Lovastatin ọgwụ ahụ: usoro nke ime ihe na nyocha

Nsogbu a na cholesterol ọbara mgbali na-echegbu ọtụtụ ndị. Nke a bụ n'ihi n'eziokwu na ọnọdụ dị otú ahụ nwere ike ibute malfunctions nke obi na usoro vaskụla dum. Iji kpochapụ hyperlipoproteinemia, ọ dị mkpa ọ bụghị naanị iri nri ziri ezi, kamakwa ị takeụ ụfọdụ ọgwụ.

Consideredzọ kachasị dị irè iji belata cholesterol ọbara bụ ọgwụ "Lovastatin." Ntuziaka maka iji, ọnụahịa, nyocha, analogues na contraindications nke ọgwụ a ga-egosi n'okpuru. Will ga-amụtakwa ihe ndị ọkachamara kwuru gbasara ya yana ụdị nzaghachi ndị ahịa na-ahapụ.

Formdị, ihe mejupụtara, nkwakọ ngwaahịa na nkọwapụta nke ọgwụ ọgwụ

A na-ere ọgwụ ahụ “Lovastatin”, ntuziaka maka itinye ya na igbe kaadiboodu, n'ụdị mbadamba ọcha na gburugburu. Ngwakọta ọrụ na-arụ ọrụ na ọgwụ a bụ lovastatin. Banyere ihe inyeaka, ha gụnyere lactose monohydrate, stachi, cellulose, ascorbic acid, butyl hydroxyanisole, citric acid na magnesium stearate.

Emeputara ogwu ahu na blisters na ngwugwu nke kaadiboodu n’otu n’otu.

Ofzọ usoro nke ọgwụ ahụ

Gini bu iwu nke oru "Lovastatin"? Ntuziaka maka ojiji, mkpesa akụkọ na ndị na-anabata LP nke imeju na-edozi ọdịnaya nke lipoproteins n'ime ọbara. A na - esite na ya site na mmekorita ya na ndi nnabata ha kwuru. N'ihi ya, a na-agwakọta cholesterol n'ime sel imeju.

A kọwara ofkpụrụ nke usoro ọgwụ a na-enyo enyo site na mwepu nke 3-hydroxy-3-methylglutaryl-coenzyme A reductase. Nke a bụ enzyme ya na ntinye nke ejiri cholesterol rụọ.

Redubelata usoro cholesterol gụnyere mmụba na-akwụ ụgwọ na ọnụ ọgụgụ ndị na-anabata LP na hepatocytes. N'ihi nsonaazụ a, usoro mwepụ nke obere lipoproteins dị ala na-agbadata, a na-ebelatakwa kọlesterol, cholesterol dị ala na ọkara nke njupụta.

Njirimara nke ogwu

Kedu ihe ndị ọzọ dị mbadamba Lovastatin nwere? Ntuziaka maka ojiji (ọnụahịa, a na-ewepụta nyocha na njedebe nke ederede) na-egosi na ngwá ọrụ a nwere ike belata ọdịnaya nke apolipoprotein B na triglycerides, yana nwetakwa ogo lipoproteins dị elu.

Mmetụta ọgwụgwọ mgbe ị takingụ ọgwụ ahụ pụtara n’izu abụọ, ma karịa - ka ihe dị ka otu ọnwa na ọkara. Agbanyeghị, ọ na-adịgide ruo izu isii ka akwụsịrị ọgwụ ịkwụsị.

Ọgwụ nke iji ọgwụ were ogologo oge anaghị ebelata. Okwesiri iburu n'uche na enwetara ya na biopultures nke Aspergillus terreus na Monascus ruber.

Ngwongwo kinetic

Ogologo oge ole ka Lovastatin na-ewe? Ntuziaka maka ojiji (ọnụahịa ọgwụ adịghị elu) na-ekwu na nnabata nke ọgwụ a na ngịga diges. Ọzọkwa, ọ na-ebelata oriri nke mbadamba nkume na afọ efu.

Nnukwu ndu nke ogwu a di ala (ihe dika 30% nke ọgwụ were). Mgbe ihe dị ka awa anọ gachara, a na-enweta ọgwụ kachasị n'ọbara. Emesia ubochi ozo o wedata ma ihe dika 10% kachasi.

Ọgwụ a na-ajuju bụ 95% nwere protein protein. A na-achọpụta mkpochapụ ọgwụ na otu ọgwụ n’ụbọchị nke atọ.

Gịnị bụ Ọgwụ Lovastatin? Ntuziaka maka iji akụkọ na-ekwu na nke a bụ prodrug. Mgbe ụzọ mbu gafesịrị, ọ na-arụ ọrụ.

A na-agwakọta ọgwụ ahụ site na isoenzymes. Ọkara ndụ ya bụ nkeji iri asatọ. Ihe dị n’ọrụ ọgwụ ahụ, yana metabolites ya, akụrụ na-aga n’ime eriri afọ.

Ihe ngosi maka ị pụ ọgwụ

Ọnụnọ ọnọdụ dị a areaa ka ndị dọkịta depụtara mbadamba Lovastatin? Ntụziaka maka ojiji (nkọwa, ihe mejupụtara ọgwụ ahụ na mmalite isiokwu ahụ) na-akọ na ọgwụ a dị oke mma maka hypercholesterolemia (ụdị IIb na ụdị IIa lipolipoproteinemia) nwere ọdịnaya LDL dị elu (ma ọ bụrụ na usoro ọgwụgwọ nri na ndị mmadụ nwere nnukwu ihe ize ndụ nke ịmalite ọrịa akwara na-adịghị mma) , yana yana hypertriglyceridemia na hypercholesterolemia jikọtara ọnụ.

Ekwesịrị iburu n'uche na a na-edenye ọgwụ na-agbagha ọgwụ maka atherosclerosis.

Contraindications maka iwere prodrugs

N'ọnọdụ dịgasị a ka akwadoghị onye ọrịa ka o jiri mbadamba Lovastatin? Ntuziaka maka ojiji (ị withụ ọgwụ a kwesịrị ka ọ bụrụ naanị onye dọkịta) nyere akụkọ na-akọ na ọgwụ a contraindicated bụrụ nke ọrịa imeju na-arụ ọrụ, ime ma ọ bụ na o nwere ike, mmụba nke transaminases nke enweghị nkọwa sitere na ya, yana n'oge ịfeụ ara, na ọnọdụ siri ike nke onye ọrịa (izugbe) yana ịba ụba. uche nke lovastatin.

