Fenofibrate: ntuziaka maka ojiji, analogues, ọnụahịa na nyocha

Nkọwa nke metụtara 30.08.2016

• Aha Latin: Fenofibrate
• Koodu ATX: C10AB05
• Arụ Ọrụ: Fenofibrate
• Emeputa: Sopharma (Bulgaria), Canonfarm Production CJSC (Russia)

1 mbadamba 145 mg fenofibrate. Ọkpụkpọ ọka, silicon dioxide, croscarmellose sodium mannitol, magnesium stearate, povidone, MCC, dị ka ihe inyeaka.

Mlọ ọgwụ

Ọkpụkpụ hypolipPs fibroic acid. Rụọ ọrụ ndị na-anabata alfana-ewusi lipolysisatherogenic lipoproteins. Na-enye aka mbelata ọkwa VLDL na LDL na abawanye na nkebi HDL. Na -ebelata ọdịnaya site na 40-55% triglycerides na cholesterol (rue n’obere obere - site na 20-25%).

Nyere mmetụta ndị a, ojiji nke fenofibrate na-egosi na ndị ọrịa nwere hypercholesterolemiajikọtara ya na hypertriglyceridemia (ma ọ bụ na-enweghị ya). Tendons belata nke ukwuu n'oge ọgwụgwọ xanthomas (nkwụnye ego cholesterol), mmụba ahụ na-ebelata fibrinogen na C-reactive proteinịta uric acid (25%). Na mgbakwunye, ihe na-arụ ọrụ na-ebelata nchịkọta ọgụgụ platelet na ọbara shuga mgbe ọrịa shuga.

Mlọ ọgwụ

Ọgwụ n'ụdị ihe ejiri micronized arụ ọrụ nwere bioavailability dị elu. A na - emewanyewanye izu ike na nri. Cmax kpebisiri ike mgbe awa 4-5 gachara. Site n'iji ogologo oge eme ihe, ịta ụta plasma ka kwụsiri ike. Ihe bụ isi metabolite bụ fenofibroic acid, nke kpebisiri ike na plasma. Gidesie ya ike albumin.

Ọ bụ ya na akụrụ ya na ọkara ndụ nke awa 20. N'ime otu izu ka egosiri ya kpamkpam. Ọgwụ anaghị adọnye ọbụlagodi iji ogologo oge.

Ihe ngosi maka ojiji

• belata na ịta triglycerides na hyperglyceridemia,
• ngwakọta ọgwụgwọ na akpụ ya na agwakọta dyslipidemia na ndị ọrịa na- Ọrịa ụbụrụ Ischemic, vaskụla atherosclerosis, ọrịa shuga,
• isi hyperlipidemia.

Ihe ngbanwe

• hypersensitivity
• afọ ruo afọ 18
• imeju imeju
• dị arọ gbasara akwara,
• ọrịa ọnya afọ
• adịghị ala ala ma ọ bụ nnukwu ọria aru,
• inye ara.

Eji nlezianya tụọ mgbe hypothyroidism, ị abuseụbiga mmanya ókè na ịka nká, ma ọ bụrụ na eburu ibu nke ọrịa muscle ike.

Nsonaazụ

• ọgbụgba, ida agụụ, ike na-egbu mgbu na epigastric,
• iju haemoglobin,
• ntutu isi
• leukopenia,
• abawanye transaminase,
• myositis na ohere rhabdomyolysis (ya na arụ ọrụ ezumike ya arụ ọrụ).

Njirimara nke ihe eji eme ihe

Dabere na radar, fenofibrate (fenofibrate) bụ ọgwụ sitere na otu nke fibrates, nke bụ usoro nke fibroic acid. Aghọtaghị usoro nke ihe ọ bụla. Ma, dabere na usoro a kọwara na akwụkwọ a, enwere ike ikwubi na a na-enweta nsonaazụ mmachi n'ihi ọrụ enzymatic - n'ihi catalysis nke lipoprotein lipase. N'okpuru oru nke enzyme a, mmebi nke triglycerides na-agbatịkwu ma na -emepụta mmepụta cholesterol.

Na mgbakwunye, faiba a na-ebelata ike platelet (ha na-agbakọ ike karị), na-ebelata ọbara shuga n’ebe ndị ọrịa nwere ọrịa shuga nọ, ma belata ọnụ ọgụgụ uric acid. A na-eme metabolism bụ isi nke imeju na imeju, njikọta protein dị elu na-enye nnukwu bioavailability. Ọ bụ ya bụ akụrụ gafee, ya mere, tupu oge a ga-eme nyocha fenofibrate, ekwesịrị inyocha ihe omume ha. Dị na mbadamba ụrọ nwere usoro ọgwụ nke 145 mg. Ọnụ ọgụgụ dị na otu ngwugwu dịgasị site na 10 ruo 100 PC.

Usoro nke ime ihe

Fenofibrate bụ usoro nke fibrin acid. Ọ na - e belata ogo anụ ahụ site na ịgbalite peroxisome alfa receptor proliferation activator (PPARa). PPARa na-eme ka lipoprotein na-egbu egbu ma belata ọkwa nke apoprotein CIII, na-abawanye lipolysis ma wepụ irighiri ihe na-akpata plasma. PPAR na-emekwa ka ọkwa nke apoproteins AI na AII, nke na-ebelata ego nke lipoproteins dị obere (VLDL) na njupụta lipoproteins dị ala (LDL) na-ebu apoprotein ma na-eme ka lipoproteins dị elu (HDL) njupụta dị elu nwere HDP nke nwere apoproteins AI na AII. Na mgbakwunye, site na ibelata njikọta na ịbawanye catabolism nke lipoproteins dị ntakịrị, fenofibrate na-abawanye lumen nke LDL ma belata ọnụ ọgụgụ obere LDL dị nta na okirikiri na-esonyere ọrịa obi.

