Ngati zakudya zotsitsa za lipid sizigwira ntchito mokwanira, mankhwalawa amatha kuthandizidwa kuti athetse kuphwanya magazi kagayidwe m'thupi. Ngati kuchuluka kwa cholesterol yathunthu m'magazi kukwera kuposa 6.5 mmol / l, ndiye kuti dokotala atha kupangira chithandizo chapadera kuti chichepetse koyambirira kuposa nthawi ino.
Gulu lalikulu la mankhwala
Choyamba, mankhwala ochepetsa zamadzimadzi ayenera kukumbukiridwa. Izi zikuphatikiza:
- mafupa;
- ma statins
- anion amasinthana mankhwala ndi ma resini omwe amachepetsa kuyamwa kwa cholesterol m'matumbo;
- nicotinic acid;
- phenucol.
Kutengera momwe amathandizira, mankhwalawa amatha kugawidwa m'magulu angapo:
- mankhwala omwe amalepheretsa kupanga cholesterol otsika kwambiri (amatchulidwanso kuti ndi oyipa): ma statins, fibrate, nicotinic acid, probucol, atiflavin;
- othandizira omwe amatha kuchepetsa mayamwidwe a cholesterol: magiya, ozungulira a bile acid;
- mafuta metabolism okonza omwe amachititsa cholesterol yapamwamba kwambiri: lipostabil, zofunika.
Otsatira a bile acid
Mankhwala omwe bile bile acid amadziwika kuti ma anion exchange resins. Mankhwalawa akangolowa m'matumbo, ma acid amamugwidwa ndikuwachotsa m'thupi.
Wotsirizayo adayankha izi pochititsa kuti mavitamini atsopano a bile azipezeka m'masitolo a cholesterol omwe alipo. Cholesterol imatengedwa kuchokera m'magazi, omwe amathandiza kuchepetsa.
Makampani opanga zamankhwala amapereka mankhwala opangira cholestyramine, komanso colestipol, kuti muchepetse cholesterol yamagazi. Itha kugwiritsidwa ntchito mu Mlingo wa 2-4, ndi kukakamiza koyambirira kwamadzimadzi ndi madzi.
Ma resin osinthana ndi anion sangathe kulowa mu magazi ndi "kugwira ntchito" kokha m'matumbo a lumen. Chifukwa cha izi, mankhwalawa sangathe kukhala ndi vuto lalikulu mthupi.
Zotsatira zoyipa zingaphatikizeponso:
- kutulutsa;
- nseru
- kudzimbidwa.
Ngati othandizira okhazikika a bile acids akhala akudya muyezo waukulu kwa nthawi yayitali, ndiye pamenepa mwina pali kuphwanya mayamwidwe mavitamini ena, komanso bile acid.
Mankhwala omwe ali mgululi amachepetsa kuchuluka kwa omwe amadziwika kuti ndi zoipa cholesterol, ndipo kupezeka kwa triglycerides m'magazi kumakhalabe pamlingo womwewo.
Cholesterol Absorption Suppressants
Chifukwa cha kuchepa kwapang'onopang'ono kwa cholesterol kuchokera ku chakudya, gulu la mankhwalawa limatha kuchepetsa kuchepa kwake. Wothandiza kwambiri amakhala gitala. Chowonjezera ichi chopatsa thanzi ndichotetezeka kwathunthu ndipo chimachokera ku mbewu ya nyemba za hyacinth. Zomwe zimapangidwazo zimaphatikizapo polysaccharide, yomwe, polumikizana ndi madzi, imasandulika mafuta.
Guarem imatha kupanga molekyu mamolekyulu am'makoma a matumbo. Kuphatikiza apo, mankhwalawa:
- imathandizira kuchoka kwa bile acid;
- chimapangitsa chilala;
- amathandizira kuchepetsa kuchuluka kwa chakudya chomwe amadya.
Izi zothandizira kuponderezera zili mu mawonekedwe a granules kuti ziwonjezeke kumwa. Kugwiritsa ntchito mankhwalawa kumatha kuphatikizidwa mosavuta ndi njira zina.
