I-Simvastatin umuthi onezici ezokwehlisa i-lipid. Thola umuthi usebenzisa ukwakheka kwamakhemikhali kumkhiqizo we-enzymatic metabolism ye-Aspergillus terreus.
Isakhiwo samakhemikhali sento siyindlela engasebenzi ye-lactone. Ngokuguqulwa kwezinto eziphilayo, i-cholesterol synthesis iyenzeka. Ukusetshenziswa kwesidakamizwa kuvimbela ukunqwabelana kwama-lipids anobuthi emzimbeni.
Ama-molecule ento anomthelela ekunciphiseni kokugxiliswa kwe-plasma ye-triglycerides, izingxenyana ze-atherogenic ze-lipoproteins, kanye nezinga le-cholesterol ephelele. Ukucindezelwa kokuhlanganiswa kwe-liphero ye-atherogenic kwenzeka ngenxa yokucindezelwa kokwakhiwa kwe-cholesterol kuma-hepatocytes kanye nokwanda kwesibalo sezinhlaka ze-receptor ze-LDL kulwelwesi lweseli, okuholela ekuqalisweni nasekusetshenzisweni kweLDL.
Iphinde inyusa izinga le-lipoproteins ephezulu kwabantu, inciphise isilinganiso se-atherogenic lipids ku-antiatherogenic kanye nezinga le-cholesterol yamahhala yezingxenyana ze-antiatherogenic.
Ngokwezivivinyo zomtholampilo, umuthi awubangeli ukuguqulwa kwamaselula. Izinga lokuqala komphumela wokwelapha Ukuqala komphumela yizinsuku eziyi-12-14, umphumela omkhulu wokwelapha wenzeka enyangeni kamuva ukusuka ekuqaleni kokusetshenziswa. Umphumela uhlala njalo ngokunwetshwa kokwelashwa. Uma uyeka ukuthatha lo muthi, izinga le-cholesterol ye-endo native libuyela ezingeni lakhona lasekuqaleni.
Ukwakheka kwalesi sidakamizwa kuvezwa yinto esebenzayo i-Simvastatin nezinto ezisizayo.
Le nto ine-ukumuncwa okuphezulu kanye ne-bioavailability ephansi. Ukufaka igazi, kuyabopha i-albhamuin. Uhlobo olusebenzayo lomuthi luhlanganiswa ngokuphendula okuthile okuphathelene nezinto eziphilayo.
I-simvastatin metabolism yenzeka kuma-hepatocytes. Inomphumela "wokuhamba phambili" kumaseli wesibindi. Ukulahlwa kwenzeka ngendlela yokugaya (kuze kufike ku-60%) ngendlela yama-metabolites angasebenzi. Ingxenye encane yento ilahlwa yizinso ngendlela efakiwe.
Izinkomba zokusetshenziswa
Ukwelashwa nge-simvastatin kunqunyelwe ukwehlisa i-lipids yegazi, ngoba umuthi ubhekisele kwezidakamizwa ezisehlisa i-lipid.
Umuthi unqunyelwe ukwamukelwa kuphela ngudokotela ohambelayo, ukuzilawula ngokwawo umuthi akuvunyelwe nakancane.
Izinkomba zokusetshenziswa yizimo ezihambisana ne-cholesterol ephezulu kanye ne-atherogenic lipids.
Lezi zifo zifaka ama-pathologies alandelayo:
- Isimo se-hypercholesterolemia eyisisekelo ngokusebenza okunganele kwezinyathelo zokulawula ezingezona zamakhemikhali ezigulini ezisengozini yokuthuthukiswa kwe-coronary artery atherossteosis.
- Ifomu elihlanganisiwe le-hypercholesterolemia ne-hypertriglyceridemia, ukudla okungalawuleki ne-cholesterol ephansi kanye nokuzivocavoca komzimba okukhishwa.
- I-IHD yokuvimbela ubungozi bokushona e-acute coronary syndrome (ukuze inciphise ukuqhubeka kwe-coronary artery atherosranceosis), ukuphazamiseka kwegazi okuqubuka emzimbeni nokuphazamiseka kwengqondo okuhamba kwesikhathi kwegazi.
- Ukunciphisa ingozi yokuvuselelwa kabusha kwempilo.
