Pehea e hoʻohana ai Atorvastatin 20?

Nā papa hana ʻaniʻoniʻoni, 20 mg.

Aia ma ka papa papa

• mea kūlohelohe - atorvastatin (ma ke ʻano o ka paʻakai calcium atorvastatin) - 20 mg
• nā mea waiwai - ka lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, hypromellose 2910, polysorbate 80, calcium stearate, calcium carbonate
• hana kiko - hypromellose 2910, polysorbate 80, titanium dioxide (E 171), talc

Nā papa wīwī keʻokeʻo biconvex keʻokeʻo. Ma ka hoʻomaha, keʻokeʻo a keʻokeʻo paha nā papa.

Lapaʻau lāʻau

ʻO ka 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-methylglutarylcoenzyme 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 receptors LDL (haʻahaʻa lipoproteins haʻahaʻa) i loko o ka ate, a me nā ʻili extrahepatic. Hāʻawi kēia mau mea i ka palaka LDL a kāpae iā lākou mai ke kahe koko, ke alakaʻi nei i ka LDL cholesterol i ke koko.

ʻO ka hopena antisclerotic o ka atorvastatin he hopena o ka hopena o ka lāʻau lapaʻau ma nā paia o nā kīʻaha koko a me nā ʻike koko. Mālama ka lāʻau lapaʻau i ka hoʻohuihui ʻana o ka isoprenoids, ʻo ia nā mea ulu o nā pūpū o nā pona o nā loko o loko o nā kīʻaha koko. Ma lalo o ka hopena o ka atorvastatin, e hoʻonui ai ka hoʻonui ʻana i ka hilinaʻi o ka endothelium. Atorvastatin lowers kolesterol, lipoproteins haʻahaʻa haʻahaʻa, apolipoprotein B, triglycerides. Ke kumu o ka hoʻonui ʻana i ka cholesterol HDL (lipoproteins kiʻekiʻe kiʻekiʻe) a me ka apolipoprotein A.

ʻO ka hana o ka lāʻau lapaʻau, ma ke ʻano he kānāwai, hoʻomohala ma hope o 2 mau pule o ka hoʻokele, a me ka hopena ʻoi loa ka hopena ma hope o nā hebedoma ʻehā.

Lapaʻau lāʻau

He kiʻekiʻe nā Absorption. ʻO ka manawa e hiki ai i ka manawa kiʻekiʻe ka 1-2 mau hola, ʻo ka nui o ka manaʻo o ka wahine ma mua o 20% ʻoi aku ka kiʻekiʻe, ʻo AUC (ma lalo o ka pihi) he 10% haʻahaʻa, ʻoi ka nui o ka nui o ka nui o nā maʻi me ka cirrhosis alikaola he 16 mau manawa, ʻo AUC he 11 mau manawa ma mua o ka maʻamau. Hōʻemi ka meaʻai i ka wikiwiki a me ka lōʻihi o ka lawe ʻana mai i ka lāʻau (e 25% a me 9%, pākahi), akā me ka hoʻēmi ʻana o ka kolamu LDL e like like me ka hoʻohana ʻana o ka atorvastatin me ka ʻole o ka meaʻai. ʻO ka ʻike o ka atorvastatin i ka wā i ke ahiahi ma lalo iho o ke kakahiaka (ma kahi o 30%). Ua hōʻike ʻia kahi pilina palena ma waena o ke kūkaʻi o ka huina a me ka loaʻa ʻana o ka lāʻau lapaʻau.

Bioavailability - 14%, bioavailability o ka ʻōnaehana o ka hana pale i kūʻē i ka HMG-CoA reductase - 30%. ʻO ka bioavailability systemic haʻahaʻa ma muli o ka presystemic metabolism ma ka membous mucous o ka gastrointestinal tract a ma ka "papa mua" ma o ka puʻu.

ʻO ka nui o ka hoʻoliʻiliʻi o 381 l, ka pilina me nā protein plasma he 98%. Hoʻomili ia i ka nui o ka puʻu ma lalo o ka hana a ka cytochrome P450 CYP3A4, CYP3A5 a me CYP3A7 me ka hoʻokumu ʻana i nā metabolites ikaika pharmacologically (ortho- a me nā parahydroxylated derivatives, nā hua beta-oxidation). ʻO ka hopena o ka hopena o ka lāʻau e kūʻē i ka HMG-CoA reductase ma kahi o 70% e hoʻoholo ana e ka hana o nā metabolites ka hele.

Hoʻohui ʻia ia i loko o ka bile ma hope o ka hepatic a / a i ʻole metabolism nui aʻe (ʻaʻole ia i loaʻa i ka enterohepatic recirculation).

ʻO ka hapalua-ola he mau hola 14. ʻO ka hana o ka pale ke kūʻē i ka HMG-CoA reductase e hoʻomau nei no kahi o 20-30 mau hola, ma muli o ka hikiʻana o nā metabolites ikaika. ʻOi ka liʻiliʻi o 2% o kahi kūpono i loko o ka waiʻai.

ʻAʻole ia i excreted i ka wā hemodialysis.

