamodzi patsiku, kusankha kwa mankhwalawa kuyenera kuchitika molingana ndi magawo oyamba a LDL-C, cholinga cha mankhwala ndi zotsatira zake. Mlingo waukulu kwambiri ndi 80 mg kamodzi patsiku.

Kumayambiriro kwa mankhwalawa komanso / kapena pakuwonjezeka kwa mlingo wa Liprimar, ndikofunikira kuyang'anitsitsa zomwe zili m'magazi a plasma masabata onse a 2-4 ndikusintha mlingo moyenerera.

Kwa hypercholesterolemia yoyamba komanso yophatikizika (yophatikiza) hyperlipidemia kwa odwala ambiri, mlingo wa Liprimar ndi 10 mg kamodzi patsiku. Zotsatira zakuchiritsika zimawonekera mkati mwa masabata awiri ndipo nthawi zambiri zimafika pakadutsa masabata anayi. Ndi chithandizo chakanthawi, zotsatira zake zimapitilira.

Ndi homozygous achibale hypercholesterolemia, mankhwala ndi mankhwala 80 mg kamodzi patsiku. (kutsika kwa mulingo wa LDL-C ndi 18-45%).

Ngati vuto la chiwindi likulephera, mlingo wa Liprimar uyenera kuchepetsedwa motsogozedwa ndi zochitika za ACT ndi ALT.

Ntchito yaimpso yolakwika siyikhudza kuchuluka kwa atorvastatin m'madzi am'magazi kapena kuchepa kwa zomwe LDL-C ikugwiritsa ntchito Liprimar, motero, kusintha kwa mankhwalawa sikofunikira.

Mukamagwiritsa ntchito mankhwalawa odwala okalamba, panalibe kusiyana kwazotetezeka, kugwira ntchito bwino poyerekeza ndi kuchuluka kwa anthu, komanso kusintha kwa mankhwala sikofunikira.

Ngati ntchito yolumikizana ndi cyclosporine ndikofunikira, mlingo wa Liprimar® sayenera kupitirira 10 mg.

Chiwopsezo cha zaka 10 = 160

* Akatswiri ena amalimbikitsa kugwiritsa ntchito mankhwala ochepetsa mphamvu ya lipid omwe amachepetsa zomwe zili mu LDL-C ngati kusintha kwa moyo wawo sikungamupangitse kuchepa kwa zomwe zili pamlingo wa malangizo ogwiritsira ntchito mankhwalawa

Popeza kuti atherosulinosis ndi matenda akupha, ndikofunika kupita kuchipatala ndiudindo. Muyezo wagolide wothandizira ndi ma statins.

Makina awo ochita chimodzimodzi ndi gulu lonse ndipo ali mu blockade ya HMG-CoA reductase enzymes yomwe imapanga cholesterol m'chiwindi.

Mtengo wake ndendende ndi theka womwe umakopa anthu ambiri, chifukwa ndalama zomwe amasunga ndi 50%. Imalengezedwa bwino, pali ndemanga zabwino za izi, kotero anthu amatenga nazo chisangalalo.

Mankhwalawa ndi osiyana kwambiri ndi mawonekedwe ake, ngati mu maphikidwe oyambawo pali zinthu zoyambirira za atorvastatin ndi chinthu chothandizira mu mawonekedwe a lactose, ndiye ku Torvakard palinso mankhwala ena othandizira.

Kapangidwe ka mankhwala akuphatikiza:

1. Mchere wamchere wa Atorvastatin, mamiligalamu 10 - yogwira ntchito,
2. Croscarmellose sodium - chosagawika chomwe chimapereka kuwonongeka kwa mapiritsi m'mimba,
3. Magnesium oxide amalepheretsa kupindika,
4. Lactose monohydrate - chojambula chowonjezera chochuluka,
5. Glucose wa monocrystalline ndi kununkhira ndi kununkhira,
6. Magnesium stearate ndi zinthu zotsutsana ndi ndodo kuti muchepetse kupanga ndi kulongedza.

Mapangidwe a chipolopolocho ndi:

• titanium dioxide - utoto wamamineral mu ufa wabwino,
• talc ndi chinthu chosunthira chomwe chimachepetsa kukwiya chifukwa cha adsorption pansi pa granules.

Monga tikuwonera kuchokera pamwambapa, mankhwala a Torvakard ali ndi zinthu zambiri zowola zomwe zimawonjezera kulemera kwake komanso zolimbitsa thupi. Kwa ambiri mwa zinthuzi, odwala matendawa amatha kuyamba kusalolera kapena kuyambika chifukwa cha kuyamwa, kuyambira kuyabwa pakhungu mpaka edema la Quincke, choncho sakulimbikitsidwa kugwiritsa ntchito mankhwalawa. Kapena, tengani mayeso ndi mayeso a allergenic pazinthu izi kuti muwonetsetse kuti kumwa mankhwalawo ndikotetezeka kwa thanzi.