Ihe omumu: ihe ngosi ndi ejiri

Ọrịa tricor bụ ọgwụgwọ bụ isi maka hypercholesterolemia na hypertriglyceridemia naanị ma ọ bụ n'ụdị ọrịa dị iche iche (ụdị dyslipidemia IIa, IIb, III, IV na V), na / ma ọ bụ ma ọ bụrụ na usoro izizi ezughi oke ma ọ bụ nwee mmetụta na-adịghị anabata ya. Na mgbakwunye, na Europe, a na-eji fenofibrate maka hyperlipidemia agwakọta na ndị ọrịa nwere nnukwu ọrịa nke ọrịa obi na mgbakwunye na statin ma ọ bụrụ na triglycerides na HDL anaghị achịkwa nke ọma. Fenofibrate bụ contraindicated na ụmụaka, ụmụ nwanyị dị ime na onye na-elekọta nwa, ndị ọrịa nwere ọrịa imeju, ọnụnọ nke gallstones, ndị ọrịa nwere hymonsensee fenofibrate na / ma ọ bụ ndị ọpụpụ, n'ihe banyere photoallergy mara ma ọ bụ mmeghachi omume fototoxic na ọgwụgwọ nke fibrates ma ọ bụ ketoprofen.

Mmekorita

Na-eme ka mmetụta anticoagulants pụta - enwere nsogbu ọbara ọgbụgba. A na-atụ aro ka ọ belata ọgwụ anticoagulants.

Njikọ na MA inhibitors na cyclosporine nwere ike imebi ọrụ akụrụ. Cholestyramine belata mmịpụta. Mgbe gị na ndị ọzọ nọ fibrates na akpụ enwere ihe ojoo ojoo na aru aru.

Ọgwụ Farmacology

Site na itinye ndị na-anabata PPARα (Alfa ndị na-anabata ya na-eme ka onye na-eme mkpọtụ peroxisome) rụọ ọrụ, fenofibroic acid (metabolite nke fenofibrate na-arụ ọrụ) na-akwalite lipolysis na plasma na -akwụsị nke atherogenic lipoproteins site na ịgbalite lipoprotein lipase na ibelata njikọta nke CIIP. Ationrụ ọrụ PPARα na-eduga n'ịba ụba njikọ nke apolipoproteins AI na AII.

Mmetụta ndị akọwapụtara n'elu na lipoproteins na-eduga n'ịbelata ọdịnaya nke LDL na ụmụ irighiri VLDL, nke gụnyere apolipoprotein B, yana mmụba nke ọdịnaya nke HDL, nke gụnyere apolipoproteins AI na AII.

N'ihi mgbazi nke mmebi nke njikọta na catabolism nke VLDL, fenofibrate na-eme ka mmụpụ nke LDL belata ma belata ọdịnaya nke nju na obere ururu nke LDL, mmụba nke a na-ahụ na ndị ọrịa nwere ọgwụ na-adịghị mma atherogenic (nke na -emekarị ndị ọrịa n'ihe ize ndụ nke ọrịa akwara akwara).

Na nyocha nke ulo ogwu, emere ka amara ya na iji fenofibrate belata cholesterol zuru oke site na 20-25% na triglycerides site na 40-55% na mmụba nke cholesterol HDL site na 10-30%. N'ime ndị ọrịa nwere hypercholesterolemia, nke ọnọdụ LDL-cholesterol belatara site na 20-35%, ojiji nke fenofibrate butere mbelata nke oke: “kọlestrọl / HDL-cholesterol”, “LDL-cholesterol / HDL-cholesterol” na “Apo B / Apo AI ", Nke bụ ihe nrịbama nke ihe egwu atherogenic.

Nyere nsonaazụ LDL cholesterol na triglycerides, ojiji nke fenofibrate dị irè na ndị ọrịa nwere hypercholesterolemia, ma na ma na-enweghị hypertriglyceridemia, gụnyere hyperlipoproteinemia nke abụọ, gụnyere ya na ụdị ọrịa shuga mellitus nke 2. Na mgbakwunye, ọ na-ebelata ịba ụba nke fibrinogen na uric acid na plasma, na iji ọgwụgwọ ogologo oge ọ na-ebelata nkwụnye cholesterol extravascular.

Mgbe nchịkwa ọnụ gachara, mmiri ọgwụ fenfibrate na-enweta mmiri ngwa ngwa site na esterases. Na plasma, a na - ahụkarị metabolite dị ike nke fenofibrate - fenofibroic acid, T_max bụ nke a na-enweta na plasma n'ime awa 2-3. Ijikọ fenofibroic acid na protein plasma bụ ihe dịka 99%, C_ss jisiri n’ime otu izu. Fenofibrate na fenofibroic acid adịghị enweta metabolism oxidative metụtara cytochrome P450. Ndi_1/2 fenofibroic acid - ihe dị ka awa 20. Ọ bụ ndị akụrụ na-apụkarị ya (fenofibroic acid na glucuronide). Ọ dịghị akpọnwụ.

Nwepu nke Fenofibroic acid mgbe otu nchịkwa nke fenofibrate anaghị agbanwe dabere na afọ ma ọ bụrụ na ọ bụ 1.2 l / h na ndị ọrịa agadi (afọ 77-87) na 1.1 l / h na ndị ọrịa na-eto eto.

N'ime ndị ọrịa nwere nnukwu akụrụ oke (creatinine Cl creatinine Cl 30-80 ml / min) na-abawanye T_1/2 fenofibroic acid.

N'ime ihe omumu ihe omumu, emere ihe nleghari abuo abuo nke fenofibrate - "micronized" na "ndi na - adighi micronized." Tụnyere ihe nlele ọbara nke ndị ọrụ afọ ofufo mara mma mgbe ebupusịrị ụdị ndị a gosipụtara na 67 mg nke ụdị "micronized", bioequurate ka 100 mg nke ụdị "micro-na-abụghị micronized".