Ọzọkwa, edeghị ọgwụ a na-atụle ọgwụ na obere oge, enwere myopathy na cholestasis.

Amachibidoro ijikọta ọgwụ ị drugụ ọgwụ na mmanya. Site na oke ịkpachapụ anya, a na-enye ya ndị ọrịa mgbe akwara akwara akwara ịwa grafting.

Ọgwụ "Lovastatin": ntuziaka maka ojiji

Ọnụahịa, analogues nke ngwaọrụ a ga-atụle ntakịrị n'ihu.

Dika ntuziaka ejikọtara, a ga-ewererịrị mbadamba mkpụrụ osisi Lovastatin n'oge nri abalị otu ugboro n'ụbọchị.

N'ọnọdụ ọrịa dịka hyperlipidemia, a na-enye ọgwụ ọgwụ na ọnụọgụ 10-80 mg otu ugboro (ọnụọgụ ahụ dabere na ogo ahụ).

Ọgwụ na ọgwụ ọjọọ a na - ebido n’etinye obere ọgwụ. Mgbe ahụ, ọ na-eji nwayọọ nwayọọ amụba. Sbọchị ị highestụ ọgwụ kacha elu kwa ụbọchị, nke ruru 80 mg, enwere ike ị takenụ ya otu ugboro ma ọ bụ ugboro abụọ n'ụbọchị (n'ụtụtụ na tupu ị lakpuo ụra). Nhọrọ nke ọgwụgwọ ọgwụgwọ nwere oge dị otu ọnwa.

Kedu ka edeputara Lovastatin maka ọrịa akwara na -akpata ụbụrụ? Ntuziaka maka iji mee mkpesa na na ọrịa dị otú a, a na-enye ọgwụ ọgwụ ahụ na ọgwụ 20-40 mg. Ọ bụrụ na ọnụego ọgwụ ahụ akọwapụtara enweghị isi, mgbe ahụ ọ na-amụba ka 60-80 mg.

Mgbe agwakọta ọgwụ ahụ na fibrates ma ọ bụ nicotinic acid, usoro ya ekwesịghị ịdị elu karịa 20 mg kwa ụbọchị.

Ihe Omume Ọjọọ

Ogwu Lovastatin na-akpata nsonaazụ? Ntuziaka maka iji gosipụta ajọ ihe ndị a:

• cataracts, isi ọwụwa,
• optic atrophy, anya isi,
• nsogbu ehighị ụra, nsogbu ihi ụra, nchekasị, adịghị ike nke izugbe, paresthesia,
• olu nro, myalgia, myositis
• ndị mmadụ na-a nụ nicotinic acid, Cyclosporin ma ọ bụ Gemfibrozil, na-abawanye ohere nke rhabdomyolysis,
• thrombocytopenia, hemolytic anaemia,
• obi mgbawa, biliary cholestasis, ọgbụgbọ, ịba ọcha n'anya, flatulence, uto oke, afọ ntachi, cholestatic jaundice, afọ ọsịsa,
• mmụba nke creatine phosphokinase na imeju transaminases,
• mmụba na bilirubin na alkaline phosphatase,
• Isi awọ nke Quincke, ọnya afọ, itching, arthralgia, urticaria,
• alopecia na mbelata ikike.

Rug overụbiga mmanya ókè

Site na nchịkwa ọghọm nke usoro ọgwụ dị elu, a gaghị ahụ ihe mgbaàmà doro anya na onye ọrịa.

Mgbe ọ na-elele ọnọdụ ahụike, a na-eji afọ were sachaa afọ ma nye ọgwụ iri. Ọzọkwa, a na-enyocha onye ọrịa maka ọrụ dị mkpa, ọrụ imeju na mmemme phoineho.

Mkparịta ụka ọgwụ ọjọọ

Ojiji nke nnukwu mkpụrụ osisi grape, yana Gemfibrozil na Fenofibrat, na - enye aka n'ihe egwu dị elu nke myopathies.

Were ọgwụ nicotinic acid, Clarithromycin, Erythromycin, Cyclosporin, ọgwụ antifungal (Itraconazole, Ketoconazole), Nefazodone na Ritonavir na-eduga na mmụba nke ọgwụ ahụ na ọbara, yana mbibi akwara. anụ ahụ na ihe ize ndụ nke ịmalite ọrịa myopathy.

Ijikwa “Lovastatin” na “Warfarin” na-eme ka ọbara ọgbụgba dịkwuo ike.

Ọgwụ "Colestyramine" na-ebelata bioavailability nke ọgwụ ahụ nọ na ajụjụ. Yabụ, oge nkeji dị n'etiti ihe ha na-eri kwesịrị ịdịkarịa ala awa 2-4.

Ego ọgwụ na analogues ya

Ugbu a, ọ gaghị ekwe omume ịzụta ọgwụ ọgwụ na ụlọ ahịa ọgwụ na Moscow na obodo ndị ọzọ Russia. Ọ bụrụ na ọ dị mkpa, enwere ike inye ya iwu site na World Wide Web. Ọnụ ahịa ahịa ahịa n'ịntanetị dịgasị iche iche. Enwere ike ịzụta ọgwụ a na mpaghara 300-600 rubles.

Ọ bụrụ na ọ dị mkpa, enwere ike dochie ọgwụ dị na ọgwụ ahụ dịka Apextatin, Fluvastatin, Cardiostatin, Iinvastin, Vero-Lovastatin, Pravastatin, Holetar, Lovasterol, Mevacor , Mevinacor, Lovacor.

Nyocha Ọgwụ

Ugbu a ị maara ihe ọgwụ ndị dị ka Lovastatin bụ. Ntuziaka, ihe mejupụtara, ojiji, analogues nke ọgwụ a ka akọwara.

Dị ka ndị ọkachamara si kwuo, a na-eji ọgwụ ndị na-eme ka mmiri dị ala na-agwọ ọrịa ma na-egbochi atherosclerosis na nsogbu ya.

Ofkpụrụ nke usoro ọgwụ a bụ iji belata ọdịnaya nke liheprotiins atherogenic n'ime ọbara

Dabere na ndị dọkịta na-ekwu, ugbu a, enwetarala ọtụtụ ahụmịhe n'ọgwụ ọgwụgwọ nke Lovastatin. Ọ bụ otu n'ime ọgwụ kachasị nchebe. Ọgwụ a nwere nnabata ọfụma.

