Tulip 10

Daim ntawv koob tshuaj - cov ntsiav tshuaj zaj duab xis: 10 mg - dawb los yog yuav luag dawb zaj duab xis txheej, HLA 10 engraving rau ntawm ib sab, 20 mg - lub teeb xim daj zaj duab xis txheej, HLA 20 engraving ntawm ib sab, 40 mg - zaj duab xis dawb nrog lub ntsej muag daj-xim daj, zaj duab xis txheej ntawm ib sab, "HLA 40" kos duab, ntsiav tshuaj biconvex, puag ncig, ntu - dawb (10 pcs. hauv blisters, hauv ib pob ntawv los ntawm 3, 6, 9 hlwv).

Composition 1 ntsiav tshuaj:

• cov tshuaj nquag: atorvastatin (nyob rau hauv daim ntawv ntawm atorvastatin calcium) - 10, 20 lossis 40 mg,
• Cov khoom siv pabcuam: croscarmellose sodium, lactose monohydrate, polysorbate 80, hyprolose, colloidal silicon dioxide, magnesium stearate, hnyav magnesium oxide, microcrystalline cellulose,
• zaj duab xis txheej: hyprolose, hypromellose, macrogol 6000, talc, titanium dioxide, rau ib koob tshuaj 20 thiab 40 mg, ntxiv rau, hlau oxide yog daj.

Kev ntsuas rau siv

• thawj hypercholesterolemia, heterozygous tsev neeg thiab tsis-tsev neeg hypercholesterolemia thiab sib xyaw (sib xyaw) hom IIa thiab IIb hyperlipidemia raws li kev faib tawm ntawm Fredrickson - Tulip yog siv ua ke nrog kev noj zaub mov hypocholesterolemic kom txo qis ntau ntau ntawm cov roj (Chc), cov roj lipoprotein tsawg (A) B (apoV), thyroglobulin (TG), thiab nce qhov ntau ntawm cov roj lipoprotein ntau ntau (HDL-C), thaum tsuas yog kev noj zaub mov noj thiab lwm txoj hauv kev tsis siv tshuaj. lawv muaj cov nyhuv me
• homozygous tsev neeg hypercholesterolemia - txhawm rau kom txo qis ntau ntau ntawm LDL-C thiab tag nrho cov roj (cholesterol), thaum tsuas yog kev noj zaub mov noj thiab lwm txoj kev siv tshuaj tsis zoo txaus,
• kev mob plawv hauv cov neeg mob uas tsis muaj cov kab mob ntsig txog mob plawv (CHD), tab sis nrog qee qhov kev pheej hmoo rau nws txoj kev loj hlob, xws li kev muaj nicotine, kev mob ntshav siab, retinopathy, ntshav qab zib mellitus, albuminuria, ntshav ntau tsawg ntawm HDL-C, caj ces predisposition, suav nrog tiv thaiv keeb kwm ntawm dyslipidemia, hnub nyoog ntau dua 55 xyoos - rau kev tiv thaiv,
• mob plawv rau cov neeg mob uas muaj mob ua rau mob ntshav tawm ntawm lub cev - txoj kev tawm tsam thib ob ntawm tus mob kom txo tag nrho cov neeg tuag, mob ntshav hlab plawv, mob ntshav qab zib, rov qab pw tsev kho mob rau angina pectoris thiab qhov xav tau rov qab los ua kom rov zoo siab.

Cov Yuav Tsum Muaj

• daim siab puas tsuaj nyob rau theem nquag,
• kev nce ntshav hauv kev ua haujlwm ntawm hepatic transaminases ntawm cov tsis paub keeb kwm hauv kev sib piv nrog qhov kev txwv siab tshaj qhov qub (VGN) los ntawm ntau dua 3 zaug,
• Cov ntshav qabzib-galactose malabsorption syndrome, lactose tsis haum, lactase deficiency (suav nrog lactose),
• cev xeeb tub thiab lub sijhawm pub mis niam (lactation),
• cov menyuam yaus thiab cov tub ntxhais hluas hnub nyoog qis dua 18 xyoo (qhov ua tau zoo thiab kev nyab xeeb ntawm kev noj atorvastatin hauv pawg hnub nyoog ntawm cov neeg mob tsis tau tsim)
• ntxiv rau ib tus neeg rhiab rau cov tshuaj ntawm cov tshuaj.

Nrog ceev faj, Tulip siv rau thaum muaj hluav taws xob tsis txaus, keeb kwm ntawm daim siab mob siab, kev haus cawv, cov kab mob ntawm cov leeg thiab keeb kwm ntawm cov leeg mob vim yog siv lwm yam tshuaj ntawm cov pab pawg ntawm HMG-CoA reductase inhibitors, metabolic thiab endocrine (hyperthyroidism) ) mob cuam tshuam, mob ntshav liab hypotension, mob ntshav qab zib mellitus, mob hnyav hnyav (sepsis), tswj tsis tau tus mob vwm, kev phais mob ntev ntev, kev poob plig, txhoj puab heev lipid txo kev kho mob (atorvastatin ntawm ib koob ntawm 80 mg) rau kev tiv thaiv kab mob thib ob hauv cov neeg mob uas muaj keeb kwm ntawm hemorrhagic lossis lacunar stroke.

Tsuas tshuaj thiab tswj hwm

Ua ntej pib siv cov tshuaj Tulip, tus neeg mob yuav tsum pom zoo rau tus qauv hypocholesterolemic noj, uas yuav tsum tau pom thoob plaws hauv tag nrho lub sijhawm kho nrog cov tshuaj.

Cov ntsiav tshuaj tau noj ntawm qhov ncauj, tsis hais txog ntawm cov khoom noj.

Cov kev pom zoo ntau ntawm cov tshuaj txhua hnub ntawm Tulip yog 10-80 mg, qhov koob tshuaj tshwj xeeb raug xaiv raws li cov kev sib xyaw ntawm LDL-C, lub hom phiaj ntawm kev kho mob thiab cov tshuaj kho mob ntawm tus neeg mob.

Thawj koob tshuaj rau hauv feem ntau yuav yog 10 mg rau ib hnub, qhov ntau tshaj - 80 mg ib hnub twg.

Thaum pib ntawm txoj kev kho, tom qab 14-28 hnub thiab / lossis nrog txhua qhov nce ntawm cov tshuaj, cov ntshav plasma lipids yuav tsum raug tswj thiab, yog tias tsim nyog, cov tshuaj atorvastatin yuav tsum kho.

Cov tshuaj pom zoo:

• thawj (kab mob heterozygous kab mob thiab polygenic) hypercholesterolemia (hom IIa) thiab sib xyaw hyperlipidemia (hom IIb): ib koob tshuaj 10 mg ib hnub ib zaug feem ntau txaus (10 thiab 20 mg ntsiav tshuaj tuaj yeem siv), yog tias tsim nyog, maj mam nce lub koob rau 80 mg (2 ntsiav tshuaj ntawm 40 mg), suav txog tus neeg mob cov lus teb thiab soj ntsuam lub sijhawm nruab nrab ntawm cov koob tshuaj nce ntxiv ntawm 14-28 hnub, vim hais tias cov kev kho kom zoo pom tau tom qab 14 hnub, thiab cov txiaj ntsig kho tau ntau tshaj plaws tau sau tseg tom qab 28 hnub thiab kav ntev li tus ntoo khaub lig
• homozygous kev mob muaj keeb hypercholesterolemia: 80 mg (2 ntsiav tshuaj ntawm 40 mg) 1 lub sijhawm hauv ib hnub,
• kab mob plawv (rau prophylaxis): 10 mg ib hnub ib zaug, yog tias tsis pom qhov ntshav siab zoo ntawm LDL tsis tau txog, nws raug tso cai maj mam nce cov koob tshuaj mus rau 80 mg (2 ntsiav tshuaj ntawm 40 mg), coj mus rau hauv tus account tus neeg mob cov lus teb thiab saib xyuas lub sijhawm nruab nrab ntawm koob tshuaj nce 14 –28 hnub.

Tsis tas yuav txhaj koob tshuaj Tulip rau cov neeg mob lub raum thiab cov neeg laus laus.

