Ntsiav tshuaj Simgal: cov lus qhia rau kev siv, cov tshuaj raug txwv rau dab tsi?

Muaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj puag ncig, zaj duab xis-coated nrog kev pheej hmoo ntawm ib sab. Cov ntsiav tshuaj tuaj yeem yog 10 (lub teeb xim liab), 20 (paj yeeb) lossis 40 mg (tsaus liab). Hauv pob blister ntawm 14 ntsiav tshuaj. Cov blisters ntawm 2 lossis 6 daim yog muab tso rau hauv cov duab los qhia.

Kuj tseem muaj cov kev xaiv ntim hauv hwj ntim 28 ntsiav tshuaj, txhua lub hwj tau muab tso rau hauv lub thawv ntawv thawv ntawv cais.

Cov Tshuaj Hauv Tshuaj

Tom qab noj, simvastatin yog hydrolyzed los tsim ib qho kev sib txuas nrog qhov qhia tau tseeb ntawm HMG-CoA reductase. Raws li qhov ua tau, qhov siab poob qis dua roj tsawg ntom ntom los ntawm kev txo nws cov synthesis thiab nce catabolism.

Cov theem ntawm apolipoprotein, triglycerides kuj raug txo thiab qhov siab yog nce me ntsis roj high ntom. Yog li ntawd, qhov piv ntawm tsawg thiab high ntom lipoprotein ntau qhov kev hloov pauv.

Cov Tshuaj Pharmacokinetics

Simvastatin tau nqus zoo tsis hais nws noj ib leeg lossis ib txhij nrog zaub mov. Qhov siab tshaj plaws tau tiav tom qab 1-2 teev.

Kev hloov pauv rau daim ntawv nquag tshwm sim hauv lub siab. Kwv yees li 5% ntawm qhov koob tshuaj tau coj mus rau hauv cov ntshav dav dav los ntawm lub siab. Tsis pom muaj cov tshuaj txuam nrog.

Tsawg kawg yog 95% ntawm simvastatin thiab nws cov nquag metabolites khi rau cov ntshav protein.

Kev tshem tawm tshwm sim tsis dhau 96 teev nrog zis (13%) thiab quav (60%).

Kev ntsuas rau siv

Kev qhia rau kev siv tshuaj:

kev kho mob hypercholesterolemia (homozygous keeb kwm, thawj), sib xyaw dyslipidemia,
tiv thaiv kev mob plawv hauv cov neeg mob nrog atherosclerosis xaws mob ntshav qab zib.

Cov Yuav Tsum Muaj

Nws yog contraindicated rau haus cov tshuaj nyob rau hauv tej yam mob:

muaj lub cev tsis haum rau cov tshuaj,
nquag theem ntawm daim siab mob,
pheej nce siab hauv ntshiab transaminases,
cev xeeb tub,
kev pub mis,
kev siv ntawm lub zog cytochrome CYPZA4 inhibitors (e.g. Erythromycin, Clarithromycin, Kwv Huam, Itraconazole, Telithromycin, Nefazodon).

Sab sij huam

Ib tus neeg mob tawm ntawm 100-1000 muaj cov kev xav tsis raug li hauv qab no:

Tsis ntau tshaj li ib ntawm 1000 qhov kev tsis txaus siab ntawd tau raug saib xyuas:

anemia,
mob taub hau,
paresthesia,
kiv taub hau,
cramps,
lub dag zog polyneuropathy,
hnyuv plab thiab cov quav tsis haum,
ntuav,
mob plab
pancreatitis,
kab mob siab, dajntoo,
ua pob, khaus,
alopecia,
mob hlwbmob leeg mob mob vwm,
asthenia,
kev mob siab heev ntawm qhov mob hypersensitivity (angioedema, vasculitis, mob caj dab, rheumatic polymyalgia, thrombocytopenia, photosensitization, eosinophilia, txog siav, tsis muaj zog),
nce rau theem ntawm transaminases, alkaline phosphatase.

Tsis tshua muaj qee qhov xwm txheej, tus txheej txheem interstitial tshwm sim hauv lub ntsws lossisdaim siab ua hauj lwm.

Simgal, cov lus qhia rau kev siv (Txoj kev thiab ntau npaum li cas)

Simgal tau noj nyob rau hauv ib koob tshuaj 10-20 mg rau 80 mg ib hnub twg. Feem ntau, ib koob tshuaj ib zaug ntawm cov tshuaj tau sau tseg rau yav tsaus ntuj. Nws raug nquahu kom tsis txhob muab sib xyaw nws nrog zaub mov.

Yog tias koj xav txiav cov ntsiav tshuaj ib nrab, koj yuav tsum txiav nws nrog rab riam, thiab tsis tawg nrog koj txhais tes.

Cov koob tshuaj yog tshuaj uas tus kws kho mob sau tseg, suav txog qee yam mob xws li lub hnub nyoog ntawm tus neeg mob, kev kuaj mob, tus yam ntxwv ntawm lub cev, kev kho mob (kev kho mob monotherapy lossis nrog lwm cov tshuaj).

Kev sib txuam

Siv tib lub sijhawm siv nrog lwm cov tshuaj tuaj yeem cuam tshuam rau lub cev ntawm lub cev lossis cov metabolism ntawm simvastatin:

nrog Bosentan - qhov kev txiav txim siab ntawm simvastatin thiab nws cov lus qhia txo qis, nws yog yuav tsum tau kho cov koob tshuaj noj mus rau hauv tus account qib cov roj (cholesterol),
nrog Cyclosporine, Danazol, Gemfibrozil, Niacin, Amiodarone, Verapamil - Simgal koob tshuaj yuav tsum raug txo kom tsis txhob muaj kev txhim kho myopathies,
nrog Erythromycin, Itraconazole, Ketoconazole, Fluconazole, Posaconazole, Clarithromycin, Telithromycin thiab lwm yam muaj zog CYP3A4 inhibitors - sib xyaw txwv tsis pub. Yog tias koj yuav tsum tau txais kev kho sai sai nrog cov tshuaj teev saum toj no, Simgal muab ncua ib ntus.

Cov lus qhia tshwj xeeb

Thaum sau daim ntawv yuav tshuaj, cov kws kho mob yuav tsum nco ntsoov qee qhov ntawm nws cov yam ntxwv thiab qhia tus neeg mob txog nws:

txhua tus neeg mob uas tau sau Simgal yuav tsum ceeb toom txog qhov yuav tsum tau mus tom tsev kho mob thaum muaj mob lossis leeg tsis muaj zog,
ob peb hnub ua ntej npaj kev phais mob, kev kho mob nrog simvastatin yuav tsum tau tsum txiav,
ua ntej pib kev kho mob, nws raug nquahu kom kuaj xyuas los txiav txim siab lub xeev kev ua haujlwm ntawm daim siab
nws yog txwv tsis pub haus cov txiv kab ntxwv qaub thaum lub sijhawm Simgal therapy,
Nws kuj tseem pom zoo tias koj yuav tsum tsis txhob haus cawv.

Thaum noj tshuaj los ntawm cov hluas, tsis muaj kev cuam tshuam txog kev loj hlob thiab kev sib deev. Kev ua thaum yau tseem tsis tau raug tshawb nrhiav.

Cov Sim Ceeb ntawm Simgal

Analogues ntawm Simgal yog cov tshuaj:

Aldesta,
Atrolin,
Vabadin,
Vasilip,
Vasostat-Kev Noj Qab Haus Huv,
Vasta,
Vaj Xab,
Zokor,
Zosta,
Cardak,
Simva Tad,
Simvagexal,
Simvakard,
Simvacol,
Simvalimite,
Simvostat.