A na-echekarị mkpesa nke nsonaazụ ya na nyocha ndị ọrịa. Mgbe ụfọdụ ọgwụ a nwere ike ibute ọgbụgbọ, afọ ọsịsa, mgbu nke afọ, afọ ntachi, ehighị ụra na mgbu mgbu. Dị ka ọ na-adị, mmeghachi omume ndị dị otú ahụ na-apụ n'anya izu abụọ mgbe mmalite nke ọgwụgwọ ma ọ bụ n'ihi nkwụsịtụ nke dose.

Lovastatin ọgwụ ahụ: usoro nke ime ihe na nyocha

Otu ìgwè nke statins (cholesterol na-ebelata ọgwụ) gụnyere Lovastatin dị irè. A na-eji ọgwụ ahụ eme ihe ọ bụghị naanị na ọgwụgwọ nke hypercholesterolemia, hyperlipoproteinemia, kamakwa na mgbochi nke ọrịa obi.

Ekwesịrị iji ọgwụ a jikọta ya na nri nri pụrụ iche, mmega ahụ na mmezi ahụ. N'isiokwu a, ị nwere ike ịmụtakwu banyere Lovastatin, ntuziaka maka ojiji, ọnụahịa, nyocha, analogues.

Ntuziaka maka iji ọgwụ ahụ

A na-emepụta Lovastatin 20 mg ma ọ bụ 40 mg n'ụdị mbadamba, akụkụ a na-arụ ọrụ nke nwere otu aha. Ihe ozo nke ogwu ahu bu lactose monohydrate, sitashi, cellulose, magnesium stearate, butylhydroxyanisole, citric na ascorbic acid.

A na-ere ọgwụ naanị mgbe mmadụ nwere ọgwụ dọkịta nyere ya. Mgbe ị na-azụ ọgwụ ahụ, onye ọrịa ahụ kwesịrị ị attentiona ntị na ntinye mgbakwunye. Ntụziaka ahụ nwere ọtụtụ ihe ngosi maka iji ọgwụ a:

• ọgwụgwọ hypercholisterinemia bụ isi jikọtara ụdị IIa na IIb,
• ọrịa hyperlipoproteinemia (nke nwere ọrịa shuga na ọrịa nephrotic syndrome),
• ọgwụgwọ nke akwara umeji akwara (yana ọgwụ na vitamin na abụba abụba).
• mgbochi ọrịa obi
• ọrịa hypertriglyceridemia.

Ekwesịrị iji mbadamba nkume mee ihe 1 oge kwa ụbọchị n'oge nri abalị. Usoro onunu ogwu a dabere na oria. Yabụ, na hyperlipidemia, otu ọgwụ 10-80 mg ka enyere n’aka.

Usoro ọgwụgwọ nke pathology na-amalite site na obere doses, na ikike nke dọkịta, enwere ike ịba ụba nke nta nke nta. Ọ na-atụ aro ka ịhọrọ usoro onunu ogwu kwa izu anọ.

Enwere ike ekewa mkpụrụ ọgwụ kachasị elu (80 mg) na usoro onunu abuo - n'ụtụtụ na mgbede.

Na ọgwụgwọ nke atherosclerosis, ezigbo usoro ọgwụgwọ bụ 20-40 mg. Ọ bụrụ na ọgwụgwọ anaghị arụ ọrụ, mmụba ruru 60-80 mg ga-ekwe omume. Ọ bụrụ na onye ọrịa ahụ na-ewere fibrates ma ọ bụ nicotinic acid n'otu oge, ekwesịrị iji Lovastatin ihe na-erughị 20 mg kwa ụbọchị. Ọzọkwa, usoro onunu ogwu aghaghi ibelata n'ọnọdụ ndị a:

1. Eji mkpuchi immunosuppressants mee ihe.
2. Ojiji nke ọgwụ nje.
3. Ọgwụ na ọgwụ antifungal.
4. Ọgwụgwọ ọrịa nke imeju nke etiology ma ọ bụ izugbe.
5. Ojiji ogwu nwere anticoagulants.

Ọ dị mkpa iji chekwaa ọgwụ n'oge okpomọkụ agaghị erughị ogo 25 Celsius.

Mgbe mmebi ahụ gwụsịrị, nke bụ afọ 2, amachibidoro iji ngwaahịa a.

Ngwurugwu mgbochi na nsonaazụ ya

Lovastatin nwere ndepụta contraindications dị obere. Amachibidoro iji ọgwụ ahụ eme ihe maka myopathy (ọrịa neuromuscular na-adịghị ala ala), ịtụrụ ime, cholestasis, nsị imeju, na-erubeghị afọ 18 na hypersensitivity nke akụkụ ahụ.

Ekwesịrị iji ọgwụ ahụ mee ihe na-akpachara anya na ndị ọrịa nwere ọrịa akwara ọbara banyere ọrịa grafting. N'ọnọdụ ọ bụla ị ga-a medicationụ ọgwụ mmanya.

N'ọnọdụ ụfọdụ, ọgwụ nwere ike ibute nsonaazụ. N'ime ha, ọ dị mkpa igosipụta:

• Mmeghachi omume metụtara ọrụ eriri afọ: ọgụ nke ọgbụgbọ, obi mgbawa, ịba ụba gas, mgbanwe uto, afọ ọsịsa, dochie afọ ntachi.
• Ọgba aghara nke usoro akwara dị n’etiti: isi ọwụwa, ụra na-adịghị mma, nchekasị, ọgbụgbọ, paresthesia, myositis, ihe mgbu akwara na myalgia. Mgbe ị na-eji cyclosporine, gemfibrozil ma ọ bụ nicotinic acid, enwere ohere nke rhabdomyolysis.
• Mmeghachi omume nke sistemụ biliary: ụba ọrụ nke bilirubin, alkaline phosphatase, transminases imeju na creatine phosphokinase. Mgbe ụfọdụ, ịba ọcha n'anya, cholestatic jaundice na biliary cholestasis ga-ekwe omume.
• Mmeghachi omume nfụkasị ahụ: itching, ọnya anụ ahụ, urticaria, angioedema, arthralgia.
• Ọkpụkpụ nke nku anya: atrophy nke akwara optic na mmepe nke cataracts.
• Mmetụta ndị ọzọ: mbelata ikike, ọrịa ịba, alopecia.

