Liprimar 10 mg - cov lus qhia rau kev siv

Dosage daim ntawv ntawm Liprimar - ntsiav tshuaj: elliptical, coated nrog zaj duab xis daim nyias nyias ntawm cov xim dawb, thaum tawg - ib qho tseem ceeb ntawm cov xim dawb:

• Nrog txua “10” ntawm ib sab thiab PD “155” ntawm ib sab (10 pcs. Hauv cov hlwv, hauv pob ntawv muaj 3 los yog 10 blisters),
• Nrog kev txua "20" rau ntawm ib sab thiab PD "156" ntawm lwm qhov (10 pcs. Hauv cov hlwv, hauv daim npav ntawm pob los ntawm 3 lossis 10 hlwv),
• Nrog txua “40” ntawm ib sab thiab PD “157” ntawm ib sab (10 pcs. Hauv cov hlwv, 3 lub hlwv hauv ib lub thawv ntawv)
• Nrog txua "80" ntawm ib sab thiab PD "158" ntawm ib sab (10 pcs. Hauv cov hlwv, hauv ib daim ntawv qhwv cardboard 3 blisters).

Txhua cov ntsiav tshuaj muaj:

• Cov khoom xyaw nquag: atorvastatin (hauv daim ntawv ntawm calcium ntsev) - 10, 20, 40 lossis 80 mg,
• Ntu cov khoom siv: croscarmellose sodium, magnesium stearate, lactose monohydrate, microcrystalline cellulose, calcium carbonate, hyprolose, polysorbate,
• Cov sib xyaw ua ke ntawm cov zaj duab xis txheej: opadry dawb YS-1-7040 (tswm ciab tswm ciab, titanium dioxide, polyethylene glycol, talc, hypromellose, simethicone emulsion (stearic emulsifier, sorbic acid, simethicone, dej)).

Kev ntsuas rau siv

Kev kho mob ntawm cov kab mob hauv qab no:

• Thawj hypercholesterolemia (heterozygous tsev neeg thiab tsis-tsev neeg hypercholesterolemia (hom IIa raws li kev faib tawm ntawm Fredrickson),
• Familial endogenous hypertriglyceridemia (hom IV raws li kev faib tawm ntawm Fredrickson), tiv taus kev noj haus,
• Dysbetalipoproteinemia (hom III raws li kev faib tawm ntawm Fredrickson) (ntxiv rau kev noj haus),
• Ua ke hyperlipidemia (IIa thiab IIb hom raws li kev faib tawm ntawm Fredrickson),
• Homozygous tsev neeg hypercholesterolemia (cov tshuaj yog siv thaum tsis muaj txiaj ntsig ntawm tsis-ntawm pharmacological txoj kev kho mob, suav nrog kev kho kev noj zaub mov noj).

Liprimar kuj tseem raug kho rau lub hom phiaj tiv thaiv:

• Kev tiv thaiv kab mob plawv hauv cov neeg mob tsis muaj kev soj ntsuam cov kab mob plawv, tab sis nrog ntau yam kev pheej hmoo ua rau nws txoj kev loj hlob: hnub nyoog tshaj 55 xyoos, kev haus luam yeeb, ntshav qab zib mellitus, mob ntshav siab, caj ces tsis txaus, tsis tshua muaj siab ntawm lipoprotein cov roj ntshav siab (HDL-C) hauv ntshav,
• Kev tiv thaiv kab mob thib ob hauv kev mob plawv hauv cov neeg mob mob plawv lub plawv txhawm rau txhawm rau txo qis kev pheej hmoo ntawm angina pectoris, mob stroke, myocardial infarction, kev tuag, nrog rau qhov xav tau kom rov qab ua kab mob hauv lub plawv.

Cov Yuav Tsum Muaj

• Mob lub siab ua haujlwm lossis muaj kev ua haujlwm ntau ntawm hepatic transaminases ntawm cov tsis paub keeb kwm (ntau dua 3 zaug piv nrog uas nyob rau hauv kev ua haujlwm ntawm lub qog nqaij hlav adrenal)
• Tsis txog 18 xyoo
• Cev xeeb tub
• Lactation (lossis pub mis yuav tsum tsis ua mus ntxiv),
• Hypersensitivity rau lub Cheebtsam ntawm cov tshuaj.

Tus txheeb ze (xav tau kev saib xyuas ntxiv):

• Keeb kwm ntawm kab mob siab,
• Cawv kev quav cawv.

Tsuas tshuaj thiab tswj hwm

Ua ntej pib Liprimar, nws yog ib qho tsim nyog los ua kom tau txais kev tswj hwm ntawm hypercholesterolemia nrog kev pab ntawm kev noj zaub mov noj, ua si lub cev thiab poob phaus hauv cov neeg mob rog, nrog rau kev kho mob los ntawm tus kab mob hauv qab.

Cov tshuaj yuav tsum tau noj qhov ncauj 1 zaug nyob rau ib hnub nyob rau txhua lub sijhawm thaum nruab hnub, tsis hais noj zaub mov.

Qhov koob tshuaj txhua hnub tuaj yeem txawv ntawm 10 txog 80 mg. Tus kws kho mob xaiv cov koob tshuaj noj rau hauv cov lus cim, cov ntsiab lus thaum pib ntawm cov roj lipoprotein tsawg (LDL-C) thiab kev kho mob ntawm Liprimar.

Nyob rau hauv thawj hypercholesterolemia thiab sib xyaw hyperlipidemia, ib koob tshuaj txhua hnub txaus rau cov neeg mob feem ntau yog 10 mg. Kev kho mob nyhuv yog manifested li 2 asthiv, nce mus txog qhov siab kawg tom qab kwv yees li 4 lub lis piam.

Nrog homozygous tsev neeg hypercholesterolemia, cov tshuaj feem ntau yog tshuaj hauv ib hnub 80 mg.

Cov neeg mob uas muaj daim siab tsis txaus yuav tsum txo qhov koob tshuaj Liprimar nyob rau hauv kev soj ntsuam tas li ntawm kev ua haujlwm ntawm alanine aminotransferase (ALT) thiab aspartate aminotransferase (AST).

Tus neeg mob yuav tsum ua raws li tus qauv hypocholesterolemic noj haus pom zoo los ntawm kws kho mob thoob plaws lub sijhawm kho.

Txhua 2-4 lub lis piam thaum pib kho thiab nrog txhua qhov nce ntxiv, nws yog ib qho tsim nyog los tswj cov ntsiab lus ntawm lipids hauv cov ntshav thiab, yog tias tsim nyog, kho qhov koob tshuaj.

Yog tias kev sib xyaw ua ke nrog cyclosporine yog qhov tsim nyog, koob tshuaj Liprimar yuav tsum tsis pub tshaj 10 mg.

Sab sij huam

Yeej, cov tshuaj zoo tiv thaiv. Cov kev mob tshwm sim, yog tias lawv tshwm sim, feem ntau muaj qhov hnyav me ntsis thiab qhov ua cim pauv.

Cov tshwm sim tsis zoo:

• Nruab nrab hauv lub paj hlwb: feem ntau (≥1%) - mob taub hau, pw tsaug zog, asthenic syndrome, tsis tshua muaj (%1%) - kiv taub hau, hypesthesia, paresthesia, malaise, peripheral neuropathy, amnesia,
• Lub plab zom mov: feem ntau - mob plab, pom pob, mob plab, xeev siab, raws plab, cem quav, tsis tshua muaj - ntuav, cholestatic jaundice, pancreatitis, mob siab, mob ntshav qab zib, tsis nco qab,
• Musculoskeletal system: feem ntau - myalgia, tsis tshua muaj - myositis, mob leeg, myopathy, rhabdomyolysis, mob rov qab, mob pob txha,
• Hematopoietic system: tsis tshua muaj - thrombocytopenia,
• Kev tiv thaiv kab mob: tsis tshua muaj - hyperglycemia, hypoglycemia, ntau ntau ntawm cov ntshiab si creatine phosphokinase,
• Ua xua: tsis tshua muaj - khaus, tawm pob ntawm daim tawv nqaij, urticaria, ua pob liab vog, lom ua kom muaj mob, ua rau mob ntau yam, ua kom tsis nco qab,
• Lwm yam: tsis tshua muaj - mob hauv siab, tsis muaj zog, mob nkees, ua kom hnyav, tinnitus, alopecia, mob raum tsis ua haujlwm, mob pob txha txha.

Cov lus qhia tshwj xeeb

Zoo li lwm yam tshuaj lipid-txo cov tshuaj ntawm tib chav, Liprimar tuaj yeem cuam tshuam cov kev ua ntawm daim siab enzymes. Vim li no, ua ntej nws teem caij, tom qab 6 thiab 12 lub lis piam tom qab pib siv, txhua koob nce, raws li lub sijhawm ib txwm nyob rau hauv kev kho mob, nws yog qhov yuav tsum tau soj ntsuam daim siab ua haujlwm tsis zoo. Ib txoj kev kawm ntawm daim siab kev ua haujlwm kuj tseem ceeb thaum muaj kev kho mob cov cim ntawm nws qhov kev puas tsuaj. Yog tias qhov nce hauv ALT lossis AST kev ua haujlwm los ntawm ntau dua 3 zaug tseem piv nrog rau tib qho ntsuas rau kev tiv thaiv qog nqaij hlav adrenal, qhov koob tshuaj yuav tsum raug txo lossis cov tshuaj yuav tsum tau txiav tawm.

Muaj cov ntaub ntawv qhia txog qee tus neeg mob rhabdomyolysis uas tsis tshua muaj mob, nrog rau kev mob raum tsis ua haujlwm vim yog myoglobinuria, hauv cov neeg mob noj Liprimar. Vim li no, yog tias muaj kev pheej hmoo rau lub raum tsis ua haujlwm vim rhabdomyolysis (xws li mob hnyav, mob, mob phais, phais ntshav qis, endocrine, electrolyte thiab metabolic ntshawv siab, tswj tsis tau tus mob) lossis yog cov tsos mob tshwm sim uas tuaj yeem siv rau kev xoom xaim myopathy, Liprimar yuav tsum nyob ib ntus lossis txiav txim siab tag nrho.

Txhua tus neeg mob yuav tsum tau ceeb toom tias lawv yuav tsum tau sab laj nrog kws kho mob sai li sai tau yog tias lub cev tsis muaj zog lossis tsis hnov ​​mob nqaij mob, tshwj xeeb yog tias lawv nrog tus neeg mob ua npaws thiab / lossis malaise.

Cov poj niam ntawm lub hnub nyoog yug me nyuam tuaj yeem yog kws kho Liprimar tsuas yog tias qhov tshwm sim ntawm cev xeeb tub muaj tsawg heev, thiab cov neeg mob lawv tus kheej tau qhia txog cov kev pheej hmoo txaus ntshai. Tag nrho lub sijhawm kho yuav tsum siv txoj kev ua kom muaj txiaj ntsig zoo.

Cov ntaub ntawv hais txog cov nyhuv ntawm atorvastatin rau ntawm tus nqi ntawm cov tshuaj tiv thaiv thiab kev xav tau yog tsis muaj.

Yeeb tshuaj sib cuam tshuam

Nrog tib lub sijhawm siv cov fibrates, cyclosporins, nicotinic acid nyob rau hauv cov tshuaj tiv thaiv hypolipidemic, clarithromycin, erythromycin thiab antifungal tus neeg sawv cev uas yog derivatives ntawm azole, qhov kev pheej hmoo ntawm kev tsim myopathy nce.

Atorvastatin yog metabolized los ntawm CYP3A4 isoenzyme, yog li ntawd, cov tshuaj tiv thaiv ntawm isoenzyme no (suav nrog clarithromycin, itraconazole thiab erythromycin, diltiazem) tuaj yeem nce qhov concentration ntawm atorvastatin hauv cov ntshav ntshav.

Nws yuav tsum tau yug hauv lub siab tias kua txiv kab ntxwv qaub muaj tsawg kawg yog ib qho kev tivthaiv uas tiv thaiv CYP3A4 isoenzyme, yog li nws cov kev noj ntau dhau (ntau tshaj li 1.2 liv ib hnub) tuaj yeem ua rau muaj kev nce ntxiv ntawm cov tshuaj atorvastatin hauv ntshav.

Inducers ntawm cytochrome CYP3A4 isoenzyme (piv txwv li, efavirenz thiab rifampicin) tuaj yeem txo cov ntshav plasma concentration ntawm atorvastatin. Yog tias tsim nyog, kev siv phom sij ib txhij, cov tshuaj ob leeg raug pom zoo kom noj ib txhij, ncua kev tswj hwm ntawm liprimar tom qab rifampicin ua rau muaj kev txo qis hauv theem ntawm atorvastatin hauv cov ntshav.