Usoro onunu ogwu na nhazi

Mpempe akwụkwọ Fenofibrate na-a drunkụbiga mmanya ókè, anaghị ata ata ma ọ bụghị kewaa. Ya mere, oke ọgwụ a na-enweta ga - arụpụta - maka oke akpụkpọ ahụ, ọ rutere akụkụ achọrọ nke eriri afọ ma na - abanye na ha. Maka ndị ọrịa okenye, ọgwụ a na-eme kwa ụbọchị bụ 1 capsule otu ugboro n'ụbọchị. A na-atụle ya kacha - 145 mg.

N'ime akwụkwọ a, enwere ihe akaebe banyere ojiji nke ọgwụ a n'oge afọ ime. Na mmechi nke ọtụtụ ọmụmụ sayensị, achọpụtara na teratogenic na mmetụta fetotoxic sitere na mbadamba fenofibrate. Agbanyeghị, data ndị a dị ụkọ na anaghị enye nkọwapụta ọgwụgwọ doro anya maka ịhọpụta ọgwụ. Ya mere, n'oge afọ ime, enwere ike wepu ya naanị na nyocha siri ike nke mmerụ na uru ya. N'oge a na-enye nwa ara, ọnọdụ ndị dọkịta kwụsiri ike - a machibidoro akwara akwụkwọ.

Nyocha Nyocha

Nyocha nke ndị dọkịta na ndị ọrịa ha tookụrụ ọgwụ dabere na Fenofibrate, ọkacha mma. Site n'ike nke mmetụ egbugbere ọnụ, ha dị ala karịa statins, mana na-ebute mmeghachi omume dị ala. A na-ejikarị akụkụ dị ka akụkụ nke usoro ọgwụgwọ n'ọtụtụ na-emegide mgbanwe ndụ, mgbanwe nri na ịhọpụta ọgwụ metabolic mmezi.

Nsonaazụ

Ekwesịrị iburu n'uche na ọgwụ ahụ nwere ọtụtụ nsonaazụ ya, yabụ ịkwesịrị ijide n'aka na enweghị ọgwụ mgbochi ọ bụla. Mgbe o kwusịchara mbadamba nkume ndị ahụ, onye ọrịa ahụ nwere ike ịmalite mmeghachi nfụkasị ahụ na ncha, itching, hives ma ọ bụ mmeghachi omume, yana itinye uche nke creatinine na urea nwere ike ịba ụba.

Mmeghachi omume ndị a na-achọghị na-enwe ike ime n'ụdị mgbu afọ, ọgbụgbọ, ọgbụgbọ, afọ ọsịsa, flatulence. N'ọnọdụ ndị na-adịghị ahụkebe, ọrịa akwara dị ala na-apụta, ụdị gallstones, adịkarịghị etolite ịba ọcha n'anya. Ọ bụrụ na mmadụ nwere ihe mgbaàmà yana ọrịa jaundice ma ọ bụ itching skin, a ga-anwale onye ọrịa ahụ maka ịba ọcha n'anya wee kwụsị ịenoụ Fenofibrate.

Mgbe ụfọdụ nsonaazụ na - apụta n'ụdị mgbasa ozi myalgia, myositis, spasm muscle, adịghị ike, rhabdomyolysis, ịba ụba ọrụ nke creatine phosphokinase. Peoplefọdụ ndị mmadụ na-etolite nnukwu akwara nke mkpụrụobi, akwara umeji, ịba ụba haemoglobin na ọnụ ọgụgụ ọbara ọcha, isi ọwụwa, na dysfunction mmekọahụ. N'ọnọdụ ndị pụrụ iche, a na-achọpụta ọrịa ịba n'etiti pneumopathy.

Achọpụtabeghi na ịdoụbiga ihe ókè ókè, mana ọ bụrụ na enwere enyo enyo iji ọgwụ adịghị mma, a na-edenye usoro ọgwụgwọ na nkwado. Ojiji nke hemodialysis adighi ike. Amaghị ọgwụ mgbochi ụfọdụ.

Mgbe ị na-eji usoro ọgwụgwọ siri ike na ojiji nke ọgwụ ndị ọzọ, a ghaghị ilezi anya pụrụ iche.

• Fenofibrate na-akwalite mmetụta nke ọgwụ anticoagulants, nke a na-ebute ọbara ọgbụgba. Yabụ, na ọkwa mbụ nke usoro ọgwụgwọ, usoro ọgwụgwọ anticoagulants belata 1/3. Na-esote, dọkịta na-ahọrọ ọgwụ ahụ n'otu n'otu, na-elekwasị anya na ọnọdụ onye ọrịa n'ozuzu ya na nsonaazụ nke ule ahụ.
• Cyclosporin, ejiri ya na fenofibrate, na-ebelata ọrụ gbasara akụrụ, n'akụkụ nke a, enwere nnukwu mgbanwe na paradaịs, a na-akwụsị ịgwọ ọrịa. Ọ bụrụ na ejiri ọgwụ nephrotoxic mee ihe, a na-atụle uru na ihe ize ndụ, mgbe nke ahụ gasịrị, a na-ekpebi otu kachasị dị ize ndụ.
• Ọ bụrụ na ijikọ ọnụ ị theụ ọgwụ ahụ na otu HMG-CoA reductase inhibitors, nnukwu akwara renal, myopathy, rhabdomyolysis nwere ike ịmalite. Ọ bụrụ na ekpughere ya na ndị na - esote bile acid, nnabata nke Fenofibrate belatara, ya mere, a na-ewere mbadamba mkpụrụ ndụ nwere otu elekere ma ọ bụ awa isii mgbe ị drugụ ọgwụ ọzọ.

