I-Atorvastatin-Teva isidakamizwa se-hypolipidemic. Indlela yokusebenza yezidakamizwa ezokwehlisa i-lipid ukunciphisa izinga lekholesteroli "elibi", kanye nenani lama-triglycerides nama-lipoprotein asezingeni eliphansi nelincane kakhulu. Futhi, bandisa ukugcwala kwama-lipoprotein aphezulu kwabantu kanye ne-cholesterol "enhle".
I-Atorvastatin-Teva iyatholakala ngesimo samathebhulethi amhlophe aqukethe ifilimu. Kuqoshwe imibhalo emibili ebusweni bawo, omunye wawo ngu- "93", owesibili uncike kwimithamo yomuthi. Uma umthamo ungu-10 mg, ke kwaqoshwa okubhalwe "7310", uma kungu-20 mg, bese kuthi "7311", uma-30 mg, bese "7312", kanti uma kungu-40 mg, bese "7313".
Isithako esikhulu esisebenzayo se-Atorvastatin-Teva yi-atorvastatin calcium. Futhi, ukwakheka kwalo muthi kufaka izinto eziningi ezingeziwe, eziziwayo. Lokhu kufaka, ngokwesibonelo, i-lactose monohydrate, i-titanium dioxide, i-polysorbate, i-povidone, i-alpha-tocopherol.
Indlela yokusebenza ye-Atorvastatin-Teva
I-Atorvastatin-Teva, njengoba sekushiwo ekuqaleni, umenzeli ongehlisa i-lipid. Wonke amandla akhe ahlose ukuvimbela, okungukuthi, ukuvimbela isenzo se-enzyme ngaphansi kwegama elithi HMG-CoA reductase.
Indima eyinhloko yalesi enzyme ukulawula ukwakheka kwe-cholesterol, ngoba ukwakheka kwangaphambi kwayo, i-mevalonate, kusuka ku-3-hydroxy-3-methyl-glutaryl-coenzyme A. kwenzeka kuqala. I-cholesterol ehlanganisiwe, kanye ne-triglycerides, ithunyelwa esibindini, lapho ihlangana khona ne-lipoproteins ephansi kakhulu. . I-eyakhekile eyedlule idlulela kuyi-plasma yegazi, bese-ke ngesimo sakhona idluliselwa kwezinye izitho nezicubu.
Ama-lipoprotein aphansi kakhulu aguqulwa abe ama-lipoprotein aphansi kakhulu ngokuxhumana nama-receptors awo athile. Ngenxa yalokhu kuhlangana, i-catabolism yabo iyenzeka, okungukuthi, ukubola.
Umuthi wehlisa inani le-cholesterol ne-lipoprotein egazini leziguli, uvimbela umphumela we-enzyme futhi ukhuphula inani lama-receptors esibindini ama-lipoprotein aphansi. Lokhu kunomthelela ekubanjweni nasekulahlelweni kwabo okukhulu. Inqubo yokuhlanganiswa kwama-lipoprotein e-atherogenic nayo incishiswa kakhulu. Ngaphezu kwalokho, ukuqoqwa kwe-cholesterol ephezulu kwe-density lipoprotein cholesterol kuyanda futhi ama-triglycerides anciphisa kanye ne-apolipoprotein B (amaprotheni othwala).
Ukusetshenziswa kwe-Atorvstatin-Teva kukhombisa imiphumela ephezulu ekwelapheni hhayi nje i-atherosclerosis kuphela, kepha nezinye izifo ezihambisana nomzimba we-lipid, lapho okunye ukwelashwa kwe-lipid-ukwehlisa kwakungasebenzi.
Kwatholakala ukuthi ubungozi bokuthola izifo ezihambisana nenhliziyo nemithambo yegazi, njengokuhlaselwa yisifo senhliziyo nemivimbo, kuncishiswa kakhulu.
I-Pharmacokinetics ye-Atorvastatin-Teva
Lesi sidakamizwa sidonswa ngokushesha. Isikhathi esingamahora amabili, ukugcwala okuphezulu kakhulu kwezidakamizwa kubhalwe egazini lesiguli. I-Absorption, okungukuthi, ukumuncwa, kungashintsha ijubane layo.
