Ekusebenzeni kwenhliziyo, izidakamizwa ezokwehlisa izinga le-cholesterol ye-endo native zithole ukuthandwa okuthile. Izibalo ezinjalo zihambisana nesibalo esikhulu sokuxhamazeleka kwenhliziyo okubangelwa ukungalingani kwe-lipid. Ngokwezivumelwano zomhlaba wonke, izidakamizwa zeqembu lama-statin ziyisinyathelo sokuqala ekwelashweni kweziguli kwesiguli.
Odokotela bavame ukuba nokukhetha - Simvastatin noma Atorvastatin?
Ukukhetha phakathi kwale mishanguzo emibili kwenziwa ngudokotela wesiguli kuphela, ebheka zonke izici zesiguli.
Naphezu kodumo olungamangabazisayo oludonswe ubukhona bezinkinga eziningi, ama-statin yizo izidakamizwa ezisebenza kahle kakhulu zokunciphisa ukushona kwabantu ezinqubeni ze-atherosselotic.
Izinkomba ze-statins
Izimo ziyiqembu lezidakamizwa elehlisa i-lipid.
Isibonakaliso esiyinhloko sokuqokwa ukulungiswa kwe-lipid metabolism.
Umuthi wokutholwa wokuqala wesidakamizwa ukuvumela ukuthi wenze ngokwejwayelekile umzimba we-metabolism futhi ususe zonke izimpawu zokulimala kwe-atherosulinotic.
Emsebenzini wezokwelapha, ukusetshenziswa kwama-statins kunconyelwe:
- ukwelashwa okuyinkimbinkimbi kuhlangene nokudla kokuzivocavoca okwenziwe emzimbeni kweziguli ezinamazinga aphezulu e-liphero ye-atherogenic egazini;
- ukwandisa izinga lama-lipoprotein e-antiatherogenic;
- ukusetshenziselwa ezigulini ezibika izikhalazo ezenziwa ngokudalwa kwenhliziyo, kepha zisengcupheni (umlando ophathelene nefa, ukubhema, ukuphazamiseka kwengqondo okuphezulu, isifo sikashukela);
- ukwelashwa kwezifo zenhliziyo ezi-coronary, okuboniswa yi-angina pectoris;
- ukuvimbela izinhlekelele ezinamandla zenhliziyo;
- ukwelashwa kwezifo zofuzo ezihambisana nokuphazamiseka kwe-dyslipidemic.
- ukwelashwa kwe-metabolic syndrome.
Iphuzu lokusebenzisa lezi zidakamizwa zombili yi-lipid metabolism.
Ukuzikhethela okuhle kwe-Atorvastatin noma i-Simvastatin, okuyiqembu elifanayo lezinto, kuzoncika ezintweni eziningi. Isibonelo, i-statin yokuqala ingaba ngcono kakhulu ekuvinjelweni, elesibili elashwa.
Futhi, ukukhetha kuncike ekubeni khona kwe-contraindication nemikhawulo yokusebenzisa.
Ukweluleka umuthi othize, ukungazazi isimo somtholampilo, kuyiphutha lokunganaki. Ukuqokwa kudinga ukuqondwa okugcwele kwesimo sempilo sesiguli.
Izici ezijwayelekile zama-statins
Ngokusho kwesigaba samazwe omhlaba, ama-static ahlukaniswe izidakamizwa zokuqala zokwenziwa ezenziwe ngemisisi futhi, kamuva, zenziwa. Izizukulwane ezi-4 zezidakamizwa nazo ziyahlukaniswa.
ISimvastatin yi-statin yesizukulwane sokuqala eyenziwe ngesigaba sokuqala. I-Atorvastatin - izindlela zokwenziwa zesizukulwane sesi-4. Isizukulwane sesine sama-statins sibonakaliswa ngokusebenza okuphezulu kanye ne-spectrum encane yemiphumela emibi.