Analogues nke ọgwụ

E nwere ọtụtụ ọgwụ nwere otu mebere. Ndị a gụnyere Trilipix, Exlip, Tsiprofibrat, Lipantil, mbadamba Tricor. Ọzọkwa na ụlọ ahịa ọgwụ ị nwere ike ịzụta ọgwụ ọgwụ na otu ụdị na ahụ - Livostor, Storvas, Tulip, Atorvakor.

Onye ọrịa ahụ nwere ike iji aka ya họrọ ọgwụ nnọchi, nyere ya ụdị dọkịta ahụ ga-enye ya. Na-ekpebi site na nyocha, mbadamba emere na Japan, USA, Western na Eastern Europe na-ahụta nke kachasị arụmọrụ.

Ya mere, fenofibrate dị irè n'ịgwọ hypercholesterolemia megide ụdị ọrịa shuga 2 nke ọrịa mellitus. Iji nweta nsonaazụ ọsọ ma dị irè karị, a na-ewere statins ọzọ. A na-eji ọgwụ ahụ eme ihe nke ọma maka ọgwụgwọ okenye. Ọgwụ na-ebelata triglycerides, kwụsị uto nke mgbanwe fundus, melite ọnọdụ nke ụkwụ.

A kọwara ọgwụgwọ nke atherosclerosis na vidiyo n'isiokwu a.

Irè

Atọ atọ, nke gbara okpukpu abụọ, ọtụtụ ihe, ọnwụnwa nke atọ gosiri na dịka ọgwụgwọ nke fenofibric acid na statins (atorvastatin, rosuvastatin na simvastatin), a na-ahụkwu ọganihu na HDL na ọkwa triglycerides karịa na statin monotherapy. Na mgbakwunye, enwere ọganihu dịwanye elu na ọkwa LDL ma e jiri ya tụnyere fenofibric acid monotherapy. Ọmụmụ FIELD na 2005, nke nyochara nsonaazụ fenofibrate na ọrịa shuga mellitus, nke kachasị ukwuu, gụnyere ndị ọrịa 9795 nwere ọrịa shuga 2, egosipụtaghị mbelata ihe ize ndụ maka isi ihe dị na (infarction myocardial na-abụghị nke na-egbu egbu) na ọnwụ n'ihi ọrịa obi. N'ọgwụ nke abụọ (ọrịa obi niile), a chọpụtara na mbelata ihe dị ka ọrịa ọnụọgụgụ nke ọrịa 11%. Imirikiti ndị ọrịa na otu placebo natara akpụ n'oge ọmụmụ ihe ahụ, nke kpatara mmetụta na-agwụ ike. Mgbe emezigharịrị maka akpụ, mbelata ihe ọghọm dị 19% maka ọrịa infarction na-abụghị nke na-egbu egbu na ọrịa obi obi, yana 15% maka ọrịa obi. Ọmụmụ ihe a gosikwara uru mbelata bara uru n’ihe ọghọm nke ọrịa microvascular n’ebe ndị ọrịa nwere ụdị shuga nke 2 nọ. Ojiji nke fenifibrate belatara oganihu albuminuria (ihe na-erughi 14% na ndaghari 15% karie ya na placebo). Na mgbakwunye, enwere mbelata 30% na mkpa ọgwụgwọ ọgwụgwọ laser nke retinopathy. Nchịkọta enyemaka nke ọmụmụ ahụ gosipụtara na fenofibrate belatara mkpa maka ọgwụgwọ laser isi site na 31%, belata ụbụrụ isi site na 31% na protinerative retinopathy site na 30%.N'ime ọmụmụ ihe dị ala, e gosipụtara fenofibrate na-akpata mbelata 22% na mmepe ma ọ bụ ọganihu nke ọrịa retinopathy na ndị ọrịa niile na site na 79% na ndị ọrịa nwere ọrịa retinopathy dị adị. Na mgbakwunye, ọmụmụ ahụ gosipụtara na fenofibrate belata ọnụ ọgụgụ nke mbepụ ọghọm trauma na-erughi 38%. Dịka ọ bụla fibrates, fenofibrate nwere ike ibute ọgbụgba na myopathy (mgbu mgbu), yana ọrịa rhabdomyolysis dị obere. Ihe ize ndụ ahụ na-abawanye mgbe ejiri ya na statins. Ka o sina dị, ọmụmụ a na-enye ozi dị mkpa na iji fenofibrate ogologo oge dị mma n'ihe banyere nchekwa maka ndị ọrịa nwere ọrịa shuga 2, ọbụlagodi na mgbakwunye nke ọgwụ a na-amụghị n'ọrịa hypoliplera. N'ime usoro ọmụmụ a, ọ bụghị otu ikpe nke rhabdomyolysis na ndị ọrịa na usoro ọgwụgwọ njikọta na fenofibrate na statin ka edekọtara. N'ihi ya, enwere ọtụtụ ihe akaebe na ojiji jikọtara fenofibrate / statins dị mma ma na-adị irè n'ịgwọ ọrịa dyslipidemia na ndị ọrịa nwere ọrịa shuga 2dị nke 2 nwere ike ibute ọrịa obi. Agbanyeghị, ọmụmụ ihe ọzọ, ACCORD anaghị akwado nkwupụta dị n'elu nke ịdị irè. Nchoputa nyocha nke FIELD na nso nso a, nke eweputara na 2009 site na Diabetes Care gosiputara na fenofibrate na - ebute mbelata nke ukwuu na nsogbu nke ibute oria obi n’aria ndi oria cholesterol HDL na obara mgbali ala. A hụrụ ịdị ike kachasị ukwuu nke fenofibrate iji belata ihe ize ndụ nke CVD na ndị ọrịa nwere nnukwu dyslipidemia (TG> 2.3 mmol / L na HDL-C) dị ala nke gosipụtara mbelata 27% n'ihe ize ndụ dị na ọnụ ọgụgụ nke CVDs. Evidencefọdụ ihe akaebe na-egosi na uru zuru oke nke fenofibrate na-abawanye na ọnụnọ metabolic atụmatụ nke ọrịa ahụ. A na-ahụkarị ihe ize ndụ kachasị na uru kasịnụ nke fenofibrate n'etiti ndị ọrịa nwere nnukwu ọbara mgbali elu, agbanyeghị, nchọpụta ndị a esiteghị ebumnuche nke ọmụmụ ihe a. Ihe nrịba ama nke akwara maka oria ojoo na anria microvascular na mkpi ndi nwere aka na ndi nwere oria 2 noo. Usoro ọgwụgwọ Fenofibrate nwere njikọ dị ala nke mbelata, ọkachasị obere mbepụ na-enweghị ọrịa ndị a ma ama na nnukwu arịa, ikekwe site na usoro ndị na-enweghị ọgwụgwọ. Nchọpụta ndị a nwere ike ibute mgbanwe n'ọdịdị ọgwụgwọ na mgbochi nke mbepụ mkpịsị ụkwụ ndị metụtara ọrịa shuga. N'afọ 2010, nnyocha otu nzukọ akpọrọ Organisation maka njikwa ọrịa obi gosipụtara na fenofibrate na statins na ndị ọrịa nwere ụdị shuga 2 anaghị ebelata ohere ịba ọria obi karịa ojiji nke statins naanị. N'ime ule nke ACCORD, a mụrụ ndị ọrịa 5,518 n'ime afọ 4.7, na-enye ihe akaebe na-ekwe nghọta nke obere maka enweghị ezigbo ndụ uru mgbe ha na-eji fibrates na ndị ọrịa nwere ọrịa cholesterol dị elu. Ọ bụ ezie na ihe omumu ihe omumu nke ACCORD enyeghi nkwado maka data banyere uru nke ịgbakwunye fenofibrate na statins n'ime ndị ọrịa nwere ụdị ọrịa shuga 2 (ọrịa shuga 2), o mere ntinye aka dị ukwuu na nsonaazụ fibrate monotherapy, na-egosipụta uru ọgwụgwọ a na mpaghara ndị ọrịa nwere nnukwu dyslipidemia. Karịsịa, ihe omumu ihe omumu nke ACCORD gosipụtara na-akwado nkwubi okwu na enwere ike itinye fenofibrate na statin therapy na ndi oria nwere oria 2 na cholesterol zuru oke, ma nogidere, oke hypertriglyceridemia (> 200 mg / DLL) na obere lipoprotein cholesterol njupụta dị elu (ọgwụ dị ala, fibrates, lipolysis, mbelata nke cholesterol, ọrịa obi, hypercholesterolemia, hypertriglyceridemia, albuminuria, ọrịa shuga, ọrịa shuga, g Purton, dyslipidemia

