Mankhwala Lovastatin: limagwirira ntchito ndi kuwunika

Gulu la ma statins (mankhwala ochepetsa mphamvu ya cholesterol) limaphatikizanso Lovastatin yothandiza. Mankhwala amagwiritsidwa ntchito osati mankhwalawa hypercholesterolemia, hyperlipoproteinemia, komanso kupewa matenda a mtima.

Mankhwala ayenera kugwiritsidwa ntchito limodzi ndi zakudya zapadera, masewera olimbitsa thupi komanso kusintha thupi. Munkhaniyi, mutha kuphunzira zambiri za Lovastatin, malangizo ogwiritsira ntchito, mtengo, ndemanga, analogues.

Limagwirira a zochita za mankhwala

Lovastatin ndi m'gulu la mankhwala omwe amachepetsa lipid omwe amaphwanya kapangidwe ka cholesterol m'chiwindi koyambirira. Mankhwalawa amadziwika kuti ndiwofunika kwambiri pakati pa ma statin ena. Amachotsedwa ku biocultures Aspergillusterreus ndi Monascusruber.

Mukangodya m'mimba, mankhwalawo amabwereranso ku zotsatira za michere ya m'mimba ndipo pang'onopang'ono amayamba. Kuphatikiza apo, kuchuluka kwa mankhwalawo, kumalimbikitsidwa mofulumira kwambiri. Katundu wogwira amalowa m'matumbo, kenako amalowa m'magazi. Zolemba zazikulu za plasma zimafikiridwa pambuyo pa maola 2-4. Kulowerera mu minyewa ina yonse ya thupi kumachitika mwaulere-hydroxy acid.

Zochita za Lovastatin ndizolinga ziwiri zokha. Choyamba, chimasokoneza kaphatikizidwe wa cholesterol m'chiwindi, kuletsa kusintha kwa reductase kukhala melovanate. Kachiwiri, zimatsogolera ku activation ya kuthamanga kwa catabolism (kagayidwe ka metabolic) ka LDL. Mothandizana ndi njirayi, pali kuwonjezeka kwa HDL, kapena cholesterol "yabwino".

Hafu ya moyo wa gawo yogwira ndi maola atatu. Ma metabolabolites omwe ali ndi mphamvu yogwira ntchito amathandizidwa kudzera impso ndi matumbo.

Malangizo ogwiritsira ntchito mankhwalawa

Lovastatin 20 mg kapena 40 mg imapezeka mu mawonekedwe a piritsi, gawo logwira ntchito lomwe limakhala ndi dzina lomweli. Zowonjezera za mankhwalawa ndi lactose monohydrate, starch, cellulose, magnesium stearate, butylhydroxyanisole, citric ndi ascorbic acid.

Mankhwala amagulitsidwa pokhapokha munthu akalandira mankhwala ndi dokotala. Pogula malonda, wodwalayo ayenera kuyang'anira chidwi chake. Malangizowa ali ndi malingaliro angapo ogwiritsira ntchito mankhwalawa:

• mankhwalawa chachikulu hypercholisterinemia pamodzi, mtundu IIA ndi IIb;
• hyperlipoproteinemia mankhwala (zovuta ndi matenda a shuga ndi nephrotic);
• mankhwalawa coronary atherosulinosis (palimodzi ndi mavitamini ndi mavitamini osaphatikizidwa);
• kupewa matenda a mtima;
• hypertriglyceridemia mankhwala.

Kugwiritsa ntchito mapiritsi kuyenera kuchitika nthawi imodzi patsiku la chakudya chamadzulo. Mlingo wa mankhwalawa zimatengera matendawa. Chifukwa chake, ndi hyperlipidemia, mlingo umodzi wa 10-80 mg ndiwo mankhwala. Chithandizo cha matenda am'mimba chimayambira ndi Mlingo wocheperako, ndikuloledwa ndi dokotala, amatha kuchepa. Ndikulimbikitsidwa kusankha mlingo uliwonse pakatha masabata anayi. Mlingo wapamwamba kwambiri (80 mg) ungagawidwe pawiri - m'mawa ndi madzulo.