OATP1B1 inhibitors (piv txwv li, cyclosporine) tuaj yeem nce cov bioavailability ntawm atorvastatin.

Nrog rau kev tswj hwm tib lub sijhawm ntawm antacids muaj aluminium lossis magnesium hydroxide, cov tshuaj atorvastatin txo tsawg li 35%, tab sis qhov no tsis cuam tshuam rau cov neeg kawm ntawv qib qis hauv LDL-C qib.

Colestipol txo qis kev ua haujlwm ntawm atorvastatin hauv plasma los ntawm kwv yees li 25%, txawm li cas los xij, lipid-txo cov nyhuv ntawm kev siv ntawm cov kev sib xyaw yog qhov zoo dua rau kev cuam tshuam ntawm kev noj txhua yam tshuaj cais.

Yog tias tsim nyog, kev teem sij hawm Liprimar ib txhij nrog digoxin yuav tsum tau soj ntsuam kuaj mob.

Thaum xaiv qhov ncauj tsis haum rau tus poj niam niaj hnub kho mob nrog Liprimar, nws yuav tsum tau yug los rau hauv lub siab tias atorvastatin ua rau ntau qhov kev xav ntawm ethinyl estradiol thiab norethisterone (kwv yees li 20% thiab 30%, feem).

Liprimar: cov lus qhia rau kev siv

Saib ntawm daim vis dis aus ntawd thiab:

Liprimar: xyuas

Hauv Is Taws Nem koj tuaj yeem pom kaum ob ntawm kev tshuaj xyuas txog Liprimar. Cov tshuaj no zoo siv, txawm tias lawv cov nqi hnyav. Thaum tib neeg sau kev tshuaj xyuas ntawm lwm cov tshuaj atorvastatin (Atoris, Torvacard), lawv feem ntau yws txog lawv cov kev mob tshwm sim. Kev txheeb xyuas txog cov tshuaj Liprimar yog tag nrho ntawm cov lus tsis txaus siab txog tus nqi siab ntawm cov tshuaj. Tab sis yuav luag tsis muaj leej twg sau phau ntawv hais txog phiv.

Tib neeg paub tseeb tias txij li lawv tau noj tshuaj uas kim tshaj plaws hauv lawv pawg, nws yuav tsis muaj kev phiv. Xaiv qhov pheej yig dua li Liprimar, nws cov analogues - Atoris, Torvakard lossis lwm tus - cov neeg mob txuag nyiaj.Txawm li cas los xij, lawv ntseeg ua ntej tias cov tshuaj pheej yig dua ua rau muaj kev phiv ntau dua. Txawm hais tias nyob hauv kev muaj tiag qhov no tsis yog li ntawd. Feem ntau cov kev mob tshwm sim ntawm statins uas tib neeg yws txog hauv lawv qhov kev txheeb xyuas yog vim kev mob hlwb, es tsis yog qhov cuam tshuam tiag ntawm cov tshuaj.

Ntau qhov kev tshuaj xyuas yog sau los ntawm cov neeg uas noj atorvastatin tom qab myocardial infarction. Tau muaj txoj sia nyob nrog kev mob plawv, cov neeg tsis nyob hauv txoj kev cawm lawv ntawm kev kho mob. Lawv txaus siab yuav yuav cov tshuaj uas kim tshaj plaws, uas suav nrog Liprimar. Hmoov tsis zoo, ob peb tus neeg npaj tau them sai sai thiab siv nyiaj rau lawv txoj kev noj qab haus huv nyob rau theem ntawm kev tiv thaiv, thaum kev mob plawv tseem tuaj yeem tiv thaiv lossis qeeb. Nyeem cov ncauj lus kom ntxaws nyeem ntawm cov neeg mob uas siv Liprimar.

Cov Lus Nquag Nug thiab Cov Lus Teb

Hauv qab no yog cov lus teb rau cov lus nug uas feem ntau tshwm sim hauv cov neeg mob.

Kuv yuav tsum tau coj Liprimar ntev npaum li cas?

Ib yam li lwm yam statins, Liprimar yuav tsum noj tsis muaj hnub kawg, txhua hnub, rau tas koj lub neej, yog tias koj muaj kev pheej hmoo siab thawj zaug lossis rov mob plawv, nrog rau mob ntshav ischemic. Nyeem cov kab lus tseem ceeb ntawm statins thiab nrhiav seb leej twg yuav tsum siv cov tshuaj no thiab leej twg tsis noj. Koj yuav tsum tsis txhob so thaum koj noj cov ntsiav tshuaj cholesterol uas koj tau muab los noj. Nqa lawv txhua hnub nyob rau tib lub sijhawm.

Liprimar, zoo li lwm cov statins, tuaj yeem ua rau qaug zog, mob hauv cov leeg thiab pob qij txha. Xav paub ntau ntxiv, saib kab lus "Sab phiv los ntawm statins." Txawm li cas los xij, cov tshuaj no cuam tshuam ntev dua lub neej, txo txoj kev pheej hmoo ntawm thawj zaug thiab rov ua mob plawv. Yog li ntawd, nws txoj kev ua tsis zoo ntawm qhov mob me mus rau mob nyhav tuaj yeem tiv taus. Yog tias atorvastatin ua rau muaj teeb meem loj, tom qab ntawd tawg rau hauv nws qhov kev pabcuam nws tsis zoo li yuav pab tau. Tom qab kev so, cov kev mob tshwm sim muaj feem ntau yuav rov qab los. Cov neeg mob uas tau txais cov kev mob tshwm sim tsis txaus ntseeg yuav tsum tham nrog lawv tus kws kho mob kom txo tau qhov ntau npaum li cas, hloov mus rau lwm cov tshuaj, lossis kev ua kom tiav ntawm statins.

Liprimar yuav tsum tsis txhob noj txhua txhua hnub. Xws li tus nqi kho mob tseem tsis tau raug sim hauv txhua qhov kev tshawb fawb soj ntsuam. Nws tsis zoo li tias nws yuav tuaj yeem tiv thaiv koj zoo los ntawm lub plawv nres. Cov kws kho mob tau hais kom noj atorvastatin los yog lwm cov statins txhua hnub ntxiv yog koom nrog "kev ua si pib xyaum ua." Nws yog qhov zoo dua los hloov xws li tus kws kho mob hloov mus rau tus kws tshaj lij tshaj lij. Yog tias koj zam kev kho mob nrog Liprimar ntsiav tshuaj zoo, tom qab ntawd coj lawv txhua hnub. Thiab yog tias nws tsis zoo, ces sab laj nrog koj tus kws kho mob yuav ua li cas.

Kuv puas tuaj yeem faib cov ntsiav tshuaj ib nrab?

Liprimar ntsiav tshuaj tsis tuaj yeem muab faib ua ke. Tsis muaj kev sib faib kab hauv lawv. Tsis tas yuav - koj tuaj yeem faib tawm, tab sis nws zoo dua tsis txhob ua nws. Vim tias nyob hauv tsev, koj tsis tuaj yeem faib cov ntsiav tshuaj kom yog ib nrab, txawm hais tias siv rab chais siv li chais, thiab ntau ntxiv nrog rab riam. Raws li qhov tshwm sim, txhua txhua hnub koj yuav tau noj ntau yam tshuaj uas txo qis cov "cholesterol" phem. Qhov no yuav cuam tshuam zoo qhov tshwm sim ntawm kev kho mob.

Nco ntsoov tias ib koob tshuaj atorvastatin 5 mg rau ib hnub tsis tau kuaj hauv qhov kev tshawb fawb tshawb fawb twg. Feem ntau cov yuav, nws tsis tiv thaiv txaus los ntawm tus thawj thiab rov ua plawv nres. Yog li, koj yuav tsum tsis txhob faib ib ntsiav tshuaj 10 mg los noj 5 mg ib hnub. Qee tus neeg, sim txuag nyiaj, yuav cov tshuaj uas muaj cov tshuaj Liprimar ntau kawg. Tom qab ntawd cov ntsiav tshuaj no tau muab faib ua ib nrab kom txhua ntawm lawv muaj txaus rau 2 hnub. Nws zoo dua yog tsis ua qhov no thiaj li hais tias cov tshuaj uas koj noj tau tseem nyob li niaj hnub.

Saib cov vis dis aus "Cov Roj (Statins Cholesterol): Cov Lus Qhia Txog Tus Neeg Mob."

Koj tuaj yeem pom zoo cov analogues ntawm Liprimar uas pheej yig dua?

Liprimar yog qhov tshuaj qub ntawm atorvastatin. Nws paub tias yuav zoo, tab sis kim. Yog tias koj tuaj yeem them taus, tom qab ntawd xaiv cov tshuaj qub rau kev kho koj thiab tsis them sai sai rau lawv cov analogues. Hmoov tsis zoo, tus nqi siab ua rau thawj npaj rau cov kab mob plawv tsis tuaj yeem siv rau cov neeg mob feem ntau. Hauv qhov no, qhov kev xaiv zoo tshaj plaws yog cov tshuaj analogues ntawm Liprimar ntsiav tshuaj, uas muaj nyob hauv Eastern Europe. Nov yog Atoris, Torvakard, Tulip lossis lwm tus.

Pheej yig dua analogues yog atorvastatin ntsiav tshuaj tsim nyob rau hauv Lavxias Federation thiab lub teb chaws CIS. Lawv yog tsim los ntawm ALSI Pharma, Canonfarm Ntau Lawm, VERTEX thiab lwm yam. Tus kws kho plawv paub txog kev ua kom tsis txhob rau lawv, nyeem ntxiv ntawm no. Xum atorvastatin ntsiav tshuaj uas tau tsim hauv Czech koom pheej, Slovenia thiab lwm lub teb chaws ntawm Eastern Europe. Nws mas nws tsis tsim nyog noj cov tshuaj roj uas txhaws tuaj ntawm Is Nrias teb.

Liprimar lossis atorvastatin: uas yog qhov zoo dua?

Liprimar yog cov tshuaj qub uas muaj cov tshuaj tiv thaiv yog atorvastatin, tsim los ntawm Pfizer. Nws suav hais tias yog qhov zoo tshaj plaws ntawm cov atorvastatin npaj. Tag nrho lwm cov ntsiav tshuaj uas muaj atorvastatin yog nws cov tshuaj tiv thaiv (cov tshuaj pleev ib ce). Cov neeg mob uas xav kom noj tshuaj zoo tshaj plaws atorvastatin yuav tsum xaiv Liprimar. Rau txhua pob ntawm cov tshuaj no, koj yuav tsum tau them tus nqi tseem ceeb. Yog tias koj xav txuag, tom qab ntawd them rau atorvastatin npaj, uas muaj nyob hauv Eastern Europe. Lawv tau muab piav qhia kom meej hauv cov lus teb rau lo lus nug dhau los.

Liprimar lossis rosuvastatin: uas yog qhov zoo dua?

Raws li koj twb paub, cov tshuaj nquag ntawm Liprimar ntsiav tshuaj yog atorvastatin. Thiab rosuvastatin yog ib qho kev kho mob tshiab rau cov roj (cholesterol) ntau dua li atorvastatin. Nws tseem muaj zog ntau dua qhov "tsis zoo" roj uas txhaws LDL nyob rau hauv cov ntshav ntawm cov neeg mob, txawm tias nws yog los ntawm kev noj tshuaj tsawg dua. Tab sis atorvastatin zoo dua kawm, vim tias nws siv sijhawm ntev. Nyeem cov ncauj lus kom ntxaws ntawm rosuvastatin, qhov txuas txuas uas tau muab rau saum toj no. Tshawb nrhiav hauv nws qhov twg zoo dua - atorvastatin lossis rosuvastatin.

Tib neeg siv cov tshuaj statins los txhim kho lawv cov roj lawv cov roj cholesterol, zoo li txo qis kev pheej hmoo ntawm thawj thiab thib ob lub plawv nres. Yog tias koj noj Liprimar thiab nws pab koj zoo, ces nws ua rau tsis muaj kev paub xav kom hloov mus rau rosuvastatin tsuas yog vim tias nws yog cov tshuaj tshiab dua. Txawm li cas los xij, hauv qee cov neeg, atorvastatin tsis txaus cov roj "LDL" cov roj (cholesterol) phem. Hauv qhov no, koj yuav tsum tau sab laj nrog kws kho mob seb nws puas tsim nyog hloov mus rau rosuvastatin, uas ua kom muaj zog dua. Tsis txhob hloov ntawm koj tus kheej txoj kev pib ib cov tshuaj rau roj rau lwm txoj. Ua qhov no tsuas yog pom zoo los ntawm koj tus kws kho mob.