Achọpụtaghị mgbaàmà nke ịdoụbiga mmanya ókè mgbe ị na-eji nnukwu ọgwụ. Ndabere nke ọgwụgwọ ahụ bụ nhichapụ nke Lovastatin, lavage gastric, ojiji nke anwansi (carbon dọkụment, Smecta, Polysorb, Atoxil) na-achịkwa ọrụ ndị dị mkpa, ọrụ imeju na mmemme phosphokinase.

Mmekọrịta na ụzọ ndị ọzọ

Ekwesighi iji Lovastatin mee ihe na ogwu niile, n'ihi mmekorita ha na aru nwere ike ime ka anyi mee ihe ojoo. Ọzọkwa, ụfọdụ ọgwụ nwere ike ime ka ịta ụta nke ihe arụ ọrụ dị, ma ụfọdụ nwere ike belata.

Nnukwu ihe egwu nke mbibi akwara na myopathy, yana mmụba nke ọdịnaya ahụ na - arụ ọrụ, na - akpasu ojiji nke Lovastatin n'otu oge yana nicotinic acid, Cyclosporine, Ritonavir, Erythromycin, Nefazodone na Clarithromycin.

Ojiji siri ike nke otu ogwu nwere nkpuru osisi grape, fenofibrate, gemfibrozil na-abawanye ohere nke myopathy.

Ewu ọbara na-abawanye site na iji ọgwụ wararin. A na - ebelata bioavailability nke lovastatin mgbe ị na - eji colestyramine. Iji mee ka bioavailability nke ọgwụ ahụ ka ọ bụrụ ihe a na-ahụkarị, ọ dị mkpa iji ọgwụ dị n’agbata awa 2-4.

Site na ọrịa concomitant, onye ọrịa ahụ kwesịrị ịga hụ dọkịta maka ị medicationsụ ọgwụ.

Offọdụ n'ime ha ekwekọghị na Lovastatin, yabụ, machibidoro ị independentụ ọgwụ ọ bụla.

Efu, analogues na nyocha onye ọrịa

O di nwute, ugbu a enweghi ike izuta Lovastatin n'ihi E mepụtaghị ya na Russia.

Lọ ọrụ ọgwụ dị ka Lekpharm (Belarus), Replekpharm AD (Macedonia) na Kievmedpreparat (Ukraine) bụ ndị na-emepụta ọgwụ.

N'akụkụ a, dọkịta ahụ nwere ike ịkọpụta analog nke Lovastatin, nke nwere otu usoro ọgwụgwọ ahụ.

Ọgwụ kachasị ewu ewu bụ:

1. Holetar. O nwere akụrụngwa a na-arụ ọrụ - lovastatin, yabụ na ọ bụ okwu maka Lovastatin. Ogwu ahu nwere otu ihe egosi, contraindications na mmeghachi omume ojoo dika Lovastatin.
2. Cardiostatin. Ọgwụ ọzọ a ma ama bụ okwu maka Lovastatin, n'ihi na nwere otu ụdị ihe eji eme ihe. Mgbe ị na-ewere Cardiostatin, a na-achọpụta mmetụta ọgwụgwọ akpọrọ maka izu abụọ, yana kachasị ka izu isii nke ị weeksụ ọgwụ ahụ gasịrị. Ọnụ ego dị 290 rubles (na ngwugwu nke mbadamba 30 nke 20 mg).
3. Pravastatin. Ọ nwere ụdị ọrụ dị iche iche. Ihe eji eme ihe bu pravastatinum. A na-eji ọgwụ ahụ eme ihe maka hypercholesterolemia bụ isi na dyslipidemia gwara ọgwa, yana maka mgbochi nke ọrịa obi nke ischemic. Ojiji Pravastatin ga - ekwe omume dị ka ihe mgbochi nke abụọ maka infarction myocardial, angina pectoris na hyperlipidemia post-transplant.
4. Zokor. Ihe na-arụ ọrụ nke ọgwụ ahụ bụ simvastatin. Isi ihe na-egosi ọgwụ ahụ bụ ọgwụgwọ nke hypercholesterolemia. Ejikwa Zokor ka prophylactic iji gbochie mmepe nke ọrịa obi. Nkezi ọnụ bụ 380 rubles (mbadamba 28 nke 10 mg) na 690 rubles (mbadamba 28 nke 20 mg).

Dabere na Index Vyshkovsky, ndị isi n'ahịa ọgwụ Russia bụ Cardiostatin, Mevacor, Holetar na Rovacor.

Nzaghachi na Lovastatin, ma ndị ọrịa ma ndị dọkịta, dị mma. Ọgwụ ahụ dị mma ma nabata ndị ọrịa, ọbụlagodi iji ogologo oge.

Mmeghachi omume metụtara ọrịa dyspeptik na-egosi mgbe ụfọdụ na mmalite ọgwụgwọ. Mgbe izu abụọ gachara, mgbe ahụ arụrụ mmụọ ọrụ ji arụ ọrụ, ihe mgbaàmà na-akwụsị. Oge ufodu, ọkwa nke ALT na AST abawanye, ya mere odi nkpa ijikwa ọdịnaya ha.

Mgbe ọnwa 1.5 gachara site na mbido ọgwụgwọ, a na-eme nyocha ọzọ. Dịka iwu, enwere ọnọdụ dị mma na nyocha ahụ, i.e. itinye egbugbere ọnụ.

Akọwara etu esi wedata cholesterol na vidiyo n’isiokwu a.

Gosiputa shuga gi ma obu hota nke nwoke maka ntule ndi a achoghi ihe Nchoputa ihe nyocha achoputaghi.

Mwepụta wepụtara ya na ihe mejupụtara

Lodị usoro Lovastatin si ewepụta ya bụ mbadamba nkume: okirikiri cylindrical, na-acha ọcha nwere obere odo na-acha odo odo, yana bevel (na ngwugwu kaadiboodu 1-3 ngwugwu 10, 15 ma ọ bụ mbadamba 20 ọ bụla).

Ngwakọta 1 mbadamba:

• ihe na-arụ ọrụ: lovastatin - 20 ma ọ bụ 40 mg (na usoro 100% akọrọ okwu),
• ihe inyeaka: colloidal silicon dioxide, magnesium stearate, ọka ọka, butylhydroxyanisole, microcrystalline cellulose, shuga mmiri ara ehi.

