Ngaphezu kokwelashwa kokudla, izidakamizwa eziningi zisetshenziselwa ukwelapha isifo esivamile njenge-atherosclerosis.
Enye yazo i-fluvastatin, okuyi-hypocholesterolemic ntho yokulwa ne-cholesterol ekhuphukayo egazini lomuntu.
I-Fluvastatin yinto enobuthi enombala omhlophe noma ophuzi kancane. I-soluble kahle emanzini, amanye ama-alcohols, anezici ze-hygroscopic.
Enye ye-drug analogues (i-generics), efaka i-fluvastatin esebenzayo yezinto, yi-Leskol Forte. Kuyithebhulethi esebenza isikhathi eside efakiwe. Zinejamo eliyindilinga, ele-biconvex elinemiphetho eyenziwe nge-beveled. Kuqukethe i-80 mg ye-fluvastatin kuthebhulethi eyi-1.
Yisidakamizwa se-hypocholesterolemic esenziwe ngokwenziwe. Ivimbela umsebenzi we-HMG-CoA reductase, omunye wemisebenzi yawo ukuguqulwa kwe-HMG-CoA kuye kwangaphambi kwama-sterols, okuyi-cholesterol, mevalonate. Isenzo saso senzeka esibindini, lapho kunokwehla kwe-cholesterol, ukwanda kwesenzo se-LDL receptors, ukwanda kokuthathwa kwezinhlayiya ze-LDL ezinyakazayo. Ngenxa yalokho, ngenxa yesenzo sazo zonke lezi zinqubo, kukhona ukwehla kwe-cholesterol ye-plasma.
Ososayensi baveze ukuthi ngenani elikhulayo le-cholesterol ye-LDL ne-triglycerides eplasma yegazi, i-atherosulinosis iyanda kanye nengozi yokuba nezinye izifo zenhliziyo nezemithambo yanda, okuvame ukuholela ekufeni. Kodwa-ke, ukwanda kwamazinga aphezulu we-lipoprotein ephezulu kunomthelela ophambene.
Ungabheka ukusebenza komtholampilo lapho uthatha umuthi ngemuva kwamaviki ama-2, ubulukhuni bawo obukhulu butholakala kungakapheli inyanga kusukela ekuqaleni ukwelashwa futhi kugcinwa kuso sonke isikhathi sokusetshenziswa kwe-fluvastatin.
Ukuhlushwa okuphezulu kakhulu, isikhathi sokusebenza kanye nengxenye yempilo kuncike ngqo:
- Ifomu lomthamo lapho umuthi usetshenziswa khona;
- Izinga nesikhathi sokudla, okuqukethwe ngamafutha okukuwo;
- Isikhathi sesikhathi sokusetshenziswa;
- Izici ngazinye zezinqubo zabantu zokusebenzisa umzimba.
Lapho kusetshenziswa i-fluvastatin sodium kwiziguli ezine-hypercholesterolemia noma i-dyslipidemia, ukwehla okukhulu kwe-LDL ne-triglycerides kanye nokwanda kwe-cholesterol ye-HDL kwaqashelwa.
Ngesikhathi sokuqokwa kuyadingeka ukulandela izincomo ezikhethekile.
Uma umuntu enezifo zesibindi, isifiso sokuya ku-rhabdomyolysis, ukusetshenziswa kwezinye izidakamizwa zeqembu lama-statin noma ukusetshenziswa kabi kotshwala, i-fluvastatin inqunywa ngokuqapha. Lokhu kungenxa yokuphazamiseka kwesibindi, ngakho-ke, ngaphambi kokuyithatha, ngemuva kwezinyanga ezi-4 noma ngesikhathi sokukhulisa umthamo, zonke iziguli kudingeka zihlole isimo sesibindi. Kunobufakazi bokuthi ezimweni ezingavamile kakhulu, ukusetshenziswa kwento kunomthelela ekuqaleni kwe-hepatitis, eyabonakala kuphela ngesikhathi sokwelashwa, futhi ekugcineni kwadlula;
Ukusetshenziswa kwe-fluvastatin kwezinye izimo kungadala ukuvela kwe-myopathy, myositis kanye ne-rhabdomyolysis. Iziguli kumele zazise udokotela ovelelayo ngokubonakala kobuhlungu bemisipha, ukuqina noma ubuthakathaka bemisipha, ikakhulukazi lapho kukhona ukwanda kokushisa;
Ukuvimbela ukuthuthukiswa kwe-rhabdomyolysis ngaphambi kokusetshenziswa, kunconywa ukutadisha ukuhlushwa kwe-creatine phosphokinase phambi kwesifo sezinso ezigulini; isifo se-yegilo; zonke izinhlobo zezifo zofuzo zohlelo lwemisipha; umlutha wotshwala.