Isibonelo, inganciphisa ngenkathi uthatha amaphilisi ngokudla. Kepha uma ukumunyiswa ngaleyondlela kwehlisa ijubane, khona-ke akuwuthinti umphumela we-Atorvastatin nganoma iyiphi indlela - cholesterol iyaqhubeka incipha ngokuya ngomthamo. Uma ungena emzimbeni, isidakamizwa siba nezinguquko ezi-presystemic ephepheni lesisu. Iboshwe kakhulu amaprotheni e-plasma - 98%.
Izinguquko ezinkulu ze-metabolic ne-Atorvastatin-Teva zenzeka esibindini ngenxa yokuchayeka kuma-isoenzymes. Njengomphumela walomphumela, kwakhiwa ama-metabolites asebenzayo, anecala lokuvinjwa kokunciphisa kwe-HMG-CoA. Ama-70% ayo yonke imiphumela yesidakamizwa yenzeka ngokunembile ngenxa yalawa ma-metabolites.
I-Atorvastatin ikhishwa emzimbeni nge-hepatic bile. Isikhathi lapho ukuhlangana komuthi egazini kuzolingana nohhafu wangempela (okubizwa ngokuthi yingxenye yempilo) kungamahora ayi-14. Umphumela we-enzyme uhlala cishe usuku. Akukho ngaphezu kwamaphesenti amabili esamba esamukelekile esinganqunywa ngokuhlola umchamo wesiguli. Ezigulini ezinokungasebenzi kahle kwe-renal, kufanele kukhunjulwe ukuthi ngesikhathi se-hemodialysis Atorvastatin ayishiyi emzimbeni.
Inani eliphakeme lomuthi lidlula inani elijwayelekile ngama-20% kwabesifazane, futhi isilinganiso sawo sokuqeda sincishiswe ngo-10%.
Ezigulini ezinokulimala kwesibindi ngenxa yokusebenzisa kabi utshwala ngokungapheli, inani eliphakeme likhuphuka ngezikhathi eziyi-16, futhi isilinganiso se-excretion sehla ngezikhathi eziyi-11, ngokungafani nokwejwayelekile.
Izinkomba kanye ne-contraindication ukuze zisetshenziswe
I-Atorvastatin-Teva umuthi osetshenziswa kabanzi kwezokwelapha zanamuhla.
Ukwelashwa kwanoma yiziphi zalezi zifo ezingenhla kanye ne-pathologies kwenziwa ngenkathi kugcinwa ukudla okusiza ukwehlisa i-cholesterol yegazi (ephezulu yemifino entsha nezithelo, izinsalela, amakhambi, amajikijolo, ukudla kwasolwandle, izinkukhu, amaqanda), kanye nalapho kungekho khona imiphumela evela ekuqaleni ukwelashwa okusetshenzisiwe.
Kunezinkomba ezimbalwa zokukhombisa ukuthi aphumelela impela:
- isifo sokuqina kwemizwa;
- i-hypercholesterolemia eyinhloko;
- i-heterozygous yomndeni kanye ne-non-abomndeni hypercholesterolemia;
- uhlobo oluxubile hypercholesterolemia (uhlobo lwesibili ngokusho kukaFredrickson);
- i-triglycerides ephakeme (uhlobo lwesine ngokusho kukaFredrickson);
- ukungalingani kwama-lipoproteins (uhlobo lwesithathu ngokusho kukaFredrickson);
- homozygous womndeni hypercholesterolemia.
Kukhona futhi ukuphikisana okuningi kusetshenziswa kwe-Atorvastatin-Teva:
- Izifo zesibindi esigabeni esisebenzayo noma esigabeni sokuqhuma.
- Ukwanda kwezinga lamasampula e-hepatic (ALT - alanine aminotransferase, AST - aspartate aminotransferase) kungaphezu kwezikhathi ezintathu, ngaphandle kwezizathu ezicacile;
- Ukwehluleka kwesibindi.
- Ukukhulelwa nokukhulelwa.
- Izingane zeminyaka encane.
- Ukubonakaliswa kwe-allergic lapho uthatha noma yiziphi izakhi zomuthi.