Mlọ ọgwụ

Lovastatin bụ ihe mgbochi nke cholesterol njikọ imeju. Ihe dị n’ime ahụ n’ụdị lactone na-adịghị arụ ọrụ bụ nke a na-agbanye mmiri n’ọrụ n’ụzọ kwekọrọ na ya, nke na-arụ ọrụ dị ka onye na-asọ mpi nke 3-hydroxy-3-methylglutaryl-coenzyme-A reductase (HMG-CoA reductase). Nke a bụ enzyme nke na-egbochi ntụgharị nke HMG-CoA na mevalonate, nke bụ nzọụkwụ mbụ na cholesterol biosynthesis.

Isi mmetụta nke lovastatin:

• mbelata nke cholesterol ọbara na cholesterol dị na LDL na VLDL (lipoproteins dị ntakịrị na njupụta dị ntakịrị nke ukwuu),
• na-ebelata mbelata nke ọdịnaya apolipoprotein B, mkpokọta nke triglycerides na plasma ọbara na mmụba dị elu na mkpokọta nke HDL (nnukwu njupụta lipoproteins),
• nkwanye ihe ncheta, ndozi nke ọrụ endothelial, antithrombogenic na mmetụta mgbochi mkpali (na-eso akpata antiatherosclerotic).

Mmetụta ọgwụgwọ akpọvosatin akpọpụtara pụtara na ụbọchị iri na anọ, ma kachasịa mgbe ọnwa 1-1.5 nke nchịkwa usoro dị. N'ime otu oge ahụ mgbe ịkwụsị ngalaba ọgwụgwọ, nsonaazụ ahụ na-adịgide. Site na iji ogologo oge (ruo afọ 5), ịdị irè nke lovastatin anaghị ebelata.

Mlọ ọgwụ

Lovastatin na-abanye na ngari nri (eriri afọ) nwayọ na ezughi ezu - ihe dịka 30% nke dose. Mgbe ewere ya na afọ efu, a na-ebelata mmịcha ahụ 1/3 ma e jiri ya na nri.

Tmax (oge iru ịta kachasị) sitere na awa 2 ruo 4, Cmax (ịta kachasị) bụ 7.8 na 11.9 ng / ml (maka lovastatin na beta-hydroxyacids), mgbe ahụ ịta Plasma na-ebelata ngwa ngwa. Mgbe awa 24 gachara, ọ bụ 10% kachasị. Nkwurita okwu na protein protein plasma - 95%. N'iji otu ugboro n'abalị, ịhapụ lovastatin na metabolites ya na-arụ ọrụ na-erute mgbe awa 48-72 gachara.

Penetrates site na ụbụrụ ọbara na placental ihe mgbochi.

Mgbe ị na-agafe imeju na nke mbụ, lovastatin na-enwe metabolism kpụ ọkụ n'ọnụ, oxidizes na beta-hydroxy acid, ihe 6-hydroxy nke ya na metabolites ndị ọzọ, ụfọdụ n'ime ha na-egosipụta ọrụ ọgwụ (ha na-egbochi HMG-CoA reductase). Ndị nọpụrụ iche nke CYP3A4, CYP3A7 na CYP3A5 na-ekere òkè na metabolism nke lovastatin.

Ndi_1/2 (ọkara ndụ) bụ awa 3. 83% nke ọgwụ a weputara site na eriri afọ, 10% - site na akụrụ.

Ihe ngosi maka ojiji

• ogo cholesterol zuru oke, LDL cholesterol na triglycerides na ọbara serum n'ime ndị ọrịa nwere hypercholesterolemia (dika Fredrickson ụdị IIa na IIb), gụnyere ezinụlọ hyperlipidemia, polygenic hypercholesterolemia na heterozygous hypercholesterolemia: na ọnụọgụ ọnya na-ele ya, a ga-ahụ maka ọnụnọ kacha mma iji gosipụta ya na ọnaghị ya, ọ bụrụ na ọnụnọ ya ka ọ dị mma maka ya, ọ bụrụ na a ga-eme ka ọ bụrụ na a ga-eji ya aka mma, ọ bụrụ na ọnụnọ ya ka ọ dị mma, ka i gosipụta ya ka ọ dị mma iji gosipụta ya na-adịkwa ya mma ihe ndi ozo n’abughi ogwu
• akwara ọbara na atherosclerosis na ndị ọrịa nwere ọrịa obi (ọrịa obi na-arịa): a na-eme ọgwụgwọ iji belata ọganiru ya.

Ọrịa hyperlipidemia

Usoro a na-atụ aro ya kwa ụbọchị nke Lovastatin bụ 1080 mg otu ugboro n'ụbọchị.

N'ime ndị ọrịa nwere hypercholesterolemia na-agafeghị oke, ọgwụ mbụ na-abụkarị 20 mg otu ugboro n'ụbọchị mgbede, yana usoro ọrịa (plasma ngụkọta cholesterol n'ọbara - site na 7.8 mmol / l) - 40 mg. Iji mezuo ọkwa cholesterol lekwasịrị anya, enwere ike ịbawanye dose ahụ ruo 80 mg (kacha) na otu ma ọ bụ karịa doses (ụtụtụ na mgbede).

Gbanwee dose ahụ na nkwụsị maka opekata mpe anọ. Ọ bụrụ na ọkwa nke oke kọlestọl na ọkwa plasma ọbara na-ada ruo 140 mg / 100 ml ma ọ bụ LDL cholesterol na 75 mg / 100 ml, enwere ike belata dose Lovastatin. Mgbe ejikọtara ya na cyclosporine, fibrates ma ọ bụ nicotinic acid (site na 1000 mg kwa ụbọchị), dose ahụ agaghị agafe 20 mg kwa ụbọchị. N'ime ndị ọrịa nwere nnukwu akụrụ siri ike na mwepụ nke creatinine erughị 30 ml / min, a na-enye ọgwụ ahụ n'okpuru nlekọta ahụike (oke kachasị - 20 mg kwa ụbọchị).

Lovasterol - ntuziaka maka ojiji

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

Na ibe a: a na-atụle nkọwa nke Lovasterol ọgwụ, mmetụta niile, contraindications na ntuziaka maka iji Lovasterol ọgwụ.