Liprimar lossis Atoris: yam tshuaj twg zoo dua?

Liprimar yog qhov qub tshuaj ntawm atorvastatin, thiab Atoris yog nws cov tshuaj (analogue). Liprimar, zoo li txhua yam tshuaj qub, yog suav tias yog qhov zoo tshaj plaws hauv nws pawg. Txawm li cas los xij, yog tias koj tsis tuaj yeem them nws, tom qab ntawd saib rau Atoris. Cov ntsiav tshuaj atorvastatin no yog tsim los ntawm cov tuam txhab nto moo KRKA nyob rau sab hnub tuaj Europe raws li EU cov qauv. Atoris yog kev sib txuam ntawm tus nqi tsim nyog thiab zoo siab.

Liprimar lossis Torvacard: yam tshuaj twg zoo dua?

Torvacard yog Zentiva atorvastatin cov tshuaj .Nws tau sib tw nrog Atoris ntsiav tshuaj, uas tau sib tham hauv teb rau cov lus nug dhau los. Liprimar yog tej zaum zoo dua li Torvacard. Tab sis yog tias tus nqi ntawm cov tshuaj xub thawj tsis kam rau peb, ces Torvacard yog qhov kev xaiv zoo. Cov tshuaj no feem ntau tsim tawm hauv Czech koom pheej. Qhia kom meej lub teb chaws ntawm keeb kwm los ntawm barcode rau ntawm pob. Koj yuav tsis pom cov ntaub ntawv ntseeg nyob qhov twg txhua yam tshuaj uas zoo dua - Atoris lossis Torvakard. Ob qho ntawm cov tshuaj no zoo atorvastatin analogues. Tawm qhov kev xaiv ntawm lawv ntawm kev txiav txim siab ntawm koj tus kws kho mob.

Tus kws kho mob nce kuv cov tshuaj Liprimar ntau npaum li cas los ntawm 10 txog 40 mg rau ib hnub, vim tias cov roj (cholesterol) khaws cia siab. Txhawj xeeb txog kev phiv.

Kawm seb C-reactive protein yog dab tsi, thiab saib xyuas qhov ntsuas no kom zoo dua li kev zom zaub mov "phem" thiab "zoo". Nws tuaj yeem tig tawm tias qhov ntau npaum tsawg ntawm statins yog qhov txaus rau koj.

Atorvastatin tuaj yeem ua rau mob caj dab, txhaws caj dab, lossis loog ntawm txhais ceg, caj npab?

Tag nrho cov tsos mob no tuaj yeem yog cov kev mob tshwm sim ntawm Liprimar thiab lwm yam statins. Ua ntej tshaj plaws, kuaj ntshav thiab tso zis uas ntsuas koj lub raum ua haujlwm. Yog tias nws muab tawm tias txhua yam muaj dab tsi nrog ob lub raum, tom qab ntawd siv tshuaj magnesium-B6 los ntawm kev mob cag. Qog caj dab los yog loog hauv ob txhais ceg, caj npab - tuaj yeem ua lub cim qhia tias koj tab tom muaj ntshav qab zib. Ntsuas koj cov piam thaj hauv ntshav tom qab noj mov (tsis yog hauv plab!) Nrog lub ntsuas ntshav qab zib hauv tsev lossis hauv qhov chaw kuaj ntshav. Yog paub tias cov ntshav qab zib tau paub meej, kawm paub tswj hwm nws li cas ntawm no. Hauv qhov no, koj yuav tsum tsis txhob tsum noj cov tshuaj statins yam tsis tau txais kev pom zoo los ntawm kws kho mob.

Kuv puas tuaj yeem haus cawv thaum noj Liprimar?

Yog tias koj raug mob los ntawm kev quav dej caw, koj tsis tuaj yeem noj Liprimar lossis lwm yam statins. Yog tias koj yog "quav dej quav cawv", koj yuav tsum tau ceev faj - noj tshuaj, tab sis feem ntau kuaj ntshav rau daim siab ua ntshav siab thiab saib xyuas cov tsos mob daj ntseg. Tawm tsam keeb kwm ntawm kev kho mob nrog atorvastatin, 2 haus dej haus ib hnub ua rau cov txiv neej uas muaj hnub nyoog 65 xyoos thiab ib qho rau cov txiv neej tshaj 65 xyoos thiab poj niam tsis hais hnub nyoog li cas. Ib qho ua haujlwm yog 10-15 g ntawm cov cawv ntshiab, i.e. ib lub npias, ib khob cawv los yog ib khob cawv muaj 40-degree cawv. Yog tias koj tsis tuaj yeem ua kom qis, nws yog qhov zoo dua rau qhov ua tiav kev qaug cawv.

Nyeem cov lus teb rau lwm 22 qhov lus nug nquag nug hauv kab lus “Statins: FAQ. Cov lus teb rau cov neeg mob cov lus nug. "

Kev siv ntawm cov tshuaj Liprimar

Liprimar yog thawj qhov tshuaj ntawm atorvastatin, yog ib qho kev mob tshiab tshaj plaws. Cov tshuaj no txhim kho cov roj cholesterol. Nws txo qis ntawm cov roj "LDL" cov roj (cholesterol) phem, thiab cov roj triglycerides, thiab cov roj (cholesterol) HDL "roj" zoo. Atorvastatin muaj pov thawj ua tau zoo hauv kev tiv thaiv ntawm thawj zaug thiab rov ua plawv nres, ischemic stroke. Yog xav paub ntau ntxiv saib tsab xov xwm “Liprimar: 15 xyoo ntawm cov pov thawj txaus ntseeg” nyob rau hauv phau ntawv journal “Rational Pharmacotherapy hauv Cardiology” No. 7/2011. Lub hom phiaj ntawm cov tshuaj no txo ​​txoj kev cia siab uas koj yuav tau ua phais mob los kho cov ntshav hauv cov hlab ntsha cuam tshuam los ntawm atherosclerosis.

Cov kev sim tshuaj mob ntawm atorvastatin, ua rau xyoo 1996-2011, koom nrog ntau dua 50,000 tus neeg mob kuaj mob: mob plawv, mob ntshav qab zib mellitus, mob ntshav qab zib ntshav, myocardial infarction. Txhua tus kawm koom coj cov qub Liprimar tshuaj. Cov tshuaj no tau ua pov thawj ua ib qho tshuaj zoo thiab muaj kev nyab xeeb, txawm tias cov neeg laus uas muaj kev pheej hmoo ntawm kev phiv. Thiab tseem muaj ntau dua, rau cov tib neeg laus ib nrab. Atorvastatin npaj ntawm lwm cov tuam ntxhab tej zaum yuav pheej yig dua, tab sis lawv tsis muaj qhov pov thawj txaus ntseeg tau ntawv.

Hauv cov teb chaws hais lus Askiv, kev npaj thawj ntawm atorvastatin yog tshaj tawm hauv lub npe Lipitor. Mus txog xyoo 2012, kom txog rau thaum daim ntawv tiav patent tiav, nws tau muag rau tus nqi nruab hnub qub - ntau dua 125 txhiab daus las. Hauv cov teb chaws CIS, tib cov tshuaj hu ua Liprimar. Tam sim no hauv kev lag luam kws tshuaj ntawm cov statins, kev sib tw tseem ceeb yog nruab nrab ntawm atorvastatin thiab cov tshuaj tshiab dua - rosuvastatin. Hauv qab no yog piav qhia txhua yam hauv cov xwm txheej twg nws yog qhov zoo dua los xaiv atorvastatin - cov tshuaj qub los yog lwm cov ntsiav tshuaj pheej yig dua.

Statins yog cov tshuaj tseem ceeb tshaj plaws rau cov neeg uas muaj kev pheej hmoo siab rau thawj zaug thiab thib ob lub plawv nres, ischemic stroke. Vim tias lawv txo qis kev pheej hmoo ntawm hlab plawv tsis txaus, ua lub neej ntev. Lub neej zoo kuj txhim kho yog tias tus neeg mob tsis dhau kev txhawj xeeb txog kev phiv. Hais txog qhov ua tau zoo rau kev tiv thaiv kev mob plawv thiab mob hlab ntsha tawg, tsis muaj lwm cov ntsiav tshuaj tuaj yeem piv nrog statins. Atorvastatin yog ib tus thawj coj ntawm statins. Tus thawj cov tshuaj Liprimar tseem yuav nrov, txawm hais tias cov ntsiav tshuaj pheej yig dua ntawm lwm cov lag luam kuj tseem muaj nyob hauv cov khw muag tshuaj.

Yuav txo tau cov roj ntshav tsawg

Atorvastatin yog ib qhov tseem ceeb tshaj plaws statins nyob hauv lub ntiaj teb thiab hauv tebchaws Lavxias. Cov kws kho mob sau ntawv rau Liprimar lossis lwm cov tshuaj atorvastatin kom txo qis "cov roj" LDL cholesterol hauv lawv cov neeg mob. Tsis tas li, cov kws tshaj lij tau them nyiaj ntau dua thiab ntau ntxiv rau qhov tshwm sim ntxiv ntawm cov tshuaj no uas tsis cuam tshuam nrog cov roj (cholesterol). Cov teebmeem no hu ua pleiotropic. Qhov loj tshaj plaws yog qhov kev txo qis ntawm kev ua paug ntev qeeb hauv cov hlab ntsha. Tej zaum qhov txo qis hauv kev tshwm sim ntawm lub plawv nres, mob hlab ntsha tawg, thiab lwm yam kev mob plawv "xwm txheej" hauv cov neeg mob cuam tshuam nrog pleiotropic cov teebmeem ntawm atorvastatin, thiab tsis yog nrog cov qub ntawm cov cholesterol.

Atorvastatin tau sau tseg hauv tshuaj ntau dua 10 txog 80 mg rau ib hnub. Qhov ntau dua koob tshuaj uas tus neeg mob noj, nws yuav ntau dua cov roj cholesterol LDL. Txawm li cas los xij, nrog kev noj tshuaj ntau dua, qhov tshwm sim ntawm cov kev mob tshwm sim ntau dua. Kev siv roj ntau dhau ntawm LDL cov roj ntsha tuaj yeem ua teeb meem nrog txoj kev xav thiab cim xeeb. Vim tias cov roj (cholesterol) tseem ceeb heev rau lub hlwb. Kev pheej hmoo ntawm kev poob siab, tsheb sib nraus thiab, muaj peev xwm, kev tuag ntawm txhua yam ua rau nce ntxiv. Kawm paub ntshav muaj roj rau cov txiv neej thiab poj niam raws hnub nyoog. Tham nrog koj tus kws kho mob txog qhov zoo tshaj plaws ntawm Liprimar.

Atorvastatin tsis tsuas yog txo qis LDL, tab sis kuj nce qib ntawm "zoo" roj HDL. Cov nyhuv no tsis yog linearly ntsig txog qhov ntau npaum ntawm cov tshuaj. Kev nce ntxiv ntawm cov tshuaj atorvastatin txhua hnub yuav tsis tas ua rau muaj kev nce ntxiv hauv cov concentration ntawm HDL cov rog hauv cov ntshav. Txhawm rau kom cov roj (cholesterol), triglycerides, thiab atherogenic coefficient dab tsi, hloov mus rau kev noj haus kom tsawg. Qhov no yuav txo qhov koob tshuaj Liprimar txhua hnub rau 10-20 mg rau ib hnub lossis txawm tias kiag li tsis kam kho nrog statins.

Atherosclerosis

Atorvastatin, zoo li lwm yam statins, inhibits kev loj hlob ntawm atherosclerosis. Vim tias qhov no, kev pheej hmoo ntawm thawj thiab lub plawv nres, ischemic stroke, teeb meem ceg, xav tau kev phais mob rov qab los ntshav ntws los ntawm cov hlab ntsha txo. Nws tau ntseeg tias cov tshuaj Liprimar thiab lwm yam statins pab tiv thaiv atherosclerosis, vim tias lawv txo qis LDL roj. Qhov qis dua qhov kev nkag siab ntawm cov "phem" cov cholesterol, tsawg dua nws tau tso rau ntawm cov phab ntsa ntawm cov hlab ntsha hauv daim ntawv ntawm cov quav hniav.