Uhlobo lomthamo wesidakamizwa singamathebulethi omlomo ngomthamo wamamitha ayi-10, 20 kanye nama-40. Umthamo wesidakamizwa ukhethwa ngawodwana, kucatshangelwa izici zomzimba womuntu.
Umuthi lowo ufakiwe kuhlu lwezidakamizwa olunganconywa ukuzilawula.
Imiyalo yokusebenzisa i-simvastatin
Ngaphambi kokuqala ukwelashwa, isiguli sinqunywa i-classic hypocholesterol yokudla, okufanele kudluliselwe kuyo yonke inkambo yokwelapha. Ithebhulethi yeSimvastatin yenzelwe ukuphathwa ngomlomo. Umuthi kufanele uphuzwe kanye njalo emahoreni angama-24 kusihlwa, uphuze amanzi amaningi. Ngesikhathi sokuthatha umuthi akufanele ube nokudla.
Isikhathi sokwelashwa nge-Simvastatin sikhethwe kuphela ngudokotela wesiguli.
Nge-hypercholesterolemia, umthamo osezingeni eliphansi wokwelapha u-5-80 mg kanye. Uma kungekho mphumela ngethamo le-40 mg, ukwelashwa kufanele kushintshwe. Lokhu kungenxa ye-myotoxicity ephezulu yesidakamizwa umthamo wedlula 40 mg. Umthamo omkhulu wokwelapha ubekelwe iziguli lapho ukwelashwa nge-40 mg kungasebenzi. Ubuncane bezokwelapha obungu-10 mg.
Ukuguqulwa kwe-dose kunconyelwe hhayi ngaphezu kwenyanga. Iziguli eziningi zizwela ekwelashweni ngomthamo omncane wento.
Ezigulini ezine-gener hypercholesterolemia, inani eliphezulu le-simvastatin ngu-40 mg. Umthamo wansuku zonke unconywa ukuba uhlukaniswe ngemithamo emibili. Kwi-hypercholesterolemia enzima, kunconywa i-hypolipidemic therapy ehlanganisiwe.
Ukwelashwa kweziguli ezinesifo se-coronary artery isifo noma kulabo abasengozini yokuthuthuka kwesifo se-artery cortery, umphumela wokwelapha utholakala ngokusetshenziswa kwe-simvastatin kusuka kuma-20 kuye kwangama-40 mg amahora angama-24. Kunconywa ukuthi uguqule umthamo kungaphambi kwenyanga ngemuva kokuqala kokusetshenziswa. Ukusebenza kokwelashwa kuza kakade kuma-20 mg ento leyo.
Uma kunesidingo, phinda kabili umthamo.
Ukuxhumana neminye imithi
Umuthi ungumenzeli osebenza kakhulu, onokwehlisa i-lipid.
Kulokhu, umuthi ungena kalula ekushintsheni nasekusebenzisaneni kwezeMithi nezinye izidakamizwa.
Ukuhlushwa nsuku zonke kwe-simvastatin kubantu abathatha izidakamizwa ezithile akufanele kudlule i-10 mg.
Imithi enjalo ngama-immunosuppressants (cyclosporin); ama-androgens okwenziwa (uDanazole); imicu; amalungiselelo e-nicotinic acid;
Ezigulini ezithatha i-Amiodarone neVerapamil, inani lomuthi akufanele libe ngaphezulu kwama-20 mg. Uma welashwa nge-Diltiazem, inani eliphezulu le-simvastatin kufanele libe ngu-40 mg.
Ezigulini zeqembu labantu asebekhulile, kanye nasezigulini ezihlulekile noma ezinqatshelwe ukwehluleka kwezinso, asikho isidingo sokulungisa umthamo. Ezigulini ezinokwehluleka kwe-renal okubolile, ukwehla kwesibalo se-creatinine esingaphansi kwamamilimitha angama-30, akunconywa ukunquma umuthi ngomuthi ongaphezu kwe-10 mg. Uma kunesidingo sokwenyusa umthamo, kufanele kuqashelwe ukwelashwa kwaleli qembu leziguli.
Ukwelashwa okuvumelanayo nezinye izidakamizwa kufanele kuvunyelwane nodokotela. Ekuqeshweni kokuqala, umlando wesiguli kufanele uqoqwe ngokucophelela futhi ukwelashwa okuhlanganisiwe kucacisiwe.
