Hana ʻia 20 mg - nā ʻōlelo aʻoaʻo no ka hoʻohana

pani ʻ -lelo ʻlelo

1 papa i hana ʻia nā pahu 10 mg / 20 mg he:
Ka kumu
Mea waiwai:
Atorvastatin calcium 10.36 mg / 20.72 mg (like me ka atorvastatin 10.00 mg / 20.00 mg)
Nā mea hoʻoweliweli:
povidone - K25, sodium lauryl sulfate, calcium carbonate, microcrystalline cellulose, lactose monxidate, croscarmellose sodium, magnesium stearate
He leʻaleʻa kiʻi
Opadry II HP 85F28751 White *
* Opadry II HP 85F28751 keokeo ka mea i: polyvinyl ka ʻona, titanium dioxide (E171), macrogol-3000, talc

ʻO keʻano

Huli, papa nā bikavex hāmeʻa, ke keʻokeʻo a ʻīwī paha i keʻokeʻo.
Kink nānā: keʻokeʻo keʻokeʻo keʻokeʻo me kahi film film membrane o ke kala keʻokeʻo a ʻokoʻa paha.

Lapaʻau lāʻau

ʻO Atorvastatin kahi mea maʻi hypolipidemic mai ka pūʻulu o nā statins. ʻO ka hana nui o ka hana o ka atorvastatin ʻo ka pale ʻana i ka hana o ka 3-hydroxy-3-methylglutaryl-coenzyme A - (HMG-CoA) reductase, he enzyme e hōʻiliʻili nei i ka huli ʻana o HMG-CoA i ka waika mevalonic. ʻO kēia hoʻololi i kekahi o nā neʻe mua i ka mekala synthesis o ke kino ma ke kino.

Hoʻokomo ʻia o Atorvastatin i ka synthesis o ka cholesterol synthes i ka hoʻonui ʻia o ka hoʻohaʻahaʻa i nā ʻae ʻawaʻawa lalo o ka lipoprotein receptors (LDL) i loko o ka ate, a me nā kaoʻu extrahepatic. Ua hoʻopaʻa kēia mau mea i ka palaka LDL a hoʻoneʻe iā lākou mai ka plasma koko, ke alakaʻi nei i ka emi o ke koena o ka LDL cholesterol (Ch) LDL (Ch-LDL) i ke koko. ʻO ka hopena antisclerotic o ka atorvastatin he hopena i kona hopena ma nā paia o nā kīʻaha koko a me nā ʻike koko. Hoʻopili ke Atorvastatin i ke kāpili ʻana o ka isoprenoids, ʻo ia nā mea ulu nui o nā pūpū o nā liʻolima o nā lau koko. Ma lalo o ka mana o ka atorvastatin, hoʻonui i ka hoʻonui ʻia o ka endothelium e pili ana i nā moku koko, e hōʻemi ka nui o ka LDL-C, LDL, apolipoprotein B, triglycerides (TG), a me ka hoʻolilo ʻana i ka lipoprotein kiʻekiʻe-density (HDL-C) a me ka apolipoprotein A hoʻonui.

Hoʻopili ʻo Atorvastatin i ka hiki o ka plasma koko a me ka hana a kekahi mau mana coagulation a me ka hui platelet. Ma muli o kēia, hoʻomaikaʻi ʻo ia i ka hemodynamics a hoʻomaʻamaʻa i ke ʻano o ka ʻōnaehana coagulation. Hoʻopilikia ka HMG-CoA reductase inhibitors i ka hana kaohiʻana o nā macrophages, poloka i kā lākou hana a pale aku i ka hiwahiwa ʻana o nā palaki atherosclerotic.

Ma ke ʻano he kānāwai, e ulu ana ka hopena therapeutic o ka atorvastatin ma hope o ʻelua pule o ka hoʻohana ʻana i ka atorvastatin, a loaʻa ka hopena kiʻekiʻe ma hope o nā hebedoma.

ʻO ka atorvastatin ma kahi o 80 mg ka nui e hoʻēmi i ka hopena o ka hoʻomohala ʻana i ka hoʻopiʻi ischemic (me ka make mai ka myocardial infarction) e ka 16%, ka hopena o ka hoʻoliʻi hou ʻana no ka angina pectoris, i hui pū ʻia e nā hōʻailona o ka ischemia myocardial - e 26%.

Lapaʻau lāʻau

Aia ke kiʻekiʻe o ka absorption Atorvastatin, ma kahi o 80% e kāʻili mai ka gastrointestinal tract. ʻO ka pae o ke kīhū a me ka ʻike ʻana i ka plasma koko e hoʻonui me ka hoʻohālikelike o ka nui. ʻO ka manawa e hiki ai i ka lōʻihi loa o ka piʻi ʻana (TCmax) ka, ma ka awelika, he 1-2 hola.ʻO nā wahine, ʻoi aku ka nui o TCmax ma ka 20%, a ʻo ka wahi ma lalo o ka curve-manawa curhat (AUC) he 10% haʻahaʻa. He ʻokoʻa nā ʻokoʻa i loko o ka pharmacokinetics i nā maʻi ma o ka makahiki a me ka wahine a he mea nui ʻole a ʻaʻole pono ke hoʻoponopono i ka dosis.

I nā maʻi me ka cirrhosis ngati waiʻona, ʻo TCmax ka 16 mau manawa ma mua o ka mea maʻamau. Hōʻemi iki ka ʻai ʻana i ka wikiwiki a me ka lōʻihi o ka inu ʻana i ka lāʻau (e 25% a me 9%, no kēlā me kēia), akā ke ʻano like ʻole ka hōʻemi o ka LDL-C me ka atorvastatin ʻole me ka ʻai.