Nā hōʻailona no ka hoʻohana ʻana

Nā hōʻailona no ka hoʻohana ʻana o atorvastatin i:

• ʻO ka hypercholesterolemia, ma ke ʻano o ka meaʻai no ka mālamaʻana i nā mea maʻi me nā kiʻekiʻe kiʻekiʻe o ka kolamu, LDL cholesterol (lipoproteins haʻahaʻa haʻahaʻa), apolipoprotein B a me ka triglycerides, a me ka hoʻonui i ka HDL cholesterol (lipoprotein kiʻekiʻe kiʻekiʻe) i nā mea maʻi me ka hypercholesterolemia a me ka hoʻoilina hoʻoilina nui. Non-mana-mana hypercholesterolemia), hoʻohui (hui pū ʻia) hyperlipidemia (Fredrickson type IIa a IIb), hoʻokiʻoki kaila triglyceride kiʻekiʻe (Fredrickson ʻano III), i nā hihia kahi loaʻa ʻole ka loaʻa ʻana o ka meaʻai.
• e hoʻohaʻahaʻa i ka kolamu nui a me ka kolamu LDL i nā mea maʻi me ka hypercholesterolemia homozygous i nā hihia inā ʻaʻohe hopena kūpono o ka meaʻai a i ʻole nā ​​ʻano lāʻau ʻē aʻe.
• no ka prophylaxis i nā mea maʻi me nā hōʻailona ʻole o ka maʻi maʻi o ka maʻi maʻi, me ka ʻole a me ka dyslipidemia, akā me nā mea koʻikoʻi e pili ana i nā maʻi naʻau coronary e like me ka uahi, hypertension, diabetes mellitus, low HDL cholesterol (HDL-C), a i ʻole ka maʻi ʻeha coronary i loko o ka mōʻaukala ʻohana (e hōʻemi i ka hopena o ka make ma ka maʻi naʻau coronary a me ka mea laʻa nonocardial infarction, hōʻemi i ka hopena o ka hōʻeha).

Ka hana lāʻau lapaʻau

ʻO ka hopena lapaʻau lāʻau hypolipidemic.

Hoʻopuka ka mea hoʻōla i ka hoʻoneʻe o ka huakaʻi HMG-CoA reductase, i pili i ke kāpili ʻana o ka kolamu a me nā lipoproteins atherogen i loko o ka ate, a e hoʻonui pū hoʻi i ka paʻa o nā ʻāpana hōʻaiaka hepatic hopu i ka LDL. ʻO ka lawe ʻana i ka lāʻau lapaʻau ma kahi o 20 mg e alakaʻi i ka emi ʻana o ka kolamu ma ka 30-46%, lipoproteins haʻahaʻa haʻahaʻa e 41-61%, triglycerides e 14-33%, a me ka hoʻonui ʻana o ka lipoproteins antiatherogenic kiʻekiʻe.

Ka kuhikuhi ʻana i ka lāʻau lapaʻau ma ka nui o ka nui o 80 mg e alakaʻi i ka emi ʻana o ka hōʻeha o nā kolohe i ka pūnaehana cardiovascular, ka hoʻokahe ʻana o ka make a me ka ʻike pinepine ʻana o nā hale mālama maʻi i ka haukapila cardiology, me ka nui o nā mea maʻi kiʻekiʻe.

Hoʻoponopono ʻia ka nui o ka lāʻau ma muli o ke kiʻekiʻe o LDL.

Loaʻa ka hana kūpono no ka 1 mau mahina ma hope o ka hoʻomaka ʻana o ka mālama ʻana.

Pharmacokinetics: i unuhi ʻia mai ka gastrointestinal tract, a hiki i ka plasma kiʻekiʻe loa ma hope o 1-2 mau hola. ʻAi ʻia ka ʻai ʻana a me ka lā o ka lā. Ke kaomi ʻia nei i loko o ka protein protein huna mokuʻāina. Hoʻokomoʻo ia i ka puʻukū me ka hoʻolālā o nā metabolites ikaika i koho. Ke hoʻoulu ʻia nei me ka bile.

I nā poʻe maʻi ma mua o 65 mau makahiki o ka makahiki, i ka hoʻohālikelike ʻana i nā mea ʻōpio'ōpiopio, ua like like ka pono a me ka palekana o ka lāʻau lapaʻau.

Hoʻopau i ka hana filtration renal i hoʻopilikia i ka hana a ka hoʻonāukiuki o ka lāʻau lapaʻau a ʻaʻole pono i ka hoʻoponopono hoʻoponopono.

ʻO ka pehu kūpono ʻo ka pēpē he contraindication no ka hoʻohana ʻana o atorvastatin.

No ke aha nā papa Atorvastatin 20

Nā hōʻailona no ka hoʻohana ʻana:

• ka hopena o ka metabolic o ka lipoproteins a me nā lipidemia ʻē aʻe,
• murni hypercholesterolemia,
• keipio
• hui ʻia a me ka hoʻi ʻole i hoʻākāka ʻole ʻia.
• ka pale ʻana o nā hanana cardiovascular ma ka nui o nā mea maʻi kiʻekiʻe,
• maʻi ʻeha coronary (angina pectoris, myocardial infarction),
• ua eha kekahi.