Ukuphendula Okubi Simvastatin
Lapho udla lo muthi, imisindo eminingi engemihle ingavela esigulini.
Ukuphendula okungafani ku-simvastatin kuncike kumthamo.
Lapho likhulu inani lezidakamizwa ezithathiwe, kulapho iba nengozi enkulu yemiphumela emibi.
Ukuphendula okuvame kakhulu kwe-simvastatin kufaka phakathi:
- Ukuphendula kwesisu: Ubuhlungu besisu, ukuqunjelwa noma isifo sohudo, ukuqhakaza, i-maldiorpion, i-malabsorption, isicanucanu ngokuhlanza, ukuvuvukala kwepancreatic, i-hepatosis noma ihepatitis, icteric syndrome, ukungasebenzi kahle kwesibindi.
- Kusukela ohlangothini lwesistimu yezinzwa: i-asthenic syndrome, ikhanda, i-paresthesia, isiyezi, i-polyneuropathy, ukuphazamiseka kokulala, imisebenzi ye-mnemonic engasebenzi kahle.
- Kusukela ohlangothini lwezakhiwo zemisipha: izicubu zomsipha nokugoba, ukuphazamiseka kwendawo yokuhlala, i-myasthenia gravis, ubuthakathaka bemisipha, i-myopathy; rhabdomyolysis, imisipha ebuhlungu.
- Kusuka ohlelweni lwenzwa: ukwephulwa kokuqonda ukunambitheka.
- Ukuphendula kwe-Hypersensitivity: i-edema kaQuincke, ukusabela okuphathelene nokungezwani komzimba, i-vasculitis, i-dermatomyositis, i-urticaria, i-pruritus, ukuqubuka kwemizwa, ukukhulisa ukuzwela kwemisebe ye-UV.
- Kusuka ku-hemopoiesis: ukwehla kwenani lamaplatelet, ama-eosinophils, ukwanda kwesilinganiso sokulinganisa se-erythrocyte, i-anemia.
- Ukusuka ohlelweni lwe-musculoskeletal: i-arthritis, i-arthrosis, izinhlungu ezihlangene
- Ku-CCC: i-tachycardia, kwenyuka umfutho wegazi.
- Ukuphendula okungafani: ukungasebenzi kahle kwezocansi emadodeni, i-alopecia.
Okudangalisa ukwedlula zonke ukwehluleka okubabazekayo be-renal ngenxa yokulimala okukhulu kwe-myoglobin ngenxa yokulimala kwemisipha ngesikhathi se-rhabdomyolysis.
Uma kuvela ezinye zezimpawu zabo, kufanele wazise udokotela wakho ngokushesha. Udokotela ohambelayo uyadingeka ukulungisa isilinganiso somuthi.
Contraindication kanye nemikhawulo yokusebenzisa
Ukuqokwa kwe-simvastatin kunokulinganiselwa okuningi.
Lokhu kungenxa yokuthi ithuluzi linomphumela othile womzimba uwonke, lilawula ukusebenza kwamafutha emzimbeni.
Ngokuvamile, umuthi awuphephile uma ushiwo ngokungafanele futhi usetshenziswa.
Lezi zimo ezilandelayo contraindication kuya Simvastatin:
- i-pathology yesibindi ngendlela esebenzayo;
- umsebenzi ophakeme wama-enzyme wesibindi wemvelaphi engaziwa;
- ukuphathwa kanyekanye kwe-Itraconazole, Ketoconazole, HAART, macrolides;
- isifo semisipha esigaxekile;
- ukukhulelwa kanye nokuncelisa;
- iminyaka yezingane;
- cholesterol ephansi;
- ukuntuleka kwe-lactase,
- i-malboorprate malabsorption;
- hypersensitivity kwento esebenzayo noma ezintweni ezisizayo,
- hypersensitivity kuma-statins.
Ukusetshenziswa kwe-simvastatin ngesikhathi sokukhulelwa ne-lactation akunconywa. Lokhu kungenxa yokuthi umuthi unomphumela we-teratogenic. Futhi, umuthi uphambaniswe ekunceliseni ibele, ngoba ungangena ubisi.