Nrog lub siab ua haujlwm tsis zoo, kev tshem tawm ntawm atorvastatin los ntawm lub cev qeeb, yog li ntawd nws raug nquahu kom siv nws nrog kev ceev faj, tas li saib xyuas kev ua haujlwm ntawm hepatic transaminases: aspartate aminotransferase (ACT) thiab alanine aminotransferase (ALT).

Sab sij huam

• kev tsim kho lub paj hlwb: feem ntau - mob taub hau, tsis xws luag - pw tsis tsaug zog (suav nrog insomnia thiab npau suav phem), kiv taub hau, asthenic syndrome, paresthesia, hypesthesia, tsis muaj zog, nco ploj / poob, tsis hnov ​​qab rhiab heev, tsis tshua muaj qhov tsis xws luag neuropathy,
• cov khoom hauv lub cev: muaj qhov tsis pom kev - qhov muag plooj, pom kev, tsis tshua pom - tsis pom kev, tsis tshua muaj - hnov ​​lus tsis zoo,
• kev mob plab zom mov: feem ntau - flatulence, cem quav, xeev siab, dyspepsia, raws plab, tsis tu ncua - ntuav, tsis nco qab, kab mob siab, kab mob ntsws, sawv, mob plab, tsis tshua muaj - cholestatic jaundice (suav nrog ob leeg), tsis tshua muaj - kab mob siab,
• musculoskeletal system: feem ntau - o ntawm cov pob qij txha, myalgia, arthralgia, mob pob qij txha, mob leeg, mob nraub qaum, tsis to taub - mob rau hauv caj dab nqaij, myasthenia gravis, tsis tshua muaj myositis, myopathy, rhabdomyolysis, tendinopathy (qee zaum ua ntej mob txha caj qaum), zaus kawg - cov xwm txheej tiv thaiv kab mob hauv lub cev,
• cov tawv nqaij thiab cov nqaij mos subcutaneous: ua haujlwm tsis xws luag - tawv nqaij ua pob khaus, khaus, urticaria, alopecia, tsis tshua muaj - ua pob xoo pob khaus, mob caj dab, mob erythema multiforme (suav nrog Stevens-Johnson syndrome) thiab Lyell syndrome (mob ua paug rau cov leeg ntshav),
• hematopoietic system: ua tsis tau - thrombocytopenia,
• metabolism: feem ntau - hyperglycemia, ua tsis tau - hypoglycemia,
• cov kab mob ua pa: feem ntau - mob caj pas, nasopharyngitis, ntswg,
• kev tiv thaiv kab mob: feem ntau - cov tshuaj tiv thaiv hypersensitivity, tsis tshua muaj - anaphylaxis,
• kuaj ntsuas: feem ntau - nce kev ua si ntawm cov ntshav creatine phosphokinase (CPK), kev ua haujlwm ntau ntawm ALT thiab AST, ua tsis tau zoo - leukocyturia, tsis tshua muaj ntau zaus - ntau ntxiv ntawm glycosylated hemoglobin,
• lwm cov kev cuam tshuam: tsis xws luag - rog nkees, lub raum lub raum tsis ua hauj lwm, lub cev tsis muaj zog, hyperthermia, peripheral edema, mob hauv siab, hnyav nce, tsis tshua muaj ntshav qab zib - mob ntshav qab zib mellitus, gynecomastia, muaj qee cov ntaub ntawv ntawm kev txhim kho atonic fasciitis, tab sis qhov sib txuas nrog kev siv atorvastatin tsis yog tsim muaj, tsis paub meej ntau zaus - interstitial mob ntsws (tshwj xeeb nrog kev siv lub sijhawm ntev), kev nyuaj siab, kev sib daj sib deev.

Yog tias dhau ntawm Tulip kev noj ntau dhau, yuav tsum kho cov tsos mob kom zoo. Atorvastatin tsis muaj qhov tshuaj tiv thaiv tshwj xeeb, thiab hemodialysis tsis ua hauj lwm vim muaj kev sib khi tseem ceeb ntawm cov tshuaj rau ntshav plasma protein.

Cov lus qhia tshwj xeeb

Tulip, zoo ib yam li lwm yam statins (HMG-CoA reductase inhibitors), tuaj yeem nce cov dej num ntawm lub siab enzymes daim siab ACT thiab ALT los ntawm ntau dua 3 zaug hauv qhov sib piv nrog VGN. Yog li, nws yuav tsum tau soj ntsuam daim siab kev ua haujlwm ua ntej noj tshuaj, tom qab 6 thiab 12 lub lis piam los ntawm kev pib kho thiab nrog qhov nce ntxiv hauv nws cov koob tshuaj. Kev tshuaj xyuas daim siab ua haujlwm tseem ceeb yog qhov tseem ceeb thaum soj ntsuam cov tsos mob ntawm nws qhov mob tshwm sim. Nrog nce kev ua haujlwm ntawm ACT thiab ALT, cov ntsuas yuav tsum tau soj qab kom txog thaum cov txiaj ntsig tseem ceeb, yog tias qhov nce siab tshaj 3 zaug siab dua li VGN thiab tseem mob siab, nws raug nquahu kom txo qis cov tshuaj lossis tsis noj tshuaj.

Kev siv cov tshuaj Tulip tuaj yeem ua rau kev loj hlob ntawm myalgia. Hauv cov neeg mob uas mob myalgia, mob leeg tsis muaj zog los yog mob thiab / lossis cim tau ntau hauv CPK cov kev ua, myopathy yuav tau qhia. Hauv qhov xwm txheej no (qhov pom tseeb / pom tseeb tias myopathy), kev kho mob atorvastatin yuav tsum tsis ua mus ntxiv.

Vim muaj kev pheej hmoo ntawm myopathy nrog kev siv tulip nrog cov tshuaj tiv thaiv kab mob, fibrates, azole antifungal tshuaj, erythromycin, nicotinic acid (hauv lipid-txo cov tshuaj ntau dua 1 g ib hnub), kev kho tshuaj yog pib tsuas yog tom qab ua tib zoo ntsuas ntawm qhov feem ntawm cov txiaj ntsig kev cia siab ntawm kev kho nrog qhov muaj feem ntawm kev phiv loj kev tawm tsam. Yog tias tsim nyog, kev kho ua ke tau pom zoo kom txiav txim siab qhov kev txhim kho ntawm kev pib thiab kev saib xyuas cov koob tshuaj ntawm cov tshuaj no hauv kev txo qis.

Thaum siv tshuaj kho, CPK cov haujlwm thiab ntshav dej qabzib feem ntau yuav tsum tau saib xyuas tsis tseg.

Cov neeg mob yuav tsum raug qhia paub txog qhov xav tau tam sim ntawd sab laj nrog kws kho mob yog tias qhov mob tsis pom thiab / lossis cov leeg tsis muaj zog tshwm tuaj, tshwj xeeb yog muaj kev cuam tshuam nrog dav dav thiab kub cev.

Cov mob tsis tshua muaj mob rhabdomyolysis nrog kev txhim kho ntawm lub raum tsis ua haujlwm vim yog myoglobinuria vim yog siv cov tshuaj Tulip, ntxiv rau lwm yam statins (HMG-CoA reductase inhibitors) tau piav qhia.

Yog tias muaj cov cim ntawm qhov ua tau myopathy lossis muaj kev pheej hmoo ntawm kev tsim muaj lub raum tsis ua haujlwm (txoj hlab ntsha hauv lub plawv, mob hnyav, mob hnyav, mob hnyav, kev cuam tshuam loj heev, kev cuam tshuam ntawm metabolic, endocrine thiab electrolyte cuam tshuam, tswj tsis tau tus mob) thaum noj rhabdomyolysis, atorvastatin yuav tsum nres lossis kev kho yuav tsum tau txiav.

Thaum kho nrog Tulip, yuav tsum ceev faj thaum tsav tsheb thiab sib koom nrog lwm yam kev ua haujlwm txaus ntshai, uas yuav tsum muaj kev mloog ntau ntxiv thiab ceev ntawm cov kev tiv thaiv psychomotor.