Lwm txoj hauv kev saib - lub ntsiab yog cov nyhuv tiv thaiv ntawm statins. Yog tias koj tua cov kev mob mus ntev, tom qab ntawd cov roj cholesterol yuav tsis raug oxidized los ntawm cov dawb radicals. LDL cov roj cholesterol, uas nyob hauv lub cev ib txwm muaj, tsis oxidized, tsis tso nyiaj rau ntawm cov phab ntsa ntawm cov hlab ntshav, tsis muaj teeb meem nws nyob hauv cov ntshav npaum li cas. Qib uas mob o tau txiav txim siab los ntawm cov txiaj ntsig kev kuaj ntshav rau C-reactive protein. Txhawm rau txo cov roj "LDL" kom qis dua li qub, cov tshuaj atorvastatin ntau npaum li 80 mg rau ib hnub, yuav tsum tau ua. Tib lub sijhawm, txhawm rau txhim kho kev ua tau zoo ntawm C-reactive protein, feem ntau nws txaus los noj Liprimar ntsiav tshuaj hauv kev noj tshuaj ntau dua. Kuaj tshuaj xwm yeem C-reactive protein, thiab tsis yog cov roj "kom zoo" thiab "tsis zoo".

Liprimar yog thawj qhov tshuaj nyob hauv statins, rau qhov uas ua tau kom txo qhov me me ntawm atherosclerotic plaques tau muab pov thawj. Tom qab ntawd, tib cov khoom ntiag tug tau pom hauv rosuvastatin. Ua ntej cov kev tshawb fawb tshawb fawb tau tshaj tawm, nws ntseeg tau tias statins tsuas tuaj yeem qeeb ntawm kev txhim kho atherosclerosis, tab sis lawv tsis cuam tshuam rau cov plaques. Txhawm rau kom qhov ntim ntawm atherosclerotic plaques pib txo qis, koj yuav tsum txo qis roj LDL ntau npaum li 40% lossis ntau dua. Txhawm rau ua qhov no, noj atorvastatin hauv kev noj tshuaj ntawm 20 mg rau ib hnub lossis ntau dua.Cov lus sau rau hauv cov ntawv kho mob feem ntau xav kom kws kho mob sau ntawv atorvastatin cov tshuaj qub hauv nruab nrab thiab ntau npaum li cas rau cov neeg mob, tab sis tsis txwv rau qhov tsawg ntawm 10 mg rau ib hnub, uas tsis pab tau txaus.

Hmoov tsis zoo, nrog kev siv atorvastatin thiab lwm yam statins rau kev kho mob ntawm atherosclerosis, tsis yog txhua yam yog qhov tseeb. Cov tshuaj no txo ​​cov roj cholesterol ntawm cov phab ntsa ntawm cov hlab ntsha. Nyob rau tib lub sijhawm, lawv txhawb qhov kev tso nyiaj ntawm calcium nyob hauv cov hlab ntshav. Arteries coated nrog quav hniav ntawm cov calcium ua txhav, thiab tsis hloov pauv, zoo li qub. Qhov no yog suav tias yog kev theem siab ntawm atherosclerosis. Ua ntej, cov plahaum roj (cholesterol) plaques tshwm sim, thiab tom qab ntawd cov khoom ntxiv calcium muaj ntxiv rau lawv. Liprimar tej zaum, zoo li lwm yam statins, ua rau nws siab. Nyeem kab lus "Statins thiab Atherosclerosis" nyob rau hauv ntau dua. Kawm yuav ua li cas kom tsis txhob muaj cov calcium calcium arterial phab ntsa ua rau thiab lub hnub nyoog qeeb.

Coronary mob plawv

Cov tib neeg tau txheeb cov kab mob plawv yog cov neeg mob ntshav siab. Lawv yuav tsum tau noj Liprimar lossis lwm cov tshuaj atorvastatin ua ib feem ntawm cov tshuaj uas cov kws kho mob yuav sau ntawv rau. Cov txiaj ntsig ntawm statins yuav ntau dua qhov kev pheej hmoo ntawm kev mob tshwm sim. Raws li koj paub, qhov ua kom mob plawv yog mob hlab ntsha hlab ntsha txhaws txhaws. Atorvastatin yuav thaiv txoj kev loj hlob ntawm atherosclerosis los yog tseem txo qhov ntim ntawm atherosclerotic plaques. Vim tias cov txiaj ntsig no, koj yuav txo qhov kev pheej hmoo ntawm lub plawv nres thiab mob hlab ntsha tawg, nrog rau kev nthuav tawm atherosclerosis ntawm cov hlab ntsha los ntawm cov ntshav uas ntws mus rau lub hlwb thiab qis qis.

Hauv phau ntawv xov xwm Atherosclerosis thiab Dyslipidemia hauv xyoo 2013, cov ntaub ntawv tshaj tawm tau tshaj tawm cov txiaj ntsig ntawm kev kho mob nrog atorvastatin hauv 25 tus neeg mob uas kuaj pom tus mob plawv.

Txhua tus neeg mob tau siv atorvastatin-Teva 80 mg rau ib hnub. Tus qub tshuaj Liprimar muab tib cov txiaj ntsig los yog zoo dua.

Nrog rau cov kab mob hlab plawv ruaj khov, koj tsis tuaj yeem maj ua lub stenting lossis hlab ntshav o kev phais mob, tab sis ua ntej sim kho nrog tshuaj noj, suav nrog siab ntawm atorvastatin. Cov kev tshawb fawb txog ntau pua pua tus neeg mob tau ua pov thawj qhov txiaj ntsig ntawm txoj hauv kev no. Tsis tas li ntawd kawm txog kab lus "Kev tiv thaiv ntawm lub plawv nres thiab mob hlab ntsha tawg" thiab ua raws cov theem uas tau piav nyob rau ntawd. Atorvastatin hauv kev txhaj tshuaj ntau tau ua rau ntau tus neeg tuaj koom hauv cov chaw kuaj mob zam kom tsis txhob muaj kev phais mob. Hauv cov kev tshawb fawb no, tsuas yog tus thawj Pfizer Liprimar tau sim. Nws tsis paub yog tias atorvastatin ntsiav tshuaj los ntawm lwm cov tuam ntxhab tuaj yeem muab cov nyhuv tib yam.

Cov kev tshawb fawb txawv teb chaws piv cov hauj lwm zoo ntawm kev siv tshuaj thiab kev kho mob ntawm kev mob plawv. Nws muab tawm tias hauv cov neeg mob ruaj khov, kev phais tsis txo kev tuag thiab kev pheej hmoo mob plawv. Tab sis kev kho mob phais yog qhov siv nyiaj kim, thiab tus neeg mob tau muaj ntau qhov kev pheej hmoo ntawm kev tuag ntawm lub rooj haujlwm ua haujlwm. Qhov kev tshawb fawb AVERT (Atorvastatin VErsus Revascularization Kev Kho Mob) pom tias kev noj Liprimar ntsiav tshuaj ntawm 80 mg rau ib hnub nrog rau lwm cov tshuaj rau 18 lub hlis tau muab qhov tshwm sim tsis muaj qhov tsis zoo dua li kev phais hauv tus neeg mob IHD ruaj khov uas muaj kev pheej hmoo mob plawv tsawg. Nws hloov tawm tias kev phais mob yog tsim nyog tsuas yog tias cov tshuaj pab tsis zoo, zoo li mob hnyav. Cov txiaj ntsig ntawm kev kawm AVERT tau luam tawm rov qab rau xyoo 1999 thiab ua suab nrov heev. Txawm li cas los xij, ntau tus neeg mob uas muaj lub cev ruaj khov ntawm cov hlab ntsha tseem tuaj yeem muaj kev phais mob tsis tseem ceeb.

Tom qab lub plawv nres

Atorvastatin lossis lwm yam statins yuav tsum tau pib sai li sai tau tom qab tus neeg mob lub plawv nres. Qhov no yuav txo txoj kev pheej hmoo ntawm rov ua dua tshiab, txhim kho cov txiaj ntsig ntawm kev kho kom rov zoo. Txoj kev npaj Atorvastatin tau sau tseg rau cov neeg mob uas tau qhia kho kev phais mob ntawm cov kab mob plawv. Xyoo 2004, cov txiaj ntsig ntawm qhov kev tshawb fawb los ntawm ARMYDA - Atorvastatin rau txo ntawm MYocardial Kev puas tsuaj thaum Angioplasty - tau luam tawm. Hauv cov neeg uas siv Liprimar 40 mg ib hnub ua ntej mob hlab hlwb angioplasty, kev phais mob tiav zoo dua li cov neeg mob uas tsis tau txais statins. Lwm txoj kev tshawb nrhiav, hu ua STATIN STEMI, pom tias atorvastatin tuaj yeem kho nyob rau hauv koob tshuaj 10 lossis 40 mg ib hnub ua ntej stenting rau 7 hnub, thiab yuav tsis muaj qhov sib txawv.

Hauv 2005, cov kev tshwm sim los ntawm IDEAL txoj kev tshawb nrhiav - Kev nce ntxiv hauv qhov xaus ntawm cov ntsiab lus los ntawm kev txhoj puab heev Lipid-txo qis - tau luam tawm. Nws tau muab tawm tias lub sijhawm ntev, atorvastatin hauv kev noj tshuaj ntau npaum 80 mg rau ib hnub yuav pab cov neeg uas muaj lub plawv tsis mob zoo dua li simvastatin 20 mg rau ib hnub. 8888 cov neeg mob tau koom nrog, uas tau ua raws yuav luag 5 xyoos. Atorvastatin thiab simvastatin tsis tau hais rau cov neeg mob tam sim ntawd, tab sis tsuas yog 21-23 hli tom qab lub plawv nres. Hauv thawj teev thiab hnub tom qab lub plawv nres, nws zoo li nruab nrab thiab qib siab ntawm Liprimar txhim kho qhov kev kuaj pom zoo dua li qis dua ntawm atorvastatin lossis qaug zog simvastatin.

Ischemic mob stroke

Atorvastatin thiab lwm yam statins nrog kev kho mob ntev ntev txo txoj kev pheej hmoo ntawm cov hlab ntsha hauv cov neeg mob ntshav siab, mob plawv thiab ntshav qab zib. Nyob rau lub Ib Hlis xyoo 2004 qhov teeb meem ntawm European Journal of Medical Research, ib qho kev tshawb fawb ntawm ntau qhov kev tshawb fawb txog qhov ua tau zoo ntawm statins rau kev tiv thaiv mob stroke tau luam tawm. Nws hais tias kev noj Liprimar ntsiav tshuaj txo txoj kev pheej hmoo mob stroke los ntawm 41%, thiab kho nrog simvastatin - los ntawm 34%. Statins rau kev tiv thaiv mob hlab ntsha tawg yuav tsum noj txawm tias cov tib neeg muaj roj cholesterol zoo, tab sis muaj lwm yam kev pheej hmoo, tshwj xeeb yog txhawb C-reactive protein ntau.

Txhawm rau kom paub tias atorvastatin muaj txiaj ntsig zoo npaum li cas hauv kev tiv thaiv kev tiv thaiv mob nrawm dua, kev tshawb fawb SPARCL, Kev Tiv Thaiv Mob Hlav los ntawm Kev Txo Cov Hluav Taws Xob Qib Roj hauv Cholesterol, tau ua nrog 4371 tus neeg mob. Cov neeg mob uas tau mob ischemic stroke thaum 6 lub hlis dhau los tau muab tshuaj kho atorvastatin (thawj cov tshuaj Liprimar) ntawm 80 mg rau ib hnub, ntxiv rau kev kho mob txheem. Kuj tseem muaj pab pawg tswj hwm cov neeg mob uas tau siv cov placebo hloov cov tshuaj tiag. Txhua tus neeg mob tau pom txog thaj tsam 5 xyoos.