ʻO nā waiwai Pharmacological

Lapaʻau lāʻau

He kiʻekiʻe nā Absorption. ʻO ka nalo o ka hapalua-ola he 1-2 mau hola, ʻo Cmax i nā wahine he 20% kiʻekiʻe, ʻo AUC he 10% haʻahaʻa, Cmax i nā mea maʻi me ka cirrhosis alikaʻi 16 mau manawa, 16 AUC mau manawa he 11 mau keu ma mua. Hōʻemi ka meaʻai i ka wikiwiki a me ka lōʻihi o ka lawe ʻana mai i ka lāʻau (e 25 a me 9%, no kēlā me kēia), akā like ka hōʻemi o ka LDL cholesterol i ka mea like me ka hoʻohana ʻana o ka atorvastatin me ka ʻole o ka ʻai. ʻO ka ʻike o ka atorvastatin i ka wā i ke ahiahi ma lalo iho o ke kakahiaka (ma kahi o 30%). Ua hōʻike ʻia kahi pilina palena ma waena o ke kūkaʻi o ka huina a me ka loaʻa ʻana o ka lāʻau lapaʻau. Bioavailability - 14%, bioavailability o ka ʻōnaehana o ka hana pale i kūʻē i ka HMG-CoA reductase - 30%. ʻO ka bioavailability systemic liʻiliʻi ma muli o ka metabolism presystemic i ka mucosa gastrointestinal a i ka wā o ka "papa mua" ma o ka ate. ʻO ka palena maʻamau o ka hoʻoili ʻana he 381 l, ʻo ka pilina me nā protein plasma eʻoi aku ma mua o 98%. Ka hana i ka nui ma ka ate ma lalo o ka hana a ka cytochrome CYP3A4, CYP3A5 a me CYP3A7 me ka hoʻokumu ʻana i nā metabolites ikaika pharmacologically (ortho and parahydroxylated derivatives, nā huahana o beta oxidation). In vitro, ortho- a me para-hydroxylated metabolites he hopena pale i ka HMG-CoA reductase, i hoʻohālikelike ʻia i ka atorvastatin. ʻO ka hopena o ka hopena o ka lāʻau e kūʻē i ka HMG-CoA reductase ma kahi o 70% i hoʻoholo ʻia e ka hana o nā kaila e hoʻoponopono i ka metabolites a hoʻomau i ka nui o nā hola 20-30 ma muli o ko lākou heleʻana. ʻO ke kāpae hapa-ola he 14 mau hola. Hoʻohui ʻia ia i loko o ka bile ma hope o ka hepatic a / a i ʻole metabolism nui aʻe (ʻaʻole ia i loaʻa i ka enterohepatic recirculation). ʻOi ka liʻiliʻi o 2% o kahi kūpono i loko o ka waiʻai. ʻAʻole ia i hoʻōla ʻia i ka wā o hemodialysis ma muli o ka hoʻopili koʻikoʻi i nā protein plasma. Me ka hikiʻole o ka puʻuwai ma nā maʻi me ka cirrhosis alikaole (Child-Pyug B), Cmax a me AUC nui e hoʻonui (16 a 11 mau manawa, kēlā). ʻO Cmax lāua ʻo AUC o ka lāʻau lapaʻau i nā ʻelemakule (65 mau makahiki he 40) he 30 a 30% ka mea, ʻoi aku ka kiʻekiʻe o nā mea maʻi ma mua o nā makahiki ʻōpio (ʻaʻohe kumu lāʻau koʻikoʻi). ʻO Cmax ma nā wahine he 20% kiʻekiʻe, a ʻo AUC he 10% haʻahaʻa ma mua o nā kāne (ʻaʻohe ona kumu lapaʻau). ʻAʻole hoʻopiʻi ka hōʻino Renal i ka plasma o ka lāʻau.

Lapaʻau lāʻau

ʻO Atorvastatin kahi mea maʻi hypolipidemic mai ka pūʻulu o nā statins. He mea hoʻowalewale pili i ka HMG-CoA reductase, kahi enzim e hoʻololi i ka 3-hydroxy-3-methylglutaryl coenzyme A i ka mevalonic acid, kahi mea i mua o ka sterols, me ka kolamu. Hoʻokomo ʻia ʻo Triglycerides a me ka kolamu ma loko o ka pūpū me ka waiwai o ka lipoproteins low haʻahaʻa (VLDL), komo i ka plasma a lawe ʻia i nā kino peripheral. Kūkulu ʻia nā lipoproteins haʻahaʻa (LDL) mai VLDL i ka wā o ke kikowaena me nā LDL taliaina. Hoʻolaha i nā pae plasma plasma a me nā lipoprotein ma muli o ka pale ʻana o ka HMG-CoA reductase, ka synthesis o ka kolamu ma ka ate a me ka hoʻonui ʻana o ka nui o nā ʻalopona "Līpika" LDL ma ka ʻaoʻao o ka puna, kahi e hoʻonui ai i ka hoʻonui a me ka catabolism o LDL. Hoʻemi i ka hoʻokumu ʻana o LDL, e hoʻoiho i ka hoʻonui nui ʻana a me ka hoʻomau i ka hana o nā ʻāpono LDL. Hoʻololi i ka LDL i nā mea maʻi me ka hypercholesterolemia homozygous, kahi mea maʻamau ʻaʻole e aloha ʻia e ka lāʻau me nā lipid-hoʻemi haʻahaʻa. E hōʻemi ana i ke kiʻekiʻe o ka nui o ka cholesterol ma o 30-46%, LDL - e ka 41-61%, ka apolipoprotein B - e ka 34-50% a me ka triglycerides - e ka 14-33%, kumu i ka hoʻonui o ka kiʻekiʻe o ka cholesterol kiʻekiʻe-lipoproteins a me apolipoprotein A. ʻO ka make-hiki i ka hoʻoliʻiliʻi i ka pae. LDL i nā mea maʻi me ka maʻi hypercholesterolemia homozygous, kūpaʻa i ka lāʻau lapaʻau me nā lāʻau lapaʻau ʻē aʻe. Hoʻonui koʻikoʻi i ka hiki ke hoʻomohala ʻana i nā hoʻopiʻi ischemic (me ka hoʻomohala ʻana o ka make mai ka myocardial infarction) ma ke 16%, ka loaʻa ʻana o ka hoʻoliʻi hou ʻana no ka angina pectoris, i hui pū ʻia e nā hōʻailona o ka ischemia myocardial, ma ka 26%. ʻAʻohe o carcinogen a me nā hopena mutagenic. Loaʻa ka hopena therapeutic i 2 mau pule ma hope o ka hoʻomaka ʻana o ka hoʻomaʻamaʻa, hiki i ka nui ma hope o 4 mau pule a kū i ka wā mālama.

ʻLoe a me ke kākele

I loko, e lawe i kēlā me kēia manawa o ka lā, me ke ʻano o ka kau ʻana o ka meaʻai. Ma mua o ka hoʻomaka ʻana o ka mālama ʻana, pono ʻoe e huli i ka ʻai e mālama ai i ka hoʻemi ʻana o nā lipids i ke koko, a nānā iā ia i ka manawa o ka mālama ʻana.

I ka pale ʻana o ka maʻi naʻau coronary ʻO ka paapa mua ma nā pākeke he 10 mg hoʻokahi i ka lā. Pono e hoʻololi ʻia ka ʻōmole me kahi manawa o nā liʻiliʻi he 2 mau hebedoma ma lalo o ka mana o nā ʻōhua lipid ma ka plasma. ʻO ka dosis kiʻekiʻe loa i kēlā me kēia lā he 80 mg ma 1 pāʻai. Me ka hoʻokolohua hui ʻana me ka cyclosporine, ka nui o kēlā me kēia lā nui o ka atorvastatin he 10 mg, me ka clarithromycin - 20 mg, me itraconazole - 40 mg.

