I-Liprimar 10 yi-ejenti yokwenziwa enomphumela ophansi we-lipid. Umuthi uyadingeka ukunciphisa ngokwanele i-cholesterol nama-lipoprotein aphansi. Ngenxa yalokhu, ukuthi kungenzeka ukwakheka kwamathafa e-atherosulinotic ezindongeni zemithambo yegazi kuyehla, izinga lama-triglycerides liyancipha futhi nomzimba wamafutha emzimbeni uyathuthuka. Isisekelo sendlela yokusebenza yi-atorvastatin, okudingeka ukuqeda i-hypercholesterolemia.
Igama Lezwe elingafanele
Atorvastatin.
I-Liprimar 10 iyadingeka ukwehlisa ngokwanele i-cholesterol nama-lipoprotein aphansi.
I-ATX
C10AA05.
Khipha amafomu nokwakheka
Umuthi uyatholakala kumathebulethi e-enteric-camera. Iyunithi lomthamo liqukethe i-10 mg ye-atorvastatin calcium njengendawo esebenza kuyo. Ukuze uthole ijubane lokufaka kanye ne-bioavailability ekhuphukayo, ithebhulethi inezinto ezingeziwe:
- i-microcrystalline cellulose;
- i-magnesium stearate;
- ushukela wobisi;
- i-hyprolose;
- i-croscarmellose sodium;
- i-calcium carbonate.
Ukuqanjwa kwamacwecwe kufaka i-microcrystalline cellulose, i-magnesium stearate, ushukela wobisi, i-hyprolose, i-croscarmellose sodium, i-calcium carbonate.
I-membrane yefilimu iqukethe i-candelilla wax, i-hypromellose, i-polyethylene glycol, i-talc, i-emulsion simethicone, i-titanium dioxide. Ezibhebheni ezimhlophe zesimo se-elliptical, kuqoshwe okuqoshwe ku-"PD 155" nedosi yento esebenzayo.
Isenzo se-Pharmacological
I-Liprimar ingeyesigaba sezidakamizwa ezisehlisa i-lipid. Into esebenzayo ye-atorvastatin iyisikhethi esinqunyiwe se-HMG-CoA reductase, i-enzyme enkulu edingekayo ekushintsheni kwe-3-hydroxy-3-methylglutaryl coenzyme ibe yi-mevalonate.
Lapho kukhona uhlobo lwendlalifa ye-hypercholesterolemia (ikhuphukile i-cholesterol), i-dyslipidemia exubekile, into esebenzayo i-Liprimara izosiza ekunciphiseni ukugcwala kwe-plasma ye-cholesterol ephelele (Ch), i-apolipoprotein B, i-VLDL ne-LDL (i-lipoproteins ephansi) kanye nenani le-triglycerides. I-Atorvastatin ibangela ukukhuphuka kwe-high density lipoprotein (HDL).
Ukusebenza kwesenzo kungenxa yokucindezela komsebenzi we-HMG-CoA reductase kanye nokuvinjwa ukwakhiwa kwe-cholesterol kuma-hepatocytes.
I-Atorvastatin iyakwazi ukukhulisa isibalo se-low density lipoprotein receptors ebusweni bangaphandle be-membrane yeseli yesibindi, okuholela ekukhupheni ukuthathwa nokucekelwa phansi kwe-LDL.
Umuthi uyakwazi ukwandisa isibalo se-low density lipoprotein receptors on the elingaphandle membrane cell cell.
Inhlanganisela esebenzayo inciphisa ukuvela kwe-LDL cholesterol nenani lama-lipoprotein ayingozi, ngenxa yalokho kunokwanda komsebenzi wama-LDL receptors. Ezigulini ezine-homozygous hereditary hypercholesterolemia ukumelana nezenzo zemithi enciphisa i-lipid, amayunithi we-LDL ancishisiwe. Umphumela wokwelapha ubonwa kungakapheli amasonto ama-2 ngemuva kokuqala kokulashwa kwezidakamizwa. Umphumela omkhulu wabhalwa ngemuva kwenyanga yokwelashwa neLiprimar.
I-Pharmacokinetics
Ngemuva kokuphathwa ngomlomo, amaphilisi awancibeki ngaphansi kwesenzo se-hydrochloric acid esiswini, awela kwi-projimal ye-projimal. Kule ngxenye yendlela yokugaya ukudla, ulwelwesi lwefilimu luthola i-hydrolysis.