Ukwelashwa nge-Hypolipidemic kwenza ukuthi sikwazi ukunciphisa ukuhlangana kwe-atherogenic lipids okungenani kwengxenye eyodwa kwezintathu.
Ngokuhlangana nokudla okulinganiselayo kanye nokuzivocavoca okwenziwe ngokomzimba, izidakamizwa zingakwazi ukwenza ngokwejwayelekile i-lipid metabolism.
Iziguli eziningi zizibuza ukuthi yini umehluko phakathi kwesidakamizwa i-Simvastatin kanye ne-Rosuvastatin eyaziwa kakhulu (igama lokuhweba - i-Crestor). Kuze kube manje, ochwepheshe bakhetha umuthi i-Rosuvastatin. Lokhu kokugcina kungumkhiqizo wesimanje wezemithi. Lapho ukhetha i-simvastatin noma i-rosuvastatin okungcono, ukukhetha kufanele kunikezwe i-rosuvastatin. Ukusebenza kwesenzo salo kungukungeniswa okusheshayo kwamamolekyulu asebenzayo kuyi-hepatocytes, lapho kunomthelela osebenzayo ezingeni le-cholesterol eyakhiwe. Ngenxa yalokhu, ukugcwala kwe-cholesterol ye-endo native kuyancipha futhi inqwaba eyakhekile ye-atherosclerotic ibhujiswe.
Kubalulekile ukuqonda ukuthi kwenqatshelwe ukusebenzisa ama-statin ngaphandle kokuyalelwa ngudokotela. Ukuvinjelwa okunjalo okuqinile kuhlotshaniswa nokwehlukahlukana okuhlukahlukene nemikhawulo.
Ngaphezu kwesigamu seziguli ezithatha ama-statin zashiya ukubuyekezwa okungathandeki mayelana nomuthi. Kodwa-ke, imiphumela emibi eminingi akuyona inkomba yokuhoxiswa kwezidakamizwa.
Ngokuvamile, ama-statins abekezelelwa kahle futhi anomphumela onenzuzo ku-lipid metabolism.
Imiyalo yokusebenzisa i-simvastatin
Umuthi ungummeleli owenziwe ngesizukulwane sokuqala wama-statins. Ukudla kwayo njalo kunomthelela ekunciphiseni okukhulu kwezinga le-cholesterol ye-atherogenic kanye nokuvinjelwa kokuthuthukiswa kwezifo zenhliziyo kakhulu.
Ngeshwa, ukusebenza kweSimvastatin kuqhathaniswa nezinye izizukulwane kuphansi. Kodwa-ke, ngobumnene nobungako obulinganiselwe bokuqina kwe-atherosclerosis futhi kuhlanganiswa nokudla nokucindezelwa, lo muthi unomphumela owanele ekwelashweni kwesiguli.
Ngokwemiyalo yokwamukelwa, umkhiqizo uhloselwe ukusetshenziswa kwangaphakathi. Umuthi uyatholakala ngesimo sethebhulethi.
Kungcono ukuthatha umthamo owodwa wesidakamizwa kusihlwa, ngaphandle kokuphula ubuqotho begobolondo.
Umthamo wansuku zonke unqunywa ngasikhathi sinye. Ngaphambi kokuqala ukwelashwa nge-simvastatin, kunconywa ukufeza ukulungiswa okuphezulu kakhulu kwe-lipid metabolism usebenzisa umsebenzi owanele womzimba nokudla okulinganiselayo. Umuthi ungabekwa kuphela uma ungekho umphumela wokudla nokucindezelwa.
Isikhathi sesifundo nomthamo we-simvastatin sinqunywa ngudokotela wesiguli, kucatshangelwa izinga lokuqala le-cholesterol nezimpawu zomzimba.
Umthamo wansuku zonke wezidakamizwa uyahluka kusuka ku-5 kuya ku-80 milligrams.
Umthamo akufanele uguqulwe kungakapheli inyanga eyodwa ngemuva kokuqala kokwelashwa.