ʻO ka haʻalulu bioroda o Atorvastatin he haʻahaʻa (12%), ka bioavailability o systemic i kahi hana pale me ka HMG-CoA reductase he 30%. ʻO ka bioavailability systemic haʻahaʻa ma muli o ka presystemic metabolism ma ka membous mucous o ka gastrointestinal tract a me ka "mahele mua" ma o ke ake.

ʻO ka nui nui o ka laha ʻana o ka atorvastatin he 381 lita. ʻOi aku ma mua o 98% o ka atorvastatin nakinaki i nā protein plasma.

ʻAʻole hiki i ke Atorvastatin ke pani i ka lolo-lolo.

Ka hana nui ia i ka ate ma lalo o ka hana a Zen4 isoenzyme o ka cytochrome P450 me ka hoʻokumu ʻana o nā metabolites hoʻolaʻa a me nā metabolites (ortho- a me nā parahydroxylated metabolite, nā hua a beta-oxidation), e pili ana i ka 70% o ka hana pale aku i ka HMG-CoA reductase ma loko o kahi manawa o 20-30 mau hola.

ʻO ka hapa-ola (T1 / 2) o atorvastatin he mau hola 14. Ua hoʻopiʻi ʻia ʻo ia me ka bile (ʻaʻole i hoʻokaʻawale ʻia i ke ʻano o ka recirculation enterohepatic, ʻaʻole i hoʻopau i ka wā hemodialysis). Ma kahi o 46% o ka atorvastatin e hoʻopili ʻia ma o nā ʻōpū a emi mai ka 2% e nā keiki.

Nā hōʻailona no ka hoʻohana ʻana

ʻO ka hōʻike no ka hoʻohana ʻana i ka lāʻau Atoris 20 mg ʻo:

• ʻO ka hypercholesterolemia mua (heterozygous familial a non-familial hypercholesterolemia (type II e like me Fredrickson),
• Hoʻohui (hui like ʻia) hyperlipidemia (IIa a me IIb ʻano like e like me Fredrickson),
• ʻO Dysbetalipoproteinemia (ʻano III e like me Fredrickson) (ma ke ʻano o ka meaʻai)
• He hypertriglyceridemia Familial (type IV na Fredrickson), kūpaʻa i ka meaʻai,
• Homozygous familial hypercholesterolemia me ka lawa ʻole o ka hana o kaʻai ʻana i ka papa ʻaina a me nā ʻano ʻē aʻe non-pharmacological o ka mālama ʻana,

Hoʻopilikia i nā maʻi Cardiovascular:

• ʻO ka pale mua ʻana o nā hoʻopiʻi cardiovascular ma nā poʻe maʻi me nā hōʻailona ʻole o ka maʻi coronary heart disease, akā me nā mea pili i ka neʻe ʻana no kona hoʻomohala: ʻoi aku ka makahiki ma mua o 55 mau makahiki, ka hoʻohui ʻana ʻo nikotine, hypertension hypertension, diabetes mellitus, nā haʻahaʻa haʻahaʻa o HDL-C i ka plasma koko, predisposition genetic, me ka e kū'ē ana i ka mua o ka dyslipidemia,
• Kāle mua i ka pale ʻana o nā hoʻopiʻi cardiovascular ma ka poʻe maʻi me ka maʻi ʻeha coronary (CHD) i ka hoʻemi ʻana i ka nui o ka make huina, myocardial infarction, stroke, re-hospitalization no ka angina pectoris a me ka pono no ka revascularization.

Nā Hoʻohui

Nā maʻi hoʻohālikelike i ka hoʻohana ʻana o nā papa Atoris:

• hypersensitivity o kekahi o nā lāʻau o ka lāʻau,
• maʻi pūpū pili ma ka hana ikaika (e komo pū ana i nā maʻi hepatitis ikaika, hepatitis palaka)
• cirrhosis o ka ake o kekahi etiology,
• mahuahua ka hana o ka "ati" transaminases o ka ʻike kumu ʻana ma mua o 3 mau manawa i hoʻohālikelike ʻia me ka palena palena kiʻekiʻe o ka maʻamau,
• aʻe ʻālaʻi huakaʻi
• hapai a me lactation,
• ʻoi aku ka makahiki 18 a keu (ʻaʻole i hoʻokū ʻia ka maikaʻi a me ka palekana o ka hoʻohana ʻana).
• lactase kakali, lactose intolerance, glucose-galactose malabsorption syndrome.

Hoʻohana i ka wā hāpai a me ka umauma

Contorisicated ʻo Atoris i ka wā hapai a ma ka wā hapai. Ua hōʻike ʻia nā haʻawina holoholona i ka hopena o ka ʻoi a maʻa paha i hiki ke loaʻa i ka pōmaikaʻi i ka makuahine.

I nā wahine o nā makahiki hānau o ka hoʻohana ʻole i ka hana kūpono o ka contraception, ʻaʻole i ʻōlelo ʻia ka hoʻohana ʻana o Atoris. Ke hoʻolālā nei i kahi hāpai hāpai, pono ʻoe e hoʻōki me ka hoʻohana ʻana iā Atoris ma kahi o ka 1 mahina ma mua o kou hoʻohala ʻia.

