Kutengera kuchuluka kwa mankhwalawa padziko lonse lapansi, malo oyamba okhala ndi malire ambiri amakhala ndi ma statins kuyambira pomwe anali ndi dzina lawolo.
Atorvastatin ndi mankhwala oyamba pa izi. Mankhwalawa adapangidwa mu August 1985 ku Germany.
Statin ndi mankhwala opangidwa kuti athane ndi hypercholesterolemia, ndi atherosulinosis yomwe ikubwera chifukwa chake. Kuchita kwawo ndikukonza maulalo a mbiri ya lipid, kuthandizira zolakwika mu khoma la mtima ndikuchepetsa kutupa kwake.
Zokhudza ma statins pa cholesterol biosynthesis
Statins amachepetsa mafuta m'thupi mwa kuphatikiza michere yake m'chiwindi.
Kuti mumvetsetse izi, ndikofunikira kutenga magawo onse kukhala magawo.
Pali zinthu zoposa makumi awiri zomwe zimagwira nawo ntchito yachilengedwe.
Posavuta pakuphunzira ndi kumvetsetsa, pali magawo anayi okha:
- gawo loyamba ndikukhazikika kwa glucose okwanira mu hepatocytes kuti ayambe kuchitapo kanthu, pambuyo pake enzyme HMG-CoA reductase iyamba kuphatikizidwa ndi njirayi, mothandizidwa ndi kuti gulu lotchedwa mevalonate limapangidwa ndi biotransfform;
- ndiye mevalonate wozunguliridwa amakhudzidwa ndi njira ya phosphorylation, imakhala mu kusamutsa kwamagulu a phosphorous ndi kugwidwa kwawo ndi adenosine tri-phosphate, pakupanga mphamvu zamagetsi;
- gawo lotsatira - njira yoperekera - imakhala pakugwiritsa ntchito madzi pang'onopang'ono ndikusintha kwa mevalonate kukhala squalene, kenako kukhala lanosterol;
- ndi kukhazikitsidwa kwa maubwenzi awiri, atomu ya kaboni imalumikizidwa ndi lanosterol - iyi ndi gawo lomaliza la cholesterol kupanga lomwe limapezeka mu organelle ya hepatocytes - endoplasmic reticulum.
Statin imakhudza gawo loyamba la kusinthika, kutsekeka kwa enzyme HMG-CoA reductase ndipo pafupifupi kuyimitsa kwathunthu kupanga mevalonate. Njira imeneyi imakhala yodziwika kwa gulu lonse. Chifukwa chake zidapangidwa koyamba ndi asayansi aku Germany ku Pfizer m'zaka zapitazi.
Patatha zaka khumi mayesero azachipatala, ma statins adawonekera pamsika wamankhwala. Woyamba mwa iwo anali mankhwala oyamba Atorvastatin, ena onse adawonekera pambuyo pake ndipo ndi makope ake - awa ndi omwe amatchedwa ma generics.
Limagwirira ntchito mthupi
Tevastor ndi statin ya m'badwo wachinayi wokhala, monga chinthu chogwira ntchito, rosuvastatin. Tevastor ndi imodzi mwazinthu zotchuka kwambiri zaku Atorvastatin m'maiko a CIS - omwe adatsogola.
Pharmacodynamics ndi pharmacokinetics amafotokoza momwe Tevastor amachitikira pambuyo kulowa thupi la munthu.
Imalowa mkati mwa mucous membrane wam'mimba, chigawo chogwira ntchito chimatengedwa ndi magazi mthupi lonse ndikuwunjikana m'chiwindi pambuyo maola asanu. Hafu ya moyo ndi maola makumi awiri, zomwe zikutanthauza kuti zimatenga pafupifupi maola makumi anayi kuti zitheke. Mankhwalawa amachotsedwa pamayendedwe achilengedwe - matumbo amachotsa 90%, zotsalazo zimatsitsidwa ndi impso. Ndi kugwiritsa ntchito mankhwalawa pafupipafupi, chithandizo chokwanira kwambiri chimawonekera patatha mwezi umodzi chiyambi cha chithandizo.