Kuyenqatshelwa ngokuzimela ukuguqula nokungezelela ukwelashwa.
Ukuphathwa ngendlela efanele kwesidakamizwa kuqinisekisa ukuqala komphumela wokwelapha ekupheleni kwenyanga yokuqala yokwelashwa.
Ngemuva kwenyanga nesigamu, lizinga le-cholesterol ye-atherogenic lenziwa labujwayelekile.
Izimo azinamphumela wokuqongelelwayo. Umuthi usebenza kuphela ngesikhathi sokuphathwa kwawo.
Uma ungalandeli indlela yokuphila enempilo ngemuva kokuyeka umuthi, ngemuva kwesikhathi esithile, ukugcwala kwe-cholesterol endo native kungakhuphuka futhi.
Imiyalo yokusebenzisa i-atorvastatin
Lesi sidakamizwa singaba nomphumela omenyezelwe futhi osheshayo. Kufanele ibekelwe i-cholesterol ephezulu, isifo senhliziyo, isifo sikashukela esibuhlungu kanye nokuvikela izinhlekelele ezinobungozi zenhliziyo.
I-Atorvastatin ithole ukubuyekezwa okuphezulu kakhulu kusuka kwabezokwelapha mayelana nokusebenza kwayo okuvelele.
I-Atorvastatin ingumuthi ohloselwe ukuphathwa ngomlomo. Ngokufanayo esimweni esineSimvastatin, i-Atorvastatin kufanele ichazwe kuphela ngemuva kokwehluleka ngokuphelele kokungalashwa kwezidakamizwa.
Kuthathwa umthamo wansuku zonke kucatshangelwa ubunzima besifo kanye nezimpawu zesiguli ngasinye.
Umthamo wokuqala wesidakamizwa ngu-10 mg. Ukulungiswa kwenziwa ngemuva kwenyanga kusukela kuqale ukwelashwa.
Ukudla njalo lesi sidakamizwa kunikeza ukwehla kokuxineka kwama-lipids atherogenic ngaphezulu kwesigamu.
Isici somuthi umphumela omnene kuma-nephrons. Kulesi sixhumano, kunconyelwa ukuthi kusetshenziswe iziguli ezinenkinga yokuhluleka ukuqina kwezinso. Umthamo omkhulu wesidakamizwa ngu-80 mg. I-Atorvastatin iboniswa ezinganeni kumthamo ongadluli kuma-20 mg.
Ngaphambi kokuyithatha, kubalulekile ukuhlola ama-enzyme wesibindi.
Kubalulekile ngesikhathi sokwelashwa futhi ukuhlola umsebenzi we-enzymatic wesibindi.
Imiphumela emibi kanye ne-contraindication yama-statins
Isici sokusetshenziswa kwe-Atorvastatin ne-Simvastatin ukuqapha okungapheli kwezitho ezibalulekile nezinhlelo. Izidakamizwa zinomphumela obalulekile kuma-metabolism wamafutha. Kulokhu kuhlangana abathintekayo ekugcineni i-homeostasis yomzimba.
Izitatimende zimemezele umsebenzi we-pharmacological, ngakho-ke, ukusetshenziswa kwazo kukhawulelwe kwezinye izimo zomzimba neze-pathological.
Lezi zimo ezilandelayo zingukuphikisana nokusetshenziswa kwama-statins:
- Umlando we-hypersensitivity kwezidakamizwa ezikhethiwe.
- Ukungabekezelelani kwe-lactose. Ukwakheka kwamalungiselelo kuqukethe i-lactose.
- Izinhlobo ezahlukahlukene ze-myopathy.
- Izifo zesibindi kwifomu elisebenzayo.
- Iminyaka yezingane ukuya eminyakeni eyi-10.
- Utshwala
- Izifo ezithathelanayo ezinzima.
- Ingozi enkulu yokwehluleka kwezinso okulimazayo.