Ihypercholesterolemia mua a hui pū ʻia (hui pū ʻia) hyperlipidemia 10 mg hoʻokahi i ka lā. Hōʻike ka hopena iā ia iho i loko o nā 2 hebedoma, ʻo ka hopena kūpono loa e nānā ʻia i loko o 4 mau pule.

IʻO ka maʻi homozygous familial hypercholesterolemia ʻo ka hopena mua he 10 mg hoʻokahi i ka lā, a laila e hoʻonui i ka 80 mg hoʻokahi i ka lā (ʻo ka make o LDL e ka 18-45%). Ma mua o ka hoʻomaka ʻana i ka maʻi, pono e hoʻolilo ʻia ka mea maʻi i ka ʻai hypocholesterolemic maʻamau, pono ia e hahai i ka wā o ka mālama ʻana. Me ka nele o ka ate, pono e hoʻemi ʻia ke ʻano. No nā keiki mai 10 a 17 mau makahiki (wale nō ke keikikāne a me nā kaikamahine hānō kāne) me ka hypercholesterolemia ʻohana heterozygous, ʻo ka hoʻomaka mua ma lalo o ka 10 mg 1 mau manawa i kēlā me kēia lā. Pono e hoʻonui ʻia ka paena i ʻole ma mua o 4 mau hebedoma a i ʻole. ʻO ka 20 ka nui o kēlā me kēia lā he 20 mg (ʻaʻole i aʻo ʻia ka hoʻohana ʻana o nā dosis ma mua o 20 mg).

Nūpepa a me nā mea maʻi me nā maʻi pūpū ʻaʻole pono ka loli ʻana i ka hoʻoponopono ʻia.

ʻO nā maʻi me ka hana pūlima hemahema pono e mālama ʻia ka mālama ʻana me ka lohi i ka hoʻohemo ʻana o ka lāʻau mai ke kino. Pono e nānā pono ʻia nā ʻōkaka a me nā ʻoihana o ka hana ate me, me ka loli nui o ka pathological, me ke ʻano o ka hoʻololi ʻana.

Hoʻohana me ka hoʻohui pū me nā lāʻau lapaʻau ʻē aʻe. Inā he manawa like ka hoʻohana ʻana i ka atorvastatin a me nā cyclosporine, ʻaʻole pono ka nui o ka atorvastatin i ka 10 mg.

Nā hopena hopena

Mai ka ʻōnaehana hoʻonāukiuki: insomnia, ʻeha, ʻehaʻeha, malaise, dizziness, peripheral neuropathy, amnesia, paresthesia, hypesthesia, ʻehaʻeha.

Mai ka pūnaehana hana ʻana: nausea, huehue, ʻeha o ka ʻōpū, dyspepsia, flatulence, constipation, luaʻi, anorexia, hepatitis, pancreatitis, cholestatic jaundice.

Mai ka ʻōnaehana musculoskeletal: myalgia, ʻeha hope, arthralgia, ʻehaʻī o ka hoopa, myositis, myopathy, rhabdomyolysis.

Nā maʻi kūwaha: urticaria, pruritus, ʻeha manu, bullous rash, anaphylaxis, polymorphic exudative erythema (me ke ʻano o Stevens-Johnson syndrome), Laille syndrome.

Mai nā heʻano hemopoietic: thrombocytopenia.

Mai ka ʻaoʻao o ka metabolism: hyp- a i ʻole hyperglycemia, hana hoʻonui i serum CPK.

ʻŌnaehana Endocrine.

ʻO kekahi: tinnitus, momona, hana lima, peripheral edema, kaupaona, hōʻeha i ka ʻeha, alopecia, nā hihia no ka hoʻomohala ʻana i nā maʻi interstitial, ka nui loa me ka hoʻohana ʻana i ka manawa lōʻihi, ka hemorrhagic stroke (i ka wā e lawe ʻia ana i nā ʻōkuhi nui me CYP3A4 inhibitors), papaha renal lua . ^ E Ha yM.

Nā Hoʻohui

hypersensitivity i kekahi o ka lāʻau

mau maʻi maʻi neʻe, hoʻonui hana o ka "ati" transaminases (ʻoi aku ma mua o 3 mau manawa) o ka ʻike kumu

nā wahine o nā makahiki hānau kīhai i hoʻohana i nā ʻano kūpono o ka contraception

nā keiki ma lalo o 18 mau makahiki (ʻaʻole i hoʻokumu ʻia a maikaʻi ʻole ka palekana)

ka loiloi ʻana me ka HIV pūloko pūlele (telaprevir, tipranavir + ritonavir)

hoʻonāukiuki galactose ulu, lactase kakali a i ʻole ke kīlohelohe glucose-galactose

Hiki ke hāʻawi ʻia ʻo Atorvastatin i kahi wahine o ka hua hānau wale nō inā he kumu hilinaʻi paha ʻaʻole ia i hānai a hoʻomaopopo ʻia i ka pilikia o ka lāʻau i ka kuʻi.

ka moolelo o na mai ate

ka hoʻonāukiuki electrolyte koʻikoʻi

nā hopena endocrine a me ka metabolic

nā maʻi maʻi ʻeha (sepsis)

hoopukui nui

Hoʻopili i nā lāʻau lapaʻau

Me ka hoʻokūkū pū ʻana o ka cyclosporine, fibrates, erythromycin, clarithromycin, immunosuppressive, antifungal lāʻau (pili i ka azoles) a me ka nikotinamide, ke kahe o ka atorvastatin i ka plasma a me ka hoʻopulapula o kuʻu manaʻo ʻana me ka rhabdomyolysis a me ka hoʻonui ʻana hoʻonui.