ʻAʻohe mea hōʻike i ka alala o ka atorvastatin me ka waiū umauma. Eia nō naʻe, i kekahi mau holoholona holoholona, ​​ʻano like ka ʻike o ka atorvastatin i ka serum koko a i ka waiū o nā holoholona lactating ka like. Inā pono e hoʻohana i ka lāʻau laʻi Atoris i ka wā lactation, i mea e pale ʻole ai ka hoʻomohala ʻana i nā hanana ʻino i nā pēpē, pono e hoʻokuʻu ʻia nā ʻōpiopio.

ʻLoe a me ke kākele

Ma mua o ka hoʻomaka ʻana i ka hoʻohana ʻana o Atoris, pono e neʻe ka mea maʻi i ka ʻai. Hāʻawi i ka hāʻawi ʻana i ka kaʻe o ka lipids i ke koko, pono e mālama ʻia i ka wā o ka mālama ʻana me ka lāʻau lapaʻau. Ma mua o ka hoʻomaka ʻana i ka hoʻomaʻamaʻa, pono ʻoe e hoʻāʻo e hoʻokō i ka hiki ʻana o ka hypercholesterolemia ma o ka hoʻomaʻamaʻa ʻana a me ka momona kaumaha i nā mea maʻi me ka momona, me ka ʻōlelo no ka maʻi ma lalo.

Lawe ʻia ka lāʻau lapaʻau ma ke ʻano, me ke ʻano o ka ʻaina. Hoʻololi ʻia ka ʻano o ka lāʻau lapaʻau mai 10 mg i 80 mg i hoʻokahi lā i kahi lā a koho ʻia e noʻonoʻo i ka ʻike mua ʻana o ka LDL-C, ke kumu o ka ʻoihana a me ka hopena therapeutic pilikino.

Hiki i nā Atoris ke kau i hoʻokahi manawa i ka manawa, akā i ka manawa like i kēlā me kēia lā.

Hoʻomaopopo ka hopena therapeutic ma hope o ʻelua mau pule o ka mālama ʻana, a hoʻomohala ka hopena ʻoi loa ma hope o nā hebedoma ʻehā. No laila, ʻaʻole e loli pono ka nui o ka dosage ma mua o ʻehā mau pule ma hope o ka hoʻomaka ʻana o ka lāʻau lapaʻau ma mua.

I ka hoʻomaka ʻana o ka lāʻau a me / a i ka manawa o ka hoʻonui ʻana i ke kinikona, pono ia e nānā i ka paʻa ʻana o nā lipids i ka plasma koko i kēlā me kēia mau hebedoma 2-4 a e hoʻoponopono pono ʻia i kēia mahele.

Homozygous hoʻoilina hypercholesterolemia

Hoʻohālikelike ka laulā like me nā ʻano ʻē aʻe o ka hyperlipidemia.

Kahi ʻia ka ʻōmole mua ma muli o ka nui o ka maʻi. I ka hapa nui o nā mea maʻi me ka homozygous hernaʻi hypercholesterolemia, ʻike ʻia ka hopena maikaʻi loa me ka hoʻohana ʻana i ka lāʻau lapaʻau i kēlā me kēia lā o 80 mg (hoʻokahi). Hoʻohana ʻia ʻo Atoris® e like me ka lāʻau pili i nā lāʻau ʻē aʻe (plasmapheresis) a i ʻole ka launa ʻana inā he hiki ʻole ke lapaʻau ʻia me nā ʻano ala ʻē aʻe.

Hoʻohana ma ka pākeke

I nā poʻe maʻi ʻelemakule a me nā maʻi me nā maʻi o ka maʻi, ʻaʻole e hoʻololi ʻia ka hapa o Atoris. ʻAʻole pili ka hana o ka renal i ka pale i ka nānā ʻana o ka atorvastatin i loko o ke kaila koko a i ʻole ka pae o ka hōʻemi o ka neʻe o ka LDL-C me ka hoʻohana ʻana i ka atorvastatin, no laila, ʻaʻole pono ka loli ʻana o ka lāʻau.

Hōʻeha ka hana ʻoluʻolu

I nā mea maʻi me ka pīhoihoi hana ʻino, pono ke mālama ʻia (ma muli o ka hoʻolohi ʻana i ka hoʻopau ʻana i ka lāʻau mai ke kino). I kēlā kūlana, pono e nānā pono ʻia nā ʻōkuhi haukapila a me nā mea hana (me ka nānā maʻamau o ka hana o ka aspartate aminotransferase (ACT) a me alanine aminotransferase (ALT). Me ka loaʻa nui o ka hana o nā transaminases hepatic, pono e hoʻemi ʻia ka nui o nā Atoris a i ʻole ke oki ʻana i ka mālama ʻana.

Nā hopena hopena

I ka wā o ka hoʻohana ʻana i nā papa o Atoris 20 mg, hiki i nā hopena hopena:

