I-Atoris ngumenzeli we-hypolipidemic ohlobene nama-statins. Into esebenzayo yi-atorvastatin. Indlela yokusebenza yayo yikhono le-enzyme ethile ebandakanyeka ekuphenduleni kwe-cholesterol.
Ngokuvimbela ukukhiqizwa kwe-cholesterol, ukuzwela kwama-receptor kuma-atherogenic lipids kuma-hepatocytes namanye amaseli kuyanda. Lezi zinhlaka ze-receptor ziyakwazi ukubopha ama-molecule e-LDL futhi zisebenzise kusuka ku-plasma, okuthi, ekugcineni, kuholele ekunciphiseni kwenqwaba yezingxenyana ze-atherogenic ze-lipoproteins egazini. Umphumela we-hypolipidemic wento ubangelwa umphumela wawo we-endothelium yemikhumbi ye-arterial nezinto ezakhiwe.
Ngaphansi kwethonya le-atorvastatin, i-vasodilation iyenzeka. Ama-molecule e-Atorvastatin anciphisa izinga le-cholesterol ephelele, izingxenyana ze-atherogenic ze-lipoproteins, TG nezinye izinto ze-atherogenic. Kuyasiza futhi ukukhuphula izinga lama-lipoprotein e-antiatherogenic. Umphumela wokwelapha ukhula usuvele emva kwamasonto angama-2-3 kusukela ekuqaleni ukusetshenziswa kwe-Atoris. Ngemuva kwenyanga, umphumela omkhulu ubonwa.
I-Atoris ngqo ifaka i-atorvastatin nezinye izinto ezisizayo.
Indlela yokusebenza yesidakamizwa nezinkomba zokusetshenziswa
Iningi lomuthi limunca umgudu wokugaya ukudla. Ngenxa yomsebenzi omkhulu we-metabolic ngesikhathi sokudlula kwesibindi, i-bioavailability yomuthi ayikho ngaphezu kwe-12%.
I-Atorvastatin ayiweli umgoqo we-neurovascular. I-compound isetshenziswa ikakhulu ekwakhiweni kwe-bile). Cishe uhhafu wento ulahlwa imfucumfucu, cishe amaphesenti amabili - ngomchamo.
Izinkomba zokuqokwa kwe-Atoris yizimo zehyperlipidemic. Ukuze wehlise i-cholesterol ephelele ye-serum, i-lipoprotein ye-atherogenic kanye ne-triglycerides.
Imibandela elandelayo izinkomba zokuqokwa kwe-Atoris:
- I-hyperlipidemia eyisisekelo: kufaka phakathi i-polygenic hypercholesterolemia, i-hypercholesterolemia yomndeni kanye nokwehluka okuxubile. Ukuphuza i-Atoris kunikeza ukwanda kwama-lipoprotein ezingxenyeni ze-anti-atherogenic egazini futhi kwehlisa izinga lesilinganiso se-atherogenic kuya ku-antiatherogenic. Kusetshenziswa lapho kungenakwenzeka ukulungisa amazinga e-lipid ngokusebenzisa ukudla nezinye izindlela ezingezona izidakamizwa zokwelapha.
- Ngokuvimbela isifo sezinhliziyo.
- Engcupheni yezinhlekelele ze-cardiogenic acute ezigulini ezinenkambo ethile yesifo senhliziyo ezi-coronary, kepha ezisengozini. Iqembu lengcuphe lifaka phakathi abantu abaneminyaka yobudala engaphezulu kweminyaka engama-55, ababhemayo abanenkinga yokuqina komfutho wegazi, isifo sikashukela, abanamazinga aphansi we-lipoprotein ephezulu, abane-genetic predisposition.
- Engcupheni engaba khona yezinhlekelele ezinamandla zenhliziyo ezigulini ezinesifo senhliziyo ukuze unciphise ingozi yokufa, i-acute coronary syndrome, i-acute cerebrovascular ajali, ukulaliswa kwesibili esibhedlela ngenxa ye-angina engazinzile kanye nokuvuselelwa kabusha.
Ifomu lokukhipha i-Atoris - amaphilisi. Imithamo elandelayo yesidakamizwa iyatholakala - amaphilisi anomthamo we-10 mg, 20 mg, 30 mg no-40 mg.