Hoʻomau nā antacids i ka hoʻouluʻana e 35% (ʻaʻole i loli ka hopena ma ka LDL cholesterol).

Hiki i ka hoʻohana mua ʻana o ka atorvastatin me warfarin i ka hopena o ka warfarin i ke koʻikoʻi coagulation koko i nā lā mua (hōʻemi o ka manawa prothrombin). Hoʻopau ʻia kēia hopena ma hope o 15 mau lā o ka kaina ʻana o kēia mau lāʻau.

ʻO ka hoʻohana ʻana o ka atorvastatin me nā inhibitor protease i kapa ʻia ʻo CYP3A4 inhibitors ka mea i hoʻohui ʻia e ka piʻi ʻana o ka mea e pili ana i ka atorvastatin (aʻo ka hoʻohana ʻana o ka erythromycin me Cmax, hoʻonui ʻia atorvastatin e 40%). ʻO nā inhibitor o ka protease HIV he mau mea paʻa o ka CYP3A4. ʻO ka hoʻohana pū ʻana o nā inhibitor o ka protein protease a me nā statins e hoʻonui i ke kiʻekiʻe o nā statins i loko o ka serum o ke koko, a ma nā hihia koʻikoʻi e alakaʻi i ka hoʻomohala ʻana i ka myalgia, a i nā hihia kūʻokoʻa i ka rhabdomyolysis, nā māla huehue a me ka uhaʻi ʻana i nā mea striated, e alakaʻi ana i ka myoglobulinuria a me ka hana ʻole ʻana i kahi māla. ʻO ka hoʻopiʻi hope loa i kekahi hapakolu o nā hihia i pau i ka make.

E hoʻohana i ka atorvastatin me ka akahele a ma ka palena liʻiliʻi ʻoi aku me ka maʻi protease pale: lopinavir + ritonavir. ʻAʻole pono ka make o ka atorvastatin ma mua o 20 mg i kēlā me kēia lā i ka wā e hui pū ʻia me nā inhibitor o ka protein protease: fosamprenavir, darunavir + ritonavir, fosamprenavir + ritonavir, saquinavir + ritonavir. ʻAʻole pono ʻo ka pakanā o ka atorvastatin e ka 40 mg i kēlā me kēia lā i ka wā e lawe pū ʻia me ka HIV protease inhibitor nelfinavir.

I ka hoʻohana ʻana i ka digoxin i hui pū me ka atorvastatin ma kahi maʻa o 80 mg / lā, hoʻonui ʻia ka ʻike o ka digoxin ma kahi o 20%.

Hoʻonui i ka neʻe (i ka wā i kuhikuhi ʻia me ka atorvastatin ma kahi o 80 mg / lā) o nā maʻi o ka waha e loaʻa ana i ka norethisterone e ka 30% a me ka ethinyl estradiol ma 20%.

ʻOi aku ka hopena o ka lipid-hoʻohaʻahaʻa i ka hui me ka colestipol no kēlā me kēia pālolo i kahi kaʻawale, ʻoiai kahi 25% hōʻemi i ka neʻe o ka atorvastatin i ka wa i hoʻohana pinepine ʻia me colestipol.

ʻO ka hoʻohana pū kekahi me nā lāʻau lapaʻau e hōʻemi i ka neʻe ʻana o nā testosterone stogenous (e komo pū ana i ka ketoconazole, spironolactone) e hoʻonui i ka hōʻemi o ka hoʻōla ʻana o nā testosterone (endogenous steroid).

ʻO ka hoʻohana nui ʻana o ka wai ukiuki i ka wā o ka mālama ʻana hiki ke alakaʻi i ka neʻe o ka plasma o ka atorvastatin. No laila, i ka wā o ka mālama ʻana, pono nā hua ʻōpala e pale.

Nā ʻōlelo kikoʻī

Hiki i ke Atorvastatin ke hoʻonui i ka hoʻonui ʻana i ka CPK serum, pono ia e mālama i ka hopena ʻē aʻe o ka ʻeha o ka umauma. Pono e noʻonoʻo i ka hoʻonui ʻana o KFK e 10 mau manawa i hoʻohālikelike ʻia me ke ʻano maʻamau, i hui pū ʻia me ka myalgia a me nā nāwaliwali o kaʻili e hiki ke hoʻopili i ka myopathy, pono e hoʻokuʻu ʻia ka mālama ʻana.

Me ka hoʻohana pū ʻana o ka atorvastatin me ka cytochrome CYP3A4 protease inhibitors (cyclosporine, clarithromycin, itraconazole), pono ka hoʻomaka mua ʻana me ka 10 mg, me ka papa pōkole o nā ʻano lāʻau lapaʻau, pono e hoʻokuʻu ʻia ʻo atorvastatin.

Pono e kiaʻi mau i nā hōʻailona o ka hana o ka ate ma mua o ka hoʻōla, 6 a me 12 mau pule ma hope o ka hoʻomaka ʻana o ka lāʻau lapaʻau a ma hope paha o ka hoʻonui ʻana i ka nui, a me kēlā manawa (kēlā me kēia 6 mau mahina) i ka manawa holoʻokoʻa o ka hoʻohana (a hiki i ka maʻamau maʻamau o ke ʻano o nā mea maʻi o nā pae o ka transaminase ma mua o ka maʻamau. ) ʻO ka hoʻonui ʻana o nā "hepatic" transaminases e nānā nui ʻia ma ka 3 mau mahina o ka hoʻokele lāʻau. Manaʻo ʻia e kāpae i ka lāʻau lapaʻau a hōʻemi paha i ka maʻi me ka piʻi o AST a me ALT ma mua o 3 mau manawa. ʻO ka hoʻohana ʻana o ka atorvastatin e hoʻoleʻaleʻa i kahi manawa ma ka hoʻomohala ʻana i nā hōʻailona lapaʻau e hōʻike ana i ka noho ʻana o ka myopathy mahele, a i ʻole ke kau ʻana i nā mea i manaʻo ʻia i ka hoʻomohala ʻana i ka hana ʻoi ʻana ma muli o ka rhabdomyolysis (maʻi lahilahi, hoʻemi i ke kahe nui o ke koko, ka nui ʻana o ka maʻi, trauma, metabolic, endocrine a i ʻole nā ​​hopena electrolyte koʻikoʻi) . ^ E Ha yM. Hoʻomaʻamaʻa ʻia nā mea maʻi e pono koke lākou e kūkā i ke kauka inā ʻaʻole i loaʻa ka ʻeha a i ʻole nā ​​nāwaliwali o ka naʻau, inā ua hele pū lākou me ka malaise a me ka maʻi maʻi.