• Mai ka pūnaehana nūhou: pinepine: headache, insomnia, dizziness, paresthesia, asthenic syndrome, pinepine ʻole: peripheral neuropathy. amnesia, hypesthesia,
• Mai nā papa inoa sensory: pinepine: tinnitus, jarang: nasopharyngitis, nosebleeds,
• Mai nā ʻāpana hemopoietic: pinepine ka maʻi: thrombocytopenia,
• Mai ka papa hanu: pinepine: ʻeha ka ʻōpū,
• Mai ka pūnaehana ʻana: pinepine: constipation, dyspepsia, nausea, ʻālā. ʻulaʻehā (bloating), ʻeha o ka ʻōpū, pinepine loa: anorexia, ʻōpū ʻole o ka leʻaleʻa, luaʻi ʻana, pancreatitis, ʻehā: hepatitis, jaundice cholestatic,
• Mai ka papa musculoskeletal: pinepine: myalgia, arthralgia, ʻeha hope. ka huhū hui, pinepine: myopathy, uaua ʻāʻī, līpoki: myositis, rhabdomyolysis, tendopathy (i kekahi mau hihia me ka tendon tendon).
• Mai ka pūnaehana genitourinary: pinepine: i hoʻohaʻahaʻa i ka potency, ʻo ka renal lua ʻole,
• Ma ka ʻāpana o ka ʻili: pinepine: ʻili ka ʻili, ʻeha, pinepine: urticaria, ʻehā loa: angioedema, alopecia, rash bullous, erythema multiforme, Stevens-Johnson syndrome, necrolysis epidermal epacola.
• Nā maʻi kūloko: pinepine: alikaʻi, kūʻai ʻole: anaphylaxis,
• Nā hōʻailona kuhikuhi: ka hana pinepine: ka hana o ka aminotransferases (ACT, ALT), i hoʻonui ʻia o ka serum creatine phosphokinase (CPK), ʻano liʻiliʻi: hyperglycemia, hypoglycemia,
• Nā mea maʻamau: pinepine: peripheral edema, pinepine: manuise, ʻehaʻeha, hiapo, loaʻa ka momona.
• ʻO ke kumu kumu o kekahi hopena kūpono ʻole me ka hoʻohana ʻana i ka lāʻau Atoris, ka mea i manaʻo ʻia he "līpono", ʻaʻole i paʻa. I ka hiki ʻana mai o nā hopena kūpono ʻole ka hoʻohana ʻana i ka lālani Atoris e hoʻōki.

Ke keu

ʻAʻole hōʻike ʻia nā hihia o ka overdose.

Ma kahi o ka overdose, pono nā ʻōnaehana holoʻokoʻa nei: ka nānā ʻana a mālama i nā hana nui o ke kino, a me ke kāohi ʻana i ka nui o ke komo ʻana i ka lāʻau (lavage gastric, lawe ʻia i ka ulaula a me nā laxatives).

Me ka hoʻomohala ʻana i ka myopathy, i ukali ʻia e ka rhabdomyolysis a me ka hāʻule ʻole ʻana o ka renal (kahi hopena ākea akā loaʻa ʻole), pono e hoʻopau koke ʻia ka lāʻau lapaʻau a hoʻomaka ʻia ka infusion diuretic a me ka sodium bicarbonate. Inā pono, e hana ʻia nā hemodialysis. Hiki i ka Rhabdomyolysis ke alakaʻi i ka hyperkalemia, e koi ana i ka hoʻoponopono intravenous i kahi hopena o ka calcium chloride a i ʻole ka hopena o ka calcium gluconate, ka infusion o kahi 5% hopena o ka dextrose (glucose) me ka insulin, ka hoʻohana ʻana o ka paʻila pākela pālima, a i ʻole, i nā hihia koʻikoʻi, hemodialysis. ʻAʻohe huakino ka Hemodialysis.

ʻAʻohe mea antidote kikoʻī.

Hoʻohui nūhou

ʻO ka hoʻohana pū ʻana o ka atorvastatin me ka cyclosporine, antibiotics (erythromycin, clarithromycin, quinupristine / dalphopristine), HIV protease inhibitors (indinavir, ritonavir), antifungal agents (fluconazole, itraconazole, ketoconazole) a i ʻole me ka hoʻonui ʻana i ka hoʻoliʻi koko. ka hopena o ka hoʻomohala ʻana i ka myopathy me ka rhabdomyolysis a me ka pana ʻole ʻole. No laila, me ka hoʻohana pinepine ʻana o ka erythromycin TCmax atorvastatin hoʻonui ʻia e 40%. ʻO kēia mau lāʻau āpau e pale i ka isoenzyme cytochrome CYP4503A4, ka mea i pili i ka metabolism o ka atorvastatin i loko o ka puʻuwai.

Hiki i kahi pilina like me ka hoʻohana pinepine ʻana i ka atorvastatin me nā fibrates a me ka hoʻohuihue nikotinic ma nā lipid-e hoʻohaʻahaʻa i ka wai (ʻoi aku ma mua o 1 g ka lā). ʻO ka hoʻohana like ʻana o ka atorvastatin ma kahi o 40 mg me diltiazem i kahi maʻa o 240 mg e alakaʻi i ka hoʻonuiʻana o ka atorvastatin i loko o ke koko koko. ʻO ka hoʻohana like ʻana o ka atorvastatin me ka phenytoin, rifampicin, kahi inducers o ka pūenzyme cytochrome CYP4503A4, hiki ke alakaʻi i ka hoʻoemi o ka hopena o ka atorvastatin. No ka mea ka hoʻoneʻe ʻana o ka atorvastatin e ka isoenzyme o ka cytochrome CYP4503A4, ka hoʻohana pinepine ʻana o ka atorvastatin me nā inhibitor o ka cytochrome CYP4503A4 isoenzyme hiki ke alakaʻi i ka hoʻonui ʻana i ka hoʻoliʻi plasma o atorvastatin.

OAT31B1 inhibits protein protein inhibitors (e.g., cyclosporine) e hoʻonui i ka bioavailability o atorvastatin.

Me ka hana like me nā antacids (ka pakanalaha o ka konuperena magnesium a me ka alumini hydroxide), e emi ana ke kukuna o ka atorvastatin i loko o ke koko koko.