Yeeb tshuaj sib cuam tshuam

• cyclosporine, erythromycin, clarithromycin, immunosuppressive, antifungal tshuaj (azole derivatives): ua rau muaj kev pheej hmoo ntawm myopathy thaum siv ib txhij nrog HMG-CoA reductase inhibitors vim tias muaj peev xwm nce ntxiv ntawm cov tshuaj lom ntawm atorvastatin,
• indinavir, ritonavir (HIV tiv thaiv cov tshuaj tiv thaiv kab mob), fibrates thiab nicotinic acid (hauv kev txo cov lipid-ntau dua 1 g hauv ib hnub): nce qhov kev pheej hmoo ntawm kev tsim myopathy,
• cov tshuaj tiv thaiv ntawm CYP3A4 isoenzyme (suav nrog cov protease inhibitors): kev nce siab ntawm plasma ntau ntawm atorvastatin yog ua tau,
• OATP1B1 thauj cov tshuaj tiv thaiv protein (xws li cyclosporine): tuaj yeem ua kom lub bioavailability ntawm atorvastatin,
• erythromycin thiab clarithromycin: nce qhov concentration ntawm atorvastatin hauv ntshav ntshav (los ntawm 40% thiab 56%, feem),
• diltiazem: ntawm koob tshuaj 240 mg nrog 40 mg ntawm atorvastatin tsub kom cov siab nyob rau tom kawg hauv cov ntshav ntshav,
• cimetidine: tsis muaj kev cuam tshuam tseem ceeb hauv chaw kho mob nrog atorvastatin raug kuaj pom,
• itraconazole: ntawm koob tshuaj 200 mg nrog 20-40 mg ntawm atorvastatin, AUC tus nqi ntawm atorvastatin 3 zaug nce,
• kua txiv kab ntxwv qaub: hauv qhov ntim ntau dua li ntawm 1.2 litres ib hnub rau 5 hnub tuaj yeem ua rau muaj qhov nce ntshav ntau ntxiv ntawm atorvastatin,
• cov tsim tawm ntawm CYP3A4 isoenzyme (piv txwv li, efavirenz lossis rifampicin): tuaj yeem ua rau muaj qhov txo qis ntawm cov tshuaj atorvastatin hauv ntshav plasma, vim tias rifampicin yog qhov tsim tawm ntawm isoenzyme CYP3A4 thiab tib lub sijhawm los cuam tshuam ntawm hepatocyte thauj protein OATP1, cuam tshuam nrog
• tshuaj tiv thaiv kab mob: ua ke ntawm lub qhov ncauj ntawm kev ncua kev kawm uas muaj txhuas thiab magnesium hydroxides nrog atorvastatin txo cov ntshav plasma concentration ntawm tom kawg

35%, tab sis cov degree ntawm kev txo qis hauv kev suav ntawm LDL-C tsis hloov,

Tulip cov duab ntxiv yog: Anvistat, Atomax, Ator, Atorvastatin, Atoris, Atorvoks, Vazator, Lipoford, Liptonorm, Liprimar, Torvazin, Novostat, Torvalip, Torvakard, Torvas thiab lwm yam.

Dosage daim ntawv

Zaj duab xis-coated ntsiav tshuaj.

1 lub ntim zaj duab xis-txheej muaj: cov tshuaj nquag: atorvastatin calcium 41.43 mg (hauv cov ntsiab lus ntawm atorvastatin 40.00 mg), tus zam: microcrystalline cellulose 284.97 mg, lactose monohydrate 69.60 mg, croscarmellose sodium 38.40 mg, hyprolose 4.00 mg, polysorbate 80 5.20 mg, hnyav magnesium oxide 52.00 mg, colloidal silicon dioxide 2.40 mg, magnesium stearate 2.00 mg, plhaub muaj pes tsawg leeg: hypromellose 5.952 mg, hyprolose 1.488 mg, titanium dioxide 2.736 mg, macrogol 6000 1,200 mg, talc 0,600 mg, hlau oxide daj E 172 0,024 mg.

Kev piav qhia

Dawb nrog lub xim daj-xim daj rau xim daj, hloov cov tshuaj pleev xim zoo nkauj, pleev xim-pleev xim, kos nrog "HLA 40" ntawm ib sab.
Kink saib: dawb ntsiav tshuaj.

Cov chaw muag tshuaj

Cov Tshuaj Hauv Tshuaj
Atorvastatin yog ib qho kev xaiv sib tw ua kom muaj zog ntawm HMG-CoA reductase enzyme uas hloov 3-hydroxy-3-methylglutaryl coenzyme A rau mevalonic acid, uas yog ib qho ua ntej ntawm sterols, suav nrog cov roj (cholesterol).
Triglycerides (TG) thiab cov roj (cholesterol) nyob rau hauv cov lus sib xyaw nrog cov lipoproteins tsawg heev (VLDL) thaum ua ke nyob rau hauv daim siab, nkag mus rau cov ntshav ntshav thiab thauj mus rau cov ntaub so ntswg. Tsawg lipoproteins tsawg (LDL) yog tsim los ntawm VLDL thaum muaj kev sib cuam tshuam nrog LDL receptors.
Cov kev tshawb fawb pom tau hais tias nce qhov kev nce siab ntawm tag nrho cov roj hauv plasma, LDL thiab apolipoprotein B (Apo-B) pab txhawb kev txhim kho atherosclerosis thiab yog ntawm cov kev pheej hmoo ntawm cov kab mob plawv, thaum nce qhov kev nce siab ntawm lipoproteins ntau (HDL) txo txoj kev pheej hmoo kev txhim kho cov kab mob plawv.
Atorvastatin txo cov tshuaj cholesterol thiab lipoproteins nyob rau hauv cov ntshav plasma vim tias tsis muaj cov HMG-CoA reductase inhibitor, cov roj (cholesterol) nyob rau hauv daim siab thiab nce ntxiv ntawm cov "mob siab" LDL receptors nyob rau ntawm tes, uas ua rau muaj kev nce siab ntau thiab catabolism ntawm LDL.
Atorvastatin txo qis kev sib txuas thiab kev tswj hwm ntawm LDL roj cholesterol, roj tag nrho, Apo-B nyob rau hauv cov neeg mob homozygous thiab heterozygous tsev neeg hypercholesterolemia, thawj hypercholesterolemia thiab sib xyaw hyperlipidemia.
Nws kuj ua rau muaj kev txo qis hauv cov kev sib txuam ntawm cov cholesterol-VLDL thiab TG thiab kev nce siab ntawm cov roj-HDL thiab apolipoprotein A (Apo-A).
Hauv cov neeg mob uas mob dysbetalipoproteinemia, qhov concentration ntawm lipoproteins ntawm ib nrab ntawm cov roj uas txhaws taus-LBP tsawg dua.
Atorvastatin nyob rau hauv koob tshuaj 40 mg txo qhov kev xav ntawm tag nrho cov roj (cholesterol) los ntawm 37%, LDL - los ntawm 50%, Apo-B - los ntawm 42% thiab TG - los ntawm 29%, ua rau muaj kev nce hauv ntau ntawm cov roj HDL roj cholesterol thiab Apo-A.
Koob-dependently txo qhov concentration ntawm LDL hauv cov neeg mob homozygous tsev neeg hypercholesterolemia, tiv taus kev kho mob nrog lwm cov lipid-txo tshuaj.
Nws tsis muaj carcinogenic thiab mutagenic teebmeem.
Kev kho mob nyhuv ntev li 2 lub lis piam tom qab pib kho, mus txog qhov siab kawg tom qab 4 lub lis piam thiab kav ntev hauv lub sijhawm kho.
Cov Tshuaj Pharmacokinetics
Kev nqus thiab faib khoom. Kev tshem tawm yog qhov siab. Qhov siab tshaj plaws hauv plasma (Cmax) tom qab kev tswj hwm ntawm qhov ncauj tau tiav tom qab 1 - 2 teev. Сmax nyob rau hauv cov poj niam yog 20% ​​siab dua, thaj chaw nyob hauv qab-concentration curve (AUS) yog 10% qis dua txiv neej, uas tsis muaj qhov tseem ceeb hauv tsev kho mob. Max nyob rau hauv cov neeg mob uas muaj dej cawv ua lub siab (qib B ntawm Kev Ntsuas Me-Pugh) yog 16 zaug, thiab AUS - 11 zaug siab dua li ib txwm.
Noj ib qho me ntsis txo qhov nrawm thiab qib ntawm kev nqus ntawm cov tshuaj (los ntawm 25% thiab 9%, feem), txawm li cas los xij, txo cov roj cholesterol LDL zoo ib yam li tias nrog atorvastatin tsis muaj kev noj haus ua ke.
Tom qab qhov ncauj tswj hwm ntawm atorvastatin nyob rau yav tsaus ntuj, qhov ntshav plasma concentration tsawg dua (Cmax thiab AUC kwv yees li 30%) dua li tom qab tau noj thaum sawv ntxov, txawm li cas los xij, qhov txo qis hauv LDL cov roj cholesterol siab tsis yog nyob ntawm lub sijhawm ntawm hnub uas cov tshuaj noj.
Txoj kab sib txuas ntawm qhov txheeb ze ntawm qhov nqus ntawm qhov nqus thiab qhov tshuaj ntawm cov tshuaj tau qhia tawm.
Bioavailability yog 12%, lub zog ua haujlwm ntawm lub cev txoj sia ntawm qhov kev tiv thaiv kom tsis txhob tiv thaiv HMG-CoA reductase yog li 30%. Tsis tshua muaj kev paub txog kev noj qab haus huv yog vim muaj lub cev presystemic metabolism hauv lub plab zom mov (GIT) thiab thaum lub sijhawm "nkag mus" rau hauv lub siab.
Qhov ntsuas nruab nrab ntawm kev faib tawm yog 381 l, kev sib txuas nrog cov ntshav plasma protein yog 98%.
Qhov kev sib piv ntawm atorvastatin hauv cov ntshav liab / ntshav ntshav yog li 0.25, uas yog, atorvastatin tsis nkag mus rau hauv cov ntshav liab zoo.
Kev ntsuas phoo thiab nthuav tawm. Atorvastatin yog metabolized feem ntau hauv daim siab ua nyob rau hauv kev ua ntawm isoenzymes CYP3A4, CYP3A5 thiab CYP3A7 nrog kev tsim cov tshuaj pharmacologically nquag metabolites (ortho- thiab para-hydroxylated derivatives, beta-oxidation khoom lag luam). Hauv vitro ortho- thiab parahydroxylated metabolites muaj qhov cuam tshuam rau HMG-CoA reductase, piv nrog ntawm atorvastatin. Qhov cuam tshuam ntawm cov tshuaj tawm tsam HMG-CoA reductase yog kwv yees li 70% txiav txim siab los ntawm kev ua si ntawm cov roj ntsha mus rau cov cev nqaij daim tawv, uas cuam tshuam ntev li 20 mus rau 30 teev, vim lawv nyob ntawd.
Tshawb nrhiav tau hauv vitro hais tias lub siab CYP3A4 isoenzyme ua lub luag haujlwm tseem ceeb hauv cov metabolism hauv atorvastatin. Qhov no tau lees paub los ntawm kev nce ntxiv ntawm qhov kev nkag siab ntawm atorvastatin hauv cov ntshav ntshav thaum noj erythromycin, uas tseem yog ib qho inhibitor ntawm isoenzyme no.
Kev Tshawb Fawb hauv vitro kuj qhia tau tias atorvastatin yog qhov ua kom tsis muaj zog ntawm CYP3A4 isoenzyme.
Nws yog tawm los feem ntau los ntawm txoj hnyuv tom qab mob hepatic thiab / lossis metabolism ntxiv extrahepatic (cov tshuaj tsis yauv mus ua enterohepatic recirculation). Ib nrab-lub neej (T1 / 2) yog 14 teev. Tsawg dua 2% ntawm kev noj tshuaj hauv qhov ncauj yog txiav txim siab nyob rau hauv cov zis.
Nws tsis yog tawm thaum lub sij hawm hemodialysis vim kev ua kom nruj rau cov ntshav protein.
Cmax thiab AUC ntawm cov tshuaj hauv cov neeg mob laus (70 xyoo thiab laus dua) yog 40 thiab 30%, feem ntau, ntau dua hauv cov neeg mob hluas, tab sis qhov no tsis muaj qhov tseem ceeb hauv chaw kho mob.
Lub raum khiav tsis zoo ua tsis cuam tshuam qhov concentration ntawm cov tshuaj hauv ntshav ntshav.