Aha mba ụwa na - abụghị nke propietary aha nke na - arụ ọrụ bụ ihe dị mkpa gbasara ọgwụ. Nke bụ eziokwu bụ na, dịka iwu, a na-emepụta ọgwụ ọgwụ nwere otu ihe na-arụ ọrụ n’okpuru aha azụmaahịa dị iche iche, ya bụ, n’ezie, nke a bụ otu ọgwụ, mana nke ụlọ ọrụ dị iche iche mepụtara. Ọ bụ INN na-enyere ndị dọkịta aka ịhọrọ ngwá ọrụ dị mma site na ọnụ ọgụgụ dị ukwuu nke ọgwụ dị na ahịa ọgwụ.

Mwepụta weputara:

Ọgwụ
Taabụ 1
lovastatin
20 mg
10 PC. - ngwugwu ọnya (3) - ngwugwu nke kaadiboodu.

Ọgwụ
Taabụ 1
lovastatin
10 mg
10 PC. - ngwugwu ọnya (3) - ngwugwu nke kaadiboodu.

Ọgwụ
Taabụ 1
lovastatin
40 mg
10 PC. - ngwugwu ọnya (3) - ngwugwu nke kaadiboodu.

taabụ. 20 mg: 30 pcs.

taabụ. 10 mg: 30 pcs.

taabụ. 40 mg: 30 PC.

Ọrịa Cerebrovascular: ụdị, ihe kpatara ya, ihe mgbaàmà, nchọpụta, etu esi agwọ

Ọrịa Cerebrovascular (CVB) bụ ọrịa na - arịa ọrịa ụbụrụ, na - eduga ischemia, hypoxia na mmebi nke ọrụ ahụ dị iche iche. N'okpuru mmetụta nke ihe na-apụnara mmadụ ihe na endogenous, arịa ụbụrụ na-emebi, mgbasa ụbụrụ na-akpaghasịkwa.

Ọrịa Cerebrovaskụla na - eduga na mmepe nke encephalopathy discirculatory - ọrịa nke na - enwe ọnya ụbụrụ nke na - aga n’ihu na - esite na ezughi oke akwara na - adịghị ala ala. A na-eleba usoro ogwu a anya dị ka nsogbu ndị agadi. Ugbu a, ụkọ nri ụbụrụ "dị obere": a na-ahụwanye ọrịa ahụ na ndị na-erubeghị afọ iri anọ. Nke a bụ n'ihi ndụ adịghị mma, ecoloji na-adịghị mma, nri adịghị mma.

Ọrịa Cerebrovascular bụ ugbu a nnukwu nsogbu ahụike. Ọ nọ n'ọkwa nke atọ n'ime ụzọ nke ngụkọta ọnwụ na mgbe akwara obi na ọrịa obi na oncopathology. CVI bụ ihe kpatara ọrịa strok na nkwarụ na-adịte aka.

Nkewa

Ọrịa Cerebrovaskụla - ọrịa nke sistem, nke gụnyere:

• Hemorrhagic na ischemic ọrịa strok.
• Ọrịa ụbụrụ na - adịghị ala ala nke ụbụrụ - occlusion na vasospasm, arteritis, aneurysm.
• Ọbara ọgbụgba n'ime intracranial.
• Ọrịa cerebrovascular hypertensive - atherosclerotic na encephalopathy hypertensive.

Isi ihe etiological nke ọrịa:

1. Ahụ ọnya Atherosclerotic nke arịa ụbụrụ na-eduga n'inwe cholesterol, ibụ ekike, ibobo na mgbochi, na-esote mmebi nke ọbara ụbụrụ, ụbụrụ trophic na usoro ọgụgụ isi.
2. Dysfunction system of coagulation system, thrombosis na thromboembolism na - ebute nsogbu nke microcirculation ụbụrụ.
3. Spasm nke akwara mgbidi mgbe ọnụnọ ọbara na-adịghị ala ala na-ebelata obara ọbara.
4. Ọrịa vasculitis na-akụda ụbụrụ ọbara dị n’ ụbụrụ.
5. Osteochondrosis nwere ike ibute ụkọ vertebro-basilar na nsogbu ga-adị n'etiti ụbụrụ.

Ihe na-akpalite mmepe nke pathology:

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

• Ọrịa shuga mellitus
• Agadi
• Hypercholesterolemia, dyslipidemia,
• Ibu ibu
• Ọbara mgbali elu
• Ọrịa ọrịa obi,
• Nchegbu
• Nsogbu ụbụrụ na-akpata
• Iji ọgwụ mgbochi ọgwụ a na-egbu egbu ruo ogologo oge.
• Ụ sịga
• Ndụ Sedentary
• Eketa.

Symptomatology

Ọrịa Cerebrovaskụla na nmalite mmalite nke mmepe ya ka a gosipụtara site na mgbaama ndị na - esochi:

1. Ndalata arụmọrụ, ike ọgwụgwụ,
2. Obi erughị ala, ọnọdụ ọjọọ, enweghị nsogbu mmetụta uche,
3. Esemokwu gabigara ókè
4. Insom
5. Thenwe ọkụ
6. Ọnụ kpọrọ nkụ
7. Asthenia
8. Obi palpitations.

N’ọdịnihu, ka ụbụrụ hypoxia na-abawanye, nsogbu dị ize ndụ na-etolite ma na akara ndị dị njọ na-apụta: ikike itinye uche, ikike nchekasị, iche echiche, mgbagha, nhazi, isi ọwụwa oge niile, mbelata arụmọrụ uche.

N'ime ndị ọrịa, ịda mba na-apụta, ọgụgụ isi na-ebelata, neuroses na psychoses na-etolite, phobias na ụjọ, egocentrism, mgbawa, obi na-esighi ike pụtara. Ndị ọrịa na-aghọ hypochondriacal na enweghị nchekwa. N’ọnọdụ siri ike, nkwarụ, ịma jijiji, inwe ihu ike, ikwu okwu na-adịghị mma, mmegharị na uche na nsọtụ niile na-etolite, mgbanwe anụ ahụ, akụkụ ahụ nke ọhụụ na-emetụta.

Mmụba ọzọ na mgbanwe mkpụrụ ndụ na akwara ụbụrụ na-eduga n'ọdịdị syndromes ndị ọzọ akpọrọ na nke a na-ahụ anya - ọgbụgba ụbụrụ na ọnya ụkwụ, paresis na ahụ mkpọnwụ, nkwarụ pelvic, dysphagia, ịchị ọchị na ịkwa ákwá.