Ntawm cov neeg mob kho nrog atorvastatin, qhov ntau zaus ntawm kev rov mob hlwb txo qis tsuas yog 16%, piv nrog cov placebo pab pawg. Nws yuav zoo li tias qhov tshwm sim tau coj tus. Tab sis nws muab tawm tias lub ntsiab lus yog qhov kev cog lus tsawg ntawm cov neeg koom nrog kev kawm. Hauv pawg atorvastatin, ntau tus neeg mob tsis tau siv lawv cov tshuaj kho mob. Ntawm qhov tod tes, hauv cov pab pawg placebo, ntau tus neeg mob tau siv cov statins, uas yog kws kho los ntawm cov kws kho mob hauv lwm lub tsev kho mob. Los ntawm hloov cov ntsuas ntawm cov roj (cholesterol) hauv cov ntshav, koj tuaj yeem txiav txim siab seb tus neeg mob noj statins lossis tsis. Ntawm cov neeg mob uas tau txais kev kho mob tiag tiag nrog statins, tus nqi ntawm cov mob stroke rov qab qis dua 31%. "

Tsis hlauv

Liprimar nrog rau lwm cov tshuaj txo qis kev loj hlob ntawm lub raum tsis ua haujlwm rau cov neeg mob ntshav qab zib mellitus. Thaum Lub Peb Hlis 2015, Phau Ntawv Lancet Diabetes & Endocrinology luam tawm cov ntsiab lus ntawm PLANET Kuv kawm - kev sib piv ntawm kev ua tau zoo ntawm atorvastatin thiab rosuvastatin hauv kev tiv thaiv lub raum hauv cov neeg mob uas muaj hom 1 thiab ntshav qab zib hom 2. Txoj kev tshawb no suav nrog 353 cov neeg mob uas twb tau kho nrog ACE inhibitors lossis cov tshuaj angiotensin-II receptor blockers. Cov kws kho mob saib lawv rau ib xyoos. Nws tau muab tawm tias cov tshiab rosuvastatin qis dua LDL cov roj cholesterol ntau dua, tab sis tiv thaiv lub raum zuj zus dua li cov qub Liprimar - thawj cov tshuaj atorvastatin.

Tsis tshua muaj mob, mob raum tsis ua haujlwm tuaj yeem yog qhov tshwm sim ntawm atorvastatin. Qhov no tshwm sim thaum cov leeg pob txha raug mob. Cov tshuaj uas ua kom lub raum puas nkag mus rau cov ntshav. Qhov kev mob tshwm sim no tsis tshua muaj tshwm sim. Txoj kev pheej hmoo yog nce ntxiv rau cov neeg kuaj mob raum tsis tu ncua los yog qog cov thyroid hormones txaus. Txhawm rau kuaj pom teeb meem ua ntej mob rau lub raum tsis ua haujlwm, koj tuaj yeem coj mus kuaj ntshav rau creatine kinase. Liprimar tej zaum yuav ua teeb meem lub raum tsawg dua li lwm cov statins.

Mob ntshav qab zib Hom 2

Atorvastatin, zoo li lwm cov statins, ua rau muaj kev pheej hmoo ntawm mob ntshav qab zib hom 2 hauv cov neeg uas tau kis tus kabmob no. Rau cov neeg uas twb muaj ntshav qab zib lawm, cov tshuaj no yuav ua rau cov ntshav qab zib ntau ntau thiab glycated hemoglobin HbA1C. Tib lub sijhawm, rau cov neeg uas muaj kev pheej hmoo siab heev ntawm kev mob plawv, cov txiaj ntsig ntawm kev noj Liprimar ntsiav tshuaj lossis lwm yam statins yog ntau dua qhov muaj feem yuav muaj ntshav qab zib thiab lwm cov kev mob tshwm sim.

Kev noj tshuaj atorvastatin ntau ntxiv yuav ua rau muaj ntshav qab zib hauv cov neeg rog dhau los, cov rog nyob ib puag ncig ntawm lub duav, ntshav siab, roj (cholesterol) tsis zoo thiab triglycerides hauv cov ntshav. Ua ke, cov tsos mob no yog hu ua kev mob metabolic. Kawm cov lus "Kev tiv thaiv lub plawv thiab mob hlab ntaws" kom paub seb yuav tswj cov metabolism hauv lub cev puas thiab tiv thaiv koj tus kheej los ntawm ntshav qab zib. Ua raws li cov lus pom zoo hauv kab lus. Hauv qhov no, txuas ntxiv noj Liprimar lossis lwm yam statins kom txo koj cov ntshav plawv. Nws yog ib qho tseem ceeb heev uas yuav tau saib xyuas ntshav qab zib rau cov poj niam uas twb tau lawm lawm. Vim tias lawv noj tshuaj atorvastatin, ua rau lawv muaj feem ua ntshav qab zib kom ntau li ntau tau.

Liprimar rau cov ntshav qab zib: cov zoo thiab cov kev pom zoo

Tshaj siab dua tus neeg mob plawv, ntau dua cov txiaj ntsig ntawm kev kho nrog atorvastatin lossis lwm yam statins. Cov neeg mob ntshav qab zib hom 2 yog cov uas muaj kev pheej hmoo siab tshaj plaws rau lub plawv nres, hlab ntsha tawg, thiab lwm yam mob plawv. Liprimar coj lawv cov txiaj ntsig tseem ceeb, txawm tias qhov tseeb tias nws nce me ntsis cov ntshav qab zib thiab glycated hemoglobin. Piv txwv, kev tshawb fawb los ntawm CARDS (Kev Sib Koom Tes Ntawm Kev Mob Ntshav Qab Zib Kev Tshawb Pom Mob Ntshav Qab Zib) tau qhia tias atorvastatin ntawm kev noj tshuaj tsuas yog 10 mg ib hnub twg txo cov kev mob plawv rau cov ntshav qab zib ntau npaum li 37%. Cov neeg mob ntshav qab zib tau zoo dua yog noj cov tshuaj statins dua li cov tib neeg muaj hnub nyoog uas cov ntshav qab zib ib txwm muaj. Thiab tsis txhob ntshai siab tshaj qhov tshuaj ntawm atorvastatin. Tsis txhob txwv koj tus kheej kom noj 10 mg ib hnub twg yog tias qhov tshuaj no pab tsis tau txaus.

Nyeem cov ntawv ntxaws ntxaws "Statins thiab Ntshav Qab Zib." Kawm yuav ua li cas rau kev ntsuas koj cov ntshav qab zib, C-reactive protein, thiab lwm yam kev phom sij ntawm lub plawv. Ntshav qab zib Hom 2 tuaj yeem tswj tau yooj yim yam tsis muaj qhov "tshaib plab" noj, tshuaj tsis zoo thiab txhaj tshuaj insulin. Cov kws kho mob muab cov ntaub ntawv no zais kom thiaj tsis plam cov neeg siv khoom.

Kev mob ntshav siab

Kev mob ntshav siab yog ib qho nyuaj ntawm cov tsos mob ntawm kev ua tsis taus pa metabolism, cov nqaij ua rau lub cev tsis txaus siab rau cov insulin. Nws suav nrog kev mob plab hauv plab (rog rog rog), tawg, ntshav tsis zoo rau cov roj (cholesterol) thiab triglycerides. Kev mob ntshav siab ua rau nce kev pheej hmoo ntawm lub plawv kev raug mob los ntawm 44%. Yog li, cov neeg mob uas tau txais kev kuaj mob no, cov kws kho mob feem ntau kho mob atorvastatin lossis lwm yam statins. Raws li kev kawm TNT (Kho Rau Lub Hom Phiaj Tshiab) txoj kev tshawb nrhiav, nyob rau hauv cov neeg mob uas mob metabolic syndrome, atorvastatin (thawj cov tshuaj Liprimar) txo txoj kev pheej hmoo ntawm lub plawv nres, mob ntshav nce hlwb, stenting thiab mob ntshav hlab los ntawm kev phais mob los ntawm 29%.

Statins pab cov neeg mob metabolic syndrome, vim tias lawv txo cov roj "tsis zoo" hauv cov ntshav, nrog rau nws cov teebmeem pleiotropic, uas tau piav saum toj no. Txawm li cas los xij, kev kho mob tseem ceeb (tswj) ntawm cov metabolic syndrome yog kev hloov mus rau kev noj qab nyob zoo, tsis yog noj tshuaj. Atorvastatin, tshuaj siab thiab lwm yam tshuaj tsuas yog ua kom tiav, tab sis tsis tuaj yeem hloov lub cev kev noj qab haus huv thiab kev kawm paub lub cev. Nyeem ntawm no yuav ua li cas tswj kev mob metabolic syog yam tsis muaj lub cev "tshaib plab" thiab ua haujlwm hnyav. Kawm yuav ua li cas ib txwm ntshav siab los ntawm kev tso cov tshuaj tsis phom sij.

Cov Tshuaj Hauv Tshuaj

Cov tshuaj tiv thaiv nquag ntawm atorvastatin, yog ib qho kev xaiv cov tshuaj tiv thaiv ntawm cov enzyme tseem ceeb rau kev hloov pauv ntawm HMG-CoA reductase rau mevalonate (ua ntej rau sterols). Nws pab txhawm rau txo cov cholesterol hauv cov ntshav los ntawm kev txo nws cov synthesis hauv lub siab thiab nce ntau ntawm LDL receptors nyob rau saum npoo ntawm lub hlwb ua lub luag haujlwm rau catabolism ntawm lipoproteins tsawg ntom.

Hauv cov neeg mob uas raug mob los ntawm keeb kwm kab mob, tsev neeg hypercholesterolemia (homo- thiab heterozygous cov ntaub ntawv), nrog rau kev sib xyaw ua ke ntawm dyslipidemia, cov tshuaj no txo ​​qis tag nrho cov roj (cholesterol), apolipoprotein B, LDL thiab triglycerides, thaum nce siab lipoproteins.

Thaum siv Liprimar, muaj qhov txo qis ntawm lub cev tsis ua mob stroke thiab lub plawv nres, ua rau cov kab mob plawv tuag, thiab qhov kev xav tau myocardial revascularization kuj txo qis.

Txo txo ​​qib ntawm cov roj (cholesterol) tag nrho, B. triglycerides apolipoprotein thiab X-LDL, cov tshuaj tsis cuam tshuam loj hlob thiab pub menyuam ntawm cov menyuam yaus thiab cov hluas thiab tsis ua txhaum qhov ntev ntawm lub cev ntas rau cov menyuam ntxhais (qhov tshwm sim ntawm kev tshawb fawb soj ntsuam).

Cov Tshuaj Pharmacokinetics

Liprimar, thaum noj ntawm qhov ncauj, zoo adsorbed los ntawm daim siab, nce mus txog cov ntshav siab kawg plasma ntau tom qab 2 teev. Lub plasma concentration ntawm cov tshuaj yog sib npaug rau cov koob tshuaj coj (hauv thaj tsam ntawm 10-20-40-80 mg). Qhov tseeb txog kev noj qab haus huv ntawm cov ntsiav tshuaj, hauv kev sib piv nrog txoj kev daws teeb meem, yog 95-99%, cov txheej txheem hauv lub cev yog 30% (qhov ntsuas no tau cuam tshuam nrog kev txiav tawm ntawm lub cev ntawm atorvastatin nyob rau hauv txoj hnyuv thiab cov nyhuv ntawm nws cov lus pom dhau los ntawm lub siab). Thaum noj cov tshuaj nrog zaub mov, muaj qee yam me me hauv kev nyab xeeb.

Kev sib txuas lus nrog cov ntshav plasma protein - 98%. Hauv kev ua tiav ntawm cov kab mob hepatic, qhov tsim muaj cov tshuaj pharmacologically nquag tshwm sim (kwv yees li 70% ntawm kev kho mob ntawm cov tshuaj pom tau hais tias vim nws cov roj ntsha hloov mus rau lub cev).

Atorvastatin feem ntau ua rau txoj hnyuv txuas nrog cov kua tsib. Nrog rau lub raum - tsuas yog 2%. Txawm li cas los xij, qhov tseem ceeb ntawm kev nkag mus ua ib qho recirculation tsis pom. Ib nrab-lub neej ntawm cov khoom xyaw nquag yog 14 teev. Lub sijhawm ntawm cov kev kho mob (vim yog metabolites ncig hauv cov ntshav) yog 20-30 teev.

Hauv cov neeg mob ntawm cov xyoo dhau los, hauv kev sib piv nrog cov ntxhais hluas thiab cov txiv neej, qhov nce ntawm ntshav plasma concentration ntawm atorvastatin tau sau tseg.

Cov hlwv ua haujlwm tsis zoo tsis cuam tshuam cov pharmacokinetics ntawm cov tshuaj. Thaum lub siab ua haujlwm tsis ua haujlwm nyob rau hauv cov ntshav ntshav, cov qib ntawm qhov tsis hloov pauv ntawm lub cev yuav nce ntau.

