Holetar: malangizo ogwiritsira ntchito, analogi, mtengo, ndemanga

Kuchuluka kwa zamadzimadzi m'thupi kumatha kupangitsa kuti magazi azithamanga, mtima, impso ndi chiwindi. Pali malangizo ambiri omwe ali ndi wowerengeka komanso mankhwala omwe angalimbane ndi cholesterol yayikulu. Imodzi mwa mankhwalawa ndi Holetar. Lero tiwona momwe Holetard imagwirira ntchito, malangizo ake ogwiritsira ntchito komanso kufunika kwa ndalama.

Zizindikiro zogwiritsidwa ntchito

Mapiritsi a Holetar amawayikira malinga ndi malangizo omwe ali mumikhalidwe iyi:

• Gulu loyambirira la IIa ndi IIb hypercholesterolemia ndi kuchuluka kwa lipids mu kalasi la LDL (kachulukidwe kakang'ono ndi mtundu wa cholesterol yomwe imakhudza thupi ndipo imatha kuyambitsa coronary atherosulinosis). Mikhalidwe imeneyi, Holetar amalembedwa ndi kusakwanira, kapena chifukwa chosakwanira chifukwa cha zakudya.
• Kukwezedwa kwa triglycerides ndi hypercholesterolemia wosakanikirana
• Lipid kuwongolera bwino odwala matenda ashuga mellitus zovuta mitundu yonse iwiri
• Ndi hyperlipoproteinemia, yomwe sikukonzedwa ndikuchita masewera olimbitsa thupi komanso kudya mokwanira.
• Zochizira atherosulinosis

Mawonekedwe ndi kipimo

Gulu la pharmacological la Holetar ndi ma statins. Zimakhudzana ndi mankhwala ochepetsa lipid, monga ma inhibitors a HMG-Coenzyme reductase. Zomwe zimagwira Holetar ndi lovastatin. Mawonekedwe ake amasulidwe ali ngati mapiritsi, zidutswa 20 phukusi lililonse. Piritsi lililonse limakhala ndi 20 mg yogwira chinthu chachikulu (lovastatin), komanso zina zowonjezera - butyl hydroxyanisole, pregelatinized starch, lactose monohydrate, magnesium stearate, coloring E131 ndi microcrystalline cellulose.

Contraindication

Malangizo a mankhwalawa akuti m'malo angapo, Holetar amalephera kuchiza matenda a cholesterol.

Kuyambira pomwe anapangana ayenera kukana milandu zotsatirazi:

• Acute m'mimba thirakiti ndi matenda a chiwindi - kuchuluka chiwindi michere (transaminases) popanda chifukwa kukhazikika, chiwindi kulephera, matenda ena a chiwindi ndi kugaya chakudya dongosolo.
• Zowonongeka. Holetar imatha kukhala ndi mbali yotsutsana ndikuwonjezera zovuta zamaso zomwe zilipo.
• Mbiri yokhudza kupatsirana kwa ziwalo.
• Mowa kudalira mtundu wodwala.
• Kulephera kwa impso.
• Mkhalidwe wovuta wamunthu.
• Mimba ndi mkaka wa m`mawere.
• Opaleshoni yodzidzimutsa.

Kuphatikizika, mawonekedwe omasulidwa

Holetar ndi miyala yozungulira, yozungulira pang'ono, yokhala ndi notch yosavuta kugawa. Piritsi limodzi lili ndi 20 mamiligalamu 40 kapena 40 ogwira ntchito. Ndiosavuta kusiyanitsa: Mlingo wa 20 mg ndi wabuluu wopepuka, 40 mg ndi wobiriwira wopepuka. Paketi imodzi ili ndi miyala 20.

Katundu wa Holetar - lovastatin. Zina zotsalazo zimapanga ntchito yothandiza. Awa ndi lactose monohydrate, butyhydroxyanisole, wowuma, cellulose, magnesium stearate. Kapangidwe ka Holetar 20 mg kuchokera kwa Holetar 40 mg amasiyana mu utoto. Piritsi ya 20 mg imakhala ndi buluu E131, ndipo 40 mg imakhala ndi chikasu E104.

Zotsatira za pharmacological

Mfundo zoyenera kuchita lovastatin ndizosavuta. Mwanjira yake, amafanana ndi enzyme HMG-CoA reductase yofunikira pakupanga kolesterol. Lovastatin imatenga malo azitsulo zomwe zimapangidwa ndi sterol synthesis, kuyimitsa. Kuphwanya mapangidwe a cholesterol kumabweretsa kuchepa kwake.

Thupi limayesetsa kulipirira kuchepa kwa chinthucho pophwanya ma cholesterol okhala ndi milomo yochepa. Chiwerengero chawo chikuchepa. Kutulutsa kwachiwiri kwa Holetar ndi kuwonjezeka kwa milomo ya lipoproteins “zabwino” zapamwamba.

Zotsatira zakusintha kwa kuchuluka kwa cholesterol, lipoproteins - kumachepetsa chiopsezo chokhala ndi atherosulinosis. Matendawa amakula motsutsana ndi mulingo wabwinobwino wazopezeka zamafuta a metabolism.

Mphamvu ya antiatherosulinotic ya lovastatin imawonjezera mphamvu yake:

• Sinthani magwiridwe antchito amkati mwa mitsempha ya magazi - endothelium,
• letsa kukula kwa magazi kuundana,
• kuchepetsa kutupa.

Malangizo a cholesterol ochulukirapo amadziwika pambuyo pa masabata awiri. Kutsiriza komaliza kumachitika pambuyo pa masabata a 4-6 kuyambira pakumwa mapiritsi a lovastatin (ntchito yayitali). Ndi kufooka kwa Holetar, kuchuluka kwa cholesterol ndi lipoproteins kumayamba kuchuluka, kubwerera ku choyambirira. Mbali iyi ya mankhwalawa imadziwika ndi ma statins onse.

Poyerekeza ndi zina za HMG-CoA reductase inhibitors, lovastatin imayamwa pang'onopang'ono. Chiwonetsero cha Holetar chojambulidwa mu maola 2-4. Kutsika kwa gawo mpaka 10% kumachitika patsiku. Tsoka ilo, ili siliri vuto lokhalo la mankhwalawa. Amadzivulaza bwino thupi. Malinga ndi malangizo, mayankho olowa ndi 30% yokha.