Vasilip - ntuziaka maka ojiji

Ọ ga - ekwe omume ibelata ọdịnaya nke ihe ndị na - eme ka ọbara ghara ịdị n’ọbara ọ bụghị naanị site n’ihe oriri na mmega ahụ. Ndị ọgwụ ọgbara ọhụrụ nwere ụzọ na-arụ ọrụ ọfụma. Vasilip bụ ọgwụ a ma ama na nke a na-ejikarị na ndị ọrịa nke ndị ọkachamara n'ihe banyere nri na ndị na-ahụ maka ọrịa obi. Tupu iwere ya, ị ga-agakwuru onye ọkachamara mgbe niile, gbaa oge wee gụọ ntuziaka maka ojiji.

Omume ọgwụ

A na - enweta ọgwụ a dịka ihe na - arụ ọrụ, ọ bụkwa ngwaahịa Aspergillus terreus gbaa ụka. Ingbanye na ahụ mmadụ, ihe ndị na-arụ ọrụ nke vasilip (simvastatin) decompose site na hydrolysis n'ime ihe ndị a na-ahụ maka hydroxy acid, nke na-eburu ọrụ ọgwụ bara uru iji belata cholesterol ọbara.

Mwepu nke akụrụngwa dị ike nke ọgwụ ahụ na-apụta na eriri afọ. Ọkwa mmịpụta dị elu, ihe dịka 61-85%. Akụkụ ọgwụ a na-agaghị etinye aka na eriri afọ ya na akwara na-apụta. Ntụziaka ahụ gosipụtara na enwere ike ịhụ ọdịnaya kachasị elu nke ihe ndị na-arụ ọrụ n'ime plasma ọbara mgbe awa 1-1.3 gasịrị ị takingụ ọgwụ ahụ. Simvastatin kachasi ike na imeju.

Ọzọkwa, ọgwụ a na - arụ ọrụ dị ka metabolite na - arụ ọrụ, nke na - eme ọ bụghị naanị na - eme ka usoro nke ọtụtụ usoro na - ebute ahụ mmadụ na - enwe cholesterol dị elu nwayọ nwayọ, mana na - egbochi Htr-CoA reductase. Enzyme a, n'aka nke ya, bụ ihe na-eme ka mbido mevalonate site na HMG-CoA. N'ihe dị ka okwu ndị a, mmadụ nwere ike ịkọwa ọkwa mbụ nke cholesterol njikọ. Vasilip na - egbochi ngwakọta nke cholesterol ma si otú a belata ọkwa ya dịka ọ dị na mbụ.

Na mgbakwunye, iji vasilip nwere ike belata mkpokọta lipoproteins dị ntakịrị, triglycerides na cholesterol zuru oke, dịka nyocha ọbara kpebiri. N'otu oge ahụ, enwere mmụba nke ogo lipoproteins dị elu, nke na-alụ ọgụ itinye nkwụnye nke lipid n'ahụ mgbidi nke arịa ọbara. Ya mere, vasilip na-ebelata ọbara atherogenicity, ya bụ, ọ na-eme ka akụrụngwa “adịghị mma” yana “mma” dị ọcha.