Imiyalo yokusebenzisa umuthi
Ngaphambi kokuqala ukwelashwa nge-Atoris, isiguli kufanele siqale ukunamathela ekudleni okwehlisa i-lipid ukuze sinciphise amazinga e-serum lipid. Ukudla kufanele futhi kulandelwe ngesikhathi sokwelashwa.
Umuthi wenzelwe ukuphathwa ngomlomo, noma ngabe kukudla. Kungcono ukuthatha umuthi kusihlwa. Udokotela usetha umthamo womuthi futhi ungahluka kusuka kuma-milligram angama-10 kuye kwangama-80 kwithamo elilodwa amahora angama-24. Ukukhetha idosi kwenziwa ngokubheka izinga lokuqala le-cholesterol, inhloso yokwelashwa kanye nezimpawu zomphumela womuthi kulowo nalowo.
Kungenzeka ukusebenzisa i-atorvastatin ngenye indlela yokukhishwa. Ubuntu bokusetshenziswa kwe-Atoris yisidingo sokugcina isikhathi esiqondile sokwamukelwa nsuku zonke. Umphumela wokwelapha utholakala emva kwamaviki ama-2 kusukela kuqale ukwelashwa, kanti okuphezulu kutholakala ngemuva kwenyanga kuqalile ukwelashwa. Kulokhu, umthamo womuthi awushintshi ngaphambi kwenyanga ngemuva kokuqala kwemithi.
Ekuqaleni kokwelashwa futhi njengoba umthamo wezidakamizwa ushintsha, izinga lezingxenyana ze-lipid esegazini kufanele liqashelwe. Ngokusho kwezinguquko kuphrofayela ye-lipid, kufanele kulungiswe ukulungiswa komthamo.
Nge-hypercholesterolemia eyisisekelo ne-hyperlipidemia exubile, ukwelashwa kuqalwa ngomthamo omncane wokwelapha, ongakhuphuka ngemuva kwenyanga yokwelashwa, kubhekwa impendulo yesiguli ekwelashweni.
Nge-hypercholesterolemia yelifa, imithamo ihambelana ne-nosology yangaphambilini. Umthamo wokuqala ukhethiwe kucatshangelwa izici zomuntu ngamunye ogulayo, futhi futhi unaka nobunzima besifo. Ezigulini eziningi, umthamo omkhulu wokwelapha uyasebenza.
Kungenzeka usebenzise i-Atoris ngokuhambisana nezinye izindlela zokwelapha (isb. Nge-plasmapheresis) noma njenge-monotherapy.
Imiphumela emibi yokuthatha i-Atoris
Umphumela ongemuhle wezidakamizwa kanye nemiphumela emibi kwezinye izimo azimele ngethamo kanye nobude besikhathi sokwelashwa.
Ngaphandle kwalokhu, imiphumela emibi ivezwa kakhulu ezigulini ezinesikhathi eside sisebenzisa imithamo ephezulu yemithi.
Ukuphendula okuphambili okuphezulu kufaka phakathi:
- Ubuhlungu bekhanda obujwayelekile, isiyezi, kuze kufike ku-migraine. Izinkinga zokulala ezahlukahlukene, kuze kufinyelele ekuthuthukisweni kwamaphupho amabi. Ukukhathala, ubuthakathaka, i-malaise ejwayelekile.
- I-Asthenia, ukukhubazeka kwememori. I-Paresthesia, i-peropheral neuropathy, ukuphazamiseka kwe-olfaction nokunambitha.
- Ukuphazamiseka kwengqondo nokukhandleka ngokomzwelo. Ukuphazamiseka kwengqondo.
- Amehlo omile. I-petechial hemorrhage ngaphansi kwe-conjunctiva, glaucoma.
- I-Tachycardia, i-arterial hypertension (umfutho wegazi ophakeme), ukuphazamiseka kwesigqi, izinhlungu ngemuva kwe-sternum.
- I-Phlebitis, vasculitis. I-Lymphadenopathy, ukwehla kwenani lokubalwa kweplatelet.
- I-Aseptic bronchitis, i-rhinitis; i-asthma ebangelwa izidakamizwa, ukuphefumula kwamakhala.
