Torvacard (20 mg) Atorvastatin
Daim ntawv tshuaj rau cov tshuaj tua Torvacard yog cov ua yeeb yaj kiab-cov ntsiav tshuaj: convex, oval, yuav luag dawb lossis dawb ntawm ob sab (10 pcs hauv lub hlwv, 3 lossis 9 hlwv hauv ib pob ntawm cardboard).
Cov khoom xyaw nquag: atorvastatin (hauv daim ntawv ntawm calcium), hauv 1 ntsiav tshuaj - 10, 20 lossis 40 mg.
Ntu cov khoom siv: tsis tshua muaj kev hloov chaw hyprolose, lactose monohydrate, magnesium stearate, croscarmellose sodium, magnesium oxide, colloidal silicon dioxide, microcrystalline cellulose.
Lub plhaub muaj pes tsawg leeg: macrogol 6000, hypromellose 2910/5, talc, titanium dioxide.
Dosage daim ntawv
Coated ntsiav tshuaj 10 mg, 20 mg, 40 mg
Ib ntsiav tshuaj muaj
cov tshuaj heev - atorvastatin 10.00 mg, 20.00 mg, 40.00 mg (raws li
atorvastatin calcium 10.34 mg, 20.68 mg, 41.36 mg, feem)
zam txim: magnesium oxide (hnyav), microcrystalline cellulose, lactose monohydrate (26.30 mg - rau cov ntsiav tshuaj nrog qhov ntau npaum ntawm 10 mg, 52.60 mg - rau cov ntsiav tshuaj nrog qhov ntau npaum ntawm 20 mg, 105.20 mg - rau cov ntsiav tshuaj nrog qhov ntau npaum ntawm 40 mg), croscarmellose sodium, qis hloov hydroxypropyl cellulose LH 21, anhydrous colloidal silicon, magnesium stearate
plhaub muaj pes tsawg leeg: hypromellose 2910/5, macrogol 6000, titanium dioxide E171, talc
Cov ntsiav tshuaj, coated nrog lub plhaub ntawm cov xim dawb lossis yuav luag xim dawb, oval, nrog lub ntsej muag biconvex, kwv yees li 9.0 x 4.5 hli hauv qhov loj me (rau qhov ntau npaum ntawm 10 mg).
Cov ntsiav tshuaj, coated nrog lub plhaub ntawm cov xim dawb lossis yuav luag xim dawb, lub qe kheej, nrog lub ntsej muag biconvex, txog 12.0 x 6.0 hli hauv qhov loj me (rau qhov ntau npaum ntawm 20 mg).
Cov ntsiav tshuaj, coated nrog lub plhaub ntawm cov xim dawb lossis yuav luag xim dawb, oval, nrog lub ntsej muag biconvex, kwv yees li 13.9 x 6.9 hli hauv qhov loj me (rau qhov muab 40 mg).
Cov chaw muag tshuaj
Cov Tshuaj Pharmacokinetics
Atorvastatin nrawm nrawm tom qab kev tswj hwm ntawm qhov ncauj, qhov siab tshaj plaws ntshav plasma concentration (Cmax) tau tiav nyob hauv 1-2 teev. Cov neeg kawm ntawv ntawm kev nqus thiab kev nqus ntawm atorvastatin hauv cov ntshav ntshav nce ntxiv hauv kev faib ua feem.
Tom qab kev tswj hwm ntawm qhov ncauj, Torvacard, cov ntsiav tshuaj pleev xim muaj txheej txheem 95% - 99% bioavailability piv rau cov tshuaj hauv qhov ncauj. Qhov tsis txaus ntseeg bioavailability ntawm atorvastatin yog tsawg (kwv yees li 14%), thiab muaj cov txheej txheem ntawm cov tshuaj tiv thaiv kev ua haujlwm tiv thaiv HMG-CoA reductase yog kwv yees li 30%. Kev siv lub cev tsis tshua muaj txiaj ntsig zoo yog vim muaj cov kab mob presystemic hauv lub plab zom mov ntawm txoj hnyuv thiab / lossis thaum "thawj hla" los ntawm daim siab. Khoom noj khoom haus me ntsis txo tus nqi thiab kev nqus ntawm kev nqus ntawm cov tshuaj (los ntawm 25% thiab 9%, feem, raws li pom los ntawm cov txiaj ntsig ntawm kev txiav txim siab ntawm Cmax thiab AUC), tab sis qhov txo qis hauv lipoprotein tsawg roj (LDL-C) yog nyob ze rau cov neeg thaum noj atorvastatin ntawm ib plab khoob. Tom qab noj atorvastatin thaum yav tsaus ntuj, nws cov ntshav plasma tsawg dua (Cmax thiab AUC los ntawm 30%) dua li tom qab noj nws thaum sawv ntxov. Muaj ib txoj kab sib txuas ntawm qhov degree ntawm nqus thiab qhov tshuaj ntawm cov tshuaj.
Qhov nruab nrab faib ntawm atorvastatin yog kwv yees li 381 litres. Qhov kev sib raug zoo ntawm atorvastatin nrog cov plasma protein yog tsawg kawg 98%. Kev zom zaub mov
Atorvastatin yog metabolized los ntawm cytochrome P450 3A4 rau ortho- thiab para-hydroxylated derivatives thiab ntau yam khoom ntawm beta oxidation. Hauvvitro ortho- thiab para-hydroxylated metabolites muaj qhov cuam tshuam rau HMG-CoA reductase, piv nrog ntawm Torvacard. Kwv yees li ntawm 70% tsawg dua hauv kev ua haujlwm ntawm HMG-CoA reductase tshwm sim vim qhov kev nqis tes ua ntawm cov roj ntsha nquag mus ua pa.
Atorvastatin feem ntau tsuas yog nyob hauv cov kua tsib tom qab cov kab mob hepatic thiab / lossis cov kab mob kev hnyav ntxiv. Txawm li cas los xij, cov tshuaj tsis raug rau kev nkag mus rau qhov kev nkag siab loj recirculation. Qhov ntshav nruab nrab ib nrab ntawm lub neej ntawm atorvastatin nyob rau hauv tib neeg yog kwv yees li 14 teev. Ib nrab-lub neej ntawm kev tiv thaiv kev ua si nrog hwm HMG-CoA reductase yog kwv yees li 20-30 teev vim qhov kev ua ntawm cov tshuaj tiv thaiv metabolites. Tom qab kev tswj hwm ntawm qhov ncauj, tsawg dua 2% ntawm atorvastatin pom nyob hauv zis.
Pharmacokinetics hauv cov pab pawg neeg mob tshwj xeeb
Cov neeg laus cov neeg mob
Qhov siab ntawm atorvastatin thiab nws cov metabolites hauv plasma ntau dua rau cov neeg mob noj qab haus huv hnub nyoog 65 xyoo thiab laus dua (Cmax kwv yees li 40%, AUC los ntawm 30%) dua li cov neeg mob hluas, thaum lub siab lipid-txo cov nyhuv ntawm txoj kev kho tau piv rau qhov pom ntawm cov pej xeem cov neeg mob hluas.
Hauv cov kev tshawb fawb hauv chav kho mob, qhov pom tseeb ntawm qhov ncauj tshem tawm ntawm atorvastatin hauv cov menyuam yaus mob zoo ib yam li cov neeg laus uas muaj qhov ntsuas tag nrho los ntawm lub cev qhov hnyav. Thoob plaws txhua qhov pom ntawm kev siv cov tshuaj atorvastatin thiab o-hydroxyatorvastatin, cov tshuaj lipoprotein roj tsawg tsawg (Cs-LDL) thiab tag nrho cov roj (Cs) tau pom.
Qhov kev txiav txim siab ntawm atorvastatin thiab nws cov metabolites hauv cov poj niam sib txawv (Cmax kwv yees li 20% siab dua thiab AUC kwv yees li 10% qis dua) los ntawm qhov ntawd hauv cov txiv neej, txawm li cas los xij, qhov sib txawv tseem ceeb hauv cov nyhuv ntawm cov tshuaj ntawm lipid metabolism hauv cov txiv neej thiab poj niam tsis tau kuaj pom.
Kab mob hauv lub raum tsis cuam tshuam rau cov tshuaj atorvastatin thiab nws cov metabolites hauv cov ntshav ntshav thiab lawv cov lipid-txo cov nyhuv, yog li, kev kho tshuaj rau cov neeg mob zoo li no tsis tas yuav tsum tau ua.
Nws tsis zoo li tias hemodialysis yuav ua rau muaj qhov nce ntxiv ntawm kev tshem tawm ntawm atorvastatin, vim tias cov tshuaj muaj feem cuam tshuam nrog cov plasma protein.
Plasma ntau ntawm atorvastatin thiab nws cov tshuaj tiv thaiv kab mob nce ntxiv (Cmax kwv yees li 16 zaug, AUC kwv yees li 11 zaug) hauv cov neeg mob uas lub siab ua mob rau daim siab (ntshav-Pugh chav B).
Cov nyhuv ntawm cov gene polymorphism SLCO1B1
Kev zom zaub mov nyob hauv daim siab ntawm txhua HMG-CoA reductase inhibitors, suav nrog atorvastatin, koom nrog OATP1B1 transporter protein. Cov neeg mob uas muaj SLCO1B1 noob polymorphism nthuav dav ntxiv rau atorvastatin, uas yuav ua rau muaj kev pheej hmoo mob rhabdomyolysis. Polymorphism nyob rau hauv cov gene encoding OATP1B1 (SLCO1B1 c.521CC) ua rau 2.4-nce ntxiv ntawm atorvastatin raug tshem tawm (AUC) piv nrog cov neeg uas tsis muaj cov caj ces txawv txav (c.521TT). Hauv cov neeg mob no, kev ua txhaum ntawm hepatic uptake ntawm atorvastatin vim tias muaj kev cuam tshuam caj ces kuj tseem muaj peev xwm ua tau. Qhov yuav tshwm sim zoo tshwm sim ntawm qhov tshwm sim ntawm kev ua haujlwm ntawm cov tshuaj yog tsis paub.
Cov Tshuaj Hauv Tshuaj
Torvacard yog qhov xaiv sib tw muaj zog ntawm HMG-CoA reductase, muaj cov enzyme tseem ceeb uas hloov 3-hydroxy-3-methylglutaryl-CoA rau mevalonic acid, ua ntej rau steroids, suav nrog cov roj (cholesterol).
Hepatic triglycerides thiab cov roj (cholesterol) nyob rau hauv cov lipoproteins tsawg heev (VLDL), nkag mus rau cov ntshav ntshav thiab raug thauj mus rau cov ntaub so ntswg. Cov tshuaj lipoproteins uas tsis muaj ntau (LDL) yog tsim los ntawm VLDL, uas yog catabolized los ntawm kev sib cuam tshuam nrog cov neeg txais kev pabcuam nrog qhov muaj siab rau LDL.
Torvacard txo cov roj ntshav plasma thiab cov lipoproteins los tiv thaiv HMG-CoA reductase thiab ntxiv biosynthesis cov roj (cholesterol) hauv lub siab, thiab tseem ua rau cov hepatic LDL receptors nyob rau hauv lub ntsej muag ntawm tes, txhim kho kev txhim kho thiab catabolism ntawm LDL-C.
Torvacard txo cov kev xav thiab tus naj npawb ntawm LDL hais. Torvacard ua rau kom muaj suab nrov thiab tsis tu ncua ntxiv hauv cov dej num ntawm LDL receptors nrog kev hloov pauv uas muaj txiaj ntsig zoo ntawm cov txheej txheem ntawm cov roj ntsha LDL. Torvacard txo cov ntshav qis ntawm LDL-C hauv cov neeg mob homozygous kab mob hypercholesterolemia (txog 20%), tiv taus kev kho nrog lwm cov tshuaj lipid-txo.