Siv thaum cev xeeb tub thiab thaum pub niam mis

Cov tshuaj Tulip ® yog contraindicated thaum cev xeeb tub.
Txij li cov roj (cholesterol) thiab cov tshuaj sib tov los ntawm cov roj (cholesterol) yog qhov tseem ceeb rau kev loj hlob ntawm tus me nyuam hauv plab, qhov kev pheej hmoo ntawm kev txwv tsis pub HMG-CoA reductase ntau dhau cov txiaj ntsig ntawm kev siv tshuaj thaum cev xeeb tub.
Yog tias kuaj pom tias cev xeeb tub thaum kho nrog Tulip ®, nws txoj kev tswj hwm yuav tsum nres sai li sai tau, thiab tus neeg mob yuav tsum ceeb toom rau qhov kev pheej hmoo rau tus menyuam hauv plab.
Cov tshuaj Tulip ® tuaj yeem siv rau cov poj niam muaj hnub nyoog yug me nyuam tsuas yog tias muaj feem ntau ntawm cev xeeb tub muaj tsawg heev, thiab tus neeg mob tau paub txog qhov kev pheej hmoo rau tus me nyuam hauv plab thaum kho.
Cov poj niam ntawm lub hnub nyoog yug me nyuam yuav tsum siv txoj hauv kev muaj txiaj ntsig kom muaj txiaj ntsig thaum kho mob nrog Tulip ®.
Atorvastatin tawm hauv cov kua mis, yog li nws yog contraindicated rau siv thaum pub niam mis, yog tias nws yuav tsum tau siv cov tshuaj Tulip ® thaum lactation, kev pub niam mis yuav tsum tau tsum tsis ua ntxiv.

Tsuas tshuaj thiab tswj hwm

Ua ntej siv cov tshuaj Tulip ®, tus neeg mob yuav tsum pom zoo rau tus qauv hypocholesterolemic noj, uas nws yuav tsum tau ua raws li thoob plaws hauv lub sijhawm kho.
Nws raug nquahu kom siv cov tshuaj Tulip ® sab hauv tsis hais lub sijhawm noj mov.
Qhov koob tshuaj Tulip ® sib txawv ntawm 10 mg txog 80 mg rau ib hnub, thiab raug xaiv los xav txog thawj zaug kev sib xyaw ntawm LDL cov roj cholesterol, lub hom phiaj ntawm txoj kev kho thiab tus kheej cov lus teb rau txoj kev kho.
Rau feem ntau cov neeg mob, qhov kev pib noj tshuaj yog 10 mg ib hnub ib zaug (nws yog siv tau cov tshuaj atorvastatin hauv daim ntawv tshuaj: cov ntsiav tshuaj ntawm 10 thiab 20 mg).
Thaum pib kho thiab / lossis thaum qhov nce ntxiv ntawm koob tshuaj Tulip ®, nws yog ib qhov yuav tsum tau soj ntsuam cov tshuaj tua ntshav lipids hauv cov ntshav ntshav txhua 2 rau 4 asthiv thiab kho qhov tshuaj ntau npaum li cas.
Qhov siab tshaj plaws niaj hnub noj yog 80 mg / hnub.
Thawj (kab mob heterozygous muaj keeb thiab polygenic) hypercholesterolemia (hom IIa) thiab sib xyaw hyperlipidemia (hom IIb)
Thawj koob tshuaj 10 mg ntawm cov tshuaj Tulip ® 1 zaug nyob rau ib hnub (nws yog siv tau cov tshuaj atorvastatin hauv daim ntawv tshuaj: cov ntsiav tshuaj ntawm 10 thiab 20 mg). Yog tias tsim nyog, maj mam nce ntxiv ntawm lub koob tshuaj ntxiv rau 80 mg (2 ntsiav tshuaj ntawm 40 mg) ua tau, nyob ntawm tus neeg mob cov tshuaj tiv thaiv nrog ntu ncua ntev li 2 txog 4 lub lim tiam, txij li cov txiaj ntsig kho tau pom tom qab 2 lub lis piam, thiab cov txiaj ntsig kho siab tshaj plaws tom qab 4 lub lis piam. Nrog kev kho mob ntev, cov nyhuv no mob tsawv. Homozygous muaj keeb tiv thaiv hypercholesterolemia
Cov tshuaj Tulip ® feem ntau siv rau hauv koob tshuaj 80 mg (2 ntsiav tshuaj ntawm 40 mg) ib hnub ib zaug.
Koob tshuaj kho Tulip ® hauv cov neeg mob uas lub raum tsis ua hauj lwm thiab cov neeg laus tsis tas yuav.
Kev Tiv Thaiv Kab Mob Tiv Thaiv Kab Mob
Tulip ® yog siv rau hauv koob tshuaj 10 mg ib hnub ib zaug. Yog tias qhov ua kom zoo ntshav LDL cov ntsiab lus tsis tau ncav cuag, nws tuaj yeem nce qhov ntau ntxiv rau 80 mg rau ib hnub, nyob ntawm tus neeg mob cov tshuaj tiv thaiv nrog ntu li 2 mus rau 4 lub lis piam.
Hauv cov neeg mob uas lub siab tsis ua haujlwm, qhov kev tshem tawm ntawm atorvastatin los ntawm lub cev tau qeeb, yog li ntawd nws raug nquahu kom siv nws nrog kev ceev faj nrog kev saib xyuas tas li ntawm kev ua haujlwm ntawm "mob siab": aspartate aminotransferase (AST) thiab alanine aminotransferase (ALT). Yog tias qhov pom tau nce ntxiv hauv AST lossis ALT kev ua haujlwm los ntawm ntau dua 3 zaug piv nrog kev txwv qis dua ntawm ib txwm muaj (VGN) tseem tshuav, nws raug nquahu kom txo qhov tshuaj lossis tshem tawm cov tshuaj Tulip ®.