Ezigulini ezineminyaka engaphezu kwengama-70, isidingo sokunquma izinga le-CPK kufanele sihlolwe lapho kunezinye izici ezibikezela ukukhula kwe-rhabdomyolysis.
Kuzo zonke lezi zimo, udokotela ohambelayo uhlola izinzuzo zokwelashwa nezingozi ezihambisana nakho. Iziguli zigadwe njalo futhi ngokucophelela. Endabeni yokwanda okukhulu ekuqoqweni kwe-CPK, kunqunywa futhi ngemuva kwesonto. Uma umphumela uqinisekisiwe, ukwelashwa akunconywa.
Ngokunyamalala kwezimpawu kanye nokujwayelekile kokuhlushwa kwe-creatine phosphokinase, ukuqala kabusha kokulashwa nge-fluvastatin noma amanye ama-statins kunconyelwa ukuthi aqale ngethamo eliphansi kakhulu futhi ngaphansi kokugadwa okuhlala njalo.
Iphuzu elibalulekile ukugcinwa kokudla kwe-hypocholesterol kokubili ngaphambi kokuqala kokwelashwa nangesikhathi sokwelashwa.
Kuthathwa ngomlomo, kungakhathalekile ukuthi kudliwani. Kuyadingeka ukugwinya ithebhulethi yonke, igezwe ngenani elikhulu lamanzi acacile, isikhathi esingu-1 ngosuku.
Njengoba umphumela omkhulu we-hypolipidemic uphawulwa ngeviki 4, ukubukezwa komthamo akufanele kwenzeke ngaphambi kwalesi sikhathi. Umphumela wokwelapha weLescol Forte uphikelela ngokusetshenziswa isikhathi eside.
Ukuqala ukwelashwa, umthamo onconywayo ngu-80 mg kanye ngosuku, ofana nethebhulethi eyi-1 yeLeskol Forte 80 mg. Ebukhoneni besifo esibuthakathaka salesi sifo, kungamiswa i-20 mg ye-fluvastatin, noma i-1 kapuleti Leskol 20 mg. Ukukhetha umthamo wokuqala, udokotela uhlaziya izinga lokuqala le-cholesterol egazini lesiguli, aqoke izinhloso zokwelapha futhi anaka izici zesiguli ngasinye.
Esimweni lapho isiguli sinenkinga yesifo senhliziyo futhi senziwe ukuhlinzwa kwe-angioneoplastic, umthamo wokuqala onconywayo ukusetshenziswa kwama-80 mg ngosuku.
Ukulungiswa kwedosi akwenziwa ezigulini ezinomsebenzi we-renal ongasebenzi kahle. Lokhu kungenxa yokuthi iningi le-Fluvastatin likhishwa isibindi, futhi yingxenye encane kuphela yento etholwe emzimbeni efakwa umchamo.
Lapho wenza ucwaningo, kwafakazelwa ukusebenza okuhle nokubekezelela okuhle hhayi kuphela kwiziguli ezisencane, kodwa nakubantu abangaphezu kweminyaka engama-65.
Eqenjini lobudala elingaphezu kweminyaka engama-65, impendulo ekwelashweni yayivezwa kakhulu, kuyilapho kungekho datha ekhombisa ukubekezelela okungathí sina okutholakele.
Umuthi lo unemiphumela emibi eminingana:
- Imvamisa, ukuvela kwe-thrombocytopenia kungabhekwa;
- Mhlawumbe ukwenzeka kokuphazamiseka kokulala, ikhanda, i-paresthesia, i-dysesthesia, i-hypesthesia;
- Ukuvela kwe-vasculitis akuvamile ukuba kwenzeke;
- Ukubonakala kokuphazamiseka kwendlela yomgudu wesisu - dyspepsia, Ubuhlungu besisu, isicanucanu;
- Ukuvela kokuphendula kwesikhumba se-allergic, eczema, dermatitis;
- Ubuhlungu bemisipha, i-myopathy, i-myositis, i-rhabdomyolysis, kanye nokuvela kwe-lupus akuvamile ukwenzeka.