Mankhwalawa amachotsedwa m'thupi ndi ndowe, mkodzo. Holetar amatha kulowa mkati mwa chotchinga. Ndi vuto la chiwindi / impso, imadziunjikira m'thupi.

Holetar: Zizindikiro zogwiritsidwa ntchito

Lovastatin imalembedwa kwa odwala omwe ali ndi cholesterol metabolism disorder omwe sanathandizidwe ndi zakudya, kuchita masewera olimbitsa thupi nthawi zonse, komanso kuchepa thupi. Zikhala zofunikira kukhumudwitsa iwo omwe akufuna kutenga mapiritsi a Holetar kuti athetse vuto la atherosclerosis, koma osakonzeka kusintha moyo wawo. Zotsatira zake za mankhwalawa ndizotheka pokhapokha mutatsatira zakudya nthawi yonse ya chithandizo.

Malinga ndi malangizo, Holetar amatengedwa kuti akonze cholesterol, LDL, triglycerides ya:

• heterozygous achibale hypercholesterolemia,
• Hypercholesterolemia ІІа, ІІв mitundu malinga ndi Fredrickson,
• Hypertriglyceridemia wosakanikirana ndi chiopsezo chokhala ndi coronary atherosulinosis.

Lovastatin tikulimbikitsidwa kuti tipewe / kuchepetsa kupitirira kwa zovuta zotsatirazi:

• atherosulinosis,
• Matenda a mtima wa Ischemic,
• vuto la mtima
• sitiroko
• maonekedwe a angina akuwukira.

Njira ya ntchito, Mlingo

Kuwongolera kuphwanya kwa mafuta a cholesterol, ndikokwanira kutenga piritsi limodzi la Holetar madzulo ndi chakudya. Pa mlingo waukulu, dokotala angalimbikitse kuswa Mlingo watsiku ndi tsiku muyezo.

Ndi Hypercholesterolemia wolimbitsa, mlingo woyambirira ndi 10-20 mg. Komabe, ngati cholesterol yaposa 7.8 mmol / L, chithandizo chimayamba ndi 40 mg. Pambuyo pa masabata 4-6, kuwongolera kwa kuphwanya malamulo kumawunikiridwa. Ngati cholesterol ikadalipo, onjezani mlingo. Mlingo wokhazikika wokhazikika ndi 20-40 mg, omwe ndi 80 mg. Pa mlingo wapamwamba kwambiri, kuchuluka kwa milingo kumawonjezereka mpaka awiri.

Malangizo ogwiritsira ntchito Holetar akutsimikiza kuti achepetse mlingo wake ngati kuchuluka kwa cholesterol kutsika pansi pa chizindikiro cha 3.6 mmol / L, ndi LDL - 1.94 mmol / L.

Chithandizo cha atherosulinosis chimayamba ndi 20-40 mg. Chovomerezeka kuwonjezera kuchuluka kwa Holetar mpaka 80 mg. Ngati kufunika komwe sikukwaniritsidwa, mankhwalawo amasinthidwa ndi analogue yamphamvu kwambiri.

Musanayambe kumwa mapiritsi a lovastatin, muyenera kukayezetsa magazi a cholesterol yonse, LDL, VLDL, HDL. Macheke obwereza amachitika pafupipafupi munthawi yonse ya chithandizo kuti awone momwe amagwirira ntchito.

Ngati wodwala atenga cyclosporine, fibrate, vitamini PP (oposa 1 g / tsiku), mlingo waukulu wa Holetar sayenera kupitirira 20 mg.

Aphwanya kwambiri chiwindi (chilolezo cha CPK chochepera 30 ml / min), Holetar amatengedwa muyezo mpaka 20 mg / tsiku.

Malangizo ogwiritsira ntchito Holetar, kufotokozera, analogi, mtengo, ndemanga

1. Mawonekedwe ndi kipimo
2. Zizindikiro
3. Contraindication
4. Zotsatira zoyipa
5. Bongo
6. Kuchita ndi mankhwala ena
7. Holetar - malangizo ogwiritsira ntchito
8. Holetar - mtengo
9. Holetar - analogues
10. Holetar - ndemanga

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

Mokulira kwa kuchuluka kwa lipid m'thupi, ntchito yamtima ndi kuzungulira kwazinthu ziwonjezereka, chiwindi ndi impso zimavutika. Kuti muchepetse kuchuluka kwa zinthu zovulaza m'thupi, muyenera kumwa mankhwala osiyanasiyana. Chimodzi mwa mankhwala othandiza kwambiri ndi choletar.

Zotsatira zoyipa

Pakhoza kukhala mutu, chizungulire, kupweteka kwam'mimba

• Kuchokera m'mimba thirakiti: kupweteka kwam'mimba, kutsekula m'mimba kapena kudzimbidwa, nseru, matenda a anorexia,
• dongosolo lamanjenje: kupweteka mutu, chizungulire, kupweteka kwa minofu ndi kupsinjika, kufooka, kusowa tulo, kusawona bwino ndi kulawa.
• kuchokera ku chiwindi: kuwonjezeka kwa bilirubin, kuchuluka kwa transaminases, alkaline fascatase ndikotheka. Kuphatikiza pazotsatira zoyipa, thupi lanu siligwirizana. Kukula kwa myopathy ndi rhabdomyolysis pambuyo pake ndikosowa kwambiri.
• dongosolo la minofu ndi mafupa akhoza kukhala chinthu choyambitsa mavuto. Mwina mawonekedwe a myalgia, minofu kukokana, myopathy, myositis, dermatomyositis. Nthawi zambiri rhabdomyolysis imayamba,
• ziwengo kumachitika ndi hypersensitivity syndrome, poyizoni epidermal necrolysis, kuyabwa pakhungu, zotupa.

Potency nthawi zina amachepetsa, kulephera kwa impso, palpitations, kupweteka pachifuwa kumayamba.