Kwezinye izimo, la maphilisi kufanele abekwe ngokuqapha ngokweqile. Lezi yizimo ezifana:
- ukuphuza ngokweqile utshwala;
- ukuhlangana kwesibindi kokudla;
- ukungalingani kwe-hormonal;
- ukungalingani kwama-electrolyte;
- ukuphazamiseka kwe-metabolic;
- umfutho wegazi ophansi;
- izilonda ezithathelanayo ezihlasela kakhulu;
- isifo sokuwa esingalashwa;
- imisebenzi eminingi nokulimala okulimazekayo;
Ngaphezu kwalokho, ukuqaphela lapho uthatha umuthi kufanele usebenzise umzimba lapho kukhona ama-pathologies wesistimu yemisipha.
Imiyalo yokusebenzisa umuthi
Umthamo wesidakamizwa unqunywa yisifo sokuqala esidinga ukwelashwa, izinga le-cholesterol, lipoproteins ne-triglycerides. Futhi, ukusabela kweziguli ekwelashweni okuqhubekayo kuhlala kucatshangelwa. Isikhathi sokuthatha umuthi asincike ekudleni kokudla. Kufanele uthathe ithebhulethi elilodwa noma ngaphezulu (kuya ngokuya kadokotela) ngosuku.
Ngokuvamile, ukusetshenziswa kwe-Atorvastatin-Teva kuqala ngomthamo we-10 mg. Kodwa-ke, umthamo onjalo awusebenzi ngaso sonke isikhathi, futhi ngenxa yalokho umthamo ungandiswa. Okuvunyelwe okuphezulu yi-80 mg ngosuku. Uma ukwanda komthamo wesidakamizwa kusadingeka, khona-ke kanye nale nqubo, ukubhekwa kwephrofayili ye-lipid njalo kufanele kwenziwe futhi ukwelashwa kufanele kukhethwe ngokuhambisana nabo. Ukushintsha inkambo yokwelashwa akudingeki nje ngenyanga.
Umgomo oyinhloko wokwelapha ukwehlisa i-cholesterol ibe eyejwayelekile. Isimo se-cholesterol esegazini yi-2.8 - 5.2 mmol / L. Kufanele kukhunjulwe ukuthi ezigulini ezinenkinga yokuhluleka kwesibindi, kungadingeka ukunciphisa umthamo noma ukuyeka ngokuphelele ukusebenzisa umuthi.
Imiphumela emibi yesidakamizwa
Ngesikhathi sokusebenzisa i-Atorvastatin-Teva, kungaba nokuhluka okuhlukahlukene okuvela ezinhlotsheni nasezinhlotsheni zezitho ezahlukahlukene. Eminye imiphumela emibi yiyona ejwayelekile kakhulu.
Uhlelo lwezinzwa oluphakathi nolwezinsizakalo: ukuphazamiseka kokulala, ikhanda, ukuthikamezeka kwenkumbulo, ubuthakathaka, ukuncipha noma ukuthambekela kokuqonda okuhlanekezelwe, i-neuropathy.
Ipheshana lesisu: Ubuhlungu besisu, ukugabha, isisu, ukwakheka ngokweqile kwegesi, ukuqunjelwa, ukugayeka, izinqubo zokuvuvukala esibindini kanye namanyikwe, i-jaundice ehambisana nokuqina kwe-bile, ukukhathala.
Uhlelo lwe-musculoskeletal: Ubuhlungu emisipha, ikakhulukazi izicubu zomhlane, ukuvuvukala kwemicu yemisipha, izinhlungu ezihlangene, i-rhabdomyolysis.
Ukubonakaliswa kwe-allergic: ngohlobo lokuqhuma kwesikhumba ngohlobo lwe-urticaria, ukulunywa, ukusabela komzimba osheshayo ngendlela yokuthuthumela kwe-anaphylactic, ukuvuvukala.
Uhlelo lweHematopoietic: ukwehla kwenani lokubalwa kweplatelet.
Uhlelo lweMetabolic: ukwehla noma ukwanda kweglucose yegazi, ukwanda komsebenzi we-enzyme ebizwa ngokuthi yi-creatine phosphokinase, i-edema yemikhawulo ephezulu nephansi, inzuzo yesisindo.