- Ukwelapha ngama-immunosuppressants.
- Ukuhlelela ukuhlinzwa okubanzi.
- Kwenqatshelwe ukushayela izimoto nezinqubo ezidinga ukugxilwa okukhulu nokunakwa ngenkathi uthatha ama-statin.
- Ukukhulelwa Umuthi unomphumela oqinile we-teratogenic. Kulesi sixhumano, kwenqatshelwe ukusetshenziswa kwabesifazane abakhulelwe.
- Isisu.
Lapho uthatha ama-statin ama-semi-synthes, kuyadingeka ukushiya amajusi we-citrus, ngoba lapho ehlanganiswa, ubungozi bemiphumela emibi buyanda.
Imiphumela emibi ikhula kakhulu ngenxa yemithamo ekhethwe ngendlela engafanele. Kodwa-ke, kwezinye izimo, imiphumela emibi ayihlotshaniswa nomthamo wesidakamizwa.
Imiphumela elandelayo elandelayo ibonakala kuma-statin:
- ikhanda, kuze kube sekukhuleni kwezinhlungu ze-cluster kanye ne-migraine;
- ukuphazamiseka kwesistimu yokugaya;
- ukuphazamiseka kokulala nezigaba zokulala;
- ubuthakathaka, ukukhathala;
- ukungasebenzi kwesibindi;
- komzimba
- Ukuphazamiseka kwe-CNS.
Okudangalisa kakhulu futhi okuxakayo kakhulu kwe-statin therapy ukuthuthukiswa kwe-rhabdomyolysis. Le nto yenzeka ngenxa yomphumela onobuthi wesidakamizwa emicubeni yemisipha.
I-Rhabdomyolysis yisimo esiyingozi kakhulu esiholela ekulimaleni kwezimbumbulu ze-renal kanye nokukhula kokwehluleka kwe-renal reute.
Ukukhetha izidakamizwa
Ukunquma ukusebenza kwesidakamizwa kungenzeka kuphela lapho usisebenzisa esigulini esithile. Ukwahlulela ngezakhiwo zamakhemikhali, i-Atorvastatin iyithuluzi lesimanje futhi elinamandla kakhulu, uma sithatha ama-semi-syntaff agents uma siqhathanisa. Umehluko omkhulu usezimpawu zokuqamba kanye ne-pharmacodynamics yezidakamizwa.
Ukusetshenziswa kwe-atorvastatin kufaka ukunqwabelana komkhiqizo onobuthi we-metabolic - sterol, obangela umthelela omubi ezinhlakeni zemisipha. Ukwamukelwa Simvastatin kuhlotshaniswa nemiphumela ye-myotoxic, kepha ngezinga elincane kakhulu.
Ukuhlaziywa kokuqhathanisa kwezidakamizwa kukhombisa ukuthi i-atorvastatin isiza ngokwejwayelekile i-cholesterol ngokushesha. Le nto ngumehluko omkhulu phakathi kwamathuluzi amabili.
Ngokusho kocwaningo, ukwelashwa okuhlanganiswa nezidakamizwa ze-phyto kuyasebenza. Le nhlanganisela inomphumela onamandla, futhi inciphisa imiphumela emibi yezimali. Lokhu akusho ukuthi amakhambi amakhambi, anjenge-Ateroklefit noma iRavisol, asebenza kangcono kune-Atorvastatin yakudala, kepha kungcono ukuyithatha ihlanganiswe.
Ngokwezibalo, ukusetshenziswa kwe-Atorvastatin kunobulungiswa bezindlela ezisezingeni eliphakeme zalesi sifo, kuyilapho iSimvastatin inconyelwa i-prophylaxis. Kufanele uthenge izidakamizwa emaketangeni asemthethweni ekhemisi noma emakhemisi online. Intengo eRussia ne-CIS kuya ngomkhiqizi.
Izinzuzo zokusebenzisa ama-statins zichazwe kuvidiyo kule ndatshana.