Me ka hana like o ka atorvastatin me colestipol, hoʻemi ʻia ka manaʻo o ka atorvastatin i ka plasma koko e 25%, akā ʻoi aku ka hopena o ka hopena therapeutic ma mua o ka hopena o atorvastatin wale nō.

Hoʻohana pinepine ka hoʻohana ʻana i ka atorvastatin me nā lāʻau lapaʻau e hōʻemi i ka neʻe ʻana o nā testosterone steroid endogenous (me ka cimetidine, ketoconazole, spironolactone) hoʻonui i ka hopena o ka hoʻohaʻahaʻa i nā hormones steroid endogenous (pono e mālama ʻia).

Me ka hoʻohana like ʻana o ka atorvastatin me ka Contraceptives waha (norethisterone a me ka ethinyl estradiol) hiki ke hoʻonui i ke komo ʻana o nā contraceptive a hoʻonui i ko lākou kūpaʻa ʻana i ka plasma koko. Koho ʻia nā koho o nā kalaiwa ʻana i nā wahine e hoʻohana ana me ka atorvastatin.

ʻO ka hoʻohana like ʻana o ka atorvastatin me ka warfarin i nā lā mua hiki ke hoʻonui i ka hopena o ke warfarin i ke koko coagulation (hōʻemi i ka manawa prothrombin).E nalo aku kēia hopena ma hope o 15 mau lā o ka hoʻohana like ʻana o kēia mau lāʻau.

Me ka hana like o ka atorvastatin a me terfenadine, ʻaʻole i ʻike ʻia nā loli nui loa i ka ʻoihana pharmacokinetics o terfenadine.

I ka hoʻohana ʻana i ka atorvastatin me nā mea antihypertensive a me ka estrogens i mahele o ke ʻano hoʻonaninani, ʻaʻohe hōʻailona hōʻailona o ka launa pū ʻana o nā maʻi nui.

ʻO ka hoʻohana nui ʻana o ka wai pāpaʻa i ka wā o ka hoʻohana ʻana o Atoris® hiki ke alakaʻi i ka piʻi ʻana o ka loko o ka plasma o ka atorvastatin. I kēia hana, nā mea maʻi e lawe i ka lāʻau ʻo Atoris® e pale i ka inu ʻana i ka wai ʻōpala ʻoi aku ma mua o 1,2 lita i kēlā me kēia lā.

Nā ʻōlelo kikoʻī

ʻOiai e lawe ana i Atoris, ʻoi ka hopena o ka hoʻomohala ʻana i ka myalgia. Pono nā maʻi ma lalo o ka mālama mālama olakino mau. I nā hihia e loaʻa ai nā hoʻopiʻi i ka nāwaliwali a me ka hoʻomohala ʻana o ka ʻehaʻeha o ke aʻalolo, hoʻopau koke ka hoʻohana ʻana o Atoris.

ʻO ka pūnaehana o ka lāʻau me ka lactose, pono e noʻonoʻo ʻia i nā mea maʻi i ka intolerance lactose a me ka nele o ka lactase.

Pono e hoʻohana ʻia ka lāʻau lapa maʻi me ka mālama nui loa i nā poʻe maʻi e hōʻeha nei i ka ʻawaʻawa a inā he moʻolelo o ka hana maoli o ka hana o ka ate.

Ma kahi e ʻike pono ʻia nā hōʻike o myopathy, pono e hoʻōki ka hoʻohana ʻana o Atoris.

Hiki i nā mea hoʻihoʻi ke kōkua i ka hoʻomohala ʻana o ka dizziness, no laila no ka lōʻihi o ka mālama ʻana e pale aku i nā kaʻa a me nā hana e koi ai i ka neʻe ʻana o ka makaʻala.

Hoʻohui Kūʻai Kūʻai

Hoʻopili aku nā mea hoʻohālikelike me nā lau inoa: Liprimar, Atorvastatin-Teva, Torvakard, Liptonorm. Inā pono e koho i kahi pono, pono ia e kuka mua me kāu kauka.

ʻO ke kumu kūʻai o nā papa ʻo Atoris 20 mg i loko o nā lāʻau lapaʻau ma Moscow he:

• 20 mg papa, 30 pcs. - 500-550 kahaha.
• Nā Papa 20 mg, 90 mau ʻōpona. - 1100-1170 ʻōpala.