Torvacard txo cov roj (cholesterol) ntau los ntawm 30-46%, LDL cov roj cholesterol los ntawm 41-61%, apolipoprotein B los ntawm 34-50%, triglycerides los ntawm 14-33% thiab VLDL hauv cov neeg mob heterozygous thiab homozygous tsev neeg hypercholesterolemia, cov sib xyaw ntawm hypercholesterolemia, , thiab nyob rau hauv cov neeg mob uas tsis muaj tshuaj insulin-mob ntshav qab zib mellitus.
Txo cov roj (cholesterol) tag nrho, LDL cov roj (cholesterol) thiab apolipoprotein B txo cov kev pheej hmoo ntawm kev tsim kab mob plawv thiab muaj kev pheej hmoo tuag.
Kev ntsuas rau siv
- nyob rau hauv kev sib xyaw nrog kev noj haus rau kev kho mob ntawm cov neeg mob uas muaj plasma ntau cov ntsiab lus ntawm cov roj (cholesterol) tag nrho, LDL-C, apolipoprotein B thiab triglycerides thiab nce HDL-C hauv cov neeg mob hypercholesterolemia (heterozygous tsev neeg thiab tsis mob ntshav qab zib), sib xyaw (sib xyaw) hyperlipidemia IIa thiab IIb raws li Frederickson), nrog cov ntsiab lus tseem ceeb ntawm triglycerides hauv ntshav ntshav (hom IV raws li Frederickson) thiab cov neeg mob dysbetalipoproteinemia (hom III raws Frederickson), thaum tsis muaj cov txiaj ntsig tsim nyog nrog di oterapii
- txhawm rau txo cov ntshav plasma ntau ntawm cov tag nrho cov roj (cholesterol) thiab LDL-C hauv cov neeg mob homozygous tsev neeg hypercholesterolemia nrog cov tsis muaj txiaj ntsig ntawm kev noj zaub mov noj thiab lwm txoj kev siv tshuaj tsis zoo ntawm kev kho mob.
-yog kom txo txoj kev pheej hmoo ua rau mob plawv thiab mob txaus ntshai txhim kho myocardial infarction, angina pectoris, mob stroke thiab txo cov kev xav ua kom rov ua haujlwm nyob hauv cov neeg mob mob plawv thiab / lossis dyslipidemia, thiab yog tias muaj cov kab mob no tsis tau pom, tab sis muaj tsawg kawg yog peb cov xwm txheej pheej hmoo rau kev txhim kho CHD, xws li muaj hnub nyoog tshaj 55 xyoos, haus luam yeeb, mob ntshav siab, ntshav ntau ntawm HDL-C, thiab cov xwm txheej ntawm kev txhim kho mob plawv thaum ntxov hauv cov txheeb ze
- nyob rau hauv kev sib xyaw nrog kev noj haus rau kev kho mob ntawm cov menyuam hnub nyoog 10-17 xyoo nrog rau cov ntsiab lus plasma ntau dua ntawm cov roj cholesterol tag nrho, LDL-C thiab apolipoprotein B nrog heterozygous tsev neeg hypercholesterolemia, yog tias tom qab muaj kev noj zaub mov zoo txaus rau qib LDL-C tseem tshuav> 190 mg / dl lossis qib uas LDL tseem> 160 mg / dl, tab sis muaj qee zaum ntawm kev loj hlob ntawm cov kab mob plawv hauv cov neeg txheeb ze lossis ob lossis ntau dua muaj feem cuam tshuam rau kev mob plawv hauv cov menyuam yaus
Tsuas tshuaj thiab tswj hwm
Ua ntej siv Torvacard, tus neeg mob yuav tsum tau noj cov zaub mov lipid-txo qis, kev tawm dag zog thiab lub cev nyhav kom tswj tau hypercholesterolemia, nrog rau kev kho tus kab mob hauv qab. Kev noj haus yuav tsum raug pom thaum tag nrho lub sijhawm ntawm kev kho nrog Torvacard. Cov koob tshuaj yuav tsum tau xaiv ib tus zuj zus raws li theem pib ntawm HDL-C, lub hom phiaj ntawm txoj kev kho thiab tus neeg mob cov lus teb.
Qhov qauv pib siv tshuaj yog 10 mg ib hnub ib zaug. Kev hloov koob tshuaj yuav tsum tau ua ntawm kev ncua sijhawm ntawm 4 lub lis piam lossis ntau dua. Qhov siab tshaj plaws yog 80 mg ib zaug ib hnub.
Qhov noj tshuaj txhua hnub ntawm Torvacard noj ib zaug thaum lub sijhawm twg los ntawm hnub nrog zaub mov lossis tsis hais lub sijhawm noj mov. Lub sijhawm kho yog txiav txim los ntawm tus kws kho mob tshwj xeeb.
Thawj hypercholesterolemiathiab ua ke(sib xyaw)hyperlipidemia
Torvacard 10 mg ib hnub ib zaug. Kev ua kom zoo li qub feem ntau pom nyob hauv 2 lub lis piam, thiab cov txiaj ntsig siab kho tau feem ntau yog ua tiav nyob rau 4 lub lis piam. Cov nyhuv yog txhawb los ntawm kev kho tas mus li.
Heterozygous tsev neeg hypercholesterolemia
Cov neeg mob yuav tsum pib kho nrog ib koob tshuaj 10 mg ib hnub twg ntawm Torvacard. Thaum xaiv cov tshuaj, ib qho kev yuav tsum tau siv, cov koob tshuaj yuav tsum tau kho txhua 4 lub lis piam txog 40 mg ib hnub twg. Tom qab qhov no, cov tshuaj ntawm Torvacard tuaj yeem raug nce siab txog qhov ntau tshaj ntawm 80 mg rau ib hnub lossis 40 mg ib zaug ib hnub tuaj yeem noj nrog cov tshuaj uas ua kom muaj zog ntxiv ntawm cov kua tsib acid.
Homozygous tsev neeg hypercholesterolemia
Cov koob tshuaj ntawm Torvacard hauv cov neeg mob nrog homozygous tsev neeg hypercholesterolemia yog los ntawm 10 txog 80 mg rau ib hnub. Torvacard yuav tsum tau siv rau hauv cov neeg mob no ua ib qho kev txhawb ntxiv rau lwm hom kev kho lipid-piv txwv (piv txwv li LDL apheresis), lossis yog tias tsis muaj kev kho zoo li ntawd.
Cardio prophylaxis-leeg vascular
Nrog kev tiv thaiv thawj, qhov tshuaj yog 10 mg / hnub. Nws muaj peev xwm tias yuav tsum tau txhaj tshuaj ntau dua (ntau dua 10 mg rau ib hnub) yuav tsum ua kom tiav koj cov qib roj cholesterol (LDL), raws li koj tus kws kho mob pom zoo.
Koob tshuaj yuav tsis haum.
Torvacard yuav tsum siv nrog ceev faj hauv cov neeg mob uas muaj teeb meem mob hepatic. Txais tos Torvakard contraindicated rau cov neeg mob uas muaj lub siab ua mob rau daim siab.
Cov neeg laus cov neeg mob
Raws li cov txiaj ntsig ntawm kev kawm txog kev ua tau zoo thiab kev nyab xeeb ntawm cov tshuaj, cov neeg mob hnub nyoog laus dua 70 xyoo raug pom zoo kom siv cov koob tshuaj zoo ib yam li cov siv rau txhua lwm pawg neeg mob.
Kev siv kho cov menyuam yaus
Kev siv rau hauv kev kho menyuam yaus yuav tsum tau nqa tawm tsuas yog cov kws kho mob tau paub txog kev kho kev mob ntshav siab, thaum cov neeg mob yuav tsum tau soj ntsuam tas li kom ntsuas qhov kev ua tau zoo.
Rau cov neeg mob hnub nyoog 10 xyoo thiab laus dua, qhov kev xav kom pib ntawm atorvastatin yog 10 mg rau ib hnub nrog titration txog 20 mg rau ib hnub. Kev suav qib yuav tsum tau ua nyob rau hauv raws li ib tug neeg cov tshuaj tiv thaiv thiab coj mus rau hauv tus account lub siab tev taus ntawm cov tshuaj rau cov neeg mob kho mob. Tam sim no, muaj qee cov lus qhia txog kev nyab xeeb ntawm cov tshuaj rau cov menyuam yaus uas tau txais koob tshuaj ntau dua 20 mg, uas sib haum txog kwv yees li 0.5 mg / kg.
Muaj tsawg qhov kev paub hauv kev kho cov menyuam yaus ntawm cov tshuaj muaj hnub nyoog 6 rau 10 xyoo. Atorvastatin tsis yog siv rau kev kho mob ntawm menyuam yaus hnub nyoog qis dua 10 xyoo.
Lwm cov ntawv ntau / ntau ntau yuav haum rau pawg neeg mob no.
Torvacard yog tsim rau kev tswj hwm qhov ncauj. Txhua koob txhua hnub ntawm Torvacard tau noj tag nrho ib zaug thaum lub sijhawm txhua hnub, tsis hais noj zaub mov dab tsi.
Sab sij huam
Qhov kev tshwm sim ntawm qhov tsis zoo hauv kev soj ntsuam kev kho mob hauv qab no tau txiav txim siab siv cov txheej txheem hauv qab no: feem ntau (≥1 / 100 txog 1/10), tsis yog feem ntau (≥ 1/1000 txog 1/100), tsis tshua muaj (≥ 1/10000 txog 1 / 1000), tsis tshua muaj tshwm sim (txog li ntawm 1/10000), nrog qhov tsis paub ntau zaus (tsis tuaj yeem kwv yees los ntawm cov ntaub ntawv muaj).
- mob hauv lub pharynx thiab larynx, ntswg
- cem quav, pom quav, dyspepsia, xeev siab, raws plab
- mob myalgia, mob caj dab, mob hauv nqua, mob leeg nqaij, o ntawm cov pob qij txha, mob nraub qaum
- qhov txawv ntawm cov kev kuaj sim ntawm lub siab ua haujlwm, nce ntxiv ntawm theem ntawm creatine kinase hauv cov ntshav
- hypoglycemia, nce phaus, tsis nco qab
- npau suav phem, insomnia
- kiv taub hau, mob duav, mob ntshav qab zib, mob qia ntshav (saj tsis qab), amnesia
- ntuav, mob nyob rau sab saud thiab hauv qab ntawm lub plab ua kom plab, ntuav, mob caj pas
- urticaria, tawv nqaij sawv pob, khaus, alopecia (focal alopecia)
- caj dab mob, mob nqaij rog
- malaise, dav dav tsis muaj zog, mob hauv siab, peripheral edema, nkees, hyperthermia
- muaj cov qe ntshav dawb nyob hauv cov zis
- Quincke's edema, cov tawv nqaij mob tawv nqaij ntau dhau, suav nrog kev mob polymorphic erythema, Steven-Johnson syndrome thiab cov tshuaj lom neeg mob lom hauv lub cev
- myopathy, myositis, rhabdomyolysis, tendinopathy (leeg nqaij mob), qee zaum nyuaj los ntawm kev sib tsoo
Zaus tsis paub(tsis yooj yim los txiav txim los ntawm cov ntaub ntawv muaj)
- Immuno-mediated necrotizing myopathy
Nrog rau qee yam statins
- Kev ua haujlwm ntawm kev sib deev
- Muaj qee kis tshwj xeeb ntawm cov mob ntsws ua txhaum, tshwj xeeb nrog kev kho mob ntev
- mob ntshav qab zib mellitus: ntau zaus nyob ntawm qhov muaj lossis tsis muaj kev phom sij (yoo cov ntshav qab zib ntau dua 5.6 mmol / L, BMI ntau dua 30 kg / m2, nce triglycerides, keeb kwm ntawm kev kub siab).