Ithebhulethi iyabhidlika, izakhi zomzimba nezidakamizwa ziqala ukudonswa ngokusebenzisa i-microvilli ekhethekile.
I-Atorvastatin ingena egazini isuka odongeni lwamathumbu, lapho ifinyelela khona amazinga aphakeme we-plasma kungakapheli amahora angama-1-2. Kwabesifazane, ukuqoqwa kwento esebenzayo kungaphezulu kwamaphesenti angama-20 kunabesilisa.
I-Bioavailability ifinyelela ku-14-30%. Amanani aphansi abangelwa i-parietal metabolism ye-atorvastatin engxenyeni ye-mucous yamathumbu emathunjini kanye nokuguqulwa kumaseli wesibindi yi-isoenzyme ye-cytochrome CYP3A4. Umuthi osebenzayo ubopha i-albhamuin ngama-98%, yingakho i-hemodialysis ingasebenzi. Ukuqedwa kwesigamu sempilo kufinyelela emahoreni ayi-14. Umphumela wokwelapha uphikelela amahora angama-20-30. I-Atorvastatin ishiya umzimba kancane ngohlelo lokuchama - yi-2% kuphela yomthamo etholakala emchameni ngemuva komthamo owodwa.
Izinkomba zokusetshenziswa
Umuthi usetshenziswa kwezokwelapha ukwelapha:
- i-hypercholesterolemia eyindalo yemvelo eyindlalifa futhi engeyona eyokuthola ifa;
- amazinga aphakeme we-endo native we-triglycerides amelana nokwelashwa kokudla;
- ifa le-homozygous hypercholesterolemia ngempumelelo ephansi yokudla nezinye izindlela zokwelapha ezingezona izidakamizwa;
- uhlobo oluhlanganisiwe lwehyperlipidemia.
Umuthi ubekwa njengezilinganiso zokuvimbela izifo zenhliziyo ezigulini uma kungekho zimpawu zesifo senhliziyo, kepha kube nezimpawu zobungozi: ukuguga, imikhuba emibi, umfutho wegazi ophakeme, isifo sikashukela i-mellitus. Iqembu lengcuphe lifaka abantu abane-predisposition to hypercholesterolemia kanye nezinga eliphansi le-HDL.
Umuthi unqunywe njengendlela yokuvimbela isifo senhliziyo.
Umuthi usetshenziswa njengesijobelelo kwezokwelapha ngokudla kwe-dysbetalipoproteinemia. I-Liprimar isetshenziswa njengendlela yokuvimbela ukuthuthukiswa kwezinkinga ezigulini ezine-myocardial ischemia ukunciphisa ingozi yokufa, ukushaya kwenhliziyo, unhlangothi kanye nokulaliswa esibhedlela ngenxa ye-angina pectoris.
Contraindication
Umuthi awunqunyelwe ukwanda kokulimala kwezicubu ezintweni zezakhi zeLiprimar, kanye nakumacala alandelayo:
- izifo ezinzima zesibindi;
- izingane ezingaphansi kweminyaka engu-18;
- ukwanda komsebenzi we-plasma we-hepatic transaminases izikhathi ezingaphezu kwezingu-3.
Ukuqapha kufanele kusetshenziswe lapho usebenzisa kabi utshwala.
Ungayithatha kanjani iLiprimar 10
Amacwecwe abekelwe ukuphathwa ngomlomo, kungakhathalekile isikhathi sosuku noma sokudla. Ukwelashwa kwezidakamizwa kwenziwa kuphela ngokungasebenzi kokudla kwe-hypocholesterolemic, izindlela zokunciphisa umzimba ngemuva kwesizinda sokukhuluphala ngokweqile kwe-morbid, ukuzivocavoca. Uma ukwanda kwe-cholesterol kubangelwa isifo esiyisisekelo, ngaphambi kokusebenzisa i-Liprimar, udinga ukuzama ukuqeda inqubo main ye-pathological. Ngesikhathi sonke sokwelapha izidakamizwa, kufanele unamathele ekudleni okukhethekile.
Ukwelashwa kwezidakamizwa nge-Liprimar 10 kwenziwa kuphela ngokungasebenzi kokudla kwe-hypocholesterolemic.
