Atorvastatin-Teva ndi mankhwala a hypolipidemic. Njira yogwiritsira ntchito mankhwala ochepetsa lipid ndikuchepetsa kuchuluka kwa cholesterol "yoyipa", komanso kuchuluka kwa triglycerides ndi lipoprotein a kachulukidwe kotsika komanso kotsika kwambiri. Nawonso, amachulukitsa kuchuluka kwa lipoprotein yapamwamba kwambiri ndi cholesterol "yabwino".
Atorvastatin-Teva amapezeka mu mawonekedwe a mapiritsi oyera okhala ndi mafilimu. Zolemba ziwiri zidalemba pazolemba zawo, chimodzi mwa izo ndi "93", ndipo chachiwiri chimatengera mlingo wa mankhwalawo. Ngati mulingo uli 10 mg, ndiye kuti "7310" yalembedwa, ngati 20 mg, ndiye "7311", ngati 30 mg, ndiye "7312", ndipo ngati 40 mg, ndiye "7313".
Chofunikira chachikulu cha Atorvastatin-Teva ndi calcium atorvastatin. Komanso, kapangidwe kamankhwala kamaphatikizanso zinthu zina zowonjezera, zothandizira. Izi zimaphatikizapo, mwachitsanzo, lactose monohydrate, titanium dioxide, polysorbate, povidone, alpha-tocopherol.
Limagwirira a Atorvastatin-Teva
Atorvastatin-Teva, monga tafotokozera kale kumayambiriro, ndi wothandizika ndi lipid. Mphamvu zake zonse amakhala ndi zolepheretsa, ndiye kuti, kuletsa kuchita kwa enzyme pansi pa dzina la HMG-CoA reductase.
Udindo waukulu wa enzyme iyi ndikuwongolera mapangidwe a cholesterol, popeza mapangidwe ake oyang'anira, mevalonate, kuchokera ku 3-hydroxy-3-methyl-glutaryl-coenzyme A. amapezeka koyamba. Cholesterol yosakanikirana, pamodzi ndi triglycerides, imatumizidwa ku chiwindi, komwe imaphatikizana ndi lipoproteins yotsika kwambiri. . Wopangidwayo amapita m'madzi a m'magazi, kenako ndi mphamvu yake amaperekedwa ku ziwalo zina.
Ma lipoproteins otsika kwambiri amamasulidwa kukhala otsika osalimba lipoproteins polumikizana ndi ma receptor awo. Zotsatira zake, izi zimachitika, ndiye kuti kuwola.
Mankhwala amachepetsa kuchuluka kwa cholesterol ndi lipoproteins m'magazi a odwala, kuletsa mphamvu ya enzyme ndikuchulukitsa kuchuluka kwa zolandilira m'chiwindi kwa lipoproteins yotsika. Izi zimathandizira kuti azigwira komanso kutaya zinthu zambiri. Njira ya kapangidwe ka lipoproteins atherogenic imachepetsedwa kwambiri. Kuphatikiza apo, kuchuluka kwachulukidwe lipoprotein cholesterol kumachulukanso ndipo triglycerides imachepa limodzi ndi apolipoprotein B (mapuloteni onyamula).
Kugwiritsidwa ntchito kwa Atorvstatin-Teva kumawonetsa zotsatira zabwino pochizira osati atherosulinosis, komanso matenda ena ogwirizana ndi lipid metabolism, momwe mitundu ina yotsatsira lipid yotsika sikunathandize.
Zinapezeka kuti chiopsezo chotenga matenda omwe amalumikizana ndi mtima ndi mitsempha ya magazi, monga matenda amtima komanso minyewa, amachepetsa kwambiri.
Pharmacokinetics a Atorvastatin-Teva
Mankhwalawa amatengeka mwachangu. Kwa pafupifupi maola awiri, kuchuluka kwakukulu kwa mankhwalawa kulembedwa m'magazi a wodwala. Mafuta, kapena kuti, mayamwidwe, amatha kusintha liwiro lawo.