Ib yam li lwm yam HMG-CoA reductase inhibitors, cov neeg mob uas tau txais atorvastatin ntsib kev nce siab ntxiv. Cov kev hloov no, raws li txoj cai, tsis muaj zog, lub sijhawm luv luv thiab tsis tas yuav muaj kev cuam tshuam kev kho mob. Kev nce ntxiv hauv lub tsev kho mob (ntau dua 3 zaug ntau dua li qhov siab dua qhov ib txwm muaj) ntawm kev hloov ntshav hloov tshwm sim hauv 0.8% ntawm cov neeg mob noj atorvastatin. Qhov nce no yog koob tshuaj-tso siab thiab thim rov qab rau hauv txhua tus neeg mob.
Ntau tshaj 3-npaug dhau qhov txwv tsis pub tshaj ntawm qhov ib txwm ua rau cov ntshav dej muaj txiaj ntsig (CC) qib tau pom nyob rau hauv 2.5% ntawm cov neeg mob noj atorvastatin, qhov ntsuas tau zoo sib xws tau pom thaum lub sijhawm sim tshuaj thiab rau lwm qhov HMG-CoA reductase inhibitors. Qhov ntau tshaj 10-qhov dhau ntawm qhov tsis pub dhau ntawm ib txwm muaj tshwm sim hauv 0.4% ntawm cov neeg mob noj atorvastatin.
Sabkev ua hauv menyuam yaus
- nce ALT ntau ntau, nce ntxiv ntawm creatine phosphokinase hauv cov ntshav
Raws li cov ntaub ntawv muaj, nws tuaj yeem xav tias qhov ntau zaus, hom thiab qhov tsis zoo ntawm kev coj ua tsis zoo hauv cov menyuam yaus uas siv cov tshuaj atorvastatin zoo tib yam rau cov neeg laus. Tam sim no, muaj tsawg cov ntaub ntawv ntawm kev nyab xeeb lub sij hawm ntev rau cov tshuaj rau cov neeg mob paum.
Cov Yuav Tsum Muaj
- Kev txo tshuaj rau ib qho twg hauv cov tshuaj
- kev mob siab rau daim siab lossis kev nce qib hauv cov dej num ntawm cov ntshav transaminases (ntau dua 3 zaug piv nrog kev txwv sab sauv ntawm qhov tsis xws luag) ntawm cov keeb kwm tsis paub
- cov neeg mob uas muaj keeb kwm lactose tsis txaus ntseeg, tsis muaj peev xwm ntawm enzyme LAPP-lactase, malabsorption ntawm qabzib-galactose
- cev xeeb tub thiab lactation, nrog rau cov poj niam uas muaj hnub nyoog yug me nyuam uas tsis siv txoj kev ua kom muaj txiaj ntsig txaus
- cov me nyuam qis dua 10 xyoo
Cov tshuaj sib cuam tshuam
Qhov cuam tshuam ntawm kev tswj hwm tshuaj ntawm cov nyhuv ntawm atorvastatin
Atorvastatin yog cov tshuaj tiv thaiv los ntawm cytochrome P4503A4 (CYP3A4) thiab yog cov txheej txheem rau cov thauj cov protein, piv txwv li, cov kab mob siab hloov tsheb - OATP1B1. Kev siv ib txhij siv cov tshuaj uas yog tshuaj tiv thaiv ntawm CYP3A4 lossis thauj cov protein tuaj yeem ua rau nce qhov kev cia siab ntawm atorvastatin hauv cov ntshav ntshav thiab nce ntawm kev pheej hmoo myopathy.
Tsis tas li, qhov kev pheej hmoo tuaj yeem nce ntxiv thaum noj atorvastatin nrog lwm cov tshuaj uas tuaj yeem ua rau mob myopathy, piv txwv li, nrog derivatives ntawm fibric acid thiab ezetimibe.
Cov Zog CYP3A4 muaj zog heev tau pom tias nce siab ntawm atorvastatin ntau. Siv tib lub zog CYP3A4 inhibitors (piv txwv li, cyclosporine, telithromycin, clarithromycin, delavirdine, styripentol, ketoconazole, voriconazole, itraconazole, posaconazole thiab HIV protease inhibitors, suav nrog ritonavir, lopinavir, atazanavir, yuav tsum tau, d. Cov. Yog tias kev sib koom tes ntawm cov tshuaj no nrog atorvastatin yog qhov zam tsis tau, qhov pib ntawm qhov ntau thiab ntau kawg ntawm atorvastatin yuav tsum tau txo, thiab kev tshuaj xyuas mob ntawm cov neeg mob raug pom zoo.
CYP3A4 Cov Tshuaj Tiv Thaiv Qiv Cawv
Cov CYP3A4 Tus Qauv Nruab Nrab (xws li, erythromycin, diltiazem, verapamil thiab fluconazole) tuaj yeem ua rau muaj kev nce plasma ntau dua ntawm atorvastatin. Kev pheej hmoo ntawm myopathy yog pom thaum siv erythromycin nrog statins. Kev tshawb nrhiav ntawm kev cuam tshuam ntawm cov tshuaj nrog kev kawm txog cov teebmeem ntawm amiodarone lossis verapamil ntawm atorvastatin tsis tau ua. Nws tau tsim tsa tias amiodarone thiab verapamil inhibit qhov kev ua si ntawm CYP3A4, yog li ntawd, lawv cov kev siv ua ke nrog atorvastatin tuaj yeem ua rau muaj kev nce ntxiv hauv nws cov kev nqis tes ua. Yog li, nws yog qhov tsim nyog los sau tshuaj kom tsawg dua cov tshuaj atorvastatin thiab nws raug nquahu kom ua qhov kev kuaj mob tsim nyog ntawm cov neeg mob thaum noj cov tshuaj nrog cov muaj kev cuam tshuam CYP3A4 tsis haum. Cov kev soj ntsuam hauv kev kho mob tau pom zoo tom qab pib kho los yog kho tom qab siv tshuaj tiv thaiv kab mob inhibitor.
Qhov kev siv ntau tshaj tawm ntawm atorvastatin nrog cytochrome P4503A inducers (piv txwv, nrog efavirenz, rifampicin, St. John lub wort) tuaj yeem ua rau muaj kev hloov pauv tsis txaus nyob rau hauv cov concentration ntawm atorvastatin hauv ntshav. Vim tias ob lub tshuab sib cuam tshuam ntawm kev sib raug zoo ntawm rifampicin (induction ntawm cytochrome P4503A thiab kev txwv tsis pub thauj khoom ntawm kev nqus ntawm cov tshuaj los ntawm daim siab OATP1B1), kev siv tib lub sijhawm ntawm atorvastatin thiab rifampicin pom zoo, txij li thaum noj atorvastatin qee lub sijhawm tom qab rifampicin ua rau muaj kev txo qis hauv cov ntshav ntawm atorvastatin. Txawm li cas los xij, cov txiaj ntsig ntawm atorvastatin ntawm kev siv tshuaj ntawm rifampicin hauv hepatocytes tseem tsis tau tsim, yog li ntawd, yog tias siv cov khoom tsis raug pov tseg, kev saib xyuas ntawm cov neeg mob yuav tsum tau ua nrog qhov pom ntawm qhov kev ua tau zoo ntawm kev kho.
Cov Tshuaj Txwv Tsis Pub Tshuaj Protein
Thauj cov protein inhibitors (xws li, cyclosporine) tuaj yeem txhim kho cov txiaj ntsig ntawm atorvastatin. Cov nyhuv ntawm kev ua kom muaj zog ntawm kev nqus ntawm cov neeg thauj los ntawm cov tshuaj los ntawm daim siab tso tawm rau ntawm cov atorvastatin hauv hepatocytes tsis paub. Yog tias kev siv sib tov yog qhov zam tsis tau, nws raug nquahu kom txo qhov koob tshuaj thiab kev soj ntsuam kev soj ntsuam ntawm cov txiaj ntsig ntawm kev kho.
Gemfibrozil / fibroic acid derivatives
Cov tshuaj monotherapy qee zaum ua rau muaj teeb meem hauv cov leeg nqaij, suav nrog rhabdomyolysis. Qhov kev pheej hmoo no yuav nce ntxiv nrog kev siv cov fibroic acid thiab atorvastatin sib xyaw. Yog tias kev siv sib tov yog qhov zam tsis tau, txhawm rau kom ua tiav lub hom phiaj kho, nws yog qhov tsim nyog los sau tshuaj rau qhov tsawg tshaj plaws ntawm atorvastatin thiab tshuaj xyuas cov neeg mob kom zoo.
Ezetimibe monotherapy ua rau muaj teeb meem hauv cov leeg nqaij, suav nrog rhabdomyolysis. Yog li, qhov kev pheej hmoo no yuav nce ntxiv nrog kev siv cov ezetimibe thiab atorvastatin sib xyaw nrog. Pom zoo kev saib xyuas mob hauv cov neeg mob zoo li no.
Qhov kev nkag siab ntawm atorvastatin thiab nws cov metabolites hauv plasma tsawg dua (kwv yees li 25%) piv nrog concomitant kev kho nrog colestipol thiab atorvastatin. Cov nyhuv ntawm theem ntawm lipids tau ntau dua nrog kev tswj hwm tib lub sij hawm ntawm atorvastatin thiab colestipol npaj hauv kev sib piv nrog theem ntawm kev kho mob monotherapy nrog cov tshuaj no.
Kev tshawb nrhiav ntawm kev sib cuam tshuam ntawm atorvastatin thiab fusidic acid tsis tau ua. Xws li nrog rau lwm yam statins, thaum lub sijhawm sau npe tom qab kev soj ntsuam ntawm kev kho mob concomitant nrog atorvastatin thiab fusidic acid, cov leeg mob tau sau tseg, suav nrog rhabdomyolysis. Cov txheej txheem ntawm kev sib cuam tshuam no tsis paub txog. Cov neeg mob yuav tsum tau saib xyuas kom zoo, thiab qee qhov xwm txheej, ncua kev tswj hwm ntawm atorvastatin mus ib ntus.
Txawm hais tias tsis muaj kev kawm cuam tshuam ntawm atorvastatin thiab colchicine tau ua, tus neeg mob myopathy tau qhia nrog kev kho mob concomitant nrog atorvastatin thiab colchicine, thiab yog li ntawd yuav tsum ceev faj thaum siv tshuaj atorvastatin nrog colchicine.
Cov nyhuv ntawm atorvastatin ntawm kev sib faib tshuaj
Nrog rau kev siv ntau yam ntawm digoxin thiab 10 mg ntawm atorvastatin, qhov sib npaug ntawm digoxin ntau zog me ntsis. Cov neeg mob noj digoxin yuav raug kev saib xyuas mob.
Kev siv ua ke ntawm atorvastatin thiab tshuaj tiv thaiv qhov ncauj ua rau muaj ntau ntxiv ntshav ntau ntxiv ntawm norethindrone thiab ethinyl estradiol.
Tsis muaj qhov sib cuam tshuam loj ntawm kev sib cuam tshuam ntawm atorvastatin nrog warfarin raug kuaj pom.
Qhia tsawg tsawg zaus cov chaw sib tham tseem ceeb nrog cov tshuaj anticoagulants. Ua ntej pib kho nrog atorvastatin thiab ntxiv thaum pib ntawm kev kho mob, nws raug nquahu kom txiav txim siab lub sijhawm prothrombin hauv cov neeg mob noj coumarin anticoagulants.
Nws raug nquahu kom txo qis thawj zaug thiab ua kev soj ntsuam kab mob ntawm cov neeg mob noj atorvastatin thiab boceprevir tib lub sijhawm. Kev noj tshuaj txhua hnub ntawm atorvastatin yuav tsum tsis pub tshaj 20 mg thaum lub sijhawm sib tov nrog tshuaj boceprevir.