Umthamo wansuku zonke ngu-10-80 mg wokusetshenziswa okukodwa futhi ulungiswa ngokuya ngokusebenza kwe-LDL-C nasekufezekeni komphumela wokwelapha.
Isilinganiso esiphezulu esivumelekile ngu-80 mg.
Ngesikhathi sokulashwa ngeLiprimar, kuyadingeka ukuqapha ukugcwala kwe-plasma of lipids njalo emavikini angama-2, ngemuva kwalokho udinga ukubonana nodokotela wakho mayelana nezinguquko ohlelweni lomthamo.
Ukuqeda uhlobo oluxubile lwe-hyperlipidemia, kuyadingeka ukuthatha i-10 mg kanye ngosuku, kuyilapho i-homozygous hereditary hypercholesterolemia idinga umthamo omkhulu wokwelapha we-80 mg. Esimweni sokugcina, amazinga e-cholesterol ancishiswa ngo-20-45%.
Ukuthatha umuthi wesifo sikashukela
Iziguli ezinesifo sikashukela kufanele ziqaphele lapho kwenzeka i-hypercholesterolemia. Abantu abanjalo basengozini yokuba nesifo senhliziyo esi-coronary. I-Liprimar isetshenziswa njengesilinganiso sokuvimbela ukufakelwa kwe-myocardial. Umthamo unqunywa udokotela oya kuye ngokuya ngezinga le-cholesterol.
Iziguli ezinesifo sikashukela kufanele ziqaphele lapho kwenzeka i-hypercholesterolemia.
Kungenzeka yini uhlukanise ngesigamu
Akunobungozi ezibhebheni, okusho ukuthi ngeke kwenzeke ukwahlukanisa ifomu lomthamo.
Imiphumela emibi yeLiprimara 10
Ngokusebenzisa ngokungafanele umuthi, imiphumela emibi ingaqhamuka eyehlukahlukana kwendawo.
Amapheshana wesisu
Mhlawumbe ukubukeka kokuhlanza, isifo sohudo, izinhlungu esifundeni se-epigastric, ukuqunjelwa nokuthopha. Ezimweni ezingavamile, ukwelashwa nge-Liprimar kungavusa i-anorexia, inqubo yokuvuvukala kumanyikwe, i-hepatitis kanye ne-jaundice.
Izitho zeHematopoietic
Ezimweni ezingavamile, ukucindezelwa komongo kwenzeka, okuhambisana ne-thrombocytopenia.
I-Liprimar 10 ingadala ukuqwasha.
Isistimu yezinzwa ephakathi
Ukuphendula okungalungile ngomonakalo ohlelweni lwezinzwa kubonakala njenge:
- ukuqwasha
- i-malaise ejwayelekile;
- i-asthenic syndrome;
- ikhanda kanye nesiyezi;
- ukwehla kanye nokulahleka okuphelele kokuzwela;
- i-neuropathy ye-peripheral system;
- i-amnesia.
Kusuka ohlelweni lomchamo
Emadodeni, ukungasebenzi kahle kwe-erectile kanye nokugcinwa komchamo kungenzeka.
Kusuka ohlelweni lokuphefumula
I-Dyspnea kungenzeka.
Allergies
Ngomkhuba wokubonakalisa ukusabela kwe-anaphylactic, ukuqubuka esikhumbeni, ubomvu, ukulunywa, i-erythema exudative, i-necrosis yongqimba lwamafutha angaphansi. Ezimweni ezinzima, i-edema yeQuincke kanye ne-anaphylactic shock kukhula.
Umuthi wangaphambi komuthi okukhulunywa ngawo ungavusa ukuvela kwamaqhubu esikhunjeni.
Umthelela ekhonweni lokulawula izindlela
Umuthi awuphazamisi nemisebenzi edinga ukuphendula okusheshayo nokuxineka. Ngesikhathi sokulashwa ngomuthi, ukushayela imoto nokulawulwa kwamadivaysi e-Hardware avumelekile.
Imiyalo ekhethekile
Lapho welapha nge-Liprimar njalo emavikini ayi-6, kuyadingeka ukuthi kwenziwe ukujongwa kokuhlolwa kwesibindi nezinkomba ze-ALT, AST. Uma umsebenzi wama-aminotransferases ngaphezu komkhawulo ophezulu wokujwayelekile ungaphezu kwezikhathi ezi-3, kuyadingeka ukubonana nodokotela ngokuncipha komthamo.