Aia nā loiloi o ka hoʻolālāʻana o ka fasciitis atonic me ka hoʻohana ʻana o atorvastatin, eia naʻe, pili ʻia kahi pilina me ka lawelawe ʻana o ka lāʻau lapaʻau, akā ʻaʻole ia i hōʻoia ʻia, ʻaʻole ʻike ʻia ka etiology.

Hoʻohui i nā io uaua o ka ʻūlū. Ke hoʻohana nei i ka atorvastatin, e like me nā lāʻau lapaʻau o kēia papa, ua hōʻike ʻia nā hihia o ka rhabdomyolysis me ka lua o ka maʻi renal e hōʻeha ʻia e ka myoglobinuria. ʻO kekahi mōʻaukala o ka hana ʻana i ka hakahaka i pilikia ai ka hakahaka o ka rhabdomyolysis. Pono e nānā pono nā kūlana o nā mea maʻi no ka hoʻomohala ʻana i nā hōʻike o ka ʻāʻā o ka iwi.

Atorvastatin, a me nā statins ʻē aʻe, i nā hanana lihilihi hiki ke alakaʻi i ka hoʻomohala ʻana i ka myopathy, i hōʻike ʻia e ka ʻeha o ka naʻau a i ʻole ka nāwaliwali o ka hui pū ʻana me ka hoʻonui ʻana i ka pae o ka phosphokinase (CPK) iʻoi aku ma mua o 10 mau manawa mai ka waiwai o ka paepae kiʻekiʻe. ʻO ka hoʻohana pū ʻana o nā dosis kiʻekiʻe o ka atorvastatin me nā lāʻau lapaʻau e like me ka cyclosporine a me nā mea hoʻomehana potent o ka isoenzyme CYP3A4 (e.g., clarithromycin, itraconazole a me HIV inhibitor inhibitor) hoʻonui i ka hopena o ka myopathy / rhabdomyolysis. Ke hoʻohana nei i nā statins, nā hihia maʻamau o ka necrotizing myopathy (IONM), kahi maʻi myopathy, ua hōʻike ʻia. Hoʻohālikelike ʻia ka IONM e nā nāwaliwali o nā pūʻulu o nā pōkole proximal a me ka hoʻonui ʻana i nā pae kinase creatine kinase, e hoʻomau nei ʻo ia i ka hana ʻana o nā statins, ua ʻike ʻia ka myopathy necrotizing i ka manawa biopsy, ʻaʻole i hui pū ʻia e ka huhū nui, hoʻomaikaʻi ʻia ka hoʻomaʻemaʻe ke lawe ʻia nā immunosuppressants.

Pono e hoʻomohala ʻia ka hoʻomohala ʻana o ka myopathy i nā poʻe maʻi me ka hoʻolule i ka myalgia, ʻehaʻeha nā palupalu a me nā mea haʻahaʻa a / a me kahi mea i hoʻonui ʻia i ka pae o CPK. Hoʻomaʻamaʻa ʻia nā mea maʻi e hoʻomaopopo koke lākou i kā lākou kauka e pili ana i ke ʻano o ka hōʻeha ʻole o ka ʻeha, ʻeha a nāwaliwali paha o nā ʻūhā, ʻoiai inā hele pū lākou me ka malaise a me ka maʻi la, a inā he mau ʻuhaneʻohana e hoʻomau ma hope o ka hoʻokuʻu ʻana i atorvastatin. Me kahi piʻi nui i hoʻonui ʻia o ka pae o ka CPK, hoʻāliʻi i ka myopathy a i ʻole ʻia ka manaʻo myopathy, pono e hoʻokuʻu ʻia ka mālama ʻana me ka atorvastatin.

Pilikia ka hoʻomohala ʻana i ka myopathy i ka wā me ka mālama ʻana i nā lāʻau lapaʻau o kēia papa me ka hoʻohana pū ʻana i ka cyclosporin, nā huaʻai o ka fibric acid, erythromycin, clarithromycin, a hepatitis C virus protease inhibitor, telaprevir, hoʻohui pū me ka hoʻohana ʻana i ka pale o ka protease (me kaquinavir + ritonavir, ritinavir + ritonav, darunavir + ritonavir, fosamprenavir a me ka fosamprenavir + ritonavir), ka waikū nikotinic a me nā mea antifungal hui mai ka hui azole. I noonoo i ka ninau o ka malama ana i ka hoʻohui pū Inc me atorvastatin a me ka fibricʻakika nā mea loaʻa, erythromycin, clarithromycin, saquinavir ma ka hui pu ana, me ka ritonavir, lopinavir ma ka hui pu ana, me ka ritonavir, darunavir ma ka hui pu ana, me ka ritonavir, fosamprenavir, a fosamprenavir ma ka hui pu ana, me ka ritonavir, antifungal konohiki, mai ka pae ana o azoles a nicotinicʻakika ma kahi lipid-hoʻohaʻahaʻa nui, pono e kaupaʻi nā kauka i nā mea i makemake ʻia a me nā pōʻino i hiki mai a mālama pono ke kūlana o nā mea maʻi e ʻike i kekahi mau hōʻailona a me nā hōʻailona o ka hōʻeha o ka ʻeha, ke kaumaha a me ka nāwaliwali o ka naʻau, ʻoi aku hoʻi i nā malama o ka malama mua ʻana, a ma ka manawa o kahi hoʻonui o kēlā me kēia o kēia mau lāʻau. Inā makemake ʻoe e hoʻohana i ka atorvastatin me nā lāʻau lapaʻi i luna, pono e noʻonoʻo ʻoe i ka hiki ke hoʻohana i ka atorvastatin ma lalo o nā pae mua a me nā mālama mālama.