Txoj kev kawm txog kev sib txuas yeeb tshuaj tau ua rau cov laus xwb. Cov neeg kawm paub txog qib sib txuam nrog yeeb tshuaj hauv cov menyuam yaus tseem tsis tau paub. Cov cim ntawm kev cuam tshuam rau cov neeg laus yog qhia saum toj no, yog li ntawd, thaum kho menyuam yaus, "Cov lus qhia tshwj xeeb" yuav tsum raug rau hauv.
Kev Sib Sau thiab daim ntawv ntawm kev tso tawm
Cov tshuaj yeeb yaj kiab ib txwm muaj nyob rau hauv daim ntawv qhov sib txawv ntawm cov ntsiav tshuaj ntawm cov xim dawb los yog ze rau cov xim dawb, uas yog coated nrog ib zaj duab xis membrane, yog biconvex thiab oval.
- 1 ntsiav tshuaj muaj 40, 20 mg lossis 10 mg ntawm atorvastatin.
Cov kuaj mob thiab pab pawg tshuaj: lipid-txo tshuaj.
Cov lus qhia tshwj xeeb
Ua rau daim siab
Ua ntej kev kho thiab tsis tseg tom qab ua tiav, kev tshawb fawb ntawm lub siab ua haujlwm yuav tsum tau ua. Tsis tas li, kev kuaj xyuas lub siab ua haujlwm yuav tsum ua hauv cov neeg mob uas muaj cov cim lossis tsos mob ua rau lub siab puas. Nyob rau hauv cov ntaub ntawv ntawm kev nce hauv cov ntsiab lus ntawm hepatic transaminases, lawv cov qib yuav tsum tau saib xyuas kom txog rau thaum cov kev txwv ntawm kev suav tau mus txog. Yog tias qhov nce ntawm qib transaminase ntau dua 3 zaug ntawm qhov qis dua ntawm ib txwm tsis tu ncua, txuas ntxiv mus, nws raug nquahu kom txo qis lossis tshem tawm tag nrho cov koob tshuaj.
Torvacard yuav tsum tau siv nrog ceev faj hauv cov neeg mob uas haus ntau ntau cov dej cawv thiab / lossis muaj keeb kwm muaj kab mob siab.
Cov neeg mob uas muaj mob ntshav me lossis mob hla ischemic nres.
Rau cov neeg mob uas tau mob ntshav tsis txaus lossis lacunar infarction ntawm lub hlwb, qhov sib npaug ntawm cov kev pheej hmoo thiab cov txiaj ntsig ntawm 80 mg ntawm atorvastatin yog qhov tsis paub tseeb. Hauv cov neeg mob zoo li no, ua ntej pib kev kho mob, kev pheej hmoo hemorrhagic mob stroke yuav tsum tau ua tib zoo txiav txim siab.
Skeletal leeg ua
Torvacard, zoo li lwm yam tshuaj tiv thaiv ntawm HMG-CoA reductase, tuaj yeem ua rau muaj qee yam muaj feem cuam tshuam rau cov leeg pob txha thiab ua rau mob myalgia, myositis, myopathy, uas tuaj yeem hloov mus rau rhabdomyolysis, ib tug kab mob tuag taus uas yog muaj qhov tseem ceeb nce hauv creatine phosphokinase qib (hauv 10 npaug ntau dua li cov kev txwv sab sauv ntawm qhov ib txwm muaj (VGN)), mob qog nqaij hlav ntshav thiab myoglobinuria, tuaj yeem ua rau txoj kev txhim kho ntawm lub raum tsis ua haujlwm.
Torvacard yuav tsum tau siv nrog ceev faj hauv cov neeg mob nrog kev paub ua ntej ntawm kev txhim kho ntawm rhabdomyolysis. Qib ntawm creatine phosphokinase (CPK) yuav tsum ntsuas ua ntej kho nrog statins hauv cov xwm txheej hauv qab no:
kev mob rau cov roj ntsha tsis sib xws hauv tus kheej lossis tsev neeg keeb kwm
keeb kwm ntawm cov leeg mob toxicity vim yog keeb kwm statin lossis fibrate
keeb kwm ua mob rau daim siab thiab / lossis kev haus cawv ntau
- hauv cov neeg laus cov neeg mob (ntau dua 70 xyoo), qhov xav tau ntawm cov kev ntsuas no yuav tsum tau txiav txim siab coj mus rau hauv tus account muaj lwm qhov kev cuam tshuam rau kev txhim kho rhabdomyolysis.
- cov xwm txheej uas kev nce qib hauv qee qib ntawm cov ntshav plasma muaj peev xwm ua tau, piv txwv li, nrog kev sib cuam tshuam ntawm cov tshuaj, nrog rau cov pab pawg tshwj xeeb ntawm cov neeg mob, suav nrog cov neeg muaj kab mob kis.
Hauv cov xwm txheej zoo li no, kev pheej hmoo ntawm kev kho yuav tsum raug txiav txim siab nyob rau hauv kev sib raug zoo rau cov txiaj ntsig tau, thiab kev soj ntsuam hauv chaw kho mob tau pom zoo. Kev kho yuav tsum tsis txhob pib yog tias qib ntawm CPK yog siab dua (ntau dua 5 zaug siab dua VGN) ib txwm muaj.
Creatine Kinase Qib Ntsuas Kev Ntsuas
Koj yuav tsum tsis txhob ntsuas qhov theem ntawm creatine phosphokinase (CPK) tom qab kev ua haujlwm qoj ib ce lossis nyob rau ntawm qhov muaj qhov laj thawj xav tau rau qhov nce hauv CPK, vim tias qhov no ua rau muaj kev cuam tshuam kev txhais ntawm qhov tseem ceeb. Yog tias cov qib hauv qib (CPK) nce siab tshaj thawj theem (ntau dua 5 zaug siab dua VGN), kom paub meej tias qhov tshwm sim, rov tshawb dua tom qab 5 txog 7 hnub.
Tus Neeg Mob Cov Ntaub Ntawv
Cov neeg mob yuav tsum tau ceeb toom txog qhov yuav tsum tau ceeb toom tam sim ntawd qhov tshwm sim ntawm cov leeg mob, cramps lossis tsis muaj zog, tshwj xeeb yog tias lawv nrog los ntawm malaise lossis kub taub hau. Yog tias cov tsos mob no tau tshwm sim thaum kho nrog Torvacard, ces qib qib CPK yuav tsum raug ntsuas. Yog tias kuaj pom tias qib CPK nce siab lawm (ntau dua 5 npaug ntau dua li qhov siab ntawm cov cai txwv), cov leeg mob hnyav thiab ua rau muaj kev cuam tshuam txhua hnub, koj yuav tsum txiav txim siab cuam tshuam kev kho mob.
Yog tias cov tsos mob tshwm sim thiab qib CPK rov qab los nyob li qub, kev txiav txim siab yuav tsum tau muab rau rov siv Torvacard lossis siv lwm qhov statin tsawg kawg hauv kev siv tshuaj thiab nrog saib xyuas zoo.
Atorvastatin yuav tsum tsis ua mus ntxiv yog tias qhov chaw kuaj mob tseem ceeb hauv qib QC raug kuaj (ntau dua 10 npaug ntau dua VGN), lossis yog tias rhabdomyolysis lossis kev xoom xaim ntawm tus kab mob no tau kuaj pom.
Muaj feem xyuamkev kho moblwm yamlamtxhais tau tias
Kev pheej hmoo ntawm rhabdomyolysis nce nrog kev siv tshuaj atorvastatin tib lub sijhawm nrog qee yam tshuaj uas tuaj yeem nce qhov kev xav ntawm atorvastatin nyob rau hauv cov ntshav ntshav, piv txwv, nrog cov muaj zog CYP3A4 inhibitors lossis thauj cov protein (xws li cyclosporine, telithromycin, clarithromycin, delavirdine, styripentol, itraconazonazole thiab HIV protease inhibitors, suav nrog ritonavir, lopinavir, atazanavir, indinavir, darunavir, saquinavir, fosamprenavir, thiab lwm yam). Tsis tas li ntawd, kev pheej hmoo ntawm myopathy yuav nce ntxiv nrog kev siv gemfibrozil tib lub sijhawm thiab lwm yam kev sib txuas ntawm fibroic acid, boceprevir, erythromycin, niacin thiab ezetimibe, telaprevir, lossis kev sib xyaw ntawm tipranavir / ritonavir. Hloov cov tshuaj no, yog tias tsim nyog, xav txog qhov ua tau los ntawm kev muab tshuaj lwm txoj (tsis cuam tshuam rau) cov tshuaj.
Tsis tshua muaj neeg qhia tiv thaiv-mediated necrotic myopathy (IONM) thaum los yog tom qab kho statin. IONM muaj kev soj ntsuam los ntawm qhov kev ua rau cov leeg ua kom tsis muaj zog thiab ua kom cov ntshav muaj zog ntau ntxiv, uas yog tas mus li txawm tias siv ceev xwmphem.
Yog tias kev sib koom tes ntawm cov tshuaj no nrog atorvastatin yog qhov tsim nyog, cov txiaj ntsig thiab kev pheej hmoo ntawm kev kho mob concomitant yuav tsum ua tib zoo kawm. Yog tias cov neeg mob tau noj tshuaj uas ua rau lub plasma qhov siab ntau dua ntawm atorvastatin, nws raug nquahu tias yuav tsum tau txhaj ntau dua ntawm atorvastatin kom tsawg. Txhawm rau kev siv tshuaj muaj zog CYP3A4 inhibitors, nws yog qhov tsim nyog yuav tsum tau sau tshuaj kom qis dua ntawm atorvastatin, thiab nws tseem pom zoo kom ua kev soj ntsuam uas tsim nyog ntawm cov neeg mob no.
Kev siv ua ke ntawm atorvastatin thiab fusidic acid tsis pom zoo, yog li ntawd, kev kho mob atorvastatin tuaj yeem raug muab ncua ib ntus thaum kho nrog fusidic acid.
Kev siv kho cov menyuam yaus
Qhov kev nyab xeeb ntawm cov tshuaj thiab nws cov nyhuv ntawm kev txhim kho menyuam yaus tsis tau teeb tsa.
Cov mob ntsws interstitial
Tsis tshua muaj neeg kis tus kab mob ntsws interstitial mob ntsws uas tau hais qhia tshwj xeeb tshaj yog siv sijhawm ntev siv qee yam statins. Cov tsos mob hauv qab no tau pom: ua pa tsis taus, tsis hnoos tsis zoo thiab ua kom tsis muaj mob rau hauv kev noj qab haus huv (qaug zog, poob phaus, thiab kub cev). Yog tias muaj kev xoom xaim uas tus neeg mob tau mob ntsws ntsig, kev siv tshuaj statin yuav tsum tsis ua mus ntxiv.
Qee cov ntaub ntawv pov thawj qhia tias statins ua ib chav kawm ntawm cov tshuaj nce ntshav siab, thiab hauv qee tus neeg mob uas muaj kev pheej hmoo siab mob ntshav qab zib, hyperglycemia tuaj yeem ncav cuag uas nws tau pom zoo kom kho kev kho mob ntshav qab zib. Txawm li cas los xij, qhov kev pheej hmoo no tau pab txhawb los ntawm kev txo qis txoj kev pheej hmoo ntawm kev tsim muaj cov mob vascular nrog kev pab ntawm statins thiab, yog li ntawd, yuav tsum tsis txhob yog qhov laj thawj ntawm txiav kev kho mob nrog statins. Kev soj ntsuam ntawm cov neeg mob uas muaj kev pheej hmoo (nrog ceev cov piam thaj ntawm 5.6-6.9 mmol / l, BMI> 30 kg / m, nce triglycerides, kub siab) yuav tsum tau nqa los ntawm ob qho chaw kuaj mob thiab biochemical tswj txoj hauv kev raws li kev pom zoo hauv tebchaws.