Ngenxa yokwelashwa kwe-hypocholesterolemic, kwezinye izimo, ukubonakala kobuhlungu bemisipha ngokumelene nesizinda se-myopathy kwabonwa. Ngasikhathi sinye, izifundo zaselabhorathri ziveze ukwanda okuphindwe kashumi emsebenzini we-creatine phosphokinase kuqhathaniswa nokujwayelekile.
Uma isiguli sibuthakathaka nobuhlungu emithanjeni yezicubu zamathambo, kubalulekile ukuyeka ukuthatha lo muthi.
Ezimweni ezingavamile, i-rhabdomyolysis ithuthukisiwe - ukulimala kwe-necrotic kwezicubu zemisipha, kuhambisana nokwehluleka kobuhlungu be-renal.
Ukusetshenziswa kwomuthi kumele kumiswe ngokuncipha kwengcindezi yegazi.
Ukungasebenzi kahle kwamakhala kungumphumela we-myoglobinuria. Ukuze wehlise amathuba okuba ne-rhabdomyolysis, udinga ukuyeka ukuthatha umuthi kulezi zimo ezilandelayo:
- ngesikhathi sokuhlinzwa ngensimu ebanzi;
- ukulimala okukhulu kwezifo ezithweni;
- ukwehla okunamandla komfutho wegazi;
- ukulimala kwemishini;
- izicubu zomsipha.
Isiguli kufanele saziswe ngobungozi be-rhabdomyolysis. Ngemvume yokwelashwa, isiguli siphoqelekile ukuba sifune usizo lwezokwelapha sinomuzwa wobuthakathaka bemisipha kanye nokubonakala kobuhlungu obungachazeki, obuhambisana nomkhuhlane nokukhathala.
Ukuyalela i-Liprimar ezinganeni eziyi-10
Umuthi awuvunyelwe ukusetshenziswa ezinganeni.
Ukuhambisana notshwala
Umuthi akufanele uhlanganiswe nemikhiqizo yotshwala. I-ethyl yotshwala ivimbela uhlelo oluphakathi lwezinzwa, i-hepatobiliary kanye nokujikeleza kwegazi, futhi ngenxa yalokho umphumela we-hypocholesterolemic wokusetshenziswa kweLiprimar uncishisiwe Amathuba wokwenza ama-atherosclerotic plaque ezindongeni zemithambo yegazi ayanda.
Umuthi akufanele uhlanganiswe nemikhiqizo yotshwala.
Ukweqisa kweLiprimar 10
Lapho kwenzeka ukusetshenziswa kwe-overdose, imiphumela emibi iyanda. Into ethile ephikisayo ayikhiqizwa, ngakho-ke, ngenkathi ulaliswa esibhedlela, ukwelashwa okubonakalayo kuyenziwa.
Ukuxhumana nezinye izidakamizwa
I-Cimetidine, iPhenazone, i-Azithromycin, i-antacid, iTerfenadine, iWarfarin, i-Amlodipine ayithinti imingcele ye-pharmacokinetic yeLiprimar futhi ayihlangani ne-atorvastatin.
Inhlanganisela ayinconywa
Ngenxa yobungozi be-neuromuscular pathologies, ukuphathwa okufanayo kwe-Liprimar akunconywa nge:
- imishanguzo ye-cyclosporin;
- dericatives ye-nicotinic acid;
- I-Erythromycin;
- izidakamizwa ze-antifungal;
- imicu.
Ukuphathwa okuhambisanayo kweLiprimar ne-Erythromycin akunconyiwe.
Ukuhlanganiswa okunjalo kwezidakamizwa kungaholela ku-myopathy.
Ngokunakekela
Kunconywa ukuthi uqaphele ngenkathi usebenzisa i-Liprimar namanye amakhambi wemithi:
- I-Atorvastatin iyakwazi ukukhulisa i-AUC yezindlela zokuvimbela inzalo ngomlomo ngo-20-30%, kuya ngamahomoni aqukethe amalungiselelo.