I kēlā mau kūlana, pono e hoʻonā i ka manawa i ka hana o nā mea hoʻonaninani phosphokinase (CPK) akā, ʻaʻole ia e hōʻoia i ka pale ʻana o ka myopathy koʻikoʻi.

I ka poʻe maʻi me ka mōʻaukala o ka hemorrhagic stroke a i ʻole ka lacunar infarction, hiki ke nānā wale ʻia ka hoʻohana ʻana o Atorvastatin ma hope o ka hoʻoholo ʻana i ka hopena o ka hopena / hopena pōpilikia, pono i noʻonoʻo ʻia ka hopena o ka stroke hemorrhagic e noʻonoʻo.

Pono nā wahine o nā makahiki hānau o ka hoʻohana ʻana i nā ala e hiki ai ke hoʻopaʻa ʻia. No ka mea nui ka kolamu a me nā mea i hoʻohuihui ʻia mai ka kolesterol ka mea nui no ka hoʻomohala ʻana o ka pūpū, ʻo ka hopena o ka hiki ke hoʻoweliweli i ka hoʻōla ʻana o HMG-CoA ma mua o ka loaʻa ʻana o ka lāʻau lapaʻau i ka wā hapai. I ka hoʻohana ʻana o nā makuahine i ka lovastatin (kahi HMG-CoA reductase inhibitor) me ka dextroamphetamine i ka trimester mua o ka hāpai ʻana, hānau mai nā keiki me ka iwi o ka maʻi o ka iwi, ʻike ʻia ka tracheo-esophageal fistula, a ʻike ʻia ka anus atresia. I ka hihia o ka hapai i ka wā o ka lāʻau, pono e hoʻokuʻu koke i ka lāʻau lapaʻau, a pono e hoʻomaopopo ʻia ka poʻe maʻi i ka hopena i hiki ke kīpī.

Hōʻike kekahi mau hōʻike i nā statins e like me ka papa e hoʻonui i ka glucose koko, a i loko o nā mea maʻi i ka hopena kiʻekiʻe o ka ulu ʻana i ka maʻi diabetes, hiki iā lākou ke hoʻoulu i ke kō o ke kō, e pono ai ka mālama kūpono. Eia nō naʻe, ʻo nā pōmaikaʻi o nā statins i ka hōʻemi ʻana i nā hopena o ka maʻi cardiovascular ma mua o ka hoʻonui iki ʻana i ka hopena o ka hoʻoulu ʻana i ka maʻi diabetes, no laila, ʻaʻole pono e hoʻoneʻe ka hoʻohana ʻana o statin. Aia nā kumu no ka mālama mau ʻana i ka glycemia i nā mea maʻi i ka hopena (ʻo ka wikiwiki o ka wikiwiki o ka 5.6 - 6.9 mmol / l, ka nui o ka waihona kino> 30 kg / m2, i hoʻonui ʻia ai nā triglycerides, hypertension), e like me nā ʻōlelo ʻana o kēia manawa.

Nā hiʻohiʻona o ka hopena o ka lāʻau lapaʻau ma ka hiki ke hoʻokau i nā kaʻa a i ʻole nā ​​mea e hoʻopilikia ai paha: hāʻawi ʻia i nā hopena kūpono o ka lāʻau lapaʻau, pono e makaʻala i ka wā e hoʻokele ai i nā kaʻa kaʻa a i ʻole nā ​​mea hoʻokūkū ʻē aʻe paha.

Ke keu

Nā Hoʻomaka ʻAʻole paʻa i nā hōʻailona kikoʻī o kahi overdose. Hiki i kēia ʻōhuhi ke komo i ka ʻeha i ke akepaʻa, paʻa ʻole ʻo ka renal ʻole, ka hoʻohana lōʻihi ʻana i ka myopathy a me ka rhabdomyolysis.

Lāʻau: ʻaʻohe ʻano antidote kiko'ī, ka maʻi maʻi a me nā kaʻina e pale ai i ka hoʻopili hou ʻia (gastage lavage a me ka hāmeʻa i hana ʻia). Hoʻopili nui ʻia ʻo Atorvastatin i nā protein protein; ma ka hopena, ʻaʻohe pono o ka hemodialysis. Me ka hoʻomohala ʻana i ka myopathy, i ukali ʻia e ka rhabdomyolysis a me ka hāʻule ʻole ʻana o ka maʻi (lune) - wehe koke ʻia ka lāʻau a me ka hoʻopuka ʻana o kahi hopena diuretic a me ka sodium bicarbonate. Hiki i ka Rhabdomyolysis ke alakaʻi i ka hoʻouluʻana o ka hyperkalemia, e pono ai ka hoʻokele intravenous o ka calcium chloride a i ʻole ka gluconate calcium, ka infusion o glucose me ka insulin, ka hoʻohana ʻana i nā mea kūʻai aku o ka pālima kalima a i ʻole, i nā hihia koʻikoʻi, hemodialysis.