Okwesiri iburu n'uche na mmetụta dị mma nke "akụkụ" nke vasilip, dị ka ịbelata mgbasa na sel nke mkpụrụ ndụ ma ọ bụrụ na usoro atherosclerotic dị na ahụ mmadụ amalitelarị. A na-egosi ha niile na ntuziaka. Ọtụtụ mgbe, a na-ahụ ka ịmụba na njedebe nke ngụgụ, ọ bụkwa mmụba nke ọnụ ọgụgụ sel nke n'ọtụtụ ụzọ na-aghọ mmalite nke ịmalite ite n'ime arịa. Simvastatin kpochapu usoro ndi a kpam kpam ma chekwaa steeti nke arịa n'ụdị mbụ ya.

N'ikpeazụ, vasilip na-enyere aka ịhazi ọnọdụ arụ ọrụ nke vaskụla endotheliocytes. Ihe ndị a mejupụtara ihe ndị dị ezigbo mkpa maka nhazi nke ụda olu, akụrụngwa, ọrụ nke akụrụngwa na ọrụ mkpo. N'ihe banyere mmụba nke ọkwa cholesterol n'ime ọbara, nguzozi nke ihe ndị sitere na endotheliocytes mepụtara, na-eduga n'ọhụụ nke nsogbu nke abụọ. Ojiji nke vasilip dị ka ihe na-eme ka mmanụ dị ala na-enye gị ohere ịmalite ọrụ arụmọrụ nke endothelium ma si otú a na-ebute ihe mejupụtara ọbara na parampat dabara na ụkpụrụ kwesịrị.

Usoro onunu ogwu na nhazi

Ihe mbu nke ogwu a anaghi egosiputa site na mgbanwe di omimi na ihe mejuputara obara. Dịka ntuziaka ahụ si dị, mbido vasilip nwere ike ime izu abụọ ka emesịrị, nke bụ ihe dị mma na-egosighi mmụọ dị ala banyere nnabata ya. A na-enweta mmetụta ọgwụgwọ kachasị elu mgbe izu 4-6 gasịrị site na mmalite nke iji vasilip. Site na iji usoro ọgwụgwọ a na-aga n'ihu, a na-echekwa nsonaazụ ya. Mgbe akagbuola, ihe cholesterol ọbara na-alaghachi na nke mbụ, ya bụ, n’ogosi a hụrụ na onye ọrịa ahụ tupu a gwọọ ya.

Ofzọ eji arụ ọrụ dabere n'ụdị ọrịa ahụ na ogo ya. Na ọrịa obi, akwara na - enye onye ọrịa ọgwụ ka ọ malite ịbọ ahụ 20 mg / ụbọchị. Enwere ike ịbawanye ubochi ubochi obula, oburu na enwere ihe egosi. A na-eme nke a ọ bụghị tupu ọnwa tupu mmalite ọgwụ. Ọnụ kachasị ọgwụ a na-a perụ kwa ụbọchị bụ 40 mg.

Maka ndị ọrịa nwere nsogbu gbasara akụrụ ma ọ bụ ndị agadi, a na-atụkarịkarị mmụba nke vasilip kwa ụbọchị. Ọ bụrụ na akpọpụta ọdịda akụrụngwa (amapụtara ya site na ọkwa doro anya nke na-erughị 30 ml / min), mgbe ahụ, kadiologist na-edepụta otu ọgwụ kwa ụbọchị agaghị akarị 10 mg / ụbọchị. Ọbụlagodi ntakịrị mmụba n’inye ndị ọrịa dị otu a kwesịrị ime n’okpuru nlekọta nke dibịa ma were nleba anya na ọnọdụ ahụ mgbe niile.

Na hypercholesterolemia, ị dailyụ ọgwụ kwa ụbọchị dịgasị iche site na 10 ruo 80 mg. Ekwesịrị ị drugụ ọgwụ a na mgbede, ọ dabereghị na nri mgbede. Dịka ọ na - arịa ọrịa obi, a na - amalite ọgwụ vasilip site na mmalite nke 10 mg. Naanị mgbe izu anọ gasịrị ka ị nwere ike jiri nwayọ dịkwuo oke nke ọgwụ a na-ewere kwa ụbọchị. Ọ bụrụ na hypercholesterolemia bụ ihe ketara eketa, ọgwụ a na-akwụ kwa ụbọchị sitere na 40 ruo 80 mg. Ole ọgwụ ahụ dabere ogo ọrịa ahụ.

Ọ bụrụ na ọgwụ a ga-ewererịrị onye ọrịa nke mecharala ntụgharị, na usoro a na ịbido cyclosporine, mgbe ahụ ihe ngosipụta maka iji vasilip ga-akpachara anya. Yabụ, na nke a, usoro ọgwụ a tụrụ aro dabere na ntuziaka ekwesịghị gafere 10 mg / ụbọchị.

Nsonaazụ

• Site n'akụkụ nke sistemụ akwara: ike ọgwụgwụ, akwara neuropihies akụkụ, ịda mba, nsogbu ụra, isi ọwụwa.
• Site na akwara gbasara akwara: ịba ụba ọrụ nke ọrịa hepatic transaminases, dyspepsia, pancreatitis, ọgbụgbọ na ọgbụgbọ, afọ ntachi.
• Site na usoro mkpụrụ ndụ: ikike adịghịzi, arụ ọrụ ezumike.
• Na akụkụ akwara ahụ: dermatomyositis, ike ọgwụgwụ nke akwara, rhabdomyliosis na ọdịda nke akụrụ. Mmetụta akụkụ a na-etolite na-anaghị ahụkebe, ọkachasị ndị ọrịa na-a cyụ ọgwụ cyclosporine ma ọ bụ ọgwụ ndị ọzọ site na otu nke statins.
• Site na echiche: opacification nke lens.
• Mmetụta ndị ọzọ nwere ike ịpụta: photoensitivity, alopecia.

