Popanda cholesterol, thupi la munthu silipezeka kwathunthu. Izi ndi gawo la ziwalo za cell, kuphatikiza apo, popanda izi, ntchito yamanjenje ndi ziwalo zina zofunika mthupi la munthu sizingatheke.
Ndi zochuluka za thunthu limatanthauza cholesterol yoyipa, yomwe pamodzi ndi mapuloteni amapanga pawiri - lipoprotein. Ilinso m'mitundu iwiri: kachulukidwe kochepa komanso kachulukidwe kakakulu. Kuchulukana kwambiri kwa lipoprotein sikuvulaza thupi, mosiyana ndi mitundu yake iwiri. Ngati vutoli silikuyenda ndipo mulingo wa lipoprotein m'mwazi suvuta, zidzakhala zokwanira kuti wodwalayo asinthe ndikudyetsa zakudya ndikuyamba kuchita zomwe akuchita.
Koma izi sizipereka nthawi zonse zotsatira zomwe zimafunikira, nthawi zina, wodwala angafunike kutsuka ziwiya.
Asayansi akhala akugwira ntchito kwa nthawi yayitali kuti apange mankhwala abwino ochepetsa cholesterol "yoyipa".
Yankho labwino kwambiri silinapezeke, magulu angapo azachipatala apangidwa kuti achepetse cholesterol, iliyonse ili ndi malingaliro ake abwino komanso osagwirizana.
Ma Statin ndi ena mwa mankhwala abwino kwambiri a lipoprotein amadzimadzi ambiri, koma chifukwa cha zolakwa zingapo komanso kupezeka kwa zotsatira zowopsa za thupi, makamaka mukamagwiritsa ntchito mlingo waukulu wa mankhwalawo, samakhala wofulumira kupereka mankhwala.
Makhalidwe a Cholesterol Absorption Inhibitors
Mukamachiza cholesterol yayikulu magazi, ma statin samasakanikirana ndi nicotinic acid ndi ma fiber, omwe ndi mankhwala a gulu lina, chifukwa chakuti sakhala otetezeka mokwanira ndipo angayambitse kukula kwa matenda ena. Mwachitsanzo, kuphatikiza kwa ma fibrate ndi ma statins kumawonjezera chiopsezo cha myopathy, chinthu chomwecho chitha kuchitika ndikuphatikizidwa kwa nicotinic acid ndi ma statins, kuphatikiza pa chilichonse chomwe chiwindi chimakhudzidwa.
Koma akatswiri azamankhwala atapeza yankho, adapanga mankhwala omwe njira zawo zimawunikidwa kuzinthu zina kuti apange hypercholesterolemia, makamaka, pakuyamwa kwa cholesterol m'matumbo. Chimodzi mwa mankhwalawa ndi Ezithimibe kapena Ezeterol.
Ubwino wa mankhwalawa ndikuti umakhala wotetezeka kwambiri chifukwa chakuti ziwalo zake sizilowa m'magazi. Izi ndizofunikira kwambiri chifukwa mankhwalawa amapezeka kwa odwala omwe ali ndi chiwindi ndi omwe amatsutsana kuti agwiritse ntchito ma statins pazifukwa zingapo. Kuphatikiza kwa ezeterol ndi ma statins kungathandizire kukulitsa kuchiritsa kwacholinga chofuna kuchepetsa cholesterol m'thupi.
Ponena za zovuta zamankhwala, mtengo wake wokwera umasiyanitsidwa ndipo, pankhani ya monoprint, zotsika zochepa zomwe zimagwiritsidwa ntchito, mukayerekeza ndi zotsatira zamankhwala.
Zisonyezero zamankhwala
Kodi amalimbikitsidwa kuti apatsidwe mankhwala liti? Zimawonetsedwa kwa hypercholesterolemia yoyamba, Ezithimibe imagwiritsidwa ntchito palokha popanda kuwonjezera zakudya zamagulu, kapena kuphatikiza ma statins.
Mankhwalawa amathandizira kuchepetsa osati kuchuluka kwa cholesterol yathunthu, komanso apolipoprotein B, triglycerides, LDL cholesterol, komanso kukulitsa cholesterol ya HDL.
