Iqembu lama-statins (izidakamizwa ezokwehlisa i-cholesterol) lifaka iLovastatin esebenzayo. Umuthi awusetshenziswa kuphela ekwelapheni i-hypercholesterolemia, i-hyperlipoproteinemia, kepha futhi nasekuvimbeleni izifo zenhliziyo.
Umuthi kumele usetshenziswe ngokuhambisana nokudla okukhethekile, ukuzivocavoca kanye nokulungiswa kwesisindo. Kulesi sihloko, ungafunda okuningi ngeLovastatin, imiyalo yokusebenzisa, intengo, ukubukeza, ama-analogues.
Indlela yokusebenza yesidakamizwa
ILovastatin ingeyeqembu lezidakamizwa ezokwehlisa i-lipid ezihlukumeza ukuvela kwe-cholesterol esibindini ekuqaleni kwesigaba. Lesi sidakamizwa sithathwa njengento ephambili kakhulu phakathi kwamanye ama-statins. Ikhishwa kuma-biocultures Aspergillusterreus naseMonascusruber.
Lapho usuphezu kokugaya ukudla, umuthi uzibiza ngemiphumela yama-enzymes wokugaya futhi kancane kancane umunca. Ngaphezu kwalokho, lapho sikhulisa umthamo womuthi, ngokushesha simunca kakhulu emgodini wokugaya ukudla. Into esebenzayo ingena ngaphakathi kwezicubu zamathumbu, bese ingena egazini. Okuqukethwe kwe-plasma okuphezulu kufinyelelwa ngemuva kwamahora we-2-4. Ukungena kuwo wonke amanye izicubu zomzimba kwenzeka ngesimo se-beta-hydroxy acid yamahhala.
Isenzo seLovastatin sihloselwe izinqubo ezimbili. Okokuqala, kuphazamisa ukwakheka kwe-cholesterol esibindini, kuvimbela ukuguqulwa kokuphinda kube yi-melovanate. Okwesibili, kuholela ku-activation ye-catabolism esheshayo (inqubo yokubola kwe-metabolic) ye-LDL. Ngokuhambisana nale nqubo, kukhona ukwanda kwe-HDL, noma i-cholesterol "enhle".
Ukuphila kwesigamu kwengxenye esebenzayo kungamahora ama-3. Ama-Metabolites anento esebenzayo akhishwa ngokusebenzisa izinso namathumbu.
Imiyalo yokusebenzisa umuthi
ILovastatin 20 mg noma i-40 mg itholakala ngefomu lethebhulethi, isakhi esisebenzayo sinegama elifanayo. Izinto ezingeziwe zomuthi yi-lactose monohydrate, isitashi, i-cellulose, i-magnesium stearate, i-butylhydroxyanisole, i-citric ne-ascorbic acid.
Umuthi uyathengiswa kuphela uma umuntu enikezwe udokotela incwadi yakhe. Lapho uthenga umkhiqizo, isiguli kufanele sinake okufakiwe okunamathiselwe. Umyalo unezinkomba eziningi zokusetshenziswa kwalesi sidakamizwa:
- ukwelashwa kwe-hypercholisterinemia eyinhloko kuhlangene, thayipha i-IIa ne-IIb;
- hyperlipoproteinemia therapy (eyinkimbinkimbi nesifo sikashukela kanye nephrotic syndrome);
- ukwelashwa kwe-coronary atherossteosis (kanye ne-Vitamin therapy kanye nama-acid angenakuqina);
- ukuvimbela kwama-pathologies wezinhliziyo;
- hypertriglyceridemia therapy.
Ukusetshenziswa kwamathebulethi kufanele kwenziwe isikhathi esi-1 ngosuku ngesikhathi sokudla kwakusihlwa. Umthamo wesidakamizwa uncike kulesi sifo. Ngakho-ke, nge-hyperlipidemia, kuthathwa umthamo owodwa we-10-80 mg. Ukwelashwa kwe-pathology kuqala ngemithamo emincane, ngemvume kadokotela, bangandiswa kancane kancane. Kunconywa ukukhetha umthamo njalo emavikini ama-4. Umthamo omkhulu kakhulu (80 mg) ungahlukaniswa ngemithamo emibili - ekuseni nakusihlwa.