Kev siv ntau ntawm cov kua txiv kab ntxwv qaub thaum noj atorvastatin tsis pom zoo.
Torvacard muaj cov lactose monohydrate. Cov neeg mob uas muaj cov qe tsis tshua muaj txiaj ntsig ua rau tsis txaus, Lapp lactase deficiency lossis glucose-galactose malabsorption yuav tsum tsis txhob noj cov tshuaj no.
Torvacard yog contraindicated nyob rau hauv cev xeeb tub. Cov poj niam ntawm lub hnub nyoog yug menyuam yuav tsum ua qhov tsim nyog siv kev tiv thaiv kom zoo thaum lub sijhawm kho nrog Torvacard. Tsis muaj kev tswj xyuas cov kev tshawb fawb soj ntsuam ntawm atorvastatin hauv cov poj niam cev xeeb tub tau ua. Muaj qee qhov kev qhia hais txog kev txawv txav ntawm lub cev thaum yug tom qab raug mob rau HMG-CoA reductase inhibitors. Cov kev tshawb fawb tsiaj tau pom tias cov tshuaj muaj cov tshuaj lom rau lub cev tsis muaj zog.
Kev kho mob ntawm leej niam nrog atorvastatin tuaj yeem txo qhov kev txiav txim siab ntawm mevalonate hauv tus menyuam, uas yog qhov ua ntej rau cov roj ntsha biosynthesis. Txij li thaum atherosclerosis yog ib qho kev kho mob ntev, kev tshem tawm lipid-txo txoj kev kho mob thaum cev xeeb tub tsis muaj kev cuam tshuam ntawm kev pheej hmoo ntev ntev uas cuam tshuam nrog thawj hypercholesterolemia. Yog li no, Torvacard yuav tsum tsis txhob coj los ntawm cov poj niam cev xeeb tub, cov poj niam uas tab tom npaj kho cev xeeb tub los yog xav tias lawv muaj me nyuam. Kev kho mob Torvacard yuav tsum tau muab tshem tawm thaum muaj menyuam hauv plab, lossis txog thaum nws pom tseeb tias tus pojniam tsis xeeb tub.
Cov ntaub ntawv hais txog seb atorvastatin ua tawm hauv tib neeg cov kua mis tsis muaj. Hauv cov nas, cov concentration ntawm atorvastatin thiab nws cov metabolites hauv plasma zoo ib yam li lawv cov concentration hauv mis. Vim tias qhov tshwm sim muaj cov kev mob tshwm sim loj heev, cov poj niam noj Torvacard yuav tsum tsis txhob pub mis. Atorvastatin yog sib kis thaum lactation.
Cov yam ntxwv ntawm cov nyhuv ntawm cov tshuaj ntawm lub peev xwm tsav lub tsheb thiab muaj cov phom sij phom sij
Muab cov kev phiv los ntawm cov tshuaj, ceev faj yuav tsum tau siv thaum tsav tsheb thiab lwm yam uas yuav muaj kev phom sij.
Pharmacological kev txiav txim
Torvacard noj tshuaj, yog ib qho kev xaiv sib tw inhibitor ntawm HMG-CoA reductase, ua rau txo cov ntshav hauv cov ntshav siab. Torvacard muaj txiaj ntsig tiv thaiv keeb kwm ntawm homozygous tsev neeg hypercholesterolemia, uas feem ntau tsis txaus siab los kho nrog lwm cov tshuaj zoo sib xws.
Ib qhov ua tau zoo kho tau pom tom qab 1.5-2 lub lis piam, thiab qhov siab tshaj plaws - tom qab ib hlis. Ntxiv mus, yav tom ntej, cov nyhuv ntawm cov tshuaj yog khaws cia.
Cov lus qhia rau kev siv
Torvacard yuav tsum noj ntawm qhov ncauj thaum lub sijhawm yooj yim ntawm lub hnub, tsis hais noj mov dab tsi. Ua ntej yuav sau cov tshuaj, tus neeg mob raug pom zoo kom noj cov zaub mov lipid-txo qis, uas nws yuav tsum ua raws li txhua lub sijhawm ntawm kev kho mob.
Cov koob tshuaj yog xaiv ib tus zuj zus, suav txog qhov ntsuas pib ntawm LDL-C, lub hom phiaj ntawm kev kho thiab tus neeg mob cov lus teb rau kev kho.
- Thawj koob tshuaj yog qhov nruab nrab li 10 mg 1 teev / hnub. Cov koob tshuaj nws txawv ntawm 10 txog 80 mg 1 zaug / hnub. Cov tshuaj tuaj yeem noj tau txhua lub sijhawm ntawm ib hnub, tsis hais lub sijhawm noj mov. Cov koob tshuaj yog xaiv rau hauv kev txiav txim siab thawj theem ntawm LDL-C, lub hom phiaj ntawm txoj kev kho thiab cov txiaj ntsig ib leeg rau ib leeg. Thaum pib kho mob thiab / lossis thaum muaj qhov nce ntxiv ntawm Torvacard, nws yog qhov yuav tsum tau soj ntsuam cov ntshav lipid txhua qib 2-4 lub lis piam thiab kho qhov tshuaj raws li. Qhov tshuaj ntau tshaj txhua hnub yog 80 mg hauv 1 koob tshuaj.
- Nrog rau kev sib xyaw nrog hyperlipidemia thiab thawj hypercholesterolemia, raws li txoj cai, koob tshuaj 10 mg ib hnub ib zaug yog txaus, ib qho tseem ceeb ntawm kev kho yog pom tom qab 2 lub lis piam. Tom qab 4 lub lis piam, cov txiaj ntsig siab tshaj plaws feem ntau yog ua kom pom, uas ua mob ntev nrog kev kho mob ntev.
Ib cov lus hais txog kev kho mob tau pom tsuas yog tom qab 2 lub lis piam ntawm kev kho kab mob nrog Torvacard, thiab qhov siab tshaj plaws - tom qab ib hlis. Raws li kev txheeb xyuas ntawm Torvacard los ntawm cov neeg mob, nrog kev siv tshuaj ntev, cov txiaj ntsig kho tau zoo yog kev tswj hwm.
Pom tau tsa tes yeeb ncuab MUSHROOM ntawm ntsia hlau! Koj cov ntsia hlau yuav raug ntxuav hauv 3 hnub! Coj nws. | |
| Yuav ua li cas kom ceev cov leeg nrawm tom qab 40 xyoo? Daim ntawv qhia yooj yim, sau cia. | |
| Nkees hemorrhoids? Muaj ib txoj kev tawm! Nws tuaj yeem raug kho nyob hauv tsev hauv ob peb hnub, koj xav tau. | |
| Txog qhov muaj cov cab li hais tias ODOR los ntawm lub qhov ncauj! Ib zaug ib hnub, haus dej nrog ib tee .. Lus qhia txuj ciCov nta ntawm daim ntawv tso tawm tau piav qhia txhua yam hauv Torvacard ntsiav tshuaj cov lus qhia. Los ntawm nws koj tuaj yeem paub tias cov tshuaj nyob hauv cov qauv tshuaj, cov tshuaj sib txuas yog them nrog cov nyias zaj duab xis ntawm cov zaub mov. Nquag, qhov ntxoov ntxoo yog dawb lossis ze heev ntawm cov xim no. Ib kem cais muaj cov qauv ntawm oval, convex ntawm ob tog. Qhov tseem ceeb muaj nyob hauv txhua lub ntsiav tshuaj yog atorvastatin calcium molecule. Hais txog cov ntshiab huv statin, ib qho piv txwv muaj 10, 20 lossis 40 mg ntawm cov tshuaj nquag. Qhov ntau npaum li cas tau hais tsuas yog tsis nyob hauv cov ntaub ntawv nrog cov tshuaj, tab sis kuj nyob sab nraud ntawm pob. Nws tseem sau tseg ntau npaum li cas cov tshuaj hauv sab hauv.
Noj ntau dhauCov tsos mob nce kev phiv. Kev Kho Mob: tsis muaj cov tshuaj tiv thaiv tshwj xeeb. Yog tias muaj kev noj tshuaj ntau dhau ntawm Torvacard tau tshwm sim, kev kho mob ntawm tus neeg mob yuav tsum muaj tsos mob, kev kuaj ntshav ntawm lub siab yuav tsum tau ua thiab ntsuas qib CPK yuav tsum tau saib xyuas. Txij li thaum atorvastatin khi rau cov ntshav muaj protein ntau, hemodialysis ua tsis tau dab tsi. Cov Lus Cim TorvakardCov qauv ntawm cov qauv ua haujlwm:
Xim: kev siv cov analogues yuav tsum pom zoo nrog tus kws kho mob koom. Tus nqi nruab nrab ntawm cov tshuaj TORVACARD hauv cov khw muag tshuaj (Moscow) yog 300 rubles. Tsuas tshuaj thiab tswj hwmUa ntej kev kho mob, tus neeg mob raug nquahu kom ua raws li kev noj cov zaub mov lipid-txo qis, thiab lub sijhawm kho tag nrho yuav tsum ua raws. Torvacard yuav tsum tau noj qhov ncauj thaum lub sijhawm txhua hnub, tsis hais txog qhov kev noj zaub mov. Tus kws kho mob xaiv cov koob tshuaj zoo nyob ntawm qhov ntsuas, theem pib ntawm LDL-C thiab cov txiaj ntsig ib ntawm cov tshuaj. Thawj koob tshuaj, raws li txoj cai, yog 10 mg ib hnub ib zaug. Qhov nruab nrab kho mob yuav txawv ntawm 10 txog 80 mg hauv 1 koob tshuaj. Qhov kev tso cai ntau tshaj plaws yog 80 mg / hnub. Thaum pib ntawm txoj kev kho, txhua 2-4 lub lis piam thiab / lossis thaum nce ib koob ntxiv, nws yog qhov yuav tsum tswj hwm cov ntshav lipid thiab, nyob ntawm cov txiaj ntsig, kho qhov koob tshuaj atorvastatin yog tias tsim nyog. Nrog rau thawj qhov mob hypercholesterolemia thiab sib xyaw hyperlipidemia, feem ntau cov neeg mob xav tau 10 mg ib hnub ib zaug. Ib lub suab nrov pom tau pom los ntawm qhov kawg ntawm lub lim tiam thib ob ntawm kev kho mob, qhov siab tshaj plaws - tom qab 4 lub lis piam. Nrog kev kho kom ntev, cov nyhuv no mob tsawv. Nrog homozygous tsev neeg hypercholesterolemia, qhov siab tshaj plaws txhua hnub koob ntawm 80 mg yog feem ntau xav tau. Yeeb tshuaj sib cuam tshuamNrog rau kev tswj hwm tib lub sij hawm ntawm kev npaj muaj aluminium hydroxide los yog magnesium hydroxide, qhov concentration ntawm atorvastatin hauv cov ntshav ntshav yuav poob qis, txawm li cas los xij, cov neeg kawm ntawv qib poob hauv qib LDL-C tsis hloov. Torvacard txhim kho cov nyhuv ntawm cov tshuaj uas txo cov kev xav ntawm cov tshuaj hormones endogenous steroid, suav nrog ketoconazole, cimetidine, spironolactone, yog li ceev faj yuav tsum tau siv thaum kho cov tshuaj sib txuas ua ke. Atorvastatin tsub kom ntau ntxiv ntawm kev tiv thaiv qhov ncauj uas muaj ethinyl estradiol thiab norethindrone (los ntawm 20% thiab 30%, feem), uas yuav tsum xav txog thaum xaiv kev tswj kom tsis txhob muaj poj niam. Thaum atorvastatin siv nyob rau hauv kev sib xyaw nrog colestipol, lub plasma concentration ntawm cov qub txo los ntawm kwv yees li 25%, txawm li cas los xij, lipid-txo cov nyhuv ntawm kev sib xyaw no yog qhov zoo dua uas thaum noj txhua cov tshuaj cais. Cov tshuaj uas thim cov metabolism sib cais los ntawm CYP450 isoenzyme 3A4 thiab / lossis kev thauj tshuaj, tshuaj tua kab mob los ntawm pawg azole, fibrates, erythromycin, nicotinamide, nicotinic acid, clarithromycin, cyclosporine, tshuaj tiv thaiv kab mob nce ntxiv ntawm atorvastatin hauv ntshav plasma, vim tias qhov ntxim nyiam ntawm kev tsim myopathy nce. Kev siv cov kev sib txuas ua ke no tau tsuas yog ua tau tom qab ntsuas kev pheej hmoo txaus ntshai. Txoj kev kho yuav tsum ua raws li kev saib xyuas tus mob kom zoo thiaj li paub qhov mob lossis tsis muaj zog ntawm cov leeg hauv lub sijhawm. Nws tseem tseem ceeb rau kev txiav txim siab txhua yam haujlwm ntawm CPK. Nws yuav tsum tau yug hauv siab tias qhov kev tswj hwm ntawd tsis tiv thaiv qhov kev txhim kho ntawm myopathy loj heev. Nrog rau qhov kev nce qib hauv CPK cov haujlwm, kev xoom xaim ntawm myopathy, Torvacard tau muab tso tseg. Thaum siv atorvastatin hauv ib koob tshuaj txhua hnub ntawm 10 mg ib txhij nrog digoxin, lub plasma qhov siab ntawm qhov kawg tsis hloov. Txawm li cas los xij, yog tias atorvastatin noj hauv ib koob tshuaj 80 mg txhua hnub, theem ntawm digoxin nce ntxiv txog 20%. Yog li, qhov sib xyaw ua ke no tuaj yeem tsuas yog ua raws li kev saib xyuas ntawm tus neeg mob lub sijhawm. Cov lus piv txwv ntawm Torvacard yog: Atoris, Liprimar, Atorvastatin, Atorvastatin-Teva. Yuav noj li cas?Ua ntej noj cov tshuaj, tus neeg mob yuav tsum pib ua raws kev noj zaub mov lipid-qis. Kev kho mob tuaj yeem pib nrog koob tshuaj 10 mg ntawm 1 zaug hauv ib hnub. Tsuas tshuaj yuav tuaj yeem hloov kho hauv 10-80 mg / hnub. Cov tshuaj tuaj yeem siv nyob rau txhua lub sijhawm ntawm hnub, tsis hais noj zaub mov. Qhov nruab nrab koob rau kev kho mob hyperlipidemia yog 10 mg / hnub. Kev kho kom haum thaum noj cov tshuaj tau sau tseg tom qab 1.5-2 lub lis piam. Cov kev ua siab tshaj plaws ntawm cov tshuaj yog pom tom qab 4 lub lis piam. Nrog kev kho kom ntev, cov nyhuv tsis ploj.