Mwachitsanzo, imatha kutsika ndikumwa mapiritsi ndi chakudya. Koma ngati mayamwidwe atachedwa, ndiye kuti sizikhudza mphamvu ya Atorvastatin mwanjira iliyonse - cholesterol imapitilirabe kuchepa kutengera mlingo. Mukalowa m'thupi, mankhwalawa amapezeka m'matumbo am'mimba. Amamangidwa kwambiri ndi mapuloteni a plasma - 98%.
Kusintha kwakukulu kwa metabolic ndi Atorvastatin-Teva kumachitika m'chiwindi chifukwa kukhudzana ndi isoenzymes. Zotsatira zake, izi zimapangidwa, zomwe zimayambitsa zoletsa za HMG-CoA. 70% yazotsatira zonse za mankhwalawa zimachitika molondola chifukwa cha ma metabolites awa.
Atorvastatin amachotsedwa m'thupi ndi hepatic bile. Nthawi yomwe kukhazikika kwa magazi m'magazi kudzakhala wofanana ndi theka la zoyambirira (zotchedwa theka-moyo) ndi maola 14. Zotsatira za enzyme zimatha pafupifupi tsiku. Palibe zopitilira ziwiri peresenti ya kuchuluka zovomerezeka zomwe zingatsimikizidwe mwa kupenda mkodzo wa wodwala. Kwa odwala omwe ali ndi vuto la impso, ayenera kukumbukiridwa kuti pa hemodialysis Atorvastatin sasiya thupi.
Kuchuluka kwa mankhwalawa kumaposa zomwe 20% zimachitika mwa amayi, ndipo kuchuluka kwake kumachepetsedwa ndi 10%.
Odwala omwe ali ndi vuto la chiwindi chifukwa chomwa mowa kwambiri, kuchuluka kwambiri kumawonjezeka nthawi 16, ndipo kuchuluka kwa chimbudzi kumatsika ndi 11, mosiyana ndi chizolowezi.
Zizindikiro ndi contraindication kuti mugwiritse ntchito
Atorvastatin-Teva ndi mankhwala omwe amagwiritsidwa ntchito kwambiri masiku ano.
Chithandizo cha matenda aliwonse omwe ali pamwambapa ndi kuchitika zimachitika ndikumangodya zakudya zomwe zimathandiza kuchepetsa magazi a cholesterol (okwera masamba ndi zipatso, nthangala, zitsamba, zipatso, nsomba zam'madzi, nkhuku, mazira), komanso popanda zotsatira zoyambira kale ntchito mankhwala.
Pali zisonyezo zingapo momwe adatsimikizira kuti ndiwothandiza:
- atherosulinosis;
- chachikulu hypercholesterolemia;
- heterozygous achibale komanso osakhala aubanja hypercholesterolemia;
- mtundu wosakanizidwa hypercholesterolemia (mtundu wachiwiri malinga ndi Fredrickson);
- okwera triglycerides (mtundu wachinayi kutengera Fredrickson);
- kusagwirizana kwa lipoproteins (mtundu wachitatu malinga ndi Fredrickson);
- homozygous achibale hypercholesterolemia.
Palinso zolakwika zingapo pakugwiritsa ntchito Atorvastatin-Teva:
- Matenda a chiwindi mu gawo logwira kapena gawo lakuchulukirachulukira.
- Kuchulukitsidwa kwa kuchuluka kwa ma hepatic sampuli (ALT - alanine aminotransferase, AST - aspartate aminotransferase) kuchulukanso katatu, popanda zifukwa zomveka;
- Kulephera kwa chiwindi.
- Mimba komanso kuyamwa.
- Ana a misinkhu yaying'ono.
- Mawonetseredwe a thupi lawo pamene mutenga chilichonse chomwe chimapanga mankhwalawo.