Kev Sau ua ke, daim foos tso tawm

Simgal yog cov ntsiav tshuaj coated uas zoo li cov nplooj lentils hauv lawv cov duab. Rau kev yooj yim ntawm kev siv, nws muaj nyob hauv peb qhov ntau: 10, 20, 40 mg, 28, 84 pcs. Cov xim ntawm Simgala ntsiav tshuaj nyob ntawm qhov kev saib xyuas ntawm cov tshuaj nquag: 10 mg - daj ntseg liab, 20 mg - sib sib zog liab, 40 mg - tsaus liab.

Ntxiv rau qhov tseem ceeb ntawm simvastatin, cov tshuaj muaj pes tsawg leeg suav nrog butylhydroxyanisole, ascorbic acid, citric acid derivatives, hmoov txhuv nplej siab, cellulose, mis qab zib monohydrate, magnesium stearate, Opadry II txheej.

Pharmacological kev txiav txim

Simgal nkag mus rau hauv tib neeg lub cev ua tsis tiav. Nws ua kom tshwm sim hauv lub siab, qhov twg cov roj (cholesterol) yog qhov tseeb ua ke. Sib cuam tshuam nrog lub enzyme HMG-CoA reductase, nws nres cov synthesis ntawm cov teeb meem roj nyob rau theem ntawm kev tsim ntawm nws cov neeg ua ntej, mevalonic acid. Qhov no nce tus naj npawb, nrog rau kev ua si ntawm LDL receptors. Lub cev ua rau qhov no los ntawm kev rhuav tshem cov roj cholesterol sai, lipoproteins phom sij.

Qib ntawm lipoproteins zoo (nrog rau lub siab tuab) yog nce ntawm qhov tsis sib xws. Qhov no pab tau lub cev tua atherosclerosis li cas? Protein-rog complexes ntawm tsawg ntom thiab cov roj cholesterol feem ntau yuav txiav txim siab ntawm phab ntsa ntawm cov hlab ntshav. Cov ntaub ntawv no atherosclerotic plaques. HDL txhawb nqa kev sib sau ntawm cov roj (cholesterol) los ntawm cov nqaij hauv phab ntsa ntawm cov hlab ntsha, nrog rau lwm cov qauv hauv lub cev.

Cov tshuaj yog tus cwj pwm los ntawm kev nqus zoo. Qhov kev cia siab tshaj plaws ntawm cov khoom tseem ceeb ntawm Simgal tau kaw tom qab 60-120 feeb. Cov tshuaj raug tawm ntawm lub cev tsuas yog nrog quav, tso zis xwb. Nws txoj kev muaj peev xwm hla mus rau niam mis tsis tau kawm.

Khoom noj khoom haus tsis muaj kev cuam tshuam qhov nqus ntawm Simgal ntsiav tshuaj. Yog li ntawd, cov lus qhia tau qhia tias nws tuaj yeem noj ua ntej, tom qab lossis nrog zaub mov.

Simgal: kev taw qhia rau kev siv

Ua raws li cov lus qhia rau kev siv Simgal, nws yog tshuaj rau cov neeg mob ua txhaum thawj ntawm cov roj cholesterol, thaum ib qho khoom noj tsis txaus. Tsis tas li, cov tshuaj no yog ib feem ntawm txoj kev kho mob rau cov kab mob uas nrog los ntawm kev ua rau lub cev tsis muaj roj. Qhov no feem ntau yog ua mob rau cov hlab plawv (CHD), mob ntshav qab zib.

Simgal ntsiav tshuaj yog tshuaj raws li kev kho mob rau homozygous kab mob hypercholesterolemia, tab sis tsuas yog thaum txoj kev kho mob tseem ceeb (kev noj haus, kev tawm dag zog, LDL plasmapheresis) tsis txaus lossis lawv tsis muaj txiaj ntsig.

Txoj kev ntawm daim ntawv thov, ntau npaum li cas

Raws li cov lus qhia rau Simgal ntsiav tshuaj, ntau npaum li cas yog tau los ntawm 10 txog 80 mg / hnub. Cov tshuaj tau noj ib hnub ib zaug, lub sijhawm pom zoo ntawm kev txais neeg yog yav tsaus ntuj. Raws li txoj cai, txoj kev tswj hwm ntawm Simgal tau pib nrog kev noj haus tsawg kawg nkaus / qib qis nrog kev maj mam nce ntxiv hauv cov tshuaj, yog tias tsim nyog. Lub sijhawm hloov kho tsawg kawg nkaus yog 4 lub lis piam. Qhov siab tshaj plaws ntawm cov tshuaj yog tshuaj hauv cov mob uas tsis tshua muaj siab thaum noj ntau dua me dua yog qhov tsis muaj txiaj ntsig.

Lub luag haujlwm txoj cai ntawm kev siv rau Simgal yog cov khoom noj uas muaj roj cholesterol tsawg.

Nrog hypercholesterolemia, Simgal ntsiav tshuaj noj ntawm ib koob ntawm 20 mg / hnub. Ntau dua qhov siab ntawm cov tshuaj (40 mg / hnub) yog cov kws kho mob, yog tias tsim nyog, cov roj cholesterol txo qis, LDL (ntau dua 45%). Txog rau me / mob hypercholesterolemia, kev qhia tso cai rau kev siv ntawm Simgal ntsiav tshuaj rau hauv qhov txo cov tshuaj (10 mg / hnub).

Nrog txoj kev pheej hmoo siab mob ntsig txog mob plawv, Simgal ntsiav tshuaj tau kho raws li kev kho mob ib zaug ntawm 40 mg / hnub. Koob tshuaj hloov kho yog nqa tawm raws li tau piav saum toj no. Simgal pab ua kom cov rog nyob zoo, thiab lwm yam khoom ntawm cov rog rog. Qhov no muaj cov txiaj ntsig zoo rau kev txo qis kev pheej hmoo ntawm lub plawv thiab kev tuag.

Rau cov neeg laus uas muaj keeb tiv thaiv heterozygous cov kab mob hypercholesterolemia, cov tshuaj hauv tshuaj yog muab tshuaj hauv 40 mg. Peb lub tshuaj muaj peev xwm ntau npaum li cas ntawm 80 mg / hnub: 20 mg thaum sawv ntxov, 20 mg thaum tav su, 40 mg rau yav tsaus ntuj. Rau cov tub hluas hnub nyoog 10-17 xyoo, raws li cov ntxhais uas lawv lub cev ntas pib tsawg kawg ib xyoos dhau los, Simgal tau sau tseg hauv 10 mg. Raws li cov lus qhia, qhov siab tshaj rau cov neeg mob hluas yog 40 mg. Cov kev tshawb fawb txog qhov cuam tshuam ntawm Simgal ntsiav tshuaj ntawm lub cev ntawm cov menyuam yaus tsis tau ua.