Ekwelapheni i-coronary atherossteosis, umthamo ophelele ngu-20-40 mg. Uma ukwelashwa kungasebenzi, ukukhula ngo-60-80 mg kungenzeka. Uma isiguli sithatha i-fibrate noma i-nicotinic acid ngasikhathi sinye, iLovastatin akufanele isetshenziswe kungabi ngaphezu kwama-20 mg ngosuku. Futhi, umthamo kumele wehliswe ezimweni ezinjalo:
- Ukusetshenziswa okufanayo kwama-immunosuppressants.
- Ukusetshenziswa kwama-antibiotic agents.
- Ukwelashwa ngezidakamizwa ze-antifungal.
- Ukwelashwa kwezifo zesibindi ze-etiology ethize noma ejwayelekile.
- Ukusetshenziswa kwezidakamizwa eziqukethe ama-anticoagulants.
Kuyadingeka ukugcina umuthi endaweni yokushisa engeqi ngama-25 degrees Celsius.
Ngemuva kosuku lokuphelelwa yisikhathi, okuyiminyaka engu-2, kwenqatshelwe ukusebenzisa umkhiqizo.
Contraindication kanye nemiphumela emibi
ILovastatin inohlu oluncane lwe-contraindication. Ukusetshenziswa kwomuthi akuvunyelwe i-myopathy (isifo se-neuromuscular chronic), ukukhulelwa, i-cholestasis, ukungasebenzi kwesibindi, okungaphansi kweminyaka engu-18 kanye ne-hypersensitivity yomuntu ngamunye kwizakhi.
Umuthi kufanele usetshenziswe ngokuqapha ezigulini ezedlule ezihamba ngokuxhunyaniswa kwe-artery. Akunakusho ukuthi ungaphuza umuthi ngotshwala.
Kwezinye izimo, umuthi ungadala imiphumela emibi. Phakathi kwazo, kubalulekile ukugqamisa:
- Ukusabela okuhambisana nomsebenzi wepheshana lesisu: ukuhlaselwa isicanucanu, ukushisa kwenhliziyo, ukwanda kwerhasi, ushintsho ekunambithekeni, kuhudo, ukubuyisela ukuqunjelwa.
- Ukuphazamiseka kwesistimu yezinzwa ephakathi: ikhanda, ukulala kabi, ukukhathazeka, isiyezi, i-paresthesia, i-myositis, ukuqina kwemisipha kanye ne-myalgia. Uma usebenzisa i-cyclosporine, i-gemfibrozil noma i-nicotinic acid, kungenzeka ukuthi kube ne-rhabdomyolysis.
- Ukuphendula kohlelo lwe-biliary: umsebenzi owengeziwe we-bilirubin, i-alkaline phosphatase, i-transaminases yesibindi ne-creatine phosphokinase. Ngezinye izikhathi i-hepatitis, i-cholestatic jaundice ne-biliary cholestasis kungenzeka.
- Ukuphendula kwe-allergic: ukulunywa, ukuqhuma kwesikhumba, i-urticaria, i-angioedema, i-arthralgia.
- Ukuphazamiseka kwezimpawu zamehlo: i-atrophy yezinzwa ze-opic kanye nokuthuthukiswa komoya.
- Eminye imiphumela emibi: ukuncipha kwe-potency, i-malaise ejwayelekile, i-alopecia.
Izimpawu ze-overdose uma usebenzisa imithamo emikhulu yemithi ayibonwa Isisekelo sokwelashwa ukuqedwa kweLovastatin, ukugcwala kwesisu, ukusetshenziswa kwama-sorbents (namalahle ocushiwe, i-Smecta, iPolysorb, i-Atoxil) yokulawulwa kwemisebenzi ebalulekile, umsebenzi wesibindi nomsebenzi we-creatine phosphokinase.
Ukuxhumana nezinye izindlela
ILovastatin akufanele isetshenziswe nazo zonke izidakamizwa, ngoba ukuxhumana kwabo kungaholela ekuphendukeni kabi komzimba. Ngaphezu kwalokho, eminye imishanguzo ingakhulisa ukugcwala kwento esebenzayo, futhi eminye ingancipha.
Ingozi enkulu yokubhujiswa kwemisipha kanye ne-myopathy, kanye nokwanda kokuqukethwe kwengxenye esebenzayo, kuthuthukisa ukusetshenziswa kanyekanye kweLovastatin kanye ne-nicotinic acid, uCyclosporine, iRitonavir, i-Erythromycin, iNefazodon neClithithyycin.