Nthawi zina, mapiritsiwa ayenera kuikidwa mosamala kwambiri. Izi ndi milandu monga:
- kumwa kwambiri mowa;
- concomitant chiwindi matenda;
- kusowa kwa mahomoni;
- kusakhazikika kwa ma elekitirodi;
- kagayidwe kachakudya matenda;
- kuthamanga kwa magazi;
- pachimake matenda opatsirana;
- khunyu yopanda kuchitidwa;
- ntchito zochulukirapo ndi kuvulala koopsa;
Kuphatikiza apo, kusamala mukamwa mankhwalawa kuyenera kuchitidwa pamaso pa matenda a minofu.
Malangizo ogwiritsira ntchito mankhwalawa
Mlingo wa mankhwala umatsimikiziridwa ndi matenda oyamba omwe amafunikira chithandizo, kuchuluka kwa cholesterol, lipoproteins ndi triglycerides. Komanso, momwe odwala amathandizira pakumwa kosalekeza amakumbukiridwa nthawi zonse. Nthawi yakumwa mankhwalawa sizimadalira chakudya. Muyenera kumwa piritsi limodzi kapena kupitilirapo (kutengera zomwe dokotala wakupatsani) kamodzi patsiku.
Nthawi zambiri, kugwiritsa ntchito Atorvastatin-Teva kumayamba ndi 10 mg. Komabe, kumwa koteroko sikugwira ntchito nthawi zonse, chifukwa chake mankhwalawa akhoza kuchuluka. Chovomerezeka chachikulu ndi 80 mg patsiku. Ngati kuwonjezeka kwa mlingo wa mankhwalawa kumafunikabe, ndiye limodzi ndi njirayi, kuwunika kawirikawiri mawonekedwe a lipid kuyenera kuchitika ndipo mankhwala ayenera kusankhidwa mogwirizana ndi iwo. Sinthani njira ya chithandizo ndikofunikira mopitilira kamodzi pamwezi.
Cholinga chachikulu cha mankhwalawa ndikuchepetsa cholesterol kukhala yokhazikika. Muyezo wa cholesterol yathunthu m'magazi ndi 2.8 - 5.2 mmol / L. Tiyenera kukumbukira kuti kwa odwala omwe ali ndi vuto la chiwindi, pangafunike kuchepetsa mlingo kapena kusiya kugwiritsa ntchito mankhwalawo.
Zotsatira zoyipa za mankhwalawa
Pogwiritsa ntchito Atorvastatin-Teva, zimachitika zingapo zosiyanasiyana kuchokera ku ziwalo zosiyanasiyana ndi ziwalo. Zotsatira zina zoyipa ndizambiri.
Kati ndi zotumphukira mantha dongosolo: kusokonezeka tulo, mutu, kusokonezeka kwa chikumbumtima, kufooka, kuchepa kapena kusokoneza kwamalingaliro, neuropathy.
M`mimba thirakiti: m'mimba kupweteka, kusanza, kutsegula m'mimba, kupanga mpweya wambiri, kudzimbidwa, kudzimbidwa, chiwindi ndi kapamba, jaundice komwe kumakhudzana ndi kusayenda kwa ndulu, kutopa.
Musculoskeletal system: kupweteka kwa minofu, makamaka minyewa yam'mbuyo, kutupa kwa minyewa yam'mimba, kupweteka kwa molumikizana, rhabdomyolysis.
Mawonetseredwe A ziwonetsero: mwa mtundu wa zotupa pakhungu mu mawonekedwe a urticaria, kuyimitsidwa, matupi awo sagwirizana ndi mawonekedwe anaphylactic, kutupa.
Hematopoietic dongosolo: kuchepa kwa kuchuluka kwa mapulosi.
Machitidwe a metabolism: kuchepa kapena kuwonjezeka kwa shuga m'magazi, kuwonjezeka kwa ntchito ya enzyme yotchedwa creatine phosphokinase, edema ya malekezero apamwamba ndi otsika, kulemera.