Pawg tshuaj, daim ntawv tso tawm thiab tus nqi ntawm cov tshuaj

Simgal belongs rau cov pab pawg neeg hypolipidemic ntawm cov tshuaj - statins. Lawv yog cov tshuaj tiv thaiv HMG-CoA reductase. Cov tshuaj INN rau cov tshuaj no yog simvastatin (Simvastatin). Cov tshuaj no tsuas muaj rau hauv cov qauv ntsiav tshuaj. Cov ntsiav tshuaj sib txawv hauv cov duab thiab xim ntawm lub plhaub, nyob ntawm seb ntau npaum li cas ntawm cov khoom siv tseem ceeb hauv lawv - simvastatin:

noj tshuaj nrog tshuaj qhov ntau thiab tsawg ntawm 10 mg - lub teeb xim ntxoov ntxoo, convex ntawm ob sab thiab puag ncig puab,
ntsiav tshuaj nyob rau hauv uas 20 mg ntawm lub nquag sib xyaw ua ke yog puag ncig thiab liab xim hauv xim, thiab tseem muaj qhov sib cais sib cais ntawm ib qho ntawm sab nraud convex,
cov tshuaj uas muaj cov tshuaj tiv thaiv ntawm 40 mg yog qhov tsaus ntuj xim tsaus ntxoov ntxoo, puag ncig thiab tseem muaj qhov sib cais ntawm ib sab.

Cov tshuaj yuav ntim hauv cov hlwv ntawm 14 ntsiav tshuaj, ib yam li hauv thawv ntawm cardboard ntawm 2 lossis 6 lub hlwv. Tus nqi nruab nrab rau Simgal hauv thaj chaw ntawm Lavxias Lavxias (Cov Lus 1)

Tsuas tshuaj ntawm cov nquag muaj tshuaj	Cov naj npawb ntawm cov ntsiav tshuaj ib pob	Nqe (RUB)
10 mg	28	217-224
10 mg	84	591-611
20 mg	28	282-392
20 mg	84	593-880
40 mg	28	584-650
40 mg	84	1357

Qhov muaj pes tsawg leeg ntawm lipid-txo cov tshuaj

Ntxiv rau simvastatin, cov tshuaj muaj cov tshuaj ntxiv uas tseem ua rau lub luag haujlwm tseem ceeb hauv kev txiav txim ntawm cov ntsiav tshuaj. Ntawm lawv yog:

lactose
MCC
ascorbic acid
hmoov txhuv nplej siab
magnesium stearate,
talc thiab citric acid,
tivthaiv opadry (paj yeeb thiab xim av), uas yog ib feem ntawm lub plhaub.

Kev taw qhia rau siv hauv kev kho thiab contraindications

Simgal feem ntau yog siv rau kev ua haujlwm ntawm lub plawv thiab cov ntshav khiav. Cov tshuaj yog kws kho rau cov kab mob xws li:

nrog angina pectoris txo qis kev nce ntawm pathology, uas txo kev pheej hmoo ntawm kev tuag nyob rau hauv cov neeg ntawm cov hnub nyoog sib txawv nrog cov kab mob ntawm lub plawv,
nrog mob ischemia, txoj kev pheej hmoo ntawm lub plawv nres yog ob peb zaug txo,
tiv thaiv qhov tshwm sim ntawm cov khoom sib chwv los ntawm cerebral ischemia lossis cerebral hemorrhage,
rau kev kho mob ntawm cov kab mob atherosclerosis thiab tiv thaiv nws txoj kev hloov mus rau ib daim ntawv nyuab.

Cov tshuaj no kuj tseem siv los kho ntau hom mob hypercholesterolemia:

nrog heterozygous thiab homozygous hypercholesterolemia,
nrog thawj thiab sib xyaw hyperlipidemia,
nrog rau kev tsim kho hypertriglyceridemia thiab dyslipidemia.

Tsis tas li ntawd, cov tshuaj siv tshuaj rau kev ua haujlwm ntawm cov kab mob endocrine, uas ua rau muaj ntshav qab zib, uas ua rau muaj kev sib kis nrog cov kab mob atherosclerosis.

Cov tshuaj tiv thaiv kev siv tshuaj yog:

pathology hauv cov qog hlwb uas nyob rau theem ntawm exacerbation,
kev ua haujlwm siab ntau ntawm transaminase enzymes hauv lub siab ua haujlwm, thiab daim siab ua haujlwm,
cia li pib mob raum,
koj tsis tuaj yeem noj cov tshuaj statin thaum cev xeeb tub hauv poj niam, nrog rau lub sijhawm pub mis niam nrog lub mis,
intolerance rau lub cev ntawm lub ntsiab tivthaiv ntawm simvastatin lossis lwm yam tshuaj ntxiv,
nws yog txwv tsis pub sau ntawv rau cov tshuaj rau cov menyuam yaus hnub nyoog qis dua 10 xyoo.

Tsis txhob xaj rau cov poj niam thaum yug menyuam lub hnub nyoog yam tsis muaj kev tiv thaiv zoo tiv thaiv kev tiv thaiv tsis tau xeeb tub. Cov ntsiab lus ntawm kev xeeb tub ntawm menyuam thaum lub sijhawm kho Simgal, nws yog qhov tsim nyog los cuam tshuam kev kho mob nrog statins ua ntej thaum kawg ntawm cev xeeb tub. Yog tias tshem tawm ntawm cov tshuaj txaus ntshai tus neeg mob uas muaj kev pheej hmoo tuag, ces lo lus nug tshwm sim ntawm kev rho menyuam.

Cov ntxhais tuaj yeem kho qhov tshuaj tom qab pib qhov coj khaub ncaws, thiab cov tub hluas txij li 10 xyoo nrog kev kho mob rau homozygous tsev neeg hypercholesterolemia.

Tsuas tshuaj

Siv cov ntsiav tshuaj raws li kev noj tshuaj rau tus kheej yog txwv tsis pub, vim tias tsuas yog tus kws kho mob thiaj li tuaj yeem xaiv txoj kev noj tshuaj zoo thiab pleev xim rau kev kho mob. Tsis txhob hnov qab tias kev kho mob yuav tsum tsim nyog tshwm sim ua ke nrog kev tawm tsam cov rog.

Kev noj tshuaj txhua hnub tuaj yeem yog 10, 20 lossis 80 mg:

Qhov ntau kawg noj rau hauv cov tshuaj kho mob tsis tshua muaj thiab hauv chaw kho mob.
Nrog hypercholesterolemia, qhov tshuaj txhua hnub ntawm 10 mg yog tshuaj. Nrog ischemia ntawm lub siab hloov khoom nruab nrog, ib koob tshuaj 20 mg yog tshuaj, nrog atherosclerosis, qhov kev siv tshuaj ntawm cov tshuaj yog 20-40 mg.
Qhov koob tshuaj 5 milligrams yog tus kws kho mob thaum noj cov statins thiab fibrates hauv txoj kev kho mob.

Thawj qhov tshwm sim ntawm cov tshuaj tuaj yeem paub tom qab 2 lub lis piam. Kev hloov pauv koob tshuaj tuaj yeem nqa tawm tsuas yog tom qab noj cov tshuaj rau ib hlis, thiab tseem nyob rau lub sijhawm no koj tuaj yeem hloov cov tshuaj nrog tshuaj pleev ib qho.

Kev sib cuam tshuam Simgal nrog lwm cov tshuaj

Nws yog ib qho tsim nyog kom nruj me ntsis tswj kev nqus ntawm statins thiab lwm yam tshuaj. Cov cai ntawm kev sib txuam:

thaum kho nrog cyclosporine thiab statins, qhov tseem ceeb ntawm simvastatin hauv cov ntshav muaj ntau ntxiv hauv ob peb zaug. Yog li, qhov sib koom ua ke siv ntawm ob hom tshuaj no yog contraindicated,
Cov lus qhia tshwj xeeb thiab cov lus qhia

Txog kev kho kom zoo, nws yog ib qho tseem ceeb kom ua raws li cov cai no:

Nrog kev kho ntev dua, cov suav tshuaj enzyme yuav tsum tau saib xyuas ib zaug txhua txhua 180 hnub.