Ukusetshenziswa okuyinkimbinkimbi kwesidakamizwa esinejusi yamagilebhisi, i-fenofibrate, i-gemfibrozil nakho kukhulisa amathuba e-myopathy.
Ingozi yokopha iye yanda ngokusetshenziswa kwe-warfarin. I-bioavailability ye-lovastatin iyancipha lapho usebenzisa i-colestyramine. Ukuze i-bioavailability yomuthi ihlale ijwayelekile, kuyadingeka ukusebenzisa izidakamizwa ngokunqunyelwa kwamahora angama-2-4.
Ngezifo ezihlangana njalo, isiguli kufanele sibonane nodokotela ngokuthatha umuthi.
Ezinye zazo azihambelani neLovastatin, ngakho-ke, ukusetshenziswa okuzimele kwezidakamizwa kwenqatshelwe ngokuphelele.
Izindleko, ukuqondana nokubuyekezwa kweziguli
Ngeshwa, okwamanje akunakwenzeka ukuthenga iLovastatin ngoba Akukhiqizwa eRussia.
Izinkampani ezenza umuthi ezifana neLekpharm (Belarus), iReplekpharm AD (Macedonia) neKievmedpreparat (Ukraine) zingabakhiqizi balesi sidakamizwa.
Kulokhu, udokotela angahle anikeze i-analog yeLovastatin, enezici ezifanayo zokwelapha.
Imithi ethandwa kakhulu yile:
- Holetar. Kuqukethe isithako esisebenzayo - i-lovastatin, ngakho-ke, isichazamazwi seLovastatin. Umuthi unezinkomba ezifanayo, ama-contraindication kanye nemiphumela emibi njengeLovastatin.
- I-Cardiostatin. Esinye isidakamizwa esaziwa kakhulu isichazamazwi seLovastatin, ngoba iqukethe ingxenye efanayo esebenzayo. Lapho uthatha i-Cardiostatin, umphumela wezokwelapha obekiwe ubonwa amasonto amabili, bese kuthi phezulu ngemuva kwamasonto angama-4-6 wokuphuza umuthi. Intengo ejwayelekile ingama-ruble angama-290 (kwiphakeji yamathebulethi angama-30 ama-20 mg).
- Pravastatin. Inobubanzi besenzo. Isithako esisebenzayo yi-pravastatin. Umuthi usetshenziselwa i-hypercholesterolemia eyisisekelo ne-dyslipidemia, kanye nokuvimbela isifo senhliziyo se-ischemic. Ukusetshenziswa kwePravastatin kungenzeka njengokuvimbela kwesibili kwe-myocardial infarction, angina pectoris kanye ne-post-transplant hyperlipidemia.
- I-Zokor. Into esebenzayo yesidakamizwa yi-simvastatin. Isibonakaliso esiyinhloko somuthi ukwelashwa kwe-hypercholesterolemia. I-Zokor isetshenziswa futhi njenge-prophylactic ukuvimbela ukuthuthukiswa kwe-pathologies yehliziyo Izindleko ezijwayelekile ngama-ruble angama-380 (amaphilisi angama-28 we-10 mg) kanye nama-ruble angama-690 (amaphilisi angama-28 we-20 mg).
Ngokusho kweVyshkovsky Index, abaholi basemakethe yezokwelapha yaseRussia yiCardiostatin, Mevacor, Holetar neRovacor.
Impendulo eLovastatin, evela ezigulini nakodokotela, iyakhanya. Umuthi uphephile futhi ubekezelelwa kahle yiziguli, noma usetshenziswa isikhathi eside.
Ukuphendula okuhambisana nokuphazamiseka kwe-dyspeptic kwesinye isikhathi kubonakala ekuqaleni kokwelashwa. Ngemuva kwamasonto amabili, lapho umzimba ujwayela ukuthonya ingxenye esebenzayo, izimpawu ziyaphela. Ngesinye isikhathi, amazinga e-ALT ne-AST akhuphuka, ngakho-ke kuyadingeka ukulawula okuqukethwe kwawo.
Ngemuva kwezinyanga eziyi-1.5 kusukela kuqale ukwelashwa, kwenziwa uhlolo lokulawula. Njengomthetho, kunomkhuba omuhle ekuhlaziyeni, i.e. ukunakekelwa kwe-lipid kuncishisiwe.
Ukuthi wehlise kanjani i-cholesterol echazwe kule vidiyo kulesi sihloko.