Cov Cai Siv Tshuaj SoKoj tuaj yeem yuav cov tshuaj tsuas yog los ntawm cov tshuaj noj. Hauv cov chaw muag tshuaj Lavxias, tus nqi ntawm cov roj ntsha tswj hwm pib thaum 299 rubles. rau ib pob ntawm 30 ntsiav tshuaj. Raws li hloov chaw rau cov tshuaj, koj tuaj yeem xaiv cov txhais tau tias:
Olga Alekseeva (kws kho mob), 43 xyoo, Pervouralsk. Ib qho tshuaj tiv thaiv hypolipidemic zoo tswj cov roj cholesterol thiab LDL. Tag nrho lub sijhawm thaum lub sijhawm kuv kho nws rau kuv cov neeg mob, Kuv tsis tau saib pom muaj qhov tsis zoo tshwm sim. Nws yog ib qho tsim nyog yuav tau siv cov ntsiav tshuaj hauv tag nrho cov txheej txheem kav ntev txog 4 txog 6 lub lim tiam. Kev siv sijhawm luv luv yog qhov tsis muaj txiaj ntsig. Nrog rau kev xaiv ntawm cov tshuaj tsis muaj teeb meem. Nws yog qhov zoo dua rau noj tshuaj thaum yav tsaus ntuj. Tus nqi ntawm cov tshuaj yog tag nrho kev txaus siab los ntawm nws cov ua tau zoo. Irina Gorbunkova, 39 xyoo, Salsk. Twb tau qee qhov, Kuv "haunted" los ntawm cov roj cholesterol qis. Tsis ntev tas los kuv txiav txim siab pib daws qhov teeb meem los ntawm kev hu rau tus kws kho mob. Tus kws kho mob tshwj xeeb tau cov tshuaj no. Nws coj raws li cov koob tshuaj pom zoo, sim kom tsis txhob nco cov kev txais tos. Thawj 2 lub lis piam kuv kev pw tsaug zog rov zoo li qub, thiab raws li, kuv kev xav zoo tuaj. Cov tshuaj ua haujlwm. Kuv tsis tu siab qhov siv nyiaj. Nikolai Kozhevnikov, 51 xyoo, Taganrog. Kuv tau mus cuag kws kho mob nrog kev tsis txaus siab ntawm lub siab mob. Tom qab kev tshuaj xyuas, nws pom tias theem ntawm cov roj cholesterol hauv kuv lub cev tau siab dua li ib txwm. Tus kws kho mob tau sau cov tshuaj no. Thaum ntxov, lub siab tau dhia me ntsis, tab sis tom qab ntawd txhua yam ua tiav. Cov roj khov ua ntu zuj zus rov qab zoo li qub. Lub sijhawm ntawm txoj kev kho kom zoo yog 4.5 lub hlis. Zinaida Chistyakova, 50 xyoo, Togliatti. Kuv tau mus rau hauv qhov chaw kho mob, qhov twg kuv raug kuaj pom muaj cov roj (ua haujlwm siab txog 6.8). Tus kws kho mob tau sau tseg rau cov cai no. Ib hlis tom qab, cov roj cholesterol rov qab zoo li qub. Tus nqi ntawm cov khoom haum kuv, muab nws txoj haujlwm sai thiab kav ntev. Igor Zemlyakov, 47 xyoo, Syzran. Kuv siv cov ntsiav tshuaj los tiv thaiv myocardial infarction rau kev pom zoo ntawm kws kho mob. Yog tias tsis yog rau cov tshuaj no, ces kuv cov tshuaj kho mob tau ntev ntev, thiab yog li kuv haus nws tsuas yog li 3 lub lis piam. Hais txog muaj pes tsawg leeg ntxivThaum txhim kho cov khoom lag luam, tus neeg tsim khoom siv ntau cov khoom ntxiv. Nws yog qhov tshwj xeeb tshaj yog rau cov neeg uas tsis mob siab rau lossis ua xua rau tej yam muaj nyob hauv kev lag luam kws tshuaj kom paub lawv tus kheej kom tiav cov npe ua tiav. Cov chaw tsim khoom muaj peev xwm kho me ntsis ntawm cov lus qhia nyob rau hauv cov nqe lus ntawm cov khoom siv ntxiv, yog li ntawd, nws yog qhov yuav tsum tau kawm cov ntu no kom paub meej thaum yuav khoom txhua pob tshiab, yog tias muaj laj thawj ntshai qhov kev cuam tshuam ntawm kev tsis haum. Feem ntau, Torvacard ntsiav tshuaj muaj cov hmoov txhuv nplej siab thiab talc, cellulose thiab lactose, thiab sodium thiab magnesium sib xyaw ua ke nrog cov khoom xyaw. Cov neeg tsim khoom siv cov carmellose, hyprolose, silicon tebchaw. Rau kev tsim lub plhaub, cov titanium molecules, hypromellose thiab macrogol tau siv. Kws TshuajCov lus piav qhia txog kev txiav txim ntawm cov tshuaj ua rau nws ua rau pom tias vim li cas cov ntsiav tshuaj no pab tau. "Torvacard" belongs rau chav kawm ntawm lipid-txo cov statins. Nws xaiv tsis zoo qhov kev txwv tsis pub reductase ntawm GMG-CoA. Cov hais txog enzyme tau koom nrog hauv kev hloov pauv ntawm coenzyme A mus rau hauv ib qho tshwj xeeb acidic compound ua ntej cov tshuaj steroids, uas suav nrog cov roj (cholesterol). Nws cov synthesis yog suppressed, thiab qhov no tiv thaiv tau qhov tsim ntawm atherosclerotic plaques hauv phab ntsa ntawm cov hlab ntsha. Tib neeg lub siab yog thaj chaw hauv ib cheeb tsam ntawm biochemical cov tshuaj tiv thaiv thaum cov roj cholesterol, triglycerides dhau los ua ib feem ntawm cov lipoproteins uas tsis tshua muaj siab. Tom qab ntawd lawv nkag mus rau hauv cov hlab plawv thiab txav mus los ntawm cov ntaub so ntswg. Cov khoom siv uas tsis muaj qhov muag tau hloov mus rau hauv lipoproteins thaum muaj kev cuam tshuam nrog cov receptors tshwj xeeb. Kev siv cov atorvastatin pab txo cov ntsiab lus ntawm cov roj (cholesterol) thiab lipoproteins hauv cov ntshav, vim tias cov kab mob enzyme molecules raug tiv thaiv, kev tsim cov tshuaj phem no los ntawm daim siab ua haujlwm tiv thaiv. Nyob rau tib lub sijhawm, cov xov tooj ntawm cov khoom siv lipoprotein tsawg ntawm cov khoom siv ntawm tes tau loj hlob tuaj. Kev ntes nrog tom qab catabolism ntawm lipoproteins yog nqi ntau dua thiab sai dua.
Atorvastatin: pharmacological nuancesMuaj cov tshuaj atorvastatin nyob rau hauv cov tshuaj tso cai rau koj hais txog ntau yam mob uas “Torvacard” raug tshuaj. Cov tshuaj no pab tau li cas? Los ntawm kev txo qis qhov kev txaus siab ntawm cov roj cholesterol, cov tshuaj ib txhij txo cov kev pheej hmoo ntawm lub plawv nres, mob hlab ntsha tawg thiab ntau lwm yam kev mob txaus ntshai. Cov nyhuv ntawm atorvastatin ua kom lub zog tsawg ntawm cov lipoproteins uas tsis muaj ntau. Lub caij no, cov kev ua ntawm cov receptors ntawm cov xovtooj ntawm tes yog khov kho nce thiab tseem nyob ruaj khov. Cov ntsiab lus ntawm qhov qis-ntuag qauv txo qis nrog homozygous hypercholesterolemia, yog tias ib tus tau tsim hauv tsev neeg hom.Nws tau sau tseg tias qhov mob pathological no nyuaj rau kev tswj hwm los ntawm lwm cov lipid-txo cov tshuaj lag luam. Kev siv cov tshuaj yaj yeeb pab txo qis kev saib xyuas ntawm cov roj (cholesterol) tag nrho los ntawm ib feem peb, qee zaum kev poob qis nce mus txog 46%. Tsawg-ntom qauv ua 40-60% tsawg dua. Raws li kev soj ntsuam ntawm cov pab pawg sim, B-hom apolipoprotein hauv cov ntshav ncig pom hauv qhov siab ib feem peb lossis txawm ib nrab qis dua li thawj zaug. Triglycerides hauv cov khoom ntim yog txo los ntawm 14-33%. Torvakard ntsiav tshuaj ua rau muaj kev nce ntxiv hauv cov ntsiab lus ntawm cov kev ua kom muaj roj cholesterol siab. Kev nce ntxiv hauv cov ntsiab lus ntawm A-hom apolipoprotein yog ua haujlwm. Nrog rau kev txiav txim siab hypercholesterolemia ntawm homozygous hom, qhov tsis haum ntawm cov roj ntsha qes qis feem ntau poob qis raws li cov koob tshuaj siv.