Phiv los ntawm cov tshuaj thiab overdose

Simgal muaj ntau qhov tshwm sim rau tus neeg mob lub cev. Ntawm lawv yog:

tsis hnov qab potency nyob rau hauv cov txiv neej,
kev hloov pauv hauv kev ua haujlwm ntawm lub raum thiab mob siab,
nce siab ntawm raum transaminases,
dyspepsia
mob hauv daim ntawv ntawm pancreatitis,
xeev siab, ntuav, raws plab thiab cem quav,
peripheral neuropathy,
kev nyuaj siab
lub cev qaug zog,
pw tsis tsaug zog thiab nkees nkees,
mob taub hau
leeg tsis muaj zog,
rhabdomyolysis thiab alopecia.

Tsis muaj kev kho tshwj xeeb rau kev noj ntau dhau. Txoj kev kho mob tsuas yog tshwm sim thiab muaj nyob rau hauv kev ntxuav lub plab.

Rau kev kho mob ntawm hypercholesterolemia, tus kws kho mob tuaj yeem xaiv analogues ntawm cov tshuaj. Sau npe ntawm Simgal analogues nrog cov khoom xyaw simvastatin:

Simvakard yog lub Czech-ua yeeb tshuaj uas muaj cov kev kho mob siab tshaj plaws uas muaj kev cuam tshuam tsawg kawg ntawm tus neeg mob lub cev.
Simvastatin Zenith yog Czech tshuaj kho mob zoo rau kev kho mob ntawm thawj hom hypercholesterolemia hom 2A thiab 2B raws li Fredrickson ua ke nrog anticholesterol khoom noj.
Simvastol yog cov tshuaj Romanian yog qhov pheej yig dua li cov tshuaj qub. Simvastol yog tshuaj yog ib qho prophylaxis ntawm pathologies ntawm lub plawv thiab cov ntshav khiav ceev.

Kev tshuaj xyuas ntawm cov kws kho mob thiab cov neeg mob

Cov neeg mob thiab kws kho plawv feem ntau tawm hauv kev tshuaj xyuas zoo txog cov tshuaj. Lawv sau tseg txog qhov muaj txiaj ntsig zoo ntawm kev txo qis cov roj cholesterol thiab qhov kev pheej hmoo tsawg dua ntawm kev tsim kab mob ntawm cov hlab plawv:

Yog tias kev noj tshuaj kom raug yog xaiv los ntawm tus kws kho mob thiab cov zaub mov roj yog pom, cov nyhuv ntawm cov tshuaj nce nrog qhov tshwm sim tsawg heev. Siv Simgal hauv kev kho mob, tsis tsuas yog muaj kev pheej hmoo ntawm kev mob hlab ntsha plawv thiab plawv nres, tab sis kuj tseem mob plawv dhia tsis ua haujlwm thiab tachycardia txo qis.

Pharmacological pawg

Cov neeg sawv cev hypolipidemic. HMG-CoA reductase inhibitors. ATC code C10A A01.

Kev kho mob ntawm thawj hypercholesterolemia los yog sib xyaw dyslipidemia raws li kev txuas rau kev kho zaub mov noj, thaum kev noj zaub mov noj lossis lwm yam kev kho mob tsis muaj tshuaj (piv txwv li, kev tawm dag zog, kev poob phaus) yog qhov tsis muaj txiaj ntsig.

Kev kho mob homozygous kab mob hypercholesterolemia ua tus kho rau kev noj haus thiab lwm txoj hauv kev kho mob txhawm rau txo qis lipids (piv txwv li, LDL plasmapheresis), lossis thaum cov hau kev no tsis muaj txiaj ntsig.

Kev Tiv Thaiv Kab Mob Tiv Thaiv Kab Mob

Txo cov neeg tuag thiab morbidity los ntawm cov kab mob plawv hauv cov neeg mob loj atherosclerotic los yog ntshav qab zib mellitus, nrog cov roj ntshav kom sib luag lossis nce siab raws li kev kho mob rau kev kho ntawm lwm yam kev pheej hmoo thiab lwm yam kev kho plawv.

Tsuas tshuaj thiab tswj hwm

Ua ntej pib txoj kev kho kom zoo thiab thoob plaws kev kho mob, tus neeg mob yuav tsum ua raws li kev noj haus hypocholesterol.

Cov tshuaj Simgal tau noj ntawm qhov ncauj ib zaug ib hnub (thaum yav tsaus ntuj), tshwj tsis yog muaj lwm yam tshuaj. Cov tshuaj raug nquahu kom noj kom nyias nyob nyias ntawm kev noj mov, ntxuav nrog kom muaj dej txaus lossis lwm yam kua.

Hypercholesterolemia: 10-80 mg ntawm simvastatin ib zaug ib hnub (yav tsaus ntuj). Thawj koob tshuaj yog 10 mg, thiab qhov siab tshaj ib hnub yog 80 mg. Txhua qhov hloov pauv koob tshuaj yog ua tiav ntawm ntu ntawm plaub lub lis piam. Cov txiaj ntsig zoo ntawm cov tshuaj feem ntau tau tiav hauv koob tshuaj ntau txog 20 mg rau ib hnub,
Homozygous cov kab mob sib deev hypercholesterolemia: 40 mg ib hnub ib zaug (thaum yav tsaus ntuj) lossis 80 mg hauv peb faib peb zaug (20 mg thaum sawv ntxov thiab yav tav su, 40 mg nyob rau yav tsaus ntuj),
Cov kab mob plawv thiab muaj kev pheej hmoo siab ntawm nws txoj kev loj hlob: 20-40 mg Simgal ib hnub. Qhov tshuaj thawj zaug yog 20 mg rau ib hnub. Txhua qhov hloov pauv koob tshuaj yog ua tiav ntawm ntu ntawm plaub lub lis piam. Yog tias tsim nyog, koj tuaj yeem nce lub siab ntxiv rau 40 mg ib hnub twg. Nrog tag nrho cov roj cholesterol ntsiab lus ntawm 3.6 mmol / L, thiab qis lipoproteins ntawm 1.94 mmol / L, cov koob tshuaj yuav tsum raug txo kom tsawg.

Cov neeg laus uas mob mentsis mus rau lub raum tsis ua haujlwm tsis tas yuav tsum yoog kom haum rau Simgal.

Hauv kev kho mob raum tsis ua hauj lwm (kev tshem tawm ntawm creatinine tsawg dua 30 ml / min) lossis kev siv ua ke sib luag ntawm danazol, cyclosporine, nicotinic acid nyob rau hauv cov koob tshuaj ntau dua 1 g ib hnub, gemfibrozil lossis lwm cov fibrates, cov koob tshuaj simvastatin yuav tsum tsis pub tshaj 10 mg rau ib hnub, thiab thaum siv ua ke nrog verapamil lossis amiodarone - 20 mg ib hnub twg.