- I-Atorvastatin enomthamo we-40 mg ngokuhlangana ne-240 mg ye-Diltiazem iholela ekonyukeni kokuqina kwe-plasma ye-atorvastatin egazini. Lapho uthatha i-200 mg ye-Itraconazole ene-20-40 mg yeLiprimar, ukukhuphuka kwe-AUC ye-atorvastatin kwabonwa.
- I-Rifampicin yehlisa amazinga e-plasma e-atorvastatin.
- I-Colestipol ibangela ukwehla kwesidakamizwa esinciphisa i-plasma cholesterol.
- Ngokulashwa okuhlanganisiwe nge-digoxin, ukuqoqwa kokugcina kukhuphuka ngo-20%.
Ijusi lamagilebhisi licindezela isenzo se-cytochrome isoenzyme CYP3A4, yingakho uma uphuza ngaphezulu kwamalitha ayi-1,2 kalamula ngosuku, ukugcwala kwe-plasma kwe-atorvastatin kukhuphuka. Umphumela ofanayo uyabonakala lapho uthatha i-CYP3A4 inhibitors (Ritonavir, Ketoconazole).
I-Liprimar iyenqatshelwe ukusebenzisa kwabesifazane abangu-10 abakhulelwe.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Kuyenqatshelwa ukusebenzisa lesi sidakamizwa kwabesifazane abakhulelwe, njengoba kunobungozi bokwephulwa kokubekwa okufanele kwezicubu nezitho zomzimba ngesikhathi sokukhula kombungu. Akukho datha emandleni weLiprimar ukungena ngaphakathi kwe-hematoplacental barriers.
Ngesikhathi sokwelashwa ngezidakamizwa, ukuncelisa ibele kufanele kuyekwe.
Ama-Analog
Ukufakwa kwesidakamizwa okunomphumela ofanayo kufaka phakathi:
- Atoris;
- Tulip;
- I-Vazator;
- Atorakord;
- Atorvastatin-SZ.
Ukufakwa esikhundleni kwenziwa ngemuva kokubonisana nodokotela.
Imibandela yekhefu lekhemisi
Umuthi uthengiswa ngokuqinile ngomuthi.
Ngingakwazi ukuthenga ngaphandle kadokotela?
Cha.
Intengo yeLiprimar 10
Izindleko ezijwayelekile zamaphilisi ayi-10 mg ama-ruble ayi-750-1000.
Izimo zokugcina zomuthi
Kuyadingeka ukugcina umuthi endaweni enomugqa ophansi womswakama at lokushisa lika + 15 ... + 25 ° C.
Isikhathi sokuphelelwa yisikhathi
Iminyaka emithathu
Umkhiqizi
IGedecke GmbH, eJalimane.
I-analog yeLiprimar - isidakamizwa i-Atoris sithengiswa emakhemisi ngokuqondile ngokuyalelwa.
Ukubuyekezwa ku-Liprimar 10
U-Elvira Ignatieva, oneminyaka engama-76, iLipetsk
Ezinyangeni ezi-6 ezedlule, ngesikhathi kuthathwa ukuhlolwa kwegazi okujwayelekile, kwembulwa i-cholesterol ephezulu ye-7.5 mmol. Nginokugula kwenhliziyo, ngakho-ke, ukuvimbela izinkinga zamaseli, i-cholesterol kwadingeka ukuthi incishiswe ngokushesha ngesikhathi esifushane. Udokotela unqume i-Liprimar 40 mg nsuku zonke. Intengo iphakeme, kepha kufanelekile ngokusebenza kahle. Ukuhlaziywa kwakamuva kukhombise ukwehla kwe-cholesterol ukuya ku-6 mmol.
UKristina Molchanova, oneminyaka engama-24, uYaroslavl
Ugogo unesifo sokuqina kwemithambo yemikhumbi esezingeni eliphansi kanti ikholesterol yakhe ne-LDL ziyanda. Kuqale kwaqoka uRosuvastatin, obekungafanele. Azikho izinguquko ezinhle. Ngemuva kweRosvvatinatin, kwaqalwa iLiprimar.Ngenxa yesidakamizwa, iphrofayili yokugcina ye-lipid ibonise ukuthuthuka: i-cholesterol kanye nesisindo somzimba sehle, ukuqina kwe-lipoproteins ephezulu kwabantu kwanda.