Mukamagwiritsa ntchito, mavuto amakhudzanso, mwachitsanzo, kuwonda chopondapo, kupweteka m'matumbo, mseru komanso kutulutsa. Zizindikirozi ndizochepa komanso sizimachitika kawirikawiri. Ngakhale pakalibe chithandizo, amadutsa mwachangu, pomwe pali kuchepa kwadongosolo kwa cholesterol yamagazi.
Nicotinic Acid
Nicotinic acid ndi zotuluka zonse, mwachitsanzo:
- acipimox
- kumakumakumma
- enduracin
kwenikweni, ndi mavitamini a B. Mankhwalawa amachepetsa cholesterol yotsika komanso amathandizira dongosolo la fibrinolysis, lomwe limathandizanso kuchepetsa mwayi wokhala ndi thrombosis. Njira ndizabwino kuposa mankhwala ena ochepetsa lipid kumachulukitsa zomwe zimakhala ndi cholesterol m'magazi a wodwala.
Chithandizo cha nicotinic acid chimatenga nthawi yayitali ndikuwonjezera kovomerezeka. Mukamaliza kukonzekera, musanamwe madzi akumwa otentha, makamaka khofi wachilengedwe.
Niacin amatha kukwiyitsa makoma am'mimba, omwe samapatula kugwiritsidwa ntchito kwake ngati zilonda zam'mimba. Mwa odwala ambiri, redness ya nkhope imatha kuonedwa koyambirira kwa chithandizo, komabe, chizindikiro ichi chimazimiririka pakapita nthawi. Kuti muchepetse kufiyanso, muyenera kumwa 325 mg wa aspirin theka la ola musanagwiritse ntchito mankhwalawa.
The contraindication akuluakulu a nikotini acid ndi monga:
- matenda a chiwindi;
- gout
- kutentha kwa mtima.
Pali mankhwala omwe angayambitse zotsatira zoyipa zochepa komanso amakhala nthawi yayitali - awa ndi enduracin.
Primphol
Ma probucol samakhudzana ndi triglycerides, komanso amawongolera moyenera cholesterol yabwino komanso yoyipa m'magazi. Mapiritsi amaletsa peroxidation wa mafuta ndikuwonetsa kutchulidwa kwa anti-atherosulinotic kwenikweni, okhudza kuchepa kwa mafuta m'thupi.
Zotsatira zamankhwala omwe amapezeka ndi Probucol zitha kupezeka pambuyo pa miyezi iwiri ndipo zimatha mpaka miyezi isanu ndi umodzi atasiya kugwiritsa ntchito. Chidacho chimatha kuphatikizidwa bwino bwino ndi mankhwala ena omwe amachepetsa cholesterol.
Pa mankhwala, kuwonjezereka kwa nthawi ya mtima komanso kukulira kwa mtima wama mtima kumatha kuzindikirika. Pofuna kupewa izi, ndikofunikira kuti muzitha kugwiritsa ntchito electrocardiogram nthawi imodzi m'miyezi isanu ndi umodzi.
Ma probucol sangathe kutumikiridwa nthawi yomweyo ndi cordarone.
Zotsatira zoyipa za thupi zimaphatikizapo kupweteka pamimba, nseru ndi m'mimba.
Mankhwala sayenera kumwedwa ndi:
- chamitsempha yama arrhythmias;
- pafupipafupi magawo a myocardial ischemia;
- magawo otsika a HDL.
Fibates
Fibates amatha kuthana nawo moyenera mulingo wa triglycerides, komanso ndende ya LDL ndi VLDL. Zitha kugwiritsidwa ntchito ndi hypertriglyceridemia yofunika. Otchuka kwambiri amatha kutchedwa mapiritsi:
- gemfibrozil (lopid, gevilon);
- fenofibrate (Tipantil 200 M, Tricor, Exlip);
- cyprofibrate (lipanor);
- choline fenofibrate (trilipix).