Tsuas tshuaj thiab tswj hwm

Qhov tshuaj ntau ntau yog 10-80 mg rau ib hnub raws li ib qho tshuaj noj thaum yav tsaus ntuj. Yog tias tsim nyog, hloov cov tshuaj tusyees ib lub sijhawm, tsawg kawg 4 lub lis piam, txog 80 mg rau ib hnub twg, uas yuav tsum noj thaum yav tsaus ntuj. Kev noj tshuaj ib zaug ntawm 80 mg rau ib hnub tsuas pom zoo rau cov neeg mob hypercholesterolemia nkaus xwb thiab muaj kev pheej hmoo siab heev ntawm cov kab mob plawv. Yog tias tus kws kho mob tau sau ntawv txog ib nrab ntawm lub ntsiav tshuaj, koj tsis tuaj yeem tsoo lub ntsiav tshuaj nrog koj txhais tes. Ntu ntsiav tshuaj yuav tsum tau nqa tawm siv rab riam.

Cov neeg mob yuav tsum yog daim ntawv noj zaub mov zoo rau txo qis roj, uas yuav tsum tau pom thaum kho nrog Simgal. Tus txheej txheem pib siv yog 20 mg rau ib hnub li qhov tshuaj txhaj thaum yav tsaus ntuj. Thaum qhov kev txo qis hauv LDL cov roj (yuav tsum muaj ntau dua 45%), qhov yuav tsum tau muab thawj zaug yog 40 mg rau ib hnub raws li qhov noj ib zaug thaum yav tsaus ntuj. Yog tias tsim nyog, kev hloov kho tshuaj yog tau ua raws li tau piav qhia saum toj no. Cov neeg mob uas mob me lossis mob nyhav hypercholesterolemia tuaj yeem raug kho nyob rau hauv thawj zaug ntawm 10 mg.

Homozygous muaj keeb tiv thaiv hypercholesterolemia

Qhov koob tshuaj pom zoo yog 40 mg simvastatin ib hnub rau yav tsaus ntuj lossis 80 mg rau ib hnub hauv

3 koob tshuaj 20 mg thaum sawv ntxov, 20 mg nyob rau yav tav su thiab ib hmos 40 mg. Simgal yuav tsum tau siv los ua qhov txuas rau lwm txoj kev kho mob txhawm rau txo qis lipid ntau (piv txwv li, LDL plasmapheresis) lossis yog tias tsis muaj kev kho zoo li ntawd.

Kev Tiv Thaiv Kab Mob Tiv Thaiv Kab Mob

Cov koob tshuaj ntawm Simgal yog 40 mg rau ib hnub yog qhov txhaj tshuaj ib zaug thaum yav tsaus ntuj rau cov neeg mob uas muaj feem yuav muaj mob plawv (CHD, nrog lossis tsis muaj hyperlipidemia). Kev siv tshuaj kho mob tuaj yeem pib ua haujlwm tib lub sijhawm kev noj haus thiab kev tawm dag zog. Yog tias tsim nyog, kev hloov kho tshuaj yog tau ua raws li tau piav qhia saum toj no.

Simgal ua tau zoo nyob rau hauv daim ntawv ntawm monotherapy lossis hauv kev sib xyaw nrog tshuaj, txhim kho kev nthuav tawm ntawm cov kua tsib acid. Cov tshuaj yuav tsum tau noj ntau dua 2:00 ua ntej lossis ntau dua 4:00 teev tom qab kev siv tshuaj uas txhim kho lub zog ntawm cov kua tsib acid.

Hauv cov neeg mob noj cov tshuaj cyclosporine, danazole, gemfibrozil, lwm cov fibrates (tshwj tsis yog fenofibrate), lossis lipid-txo cov koob tshuaj (g1 g / hnub) ntawm niacin nrog rau Simgal, koob tshuaj Simgal yuav tsum tsis pub tshaj 10 mg rau ib hnub. Rau cov neeg mob noj tshuaj amiodarone lossis verapamil tib lub sijhawm zoo li Simgal, koob tshuaj Simgal yuav tsum tsis pub ntau tshaj 20 mg ib hnub.

Tsis tas yuav muaj qhov hloov pauv rau cov neeg mob uas mob raum tsis txaus. Hauv kev mob raum tsis ua haujlwm zoo (kev tshem tawm creatinine)

Siv thaum cev xeeb tub lossis lactation

Simgal yog contraindicated rau hauv kev xeeb tub. Qhov kev nyab xeeb ntawm cov tshuaj rau cov poj niam cev xeeb tub tsis tau tsim. Tsis muaj kev tswj xyuas cov kab mob hauv cov poj niam cev xeeb tub. Muaj ntau daim ntawv tshaj tawm txog kev muaj peev xwm ua tsis tau zoo thaum lub sijhawm yug menyuam tshiab uas nws niam coj HMG-CoA reductase inhibitors thaum cev xeeb tub. Txawm li cas los xij, thaum kev txheeb xyuas cov txheej txheem ntawm cev xeeb tub hauv kwv yees li 200 tus poj niam noj simvastatin lossis lwm tus muaj feem xyuam HMG-CoA reductase inhibitor thaum thawj peb lub hlis, nws tau pom tias qhov ntau zaus ntawm qhov mob qog tsis zoo tau muab piv rau qhov ntau zaus pom hauv cov pej xeem. Tus naj npawb ntawm cov cev xeeb tub no muaj ntaub ntawv txaus cais tawm

Qhov 2.5-fold lossis siab dua qhov nce ntawm zaus ntawm qhov kev ntsuas tsis txaus ntseeg tawm tsam keeb kwm ntawm qhov dav dav. Txawm hais tias tsis muaj pov thawj pom tias qhov ntau zaus ntawm kev mob qog nqaij hlav ntshav hauv cov menyuam uas lawv niam coj simvastatin lossis lwm yam HMG-CoA reductase inhibitor tsis txawv ntawm cov zaus tau pom nyob hauv cov pej xeem, kev kho mob ntawm leej niam nrog simvastatin tuaj yeem txo cov me nyuam hauv plab mevalonate, uas yog tus txheej txheem ua ntej ntawm cov roj cholesterol biosynthesis. Atherosclerosis yog ib qho kev coj ua ntev, thiab, raws li txoj cai, kev txiav tawm cov lipid-txo cov tshuaj thaum cev xeeb tub yuav tsum tsis txhob cuam tshuam lub sij hawm ntev uas muaj feem cuam tshuam nrog thawj hypercholesterolemia. Hauv qhov no, nws tsis pom zoo kom siv Simgal thaum cev xeeb tub, thaum lub sijhawm npaj, thiab tseem yog tias cev xeeb tub tsuas yog xav tau. Kev kho mob tiag tiag yuav tsum raug ncua rau lub sijhawm cev xeeb tub lossis kom txog thaum nws tsim tau tias tus neeg mob tsis xeeb tub.

Nws tseem tsis tau paub meej tias simvastatin lossis nws cov metabolites nkag mus rau hauv niam mis. Txij li ib cov txiaj ntsig tseem ceeb ntawm cov tshuaj tau dhau mus rau niam mis, thiab kuj vim tias qhov kev pheej hmoo siab tshwm sim tsis zoo, cov poj niam noj Simgal yuav tsum tso tseg tsis pub mis.