- Ukuphazamiseka kusuka emgudwini wesisu: isicanucanu, ukugabha, umuzwa ovuthayo ngemuva kwesigaxa, ukuphazamiseka kwesitulo, ukuqhakaza, ukulahleka kwesisindo somzimba, ukwanda noma ukuncipha kokudla, ukuncipha kwesisindo, umlomo omile kakhulu, ukubekezela okuqhubekayo, izinguquko zokuvuvukala emgodini womlomo; i-esophagus; ulwelwesi lwe-mucous lolimi, isisu, amathumbu amancane. Mhlawumbe ukungezwa kwesilonda esise-duodenal, ukopha okungunxantathu, izitulo zegazi nama-tenesmus. Izinsongo zokuphuma kwegazi okukhulu. Ukusonteka okuvusa imisipha yomlenze, ushintsho lokuvuvukala esikhwameni esihlanganayo, ubuthakathaka bemisipha, izinhlungu zemisipha kanye naphansi emuva.
- Amandla wokutheleleka ezithweni zezitho zofuzo. Ukwephulwa komsebenzi wokuchama, kanye nokulahleka kwamangqamuzana egazi abomvu emchameni.
- Ukopha okuvela emthanjeni, ukopha kwesibeletho. ICD.
- Ukuvuvukala kwe-epididymis, ukungasebenzi ngocansi emadodeni. Kukhulisa umjuluko. Imishayo ye-eczematous, seborrhea, ukulunywa kwesikhumba. Izinkinga ze-Allergic: dermatitis; i-urticaria; I-edema kaQuincke, ukushaqeka kwe-anaphylactic kungenzeka.
- Ukuvuvukala kwemisipha ye-systemic. I-Hypersensitivity kwimisebe ye-UV, isifo seStevens-Johnson, iLyell
- Ushukela omncane wegazi (hypoglycemia).
- Ukuvuvukala.
Izinkinga ezingejwayelekile zifaka i-gynecomastia; ukukhuphula ukungasebenzi kahle kwe-purine metabolism; umkhuhlane, ufuzo olungacacile nobunqunu.
Ukulinganiselwa nemiphumela emibi
Ekuzijwenzeni kwezokulima, akunconywa ukuthi ushintshe umthamo wokuqala womuthi. Kubantu abanenkinga yokuqina kwesibindi, kuyadingeka ukusebenzisa umuthi ngokucophelela okwedlulele (ngoba isilinganiso se-metabolism kanye nokusetshenziswa kwe-atorvastatin kuncishisiwe).
Kulokhu, kunconyelwa ukuthi kuqashwe njalo idatha yaselebhu yamaphrofayili we-lipid nomsebenzi wesibindi. Ngokwanda okukhulunywa ngakho kuma-enzymes wesibindi, inani lomuthi osetshenziswayo liyanconywa ukunciphisa noma ukwenqaba ukwelashwa.
Ezigulini ezinesifo senhliziyo, kanye nakwabanye abamele iqembu elisengozini enkulu yenhliziyo, inhloso yokwelapha ukunciphisa amazinga e-LDL angaphansi kuka-3 mmol / L kanye ne-cholesterol engaphansi kwama-5 mmol / L.
Ukuphikisana kokuqokwa kwe-Atoris kufaka imibandela elandelayo:
- isifo sesibindi esibuhlungu, kufaka phakathi i-hepatitis engamahlalakhona;
- ukwehluleka kwe-hepatic cell;
- ushintsho lwe-cirrhotic kwezicubu zesibindi;
- umsebenzi owandayo wama-enzyme wesibindi we-etiology engaziwa;
- isifo semisipha esishubile;
- ukukhulelwa nokuqunjelwa;
- ukungabekezelelani kwe-galactose;
- ingozi enkulu yokukhulelwa;
- i-pancreatitis eyingozi;
- iminyaka yezingane;
- ukungabekezelelani.
Akunconyelwe ukunquma umuthi ngesikhathi sokukhulelwa nokukhishwa komzimba. Ithuluzi livunyelwe ukusetshenziswa ngabesifazane beminyaka yokuzala izingane kuphela esimweni esiphansi sokukhulelwa kanye nolwazi oluphelele lowesifazane ngomphumela we-teratogenic womuthi.
Abesifazane beminyaka yokuzala izingane ngesikhathi sokuthatha i-Atoris bayanconywa ukuthi bavikeleke ekukhulelweni. Endabeni yokuhlelela ukukhulelwa, yeka ukuthatha lo muthi emavikini ama-4 ngaphambi kosuku lokuhlela.
Kuyavunyelwa ukusebenzisa umuthi ekusebenzeni kwezingane.