Bongo

Ngati mankhwala osokoneza bongo, mankhwalawa amathetsedwa. Zochita zimatengedwa kuti zikhale zofunikira zogwira ntchito mthupi la wodwalayo ndikuletsa kuyamwa kwa mankhwalawo. Kuti muchite izi, gwiritsani ntchito makala ngati makala kapena mankhwala ofewetsa thukuta.

Ngati pali chiopsezo chotenga myopathy ndi rhabdomyolysis, komanso kulephera kwa impso, intravenous sodium bicarbonate ndi diuretic. Hyperkalemia ikachitika, calcium chloride kapena calcium gluconate imayendetsedwa kudzera m'mitsempha. Glucose imalowetsedwa ndi insulin, ndipo nthawi zovuta, hemodialysis.

Kuchita ndi mankhwala ena

Kugwiritsa ntchito mankhwala munthawi yomweyo ndi ma anticoagulants kumawonjezera nthawi ya prothrombin, ndiko kuti, chiopsezo chotaya magazi chikuwonjezeka.

Kugwiritsa ntchito munthawi yomweyo niacin, ma macrolide opatsirana, komanso ketoconazole, clofibrate, gemfibrozil ndi cyclosporine kumawonjezera chiopsezo cha myopathy.

Kuchuluka kwa madzi a mphesa kumawonjezera kuchuluka kwa lovastatin m'magazi, zomwe zingayambitse kukula kwa myopathy.

Mtengo ndi fanizo

Analogs ndi mankhwala otsatirawa:

• Cardiostatin
• Lipoford
• Atorvastatin - Teva,
• Lovastatin,
• Apextatin.

Cardiostatin imapangidwa ndi kampani yaku Russia Nizhpharm. Zomwe zimagwira ndi lovastatin.

Apextatin amapangidwa ndi Canonfarm Production (Russia). Mankhwalawa amakhala ndi ma statins angapo. Izi zimawonjezera kugwira ntchito kwake.

Lovastatin imapangidwa ndi Lekpharm, kampani yaku Belarus. Chofunikira chachikulu ndi lovastatin.

Mtengo wa ma statins muma pharmacista osiyanasiyana amatha kukhala osiyanasiyana. Izi ndichifukwa cha kuchuluka kwa zinthu zomwe zikugwira, kuchuluka kwa mapiritsi mumsanja komanso malire a malonda.

Chifukwa cha Holetar chimakulitsa thanzi

Malinga ndi odwala, Holetar amathandizira kutsitsa kuchuluka kwa cholesterol m'magazi. Chifukwa cha zotsatira za mankhwalawa, thanzi lanu limakhala labwino komanso magwiridwe antchito amakula.

Zotsatira zoyipa

Kugwiritsa ntchito Holetar, monga mankhwala ena aliwonse, kumatha kuyambitsa zovuta zina mthupi. Malinga ndi malangizo, ziwalo zosiyanasiyana zimakhala ndi zizindikiro komanso njira zomwe ma statin angayambire.

• Pa gawo la chakudya cham'mimba: nseru, kusokonezeka kwa chifuwa, kutentha kwa pakamwa, pakamwa pouma, kupindika kapena kuchepa kwa chakudya, kumva kukomoka komanso kupweteka m'mimba (nthawi zambiri m'mimba), kuchuluka kwa michere ya chiwindi - transaminases, kapamba, hepatitis.
• Matenda a m'mitsempha komanso m'maganizo.
• Ziwalo za musculoskeletal: odwala amathandizika pamodzi ndi cyclosporine kapena vitamini PP (nicotinic acid) ndi Holetar, rhabdomyolysis imayamba. Vutoli ndi gawo lalikulu la myopathy, momwe maselo amisempha minofu amawonongeka. Zizindikiro zake zimaphatikizira kusanza, mseru, komanso kusokonezeka kwa mtima, kuphatikizapo chikomokere.
• Kuchokera kumbali ya chosakanizira chowonekera: pamaso pao pali kumverera kwa "kuthina", kuwonongeka kwa khungu, kusinthika ndi kuwonekera kwa ulusi wamitsempha yamagalasi, kusintha kwa mandala ndi kuphatikizika kwina.
• Matenda a hememopoietic: Choletar imatha kuyambitsa magazi m'thupi komanso thrombocytopenia.
• Thupi lawo siligwirizana: zotupa pakhungu, urticaria, edema, matenda a Lyell.
• Zosintha zasayansi pazakuwunikira: kuchuluka kwa lipids, alkali phosphatase, kupanga phosphokinase, bilirubin, michere ya chiwindi,
• Zina: Kukula kwa aimpso pambuyo pa rhabdomyolysis, tachycardia, kupweteka pachifuwa.

Gwiritsani ntchito pa nthawi yoyembekezera

Monga taonera malangizo omwe ali mu gawo la contraindication, panthawi yoyembekezera, poyamwitsa, Holetar sagwiritsidwa ntchito.

Chitetezo ndi kuthekera kwa mankhwala kwa ana sikunakhazikitsidwe. Chifukwa chake, Holetar sanapatsidwe ana.

Kuchita ndi mankhwala ena

Pogwirizana ndi mankhwala ena, Holetar amawonetsa zina. Malangizowo akufotokozera kuti akaphatikizidwa ndi maantibayotiki a gulu la macrolide, nicotinic acid, chiopsezo cha rhabdomyolysis chimawonjezeka. Cyclosporin imatha kuwonjezera kuchuluka kwa ma cell a metabolin m'magazi, ndikuwonjezera kawopsedwe awo. Akaphatikizidwa ndi anticoagulants, pamakhala chiwopsezo cha kukha magazi ndi magazi, popeza Holetar imakulitsa nthawi ya prothrombin nthawi ya kuchuluka kwa magazi.

Mtengo wa mankhwala

Ngakhale kugwiritsidwa ntchito kofala komanso kupezeka pafupipafupi kwa malangizo azachipatala kwa odwala a Holetar, mtengo wa mankhwalawa siwotsika kwambiri. Poyerekeza ndi anzawo a statin, mtengo wake umakhala pakati pamtengo. Kutengera ndi dera, Kholetar amatha kugulidwa pamitundu kuchokera pa ruble 290 mpaka 350 pachilichonse, ndi mulingo wa 20 mg komanso kuchokera ku ruble 350 mpaka 400 pa paketi iliyonse ndi 40 mg. Kwa okhala ku Ukraine, mtengo umasiyanasiyana pamasamba a 250 ndi 350 UAH, motero, poika Mlingo wa 20 mg ndi 40 mg. Ndikofunika kudziwa kuti kugwira ntchito kwa mankhwalawa kumavomerezeka.