Cov kev nyab xeeb thiab ua kom zoo ntawm simvastatin hauv cov hluas (cov ntxhais uas muaj tsawg kawg 1 xyoos tom qab kev coj khaub ncaws) thiab cov tub hluas hnub nyoog 10-17 xyoo nrog rau qhov muaj mob heterozygous hereditary hypercholesterolemia tau raug soj ntsuam hauv txoj kev tshawb no. Cov kev mob tshwm sim rau cov neeg mob uas tau txais simvastatin tau zoo ib yam li cov neeg mob uas tau siv cov placebo. Cov koob tshuaj ntau dua 40 mg tsis tau kawm hauv pawg no ntawm cov neeg mob. Txoj kev tshawb no tsis qhia txog kev cuam tshuam rau kev loj hlob thiab kev sib deev ntawm tus neeg hluas, nrog rau lub sijhawm ntawm lub cev ntas rau cov menyuam ntxhais. Cov menyuam ntxhais uas simvastatin yuav tsum qhia txog kev tiv thaiv kom tsis txhob muaj menyuam yaus. Simvastatin tsis tau kawm txog cov neeg mob uas muaj hnub nyoog qis dua 10 xyoo, thiab hauv cov menyuam ntxhais uas tseem tsis tau pib poj niam.

Daim ntawv thov nta

Simvastatin, zoo li lwm yam tshuaj tiv thaiv ntawm HMG-CoA (hydroxymethylglutaryl-coenzyme A) reductase, qee zaum tuaj yeem ua rau kev txhim kho myopathy, uas ua rau nws tus kheej ua mob nqaij, mob lossis tsis muaj zog, nrog CPK ntau dua

10 npaug dua siab dua qib theem siab ntawm qhov nruab nrab. Myopathy qee zaum ua tau nws tus kheej hauv daim ntawv ntawm rhabdomyolysis nrog lossis tsis muaj mob raum tsis ua haujlwm thib ob rau microalbuminuria. Hauv qhov no, kev tuag tsis tshua muaj tshwm sim. Txoj kev pheej hmoo ntawm tus mob myopathy tau nce vim yog qhov kev nce siab hauv cov ntshav plasma ntawm cov tshuaj uas muaj kev cuam tshuam ntawm kev tiv thaiv HMG-CoA reductase.

Ib yam li lwm yam HMG-CoA reductase inhibitors, qhov pheej hmoo ntawm kev tsim myopathy / rhabdomyolysis yog koob tshuaj tiv thaiv.

Kev ntsuas ntawm CPK (CC) yuav tsum tsis txhob ua tom qab kev tawm dag zog lub cev lossis thaum muaj lwm qhov laj thawj ntxiv rau nce CC ntau, vim tias qhov no ua rau muaj kev cuam tshuam kev txhais ntawm cov ntsuas uas tau txais. Yog tias cov qib ntawm lub txim txhaum tau nce siab nyob rau theem pib (> 5 lub sijhawm ntawm lub siab dua ntawm tus qauv), nws yuav tsum rov ntsuas dua hauv 5-7 hnub kom paub meej tias cov txiaj ntsig.

Txhua tus neeg mob uas pib kho nrog simvastatin lossis nrog qhov nce ntxiv ntawm simvastatin yuav tsum tau ceeb toom txog qhov kev pheej hmoo ntawm kev txhim kho myopathy thiab qhov xav tau los tshaj tawm txog qhov mob tsis tuaj yeem hnov mob leeg, mob lossis tsis muaj zog.

Kev ceeb toom yog qhia kom sau ntawv rau cov tshuaj rau cov neeg mob ua rau rhabdomyolysis. Txhawm rau tsim qhov ntsuas tswj hwm tus nqi, qib theem ntawm CC yuav tsum ntsuas ua ntej kev kho mob hauv cov xwm txheej zoo li no:

Tej laus (> 70 xyoo).
Lub raum khiav tsis zoo.
Kev tswj tsis tau hypothyroidism.
Mob muaj keeb muaj mob hauv tsev neeg lossis keeb kwm tus kheej.
Keeb kwm ntawm cov leeg mob toxicity los ntawm statins lossis fibrate.
Cawv kev quav cawv.

Hauv cov xwm txheej zoo li no, qhov kev pheej hmoo cuam tshuam nrog kev kho yuav tsum tau ntsuas thiab cov txiaj ntsig tau, thiab kev soj ntsuam hauv chaw kho mob tau pom zoo. Yog tias tus neeg mob muaj keeb kwm ntawm cov leeg tsis ua mob cuam tshuam nrog statins lossis fibrates, lwm yam tshuaj ntawm chav kawm no yuav tsum siv nrog ceev faj. Yog tias cov theem ntawm CC nce siab heev nyob rau theem pib (> 5 zaug dua siab dua theem siab ntawm cov kev cai ua haujlwm), kev kho yuav tsum tsis txhob pib.

Yog tias tus neeg mob tau txais kev kho mob statin tsim kho cov leeg mob, ua kom tsis muaj zog, lossis mob plab, qib CC yuav tsum ntsuas. Yog tias, thaum tsis muaj kev tawm dag zog lub cev, cov theem no tau nce siab dua (> 5 zaug siab dua li theem siab ntawm tus qauv ntawm cov neeg nruab nrab), kev kho yuav tsum tsis ua haujlwm ntxiv. Yog tias cov tsos mob ua rau mob hnyav los yog ua rau muaj kev ntxhov siab txhua hnub, txawm tias QC Qib siab 3 zaug siab dua li cov qib siab dua, cov qib transaminase tau pom nyob hauv qee tus neeg laus cov neeg mob noj simvastatin. Nrog rau kev txiav tawm lossis tshem tawm ntawm cov tshuaj, theem ntawm kev hloov pauv hauv cov neeg mob no, raws li txoj cai, maj mam rov qab mus rau cov txiaj ntsig dhau los.

Ua ntej pib kev kho mob, thiab tom qab ntawd, ua raws li cov cim ntsuas, nws pom zoo kom txhua tus neeg mob kuaj xyuas lub siab ua haujlwm. Cov neeg mob uas nce lub koob tshuaj mus rau 80 mg yuav tsum raug tshuaj xyuas ntxiv kom ntxiv qhov koob tshuaj, 3 lub hlis tom qab nce ntxiv rau 80 koob tshuaj, thiab tom qab ntawd ib ntu (piv txwv, ib hlis ib zaug) thaum thawj xyoo ntawm kev kho mob. Tshwj xeeb yuav tsum tau muab rau cov neeg mob uas kev ua kom ntshav ntau ntau ntxiv. Hauv lawv, cov qauv yuav tsum rov ua dua tam sim ntawd, thiab tom qab ntawd ua tau ntau dua. Yog tias qib transaminase zoo li nce ntxiv, tshwj xeeb tshaj yog tias lawv loj hlob> 3 zaug dua siab dua cov qib siab ntawm cov cai thiab ruaj khov, koj yuav tsum tsis noj simvastatin.

Xyuam xim yuav tsum tau muab rau cov neeg mob haus dej haus cawv ntau.

Ib yam li lwm cov tshuaj lipid-txo qis, mob pesnrab (

Cov lus qhia rau kev siv Simgala: txoj kev thiab ntau npaum li cas

Cov ntsiav tshuaj Simgal tau noj ntawm qhov ncauj, ib zaug ib hnub (thaum yav tsaus ntuj), ntxuav cia nrog dej kom ntau.

Qhov pom zoo koob ntawm cov tshuaj nws txawv nyob hauv thaj tsam ntawm 5-80 mg rau ib hnub. Koob tshuaj hloov kho yog nqa tawm maj, nrog qhov luv ntawm tsis tsawg tshaj 1 hlis. Qhov siab tshaj plaws txhua hnub ntawm 80 mg yog kho tsuas yog rau cov neeg mob uas tsis tau ua tiav qhov xav tau qhov kev xav tau thaum noj simvastatin ntawm ib koob ntawm 40 mg ib hnub, nrog rau cov uas noj Simtal diltiazem tib lub sijhawm. Cov neeg mob uas tseem tshuav yuav tsum tsis txhob noj ntau dua 40 mg ntawm cov tshuaj ib hnub.