ʻO nā waiwai Pharmacological

Lapaʻau lāʻau
ʻO Atorvastatin kahi mea maʻi hypolipidemic mai ka pūʻulu o nā statins. ʻO ka hana nui o ka hana o ka atorvastatin ka kaohi ʻana o nā hana o ka 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, he enzyme e hōʻiliʻili nei i ka huli ʻana o HMG-CoA i ka waika mevalonic. ʻO kēia hoʻololi i kekahi o nā neʻe mua i ka mekala synthesis o ke kino ma ke kino. ʻO ke kaohi ʻana o ka synthesis cholesterol atorvastatin e alakaʻi i ka hoʻonui nui o ka hoʻohaʻahaʻa haʻahaʻa lipoprotein receptors (LDL) i loko o ka ate, a me nā kaʻi o ka nui o ke kaina. Hoʻopili kēia mau mea i ka lahilahi LDL a hoʻoneʻe iā lākou mai ka plasma koko, ke alakaʻi nei i ka hōʻemi o ka plasma cholesterol (Ch) LDL (Ch-LDL) i ka punela koko.
ʻO ka hopena antisclerotic o ka atorvastatin he hopena i kona hopena ma nā paia o nā kīʻaha koko a me nā ʻike koko. Hoʻopili ke Atorvastatin i ke kāpili ʻana o ka isoprepoids, ʻo ia nā mea ulu e ulu ai nā pehu o nā lula o ka lihi o nā kahe koko. Ma lalo o ka mana o ka atorvastatin, hoʻōla ka hopena endothelium e pili ana i nā moku koko, e hoʻoneʻe ana ka ʻike o ka LDL-C, apolipyrotein B (apo-B). triglycerides (TG). aia ka nui o ka piʻi o ka cholesterol o nā lipoproteins density kiʻekiʻe (HDL-C) a me ka apolipoprotein A (apo-A).
Hoʻopili ʻo Atorvastatin i ka hiki o ka plasma koko a me ka hana a kekahi mau mana coagulation a me ka hui platelet. Ma muli o kēia, hoʻomaikaʻi ʻo ia i ka hemodynamics a hoʻomaʻamaʻa i ke ʻano o ka ʻōnaehana coagulation. Hoʻopilikia ka HMG-CoA reductase inhibitors i ka hana kaohiʻana o nā macrophages, poloka i kā lākou hana a pale aku i ka hiwahiwa ʻana o nā palaki atherosclerotic.
E like me ke kānāwai, ua ʻike ʻia ka hopena therapeutic o atorvastatin ma hope o 2 mau pule o ka hoʻōla, a hoʻomohala ʻia ka hopena kiʻekiʻe ma hope o 4 mau pule.
ʻO Atorvastatin ma kahi o 80 mg ka nui e hoʻēmi i ka hopena o ka hoʻomohala ʻana i nā hoʻopiʻi ischemic (me ka make ʻana mai ka myocardial infarction) e ka 16%, ka pilikia o ka hoʻoliʻi hou ʻana no ka angina pectoris i hui pū ʻia e nā hōʻailona o ka ischemia myocardial e 26%.
Lapaʻau lāʻau
Aia ke kiʻekiʻe o ka absorption Atorvastatin, ma kahi o 80% e kāʻili mai ka gastrointestinal tract. ʻO ka pae o ke kīhū a me ka ʻike ʻana i ka plasma koko e hoʻonui i ka kūlike me ka vine. ʻO ka manawa e hiki ai i ka wikiwiki kiʻekiʻe (TCmax), ma ka awelika, 1-2 hola. I nā wahine, ʻoi aku ka kiʻekiʻe o TCmax ma mua o 20%, a ʻo ka wahi ma lalo o ka neʻe-manawa paʻa (AUC) he 10% haʻahaʻa. He ʻokoʻa nā ʻokoʻa i loko o ka pharmacokyetics i nā maʻi ma o ka makahiki a me ka wahine a he mea nui ʻole a ʻaʻole pono ke hoʻoponopono i ke kumu waina.
I nā maʻi me ka cirrhosis ngati waiʻona, ʻo TCmax ka 16 mau manawa ma mua o ka mea maʻamau. Hōʻemi iki ka ʻai ʻana i ka wikiwiki a me ka lōʻihi o ka inu ʻana i ka lāʻau (e 25% a me 9%, no kēlā me kēia), akā ke ʻano like ʻole ka hōʻemi o ka LDL-C me ka atorvastatin ʻole me ka ʻai. ʻO ka haʻalulu bioroda o Atorvastatin he haʻahaʻa (12%), ka bioavailability o systemic i kahi hana pale me ka HMG-CoA reductase he 30%. ʻO ka bioavailability haʻahaʻa haʻahaʻa ma muli o ka presystemic metabolism ma ka membous mucous o ka gastrointestinal tract a me ka "mahele mua" ma o ke ake. ʻO ka nui nui o ka laha ʻana o ka atorvastatin he 381 lita. ʻOi aku ma mua o 98% o ka atorvastatin nakinaki i nā protein plasma. ʻAʻole hiki i ke Atorvastatin ke pani i ka lolo-lolo. Hoʻomili ia i ka nui o ka puʻu ma lalo o ka hana a CYP3A4 isoenzyme me ka hoʻokumu ʻana o nā metabolite hoʻolaʻa pharmacologically (ortho- a me nā parahydroxylated metabolites, nā huahana beta-oxidation), e helu ana ma kahi o 70% o ka hana pale aku i ka HMG-CoA-reductase no 20-30 mau hola.
ʻO ka hapa hapalua (T1 / 2) o atorvastatin he 14 hola. Hoʻokuʻu ʻia ia ma ka bile (ʻaʻole i hoʻoweliweli ʻia ia me ka hoʻokaʻawale ʻana a enterohepatic, ʻaʻole i excreted i ka wā hemodialysis). Ma kahi o 46% o ka atorvastatin e hoʻopili ʻia ma o nā ʻōpū a emi mai ka 2% e nā keiki.
Nā hui ahonui kūikawā
E na keiki
Aia ka palena palena ma ka noi he 8 mau wiki e hōʻike ai i ka lāʻau lapaʻau i nā keiki (ʻoʻeono 6-17 mau makahiki) me ka hypercholesterolemia ʻohana heterozygous a me kahi ʻano mua o ka LDL cholesterol ≥4 mmol / L, i mālama ʻia me atorvastatin ma ke ʻano o nā papa chewable o 5 mg a 10 mg a i ʻole nā ​​papa. pani ʻia nā kiʻiʻoniʻoni ma kahi maʻa o 10 mg a 20 mg 1 paha i ka manawa no kēlā me kēia ʻO ka covariate koʻikoʻi wale nō i ka lāʻau pharmacokinetic o ka heluna kanaka e loaʻa ana i ka atorvastatin, ʻo ke kaumaha o ke kino. ʻO ka wehe ʻokoʻa o ka atorvastatin i nā keiki, ʻaʻole ia i ʻokoʻa i kēlā me nā mea pākeke me nā hoʻomehana allometric e ke kaumaha o ke kino. I ka nui o nā hana o ka atorvastatin a me o-hydroxyatorvastatin, he nānā maʻamau i loko o LDL-C a me LDL.
ʻO nā maʻi maʻi
ʻO ka pae kiʻekiʻe loa (Cmax) i ka plasma a me AUC o ka lāʻau i ka poʻe maʻi maʻi (ma luna o 65) ʻo 40% a 30%, kēlā me kēia, ʻoi aku ka kiʻekiʻe ma mua o nā maʻi maʻi o kekahi ʻōpio. ʻAʻohe ʻano like ʻole i ka hopena o ka pono a me ka palekana o ka lāʻau lapaʻau, a i ʻole ka hoʻokō ʻana i nā pahuhopu o ka hoʻomaʻapaʻa ʻana o lipid-hoʻohaʻahaʻa i nā mea maʻi ma waena o nā kānaka holoʻokoʻa.
Hola paʻa kino hana
ʻAʻohe huehue i ka hana renalally i ka ʻike ʻana i ka atorvastatin i loko o ke kaila koko a i kona hopena paha i ka metabolism lipid; no laila, ʻaʻole koi ʻia kahi hoʻololi ʻana i ka maʻi i loko o ka maʻi renal impaired.
Hōʻeha ka hana ʻoluʻolu
Hoʻonui nui ʻia ka ʻike o ka lāʻau (Cmax - ma kahi 16 mau manawa, AUC - e pili ana i 11 mau manawa) i nā mea maʻi me ka cirrhosis alikaʻi (papa B e like me ka helu ʻana o nā keiki-Pugh).