Zolemba za Holetar

M'mafakisoni mutha kupeza mankhwala omwe, malinga ndi zomwe ali, ali ofanana ndi a Cholethar omwe ali ndi kusiyana kochepa muzomwe zikuwunikira komanso njira zamankhwala zomwe zimayendera. Mankhwalawa akuphatikizapo Cardiostatin, Lovastatin, Atorvastatin-Teva. Kusankhidwa kwa mankhwala ochepetsa lipid kumachitika mosamalitsa ndi dokotala waluso, pamaziko a anamnesis, kusanthula ndi mayeso ena.

Kugwiritsa Ntchito

Pafupifupi odwala onse omwe amatenga Holetar molingana ndi malangizo a dokotala kuti azitha kuyang'anira kuchuluka kwa mapangidwe a lipid, kuchuluka kwa cholesterol ndi matenda ena a cholesterol amazindikira zabwino zochizira komanso kusakhalapo kwa zotsatira zoyipa. Malinga ndi ndemanga zawo, ena adathandizanso mankhwalawo nthawi yomweyo, ndipo kale m'masiku oyambirira chithandizo, mayesowo adayamba kubwereranso mwakale, ndipo zizindikiro za hypercholesterolemia zidayamba kuchepa. Ena amati zotsatira zake zimadza pakadutsa nthawi yayitali, nthawi zina pokhapokha sabata yachiwiri kapena yachitatu yamankhwala.

Komabe, m'malo onse awiriwa, Holetar otsika okwana mafuta m'thupi ndipo imawongolera moyo ndi thanzi la odwala ndikutsata koyenera kwamalangizo onse ndi malangizo a adokotala.

Mapiritsi abwino kwambiri ochepetsa cholesterol: mndandanda ndi mitengo

Kuchuluka kwa cholesterol m'magazi a munthu kumatha kuwononga thanzi lake.

Thupi limayenda momasuka m'magazi, ndipo limatha kukhazikika pamakoma a mtima, ndikupanga malo otchedwa cholesterol plaques. Nawonso, akuwopseza kufupikitsa minyewa yamitsempha yamagazi ndikukula kwa matenda owopsa monga kugunda kwa mtima ndi sitiroko.

Mu anthu okalamba, odwala aneurysm wamitsempha, komanso mwa anthu omwe adadwala matenda a mtima kapena stroke, kufinya ziwiya kungayambitse ngozi yayikulu, ndikupangitsa kukhazikika kwa ma pathologies ena a mtima dongosolo. Kuti muchepetse chiwopsezochi, ndikofunikira kugwiritsa ntchito mankhwala omwe amachepetsa cholesterol yamagazi.

Komabe, mapiritsi a cholesterol amayenera kuyikidwa ndi katswiri wodziwa bwino. Kugwiritsa ntchito kwawo mosasamala komanso kunyalanyaza kwa contraindication kumatha kubweretsa zotsatirapo zosayembekezereka, ndikuwonjezera kwambiri mkhalidwe wa wodwalayo. Koma musaiwale kuti limodzi ndi mankhwala othandizira, kapena posafunikira, wodwalayo ayenera kuwunika menyu ake ndikusintha zina ndi zina pa moyo wake.

Momwe mungachepetse cholesterol yayikulu?

Kuti muchepetse cholesterol yamagazi, choyambirira, wodwalayo ayenera kusiya zakudya zovulaza kwambiri. Kusunganso mamvekedwe abwinobwino a mitsempha yamagazi ndikofunikanso, kotero sitiyenera kuiwala za mapindu amasewera ndi panja.

Njira yokhazikika yochiritsira yokhala ndi cholesterol yayitali ndi yayitali, ndipo wodwala ayenera kukhala wokonzekera izi. Pankhaniyi, ndikofunikira kuti wodwalayo atsatire nthawi zonse zomwe dokotala wamupangira kuti apewe mavuto, osavulaza thanzi lake.

Chifukwa chake, kuti muchepetse cholesterol yamagazi, muyenera:

• lekani zizolowezi zoyipa,
• chepetsa mchere wambiri,
• chotsani kapena kuchepetsa kuchuluka kwa mafuta omwe amadya,
• kondani mafuta az masamba m'malo mwa nyama,
• kupangitsa menyu kukhala ndi zinthu zabwino zolemera pamanyowa,
• imwani chakudya chokwanira,
• Onetsetsani kuti muphatikiza zakudya zomwe zili ndi asidi ochulukirapo mu zakudya zanu.

Mndandanda wazinthu zoletsedwa ukuphatikizapo:

• mitundu yosiyanasiyana ya soseji (kuphatikizapo soseji ndi masoseji),
• makeke
• kuphika,
• makeke
• masikono.

Gulu

1. Anion-exchange resins ndi mankhwala omwe amachepetsa mayamwidwe (mayamwidwe) a cholesterol m'matumbo.
2. Nicotinic acid
3. Khalid.
4. Fibates.
5. Statins (3-hydroxymethyl-glutaryl-coenzyme-A-reductase inhibitors).

Kutengera ndi makina amachitidwe, mankhwalawa kuti muchepetse cholesterol yamagazi amatha kugawidwa m'magulu angapo.

Mankhwala omwe amalepheretsa kuphatikizika kwa atherogenic lipoproteins ("cholesterol yoyipa"):

• ma statins
• mafupa
• nicotinic acid
• phenucol
• ezinflavin.

Zomwe zimapangitsa kuti muchepetse kuyamwa kwa cholesterol ku chakudya m'matumbo:

• otsatizana a bile acid,
• kuwongolera.