Nrog hypercholesterolemia, thawj koob tshuaj txhua txhua hnub ntawm simvastatin yog 10-20 mg. Nyob rau hauv rooj plaub uas nws yog qhov yuav tsum tau txo qis ntawm qhov sib zog ntawm cov lipoproteins tsawg (LDL) los ntawm 45% lossis ntau dua, koj tuaj yeem nce thawj qhov tshuaj rau 20-40 mg ib hnub.

Nrog homozygous kab mob siab mob hypercholesterolemia, Simgal yog tshuaj ntawm 40 mg ib zaug ib hnub lossis 80 mg ib hnub hauv peb koob (20 mg thaum sawv ntxov thiab yav tav su, thiab 40 mg thaum yav tsaus ntuj).

Ua ntej pib txoj kev kho, tus neeg mob yog kws kho lub siab hypocholesterol, uas nws yuav tsum ua raws li kev kho mob kom thoob plaws.

Hauv cov kab mob plawv, thawj zaug ntawm simvastatin yog 20 mg ib hnub ib hnub (thaum yav tsaus ntuj), tom qab ntawd, yog tias tsim nyog, qhov koob tshuaj tau nce ntxiv rau 40 mg ib hnub twg (maj mam, txhua 4 lub lis piam).

Nrog rau kev siv ib txhij nrog gemfibrozil, danazole, cyclosporine, lwm yam fibrates (tshwj tsis yog fenofibrate) thiab nicotinic acid nyob rau hauv ib koob tshuaj txhua hnub tsawg kawg 1 g, koob tshuaj Simgal yuav tsum tsis pub ntau tshaj 10 mg rau ib hnub. Thaum ua ke nrog verapamil los yog amiodarone, Simgal 20 mg yog kho.

Simvastatin yuav tsum tau muab cais tawm ntawm bile acid sequestrants (colestyramine thiab colestipol) - 2 teev ua ntej lawv siv lossis 4 teev tom qab noj cov tshuaj no.

Cov neeg laus thiab cov neeg mob uas mob me mus txog rau lub raum tsis ua hauj lwm txoj kev kho tshuaj tsis tas yuav ua los tau. Hauv kev mob raum tsis zoo, qhov tshuaj tsis ntau tshaj 10 mg rau ib hnub, thiab kev kho yog ua raws li kev saib xyuas ntawm tus kws kho mob.

Noj ntau dhau

Nrog kev noj tshuaj ntau dhau ntawm cov tshuaj, cov tsos mob tshwj xeeb tsis tau sau npe (muaj ntau tus neeg paub thaum Simgal tau noj nyob rau ntawm 450 mg).

Txoj kev kho mob yog tus qauv: nws yog qhov tsim nyog los ntxias kom ntuav thiab muab tus neeg mob lub tshuab hluav ncaig. Yog tias tsim nyog, kev kho mob cov tsos mob raug kho. Ntsuas cov qib creatine phosphokinase qib thiab lub raum thiab lub siab ua haujlwm yuav tsum tau saib xyuas.

Nrog rau kev txhim kho ntawm mob raum tsis ua haujlwm thiab qhov tshwm sim ntawm myopathy nrog rhabdomyolysis, cov tshuaj yuav tsum tau muab tshem tawm tam sim ntawd thiab sodium bicarbonate nyob rau hauv daim ntawv ntawm kev tso ntshav thiab ib lub diuretic yuav tsum tau muab rau tus neeg mob. Yog tias tsim nyog, kev kho mob hemodialysis tau ua tiav.

Hyperkalemia, uas tuaj yeem ua rau rhabdomyolysis, raug tshem tawm los ntawm kev tswj hwm cov tshuaj calcium gluconate lossis calcium chloride, kev lis ntshav ntawm cov piam thaj thiab insulin, kev siv ntawm cov potassium pauv cov tshuaj, thiab nyob rau hauv cov mob hnyav, hemodialysis.

Cev xeeb tub thiab lactation

Simgal yog contraindicated thaum cev xeeb tub. Hauv cov menyuam yaus uas lawv niam noj cov tshuaj, kev tsis tuaj yeem ua rau mob loj tuaj (muaj cov ntaub ntawv ntawm ntau kis zoo sib xws).

Cov poj niam uas muaj hnub nyoog yug me nyuam uas sim simvastatin yuav tsum siv txoj kev tiv thaiv kom tsis muaj txiaj ntsig thiab tsis txhob xeeb tub.

Txawm hais tias cov ntaub ntawv hais txog kev faib cov simvastatin nrog rau niam mis tsis muaj, kev siv Simgal thaum pub mis niam tsis pom zoo.

Yeeb tshuaj sib cuam tshuam

Txoj kev pheej hmoo ntawm kev tsim myopathy nce nrog kev siv Simgal nrog cov tshuaj tiv thaiv kab mob, tshuaj tiv thaiv kab mob, tiv thaiv kab mob HIV protease inhibitors, cytostatics, txhaj tshuaj ntau ntawm nicotinic acid, clarithromycin, nefazodone, gemfibrozil thiab lwm cov fibrates (tshwj tsis yog fenofibrate), erythromycin thiab telithromycin.

Nrog kev sib koom tes ntawm cov thawj coj ntawm cov danazol, cyclosporine, verapamil, amiodarone, diltiazem lossis amlodipine nrog cov koob tshuaj simvastatin ntau dua, kev muaj peev xwm ntawm rhabdomyolysis / myopathy nce ntxiv.

Simgal potentiates cov nyhuv ntawm kev tiv thaiv tsis tau thiab ua rau muaj kev pheej hmoo los ntshav, ua rau lub plasma concentration ntawm digoxin ntau ntxiv.

Thaum lub sijhawm kho cov tshuaj simvastatin, yuav tsum zam kev haus dej txiv kab ntxwv qaub ntau.

Simgal's analogs yog: Aterostat, Atrolin, Aldesta, Vazilip, Vasta, Vabadin, Vazostat-Health, Vastatin, Kardak, Zosta, Zokor, Simvageksal, Simvakol, Symvostat, Simvastatin, Simvastatin Zentiva, Simvakard, Simva Tad.

Tus nqi ntawm Simgal hauv cov chaw muag tshuaj

Tus nqi ntawm cov tshuaj nws txawv nyob ntawm seb qhov ntau npaum li cas thiab ntim. Txog hnub tim, cov nqi nruab nrab rau Simgal hauv cov chaw muag tshuaj yog raws li hauv qab no:

10 mg ntsiav tshuaj, 28 pcs. hauv pob - 217-24 rubles,
10 mg ntsiav tshuaj, 84 pcs. hauv pob - 591-611 rubles,
20 mg ntsiav tshuaj, 28 pcs. hauv pob - 282–392 rubles,
20 mg ntsiav tshuaj, 84 pcs. hauv pob - 593-880 rubles,
40 mg ntsiav tshuaj, 28 pcs. hauv pob - 584-650 rubles,
ntsiav tshuaj 40 mg, 84 pcs. hauv pob - 1357 rubles.

Kev Kawm: Rostov State Medical University, tshwj xeeb "General Tshuaj".