Tus sawv cev haujlwmTom qab noj cov ntsiav tshuaj Torvakard, cov tshuaj tseem ceeb tau txais los ntawm kev ua haujlwm siab ntawm cov txheej txheem no. Qhov siab tshaj plaws nyob rau hauv cov ntshav ncig yog kaw ib teev lossis ob teev tom qab kev tswj hwm. Hauv cov poj niam, nws ntau dua qhov kev cai los ntawm ib tug thib tsib. Yog tias ib tus neeg ua txhaum kev haus cawv thiab qhov no ua rau mob ntshav siab, ntau qhov siab tshaj ntawm cov nquag ua hauj lwm hauv cov ntshav cov ntshav yog 16 zaug ntau dua li cov qauv. Cov khoom tseem ceeb ntawm cov ntsiav tshuaj "Torvakard" 20 mg (thiab lwm cov ntaub ntawv tso tawm) txais tau qhov sib xyaw txog ntawm 12%. Lub kaw lus muaj cov txheej txheem tiv thaiv kom ncav cuag 30%. Cov ntsuas me me no yog vim muaj cov txheej txheem ua haujlwm presystemic hauv kev ua haujlwm ntawm lub plab thiab lub plab hnyuv thiab lub hauv paus kab mob siab. Dab tsi yog mus hauv lub cev?Kev siv cov ntsiav tshuaj Torvacard yog nrog cov los khi ntawm cov khoom xyaw nquag mus rau whey cov nqaijrog. Feem ntau, qhov ua tau zoo ntawm cov txheej txheem nce mus txog 98%. Qhov nruab nrab ntim ntawm kev faib tawm atorvastatin yog 381 litres. Cov txheej txheem ntawm kev hloov pauv ntawm cov tshuaj nquag yog hloov kho hauv lub siab. Cov kev tawm tsam rov qab mus nrog kev koom tes ntawm enzymes CYP3A4, CYP3A5, CYP3A7. Raws li qhov tshwm sim, cov tshuaj tiv thaiv cov khoom lag luam tsim tawm uas tau cim los ntawm kev ua haujlwm pharmacological. Hauv kev kuaj pom, cov nyhuv inhibitory ntawm metabolites ntawm HMG-COA tau pom tias ze ze uas pom los ntawm thawj zaug statin nws tus kheej. Qhov ua kom rov ua tau zoo ntxiv los ntawm kwv yees li 70% feem ntau vim cov khoom tsim thaum lub cev metabolism ntawm statin. Cov tshuaj no nthuav mus ntev rau hauv lub cev.
Kev Ntaus TawmAtorvastatin muaj nyob hauv 40 mg, 20 mg lossis 10 mg Torvard ntsiav tshuaj yog tshem tawm los ntawm txoj hnyuv nrog lub zais zis zais cia. Sij hawm dhau los, cov tshuaj raug tawm tsam cov teeb meem metabolic hauv lub siab lossis sab hauv qhov chaw nruab nrog cev. Statin tsis muaj qhov rov ua dua li qub hauv txoj hnyuv lossis nplooj siab. Cov nyhuv inhibitory rau GMG-COA reductase yog tsau rau 20-30 teev. Lub sijhawm yog vim muaj cov haujlwm ntawm cov khoom lag luam metabolic. Tsis pub ntau tshaj 2% ntawm cov tshuaj tseem ceeb tau txais yog kuaj pom hauv cov zis. Kev lim ntshav tsis muaj txiaj ntsig rau kev nthuav tawm ntawm atorvastatin lossis nws cov khoom hloov pauv hauv tib neeg lub cev. Nws yuav pab thaum twg?10, 20 lossis 40 mg ntsiav tshuaj ntawm Torvacard muaj cov khoom xyaw nquag yog npaj rau kev kho mob ntawm cov neeg kev txom nyem los ntawm cov roj cholesterol ntau hauv lub cev. Cov tshuaj yog tshuaj raws li ib qho ntawm cov txheej txheem ntawm kev kawm kho mob. Nws yog ib qho tsim nyog los ua ke cov khoom lag luam tshuaj nrog cov khoom noj tshwj xeeb. Lub hom phiaj ntawm cov kev kho no yog kom txo qis qhov kev nqus ntawm tag nrho thiab cov roj av qis, nrog rau B-hom apolipoprotein. Cov tshuaj pab txo qis cov roj triglycerides. Lwm qhov taw qhia ntawm kev kho mob yog txhawm rau nce cov ntsiab lus txheeb ze ntawm cov roj ntsha roj hmab siab ntsig. Rau lub hom phiaj no, cov khoom lag luam tshuaj tau raug txiav txim rau cov neeg muaj hom hyperlipidemia. Thiab tseem, kev txom nyem los ntawm thawj hom hypercholesterolemia, tsev neeg heterozygous thiab tsis xws. Koj tuaj yeem thov cov tshuaj sib xyaw rau cov kabmob raws li kev faib tawm ntawm Fredrickson koom nrog cov chav kawm 2a, 2b. Qhov thib plaub hom hyperlipidemia ntawm tib pab pawg, nrog los ntawm ntau dhau ntawm cov ntsiab lus ntawm triglycerides hauv cov ntshav ntshav, yog qhov qhia tau rau kev teem sijhawm Torvakard ntsiav tshuaj nrog kev noj zaub mov zoo. Nws raug tso cai siv cov tshuaj hauv nqe lus nug rau dysbetalipoproteinemia, uas yog, thib peb hom kab mob ntawm kev faib tawm no. Nrog rau kev kuaj mob no, atorvastatin pom zoo tsuas yog kev noj zaub mov zoo ib leeg tsis pub kom ua tiav ib qho txiaj ntsig zoo. Raws li koj tuaj yeem xaus los ntawm cov lus qhia rau kev siv cov ntsiav tshuaj "Torvakard", cov tshuaj no yuav tsum raug siv rau cov kab mob ntawm lub plawv thiab cov hlab ntsha, zoo li nyob rau hauv muaj cov xwm txheej qhia txog kev muaj peev xwm nce ntawm ischemia. Cov kev qhia muaj xws li:
"Torvacard" yog kho rau dyslipidemia. Cov tshuaj yog kev ceeb toom thib ob, nws tau raug txo kom txo qis kev tuag, mob plawv, mob hlab ntsha tawg, mus pw hauv tsev kho mob vim mob angina pectoris. Ib qho tshuaj lag luam pab txo qis kev ua kom rov ua kom sai. Cov kev qhia rau kev siv cov ntsiav tshuaj Torvacard tau pom zoo kom siv lawv los txo cov ntsiab lus ntawm tag nrho thiab cov roj uas tsis muaj roj ntau hauv cov qauv tsev neeg. Rau kev kho mob ntawm homozygous hypercholesterolemia. Cov tshuaj tau sau tseg yog tias cov phiaj xwm kev noj zaub mov noj thiab lwm cov tshuaj tsis qhia cov txiaj ntsig uas xav tau. Ib qho khoom lag luam tshuaj ua cov txheej txheem ntxiv ntawm kev kho lipid-txo qis. Koj tuaj yeem siv nws yog tias tus neeg mob tau qhia autohemotransfusion ntawm cov ntshav los ntawm qhov tsis txaus lipoprotein suav nrog raug tshem tawm. Koj xav tau ntau npaum li cas?Ua ntej sau tshuaj rau Torvacard ntsiav tshuaj (20 mg lossis lwm daim ntawv tshuaj) rau tus neeg mob, tus kws kho mob yuav tsim kho lub phiaj xwm kev noj haus. Nws lub hom phiaj txhawm rau kom txo cov rog cov rog hauv cov khoom noj. Nws raug nquahu kom pib nws li ob peb hnub ua ntej pib kev kho. Yog hais tias cov qauv kev cai tsis zoo, nws yog ntxiv cov khoom lag luam kws tshuaj. Tas nrho lub sijhawm noj tshuaj yuav tsum ua raws li kev cai noj haus. Feem ntau, kev kho mob pib nrog 10 mg noj ib hnub ib zaug. Tom ntej no, cov koob tshuaj tau nce mus txog thaum nws tuaj yeem xaiv qhov zoo rau ib tus neeg mob twg. Kev coj ua txhua hnub yog nyob hauv qhov ntau ntawm 10-80 mg. Txhua lub ntim tso rau hnub yuav tsum tau noj ib txhij. Nws raug tso cai kom siv cov khoom txhua lub sijhawm ntawm lub hnub. Kev txais tos tsis nyob ntawm cov zaub mov. Txhawm rau txiav txim siab qhov tsim nyog cov tshuaj, tus kws kho mob yuav siv mus rau hauv lub siab ntawm cov roj ntsha txhaws qis ntawm cov roj ntsha tsawg, kev kuaj mob, kho lub hom phiaj thiab kev ntxim nyiam ntawm lub cev mus rau txoj haujlwm kho mob. Qee zaum rau tus neeg mob peb lub hlis, ib pob muaj 90 ntsiav tshuaj ntawm "Torvacard" (10 mg) txaus. Muaj qee kis thaum koj yuav tsum yuav cov tshuaj uas muaj cov roj ntau tshaj tso (40 mg) thiab noj ob ntsiav tshuaj ib hnub ib zaug. Thaum pib ntawm txoj haujlwm kho mob thiab nce ntxiv rau hauv cov tshuaj yuav tsum nrog cov kev tshuaj xyuas tas li nrog rau kev nyeem ntawv hauv ob peb lub lis piam lossis ib hlis. Tus kws kho mob kos cov qib ntawm lipids thiab kho cov ntau npaum li cas. Qhov siab tshaj plaws ntawm 80 mg yog pub rau ib hnub. Kev kuaj mob thiab kev caiTxhawm rau kom cov tshuaj lag luam kom muab cov txiaj ntsig siab tshaj plaws, nws yog qhov tsim nyog los siv nws kom raug. Yog tias koj xav paub meej seb nws puas tuaj yeem faib "Ntsuas Torvakard" ntsiav tshuaj rau hauv ib nrab, tom qab ntawd cov chaw tsim khoom tsis xav qhov no. Tsis txhob ua txhaum kev ncaj ncees ntawm lub plhaub, raws li cov ntsiab lus sab hauv raug rhuav tshem hauv qab ntawm hydrochloric acid nyob rau hauv lub plab kab noj hniav. Vim li no, sab nraud ntsiav tshuaj tsis muaj kev pheej hmoo. Muaj tshuaj muaj tsawg kawg yog muab muag. Nws yog lawv tus uas yuav tsum tau siv yog tias qhov cuam tshuam tsis zoo ntawm lub phiaj xwm kev lag luam xav tau. Thaum thawj hom hypercholesterolemia thiab koom ua ke hyperlipidemia, feem ntau cov neeg mob xav tau 10 mg ib hnub ib zaug. Cov txiaj ntsig ntawm txoj haujlwm yuav raug kaw tom qab ob peb lub lis piam. Peb pom qhov siab tshaj plaws nyob rau ib hlis tom qab pib kev pab cuam. Nws tseem muaj sia yog tias tus neeg mob siv cov tshuaj siv ntev.