Ngati wodwala ali ndi matenda osachiritsika, ma paracokinetic magawo amasintha:
- Ndi kulephera kwambiri kwa aimpso, pomwe kupangika kwa creatine kumachepera 4 kapena kupitilira, kuchuluka kwa rosuvastatin kumawonjezeka nthawi 9. Odwala a hemodialysis, zizindikirozi zimawonjezeka mpaka 45%;
- Kuchepa pang'ono komanso kwapakati kwaimpso, pomwe chilolezo chili pamwamba pa mamililita 30 pamphindi, kugwiritsidwa ntchito kwa plasma kumakhalabe pamlingo wowonjezera;
- Ndi kulephera kwa chiwindi, kupatula kwa theka la moyo kumawonjezeka, ndiye kuti, zigawo zikuluzikulu zimapitilirabe kuzungulira magazi. Izi zimatha kuyambitsa kuledzera kwakukulu, kuwonongeka kwa impso, ndi poyizoni. Chifukwa chake, munthawi yamankhwala, ndikofunikira kutsatira mosamalitsa zomwe dokotala akukuuzani, kuti muchepetse bongo wambiri komanso munthawi yopambana mayeso;
Mukamagwiritsa ntchito mankhwalawa, muyenera kukumbukira kuti mwa anthu amtundu waku Asia, kuchoka kwa rosuvastatin kumachedwetsedwa, kotero ayenera kuyikidwa mankhwala ochepera.
Mawonekedwe ndi kipimo
Maonekedwe ndi zomwe mapiritsiwo amasiyanasiyana kutengera mlingo.
Ma Tevastor 5 milligram - ali ndi mawonekedwe ozungulira, amtundu wochokera ku chikasu chowala mpaka lalanje. Pali malingaliro mbali zonse ziwiri za cholembapo: mbali inayi, mawonekedwe a kalata N, mbali inayi, nambala 5. Ngati mutaphwanya piritsi, mutha kuwona pakati poyera, wokhala ndi mchere wa rosuvastatin;
Tevastor mamiligiramu 10, ma milligram 20, ma milligram 40 - mapiritsi a pinki ozungulira ndi mapiritsi a biconvex. Zojambula patsamba lofananalo ndizofanana; pambali ya manambala, mlingo umawonetsedwa pachimake. Pazolakwika, malo oyera amakhalanso owoneka, okutidwa ndi chipolopolo.
Kapangidwe ka Tevastor ndi chimodzimodzi pamitundu yonse, kusiyana kumangokhala kuchuluka kwa yogwira pompopompo ndi othokoza:
- calcium ya rosuvastatin - chinthu chomwe chimagwira, chimaletsa enzyme yogwira yomwe imatembenuza shuga kukhala mevalonate;
- microcrystalline cellulose - chotupa chophika, chotupa, chomwe chinayambitsidwa kuti chiziwonjezera kuyimitsidwa kwam'mimba;
- lactose amagwiritsidwa ntchito ngati filimu kuwonjezera kuchuluka ndi kulemera, kuphatikiza ma cellulose amathandizira kuwonongeka;
- povidone ndi crospovidone - cholembera kuti zitsimikizire kumeza bwino;
- sodium stearine fumarate - imapitiliza madzi, imathandizira ntchito pamakina osindikizira pochepetsa kumamatira pazida.
Kuphatikiza pazinthu izi, mankhwalawa amakhala ndi utoto wa pinki ndi lalanje kuti apatse miyala piritsi yosangalatsa.
Malangizo ogwiritsira ntchito mankhwalawa
Pali mndandanda wazomwe mungagwiritse ntchito mankhwalawa.
Zizindikiro zonse zimawonetsedwa mu malangizo ogwiritsira ntchito.
Kuwongolera uku ndi gawo lofunikira pakukhazikitsa kwa mankhwala omwe agulitsidwa kudzera pa netiweki ya pharmacy.
Zizindikiro zazikulu pakugwiritsa ntchito mankhwalawa ndi:
- Pakatikati (ndi iyo, lipoprotein yotsika yokha ndi yomwe imakwezedwa) ndipo imasakanikirana (otsika kwambiri lipoproteins imakulitsidwa) hypercholesterolemia. Koma pokhapokha ngati kuwonjezeka kwa zolimbitsa thupi, kusiya zizolowezi zoyipa ndikudya zakudya sizinabweretse zotsatira zoyenera;
- Hypertriglycerinemia, ndi kuwonjezeka munthawi yomweyo lipoproteins otsika, ngati okhwima zakudya sanatsike cholesterol;
- Atherossteosis - kuonjezera kuchuluka kwa osachulukitsa lipoprotein zolandilira mu chiwindi kuti achepetse kuchuluka kwa cholesterol yoyipa;
- Poletsa kukula kwa mtima wamavuto a atherosulinosis: pachimake myocardial infarction, ischemic stroke, angina pectoris, makamaka pamaso pangozi - kusuta, uchidakwa, kunenepa kwambiri, zaka zopitilira 50.