Abanye: ukuncipha kwe-potency, izinhlungu esifubeni, ukungasebenzi kahle kwezinso, ukuqina okugxile, ukukhathala okwandayo.
Nge-pathologies nemibandela ethile, i-Atorvastatin-Teva kufanele ichazwe ngokuqapha ngokweqile, ngokwesibonelo:
- Ukusetshenziswa kabi kotshwala;
- I-Pathology yesibindi;
- Ukwanda kokuhlolwa kokusebenza kwesibindi ngaphandle kwesizathu esibonakalayo;
Ukuqapha kuyadingeka futhi ngenkathi uthatha ezinye izidakamizwa ze-anticholesterolemic, ama-antibiotics, ama-immunosuppressants, namavithamini athile.
Ukuxhumana neminye imithi
I-Atorvastatin-Teva igcwele ukuthuthukiswa kwe-myopathy - ubuthakathaka obunzima bemisipha, njengazo zonke izidakamizwa ezikuqembu le-HMG-CoA reductase inhibitors. Ngokusetshenziswa okuhlangene kwezidakamizwa eziningana, ubungozi bokuthuthukisa le-pathology bunganda kakhulu. Lezi izidakamizwa ezinjenge-fibrate (elinye lamaqembu e-pharmacological anticholesterolemic), ama-antibiotics (erythromycin nama-macrolides), izidakamizwa ze-antifungal, amavithamini (PP, noma i-nicotinic acid).
Lawa maqembu enza i-enzyme ekhethekile ebizwa nge-CYP3A4, edlala indima enkulu ku-Atorvastatin-Teva metabolism. Ngalesi hlobo lokwelashwa okuhlanganisiwe, izinga le-atorvastatin egazini lingakhuphuka ngenxa yokuvinjelwa kwe-enzyme esesikhulume ngayo ngaphambili, ngoba umuthi awukhiqizwanga kahle. Ukulungiselela okuvela eqenjini lama-fibrate, isibonelo, i-Fenofibrate, kuvimbela izinqubo zokuguqulwa kwe-Atorvastatin-Teva, ngenxa yalokho inani layo egazini libuye likhuphuke.
I-Atorvastatin-Teva nayo ingaholela ekwakhiweni kwe-rhabdomyolysis - lokhu kuyindlela ebaluleke kakhulu eyenzeka njengomphumela wesifundo eside se-myopathy. Kule nqubo, imicu yemisipha iba nokubhujiswa okukhulu, ukwabiwa kwawo umchamo kuyabonakala, okungaholela ekwehlulekeni kwe-renal acute. I-Rhabdomyolysis ivame ukukhula ngokusetshenziswa kwe-Atorvastatin-Teva kanye namaqembu wezidakamizwa angenhla.
Uma unquma umuthi endaweni ephezulu evunyelwe umthamo wansuku zonke (80 mg ngosuku) kanye ne-cardiac glycoside Digoxin, khona-ke kukhona ukwanda kokuhlushwa kwe-Digoxin cishe ingxenye eyodwa kwezihlanu komthamo othathwe.
Kubaluleke kakhulu ukuhlanganisa kahle ukusetshenziswa kwe-Atorvastatin-Teva kanye nezidakamizwa zokulawula ukuzala eziqukethe i-estrogen kanye nokuphuma kwayo, ngoba kunokwenyuka kwezinga lamahomoni abesifazane. Kunendaba nabesifazane beminyaka yokuzala.
Ngokudla, kunconywa ngokucophelela ukunciphisa ukusetshenziswa kwejusi yamagilebhisi, ngoba kuqukethe izinto ezingaphezu kwesisodwa ezivimbela i-enzyme, ngaphansi kwethonya lapho izinqubo eziyinhloko ze-metabolic ze-Atorvastatin-Teva zenzeka khona kanye nezinga lazo egazini likhuphuka. Lesi sidakamizwa singathengwa kunoma yiliphi ikhemisi ngencwadi ebhalwe phansi.
Imininingwane mayelana nomuthi i-Atorvastatin inikezwe kuvidiyo ekulesi sihloko.