Ihe ịrịba ama ndị a na-adakarị na ndị ọrịa ụbọchị dum na-egosi mmerụ oke nke mgbasa ọgbụgba - ọnya ụbụrụ. Ọ bụrụ na ha efuo na obere oge, a na-enyo enyo enwetara mpụ ọgụ dị mkpirikpi.

A na-ahụta ogo 3 nke ọrịa ụbụrụ:

• CVB nke ogo izizi gara ịhụghị anya. Mgbaàmà ya dị n'ọtụtụ ụzọ yiri mgbaàmà nke ọrịa ndị ọzọ ma ọ bụ mmerụ ahụ.
• E gosipụtara ogo nke abụọ site na nsogbu uche. Ọrịa ahụ bụ ihe ngosipụta maka ịkọwa nkwarụ, mana onye ọrịa ahụ na-ejere onwe ya ozi.
• Ngosipụta nke atọ bụ ntụgharị nke ọrịa na usoro nke akwara vaskụla. Ọrịa anaghị enwe ike ịgagharị na ịnyagharị na mbara igwe; enyemaka na nlekọta nke ndị gbara ya gburugburu chọrọ ya. Ekwesiri ịchịkwa omume nke ndị ọrịa dị otú a.

Nsogbu ndị a na-enwekarị CVB bụ: ọria ọgbụgba, ọgụ azụ nke transient, dementia, cerebrovascular coma.

Diagnostics

Nchọpụta na ọgwụgwọ nke ọrịa ụbụrụ metụtara ndị ọrịa neuropathologists na ndị na-awa ahụ. Ha na-ahọrọ ụzọ ọgwụgwọ dabere na njirimara nke ọrịa ahụ, ọnọdụ izugbe nke onye ọrịa yana ọnụnọ nke ọnya ọnya na-adịghị mma.

Nnyocha nyocha nke ndị ọrịa nwere CVI gụnyere:

1. Nnyocha ọbara nyocha
2. Omuma ọbara
3. Mkpebi nke prothrombin index,
4. Ihe mmeghari uche na oria,
5. ECG
6. Nnyocha nyocha
7. X-ray.

Intendedzọ ezubere maka nchọpụta ọrịa ụbụrụ zuru oke na nke zuru oke:

• Anakpo ulo anakpo ma o bu triplex angiocanning bu oria nke CVB. Ọ bụ nke kachasị nchebe, ngwa ngwa ma dị ọnụ ala. N'ụzọ dị otu a, enwere ike ịtụle arịa ndị emetụtara ugboro ugboro na enweghị mmerụ ahụike.
• Iomụ ihe banyere ụbụrụ bụ usoro nke ọdịiche nyocha x-ray nke arịa ọbara, nke na-enye ohere ikpebi ọnọdụ ọrụ ha, ọnụnọ nke usoro ihe ọmụmụ yana ogologo ya. A na-arụpụsị akụkụ animere na-eme ihe ma ọ bụrụ na onye nlekọta nke ihe dị iche abata n'ọbara. Ọ na - enyere onye ọrịa aka ikpebi ọnụnọ nke thrombosis, ọnya atherosclerotic na vasoconstriction, oncopathology, hematoma na aneurysm.
• Brain scintigraphy bụ usoro nyocha dị mfe ma bụrụ nke na-adịghị emerụ ahụ nke nwere ihe mgbochi ọ bụla na anaghị akpata nsogbu. Nyocha nuklia bụ ụzọ dị nganga na ozi na-achọpụta ọrịa mberede. A na-agbanye ọgwụ na-eme ka anwụ rụọ ọrụ na akwara, mgbe nkeji iri na ise gachara nyocha. Oge a ezuola ka redioisotope agbasa ahụ niile ma chịkọta anụ ahụ na - arụ ọrụ. Ihe ngosi a nwere otite radieshon na - emerughi ahu ahu.
• Ihe transcranial Doppler ultrasound bụ nyocha nke ihe ana akpụ akpụ na-achọpụta etu ọbara si agba ọsọ ma na-ekpughe ọgba aghara dị n'ọbara.
• Ihe na-adighi mkpa na nyocha nke CVB bụ MRI na CT.

Ọ gaghị ekwe omume ịchọpụta ma gwọọ ọrịa ọrịa ụbụrụ. Naanị ọkachamara nwere ahụike, tozuru etozu, nyochara mkpesa nke onye ọrịa ma nyochachaa ya kpamkpam, ga-edepụta ọgwụgwọ ruru eru. Ọgwụ zuru oke na oge a ga - eme ka ndụ onye ọrịa dị mma ma belata ihe egwu iji wee nwetachara ọnọdụ ibi ndụ egwu - ọrịa ọnya.

Ebumnuche bụ isi nke ọgwụgwọ ọrịa bụ mkpochapu nsogbu nke ọrụ ụbụrụ. Iji kpochapụ ọrịa ụbụrụ nke akụkụ ụbụrụ kpamkpam, ọ dị mkpa iji chọpụta ma kpochapụ ihe kpatara ya. Na mgbakwunye na idepụta ọgwụ, ndị ọkachamara na-enye ndị ọrịa ndụmọdụ dị mkpa: gbanwee ụdị ndụ ha, felata, anaghị a smokeụ sịga ma ọ bụ alcoholụọ mmanya, rie nri nke ọma.

Ọgwụ ọgwụ

A na-arụkarị ọrụ ọgwụgwọ zuru oke nke ọrịa ụbụrụ. Ndị ọkachamara na - ewepụ ihe ndị dị ize ndụ: dee ọgwụ antisclerotic, hypotensive, ọgwụ hypoglycemic. Naanị mgbe mgbazigharị nke metabolism bụ isi, ha na-aga na usoro ọgwụgwọ kpọmkwem.