Abesifazane besikhathi sokuzala kufanele bavikeleke ekukhulelweni ngenkathi belashwa neSimvastatin.
Ezigulini zeqembu labantu asebekhulile, ikakhulukazi, kubantu besifazane, umuthi kufanele ube nomkhawulo.
Umuthi lo uvinjelwe izingane.
Ekuqaleni kokwelashwa nge-simvastatin, ukukhuphuka kwesikhashana kwenani lama-transaminases kuyaphawulwa. Ngaphambi kokuqala ukwamukela futhi ngesikhathi sonke sokuphatha, kubalulekile ukubheka ukusebenza kwesibindi njalo.
Ngokukhuphuka kwenani lama-transaminases izikhathi ezingaphezu kwezingu-3, ukwelashwa nge-Simvastatin kufanele kuyekwe.
Izici zokusetshenziswa kwe-simvastatin
Umuthi kufanele unqunywe yi-Therapist noma i-Cardiologist. I-Simvastatin iyisidakamizwa sesizukulwane esisha, imiyalo yokusetshenziswa esiyisebenzisayo iphakamisa izici zokwelashwa, ezinquma intengo ephezulu yokwelashwa.
Umkhiqizo ukhiqiza ukukhathazeka kwemithi yamanye amazwe "Zentiva", etholakala eCzech Republic. Umenzi ukhiqiza umuthi ohlobo lomuthi ojwayelekile.
Umuthi ngokushesha futhi kufanelekile wehlisa i-cholesterol, ibangela ukwehla kwesisindo kanye nokwenza ngcono okuphelele esimweni seziguli ezine-lipid metabolism.
Umuthi umuthi.
Ukuze wonge imali, ungathenga okunye esikhundleni somuthi. Ama-analogues aseduze weSimvastatin yi-Aterostat, Zokor, Simvakard, njll. Amagama angahluka ngokuya ngomkhiqizi.
Ukulimala kwesidakamizwa, ezimeni eziningi, kungenxa yokwephulwa kwerejimeni yokuphatha kanye ne-dosing.
Ngokuvamile, ithuluzi lithole impendulo enhle nempendulo eningi evela kochwepheshe emkhakheni wezokwelapha. Umuthi uyisizukulwane esisha sokwenza okuphezulu futhi sinobuthi obuncane.
Noma kunjalo, zonke izinkomba zokusetshenziswa kufanele zilandelwe. Kwenqatshelwe ukuphuza utshwala ngesikhathi sokwelashwa. Kubalulekile ukulawula izinga le-glycemia ngesikhathi sokwelashwa kweziguli ezinesifo sikashukela, ngoba ama-statins athinta amazinga kashukela egazini.
Indlela yokwelashwa kwe-hypercholesterolemia kanye ne-atherosulinosis kufanele ibe ephelele. Ukuthatha i-Simvastatin kufanele kuhlanganiswe nokudla okunengqondo kanye nokuzivocavoca komzimba okwenziwe njalo.
Ngokungasebenzi ngempumelelo kweSimvastatin, amaqembu alandelayo wezidakamizwa angabekwa:
- Abanye abamele iqembu le-statin yi-Atorvastatin, Rosuvastatin, Rosulip, njll.
- Izicucu.
- Ukulungiselela kweNicotinic acid.
- Ama-asidi e-Omega.
Iqembu ngalinye lomuthi linobuthi obunye noma obunye. Ama-acid angama-omega-3 nama-omega-6 kuphela aphephile. Zisebenza ngezinhloso zokuvimbela. Ngokwazisa kwabo kokuqala ekudleni, ubungozi bokushona kusuka ezinkingeni zenhliziyo nezemithambo wehliswe ngo-40%. Kukhona ukuhlanzwa kwemithambo yegazi evela kuma-atherosulinotic plaque kanye nokwehla kwezinga le-atherogenic lipids.
Intengo iyahlukahluka eRussia kuye ngochungechunge lwamakhemisi nosuku lokuthenga. Ukubuyekezwa okuhle kutholwe ngomuthi owenziwe eCzech. Izindleko eRussia ziqala kusuka kuma-ruble angama-93.
Imininingwane mayelana nomuthi i-Simvastatin inikezwe kuvidiyo ekulesi sihloko.