N'ọnọdụ ụfọdụ, ị takingụ ọgwụ a bụ ihe e ji mara njiri mara ahụ dị ka hives, fever, eczema, na redness nke anụ ahụ. N'ụdị ndị a, ọ dị mkpa ịgwa dọkịta banyere ụdị mmeghachi ahụ nke anụ ahụ na ị toụ ọgwụ. Nyocha ọbara nwekwara ike igosi mgbanwe dịka ọdịnaya nke eosinophils na ESR.

N'izugbe, ndị ọrịa na-anabata vasilip nke ọma. Mmetụta ndị na-akpata nfụkasị na mmeghachi omume nfụkasị adịghị abịakarị otu oge, n'ụdị dị nro, ma gafee ngwa ngwa.

Domebiga ya ókè mgbe etinyere ya

Ọtụtụ mgbe, ị simụfe simvastatin ókè anaghị enwe nsonaazụ dị mma maka ahụike nke onye ọrịa, mana ọ ga-amatarịrị omume dị mkpa n'ọnọdụ ndị ahụ. Ọtụtụ mgbe ha nwere oke na ịbanye enterosorbents na lavage gastric. Mgbe nke a gasịrị, ọ dị mkpa iji nlezianya nyochaa ọnọdụ nke anụ ahụ, lelee ọrụ akụrụ na umeji yana ihe mejupụtara ọbara niile. Ọ bụrụ na enwere ihe iyi egwu nke rhabdomyolysis ma ọ bụ ọdịda nke akụrụngwa, ọ ga-abụ ihe ịchọrọ ịba ọcha n'anya iji wepu nsonaazụ ọjọọ nke ịdoụbiga mmanya ókè.

Ndị na-agụ akwụkwọ anyị ejirila Aterol belata cholesterol. Thehụ ihe ndị ama ama n’ahịa a, anyị kpebiri inyefe ya n’aka gị.

Ihe mgbakwunye maka iwere vasilip

Naanị iweli ọkwa cholesterol n'ime ọbara abụghị ihe mere eji họpụta onye ọrịa vasilip. Ọ dị mkpa iji nyocha ọbara maka enzymes imeju (AlAT na AsAT). Ọkwa nke transaminases ndị a mgbe ị na-ewere vasilip nwere ike ịbawanye elu, mana n'ihi na ọ bụrụ na ọdịnaya ha apụtabaghị n'iwu, a ga-akwụsịtụ ọgwụgwọ ruo nwa oge. N'oge ọgwụgwọ vasilip, a na-achọkarị nyocha ihe mejupụtara ọbara na ihe mejupụtara imeju. Nke a ga - enyere dọkịta aka ịhazi usoro ọgwụgwọ n'oge kwesịrị ekwesị ma dozie ya ma ọ bụrụ na ọ dị mkpa. Ọ bụrụ na, mgbe ịmalite ị siụ ọgwụ sivastatin, ọkwa nke hepatic transaminases na-agbago okpukpu atọ, mgbe ahụ, nke a bụ ntọala maka ịkwụsị ọgwụ.

Dọkịta ga-elebara anya karịsịa n'ihe metụtara ndị ọrịa nwere ike ị abuseụbiga mmanya ókè. Mgbe ị na-edepụta simvastatin, ị shouldụ mmanya nwere ihe ọ shouldụ alcoholụ kwesịrị ịbepụ kpamkpam, dọkịta kwesịrị ịdọ onye ọrịa aka na ntị banyere nke a. Ekwesịrị ịkpachara anya n'otu oge ahụ na ndị ọrịa nwere ọrịa imeju.

Enweghị data dị irè banyere ọgwụ dị na ndị mmadụ na-erubeghị afọ 18, ya mere na-atụ aro ịasụ ọgwụ vasilip n'oge a.

E nwekwara ihe ize ndụ nke ịmalite ọrịa myopathy. N'ime ihe omumu ihe omumu, ihe akwara gosiputara site na mmụba na uru ọrụ nke musine phosphokinase. Ọ bụrụ na ọkwa a gafere karịa iwu akwadoro ugboro iri, mgbe ahụ anyị nwere ike ikwu maka mmalite nke myopathy. Ihe mgbaàmà ndị ọzọ nwere ike ịgụnye ike akwara, isi ike. N'okwu ndị kachasị njọ, ọrịa rhabdomyliosis nwere ike ịmalite. Akwara anụ ahụ na nke a na-emebi na nkwekọ na mmepe nke nnukwu akwara ọdịda. Ndị mmadụ na - ewere fivriki (hemofibrozil, fenofibrate), ọgwụ nje macrolide (erythromycin, clarithromycin), ritonavir (onye na-egbochi nje HIV), ndị na-egbochi ọgwụ azole (ketoconazole, itroconazole, cycloforium n'ihe ize ndụ). Na ọdịda akụrụngwa dị adị, enwerekwa ihe ọghọm nke mmalite na mmepe nke myopathy.

Simme simvastatin adịghị eduga mgbanwe na mmeghachi omume, ya mere enwere ike ịkwado ya, gụnyere maka ndị ọkwọ ụgbọ ala na ndị ọrụ ha bụ ijikwa na ijikwa usoro ndị dị mgbagwoju anya.

Enwere analogues ọ bụla?

Na mfe anaas vasilip nke ọgwụ bụ simvastatin, nke bụ ihe bụ isi ọrụ ya. Ọnụ ahịa ya fọrọ nke nta ka o jiri okpukpu abụọ dị ala karịa nke vasilip. Nwekwara ike ịchọta vasilip analogues n'okpuru aha ọgwụ ọgwụ ndị a:

• simvastatin alkaloid,
• simgal
• simplacor
• Zokor
• mgbama,
• simvalimit
• oji
• simvastol
• ka esi eme
• akara
• simvaheksal,
• simvacol
• Na-eme ihe.