Mea hana

RUE Belmedpreparaty, Repubalika o Belarus

Liko o ke kānāwai a me nā Kūlana Kelima:

220007, Minsk, Fabricius, 30,

t./f .: (+375 17) 220 37 16,

Ka inoa a me ka ʻāina o ka mea hoʻopaʻa inoa palapala

RUE Belmedpreparaty, Repubalika o Belarus

ʻO ka noho ʻana o kahi hui e ʻae ana i nā hoʻopiʻi mai ka poʻe hoʻohana ma ka maikaʻi o nā huahana ma ka Repubalika o Kazakhstan:

KazBelMedFarm LLP, 050028, ka Repubalika o Kazakhstan,

Almaty, st. Kuahiwi 151

+ 7 (727) 378-52-74, + 7 (727) 225-59-98

Kaila leka uila: [email protected]

I.O. Hope ʻOlena Kuhina no ka Pono

ʻLoe a me ke kākele

Ma mua o ka hoʻomaka ʻana i ka mālama ʻana me Atorvastatin, pono e hoʻoneʻe ʻia ka mea maʻi i kekahi meaʻai e hōʻoia ai i ka hoʻemi ʻana o nā lipid koko, pono e mālama ʻia i ka wā o ka mālama ʻana me ka lāʻau lapaʻau.

Ma loko, lawe i kēlā me kēia manawa o ka lā (akā i ka manawa like), kahi ʻole o ka pili o ka meaʻai.

ʻO ka papa ʻōlelo hoʻomaka ʻia he 10 mg hoʻokahi i ka lā. ʻO ka manawa, koho ʻia ka pākolo i kēlā me kēia ma muli o ke ʻano o ka cholesterol - LDL. Pono e hoʻololi ʻia ka ʻōlelo me kahi kekona o 4 mau hebedoma. ʻO ka dosis kiʻekiʻe loa i kēlā me kēia lā he 80 mg ma 1 pāʻai.

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 hernaia hypercholesterolemia, ʻike ʻia ka hopena maikaʻi loa i ka wā e hoʻohana ai i ka lāʻau lapaʻau i kēlā me kēia lā o 80 mg (hoʻokahi).

Hōʻeha ka hana ʻoluʻolu

I nā mea maʻi me ka pīhoihoi hana ʻino, pono e hoʻomaʻamaʻa ʻia ka pilina me ka hoʻolohi ʻana i ka hōʻemi ʻana i ka lāʻau mai ke kino. Pono e nānā pono ʻia nā ʻōkola a me nā ʻōkuhi hana, a inā i ʻike ʻia nā loli pathological nui, pono e hōʻemi ʻia ka pakanā a i ʻole e hoʻokuʻu ʻia ka lāʻau lapaʻau.

Hoʻopili pū me nā lāʻau ʻē aʻe

Me ka hoʻonaninani pinepine ʻana o ka cyclosporine, hoʻonui i ka, erythromycin, clarithromycin, immunosuppressive, antifungal lāʻau (e pili ana i ka azoles) a me ka nicotinamide, ke piʻi ʻana o ka manaʻo o ka atorvastatin i loko o ka plasma (a me ka pilikia o ka myopathy) e hoʻonui.

Hoʻomau nā antacids i ka hoʻouluʻana e 35% (ʻaʻole i loli ka hopena ma ka LDL cholesterol).

ʻO ka hoʻohana ʻana o ka atorvastatin me nā inhibitor ʻo protease i ʻike ʻia ʻo CYP3A4 cytochrome P450 inhibitors i hoʻohui pū ʻia me ka hoʻonui o ka pakanui plasma o ka atorvastatin.

I ka hoʻohana ʻana i ka digoxin i hui pū me ka atorvastatin ma kahi maʻa o 80 mg / lā, hoʻonui ʻia ka ʻike o ka digoxin ma kahi o 20%.

Hoʻonui i ka neʻe ma o 20% (i ka manawa i kuhikuhi ʻia me ka atorvastatin ma kahi maʻa o 80 mg / lā) o nā mea hoʻohālikelike waha e loaʻa ana i ka norethindrone a me ka ethinyl estradiol. ʻOi aku ka hopena lipid-haʻahaʻa o ka hui me ka colestipol ma mua o kēlā me kēia lāʻau lapaʻau hoʻokahi.

Me ka hoʻokele like me ka warfarin, hōʻemi ka manawa prothrombin i nā lā mua, akā ma hope o 15 mau lā, e hoʻomaʻamaʻa kēia hōʻailona. Ma kēia hana, pono i nā poʻe maʻi e lawe ana i ka atorvastatin me ke warfarin i kahi e pono ai ka manawa i ka wā prothrombin.

ʻO ka hoʻohanaʻana i ka wai pānaʻi i ka wā o ka mālama ʻana me ka atorvastatin hiki ke alakaʻi i ka hoʻonui ʻana o ka ʻai i ka lāʻau i loko o ke koko koko. Ma kēia hana, pono i nā mea maʻi e lawe i ka lāʻau e pale i ka inu ʻana i kēia wai.

Nā hōʻailona āpau

ʻAʻole paʻa i nā hōʻailona kikoʻī o kahi overdose. Hiki i kēia ʻōhuhi ke komo i ka ʻeha i ke akepaʻa, hoʻomaikaʻi ʻole o ka renal i ʻole, hoʻohana lōʻihi a myopathy a me rhabdomyolysis.

ʻAʻohe mea antidote kiko'ī, ka maʻi maʻi a me nā kaʻina e pale ai i ka hoʻopili hou ʻia (gastage lavage a me ka hāmeʻa i hana ʻia).Hoʻopili nui ʻia ʻo Atorvastatin i nā protein protein; ma ka hopena, ʻaʻohe pono o ka hemodialysis. Me ka hoʻomohala ʻana i ka myopathy, i ukali ʻia e ka rhabdomyolysis a me ka hāʻule ʻole ʻana o ka maʻi (lune) - wehe koke ʻia ka lāʻau a me ka hoʻopuka ʻana o kahi hopena diuretic a me ka sodium bicarbonate. Hiki i ka Rhabdomyolysis ke alakaʻi i ka hoʻouluʻana o ka hyperkalemia, e pono ai ka hoʻokele intravenous o ka calcium chloride a i ʻole ka gluconate calcium, ka infusion o glucose me ka insulin, ka hoʻohana ʻana i nā mea kūʻai aku o ka pālima kalima a i ʻole, i nā hihia koʻikoʻi, hemodialysis.