Umuthi unconywa ukuthi usetshenziswe yiziguli ezindala:
- Lapho kutholwa inani elikhulayo le-cholesterol ephelele, i-triglycerides, i-low density lipoprotein cholesterol, i-apolipoprotein B, nge-hypercholesterolemia eyisisekelo ne-hyperlipidemia;
- Ebusweni besifo senhliziyo ukuze unciphise ukukhula kwe-atherosclerosis;
- Njengomuthi wokuvimbela ngemuva kwe-angioplasty.
Umuthi uphulwe ukuze usetshenziswe lapho kukhona izinto zokwaliwa; iziguli ezinezifo zesibindi, kanye nokwanda kwezinga lama-enzyme wesibindi; ngesikhathi sokukhulelwa nokuqunjelwa kwabesifazane; izingane ezingaphansi kweminyaka eyi-10.
Ngokuqapha, kuyadingeka ukunquma ikhambi leziguli ezinesifo sokuwa, ngokudakwa, ukwehluleka kwezinso futhi kusebenze i-myalgia.
Ukuphendula okuhlukile akubonwa ngethamo elilodwa lama-80 mg.
Endabeni yokunquma iziguli umuthi ngendlela yamathebulethi onokubambezeleka okukhishwa kumthamo we-640 mg izinsuku eziyi-14, ukubonakala kwemiphumela emibi evela emgodini wesisu, ukukhuphuka kwamazinga we-plasma we-transaminases, ALT, AST.
Ama-cytochrome isoenzymes abamba iqhaza ku-metabolism yesidakamizwa. Esimweni lapho kungenzeka khona enye yezindlela ezi-metabolic, kuvela, kunxeshezelwa ngokulahlekelwa abanye.
Ukusetshenziswa okuhlangene kwesidakamizwa i-Fluvastatin ne-HMG-CoA reductase inhibitors akunconyiwe.
Ama-substrates kanye nama-inhibitors wohlelo lwe-CYP3A4, i-erythromycin, i-cyclosporin, i-intraconazole inethonya elincane elishiwo ekhemisi yemithi.
Ukuze wandise umthelela wokungezelela, i-colestyramine iyanconywa ukuthi isetshenziswe kungaphambi kwamahora ama-4 ngemuva kwe-fluvastatin.
Akukho okuphikisana ekuhlanganisweni komuthi nge-digoxin, erythromycin, itraconazole, gemfibrozil.
Ukuphathwa okuhlanganisiwe kwalesi sidakamizwa ne-phenytoin kungadala ukwanda kokuhlungwa kwe-plasma yokugcina, ngakho-ke kufanele kuqashelwe lapho kunqunywa le mithi. Kwezinye izimo, ukulungiswa komthamo kungadingeka.
Kukhona ukwanda kokuhlushwa ku-plasma yegazi ye-diclofenac lapho kuthathwa ndawonye ne-fluvastatin.
I-Tolbutamide ne-losartan zingasetshenziswa ngasikhathi sinye.
Esimweni lapho umuntu enenkinga yesifo sikashukela sohlobo 2 futhi ethatha i-fluvastatin, kufanele kuqashelwe kakhulu futhi kube ngaphansi kokuqashwa njalo kwezokwelapha, ikakhulukazi lapho kwandiswa umthamo wansuku zonke we-fluvastatin kuya ku-80 mg ngosuku.
Lapho umuthi uhlanganiswa ne-ranitidine, i-cimetidine ne-omeprazole, ukwanda okuphakeme kokuhlungwa kwe-plasma kanye ne-AUC yento kuyabonwa, kuyilapho ukuncishiswa kwe-plasma kweFluvastatin kuncishisiwe.
Ngokuqapha, hlanganisa le nto nama-anticoagulants ochungechunge lwe-warfarin. Kunconywa ukubheka isikhathi nesikhathi se-prothrombin, uma kunesidingo, uguqule umthamo.
Njengamanje, umuthi ubonakala ngezibuyekezo eziningi ezinhle ezigulini ebezisithatha njengendlela yokwelashwa. Kumele kuqashelwe ukuthi ukuze uzuze umphumela omkhulu, kubalulekile ukulandela indlela yokuphila enempilo, ukudla okufanele nokuvivinya umzimba okulinganiselayo. Ngaphezu kwalokho, kunconywa inkambo ende yokusebenzisa, ngoba umuthi unomphumela owenziwe isikhathi eside, lapho unomthelela omuhle enanini le-cholesterol egazini.
Imithi equkethe i-fluvastatin kumele ithengwe emakhemisi ngencwadi kadokotela.
Ochwepheshe bazokhuluma ngama-statin kuvidiyo kule ndatshana.