Lipid metabolism okonza omwe amachulukitsa "cholesterol yabwino":

Otsatira a bile acid

Mankhwala omangira a acid (cholestyramine, colestipol) ndi ma resin osinthana ndi anion. Akangokhala m'matumbo, "amagwira" ma asidi a bile ndikuwachotsa m'thupi. Thupi limayamba kusowa ma bile acid, ofunikira kuti magwiridwe antchito azigwira bwino ntchito. Chifukwa chake, mu chiwindi, njira yophatikiza iwo kuchokera ku cholesterol imayamba. Cholesterol "imatengedwa" m'magazi, chifukwa chake, kumangika kwake kumachepa.

Cholestyramine ndi colestipol amapezeka amtundu wa ufa. Mlingo wa tsiku ndi tsiku uyenera kugawidwa mu 2 kapena 4 Mlingo, womwe umamwetsa mankhwala mu madzi (madzi, madzi).

Maini osinthanitsa ndi anion samayikidwa m'magazi, amangogwira m'matumbo a lumen. Chifukwa chake, ali otetezeka kwambiri ndipo alibe zotsatira zoyipa zosafunikira. Akatswiri ambiri amakhulupirira kuti ndikofunikira kuyambitsa chithandizo cha hyperlipidemia ndi mankhwalawa.

Zotsatira zoyipa zimaphatikizira kutulutsa, mseru komanso kudzimbidwa, m'malo ochepera. Kuti mupewe zizindikiro zotere, ndikofunikira kuwonjezera kuchuluka kwa madzimadzi ndi fiber fiber (fiber, chinangwa). Pogwiritsa ntchito mankhwalawa kwa nthawi yayitali, mwina pali kuphwanya mayankho mu matumbo a folic acid ndi mavitamini ena, makamaka osungunuka.

Mankhwala omwe amapondereza matumbo a cholesterol

Mwakuchepetsa kuyamwa kwa cholesterol ku chakudya m'matumbo, mankhwalawa amachepetsa kuyika kwake m'magazi. Chothandiza kwambiri pagululi ndalamazi. Ndi mankhwala azitsamba ochokera ku mbewu za nyemba za hyacinth. Muli ndi polysaccharide yosungunuka m'madzi, yomwe imapanga zonunkhira pakakumana ndi madzi m'matumbo a lumen.

Guarem amangochotsa mamolekyulu a cholesterol kukhoma lamatumbo. Imathandizira kuchotsedwa kwa ma asidi a bile, zomwe zimayambitsa kuwonjezeka kwa cholesterol kuchokera m'magazi kupita m'chiwindi chifukwa cha kaphatikizidwe kake. Mankhwala amachepetsa kudya ndipo amachepetsa kuchuluka kwa zakudya zomwe zimadyedwa, zomwe zimapangitsa kuti achepetse thupi komanso milomo ya lipid m'magazi. Guarem imapangidwa m'migulu yamagalimoto, yomwe imayenera kuwonjezeredwa ndi madzi (madzi, madzi, mkaka). Kumwa mankhwalawa kuyenera kuphatikizidwa ndi mankhwala ena a antiatherosselotic.

Zotsatira zoyipa zimaphatikizira kutulutsa, mseru, kupweteka m'matumbo, komanso nthawi zina zotayirira. Komabe, zimawonetsedwa pang'ono, sizichitika kawirikawiri, ndikumapitilira mankhwala zimadalira palokha.

Holetar - malangizo ogwiritsira ntchito

Bweretsani choncho:

• Mapiritsi amatengedwa pakamwa ndikutsukidwa ndi madzi ambiri.
• Mlingo ndi nthawi yayitali ya mankhwala amatsimikiziridwa ndi dokotala. Nthawi zambiri, dokotala amakupatsani piritsi limodzi pakudya, ngati kuli kotheka, dokotalayo amatha kuwonjezera kuchuluka kwake (koma osapitirira 80 mg wa lovastatin patsiku).
• Ndi kuchepa kwamphamvu kwa mafuta m'thupi (mpaka 1400 mg pa 1 lita) kapena lipoproteins yotsika (mpaka 750 mg pa 1 lita), ndikofunikira kuchepetsa kuchuluka kwa choletar.
• Kuti akwaniritse achire kwenikweni, wodwalayo ayenera kutsatira zakudya zapadera zotsika mu cholesterol.
• Mukatenga choletar, kusintha kwa ntchito ya michere ya chiwindi kumachitika, komabe, kusinthaku nthawi zambiri kumakhala kopanda tanthauzo. Komabe, madokotala ambiri amalangizira kuti ayang'anenso ntchito ya ma enzymes panthawi ya chithandizo mothandizidwa ndi choletar, kuti apewe kuyambitsa zovuta.
• Zotsatira zoyipa zimachitika, kutsitsa kwa magazi kapena kuchepa kwathunthu kotenga cholera ndikotheka.
• Holetar sichikhudzanso kuchuluka kwa momwe angachitire, choncho imatha kutengedwa ndi oyendetsa, oyendetsa ndege ndi anthu ena omwe ntchito yawo imafuna kuchitapo kanthu mwachangu.

Holetar - mtengo

Holetar amagulitsidwa phukusi laling'ono lomwe lili ndi zigawo ziwiri za mapiritsi 10. Mtengo wake umatengera dera ndi mtundu wa mapiritsi:

• Okhala ku Moscow adzayenera kulipira 290 (20 mg ya lovastatin) ndi ma ruble 350 (40 mg wa lovastatin) pa phukusi limodzi,
• Okhala ku St. Petersburg phukusi limodzi adzalipira 330 (20 mg ya lovastatin) ndi ma ruble 360 ​​(40 mg wa lovastatin),
• Okhala ku Novosibirsk azilipira 350 (20 mg wa lovastatin) ndi ma ruble 400 (40 mg wa lovastatin) pa paketi imodzi,
• Okhala ku Ukraine phukusi limodzi adzapatsidwa 250 (20 mg ya lovastatin) ndi 350 hryvnia (40 mg wa lovastatin).

Holetar - analogues

Mankhwala otsatirawa akupezeka omwe ali ofanana ndi holitar:

• Apextatin. Kupanga kumachitika ndi kampani yaku Russia ya Canonfarm Production. Kuphatikizidwa kwa mankhwalawa kumaphatikizapo kuchuluka kwa ma statins, omwe amachepetsa bwino kuchuluka kwa cholesterol m'magazi. Pamapiritsi 20, muyenera kupereka ma ruble 230-280.
• Cardiostatin. Kupanga kumachitika ndi kampani yaku Russia Nizhpharm. Chofunikira chachikulu ndi lovastatin. Pamapiritsi 20, muyenera kulipira ma ruble 250-300.
• Lovastatin. Kampani ya Belarus Lekpharm ikuchita kupanga. Chofunikira chachikulu ndi lovastatin. Pamapiritsi 20, muyenera kulipira ma ruble a 150-300.