Hoʻohana i ka wā hāpai a i ka wā o ka umauma

ʻO ka lāʻau Atoris ® e hoʻohālikelike ʻia i ka wā hapai a i ka wā o ka hoʻoulu ʻana.
Ua hōʻike ʻia nā haʻawina holoholona i ka hopena o ka ʻoi a maʻa paha i hiki ke loaʻa i ka pōmaikaʻi i ka makuahine.
I nā wahine o nā makahiki hānau o ka hoʻohana ʻole i nā hana kūpono o ka contraception, ʻaʻole i ʻōlelo ʻia ka hoʻohana ʻana o Atoris ®. Ke hoʻolālā nei i kahi hāpai hāpai, pono ʻoe e kāpae me ka hoʻohana ʻana i Atoris ®, ma ka liʻiliʻi, 1 mahina ma mua o ka hāpai ʻana i hoʻolālā ʻia.
ʻAʻohe ʻike e pili ana i ka wehe ʻana o ka atorvastatia me ka waiū umauma. Eia nō naʻe, i kekahi mau holoholona holoholona i ka wā lactation, ua like ka ʻike o ka atorvastatia i loko o ka serum koko a me ka waiū. Inā makemake ʻoe e hoʻohana i ka lāʻau lapaʻau Atoris ® i ka wā o ka hoʻoulu ʻana i ka waiū, i mea e pale aku ai i ka hopena o nā hanana ʻeha i loko o nā pēpē, pono e hoʻokuʻu ʻia ka mālama ʻana i ka umauma.