Cov lus qhia Liprimar (Atorvastatin) qhia txog kev siv

cov tshuaj nquag: atorvastatin, 1 ntsiav tshuaj muaj atorvastatin calcium, uas yog sib npaug rau 10 mg lossis 20 mg, lossis 40 mg, lossis 80 mg ntawm atorvastatin,
tus zam: calcium carbonate, microcrystalline cellulose lactose monohydrate, croscarmellose sodium, polysorbate 80 hydroxypropyl cellulose, magnesium stearate zaj duab xis txheej txheej khoom (hydroxypropyl methyl cellulose, polyethylene glycol 8000, titanium dioxide (E 171), talc) emulsion simethicone benzene, simetic acid kua qaub).

Cov chaw muag tshuaj

Liprimar yog ib qho tshuaj lipid-txo qis cov tshuaj. Atorvastatin yog ib qho inhibitor ntawm 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase.Qhov enzyme no ua rau hloov pauv ntawm HMG-CoA rau mevalonate - theem pib ntawm cov roj ntsha biosynthesis uas txwv tus nqi ntawm nws qhov tsim.

Liprimar yog qhov xaiv sib tw inhibitor ntawm HMG-CoA reductase, ib qho enzyme uas txiav txim siab qhov hloov pauv ntawm 3-hydroxy-3-methylglutaryl coenzyme A rau mevalonate, ib qho khoom muaj txiaj ntsig rau sterols, suav nrog cov roj (cholesterol). Cov roj (cholesterol) thiab triglycerides nkag mus rau hauv cov hlab ntshav kom sib xyaw nrog lipoproteins. Cov nyuaj no tau sib cais los ntawm ultracentrifugation ua feem rau HD feem (lipoproteins ntau ntom), HDL (nruab nrab ntom lipoproteins.), LDL (lipoproteins ntau ntom tsawg) thiab VLDL (lipoproteins ntau ntom tsawg). Triglycerides (TG) thiab cov roj (cholesterol) hauv lub siab yog suav nrog VLDL thiab tso tawm mus rau hauv cov ntshav ntshav rau kev thauj mus los rau cov ntaub so ntswg. LDL yog tsim los ntawm VLDL thiab yog catabolized los ntawm kev sib cuam tshuam nrog kev sib raug zoo siab LDL receptors. Kev tshawb nrhiav thiab kev tshawb fawb hais tias kev nce qib ntawm tag nrho cov roj (OX), LDL roj (LDL-C) thiab apolipoprotein B (apo B) hauv ntshav ntshav pab txhawb kev txhim kho atherosclerosis hauv tib neeg thiab muaj kev pheej hmoo rau kev txhim kho cov hlab plawv, thaum lub sijhawm thaum nce qib roj HDL ntau yog txuam nrog kev txo qis kev pheej hmoo ntawm cov kab mob plawv.

Hauv kev sim tsiaj cov qauv, lyprimar txo cov ntshav plasma cov ntshav thiab lipoprotein ntau ntau los ntawm inhibiting HMG-CoA reductase nyob rau hauv daim siab thiab cov roj synthesis thiab los ntawm kev ua rau cov hepatic LDL receptors nyob rau hauv lub xovtooj ntawm tes los txhim kho kev nqus thiab catabolism ntawm LDL thiab liprimar kuj txo LDL ntau lawm thiab qhov nyiaj ntawm cov no hais. Liprimar txo cov roj cholesterol LDL nyob hauv qee cov neeg mob nrog homozygous tsev neeg hypercholesterolemia, uas yog, cov pab pawg ntawm cov neeg uas tsis tshua muaj neeg teb rau kev kho nrog lwm cov tshuaj hypolipidemic.

Ntau cov kev tshawb fawb soj ntsuam tau pom tias nce theem ntawm tag nrho cov roj (cholesterol), LDL cov roj (cholesterol) thiab apo B (cov qog ua kua rau LDL roj) ua rau kev loj hlob ntawm atherosclerosis. Ib yam li ntawd, txo qis ntawm HDL cov roj (thiab nws txoj kev thauj - thiab A) cuam tshuam nrog kev txhim kho ntawm atherosclerosis. Kev tshawb xyuas kabmob sab nrauv tau pom tias kev mob plawv hlab ntsha thiab tuag ntawm qhov sib txawv hauv cov qib ncaj qha rau cov theem ntawm cov roj (cholesterol) tag nrho thiab LDL cov roj (cholesterol) thiab rov qab sib luag rau qib roj HDL.

Liprimar txo qis tag nrho cov roj (cholesterol), LDL cov roj (cholesterol) thiab apo B hauv cov neeg mob homozygous thiab heterozygous tsev neeg hypercholesterolemia, tsis yog tsev neeg hom hypercholesterolemia thiab sib xyaw dyslipidemia. Liprimar kuj txo qis VLDL thiab TG cov roj cholesterol, thiab tseem ua rau cov roj ntsha HDL tsis ruaj khov thiab A-1 apolipoprotein. Liprimar txo qis tag nrho cov roj (cholesterol), LDL roj cholesterol, VLDL cov roj (cholesterol), apo B, triglycerides thiab roj HDL, thiab tseem nce HDL roj cholesterol rau cov neeg mob tawg hypertriglyceridemia. Liprimar txo cov roj cholesterol kom qis qis hauv cov neeg mob dysbetalipoproteinemia.

Zoo li LDL, lipoproteins ntxiv rau cov roj (cholesterol) thiab triglycerides, suav nrog VLDL, STDs thiab seem, tuaj yeem pab txhawb kev txhim kho atherosclerosis. Txhawb cov ntshav triglycerides feem ntau ua rau lub cev tsis sib luag nrog cov roj HDL cov roj (cholesterol) thiab cov LDL me me, thiab ntxiv rau kev sib xyaw nrog cov tsis muaj lipid metabolic phom sij rau cov kab mob plawv. Nws tsis tau muaj pov thawj tas li uas txhua qib ntshav plasma triglycerides yog yam muaj kev pheej hmoo ntawm kev txhim kho cov hlab plawv plawv. Ib qho ntxiv, ib qho kev ywj pheej ntawm kev nce qib HDL lossis qis dua triglycerides ntawm txoj kev pheej hmoo ntawm cov hlab ntshav txhaws thiab hlab plawv thiab lub ntsej muag tau tsim.

Liprimar, zoo li qee yam ntawm nws cov metabolites, yog cov khw muag tshuaj muaj sia hauv tib neeg. Qhov chaw tseem ceeb ntawm kev ua ntawm atorvastatin yog lub siab, uas ua lub luag haujlwm tseem ceeb hauv kev sib txuas ntawm cov roj (cholesterol) thiab kev tshem tawm ntawm LDL. Cov koob tshuaj ntawm cov tshuaj, hauv qhov sib piv rau cov tshuaj ntawm lub cev ntawm lub cev, yog qhov zoo dua nrog kev txo qis hauv LDL cov roj (cholesterol). Xaiv cov koob tshuaj ib leeg yuav tsum tau ua raws li cov lus teb rau kev kho mob (saib Ntu "Dosage thiab Administration").

Xuas. Liprimar nrawm nrawm tom qab kev tswj hwm qhov ncauj thiab nws cov ntshav siab tshaj plaws tau nce mus txog hauv 1-2 teev. Cov neeg kawm ntawv qib nqus nce ntxiv hauv kev faib ua feem nrog cov koob tshuaj lymprim. Lub bioavailability ntawm atorvastatin (niam txiv siv tshuaj yaj yeeb) yog kwv yees li 14%, thiab cov kab ke ua haujlwm ntawm lub cev ua kom qhov kev tiv thaiv tsis zoo tiv thaiv HMG-CoA reductase yog kwv yees 30%. Kev siv tshuaj tsawg kawg ntawm lub cev yog txuam nrog kev tiv thaiv ua ntej kev txiav txim siab hauv txoj hnyuv ntawm txoj hnyuv thiab / lossis cov txheej txheem ua ntej biotransformation hauv lub siab. Txawm hais tias cov zaub mov txo qis thiab ntau npaum li cas los ntawm kev nqus ntawm cov tshuaj los ntawm kwv yees li 25% thiab 9%, feem, raws C C thiab AUC, txo cov roj cholesterol LDL zoo sib xws tsis hais lypimar noj nrog zaub mov lossis nyob ib leeg. Thaum siv atorvastatin thaum yav tsaus ntuj, nws qhov kev xav hauv cov ntshav ntshav qis dua (kwv yees 30% rau C max thiab AUC) tshaj li thaum sawv ntxov. Txawm li cas los xij, qhov txo qis hauv LDL cov roj (cholesterol) yog tib yam tsis hais lub sijhawm noj tshuaj (saib Ntu "Kev Noj Tshuaj thiab Cov Tshuaj").

Kev xa Khoom. Qhov nruab nrab faib ntim ntawm cov tshuaj lypimar yog kwv yees li 381 litres. Ntau tshaj li 98% ntawm cov tshuaj khi rau cov ntshav plasma. Qhov sib piv ntawm cov ntshav / ntshav yog kwv yees 0.25, qhia txog kev nkag mus tsis zoo ntawm cov tshuaj mus rau cov ntshav liab. Raws li kev soj ntsuam hauv cov nas, nws ntseeg tias lypimar muaj peev xwm nkag mus rau niam mis (saib Ntu "Kev Pom Tsis Zoo", "Siv thaum cev xeeb tub lossis pub mis niam" thiab "Peculiarities ntawm Kev Siv").

Kev zom zaub mov. Liprimar yog cov khoom siv dav hauv ortho thiab para-hydroxylated derivatives thiab ntau yam khoom ntawm beta oxidation. Hauv kev tshawb nrhiav hauv vitro, qhov kev txwv tsis pub HMG-CoA reductase ortho thiab parahydroxylated metabolites yog sib npaug rau kev txwv los ntawm cov tshuaj lympar. Kwv yees li 70% ntawm kev tiv thaiv kev tiv thaiv kom tsis txhob tiv thaiv HMG-CoA reductase yog txuam nrog cov tshuaj metabolites. Hauv kev tshawb fawb hauv vitro qhia qhov tseem ceeb ntawm cov metabolism hauv cov tshuaj lyprimar cytochrome P450 3A4, uas yog xwm yeem nrog kev nce siab ntawm cov tshuaj lypimar hauv tib neeg cov ntshav plasma tom qab siv nrog erythromycin, tus paub tiv thaiv ntawm qhov enzyme (saib Ntu "Kev cuam tshuam nrog lwm cov tshuaj").

Kev cais tawm. Liprimar thiab nws cov metabolites yog tawm nrog cov kua tsib tom qab cov kab mob hepatic thiab / lossis extrahepatic ntxiv, txawm li cas los xij, cov tshuaj no, pom tseeb, tsis muaj kev mob plab zom mov. Ib nrab-lub neej ntawm lypimar los ntawm tib neeg cov ntshav ntshav yog kwv yees li 14 teev, tab sis lub sijhawm ntawm qhov txo qis hauv qhov kev tiv thaiv tiv thaiv HMG-CoA reductase yog los ntawm 20 mus rau 30 teev los ntawm kev koom tes ntawm cov metabolites nquag. Tom qab noj cov tshuaj nrog zis, tsawg dua 2% ntawm koob tshuaj yog pom tawm.

Cov neeg laus cov neeg mob. Lub plasma concentration ntawm lyprimar yog siab dua (kwv yees li 40% rau C max thiab 30% rau AUC) hauv cov neeg laus noj qab haus huv (laus dua 65 xyoos) dua li cov hluas. Cov ntaub ntawv kho mob qhia pom ntau dua qhov txo qis hauv LDL thaum siv ib qho tshuaj twg hauv cov neeg laus piv rau cov neeg hluas (saib ntu "Ntu ntawm kev siv").

Cov menyuam. Tsis muaj cov ntaub ntawv pharmacokinetic rau ib pab pawg neeg mob rau menyuam yaus.

Paul Qhov kev cia siab ntawm cov tshuaj lymprim hauv cov ntshav ntshav ntawm cov poj niam sib txawv ntawm cov concentration hauv cov ntshav ntshav ntawm u (kwv yees li 20% ntau dua rau C max thiab 10% qis rau AUC). Txawm li cas los xij, tsis muaj qhov sib txawv hauv tsev kho mob los txo qhov roj LDL thaum siv tshuaj lypimar rau txiv neej thiab poj niam.

Lub raum khiav tsis zoo. Kab mob raum tsis cuam tshuam qhov kev txiav txim siab ntawm cov tshuaj lymprim hauv ntshav plasma lossis txo qis LDL cov roj cholesterol, thiab yog li ntawd, kev kho tshuaj rau cov neeg mob uas lub raum tsis ua haujlwm tsis tas yuav tsum muaj (saib Tshooj "Kev Noj Tshuaj thiab Txoj Cai", "cov ntsiab lus thov").