Tulip - malangizo ogwiritsira ntchito

Tulip ndi mankhwala omwe ali m'gulu lamankhwala ochepetsa lipid: ma statins (reductase inhibitors) a m'badwo wachinayi. Ngakhale kukana kugawidwa m'mibadwo ya ma statins ndi gulu laposachedwa kwambiri la mankhwala chifukwa chofanana ndi zomwe zimachitika mthupi la munthu, tulip m'magawo ambiri a labotale imaposa mphamvu ya ma kuchepetsa ochepa. Zitsanzo: 20 mg ya tulip imagwirizana ndi 35 mg ya lovastatin kapena 40 mg ya fluvastatin. Izi ndizofunikira kuziganizira popereka mankhwala.

Pansipa adzapatsidwa malangizo ogwiritsira ntchito mankhwalawa Tulip, omwe amalola kuti azitha kudziwa kugwiritsa ntchito mapiritsi a matenda osiyanasiyana komanso zokhudzana ndi matenda okhudzana ndi matenda kapena / kapena zomwe zimachitika motsutsana ndi maziko ambiri a cholesterol oyipa.

Kupanga ndi mawonekedwe a kumasulidwa

Tulip ndi mankhwala ogwiritsira ntchito pakamwa monga mawonekedwe a mapiritsi a mitundu yosiyanasiyana, ya film-yokutira. Mlingo wa mapiritsi: 10 mg, 20 mg, 40 mg. Chiwerengero cha mapiritsi ali mu phukusi: ma 30 ma PC, 60 ma PC., Ma 90 ma PC. Mlingo ndi kuchuluka kwake kumakhala kotheka kuti apatsidwe mankhwala.

Zogwira pophika: atorvastatin mu mawonekedwe amchere wamchere. Omwe amaphatikizidwa ndi piritsi ndi ating kuyanika kwa filimu: lactose monohydrate, cellulose m'mitundu ingapo yama cell, polysorbate, titanium dioxide (mtundu wina wa chakudya womwe ungagwiritsidwe ntchito, kutengera wopanga mankhwalawo).

Pharmacodynamic ndi pharmacostatic kanthu

Masauzidwe amkamwa ndi m'mero ​​ndi ochepa kwambiri (osapitirira 2%) chifukwa cha kupezeka kwa nembanemba yoteteza. Mafuta osachepera 98% amapezeka m'matumbo am'mimba. Ndi gawo la mankhwalawa omwe ali ndi mayamwa ambiri. Kuchepetsa kuyamwa kumadziwika pakumwa mankhwalawo ndi chakudya, kapena pakatha mphindi 30 mutatha kudya.

Kudya sikukhala ndi tanthauzo lalikulu, chifukwa sikukhudza kuzungulira kwa zinthu zomwe zimagwira mthupi. Pazitali zambiri za atorvastatin m'madzi am'magazi zimawonedwa pafupifupi maola 1.5 mutatha kumwa mankhwalawa.

Izi ndichifukwa choti chidwi chogwira ntchito m'magazi am'magazi pakumwa mapiritsi madzulo chimakhala chochepa kwambiri poyerekeza ndi chizindikiro chomwecho mukamamwa mankhwalawa m'mawa, 25-25%. Ngati wodwalayo ali ndi matenda a chiwindi (makamaka uchidakwa kapena mankhwala osokoneza bongo), kuchuluka kwambiri kwa atorvastatin m'madzi am'magazi kungadutse kupitirira nthawi 16, komwe ndi kowopsa kwa moyo ndi thanzi. Komabe, matenda a chiwindi sikuti amatsutsana kwathunthu ndi kumwa kwa Tulip, koma ndikofunikira kuti mupereke mankhwala a chakudya chamadzulo mutatha kudya komanso pamlingo wotsika kwambiri.

Kukhathamiritsa kwa mayamwidwe kumachitika ndi kukhalapo kwa kanema wofulumira wotsegulira pamapiritsi. Sitikulimbikitsidwa kuthyola mapiritsi, chifukwa imathandizira kuyamwa ndikupangitsa kuti pakhale kugawa kosagwirizana kwa madzi a m'magazi, omwe angayambitse kuchuluka kwa zinthu zosafunikira. Mlingo umakhudza mwachangu kuchuluka kwa kuyamwa: mankhwalawa ndi okwera kwambiri.

Monga atorvastatin imalowetsedwa ndi mucous membrane wamatumbo, chinthu chogwira ntchito chimalowa m'madzi am'magazi, pomwe amapanga mgwirizano wamphamvu ndi mapuloteni. Ndipo pali mayendedwe kudutsa thupi kudzera m'magazi ndikugawa zotumphukira. Tulip ali ndi digirii yambiri yomanga mapuloteni a plasma - mpaka 99%.

Poyerekeza ndi zomwe tikulephera kusintha kwa reductase (HMG-CoA) ndi kuponderezana kwa kaphatikizidwe ka cholesterol, pali kuchuluka kwa ziwonetsero za chiwindi zomwe zimayang'ana kuperewera kwa lipoproteins (LDL). Ma receptor, amathandizanso kuti LDL itenge, zomwe zimachepetsa kuchuluka kwa cholesterol yoyipa m'thupi la munthu. Mwakapangidwe, mapangidwe a mitundu yosiyanasiyana ya zinthu zomwe zimachitika machitidwe a atorvastatin akhoza kuwonetsedwa motere:

• Peresenti yayikulu ya kutsika kwathunthu kwa cholesterol m'thupi: 28 - 45%.
• Peresenti yayikulu ya kuchepa kwathunthu kwa ndende ya LDL m'thupi: 40 - 65%.
• Wapakati peresenti ya kuchepa kwathunthu kwa ndende ya apoliprotein B m'thupi: 30 - 50%.
• Wapakati peresenti ya kuchepa kwathunthu kwa ndende ya TG mthupi: 12 - 35%.
• Wapakati peresenti ya kuchuluka kwathunthu kwa kuchuluka kwa osalimba a lipoproteins (HDL) m'thupi: 10 - 35%.
• Pafupifupi kuchuluka kwazomwe zimapangitsa kuti apiloprotein A akhale ndi thupi: 12 - 35%.