Ndi homozygous Famer hypercholesterolemia, mankhwalawa amagwiritsidwa ntchito ngati chowonjezera cha ma statins kuti achepetse cholesterol yokwanira, yonse pamodzi ndi LDL.
Ezeterol amadziwika kuti ndi homozygous sitosterolemia. Zimakuthandizani kuti muchepetse milingo yayikulu yaampesterol ndi sitosterol.
Contraindication ndi zoyipa
Mankhwalawa amaletsedwa kugwiritsidwa ntchito ndi odwala omwe ali ndi vuto lochulukirapo.
Amayi oyembekezera komanso nthawi yoyamwitsa salimbikitsidwanso kugwiritsa ntchito mayamwidwe a cholesterol.
Ngati pakufunika kugwiritsa ntchito ezeterol ndi mayi woyamwitsa, ndiye kuti ziyenera kukhala zofunikira kusiya kuyamwitsa.
Zotsutsana zina zimaphatikizapo:
- zaka zosakwana 18, popeza chitetezo ndi kugwiritsa ntchito mankhwalawa sichinakhazikitsidwebe;
- kukhalapo kwa mitundu iliyonse yamatenda a chiwindi panthawi yomwe ikuwonjezeka, komanso kuwonjezeka kwa ntchito ya "chiwindi" transaminases;
- kulemera kwakukulu kapena kosapindika kwa chiwindi kulephera, monga kuyesedwa ndi muyeso wa Child-Pyug;
- kuperewera kwa lactose, tsankho la lactose, malabsorption wa glucose-galactose;
- kugwiritsa ntchito mankhwala osakanikirana ndi ma fibrate;
- ntchito odwala kulandira cyclosporine ayenera kuchitika mosamala komanso kuwunika kuchuluka kwa ndende ya cyclosporin m'magazi.
Pankhani ya monotherapy, cholesterol mayamwidwe angayambitse zovuta monga kupweteka kwam'mimba, kudzimbidwa, mutu. Ndi zovuta mankhwala othandizira omwe ali ndi ma statins, kuphatikiza ma migraines, zizindikiro zimatha kuwoneka ngati kutopa, kuphwanyaphwanya, mavuto okhala ndi chifuwa (kukhumudwa kapena kudzimbidwa), nseru, myalgia, ntchito yowonjezera ya ALT, AST, ndi CPK. Maonekedwe a chotupa pakhungu, angioedema, hepatitis, kapamba, thrombocytopenia komanso kuwonjezeka kwa michere ya chiwindi sikuti sachotsedwa pakanthawi kachipatala.
Nthawi zina, kukhazikika kwa rhabdomyolysis ndikotheka.
Mfundo zoyenera kuchitira zoletsa
Ezetimibe mosankha bwino imalepheretsa mayamwidwe a cholesterol ndi mitundu ina ya mbewu m'matumbo ang'onoang'ono. Pamenepo, mankhwalawa amapezeka m'matumbo ang'onoang'ono ndipo samalola kuti mafuta ambiri azigwira, motero amachepetsa kupezeka kwa cholesterol kuchokera m'matumbo kupita ku chiwalo china - chiwindi, ndikuchepetsa nkhokwe zake ndikuwonjezera kuchulukana kwa madzi a m'magazi.
Cholesterol mayamwidwe blockers samachulukitsa kuchuluka kwa ma asidi a bile ndipo samalepheretsa kaphatikizidwe ka cholesterol ya chiwindi, zomwe sizinganenedwe za statins. Chifukwa cha magwiridwe antchito osiyanasiyana, mankhwala a m'makalasi awa, pomwe amagwiritsidwa ntchito ndi ma statins, amatha kupitilizanso cholesterol. Kafukufuku wamtsogolo akuwonetsa kuti kuyamwa kwa 14C-cholesterol kumalepheretsedwa ndi ezeterol.
Mtheradi wa bioavailability wa ezeterol sungadziwike chifukwa phata ili limatsala pang'ono kulowa m'madzi.