Malangizo ogwiritsira ntchito kukhazikitsa njira zomveka zowerengera.
Tengani pakamwa, kumwa madzi ambiri, ngakhale osadya, osafuna kutafuna kapena kuswa. Ndikulimbikitsidwa kumwa usiku, chifukwa masana mankhwalawa amathandizira, ndipo ambiri amachotsedwa m'thupi.
Mlingo woyambirira ndi 5 mg 1 nthawi patsiku. Mwezi uliwonse, ndikofunikira kuyang'aniridwa ndi lipid ndi kuonana ndi dokotala. Asanayambe chithandizo, dokotala wamtima amakakamizidwa kuti apereke chitsogozo chovomereza ndikufotokozera mavuto omwe ayenera kusiya kulandira ndi kupita kuchipatala.
Kuphatikiza apo, nthawi yonse ya mankhwala ndikofunikira kutsatira zakudya za hypocholesterol, ndipo izi zikutanthauza kuti kuletsa kudya zamafuta, zakudya zokazinga, mazira, ufa ndi zakudya zotsekemera.
Zotsatira zoyipa za thupi
Zotsatira zoyipa zimagawidwa potengera ma pafupipafupi monga zimachitika pafupipafupi, osowa komanso osowa kwambiri.
Pafupipafupi - milandu imodzi ya anthu zana - chizungulire, kupweteka m'makachisi ndi khosi, kukula kwa matenda a shuga 2, nseru, kusanza, kukhumudwa, kupweteka kwa minofu, asthenic syndrome;
Osawerengeka - milandu imodzi pa anthu 1000 - zimachitika zonse zomwe zimagwiritsidwa ntchito ndi mankhwalawa kuchokera ku urticaria kupita ku edema ya Quincke, pancreatitis ya pachimake (kutupa kwa kapamba), zotupa pakhungu, myopathy;
Osowa kwambiri - 1/10000 milandu - rhabdomyolysis imachitika, uku ndikuwonongeka kwa minofu ya minofu ndikutulutsidwa kwa mapuloteni owonongeka kulowa m'magazi ndikuchitika kwa kulephera kwa impso.
Zotsatira zosagwirizana ndi kugwiritsa ntchito mankhwalawa ndi izi:
- Mimba - Rosuvastatin ndi woopsa kwambiri kwa mwana wosabadwayo chifukwa, poletsa kapangidwe ka cholesterol, chimasokoneza mapangidwe a khoma la cell. Izi, zimabweretsa kukula kwa intrauterine, kulephera kwa ziwalo zambiri, komanso kupuma. Mwana wosabadwayo amatha kufa kapena kubadwa ndi vuto lalikulu, motero, ndikulimbikitsidwa kuti mankhwala ena apatsidwe kwa wodwala yemwe ali ndi pakati.
- Kuyamwitsa - izi sizinayesedwe m'maphunziro azachipatala, chifukwa chake zoopsa zake sizinachitike. Pakadali pano, mankhwalawa ayenera kusiyidwa.
- Ana ndi achinyamata chifukwa cha kupanda ungwiro kwa maphunzirowa atha kusokonezeka, motero, kuvomerezedwa kwa zaka 18 ndizoletsedwa.
- Kulephera kwakukulu kwaimpso.
- Matenda a chiwindi, pachimake kapena aakulu.
- Mukalamba, ndikofunikira kupereka mankhwala mosamala. Kuyamba kwa 5 mg, osapitirira 20 mg patsiku moyang'aniridwa ndi achipatala.
- Pambuyo kupatsidwa ziwalo chifukwa cha kulephera kwa cyclosporine, komwe kumachepetsa kukana komwe kumachitika ndi rosuvastatin.
- Pamodzi ndi anticoagulants, popeza Tevastor amawonjezera zochita zawo, akuwonjezera nthawi ya prothrombin. Izi zitha kupsa ndi magazi ochokera mkati.
- Simungathe kuzitenga ndi mankhwala ena a statins ndi hypocholesterolemic chifukwa cha kuphatikiza kwa pharmacokinetics.
- Lactose tsankho.
Kuphatikiza apo, ndizoletsedwa kumwa mankhwala ngati wodwala ali ndi vuto la hypersensitivity pazinthu zilizonse za mankhwala.
Zambiri zokhudzana ndi ma statins zimaperekedwa kanema munkhaniyi.