Ọdịiche nke analogues niile dị obere. O nwere ike iso n’ime usoro onunu ogwu, ọnụọgụ mbadamba ihe n’otu ngwugwu. Aha ọgwụ dị iche iche maka ndị na-emepụta dị iche iche nwekwara ụgwọ dị iche iche, mana nke a ekwesịghị imetụta arụ ọrụ ọgwụ.

Nyocha banyere ọgwụ

Enwere m ibu karịrị akarị mgbe niile, mana naanị n'afọ ole na ole ka m malitere ịghọta na ọ na-eweta nnukwu nsogbu. Nke a abụghị naanị ibu arọ mgbe ị gafesịrị ọtụtụ steepụ. Nke a adịghị mma ọbụladị oge dị jụụ. Nke a bụ ike gwụrụ n'anya mgbe ịlele TV obere oge. N’ezie, agakwuuru m ọkachamara. Agara m onye dibia bekee na dibia anya. Mgbe nyocha ahụ gasịrị, ọ chọpụtara na enwere cholesterol dị elu, enwere nnukwu ihe ọghọm maka ọrịa strok. Ọbụna nkwarụ anya, ruo nkwarụ, nwere ike ịga n'ihu. Emere m ka m were ọgwụ ike iji wedata cholesterol ọbara m. Ahụghị m mmetụta nke mbụ nke ọgwụ ahụ, ọ bụ ezie na m rankụrụ dị ka ntuziaka ahụ si dị. Na ntanetị, dọkịta dọrọ m aka ná ntị banyere nke a, ya mere enweghị m nchegbu.Nke nta nke nta, amalitere m ịchọpụta na ọ dịịrị m mfe iku ume, na n’ozuzu ịkwaga. Nye m, nke a bụ nnukwu ọganihu. N’ezie, Aghọtara m na ọgụ a ga-alụso cholesterol agaghị abụ naanị n’ịgwọ ọgwụ, mana enwere m obi anụrị na m weere otu ihe dị mkpa iji bulie ogo ndụ m.

Anụrụ m ọrụ na nzukọ a ogologo oge, na-adụ ndị ahịa ọdụ. Dị ka ọ na-adịkarị, nrụgide abụrụla akụkụ nke ndụ m. Nri nri n'uhuruchi mechiri mmetụta nke ụjọ na iwe iwe, otu o sila dị, o mere ka ahụe ahụ ike. Agaghị m dọkịta ozugbo, naanị mgbe m nwere mmetụta ezumike na ezumike. Mgbe a nwalere m, ọ bịara bụrụ na enwere cholesterol dị elu. Dọkịta gwara m ihe dị njọ nsonaazụ cholesterol na ọtụtụ ọrịa concomitant nwere ike ịbụ. Ekpebiri m iji ahụ ike m kpọrọ ihe, ị medicationụ ọgwụ mgbe niile sokwa na ọgwụgwọ m. Vasilip bụ ọgwụ dị oke mma nke na-agbadata cholesterol ọbara n'ezie, nke pụtara na ọ na-ewepụ oke dị egwu nke nsogbu. Ahụike m mgbe ọ nwusịrị ya ọfụma, enwere m ike ugbu a karịa na-enweghị iku ume. Ugbu a enwere m ike zuru oke na enwere m olileanya na m nwere ike ịgbanwe ndụ m site na iwetulata cholesterol, vasilip bụkwa onye na-enyere m aka. Site n'ụzọ, mgbe oge ụfọdụ gasịrị site na mmalite nke ịrịa vasilip mgbe nile, dọkịta ahụ nyere m ohere belata ọgwụ ahụ, nke na-egosi mgbake m na mbụ.

Dịka ọtụtụ, ọ na-elebara ahụike ya anya dị ka ihe dị ntakịrị, anaghị agbaso nri ya na ụdị ndụ ọ na-ebi. Mgbe m ruru afọ iri anọ na ise, enweela m ibu karịrị akarị, ma ọ dị m ka ọ bụ naanị nkwarụ nkịtị, nke m nwere ike iwepụ n'oge ọ bụla. Naanị mgbe ụmụaka malitere ịta m ụta na enweghị ike maka onwe ha na ahụike ha, agara m gaa dọkịta. Ọ tụgharịrị na ọkwa cholesterol mụbara. Ọzọkwa, enwere ihe ize ndụ nke nkụchi obi ma ọ bụ ọrịa strok, n'ihi na ọnya cholesterol dị ugbu a nwere ntọala na-akwụghị chịm. Vasilip abụrụla akụkụ nke ọgwụgwọ njikọta. Iji mezuo nsonaazụ ahụ, a ga-enwerịrị ya mgbe niile, ọ bụghị site n'oge ruo n'oge. Ọ na-agbada cholesterol n'ezie. Site n'ụzọ, aghụghọ ndị mbụ ahụ gara maka m na-enweghị nsonaazụ ọ bụla, n'ihi na ọgwụ anaghị arụ ọrụ ozugbo, mana mgbe obere oge gasịrị. Agbanyeghị, nsonaazụ ya dị ogologo, ya bụ, ụbọchị ole na ole ka ọgwụ ahụ kwụsịrị, ọkwa nke cholesterol ka ga-adị ka ọ dị ruo oge ụfọdụ. Ọnụ ego ọgwụ ahụ adịghị oke, mana ọnụahịa ahụ na-arụ ọrụ dị mkpa maka ndị dị ka m - ndị mmadụ gbara afọ tupu ha ala ezumike nka. N’ikwu ya, nyocha m banyere ọgwụ a dị mma.