Cov lus pom zoo davTxij li cov kws kho mob, piav qhia seb nws puas tuaj yeem faib "Torvacard" ntsiav tshuaj ib nrab, tau qhia kom tsis txhob muaj kev ntxias, koj yuav tsum ua tib zoo kawm lawv cov lus pom zoo txog kev kho mob ua ntej thiab xaiv cov tshuaj nrog cov tshuaj kom zoo hauv lub tsev muag tshuaj. Peb xav tau daim foos ua kom tiav uas tsim nyog rau qee kis. Thaum xaiv cov koob tshuaj, tus kws kho mob yuav ua raws li cov xwm txheej tam sim no thiab theem kev xav ntawm cov concentration ntawm cov roj (cholesterol) feem. Tshwj xeeb, nrog atherosclerosis, uas nrog nrog lwm yam kab mob, nws yog qhov tsim nyog kom ua tiav cov ntsiab lus ntawm cov khoom ntawm yam tsawg 100 units. Nyob rau hauv muaj qhov xwm txheej txaus ntshai yam tsis muaj atherosclerosis, qib siab tshaj plaws yog 130 units lossis tsawg dua. Thaum tsis hais cov mob nkeeg thiab cov muaj mob txaus ntshai, tus nqi raug yog 160 units lossis tsawg dua. "Torvakard" yog qhov kev txiav txim siab yog tias qhov pib txwv tseem muaj ntau dua (ntu) rau cov mob no: 130, 160, 190 units. Hauv peb lub tebchaws, cov kev tshawb fawb tau tshawb nrhiav ntawm cov tib neeg uas tau txheeb xyuas nrog tsev neeg hom hypercholesterolemia ntawm homozygous hom. Yog tias cov neeg mob zoo li no tau tshaj tawm 80 mg ntawm atorvastatin txhua hnub, cov ntsiab lus ntawm cov roj uas txhaws qhov qis kom tsawg dua 18-45%. Nws yog ib qho tsim nyog kom pom tseeb txog qhov tshwm sim no, xaiv cov yam ntxwv ntawm cov phiaj xwm kho. Peb tau soj ntsuam kev siv Torvacard ntsiav tshuaj. Cov kev qhia taw qhia hais tias cov khoom yuav tsum siv sab hauv, sab nraum zaub mov. Lub sijhawm tshwj xeebNws raug tso cai siv tshuaj nyob rau hauv cov ntaub ntawv ntawm lub raum tsis ua haujlwm lossis pathologies hauv zos hauv cov khoom nruab nrog cev no. Cov xwm txheej tshwj xeeb, kev hloov pauv hauv cov cai ntawm kev pub nkag mus lossis txhaj tshuaj tsis tas rau cov neeg zoo li ntawd. Pathologies ntawm lub raum tsis cuam tshuam rau cov ntsiab lus ntawm atorvastatin hauv cov ntshav cov ntshav. Tsis muaj tshuaj muaj yees thiab cov teeb meem kev noj qab haus huv tau pom tau. Tsis pom meej meej txog cov tshuaj ntawm cov neeg laus hnub nyoog laus tau pom. Cov tshuaj los ntawm cov roj "Torvakard" tuaj yeem raug kho rau cov neeg zoo li no raws li kev cai dav dav. Tsis muaj qib tshwj xeeb ntawm kev ua tau zoo; cov hom phiaj kho tau zoo ib yam. Cov txiaj ntsig tsis tau nyob ntawm lub hnub nyoog. Nws puas tuaj yeem pab kuv? XyuasRaws li kev txheeb xyuas thiab cov lus qhia txog kev siv cov ntsiav tshuaj "Torvakard" (duab ntawm cov tshuaj yog nyob hauv tsab xov xwm), cov tshuaj no tau sau tseg feem ntau. Qhov tseeb tiag, ntau ntawm peb cov neeg nyob hauv ntiaj teb ntsib cov teeb meem ntawm cov muaj feem ua cov roj cholesterol hauv cov ntshav ncig. Cov tib neeg uas tau siv statins nyob rau hauv kev saib xyuas ntawm tus kws kho mob tau sau tseg tias muaj txiaj ntsig zoo. Qhov tseeb tsuas yog qhov tseeb uas ua rau qee yam tsis txaus siab yog qhov xav tau ntev, ntau lub neej ntev, kev siv cov tshuaj. Kev txheeb xyuas txog cov tshuaj "Torvakard" los ntawm cov neeg uas tau pib siv cov statins tsis yog qhov zoo. Pawg neeg no feem ntau muaj feem cuam tshuam nrog cov kev mob tshwm sim, suav nrog cov hnyav. Txhawm rau tsis txhob nyob nrog lawv, koj yuav tsum siv cov tshuaj tsuas yog nyob hauv kev saib xyuas ntawm tus kws tshaj lij nrog kev tshuaj xyuas ntshav lipid tsis tu ncua. Qhov no yuav tso cai rau koj xaiv cov tshuaj kom zoo thiab nyab xeeb thiab kom paub tseeb qhov tshwm sim siab tshaj plaws los ntawm cov phiaj xwm yeeb tshuaj. Yam tsis tau xav txogRaws li koj tuaj yeem kawm los ntawm kev txheeb xyuas thiab cov lus qhia rau kev siv nrog Torvakard ntsiav tshuaj, cov tshuaj no ua rau muaj kev phiv. Lawv tsis tshua muaj nqi, txawm li cas los xij, muaj qhov ntxim nyiam ntawm lawv qhov tsim, tshwj xeeb tshaj yog siv tsis raug thiab tsis muaj kev saib xyuas los ntawm cov kws paub tshwj xeeb. Tus neeg feem coob noj cov tshuaj qhia txog mob taub hau, xeev siab, ntuav, thiab cov quav tsis zoo. Muaj peev xwm ua rau tsis zoo lossis ua kom qab los noj mov, mob thiab mob nqaij. Muaj qhov txaus ntshai ntawm qhov tsis nco qab. Ua xua tuaj yeem tshwm sim. Qee zaum, cov neeg mob tau nce lossis tsawg dua cov piam thaj hauv ntshav, qhov nce ntawm CPK cov haujlwm hauv cov dej lom neeg. Lwm tus yws txog qhov mob hauv siab, o cov ntaub so ntswg. Muaj peev xwm ua kom tsis meej, poob cov plaub hau, ua kom nws poob phaus. Qee qhov sau tseg tias lub xeev tsis muaj zog txaus thiab lub raum tsis ua haujlwm.
Qee zaum koj ua tsis tauQhov kev tsis sib haum xeeb rau kev txais tos ntawm cov tshuaj lag luam hauv cov lus nug yog qhov theem siab ntawm kev ua haujlwm ntawm daim siab enzymes hauv cov ntshav ntshav tsis muaj peev xwm txheeb xyuas qhov ua rau ntawm tus mob. Koj tsis tuaj yeem siv "Torvakard" yog tias muaj kab mob siab rau siab tau tsim, qhov tsis txaus ntawm qhov hloov khoom nruab nrog - qib A lossis B raws li Tsev Haujlwm Menyuam-Pugh. Cov twj siv tsis yog siv ntau qhov tsis tshua muaj kab mob pathological vim muaj cov caj ces ntawm tus neeg mob. Tshwj xeeb, Torvacard tsis tuaj yeem nqa nrog lactose tsis kam lossis tsis muaj lactase, malabsorption syndrome. Cov tshuaj tsis yog npaj rau kev kho mob ntawm cev xeeb tub thiab niam mis. Yog tias tus poj niam muaj hnub nyoog yug me nyuam xav tau kev kho mob tshuaj, "Torvacard" yog tsuas yog siv thaum tus neeg mob siv tshuaj tiv thaiv uas muaj txiaj ntsig. Qhov ua tau zoo thiab kev nyab xeeb ntawm kev muab tshuaj rau cov khoom lag luam rau cov menyuam yaus tsis tau muaj npe, yog li ntawd, cov tshuaj tsis siv rau cov hnub nyoog no. Contraindication yog intolerance rau ib qho twg, suav nrog cov khoom xyaw pabcuam tam sim no hauv cov ntsiav tshuaj. Cov mob uas yuav tsum tau ceev fajNws yog ib qho tsim nyog kom ua tib zoo siv cov khoom hauv nqe lus nug yog tias tus neeg mob quav dej quav cawv. Qee zaum tib neeg nug tus kws kho mob yog tias lawv tuaj yeem nqa Haloperidol ntsiav tshuaj nrog Torvakard ntsiav tshuaj. Hauv qhov xwm txheej dav dav, cov tshuaj no tsis cuam tshuam nrog lwm tus, tab sis kev qhia ua ke ntawm cov tshuaj ib txwm xav tau kev saib xyuas ntxiv rau tus neeg mob lub sijhawm. Nws yog ib qho tsim nyog yuav tsum tau soj ntsuam kom tsis tu ncua kev ua haujlwm ntawm tib neeg lub cev, yuam kom "Torvakard", yog tias nws raug mob los ntawm daim siab mob yav dhau los, ntsib nrog lub cev tsis txaus ntawm cov zaub mov thiab kua dej hauv lub cev. Cov neeg mob uas muaj kev cuam tshuam txog metabolic thiab endocrine yuav tsum muaj kev ntseeg ntau ntxiv. Nrog kev ceev faj, "Torvacard" yog siv tiv thaiv keeb kwm ntawm cov ntshav siab qis, sepsis, thiab kev tiv thaiv kab mob sib kis tsis tau. Tshwj xeeb yog qhov tseeb yuav tsum yog cov tau ua haujlwm tseem ceeb, uas tau txais kev raug mob loj lossis tus uas muaj kabmob ntshav qab zib. Kev phom sij cuam tshuam nrog pathologies ntawm cov leeg nqaij uas txhawb cov pob txha. Cev xeeb tub thiab pub niam misRaws li tau hais los saum toj no, kev xeeb tub, lactation yog qhov tseeb contraindications rau kev siv tshuaj Torvacard. Atorvastatin txwv rau cov poj niam nyob rau lub sijhawm no, txij li cov roj (cholesterol) thiab cov khoom sib xyaw ua los ntawm nws yog qhov tseem ceeb rau kev tsim ntawm lub cev. Kev txwv tsis pub reductase HMG-COA yog qhov muaj txiaj ntsig zoo, tsis yog los ntawm cov txiaj ntsig ntawm kev noj tshuaj. Kev siv cov lovastatin, uas yog ze rau atorvastatin hauv nws cov txiaj ntsig thiab cov yam ntxwv, hauv thawj peb ntawm lub sijhawm, raws li tau paub, tau nrog kev yug los ntawm cov menyuam muaj pob txha deformities, fistulas, anus atresia. Yog tias qhov tseeb ntawm kev xeeb tub tshwm sim thaum lub sijhawm siv cov ntsiav tshuaj Torvacard, koj yuav tsum tso tseg txoj kev siv tshuaj lag luam tam sim ntawd.Tus kws kho mob muaj lub luag haujlwm los qhia tus pojniam txog txhua yam kev pheej hmoo cuam tshuam nrog qhov xwm txheej.
Puas muaj lwm txoj hauv kev?Raws li cov tshuaj analogues ntawm cov ntsiav tshuaj Torvakard, cov tshuaj muaj cov tshuaj tiv thaiv zoo tib yam tuaj yeem pom tau. Hauv yuav luag txhua lub tsev muag tshuaj hauv tsev, koj tuaj yeem nrhiav cov tshuaj pheej yig Atorvastatin. Nws yog cov tshuaj kho mob pheej yig tshaj plaws rau cov pej xeem sawv daws nrog cov nyhuv zoo sib xws. Txawm li cas los xij, ua ntej hloov cov tshuaj, koj yuav tsum xub sab laj nrog koj tus kws kho mob. Txoj kev ywj pheej hloov ntawm chav kawm kws tshuaj tuaj yeem ua rau cov kev tsis haum xeeb. Torvakard muaj ntau ntawm cov analogues. Raws li lwm txoj hauv kev rau cov tshuaj no, koj tuaj yeem xav txog cov kev npaj "Atoris" thiab "Atomax", zoo tib yam nyob rau hauv cov khoom thiab ua kom muaj kev cuam tshuam ntawm tib neeg lub cev. Txawv "Anvistat" thiab "Liptonorm." Qee zaum Torvakard raug tso cai hloov Liprimar lossis Lipoford. Rau qee qhov, cov tshuaj Tulip thiab Lipona muaj cov ntsuas zoo sib xws.
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