Mankhwala a coronary atherosulinosis, mulingo woyenera kwambiri ndi 20-40 mg. Ngati chithandizo sichikuyenda bwino, kuwonjezera kwa 60-80 mg ndikotheka. Ngati wodwala akutenga michere kapena nicotinic acid nthawi yomweyo, Lovastatin sayenera kugwiritsidwa ntchito osaposa 20 mg patsiku. Komanso, mankhwalawa amayenera kuchepetsedwa milandu:

1. Kugwiritsa ntchito ma immunosuppressants.
2. Kugwiritsa ntchito mankhwala othandizira.
3. Chithandizo cha mankhwala antifungal.
4. Chithandizo cha matenda a chiwindi a etiology kapena ambiri.
5. Kugwiritsa ntchito mankhwala okhala ndi ma anticoagulants.

Ndikofunika kusunga mankhwalawo pa kutentha kosaposa 25 digiri Celsius.

Pambuyo pa kumaliza ntchito, zomwe ndi zaka 2, ndizoletsedwa kugwiritsa ntchito malonda.

Contraindication ndi zoyipa

Lovastatin ili ndi mndandanda wocheperako wapamwamba. Kugwiritsa ntchito mankhwalawa ndizoletsedwa kwa myopathy (matenda a neuromuscular), kutenga pakati, cholestasis, chiwindi, osakwanitsa zaka 18 ndi hypersensitivity payekha pazigawo.

Mankhwalawa ayenera kugwiritsidwa ntchito mosamala odwala omwe adutsa pakuthana ndi mtsempha wamagazi. Palibe chifukwa chomwe mungamwere mankhwala ndi mowa.

Nthawi zina, mankhwala amatha kuyambitsa mavuto. Pakati pawo, ndikofunikira kufotokoza:

• Zochitika zogwirizana ndi ntchito ya m'mimba thirakiti: kuukira kwa mseru, kutentha pa chifuwa, kuchuluka kwa mpweya, kusintha kwa kakomedwe, kutsekula m'mimba, kudzimbidwa.
• Zovuta zamkati zamanjenje: kupweteka mutu, kugona tulo, nkhawa, chizungulire, paresthesia, myositis, minofu kukokana ndi myalgia. Mukamagwiritsa ntchito cyclosporine, gemfibrozil kapena nicotinic acid, pamakhala mwayi wa rhabdomyolysis.
• Zimachitika biliary dongosolo: kuchuluka kwa bilirubin, zamchere phosphatase, chiwindi transaminases ndi creatine phosphokinase. Nthawi zina hepatitis, cholestatic jaundice ndi biliary cholestasis ndizotheka.
• Thupi lawo siligwirizana: kuyabwa, zotupa pakhungu, urticaria, angioedema, arthralgia.
• Kusokonezeka kwa nsidze: kukhazikika kwa mitsempha ya optic ndi chitukuko cha matenda amkati.
• Zotsatira zina zoyipa: kuchepa kwa potency, malaise wamba, alopecia.

Zizindikiro zosokoneza bongo mukamagwiritsa ntchito Mlingo waukulu wa mankhwalawa saonedwa. Maziko othandizira ndikuchotsa Lovastatin, phala lam'mimba, kugwiritsa ntchito ma sorbents (kuyambitsa kaboni, Smecta, Polysorb, Atoxil) kuwongolera kwa ntchito zofunika, ntchito ya chiwindi ndi ntchito ya phosphokinase.

Kuchita ndi njira zina

Lovastatin sayenera kugwiritsidwa ntchito ndi mankhwala onse, chifukwa kulumikizana kwawo kumatha kudzetsa kuyipa kwamthupi. Komanso, mankhwala ena amatha kukulitsa kuchuluka kwa zinthu zomwe zimagwira, ndipo zina zimatha kuchepa.

Chiwopsezo chachikulu cha chiwonongeko cha minofu ndi myopathy, komanso kuwonjezeka kwa zomwe zimagwira ntchitoyo, kumayambitsa kugwiritsidwa ntchito kwa nthawi yomweyo kwa Lovastatin limodzi ndi nicotinic acid, Cyclosporine, Ritonavir, Erythromycin, Nefazodon ndi Clarithromycin.