Hemodialysis Txawm hais tias qhov tseeb tsis muaj kev tshawb nrhiav hauv cov neeg mob raum-mob raum, nws ntseeg tau tias hemodialysis tsis nce ntxiv lymprim tshem tawm, vim tias cov tshuaj khi sib zog ua rau cov ntshav protein.

Daim siab ua haujlwm. Qhov kev cia siab ntawm cov tshuaj lymprim hauv cov ntshav plasma yog nce zuj zus hauv cov neeg mob uas muaj kab mob rau lub siab ntev. Qhov tseem ceeb ntawm C max thiab AUC yog 4 npaug dua rau hauv cov neeg mob uas muaj chav A mob siab raws li Child-Pugh nplai. Hauv cov neeg mob nrog Me-Pugh chav ua mob siab rau lub siab, qhov tseem ceeb ntawm C max thiab AUC nce kwv yees li 16-fold thiab 11-fold, feem (saib ntu "Contraindications").

Cov nyhuv ntawm cov tshuaj thooj txhij siv cov tshuaj rau hauv pharmacokinetics ntawm atorvastatin

Liprimar rau cov neeg laus

Liprimar, zoo li lwm yam statins, yog tsim rau cov neeg laus uas tau kuaj tus kab mob plawv. Cov tshuaj no txo ​​cov kev pheej hmoo ntawm lub plawv nres, mob hlab ntsha tawg, qhov xav tau ntawm stenting lossis hlab ntsha txoj hauv kev los ntawm kev hla pob txha. Cov lus sau hauv cov ntawv kho mob txawv teb chaws pom zoo tias atorvastatin raug muab tshuaj rau cov neeg laus hauv nruab nrab thiab siab siab, thiab tsis yog nyob hauv qis. Qhov kev pom zoo no siv rau cov neeg mob 65-78 xyoo uas muaj kev pheej hmoo mob plawv - nrog rau kev kuaj mob ntawm tus mob angina pectoris, atherosclerosis ntawm qhov qis qis dua uas muaj mob plawv, mob ntshav hlab lossis phais mus rov qab los ntshav hauv cov hlab ntsha. Yog tias atorvastatin 10 mg ib hnub pab tsis tau txaus, ces koj yuav tsum nce tshuaj ntau dua. Cov kev mob tshwm sim tsis tshua phem dua li kev tuag los yog xiam oob qhab vim muaj lub plawv nres.

Nyob rau xyoo 2009, phau ntawv Journal Clinical Cardiology tau tshaj tawm cov kev tshawb pom uas muaj 2442 cov neeg laus uas muaj mob plawv tuaj koom. Ib nrab ntawm lawv tau muab cov tshuaj Liprimar hauv cov koob tshuaj siab, txog li 80 mg rau ib hnub, thiab pab pawg thib ob tau muab tib qho tshuaj atorvastatin lossis lwm yam statins rau hauv koob thiab qis. Cov kws kho mob pom cov koom hauv qhov kev tshawb fawb txog 4 xyoos. Hauv cov neeg mob noj loj dua ntawm atorvastatin, mob plawv poob qis los ntawm 27% piv nrog pab pawg thib ob. Cov kev mob tshwm sim los ntawm kev noj cov tshuaj statins feem ntau pom nyob hauv cov neeg laus dua li cov hluas. Tab sis lawv cov kev nthuav dav hauv ob pawg tsis sib txawv ntau.

Kom Cov Cholesterol hauv Cov Me Nyuam

Txawv ntxiv, cov tshuaj yog thawj cov tshuaj atorvastatin yog tsim rau cov neeg hluas uas tau kuaj pom muaj kab mob tsis tshua muaj kab mob - kab mob heterozygous tsev neeg hypercholesterolemia. Nws tuaj yeem raug kho nrog cov cuab yeej no, zoo li lwm cov statins, pib txij hnub nyoog 10 xyoo. Cov menyuam ntxhais tuaj yeem noj cov tshuaj statins tsuas yog ib xyoos tom qab lawv muaj lawv li coj khaub ncaws.

Liprimar hauv kev kho mob ntawm tsev neeg hypercholesterolemia ua rau muaj kev phiv tsis ntau tshaj li cov placebo. Tsis muaj ntaub ntawv qhia txog kev ua haujlwm ntawm cov tshuaj no rau cov menyuam yaus hnub nyoog qis dua 10 xyoo. Hauv kev sim tshuaj, atorvastatin tau muab tshuaj rau cov menyuam yaus thiab cov hluas hauv kev noj tshuaj uas tsis siab tshaj 20 mg rau ib hnub. Yog li, tsis muaj ntaub ntawv qhia txog yuav ua li cas cov koob tshuaj ntau tuaj yeem ua haujlwm. Hauv cov teb chaws hais lus Lav Xias, lub hnub nyoog 18 xyoo yog qhov kev tsis sib haum xeeb rau kev teem caij atorvastatin.

Tshooj lus piav qhia txhua yam uas cov neeg mob xav paub txog kev siv atorvastatin. Hauv tshwj xeeb, cov kev mob tshwm sim tau piav qhia txhua yam - cov lus nug uas cuam tshuam rau txhua tus. Cov kws kho mob tseem yuav pom ntau cov ntaub ntawv muaj txiaj ntsig zoo rau lawv tus kheej. Atorvastatin ua rau cov roj "tsis zoo" cov roj hauv cov ntshav ntau dua li cov cim dhau los statins - lovastatin thiab simvastatin. Nws tsis tsuas yog ua rau qeeb ntawm kev txhim kho atherosclerosis, tab sis kuj txo cov tuab ntawm atherosclerotic plaques. Cov tshuaj qub tsis cuam tshuam rau cov roj cholesterol, uas tau tshwm sim dhau ntawm cov phab ntsa ntawm cov hlab ntsha. Liprimar - thawj cov tshuaj ntawm atorvastatin, uas suav hais tias yog feem ntau cov khoom lag luam zoo. Yog hais tias muaj nyiaj txiag tso cai, mam li coj nws mus. Yog tias koj xav txuag nyiaj, tham nrog koj tus kws kho mob txog kev hloov mus rau atorvastatin ntsiav tshuaj los ntawm lwm cov tuam ntxhab.

Rosuvastatin yog cov tshuaj tshiab dua li atorvastatin. Tam sim no hauv kev lag luam kws tshuaj ntawm cov statins muaj kev sib tw loj ntawm cov tshuaj no. Atorvastatin tsis xav txog kev muaj feem yuav muaj ntshav qab zib kom ntau npaum li rosuvastatin. Atorvastatin tuaj yeem siv tau rau cov neeg mob plawv tsis ua haujlwm. Tus thawj cov tshuaj Liprimar tiv thaiv lub raum hauv cov neeg mob uas muaj hom 1 thiab ntshav qab zib hom 2 zoo dua rosuvastatin. Tab sis nws tsis paub meej tias cov ntsiav tshuaj atorvastatin pheej yig dua kuj tseem pab cov neeg mob ntshav qab zib tau. Kev xaiv cov tshuaj tshwj xeeb yuav tsum yog ua los ntawm tus kws kho mob uas koom nrog. Tsis txhob muab tshuaj rau tus kheej.

Nrog saib xyuas

Hauv cov neeg mob uas quav cawv, nyob hauv cov neeg mob uas muaj keeb kwm muaj kab mob siab.

Hauv cov neeg mob uas muaj kev pheej hmoo rau rhabdomyolysis (lub raum tsis ua haujlwm, hypothyroidism, kev mob caj ces rau cov leeg mob hauv keeb kwm ntawm tus neeg mob lossis tsev neeg keeb kwm, cov tshuaj lom los ntawm HMG-CoA reductase inhibitors (statins) lossis fibrates ntawm cov leeg nqaij, keeb kwm muaj kab mob siab thiab / lossis cov neeg mob uas haus cov dej cawv ntau, ntau dua 70 xyoo, cov xwm txheej uas nce ntshav ntau dua ntawm atorvastatin xav tau (piv txwv li, kev sib cuam tshuam nrog lwm cov tshuaj) txhais tau tias)).

Heterozygous tsev neeg hypercholesterolemia

Qhov tshuaj thawj zaug yog 10 mg rau ib hnub. Cov koob tshuaj yuav tsum tau xaiv ib tus zuj zus thiab ntsuas qhov tseeb ntawm qhov koob tshuaj txhua 4 lub lis piam nrog kev nce ntxiv txog 40 mg ib hnub twg. Tom qab ntawd, txawm tias lub koob tshuaj yuav raug nce ntxiv txog qhov siab tshaj ntawm 80 mg rau ib hnub, lossis nws yog ua tau kom sib txuas cov tshuaj tiv thaiv kab mob sib ntxiv nrog kev siv atorvastatin ntawm ib koob ntawm 40 mg ib hnub.

Kev Tiv Thaiv Kab Mob Tiv Thaiv Kab Mob

Hauv kev tshawb nrhiav ntawm kev tiv thaiv kev tiv thaiv thawj zaug, koob tshuaj atorvastatin yog 10 mg rau ib hnub. Qhov koob tshuaj ntxiv yuav tsim nyog kom ua tiav LDL-C tus nqi raws li cov lus qhia tam sim no.

Siv rau hauv cov menyuam yaus ntawm 10 txog 18 xyoo nrog rau kev tiv thaiv heterozygous tsev neeg hypercholesterolemia

Qhov pom zoo kom pib noj yog 10 mg ib hnub ib zaug. Qhov kev txhaj tshuaj yuav raug nce ntxiv mus rau 20 mg ib hnub twg, nyob ntawm qhov siv los soj ntsuam. Kev paub nrog ib koob ntau tshaj 20 mg (sib haum rau ib koob ntawm 0.5 mg / kg) yog txwv.

Cov koob tshuaj ntawm cov tshuaj yuav tsum yog titrated nyob ntawm lub hom phiaj ntawm kev kho lipid-txo qis. Kev hloov koob tshuaj yuav tsum tau ua ntawm ncua sij hawm ntawm 1 lub sijhawm hauv 4 lub lis piam lossis ntau dua.

Siv nrog rau lwm cov tshuaj

Yog tias tsim nyog, kev siv sib xyaw nrog cyclosporine, telaprevir lossis kev sib xyaw ntawm tipranavir / ritonavir, koob tshuaj Liprimar yuav tsum tsis pub tshaj 10 mg / hnub.

Kev ceev faj yuav tsum tau siv thiab kev siv tshuaj qis tshaj plaws ntawm atorvastatin yuav tsum tau siv thaum nws siv nrog HIV tiv thaiv kab mob tiv thaiv kab mob siab, kab mob siab C protease inhibitors (boceprevir), clarithromycin thiab itraconazole.

Siv thaum cev xeeb tub thiab lactation

Liprimar yog contraindicated nyob rau hauv cev xeeb tub.

Cov poj niam uas muaj hnub nyoog yug me nyuam yuav tsum siv cov kev txwv kom muaj txiaj ntsig thaum lub sijhawm kho. Kev siv Liprimar yog contraindicated rau cov poj niam thaum lub hnub nyoog yug menyuam uas tsis siv txoj hauv kev los tiv thaiv kev pheej hmoo.

Cov teeb meem tsis tshua muaj neeg ntawm qhov tsis txaus ntseeg tom qab tau sau tseg tom qab kis tau tus me nyuam hauv tsev me nyuam tom qab HMG-CoA reductase inhibitors (statins). Cov kev tshawb fawb tsiaj tau pom tias muaj kuab lom rau kev ua me nyuam muaj nuj nqi. Liprimar yog contraindicated thaum lactation. Kuj tsis paub meej tias atorvastatin ua rau niam mis tso. Yog tias nws yog qhov tsim nyog los sau tshuaj rau lub sijhawm lactation, kev pub mis niam yuav tsum nres kom tsis txhob muaj kev phom sij ntawm cov menyuam mos.