Ambiri omwe amagwira ntchito ya mankhwala amapezeka mu chiwindi. Extrahepatic metabolism nthawi zambiri simapitilira 10%. Hafu ya moyo ndi maola 14. Komabe, kufalitsidwa kwa metabolites, kulola kukhalabe ndi ochizira komwe kumayenderana ndi kuletsa kwa kuchepetsa, kumapitirira kwa maola 20 mpaka 30. Excretion imachitika ndi ndowe (zopitilira 96%) ndi mkodzo (mpaka 4%). Kupanga kumakhala kocheperako ndipo kumawonedwa makamaka ndi maphunziro othandizira omwe amapitilira miyezi 6. Palibe zoposa 1%.

Mlingo ndi makonzedwe

Njira ya mankhwalawa imayenera kugwiritsidwa ntchito ngati gawo limodzi silikupereka chithandizo chambiri. Kutalika kwa maphunzirowa amasankhidwa kutengera mtundu wa matenda / matenda, cholinga (chithandizo ndi kupewa) ndi zomwe wodwalayo ali nazo. Kutalika kwa maphunzirowa, kutengera mtundu wa matenda ndi cholinga chomwe chingaperekedwe, chitha kuyimiriridwa motere:

• Therapy ya mtima: miyezi 12 mpaka 48
• Kupewa matenda a mtima: kuyambira 3 mpaka 36 miyezi.
• Chithandizo cha matenda ashuga: kuyambira miyezi 12 mpaka 26.
• Kupewa kwa matenda ashuga: kuyambira 6 mpaka 18 miyezi.
• Chithandizo cha matenda oopsa: kuyambira 3 mpaka 18 miyezi.
• Kupewa matenda oopsa: kuyambira 2 mpaka 12 miyezi.
• Chithandizo cha lipids zamitundu yosiyanasiyana, chosavuta ndi matenda ena kapena ma pathologies: kuyambira 6 mpaka 36 miyezi.
• Kupewa kwa mitundu yosiyanasiyana ya lipids, yosavuta ndi matenda ena kapena ma pathologies: kuyambira milungu iwiri mpaka itatu.
• Chithandizo cha kunenepa: kutengera siteji kuyambira miyezi isanu ndi umodzi mpaka itatu.
• Kupewa kunenepa kwambiri pamaso pa zinthu zofunika kuchita chifukwa cha kusokonekera kwa kagayidwe kazakudya kapena ma elekitirodi a madzi mu thupi: kuyambira miyezi itatu mpaka itatu.

Lemberani kugwiritsa ntchito mankhwalawa kamodzi kapena kawiri pa tsiku. Kukhazikitsidwa kwa "Tulip" sichizindikiro chothetsa mankhwala osagwiritsa ntchito mankhwala. "Tulip" cholinga chake ndicho kuwonjezera mphamvu ya zakudya zamankhwala zokhala ndi lipid komanso magulu azolimbitsa thupi. Ndi njira yayitali yothandizira, tikulimbikitsidwa kuti muyambe ndi kuchuluka kwa 10 mg kenako ndikuchulukitsa mpaka 80 mg pang'onopang'ono wowunika kwa plasma cholesterol ndi hepatic transaminases. Ndi njira yayitali ya prophylactic, timalimbikitsidwanso kuti muyambe kumwa mankhwalawa ndi 10 mg, koma kuwonjezera kuchuluka kwa 80 mg sikofunikira. Mlingo wa Tulip kutengera matendawa ungathe kuyimiridwa motere:

• Hyperlipidemia ya mitundu yosiyanasiyana (kupatula kwa homozygous cholowa hypercholesterolemia), yopanda zovuta ndi matenda ena kapena ma pathologies: masabata awiri oyamba, mlingo umodzi wa Tulip mu mlingo wa 10 mg. Kenako, kuyesedwa kwa matenda kuyenera kuchitidwa kuti tiwone momwe achire amathandizira. Ndi zizindikiro zokwanira, mulingo umachulukitsidwa mpaka 20 mg ndipo matendawa amachitika pakatha milungu iwiri.Kutengera ndi zomwe zapezeka: mlingo umasungidwa pa 20 mg (ndi njira yokwanira yothandizira), mlingo umakulitsidwa mpaka 40 mg (osakwanira achire), mlingo umachepetsedwa mpaka 10 mg (ngati zotsatira zoyipa zimachitika). Pa mlingo waukulu wa 80 mg kamodzi patsiku, Tulip sanadziwike osapitirira miyezi itatu atangoyamba kumene chithandizo.
• Homozygous hypercholesterolemia wa mtundu wobadwa nawo. Lamula ndi kusunga mlingo wonse wa mankhwala - 80 mg. Mlingo wocheperako sapereka achire wokwanira. Mlingo umodzi wa Tulip tikulimbikitsidwa madzulo atatsala pang'ono kugona. Pazifukwa zoyipa ndi kusungidwa kwazopitilira milungu iwiri, ndikofunikira kuletsa mankhwalawo ndikusintha ndi analogues.
• Matenda a mtima wamunthu. Mlingo woyambirira ndi 10 mg kamodzi tsiku lililonse m'mawa mutadzuka. Pakatha mwezi umodzi, kuchuluka kwa mpaka 20 mg kumaloledwa - kumwa kawiri pa tsiku kwa 10 mg m'mawa ndi madzulo. Cholesterol ndi hepatic transaminases ziyenera kuyang'aniridwa kamodzi pamwezi. Kutengera ndi zomwe zapezeka, mlingo umasinthidwa. Mlingo waukulu: 80 mg mu mgawo iwiri yogawika m'mawa ndi madzulo.
• Kupewa matenda osiyanasiyana ndi matenda a pathological: koyamba Mlingo - 10 mg. Mlingo waukulu kwambiri ndi Tulip 20 mg. Mankhwala mlingo wa 20 mg amaloledwa kugwiritsidwa ntchito osapitirira mwezi umodzi chiyambire maphunziro ake.