Sab sij huam

Raws li Lub Koom Haum Ntiaj Teb Kev Noj Qab Haus Huv (WHO), tsis xav tau cov dej num yog cais raws li lawv cov kev loj hlob raws li hauv qab no: feem ntau (> 1/100, 1/1000, 1/10000, los ntawm lub cev tiv thaiv kab mob
feem ntau: kev fab tshuaj tsis haum
Tsis tshua muaj: anaphylaxis.
Los ntawm nruab nrab thiab ntu ntu paj hlwb
feem ntau: mob taub hau
pheej: kiv taub hau, pw tsaug zog ntxhov siab, suav nrog insomnia thiab "npau suav phem" npau suav, asthenic syndrome, tsis muaj zog, mob caj dab, hypesthesia, tsis hnov ​​qab saj, tsis hnov ​​qab lossis ploj hauv lub cim xeeb,
tsis tshua muaj: peripheral neuropathy.
Los ntawm cov hnyuv
feem ntau: cem quav, pom quav, dyspepsia, xeev siab, raws plab,
pheej: kev mob taub hau, ntuav, txiav quav, mob siab, mob plab, duav,
tsis tshua muaj: cholestatic jaundice (suav nrog ob leeg),
Tsis tshua muaj: daim siab ua hauj lwm.
Los ntawm cov leeg musculoskeletal thiab cov leeg mob sib kis
feem ntau: myalgia, mob caj dab, mob "o" ntawm pob qij txha, mob pob txha, mob nraub qaum, mob leeg,
pheej: leeg mob hauv caj dab, leeg tsis muaj zog,
tsis tshua muaj: myopathy, myositis, rhabdomyolysis, tendinopathy (qee zaum nyuaj los ntawm cov pob txha caj),
tsis paub zaus: tiv thaiv-mediated necrotizing myopathy.
Los ntawm cov kabmob hauv nruab nrog
pheej: tinnitus, qhov muag plooj,
tsis tshua muaj: pom kev pom
Tsis tshua muaj: hnov lus.
Ntawm feem ntawm daim tawv nqaij thiab cov rog rog subcutaneous
pheej: urticaria, tawv nqaij sawv pob thiab khaus, alopecia,
tsis tshua muaj: angioedema, ua pob ua xua pob, polymorphic exudative erythema (suav nrog Stevens-Johnson syndrome), muaj tshuaj lom epidermal necrolysis (Lyell syndrome).
Los ntawm ib sab ntawm cov metabolism
feem ntau: hyperglycemia
pheej: hypoglycemia, qhov hnyav nce.
Los ntawm cov kabmob hemopoietic
pheej: thrombocytopenia.
Los ntawm lub tshuab ua pa
feem ntau: nasopharyngitis, mob caj pas, ntswg.
Kev ntsuas ntsuas
feem ntau: nce kev ua si ntawm ntshiab si creatinine phosphokinase (CPK), kev ua si ntawm "siab" transaminases,
pheej: leukocyturia,
tsis paub zaus: muaj zog concentration ntawm glycosylated hemoglobin.
Lwm yam:
pheej: qaug zog, tsis muaj zog potency, lub raum thib ob tsis ua haujlwm, ua npaws, mob hauv siab, peripheral edema,
Tsis tshua muaj: gynecomastia, mob ntshav qab zib mellitus. Muaj cov ntawv tshaj tawm txawv ntawm kev txhim kho atonic fasciitis (kev sib txuas nrog kev siv ntawm atorvastatin tsis yog qhov tsim tau).
tsis paub zaus: kev nyuaj siab, mob ntsws interstitial (tshwj xeeb nrog kev kho mob ntev), kev sib deev ua haujlwm.

Noj ntau dhau

Tsis muaj ib qho tshuaj tshwj xeeb rau kev kho mob ntawm kev haus luam yeeb dhau.
Nyob rau hauv rooj plaub ntawm overdose, kev mob tshwm sim yuav tsum tau nqa tawm.
Hemodialysis yog qhov tsis muaj txiaj ntsig (vim tias cov tshuaj txuam nrog rau cov ntshav protein).