Cov ntaub ntawv hais txog cov tshuaj raug muab dav dav, muab rau kev qhia tawm thiab tsis hloov chaw cov lus qhia. Kev siv tshuaj rau tus kheej yog qhov txaus ntshai rau kev noj qab haus huv!

Cov kws tshawb fawb los ntawm University of Oxford tshawb nrhiav ntau qhov kev tshawb fawb, thaum lub sijhawm lawv tau txiav txim siab tias kev tsis noj zaub ua rau muaj kev phom sij rau tib neeg lub hlwb, vim tias nws ua rau nws qhov tsawg. Yog li cov kws tshawb fawb pom zoo kom tsis txhob cais cov ntses thiab nqaij los ntawm lawv cov zaub mov noj kom ntau.

Thaum txham, peb lub cev ua haujlwm tsis tiav. Txawm lub plawv nres.

Ntxiv rau tib neeg, tsuas yog ib qho tsiaj muaj sia nyob hauv ntiaj chaw ntiaj teb - dev, raug kev txom nyem los ntawm prostatitis. Cov no yog peb cov phooj ywg ncaj ncees tshaj plaws.

Yog tias koj poob los ntawm tus nees luav, koj nyiam yob koj lub caj dab ntau dua li yog koj ntog los ntawm nees. Tsuas tsis sim rau refute nqe lus no.

Hauv 5% ntawm cov neeg mob, antidepressant clomipramine ua rau lub orgasm.

Caries yog hom kis tau yooj yim tshaj plaws hauv ntiaj teb uas txawm tias tus mob npaws tsis tuaj yeem sib tw nrog.

Tib neeg lub plab ua haujlwm tau zoo nrog cov khoom txawv teb chaws thiab tsis muaj kev cuam tshuam kho mob. Gastric kua txiv yog paub tias yuav yaj txawm npib.

Qhov nruab nrab lub neej ntawm cov laug yog tsawg dua ntawm txoj cai.

Raws li kev tshawb fawb, cov poj niam uas haus ob peb khob npias lossis cawv txiv hmab ib lim tiam muaj feem ntau yuav muaj mob khees xaws mis.

Qhov hnyav ntawm tib neeg lub hlwb yog li 2% ntawm tag nrho lub cev qhov hnyav, tab sis nws noj txog 20% ntawm cov pa mus rau hauv cov ntshav. Qhov tseeb no ua rau tib neeg lub hlwb muaj kev tiv thaiv rau kev puas tsuaj los ntawm cov pa oxygen.

Yog tias koj luag nyav tsuas yog ob zaug ib hnub, koj tuaj yeem txo cov ntshav siab thiab txo qhov kev pheej hmoo ntawm lub plawv thiab mob nkees.

Cov tshuaj hnoos "Terpincode" yog ib tus thawj coj hauv kev muag, tsis muaj vim tias nws muaj tshuaj.

Qhov kub siab tshaj plaws ntawm lub cev tau sau cia ntawm Willie Jones (USA), uas tau nkag rau hauv tsev kho mob nrog qhov kub txog 46,5 ° C.

Tus mob uas tsis tshua muaj mob yog Kuru's kab mob. Tsuas yog cov neeg sawv cev ntawm pawg neeg Fore hauv New Guinea mob nrog nws. Tus neeg mob tuag ntawm kev luag. Nws ntseeg tau tias qhov ua rau tus mob yog noj tib neeg lub hlwb.

Cov poj niam feem ntau muaj peev xwm tau txais kev lom zem ntau dua los ntawm kev xav txog lawv lub cev zoo nkauj hauv daim iav dua li ntawm kev sib deev. Yog li, cov poj niam, siv zog ua kom muaj kev sib haum xeeb.

Raws li kev txheeb cais, kwv yees li 80% ntawm cov poj niam hauv Lavxias txom nyem mob los ntawm kab mob vaginosis. Raws li txoj cai, tus kab mob tsis kaj siab no tau nrog los ntawm dawb los yog txho outflows.

Cov chaw muag tshuaj

Kws tshuaj. Tom qab noj simvastatin, uas yog qhov ua kom lactone, nws yob hydrolysis los ua cov dej num kom nquag plias hydro-hydroxy acid derivative, uas yog qhov muaj zog inhibitor ntawm HMG-CoA reductase (3-hydroxy

3-methylglutaryl-CoA reductase). Qhov enzyme no ua rau muaj kev hloov pauv ntawm HMG-CoA rau mevalonate, uas yog thawj theem ntawm cov roj (biosynthesis) roj.

Simvastatin tau pom tias yuav txo qis txhua qhov qub thiab kom nce siab ntawm LDL cov roj cholesterol ntau. LDL yog tsim los ntawm lipoproteins tsawg heev (VLDL), uas yog catabolizes mas qhov siab LDL receptor. Lub tshuab ntawm LDL-txo cov nyhuv ntawm simvastatin tuaj yeem suav tag nrho ob qho kev txo qis ntawm cov ntsiab lus ntawm VLDL cov roj (cholesterol) thiab cov induction ntawm LDL receptors, uas ua rau txo qis ntau lawm thiab nce catabolism ntawm LDL roj. Simvastatin txoj kev kho kuj txo qis theem ntawm apolipoprotein B. Ntxiv rau, simvastatin nce me ntsis roj HDL (cov lipoproteins ntau ntom) thiab txo cov qib triglycerides hauv ntshav ntshav. Raws li cov txiaj ntsig ntawm cov kev pauv hloov no, qhov sib piv ntawm cov roj (cholesterol) tag nrho nrog rau HDL cov cholesterol thiab LDL cov cholesterol los sib piv nrog HDL cov cholesterol tsawg dua.

Xuas. Simvastatin yog qhov nqus tau zoo thiab raug rau kev nthuav dav thaum thawj kev nkag los ntawm lub siab. Kev rub tawm hauv lub siab tuaj yeem ua kom ntshav txaus hauv lub siab. Daim nplooj siab yog qhov chaw tseem ceeb ntawm daim foos. Qhov kev nqus ntawm β-hydroxy acid derivative mus rau hauv cov ntshav dav dav tom qab noj tshuaj simvastatin tsawg dua 5% ntawm koob tshuaj. Qhov siab tshaj plaws ntshav plasma yog mus txog

1-2 teev tom qab noj simvastatin. Kev noj ib txhij tsis cuam tshuam rau kev nqus.

Kev tshawb fawb ntawm cov tshuaj pharmacokinetics ntawm ib zaug thiab ntau zaus ntawm simvastatin tau qhia tias tom qab ntau ntau yam tshuaj tsis muaj kev txuam nrog cov tshuaj.

Kev xa Khoom. Kev khi ntawm simvastatin thiab nws cov nquag metabolites mus rau cov ntshav protein yog> 95%.

Xaus Simvastatin yog lub cev dej ntawm CYP3A4. Lub ntsiab metabolites yog

β-hydroxy acids thiab plaub ntxiv metabolites. Tom qab lub qhov ncauj tswj hwm ntawm radioactive simvastatin, 13% ntawm cov tshuaj yog tawm hauv cov zis thiab 60% nrog quav hauv lub sijhawm 96 teev. Tus nqi pom hauv cov quav yog qhov sib npaug ntawm cov tshuaj nqus tau nyob hauv cov kua tsib, nrog rau cov tshuaj uas tsis muaj qhov tsis txaus noj. Pharmacokinetic cov yam ntxwv tau kawm txog hauv cov neeg laus. Cov ntaub ntawv pharmacokinetic ntawm cov menyuam yaus thiab cov hluas yog tsis tuaj.