Usoro ọgwụgwọ akọwapụtara

Otu ọgwụ dị iche iche na-eme ka ụbụrụ ụbụrụ mejupụta ma burukwa maka ịgwọ ụkọ nri ụbụrụ:

1. Ndị na-eme ka ọnụnọ Calcium na-eme ka ọbara na-erugharị n'ụba, obere usoro a na-ebute ngwa ngwa, na-egbochi njikọta platelet ma melite nchịkọta ọbara. Ọgwụ ndị dị na nifedipine na-emebi arịa nke ụbụrụ - Korinfar, Kardipin, ọgwụ sitere na diltiazem otu Dilzem, Kardil. Cinnarizine na ihe omuma ya, Verapamil, sokwa na ndi a na-egbochi calcium channel.
2. Antioxidants. Ọgwụ antioxidant dị ike edepụtara maka ọrịa ọrịa ụbụrụ, ọrịa strok na encephalopathy bụ Cerebrolysin. Na mgbakwunye na ya, a na-ejikarị Cerebrocurin na Actovegin.
3. Edere ọgwụ antihypoxants maka ọrịa ọrịa ụbụrụ - Ketoprofen, Imidazole, Mekaprin.
4. Metabolics - “Cavinton”, “Sermion”, “Vinpocetine”, “Tanakan”.
5. Direct anticoagulants - “Heparin”, “Fraxiparin” na ndị ọzọ - “Phenilin”, “Sincumar”, “Warfarin”.
6. Ọgwụ mgbochi "Antiplatelet" "Acetylsalicylic acid", "Curantyl".
7. Ogwu nwere hypocholesterolemic action, statins - “Lovastatin”, “Lipostat”, “Probucol”, “Tykveol”.
8. Ọgwụ Nootropic - Omaron, Piracetam, Pantogam, Glycine, Phenibut.
9. Ọgwụ ndị na-emebi arịa nke ụbụrụ - Pentoxifylline, Trental, Agapurin.
10. Antispasmodics - "Papaverine", "Eufillin", "Dibazol."

Isi ọgwụgwọ

Usoro ọgwụgwọ bụ isi nke CVB bụ ịhazi ọrụ nke iku ume mpụga, sistem ụbụrụ, na-ejigide homeostasis, yana neuroprotection.

• Iji mee nke a, a na-eme ka okporo ụzọ ikuku ahụ dị ọcha, trachea na-abanye n'ime ya, na-eme ka ikuku na-efe efe ume ọkụ.
• PMgbe ihe ịrịba ama nke nkụda obi na ọrịa obi ọria aputa, “Lasix” na “Pentamine” ka eji.
• A na-egosi ọgwụgwọ antiarrhythmic maka ndị ọrịa nwere ọrịa arrhythmias. A na-edekarị ọgwụ antianginal, cardiac glycosides - Strofantin, Korglikon, antioxidants.
• “Seduxen”, “Haloperidol”, “Diphenhydramine”, “Sodium oxygenbutyrate” ga-enyere aka ịkwụsị ọrụ ahịhịa.
• Iji lụ ọgụ ụbụrụ, a na - eji osmotic diuretics - Mannitol, Furosemide.
• Iji mee ka ọbara ọgbụgba kwụghachi, Atenolol, Enalapril, Nifedipine, Dibazol ka edepụtara.
• A na - arụzi mmezi nke metabolic site na imepụtaghachi olu mmiri extracellular yana ihe ngwọta nke Ringer, plasma, glucose.
• Usoro ọgwụgwọ Symptomatic gụnyere ọgwụ anticonvulsant na psychotropic ọgwụ, izu ike akwara, nyocha - “Analgin”, “Ketorol”, “Promedol”.

Hyperbaric oxygenation bụ usoro ọgwụgwọ physiotherapeutic nke na-enye oxygenation ọbara na ntinye ya na anụ ahụ metụtara. Onye ọrịa ahụ nọ n’ime ụlọ pụrụ iche ma kubie ume oxygen. Hyperbaric oxygenation na-ewepụ ụgwọ oxygen nke akwara ma weghachite aerobic glycolysis. Usoro a na - eme ka ndụ ndị ọrịa dịkwuo mma, na - ebelata ihe mgbaàmà nke ọrịa na - egbochi mmepe nke nnukwu nsogbu.

Ọgwụ ịwa ahụ

Formsdị ajọ ọrịa, nke na-anaghị ekwe nkwụzi na ọgwụgwọ, chọrọ ịwa ahụ. A na-ewepụ ndị ọrịa ọrịa mkpụkọ ọbara na oghere atherosclerotic site na akwara akwara, mee ka lumen nke arịa ndị ahụ site na iji katuetụ na balloon, a na-etinyekwa eriri n'ime akwara ndị na-eme ka oghere nke arịa ahụ mepee.

Ọrịa Cerebrovaskụl dị n'okpuru ọgwụgwọ ịwa ahụ: ọrịa akwara ozi na ọbara ọgbụgba na intracerebral.

Ndi Ogbo

Ọgwụ ọdịnala kachasị eji mee ihe na ọgwụgwọ nke ọrịa ọrịa ụbụrụ:

• Akpọnwụwo pe peony ahụ, ala ya ga-agba ya mmiri. Ọnwụ na-agwọ ọrịa maka otu elekere, hichaa ma were 5 ugboro n'ụbọchị maka tablespoon.
• N'ime anụ anụ, a na-egwepu oroma 2 na lemon 2, uka a na mmanụ a honeyụ na-agwakọta. Ọnwụ na ụbọchị oyi, wee buru tablespoon ugboro atọ n'ụbọchị.
• A na-awụsa agịga paini na mmiri esi, na-esi ọnwụ ma tinye ihe ọ ofụ ofụ nke ọkara lemon n'ime ofe. Were ọgwụ a na afọ efu na ọnwa atọ.
• A na-ewere tinlandine na afọ ihe na-adịghị ọcha ugboro atọ n'ụbọchị maka izu 2.

Ogwu Ochie bu ezigbo mgbakwunye na isi usoro ogwu.

Mgbochi na prognosis

Usoro iji gbochie mmepe nke ọrịa ụbụrụ:

1. Normalization nke ọbara mgbali
2. Bikoro n'oge nke ibute ọrịa,
3. Na-alụ ọgụ ọjọọ
4. Mgbatị ahụ ọkụ
5. Ihe oriri kwesịrị ekwesị
6. Mmepe nke ọrụ na izu ike
7. Ighazi ibu.

Maka ebumnuche profilactic, a na-enye ndị ọrịa ọgwụ ndị na-eme ka ụbụrụ ụbụrụ na-ebelata ma na-ebelata ọbara ọbara.

Ọ bụrụ na agwọ ọrịa ahụ n'oge kwesịrị ekwesị, ọ ga - ekwe omume ọ bụghị naanị iji mee ka ndụ onye ọrịa dịkwuo mma, kamakwa iji belata ọnya ọnya ọrịa na nsogbu ndị ọzọ siri ike.