Kev cuam tshuam nrog lwm yam tshuaj

Txoj kev pheej hmoo ntawm myopathy thaum kho nrog HMG-CoA reductase inhibitors nce ntxiv nrog kev siv ua ke cyclosporine, erythromycin, clarithromycin, immunosuppressive, antifungal tshuaj (azole derivatives) vim tias muaj peev xwm nce ntxiv nyob rau hauv cov concentration ntawm atorvastatin hauv cov ntshav cov ntshav.
Nrog tib lub sijhawm siv nrog HIV protease inhibitors - indinavir, ritonavir - qhov pheej hmoo ntawm kev tsim myopathy nce.
Kev sib cuam tshuam zoo sib xws yog ua tau nrog kev siv tib lub sij hawm ntawm atorvastatin nrog fibrates thiab nicotinic acid hauv lipid tej tshuaj (ntau dua 1 g / hnub).
CYP3A4 Isoenzyme Tus Neeg Txom Nyem
Txij li thaum atorvastatin metabolized siv isoenzyme CYP3A4, kev sib xyaw ua ke ntawm kev siv tshuaj Tulip ® nrog cov tshuaj tiv thaiv ntawm no isoenzyme tuaj yeem ua rau muaj kev nce ntxiv hauv cov concentration ntawm atorvastatin hauv cov ntshav ntshav. Qib kev sib cuam tshuam thiab cuam tshuam ntawm kev nce siab ntawm atorvastatin yog txiav txim siab los ntawm qhov txawv txav ntawm cov nyhuv rau CYP3A4 isoenzyme.
OATP1B1 thauj cov tshuaj tiv thaiv protein
Atorvastatin thiab nws cov metabolites yog cov me me ntawm cov thauj protein OATP1B1.
OATP1B1 inhibitors (piv txwv li, cyclosporine) yuav ua rau kom muaj kev nyab xeeb ntawm atorvastatin. Yog li, kev siv atorvastatin ntawm koob tshuaj 10 mg thiab cyclosporine ntawm koob tshuaj 5.2 mg / kg / hnub ua rau kev nce siab ntawm atorvastatin hauv cov ntshav ntshav los ntawm 7,7 lub sijhawm.
Erythromycin / clarithromycin
Nrog rau kev siv tib txhij ntawm atorvastatin 10 mg thiab erythromycin (500 mg 4 zaug hauv ib hnub) lossis clarithromycin (500 mg 2 zaug hauv ib hnub), uas inhibit isoenzyme ntawm cytochrome CYP3A4, muaj kev nce siab ntawm atorvastatin hauv ntshav ntshav (los ntawm 40% thaum siv nrog erythromycin thiab 56% - thaum siv nrog clarithromycin).
Protease inhibitors
Kev siv tib txhij ntawm atorvastatin nrog protease inhibitors paub tias inhibitors cytochrome CYP3A4 isoenzyme tau nrog los ntawm kev nce siab ntawm atorvastatin nyob rau hauv cov ntshav ntshav (nrog siv ib txhij nrog erythromycin, Cmax ntawm atorvastatin nce 40%).
Diltiazem
Kev siv ua ke ntawm atorvastatin ntawm kev noj tshuaj ntawm 40 mg nrog diltiazem ntawm koob tshuaj ntawm 240 mg ua rau kev nce siab ntawm atorvastatin hauv cov ntshav ntshav.
Cimetidine
Tsis muaj qhov sib cuam tshuam loj ntawm kev sib cuam tshuam ntawm atorvastatin nrog cimetidine raug kuaj pom.
Itraconazole
Siv tib txhij ntawm atorvastatin hauv koob tshuaj ntawm 20 mg txog 40 mg thiab itraconazole ntawm koob tshuaj 200 mg ua rau muaj 3 zaug nce ntxiv hauv AUC ntawm atorvastatin.
Cov txiv kab ntxwv qaub
Txij li cov kua txiv kab ntxwv qaub muaj ib lossis ntau qhov cuam tshuam uas txwv CYP3A4 isoenzyme, nws cov kev noj ntau dhau (ntau tshaj li 1.2 liv ib hnub rau 5 hnub) tuaj yeem ua rau muaj plasma ntau ntau ntawm atorvastatin.
CYP3A4 Isoenzyme Inductors
Kev siv ua ke ntawm atorvastatin nrog inducers ntawm isoenzyme CYP3A4 (piv txwv li, efavirenz lossis rifampicin) tuaj yeem ua rau txo qis ntawm cov tshuaj atorvastatin hauv ntshav ntshav. Vim yog lub tshuab ob ntawm kev sib cuam tshuam nrog rifampicin (inducer ntawm CYP3A4 isoenzyme thiab hepatocyte thauj protein inhibitor OATP1B1), tib lub sijhawm siv atorvastatin thiab rifampicin tsis pom zoo, txij li kev ncua sijhawm ntawm atorvastatin tom qab rifampicin ua rau muaj kev txo qis hauv cov ntshav ntawm atorvastatin hauv ntshav plasma.
Tshuaj Antacids
Nrog kev siv atorvastatin thiab kev ncua kev kawm uas muaj cov magnesium thiab aluminium hydroxides sab hauv, cov tshuaj atorvastatin hauv cov ntshav txo qis li ntawm 35%, txawm li cas los xij, cov neeg kawm ntawv qib qis hauv kev mloog ntawm LDL cov roj cholesterol tsis hloov.
Phenazone
Atorvastatin tsis cuam tshuam rau lub pharmacokinetics ntawm phenazone, yog li ntawd, kev cuam tshuam nrog lwm cov tshuaj metabolized los ntawm tib lub isoenzymes tsis xav.
Kauj ruam
Cov lipid-txo cov nyhuv ntawm kev sib xyaw nrog colestipol yog qhov zoo dua rau qhov tshuaj rau txhua qhov sib cais, txawm hais tias 25% txo qis ntawm cov tshuaj atorvastatin thaum siv concomitantly nrog colestipol.
Fusidic acid
Cov kev tshawb fawb txog kev cuam tshuam ntawm atorvastatin thiab fusidic acid tsis tau ua. Ib yam li lwm yam statins, kev tshawb fawb tom qab muag ntawm kev siv cov tshuaj sib txuas ntawm atorvastatin thiab fusidic acid tau tshaj tawm cov kev mob tshwm sim rau cov leeg, nrog rau rhabdomyolysis. Tus txheej txheem ntawm kev sib cuam tshuam tsis paub txog. Cov neeg mob zoo li no yuav tsum tau saib xyuas kom zoo thiab, tej zaum, kev txiav tsis siv tshuaj ib ntus ntawm atorvastatin.
Colchicine
Txawm hais tias kev tshawb fawb ntawm kev sib cuam tshuam ntawm atorvastatin thiab colchicine tsis tau ua, tus neeg ntawm myopathy tau qhia thaum siv ua ke nrog colchicine, thiab kev ceev faj yuav tsum siv thaum lub sijhawm kho atorvastatin thiab colchicine.
Digoxin
Nrog kev rov qab siv digoxin thiab atorvastatin ntawm koob tshuaj 10 mg, qhov sib npaug ntawm cov digoxin hauv cov ntshav ntshav tsis hloov. Txawm li cas los xij, thaum siv digoxin ua ke nrog atorvastatin ntawm ib koob ntawm 80 mg / hnub. cov concentration ntawm digoxin hauv ntshav ntshav nce ntxiv txog 20%. Cov neeg mob noj digoxin txuam nrog atorvastatin xav tau kev saib xyuas ntawm cov concentration ntawm digoxin hauv cov ntshav ntshav.
Azithromycin
Nrog rau kev siv atorvastatin tib lub sijhawm ntawm 10 mg 1 zaug / hnub thiab azithromycin ntawm koob tshuaj 500 mg 1 zaug / hnub, kev siv tshuaj atorvastatin hauv cov ntshav ntshav tsis hloov.
Qhov ncauj txwv tsis pub muaj
Nrog rau kev siv atorvastatin thiab kev noj tshuaj ntau qhov ncauj muaj norethisterone thiab ethinyl estradiol, muaj qhov nce ntxiv ntawm AUC ntawm norethisterone thiab ethinyl estradiol txog li 30% thiab 20%, feem, uas yuav tsum tau txiav txim siab thaum xaiv qhov ncauj tiv thaiv.
Terfenadine
Atorvastatin nrog kev siv cov tshuaj concomitant nrog terfenadine tsis muaj kev cuam tshuam loj hauv kev kho mob ntawm pharmacokinetics ntawm terfenadine.
Warfarin
Hauv cov neeg mob uas siv tshuaj warfarin ntev ntev, atorvastatin ntawm 80 koob tshuaj rau ib hnub ib zaug luv dua lub sijhawm prothrombin hauv thawj hnub ntawm kev sib koom siv. Cov nyhuv no ploj mus tom qab 15 hnub ntawm kev siv cov tshuaj no ib txhij. Txawm hais tias cov xwm txheej ntawm cov neeg mob hloov pauv ntawm cov nyhuv anticoagulant tau tshaj tawm tsawg, lub sijhawm prothrombin yuav tsum tau txiav txim siab hauv cov neeg mob noj coumarin anticoagulants ua ntej thiab feem ntau txaus thaum pib kho nrog atorvastatin kom ntseeg tau tias tsis muaj kev hloov pauv ntau ntawm prothrombin lub sijhawm. Thaum lub sijhawm ruaj khov prothrombin lub sijhawm tau sau tseg, nws tuaj yeem kuaj xyuas ntawm cov sijhawm sib xws rau cov neeg mob noj coumarin anticoagulants. Yog tias koj hloov qhov koob tshuaj lossis tso tseg kev kho mob, cov kev ntsuas no yuav tsum tau ua dua. Tsis muaj kev cuam tshuam los ntawm kev siv cov tshuaj atorvastatin thiab los ntshav lossis hloov pauv lub sijhawm prothrombin hauv cov neeg mob tsis noj tshuaj anticoagulants.
Amlodipine
Nrog rau kev siv atorvastatin tib lub sij hawm ntawm 80 mg thiab amlodipine ntawm koob tshuaj 10 mg, pharmacokinetics ntawm atorvastatin hauv kev sib npaug tsis hloov.
Lwm yam tshuaj lipid-txo qis
Nrog rau kev siv atorvastatin nrog rau lwm cov tshuaj hypolipidemic (piv txwv li ezetimibe, gemfibrozil, ib qho kev sib txuas ntawm cov fibroic acid) hauv kev txo qis dua cov tshuaj, qhov kev pheej hmoo ntawm kev txhim kho rhabdomyolysis nce.
Lwm txoj kev kho kom zoo
Nrog rau kev siv ua ke ntawm atorvastatin nrog cov tshuaj tiv thaiv kabmob thiab estrogens (raws li kev hloov kho), tsis muaj kev cuam tshuam loj hauv qhov chaw kuaj mob tau pom.

Pharmacological kev txiav txim ntawm Tulip

Raws li cov lus qhia rau Tulip, cov tshuaj ua kom nquag plias ntawm cov tshuaj yog atorvastatin. Cov kev zam uas ua rau cov ntsiav tshuaj yog magnesium stearate, colloidal silicon dioxide, hnyav magnesium oxide, croscarmellose sodium, polysorbate 80, hydroxypropyl cellulose, lactose monohydrate, microcrystalline cellulose.