Kuchita ndi mankhwala ena

• Ma antibiotic mankhwala "Erythromycin" ndi "Clarithromycin." Nthawi yomweyo kumwa mankhwalawa limodzi ndi Tulip kumabweretsa chiwopsezo cha atorvastatin m'madzi am'magazi a anthu pafupifupi 50%. Ngati kuli kofunikira kuti mupereke mankhwala othandizira awa, mulingo wa Tulip uyenera kuchepetsedwa.
• Hypolipidemic mankhwala a gulu la mankhwala ena kupatula ma statins. Chiwopsezo chokhala ndi myopathy ndi rhabdomyolysis chikuchulukitsidwa.
• Njira zakulera za pakamwa zomwe zimakhala ndi ethinyl estradiol kapena norethisterone. Pali kuwonjezeka kwa kuchuluka kwa zosakaniza za kulera m'thupi mwa 20 - 40%, komwe kumayambitsa kusalingana kwa mahomoni. Komabe, kuchepetsa kuchuluka kwa njira zakulera kungapangitse chitetezo chosakwanira. Pankhaniyi, tikulimbikitsidwa kusankha njira zina zakulera panthawi ya chithandizo ndi Tulip.
• Mankhwala a antimycotic a gulu la azole. Pali kuwonjezeka kwa kuchuluka kwa atorvastatin m'madzi am'magazi pafupifupi 35%.
• Mankhwala a gulu la ma antacid. Kutsika kwa kuchuluka kwa atorvastatin m'magazi a anthu ndi 30-40% kunadziwika.
• Cyclosporin. Kugwiritsa ntchito pamodzi ndi Tulip, kumatha kukulitsa kuchuluka kwa atorvastatin mthupi la munthu ndi 6 mpaka 10, kutengera mlingo wa mankhwalawa. Kuphatikiza kwa mankhwalawa sikuloledwa.
• HIV protease inhibitors, kukonzekera kwa nicotinic acid, ma fibrate - kumawonjezera chiopsezo cha myopathy.
• Madzi a mphesa. Kugwiritsa ntchito msuzi wa mphesa mu kipimo cha lita imodzi patsiku kwa masiku asanu kapena malita 0,5 patsiku kwa sabata kungakulitse kuchuluka kwa yogwira "Tulipa". Pankhaniyi, ndikulimbikitsidwa kuti nthawi yamankhwala "Tulip" asiye kugwiritsa ntchito madzi a mphesa.

Zotsatira zoyipa ndi bongo

Kuopsa kwa zotsatirapo zake ndi 10%: kusintha kwa matupi a mitundu yosiyanasiyana (zotupa, kuyabwa, kupsinjika kwapakati, kupuma, chizungulire, zizindikiro za kukomoka, mseru, kudzimbidwa kapena kutsekula m'mimba, kupweteka kumbuyo) kutupa pang'ono), hyperglycemia.

Kuopsa kwa mavuto kuchokera ku 1% mpaka 10%: kusowa tulo, kufooka, kufooka kwakanthawi, kumva kuchepa kwa chidwi, hepatitis, matenda a anorexia ndi zina zofananira, kugwirira ndi tinnitus, kuchepa kwakanthawi kwa masomphenya, hypoglycemia, kutentha thupi .

Kuopsa kwa mavuto obwera mpaka 1%: kugwedezeka kwa anaphylactic, kukumbukira kukumbukira, matenda osokoneza bongo, kuwonongeka kwa minofu (nthawi zambiri ndikudziwonetsa kumbuyo), kuwonongeka kwa chiwindi.

Ndi osowa. Chifukwa chomangika kwambiri pa mankhwala omwe amapezeka m'mapuloteni a plasma, kugwiritsa ntchito hemodialysis sikupereka chofunikira. Mankhwala othandizira amachita.

Anastasia, wazaka 34, mkazi wa m'nyumba

Masana abwino Ndikufuna kusiya ndemanga yanga pamapiritsi a Tulip. Ndinatembenukira kwa dotolo wokhala ndi vuto la kunenepa kwambiri. Zakudya zomwe adayambitsa sizinabweretse zotsatira zoyenera - poyamba adataya mapaundi ochepa, koma patapita kanthawi mapaundiwo anabwerera. Zotsatira zake, ndinatumizidwa kukayezetsa matenda osiyanasiyana, zomwe zinandipatsa chithunzi chonse - ndinali ndi cholesterol ndendeyi kangapo kuposa masiku onse. Anandipatsa mtundu wina wa zakudya - ndikugogomezera zakudya zopanda mafuta ambiri komanso zakudya zomwe zimathandiza kuchepetsa mafuta m'thupi. Mapeto ake adakhalanso opanda ntchito. Wopezekapo adapereka maphunziro a miyezi isanu ndi umodzi a chithandizo cha Tulip. Ndinatenga 10 mg kawiri patsiku. Sindinakane zakudya zotchulidwa. Pambuyo pa miyezi itatu, zinali zotheka kudutsa momwe kilogalamuyo idabwerako. Pambuyo pakupuma kwa mwezi umodzi, maphunziro a pachaka a "Tulip" adakhazikitsidwa, kupitiliza kwa zakudya ndi magwiridwe olimbitsa thupi. Mpaka pano, vuto la kunenepa kwambiri latha, koma ndikupitiliza chithandizo pamankhwala a dokotala, popeza padatsala miyezi pafupifupi itatu.

Dmitry Ivanovich Krasnov, wazaka 67, adapuma pantchito

Tulip adandiuza adokotala, pambuyo poti Lovastatin wofatsa sanabweretse zotsatira zoyenera. Tulip anathandiza kwambiri kutsitsa cholesterol, adotolo adati. Ndipo ndinamva kupumula kwa maphunziro a ISHB. Ziwopsezo zimacheperachepera m'mwezi wachinayi wogwiritsa ntchito mankhwalawa. Pamodzi, ndidatenga metaprolol ngati mukumva ngati kuti ndili ndi bizinesi. Ubwino wina ndikuti mtengo wake unali wovomerezeka.