Imiyalo ekhethekile yokusebenzisa i-Atoris
Ngaphambi kokuqala i-Atoris, isiguli kufanele siqale ukunamathela ekudleni kwe-classical hypolipidemic. Ukudla okunjalo kuzokuphinda kabili ukusebenza komuthi. Lapho uthatha i-Atoris, ukwanda komsebenzi wama-enzyme wesibindi kungenzeka. Ukwanda okunjalo kwama-transaminases kuhamba okwesikhashana, kepha kudinga ukubhekwa njalo kwezinkomba zomsebenzi we-hepatocyte.
Ukwelashwa kumisiwe uma kwenzeka ukwanda okungaphezu kokuphindwe kathathu emazingeni ama-enzyme wesibindi. I-Atorvastatin ingavusa nokwanda komsebenzi we-creatine phosphokinase ne-aminotransferase. Uma kwenzeka kubuhlungu noma ukungaphatheki kahle kwemisipha, kufanele uthintane nodokotela wakho ngokushesha.
Lapho uthatha i-Atoris, izinhlobo ezahlukahlukene ze-myopathies zingakhula, zifike ku-rhabdomyolysis, zilandelwe ukwehluleka ngokwe-renal kwe-acute.
Ingozi enkulu ye-rhabdomyolysis ezigulini ezisetshenziswa ngokuhlanganiswa kwalezi zinhlanganisela ezilandelayo nama-statins:
- Izicucu.
- I-Nicotinic acid kanye nezinto eziphuma kuzo.
- Ama-antimetabolites.
- Imithi elwa namagciwane, iqembu lama-macrolides.
- Ama-antimycotic agents (azoles).
- Ezinye izidakamizwa ezifakiwe ekwelashweni ngezidambisigciwane.
Ngezibonakaliso zokuqala zomtholampilo zokuthuthukisa i-myopathy, izinga le -ineine phosphokinase kufanele linqunywe ngokushesha.
Ngokwanda okungaphezu kokuphindwe kashumi komsebenzi we-enzyme, ukwelashwa kuyamiswa ngokushesha.
Umuthi okwenziwayo
I-Atoris, imiyalo yayo yokuthi isetshenziswe, intengo ephezulu, ukubukeza njalo okungalungile kwenza abantu bafune izifaniso zomuthi.
Imiyalo yokusetshenziswa iyinkimbinkimbi futhi ayisiyo enkulu kuwo wonke amaqembu emithi eyehlisa i-lipid. Lokhu kungenxa yobuthi obuphakeme balezi zimali. Kepha lo mhlahlandlela uqukethe incazelo ephelele ye-pharmacokinetics kanye ne-pharmacodynamics yomuthi, ubunzima obunokubakhona kanye ne-contraindication. Umphumela wokunganaki ukufunda imiyalo ungabulala.
Ukwelashwa kwe-atoris kufanele kunqunywe ngudokotela. Akunasizathu sokuthi kufanele uzindle. Lokhu kungenxa yokuthi ithuluzi alihambelani nezinto eziningi. Akukho ukuhambisana nezidakamizwa ezinjenge-cyclosporine, i-fluconazole, i-spirolactone, njll.
Isinqumo sokubuyisa lesi sidakamizwa nomuntu osebenzelana naye osekhaya onesizotha kufanele futhi kuvunyelwane ngaso nodokotela oya khona. Umehluko, ngeshwa, ungabonakala ubalulekile.
Njengoba umuthi uthinta i-cholesterol, kufanele kubhekwe njalo ukunamathela kumthamo omncane wokwelapha.
Futhi, ngokwesimilo, utshwala abuhambelani nento esebenzayo - i-atorvastatin. Ukuhlanganiswa okunjalo akuphephile emzimbeni.
Ama-analogues adumile e-Atoris eqenjini lamakhemikhali yiRosuvastatin neSimvastatin.
Izindleko ze-Atoris ziyehluka ngokuya ngosuku lokulethwa nendawo ethengiswayo. Ungawuthenga umkhiqizo kunoma yiliphi ikhemisi eRussia. Intengo yesidakamizwa eRussia iyahlukahluka kusuka kuma-ruble angama-357 kuya kwangama-1026. Ekusetshenzisweni, ithuluzi linokubuyekezwa okuhle nokubi kwabachwepheshe bezokwelapha.
Imininingwane mayelana nama-statin inikezwe kuvidiyo kule ndatshana.