Tulip yog qhov xaiv sib tw inhibitor ntawm HMG-CoA reductase thiab ib qho enzyme uas tau koom nrog kev hloov pauv ntawm 3-hydroxy-3-methylglutaryl coenzyme A rau mevalonate, uas yog tus ua ntej ntawm steroids.

Cov nyhuv ntawm cov tshuaj yog tswj qhov txo qhov tseem ceeb:

• hluavtaws thiab cov ntsiab lus ntawm cov roj (cholesterol) tag nrho,
• tus nqi thiab hluavtaws LDL hais txog hauv cov ntshav,
• theem ntawm TG thiab apolipoprotein B,
• kev pheej hmoo ntawm kev tsim muaj teeb meem hauv cov kab mob plawv.

Tulip pab txhawb rau qhov ib txwm ua dhau los ntawm theem ntawm HDL hais thiab apolipoprotein A.

Cov tshuaj txo qis LDL ntau ntau hauv cov neeg muaj kab mob siab homozygous hypercholesterolemia uas tiv taus lwm cov lipid-txo cov tshuaj.

Thaum muab tshuaj, Tulip ua tau zoo thiab nqus tau sai. Qhov siab tshaj plaws hauv plasma mus txog tom qab 2 teev. Nws muaj bioavailability tsawg thiab muaj feem cuam tshuam nrog cov ntshav protein. Nws yog metabolized hauv daim siab nrog kev tsim ntawm ob peb lub tshuaj pharmacologically nquag metabolites. Lub sijhawm lub sijhawm ua tiav kev tshem tawm cov tshuaj tawm ntawm lub cev yog 28 teev. Nws tawm dhau los ntawm txoj hnyuv.

Kev noj tshuaj thiab kev tswj hwm ntawm tulip

Ua ntej pib txoj kev kho, tus neeg mob yuav tsum pauv mus rau qhov khoom noj muaj cov roj cholesterol tsawg. Tulip tau noj qhov ncauj 1 zaug nyob rau ib hnub, tsis hais txog ntawm kev noj zaub mov.

Kev noj tshuaj ntau npaum li cas yog xaiv los ntawm cov kws kho mob koom nrog ib tus zuj zus rau txhua tus neeg mob, nyob ntawm lub hom phiaj ntawm kev kho thiab theem ntawm LDL-C. Raws li txoj cai, koob tshuaj Tulip sib txawv ntawm 10 txog 80 mg. Dosage kev kho kom haum yog nqa tawm 1 zaug hauv 4 lub lis piam.

Cov Tshuaj Pharmacokinetics

Qhov nqus ntawm cov tshuaj muaj siab. Qhov siab tshaj plaws hauv cov ntshav ntshav tau tuaj yeem sau tseg 1-2 teev tom qab noj tshuaj. Yog tias koj siv cov tshuaj nyob rau yav tsaus ntuj, nws cov concentration hauv cov ntshav yuav qis dua piv rau cov uas tau teev cia hauv cov ntshav ntshav tom qab noj thaum sawv ntxov.

Bioavailable ntawm 12-14%. Kev zam yog los ntawm txoj hnyuv, tsawg dua 2% ntawm cov tshuaj yog tsau hauv cov zis.

Nrog saib xyuas

Hauv qee kis, kev teem caij yuav tsum ua nrog ceev faj. Nov yog lub xub ntiag ntawm cov xwm txheej hauv qab no:

• electrolyte tsis txaus,
• cov kab mob rau cov leeg
• mob ntshav qab zib mellitus
• endocrine thiab metabolic ntshawv siab,
• qaug dab peg
• arterial hypotension,
• sepsis
• keeb kwm ntawm hemorrhagic mob stroke.

Tulip siv nrog ceev faj hauv kev mob hlwb.
Cov tshuaj yog tshuaj nrog ceev faj nyob rau hauv ntshav qab zib.
Cov tshuaj yog tshuaj nrog ceev faj hauv cov neeg mob uas muaj keeb kwm ntawm mob ntshav qab zib.

Yuav ua li cas coj tulip?

Ua ntej pib txoj kev kho mob, koj yuav tsum muab cov lus qhia rau tus neeg mob tias yuav ua raws li cov khoom noj uas yog tswj cov ntshav cov roj cholesterol. Txhua tus neeg mob yuav tsum kawm cov lus qhia rau kev siv.

Cov tshuaj yuav tau xaiv li cas nyob ntawm cov kev tswj cov cholesterol hauv cov ntshav, lub hnub nyoog ntawm tus neeg mob thiab kev tsis saib xyuas tus kab mob li cas.

Koj yuav tsum nqa cov ntsiav tshuaj sab hauv, kev noj mov tsis cuam tshuam rau qhov ua tau zoo ntawm lawv kev nqus.

Kev noj tshuaj ntxiv tuaj yeem muaj txij 10 txog 80 mg rau ib hnub. Thawj qhov tshuaj yog 10 mg. Tom qab 2-4 lub lim tiam ntawm txoj kev kho, tus kws kho mob soj ntsuam cov ntsiab lus ntawm lipids hauv cov neeg mob cov ntshav. Qhov no yuav ua kom tiav los txiav txim siab ntau npaum li cas ntawm cov tshuaj.

Koj yuav tsum nqa cov ntsiav tshuaj sab hauv, kev noj mov tsis cuam tshuam rau qhov ua tau zoo ntawm lawv kev nqus.

Txhawm rau tiv thaiv qhov tshwm sim ntawm kab mob plawv, ntau npaum ntawm 10 mg rau ib hnub yog siv. Hauv kev kho mob homozygous kab mob siab mob hypercholesterolemia, nws yog qhia tias yuav tsum noj 2 ntsiav tshuaj ntawm 40 mg ib hnub twg, i.e. qhov no yog qhov ntau npaum li 80 mg.

Lub plab zom mov

Cov tsos mob tshwm sim feem ntau yog xeev siab, ntuav thiab raws plab, flatulence thiab cem quav. Muaj cov cim qhia tau tsawg dua yog ntuav, mob caj dab, ua paug thiab mob plab.

Cov tsos mob feem ntau tom qab noj cov ntsiav tshuaj yog xam tias yog xeev siab, ntuav.
Thaum siv cov tshuaj, koj tuaj yeem ntsib cov kev mob tsis zoo xws li mob hauv plab.
Qhov pom tshwm sim ntau tshaj plaws tom qab siv cov ntsiav tshuaj yuav tsum raug suav hais tias yog mob taub hau.

Los ntawm lub tshuab ua pa

Tej zaum qhov kev txhim kho nasopharyngitis, qhov tshwm sim los ntshav los ntawm lub qhov ntswg thiab mob hauv caj pas.

Tsis tas li, tus neeg mob tuaj yeem cuam tshuam los ntawm qhov muag pom kev tsis pom kev thiab tsis pom kev.
Los ntawm txoj kev ua pa, los ntshav tawm ntawm lub qhov ntswg yog tau.
Tom qab siv cov tshuaj, tus neeg mob tuaj yeem mob urticaria thiab tawm pob.

Cawv tau zoo

Tsis txhob haus dej cawv thaum kho nrog cov tshuaj.

Yuav muab cov tshuaj coj los noj thaum cev xeeb tub tsis tau.
Tsis txhob haus dej cawv thaum kho nrog cov tshuaj.
Thaum lub sijhawm kho mob nrog tshuaj kho mob, nce ceev faj yuav tsum xyaum thaum tsav tsheb.
Txij li thaum cov tshuaj nquag kis mus rau niam mis, koj yuav tsum tsis txhob pub niam mis rau menyuam noj thaum kho.

Siv thaum cev xeeb tub thiab lactation

Yuav muab cov tshuaj coj los noj thaum cev xeeb tub tsis tau. Yog tias tus poj niam cev xeeb tub thaum lub sijhawm kho, nws yog ib qho tsim nyog yuav tau qhia rau tus kws kho mob txog qhov no kom sai li sai tau thiab nres kev kho mob nrog cov tshuaj. Txij li thaum cov tshuaj nquag kis mus rau niam mis, koj yuav tsum tsis txhob pub niam mis rau menyuam noj thaum kho.