Ena: kuchepa kwa potency, kupweteka pachifuwa, kusakwanira kwa ntchito yaimpso, kukhazikika kwa dazi, kufalikira.
Mwa ma pathologies ndi zochitika zina, Atorvastatin-Teva iyenera kuyikidwa mosamala kwambiri, mwachitsanzo:
- Kuledzera;
- Matenda a chiwindi;
- Kuchulukitsidwa kwa mayesero a chiwindi popanda chifukwa chodziwikiratu;
Kusamala kumafunikiranso mukamamwa mankhwala ena a anticholesterolemic, maantibayotiki, ma immunosuppressants, ndi mavitamini ena.
Kuchita ndi mankhwala ena
Atorvastatin-Teva amawonda ndikukula kwa myopathy - kufooka kwa minofu, ngati mankhwala onse omwe ali m'gulu la HMG-CoA reductase inhibitors. Ndi kugwiritsa ntchito mankhwala angapo, chiopsezo chokhala ndi matendawa chitha kukula kwambiri. Mankhwalawa ndi mankhwala monga fibrate (imodzi mwa magulu a ma pharmacological anticholesterolemic), maantibayotiki (erythromycin ndi macrolides), mankhwala antifungal, mavitamini (PP, kapena nicotinic acid).
Maguluwa amachita ngati enzyme yapadera yotchedwa CYP3A4, yomwe imatenga gawo lalikulu mu metabolism ya Atorvastatin-Teva. Ndi mankhwala ophatikiza amtunduwu, kuchuluka kwa atorvastatin m'magazi kumatha kuchuluka chifukwa cha kuletsa kwa enzyme yomwe tatchulayi, chifukwa mankhwalawa sanaphatikizidwe moyenera. Kukonzekera kwa gulu la ma fiber, mwachitsanzo, Fenofibrate, kumalepheretsa kusintha kwa Atorvastatin-Teva, chifukwa chomwe kuchuluka kwake m'magazi kumakulanso.
Atorvastatin-Teva imatha kubweretsanso kukhazikitsidwa kwa rhabdomyolysis - ichi ndi matenda oopsa omwe amapezeka chifukwa cha nthawi yayitali ya myopathy. Mwanjira iyi, minyewa yam'mimba imawonongeka kwakukulu, magawidwe awo mu mkodzo amawonedwa, omwe angayambitse kulephera kwa impso. Rhabdomyolysis nthawi zambiri amakula ndikugwiritsa ntchito Atorvastatin-Teva ndi magulu omwe ali pamwambapa.
Ngati mukupereka mankhwala muyezo wovomerezeka wa tsiku ndi tsiku (80 mg patsiku) limodzi ndi mtima glycoside Digoxin, ndiye kuti chiwopsezo cha Digoxin ndi gawo limodzi mwa magawo asanu a mankhwalawa omwe amwe.
Ndikofunikira kwambiri kuphatikiza molondola kugwiritsa ntchito mankhwala a Atorvastatin-Teva limodzi ndi mankhwala oletsa kubereka omwe amakhala ndi estrogen ndi zotumphukira zake, popeza pali kuchuluka kwam mahomoni achikazi. Izi zimakhudzanso azimayi amsinkhu wobereka.
Zakudya, zimalimbikitsidwa mosamala kuti muchepetse kugwiritsa ntchito madzi a mphesa, chifukwa mumakhala zinthu zambiri zomwe zimalepheretsa enzyme, mothandizidwa ndi njira zoyambira za Atorvastatin-Teva zimachitikira komanso mulingo wake m'magazi umachuluka. Mankhwala angagulidwe ku mankhwala aliwonse omwe mumalandira ndi mankhwala.
Zambiri zokhudzana ndi mankhwala Atorvastatin zimaperekedwa mu kanema munkhaniyi.