Kugwiritsa ntchito mankhwalawa molumikizana ndi zakudya zomwe sizimakhudzidwa ndi chakudya sikukhudzanso bioavailability wake pa mlingo wosaposa 10 mg.
Njira yogwiritsira ntchito, Mlingo ndi mtengo wake
Asanayambe maphunziro, odwala amafunika kudya zakudya zamafuta ambiri, ziyenera kupitilizidwa kuwonedwa nthawi yonse ya kumwa mankhwalawa. Ezeterol iyenera kumwedwa tsiku lonse, mosasamala kanthu za kudya. Nthawi zambiri, dokotala yemwe amakupatsani mankhwala amakupatsani mankhwalawa 10 mg mopitilira kamodzi patsiku.
Ponena za kuchuluka kwa kuphatikiza kwa Ezithimibe ndi ma statins, ndi chithandizo chovuta, lamulo lotsatirali liyenera kutsatiridwa: kumwa mankhwalawa kamodzi patsiku ndi ma statins, onetsetsani kuti mwatsata zomwe mwalangizidwa kuti muvomerezedwe.
Mofanananso ndimankhwala omwe amamwetsa mafuta acid ndi Ezithimibe, ayenera kumwedwa pa 10 mg kamodzi patsiku, koma osapitirira maola awiri musanatenge ma sequestrants kapena osapitilira maola anayi pambuyo pake.
Panthawi ya chiwindi chodwala, odwala omwe ali ndi vuto lofooka la chiwindi safunikira kusankha kwa mankhwalawa. Ndipo kwa odwala omwe ali ndi chiwindi chambiri komanso chovuta kwambiri, nthawi zambiri sikofunikira kugwiritsa ntchito zoletsa zoperewera m'matumbo a munthu.
Monga tanena kale, mtengo wa zoletsa sizotsika mtengo kwenikweni, zomwe zimakhudzana ndi zovuta zawo.
Ezetimibe mu gawo la ma milligram 10 (zidutswa 28) zitha kugulidwa kuyambira 1800 mpaka 2000 rubles.
Ezithymibe overdose komanso mogwirizana
Mukamachita maphunziro othandizirana ndi zoletsa, ndikofunikira kutsatira mosamalitsa adokotala. Koma ngati mankhwala osokoneza bongo akupezekabe, odwala ayenera kudziwa zotsatirazi.
Nthawi zina, mankhwala osokoneza bongo omwe sanachitike, zovuta zomwe zimawoneka mwa odwala sizinachitike kukhala zokwanira. Ngati timalankhula za mayesero azachipatala, ndiye kuti m'modzi mwa iwo mankhwalawo adalangizidwa odzipereka 15 okhala ndi thanzi labwino pa mlingo wa 50 mg tsiku lililonse kwa masabata awiri.
Kafukufuku wina adakhudzapo odzipereka 18 omwe ali ndi zizindikiro za hypercholesterolemia yoyamba; adayikidwa 40 mg ya Ezithimibe masiku oposa 50. Onse omwe adakumana ndi mayesero azachipatala adalekerera bwino mankhwalawo.
Kuphatikiza kwa Ezithimibe ndi kugwiritsa ntchito maantacid kungathandize kuchepetsa kuyamwa kwa zinthu zomwe zimagwiritsidwa ntchito ndi mankhwala oyamba, koma izi sizikhudza kupezeka kwake. Ndi chithandizo chogwirizana ndi cholestyramine, kuchuluka kwa mayamwidwe kwathunthu kwa eseterol kumachepetsedwa ndi 55 peresenti.
Ndi chithandizo chovuta ndi fenofibrate, chifukwa, kuchuluka kwazowonjezera za inhibitor kumawonjezera nthawi imodzi ndi theka. Kugwiritsa ntchito ma eseterol okhala ndi ma fibrate sikunaphunzire bwino, motero kugwiritsa ntchito kwakanthawi kofanana ndi madokotala sikulimbikitsidwa.
Kuopsa kwa cholesterol yayikulu akufotokozedwa mu kanema m'nkhaniyi.