Siv rau lub sijhawm qub

Kev hloov kho ntawm cov koob pom zoo tsis tsim nyog.

Txij li cov txiaj ntsig zoo thiab kev nyab xeeb rau kev siv tshuaj rau cov menyuam yaus hnub nyoog qis dua 18 xyoo tsis tau tsim, kev noj tshuaj hauv cov hnub nyoog tsis pom zoo.

Kuv puas yuav tau yam tsis muaj daim ntawv yuav tshuaj?

Nws yog tsis yooj yim sua los yuav ib cov tshuaj uas tsis muaj tshuaj.

Koj tuaj yeem yuav cov tshuaj hauv txhua lub tsev muag tshuaj hauv Lavxias.
Koj tuaj yeem hloov cov tshuaj ntawm cov tshuaj xws li Atoris.Torvacard yog cov tshuaj zoo sib xws.
Khaws cov tshuaj nyob ntawm chav sov.
Tus nqi ntawm cov khoom pib los ntawm 300 rubles.

Tus nqi ntawm cov khoom pib los ntawm 300 rubles.

Tulip tshuaj xyuas

Kev txheeb xyuas cov cuab yeej muaj feem ntau zoo.

A.Zh. Delikhina, tus kws tshaj lij, Ryazan: "Lub cuab yeej tso cai rau koj kom ua tiav cov txiaj ntsig zoo hauv kev tawm tsam cov rog hauv cov ntshav hauv cov neeg mob."

E.E. Abanina, Tus Kws Kho Mob Endocrinologist, Tso Cai: “Cov tshuaj yuav raug kho rau kev kho mob sab nraud. Ntxiv mus, tus neeg mob cov ntshav tau saib xyuas los ntawm kws kho mob txhua lub sijhawm. "

Torvacard: analogues, tshuaj xyuas, cov lus qhia rau kev siv Atorvastatin.

Karina, 45 xyoo, Omsk: “Cov cuab yeej pab daws teeb meem ntawm cov hlab plawv. Kuv ua tsaug rau cov kws kho mob tau sau cov tshuaj no. Tus nqi yog qhov qub. "

Ivan, 30 xyoo, Adler: “Cov tshuaj yuav pab tau zoo yog tias muaj cov tshuaj lom cholesterol ntau nyob hauv cov ntshav. Qhov teeb meem no feem ntau tshwm sim vim kev noj haus tsis zoo uas muaj cov khoom kib ntau. Thiab yog li nws tau tshwm sim. Kuv yuav tsum tau mus ntsib kws kho mob, dhau qhov kev kuaj mob uas yuav tsum tau ua thiab tau txais kev kho mob nrog cov tshuaj. ”

Cov Tshuaj Hauv Tshuaj

Cov tshuaj tiv thaiv nyob rau hauv cov tshuaj yog atorvastatin, uas yog cov tshuaj tiv thaiv rau HMG-CoA reductase lwg me me. Reductase yog lub luag haujlwm rau kev sib txuas ntawm mevalonic acid, uas yog ib feem ntawm sterols thiab hauv cov roj (molecule) roj.

Cov roj ntsha ntawm cov roj (cholesterol) thiab cov roj triglyceride yog ib feem ntawm cov roj ntsha ntawm lipoproteins uas muaj cov tshuaj lwg me me, uas tau sib koom ua ke thaum lub sijhawm lawv coj los ua ke hauv lub siab ua haujlwm.

Thaum VLDLP lwg me me ua ke nrog LDL receptors, triglycerides tshem tawm los ntawm cov lipoprotein tsawg cov molecular phaus thiab lipoproteins tsawg cov molecular tsim.

Molecules nkag mus rau hauv cov ntshav thiab nqa tawm los ntawm cov hlab ntshav mus rau txhua qhov chaw ntawm lub cev.

Lwm lub npe ntawm Tulip

Nrog rau qhov kev nce ntxiv hauv cov concentration hauv cov ntshav ntshav ntawm cov roj (cholesterol) tag nrho, nrog rau nws cov roj tsawg lub cev thiab apoliprotein B lwg me me, muaj qhov pheej hmoo ntawm kev tsim cov kab mob ntawm cov kab mob atherosclerosis.

Tsis tas li ntawd, qhov nce ntawm cov feem tsawg ntawm cov lipoproteins molecular hnyav ua rau muaj kev pheej hmoo ntawm kev txhim kho cov kab mob ntawm lub plawv thiab cov ntshav txaus, thiab nce ntxiv hauv lipoproteins molecular hnyav txo cov kev pheej hmoo ntawm cov pathologies.

Cov nquag ua haujlwm ntawm atorvastatin ua rau cov kua roj kua roj (cholesterol) hauv cov ntshav tsawg zuj zus, los ntawm qhov nce ntawm LDL receptors uas ua rau kom cov catabolism ntawm cov roj uas tsis tshua muaj ceeb thawj hauv lub cev, txo nws.

Qhov nquag tivthaiv ntawm atorvastatin qhia tau hais tias muaj kev cuam tshuam zoo rau tshuaj nyob rau hauv kev kho mob ntawm:

• Homozygous muaj keeb tiv thaiv hypercholesterolemia,
• Heterozygous caj tsev neeg hypercholesterolemia,
• Thawj pathology ntawm hypercholesterolemia,
• Mixed pathology ntawm hyperlipidemia.

Noj Tulip nce qhov kev kub siab ntawm cov lipoproteins molecular phaus ntau, nrog rau apoliprotein A1 lwg me me hauv cov ntshav.

Tulip cov tshuaj noj nrog qhov ntau ntawm 120.0 milligrams thiab 20.0 milligrams txo qis qhov kev xav hauv cov ntshav:

• Cov roj (cholesterol) tag nrho cov ntsiab lus ntsuas ntawm — 29,0% — 33,0%,
• LDL lwg me rau — 39,0% — 43,0%,
• APO B lwg me me — 32,0% — 35,0%,
• Triglycerides rau — 14,0% — 26,0%.

Kev cuam tshuam nrog lwm yam tshuaj

• Antacid tshuaj txo qis cov kev coj ua ntawm tulip hauv cov ntshav qis los ntawm 35.0%,
• Thaum noj nrog digoxin, muaj kev pheej hmoo ntawm kev txhim kho cov kab mob ntawm lub plawv thiab cov ntshav tsis txaus hauv cov ntshav ncig,
• Cov tshuaj tua kab mob ntawm pawg erythromycin thiab clarithromycin, nce ntxiv ntshav plasma concentration ntawm cov tshuaj Tulip,
• Kev sib koom tes ntawm kev hloov tshuaj hormone hloov kho thiab tulip raug tso cai.

Xaus

Koj tuaj yeem kho tsuas yog siv cov tshuaj statins raws li kws kho mob tau sau tseg thiab tsis txhob hnov ​​qab tias yuav txo qis cov roj cholesterol koj yuav tsum tau siv cov khoom noj kom zoo thiab ua lub neej noj qab haus huv. Tsuas yog nyob rau hauv kev sib txuam ua ke tuaj yeem txo qis hauv cov roj cholesterol ua tiav thiab kev txhim kho ntawm atherosclerosis tiv thaiv.

Thaum siv Tulip ua kev tiv thaiv lwm yam, kev pheej hmoo ntawm lub plawv nres thiab tuag los ntawm lub hlwb thiab lub plawv nres yuav txo qis.

Oksana, 39 xyoo: Kuv tau txiav txim siab Tulip thaum kuv cov roj (cholesterol) yog 7.3 mmol ib liter, tab sis muaj ntau yam phiv nyob hauv cov txaj. Kuv tau noj cov tshuaj no rau 4 lub hlis. Kuv cov roj hauv av rov qab zoo li qub, tsuas yog kuv txoj kev noj qab haus huv tsis tau zoo dua.

George, 58 xyoo: Kuv tau mob ntshav siab rau 14 xyoo. Kuv coj tshuaj sib txawv ntawm cov tshuaj statins thiab fibrates.

Kuv muaj ntshav qab zib, yog li cov roj khov kho tas li. Raws li atorvastatin, Kuv tau noj Tulip tau 2 xyoos.

Lipid suav tsis zoo li qub thiab kuv kev noj qab haus huv zoo heev. Nov yog thawj qho tshuaj uas tsis ua rau muaj kev tsis haum nyob hauv kuv lub cev.