Zotsatira zoyipa zoledzeretsa zimachitika chifukwa cha kupweteka kwa minofu, mseru komanso kupweteka pamimba. Mitundu yowonjezereka imatha kukulitsa kupezeka kwa miyala ya impso ndi chikhodzodzo. Pafupifupi mokwanira, kuletsa kwa hematopoiesis kumatha kuchitika.
Mankhwalawa sangathe kufotokozedwera matenda a impso, chikhodzodzo ndi vuto la magazi.
Madera
Ma Statin ndi mapiritsi ochepetsa kwambiri a cholesterol. Amatha kuletsa enzyme yapadera yomwe imayankha ndikupanga chinthu chonga mafuta m'chiwindi, ndikumachepetsa kuyika kwake m'magazi. Nthawi yomweyo, kuchuluka kwa ma LDL receptors kukukulira, zomwe zimapangitsa kuti chiwopsezo cha kuchotsera kwa cholesterol chochepa kwambiri.
Monga lamulo, mankhwala otsatirawa ndi mankhwala:
- simvastatin (vasilip, chakor, aries, simvageksal, simvakard, simvakor, simvastatin, simvastol, simvor, simlo, sincard, holvasim);
- lovastatin (cardiostatin, choletar);
- pravastatin;
- atorvastatin (anvistat, atocor, atomax, ator ,x, atoris, vazator, lipoford, lypimar, liptonorm, novostat, torvazin, torvakard, tulip);
- rosuvastatin (akorta, mtanda, mertenyl, rosart, rosistark, rosucard, rosulip, roxer, rustor, tevastor);
- pitavastatin (livazo);
- fluvastatin (leskol).
Simvastatin, komanso lovastatin, amapangidwa kuchokera ku bowa. Mankhwala omwewo a mapiritsi a cholesterol okwanira amasintha kukhala metabolites yogwira. Pravastatin ndi fungal yomwe imachokera ku chinthu chomwe chimagwira.
Statin akhoza kukhala olimbikitsidwa kamodzi usiku uliwonse. Malangizo a mankhwalawa amafotokozedwa chifukwa chakuti kuchuluka kwa mafuta amafuta a cholesterol kumachitika usiku. Popita nthawi, mlingo wa ma statins utha kuwonjezereka, ndipo kutha kwake kudzakwaniritsidwa pambuyo masiku owerengeka oyamba, kufika pamlingo wopitilira mwezi umodzi.
Ma Statin ndi otetezeka anthu, koma ndikofunikira kwambiri kuti musagwiritse ntchito Mlingo waukulu, makamaka ndi fibrate, yomwe ili ndi zovuta za chiwindi.
Odwala ena atha kukhala ndi kufooka kwa minofu ndi kupweteka m'thupi. Nthawi zina, kupweteka kwam'mimba, kudzimbidwa, kunyansidwa, komanso kuwonongeka kwathunthu, kusowa tulo komanso kupweteka mutu kumadziwika.
Mankhwalawa ochepetsa cholesterol sangathe kukhudza chakudya cham'mimba komanso purine metabolism, yomwe imawalola kuti azigwiritsidwa ntchito pama degree osiyanasiyana a kunenepa kwambiri, gout ndi matenda ashuga. Dziwani kuti ngati cholesterol yayikulu imawonedwa pa nthawi ya pakati, ndikofunikira kukaonana ndi dokotala.
Ngati tilingalira za mtundu wakale wa mankhwala, ndiye kuti ma statin amatha kulumikizidwa ku chithandizo cha atherosermosis monga monotherapy kapena pamodzi ndi mankhwala ena.
Pharmacology imapereka zophatikizika zopangidwa motengera:
- lovastatin ndi nicotinic acid;
- ezetimibe ndi simvastatin;
- pravastatin ndi fenofibrate;
- rosuvastatin ndi ezetimibe.
Kusintha kwa ma statins ndi acetylsalicylic acid, atorvastatin ndi amlodipine akhoza kumasulidwa.
Kugwiritsa ntchito mankhwala opangidwa okonzekera sikuti kumangopindulitsa kwambiri pochulukitsa ndalama, komanso kumadzetsa zotsatirapo zingapo zoyipa.