Ua rau daim siab

Ib yam li kev siv lwm yam tshuaj lipid-txo qis hauv cov chav kawm no, nrog kev siv tshuaj Liprimar, qhov nruab nrab nce ntxiv (ntau dua 3 zaug piv nrog VGN) ntawm kev ua haujlwm ntawm hepatic transaminases AST thiab ALT tau sau tseg. Kev nce ntxiv hauv cov ntshav dej muaj txiaj ntsig ntawm hepatic transaminases (ntau dua 3 zaug piv nrog VGN) tau pom nyob hauv 0.7% ntawm cov neeg mob tau txais Liprimar. Kev hloov pauv ntau zaus thaum siv cov tshuaj hauv koob tshuaj 10 mg, 20 mg, 40 mg thiab 80 mg yog 0.2%, 0.2%, 0.6% thiab 2.3%, ntsig txog. Ib qho kev nce ntawm hepatic transaminase kev ua si feem ntau tsis nrog jaundice lossis lwm yam kev kuaj mob hauv lub cev. Nrog rau qhov txo qis hauv Liprimar, ib ntus lossis ua tiav tsis raug tshuaj, cov haujlwm ntawm hepatic transaminases rov qab mus rau nws cov qib qub. Feem ntau ntawm cov neeg mob txuas ntxiv noj Liprimar hauv kev txo qis yam tsis muaj kev mob tshwm sim.

Ua ntej pib, 6 lub lis piam thiab 12 lub lis piam tom qab pib noj tshuaj lossis tom qab nce qhov tshuaj, nws yog ib qhov yuav tsum tau soj ntsuam daim siab kev ua haujlwm. Lub siab ua haujlwm tseem yuav tsum tau kuaj xyuas thaum cov kab mob kev saib xyuas lub siab tshwm sim. Yog tias muaj kev nce ntawm kev ua haujlwm ntawm hepatic transaminases, lawv cov kev ua haujlwm yuav tsum tau saib xyuas kom txog thaum nws ua haujlwm li qub. Yog tias qhov nce hauv AST lossis ALT kev ua haujlwm los ntawm ntau dua 3 zaug piv nrog VGN mob siab, nws raug nquahu kom txo qhov koob tshuaj lossis tsis txiav Liprimar.

Liprimar yuav tsum tau siv nrog ceev faj hauv cov neeg mob uas haus cov dej cawv thiab / lossis muaj keeb kwm muaj kab mob siab. Lub siab ua mob siab lossis ua haujlwm tsis tu ncua los ntawm hepatic transaminases ntawm cov ntshav plasma ntawm keeb kwm tsis meej yog qhov sib kis rau kev siv Liprimar.

Ntxim rau cov leeg pob txha

Tus mob Myalgia tau sau tseg hauv cov neeg mob uas tau txais Liprimar. Kev kuaj mob ntawm tus mob myopathy yuav tsum xav nyob hauv cov neeg mob uas mob myalgia, mob nqaij los yog mob tsis muaj zog thiab / lossis cim KFK kev ua si ntau dua (ntau dua 10 zaug piv nrog VGN). Kev kho Liprimar yuav tsum tsis ua mus ntxiv thaum muaj qhov cim tseg hauv kev ua haujlwm ntawm CPK, thaum pom tias muaj tus mob myopathy pom. Txoj kev pheej hmoo ntawm myopathy thaum kho nrog lwm cov tshuaj ntawm cov hauv chav kawm no tau nce nrog kev siv zog sib xyaw ua ke ntawm CYP3A isoenzyme (piv txwv li, cyclosporine, telithromycin, clarithromycin, delavirdine, styripentol, ketoconazole, voriconazole, itraconazole, posaconazole, atavirinininavavinin darunavir), gemfibrozil lossis lwm cov fibrates, boceprevir, erythromycin, nicotinic acid hauv lipid txo cov tshuaj (ntau dua 1 g / hnub), ezetimibe, azole antifungal tus neeg sawv cev, colchicine, telaprevir, boceprevir, lossis kev sib xyaw ntawm tipranavir / ritonavir. Ntau ntawm cov tshuaj no inhibit CYP3A4 isoenzyme metabolism thiab / lossis thauj tshuaj. Nws paub tias cytochrome CYP3A4 isoenzyme yog lub siab isoenzyme lub siab koom nrog biotransformation ntawm atorvastatin. Muab tshuaj Liprimar ua ke nrog fibrates, erythromycin, immunosuppressants, antifungal tshuaj (azole derivatives) lossis nicotinic acid hauv hypolipidemic doses (ntau dua 1 g / hnub), cov txiaj ntsig uas xav tau thiab qhov pheej hmoo ntawm kev kho yuav tsum tau ua tib zoo ntsuas. Cov neeg mob yuav tsum tau soj ntsuam tas li txhawm rau txhawm rau txhawm rau txhawm rau mob leeg lossis tsis muaj zog, tshwj xeeb tshaj yog thaum thawj lub hlis ntawm kev kho mob thiab thaum lub sijhawm nce ntxiv ntawm ib qho yeeb tshuaj twg. Yog tias tsim nyog, kev sib txuas ua ke yuav tsum xav txog qhov siv tau cov tshuaj no hauv kev txo qis thiab saib xyuas cov koob tshuaj. Kev siv ua ke ntawm atorvastatin thiab fusidic acid tsis pom zoo; yog li ntawd, tshem tawm ib ntus ntawm atorvastatin raug pom zoo thaum kho nrog fusidic acid. Nyob rau tej qhov xwm txheej zoo li no, kev txiav txim siab ntawm CPK cov haujlwm txhua lub sijhawm tuaj yeem pom zoo, txawm hais tias kev saib xyuas zoo li no tsis tiv thaiv kev txhim kho kev mob myopathy.

Ua ntej kev kho mob

Liprimar yuav tsum tau siv nrog ceev faj hauv cov neeg mob uas muaj lwm yam cuam tshuam rau kev txhim kho ntawm rhabdomyolysis. Kev tswj ntawm kev ua haujlwm ntawm CPK yuav tsum tau nqa tawm hauv cov xwm txheej hauv qab no ua ntej pib kho txoj kev kho:

• lub raum tsis ua hauj lwm zoo,
• hypothyroidism
• mob rau cov mob ua haujlwm hauv cov leeg mob hauv tsev neeg lossis keeb kwm tsev neeg,
• twb hloov pauv cov tshuaj lom muaj hnub nyoog ntawm HMG-CoA reductase inhibitors (statins) lossis fibrates ntawm cov leeg nqaij,
• keeb kwm mob siab thiab / lossis cov neeg mob uas haus cawv ntau,
• nyob rau hauv cov neeg mob uas muaj hnub nyoog 70 xyoo, xav tau kev tswj hwm CPK yuav tsum raug ntsuas, muab qhov tseeb tias cov neeg mob no twb muaj lwm yam cuam tshuam rau kev txhim kho rhabdomyolysis,
• cov xwm txheej uas nce ntxiv hauv plasma ntau dua ntawm atorvastatin xav tau, xws li kev sib cuam tshuam nrog lwm yam tshuaj. Hauv cov xwm txheej zoo li no, kev pheej hmoo / cov txiaj ntsig sib piv yuav tsum raug ntsuas thiab kev tshuaj xyuas tus neeg mob tus mob yuav tsum tau ua. Nyob rau hauv qhov xwm txheej ntawm qhov nce siab hauv CPK kev ua haujlwm (ntau dua 5 npaug ntau dua li VGN), kev kho mob atorvastatin yuav tsum tsis txhob pib.

Thaum siv cov tshuaj Liprimar, zoo li lwm cov tshuaj tiv thaiv HMG-CoA reductase, muaj tsawg yam mob ntawm rhabdomyolysis nrog mob raum tsis ua haujlwm vim cov mob myoglobinuria tau piav qhia. Ib qho kev pheej hmoo txaus rau rhabdomyolysis yuav yog yav dhau los ua rau lub raum khiav tsis zoo. Cov neeg mob zoo li no yuav tsum tau txais kev saib xyuas ntau dua ntawm lub xeev ntawm cov leeg nqaij. Yog tias cov tsos mob ntawm tus mob myopathy tshwm sim lossis muaj kev pheej hmoo rau kev tsim kho lub raum tsis ua haujlwm vim qhov mob rhabdomyolysis (piv txwv, mob hnyav, mob ntshav qis, kev phais mob ntau, kev raug mob, metabolic, endocrine thiab dej-cuam tshuam kev puas tsuaj, kev tswj tsis tau tus mob), Liprimar yuav tsum tau txiav tawm ib ntus lossis lossis kiag li lawm os.

Cov neeg mob yuav tsum tau ceeb toom tias lawv yuav tsum tau sab laj nrog kws kho mob sai sai yog tias tsis hnov ​​qhov mob lossis cov leeg tsis muaj zog, tshwj xeeb tshaj yog tias lawv nrog mob tshwm sim lossis kub taub hau.

Kev tiv thaiv mob txhaws hnyav los ntawm Txo Cov Hluav Taws Xob Txo

Hauv qhov kev tshuaj ntsuam yav dhau los ntawm tus mob stroke subtypes nyob rau hauv cov neeg mob uas tsis muaj mob hlab ntsha hauv lub cev, tsis ntev los no muaj mob stroke lossis hloov ischemic nres, ntawm thawj theem uas tau txais atorvastatin ntawm koob ntawm 80 mg, qhov muaj ntau dua hemorrhagic mob stroke tau sau piv nrog cov neeg mob tau txais cov placebo. Ib qho kev pheej hmoo siab ntxiv yog tshwj xeeb tshaj yog pom hauv cov neeg mob uas muaj keeb kwm mob ntshav qab zib los yog lacunar infarction thaum pib ntawm txoj kev tshawb no. Hauv pawg no cov neeg mob, cov txiaj ntsig / kev pheej hmoo sib piv thaum noj atorvastatin hauv ib koob ntawm 80 mg tsis tau txhais tau zoo, hauv qhov no, ua ntej pib txoj kev kho mob, kev pheej hmoo ntawm kev mob hemorrhagic mob stroke hauv cov neeg mob no yuav tsum tau ua tib zoo ntsuas.

Tom qab kev txheeb xyuas tshwj xeeb ntawm kev tshawb fawb soj ntsuam koom nrog 4731 cov neeg mob uas tsis muaj mob hlab ntsha hauv lub cev uas muaj mob stroke lossis hloov ischemic nres (TIA) tsis pub dhau 6 lub hlis dhau los uas tau raug tshuaj atorvastatin 80 mg / hnub, muaj ntau dua qhov mob hemorrhagic mob stroke ntawm atorvastatin pawg ntawm 80 mg tau pom tawm piv nrog cov pab pawg placebo (55 hauv pawg atorvastatin tiv thaiv 33 hauv cov pawg placebo). Cov neeg mob hemorrhagic mob stroke thaum lub sij hawm suav nrog hauv txoj kev tshawb fawb tau muaj kev pheej hmoo siab ntxiv rau kev mob hlab ntsha tawg (7 hauv pawg atorvastatin tiv thaiv 2 hauv cov pawg placebo). Txawm li cas los xij, cov neeg mob uas tau txais atorvastatin 80 mg / hnub muaj tsawg dua qhov mob stroke ntawm txhua yam (265 piv rau 311) thiab tsawg dua kev mob plawv (123 piv rau 204).

Cov mob ntsws interstitial

Thaum kho nrog qee qhov HMG-CoA reductase inhibitors (statins), tshwj xeeb tshaj yog nyob rau cov kev kho mob mus ntev, cov neeg mob cais tawm ntawm tus mob ntsws interstitial tau raug tshaj tawm. Ua pa siav luv, hnoos tsis txaus, thiab ua kom tsis muaj mob dabtsi ntxiv (nkees, poob ceeb thawj, thiab kub ib ce) yuav tshwm sim. Yog tias tus neeg mob xav tias mob ntsws interstitial mob ntsws, kev kho atorvastatin yuav tsum tsis ua mus ntxiv.

Endocrine muaj nuj nqi

Thaum siv cov tshuaj tiv thaiv kab mob HMG-CoA reductase (statins), suav nrog atorvastatin, muaj cov mob ntawm glycosylated hemoglobin (HbA1) thiab yoo plasma ntshav qab zib concentration. Txawm li cas los xij, kev pheej hmoo ntawm hyperglycemia yog qis dua li kev paub txog kev txo qis hauv kev pheej hmoo ntawm kev mob vascular thaum noj HMG-CoA reductase inhibitors (statins).

Muaj feem xyuam rau kev muaj peev xwm ntawm kev tsav tsheb

Tsis muaj cov ntaub ntawv hais txog cov nyhuv ntawm Liprimar ntawm kev muaj peev xwm tsav tsheb thiab koom nrog cov haujlwm uas muaj kev phom sij uas xav tau kev nce siab ntawm cov xim xav tau thiab nrawm ntawm cov kev xav psychomotor. Txawm li cas los xij, vim tias muaj peev xwm ntawm kiv taub hau, ceev faj yuav tsum tau siv rau hauv cov haujlwm no