Kugwiritsa ntchito mankhwala mosokoneza bongo ndi madzi a mphesa, fenofibrate, gemfibrozil kumathandizanso mwayi wa myopathy.

Kuopsa kwa magazi kumawonjezeka ndi kugwiritsa ntchito warfarin. The bioavailability wa lovastatin amachepetsa pogwiritsa ntchito colestyramine. Kuti bioavailability ya mankhwalawa ikhale yokhazikika, ndikofunikira kugwiritsa ntchito mankhwala osokoneza bongo kwa maola 2-4.

Ndi matenda obwera nawo, wodwalayo ayenera kufunsa dokotala kuti amwe mankhwala.

Zina mwazo sizigwirizana ndi Lovastatin, chifukwa chake, kugwiritsa ntchito mankhwala mosaloledwa nkoletsedwa.

Mtengo, analogi ndi kuwunika kwa wodwala

Tsoka ilo, sizotheka kugula Lovastatin chifukwa Sipangidwa ku Russia.

Makampani opanga mankhwala monga Lekpharm (Belarus), Replekpharm AD (Macedonia) ndi Kievmedpreparat (Ukraine) ndi omwe amapanga mankhwalawa.

Pankhani imeneyi, adotolo atha kukulemberani analog ya Lovastatin, yomwe ili ndi zofanana zochizira.

Mankhwala odziwika bwino ndi awa:

1. Holetar. Ili ndi chophatikizika - lovastatin, motero, chimayenderana ndi Lovastatin. Mankhwala ali ndi zofanana, contraindication ndi zolakwika zimachitikira monga Lovastatin.
2. Cardiostatin. Mankhwala ena odziwika bwino ndi ofanana ndi Lovastatin, chifukwa ili ndi gawo lomweli. Mukamamwa Cardiostatin, njira yochizira yodziwikiratu imawonekera kwa milungu iwiri, ndipo pazabwino pambuyo pa masabata 4-6 atamwa mankhwalawo. Mtengo wapakati ndi ma ruble 290 (phukusi la mapiritsi 30 a 20 mg).
3. Pravastatin. Ili ndi zochita zambiri. Chosakaniza chophatikizacho ndi pravastatin. Mankhwalawa amagwiritsidwa ntchito poyambira hypercholesterolemia ndi dyslipidemia, komanso kupewa matenda a mtima a ischemic. Kugwiritsidwa ntchito kwa Pravastatin ndikotheka ngati njira yachiwiri yopewera kulowetsedwa kwa myocardial infarction, angina pectoris ndi post-transplant hyperlipidemia.
4. Zokor. Mphamvu yogwira ya mankhwala ndi simvastatin. Chizindikiro chachikulu cha mankhwalawa ndi chithandizo cha hypercholesterolemia. Zokor imagwiritsidwanso ntchito ngati prophylactic popewa kukula kwa mtima wamitsempha yamagazi. Mtengo wapakati ndi ma ruble 380 (mapiritsi 28 a 10 mg) ndi 690 ruble (mapiritsi 28 a 20 mg).

Malinga ndi Vyshkovsky Index, atsogoleri pamsika wazaka za Russia ndi Cardiostatin, Mevacor, Holetar ndi Rovacor.

Mayankho ku Lovastatin, ochokera kwa odwala komanso madokotala, ndi abwino. Mankhwalawa ndi otetezedwa komanso odwala bwino, ngakhale atakhala kwa nthawi yayitali.

Machitidwe omwe amayamba chifukwa cha matenda a dyspeptic nthawi zina amapezeka kumayambiriro kwa mankhwalawa. Pakatha milungu iwiri, thupi likagwiritsidwa ntchito pokopa chinthu chogwira ntchito, zizindikirizo zimatha. Nthawi zina, milingo ya ALT ndi AST imachuluka, motero ndikofunikira kuwongolera zomwe zili.

Pambuyo pa miyezi 1.5 kuyambira pachiyambireni chamankhwala, kufufuza koyeserera kumachitika. Monga lamulo, pali mawonekedwe abwino pazowunikira, i.e. ndende ya lipid yafupika.

Momwe mungachepetse cholesterol akufotokozedwa mu kanema m'nkhaniyi.