ʻLoe a me ke kākele

Ma mua o ka hoʻomaka ʻana o ka hoʻohana ʻana i ka lāʻau Atoris ®, pono e hoʻoneʻe i ka mea maʻi i kekahi meaʻai e hōʻoia ai i ka hoʻemi ʻana o ka lawelawe ʻana o nā lipids i ka plasma koko, pono e nānā ʻia i ka wā o ka mālama holoʻokoʻa me ka lāʻau lapaʻau. Ma mua o ka hoʻomaka ʻana i ka hoʻomaʻamaʻa, pono ʻoe e hoʻāʻo e hoʻokō i ka hiki ʻana o ka hypercholesterolemia ma o ka hoʻomaʻamaʻa ʻana a me ka momona kaumaha i nā mea maʻi me ka momona, me ka ʻōlelo no ka maʻi ma lalo.
Kālala ʻia ka lāʻau lapaʻau ʻia, me ka manaʻo ʻole o ka manawa o ka pāʻina. Ka loli ʻana o ka lāʻau lapaʻau mai 10 mg a 80 mg I hoʻokahi lā i kahi lā i koho ʻia e noʻonoʻo i ka ʻike mua ʻana o ka LDL-C i ka plasma, ke kumu o ka hoʻoulu ʻia a me ka hopena therapeutic kanaka.
Hiki ke kiʻi ʻia ʻo Atoris ® i kekahi manawa o ka lā, akā i ka manawa like i kēlā me kēia lā. Hoʻomaopopo ka hopena therapeutic ma hope o 2 mau pule o ka mālama ʻana, a hoʻomohala ka hopena kiʻekiʻe ma hope o 4 wiki.
I ka hoʻomaka ʻana o ka lāʻau a me / a i ka manawa o ka hoʻonui ʻana i ke kinikona, pono ia e nānā i ka paʻa ʻana o nā lipids i ka plasma koko i kēlā me kēia mau hebedoma 2-4 a e hoʻoponopono pono ʻia i kēia mahele.
ʻO ka hypercholesterolemia mua a me nā hononga (sour) hyperlipidemia
No ka hapa nui o nā mea maʻi, ʻo ka ʻōlelo aʻo Atoris ® ka mea 10 mg i hoʻokahi manawa i ka lā, e hōʻike ana ka hopena therapeutic iā ia iho i loko o 2 mau pule a hiki i ka nui loa ma hope o 4 mau wāwae. Me ka lōʻihi o ka mālama ʻana, hoʻomau ka hopena.
Homozygous familial hypercholesterolemia
Ma ka hapanui o nā hihia, akā ʻo 80 mg i kuhikuhi ʻia i hoʻokahi manawa i ka lā (a me ka emi ʻana o ka neʻe o ka LDL-C i ka plasma ma ka 18-45%).
Heterozygous familial hypercholesterolemia
ʻO ka maʻa mua he 10 mg i kēlā me kēia lā. Pono ke koho pono ʻia i ka pākuhi a loiloi i ka pilina o ke ana i kēlā me kēia mau hebedoma 4 mau me kahi hoʻonui e hoʻonui i ka 40 mg i kēlā me kēia lā. A laila, hiki ke hoʻonui ʻia i kēia helu i ka nui o 80 mg pākahi i kēlā me kēia lā, a i ʻole he mea hiki ke hoʻohui i nā sequestrants o nā hua bile me ka hoʻohana ʻana i atorvastatin ma kahi pākē o 40 mg i kēlā me kēia lā.
Kāohi pilikia Cardiovascular
I nā haʻawina o ka pale mua, ʻo ka nui o ka atorvastatin he 10 mg i kēlā me kēia lā.
Pono paha kahi hoʻonui hoʻonui e hoʻokō ai i nā waiwai LDL-C e kūlike me nā alakaʻi.
Hoʻohana ma nā keiki mai 10 a 18 paha mau makahiki me ka hypercholesterolemia ʻohana heterozygous
ʻO ka lāʻau mua i ʻōlelo ʻia ʻia e 10 mg i hoʻokahi lā. Hiki ke hoʻonui ʻia ka nui i ka 20 mg i kēlā me kēia lā, e pili ana i ka hopena lapaʻau. ʻO ka ʻike me kahi mahele o ka 20 mg (e pili ana i ka nui o ka 0.5 mg / kg) ua palena.
Pono ke koho ʻia ka hopena o ka lāʻau ma muli o ke kumu o ke kime lipid-downing. Pono e hoʻoponopono ʻia nā pila ma nā wā 1 o 4 mau hola i hoʻokahi a keu paha.
ʻO ka hana hema ʻole
Inā ʻaʻole pono ka hana ate, pono e hoʻoneʻe ʻia ka nui o ka Atoris ®, me ka mālama pinepine ʻana i nā hana o nā transaminases "ate": aspartate aminotransferase (ACT) a me alanine aminotransferase (ALT) i ke koko koko.
ʻO Renal hiki ʻole
ʻAʻole pili ka hana o ka renal papaha i ka paʻa ʻana o ka atorvastatin a i ʻole ka piʻi ʻana o ka ʻike o ka LDL-C i ka plasma, no laila, ʻaʻole pono ka hoʻoponopono ʻana o ka lāʻau lapaʻau (ʻike i ka ʻāpana "Pharmacokinetics").
ʻO nā maʻi maʻi
ʻAʻohe ʻokoʻa ʻole i ka hopena o ka hopena a me ka palekana o ka atorvastatin i nā poʻe maʻi maʻi i hoʻohālikelike ʻia me ka lehulehu holoʻokoʻa, ʻaʻole pono ka hoʻoponopono ʻana i nā dosis (ʻike i ka paukū Pharmacokinetics).
Hoʻohana me ka hoʻohui ʻana i nā lāʻau lapaʻau
Inā pono e hoʻohana like ia me ka cyclosporine, telaprevir, a i ʻole ka hui pū ʻana o tipranavir / ritonavir, ʻaʻole nui ka nui o ka hopena o Atoris ® ma 10 mg / lā (e ʻike i ka ʻāpana "Nā Kūlana Kūlana").
Pono e mālama ʻia a me ka hōʻemi o ka atorvastatin haʻahaʻa haʻahaʻa ʻo ia i ka wā e hoʻohana ʻia me ka inhibitor o ka protease, hepatitis C protease inhibitors (boceprevir), clarithromycin a me itraconazole.
Nā manaʻo e haʻi aku ai i ka Russian Cardiological Society, ka National Society for the Study of Atherosclerosis (NLA) a me ka Lūkini Russian o Cardiosomatic Rehabilitation a me ka Hoʻomaʻamaʻa Lua (RosOKR) (V hōʻano 2012)
ʻO ka ʻoi aku ka maikaʻi o ka LDL-C a me ka kolamu piha no ka maʻi kiʻekiʻe e pili ana i ka maʻi: ≤2.5 mmol / L (a ≤100 mg / dL) a me ≤4.5 mmol / L (a ≤ 175 mg / dL), kekahi a no nā mea maʻi me ka hopena koʻikoʻi nui: ≤1.8 mmol / l (a ≤70 mg / dl) a me / a inā hiki ʻole ke hoʻokō ʻia, ua manaʻo ʻia e hoʻemi ʻia ka ʻike o LDL-C e 50% mai ka waiwai mua a me ka ≤4 mmol / l (a ≤150 mg / dl), mea ʻokoʻa.

Loaʻa ka hopena

Ka papa kuhikuhi ʻana i nā mea e pili ana i ka hopena o ka hopena o ka World Health Organization (WHO):