Etu esi eji Atorvastatin-Teva? > Ọgwụgwọ na mgbochi

Mpempe usoro onunu ogwu - mbadamba ihe eji eme ihe nkiri: ihe fọrọ nke nta ka ọ bụrụ ọcha ma ọ bụ na-acha ọcha, nke a na-agbanwe kapịlị, nke a kanyere akụkụ abụọ: n'otu akụkụ - "9310", nke ọzọ - "7310", "7311", "7312" ma ọ bụ "7313" (10 PC na ọnya, na ngwungwu 3 ma ọ bụ 9 blisters).

Otu mbadamba 1 nwere:

ihe na - arụ ọrụ: calcium atorvastatin - 10.36 mg, 20.72 mg, 41.44 mg ma ọ bụ 82.88 mg, nke ya na 10 mg, 20 mg, 40 mg ma ọ bụ 80 mg nke atorvastatin, n'otu n'otu,
ihe inyeaka: eudragit (E100) (copolymer nke dimethylaminoethyl methacrylate, butyl methacrylate, methyl methacrylate), lactose monohydrate, alpha-tocopherol macrogol succinate, povidone, croscarmellose sodium, sodium stearyl fumara
Ngwakọta mkpuchi ihe nkiri: opadry YS-1R-7003 (polysorbate 80, hypromellose 2910 3cP (E464), titanium dioxide, hypromellose 2910 5cP (E464), macrogol 400).

Ihe ngosi maka ojiji

heterozygous ezinụlọ na hypercholesterolemia na-abụghị nke ezinụlọ, hypercholesterolemia na agwakọta (jikọtara) hyperlipidemia (ụdị IIa na IIb dịka usoro Fredrickson) na mgbakwunye nri nri na-agbadata iji belata ogo cholesterol, obere lipoprotein liLpro, Li-li-li-li, njupụta nke lipoprotein kọlestrọl (HDL),
dysbetalipoproteinemia (ụdị nke III dị ka nhazi ọkwa Fredrickson), triglycerides dị elu nke ọbara (ụdị IV dị ka nhazi nke Fredrickson) - na usoro ọgwụgwọ nri anaghị arụ ọrụ,
Hyzycholesterolemia homozygous - iji wedata LDL cholesterol na cholesterol zuru oke na arụmọrụ ezughi oke nke usoro ọgwụgwọ nri na ọgwụgwọ ndị ọzọ na-abụghị ọgwụ ọgwụ.

Ihe ngbanwe

mmebi imeju (classesmụaka Pugh na A na B),
pathologies imeju na-arụ ọrụ, ịba ụba enzymes hepatic (ihe karịrị ugboro 3 karịa elu elu nke nkịtị) nke esighị n'aka,
oge ime na inye nwa ara,
afọ ruo afọ 18
hypersensitivity na mmiri ọgwụ.

Iji kpachara anya, a na-atụ aro ka Atorvastatin-Teva depụta akụkọ banyere ọrịa imeju, ndị ọrịa nwere hypotension, ị alcoholụ mmanya, metabolic na endocrine aghara, enweghi ike elektrolyte, nnukwu ọrịa ọrịa (sepsis), ọrịa akwara ọkpụkpụ, ọrịa na-achịkwaghị achịkwa, yana usoro ịwa ahụ sara mbara. mmerụ ahụ.

Usoro onunu ogwu na nhazi

A na-ewere mbadamba okwu ọnụ ugboro 1 kwa ụbọchị, n'agbanyeghị nri a na-eri n'oge ọ bụla n'ụbọchị.

Dọkịta depụtara ọgwụ ahụ n’otu n’otu, na-eburu n’uche izizi nke LDL cholesterol, ebumnuche ọgwụgwọ na nzaghachi onye ọrịa na ọgwụ ahụ.

Nlekọta nke Atorvastatin-Teva kwesịrị ijikọta ya na oge niile (oge 1 kwa izu 2-4) maka ọkwa nke lipids na plasma ọbara, dabere na data enwetara, dozie dose ahụ.

Ekwesịrị imeghari dose karịa oge 1 n'ime izu anọ.

Oke kachasị kwa ụbọchị bụ 80 mg.

Na-atụ aro dosing kwa ụbọchị:

heterozygous familial hypercholesterolemia: usoro izizi bụ 10 mg, na-eme mgbanwe nha nha kwa izu anọ, a ga-ebute ya nwayọ na 40 mg. Mgbe etinyere ogo 40 mg, a na-a acidsụ ọgwụ ahụ yana usoro ọgwụ bile acid, yana monotherapy, a na-abawanye ọgwụ ahụ ruo 80 mg,
hypercholesterolemia nke mbu na agwakọta (jikọtara) hyperlipidemia: 10 mg, dịka iwu, dose ahụ na-enye njikwa dị mkpa nke ọkwa lipid. Nnukwu ọgwụgwọ ụlọ ọgwụ na-abụkarị mgbe izu anọ gachara ma nọgide na-eji ọgwụ ahụ ogologo oge.
homozygous familial hypercholesterolemia: 80 mg.

Maka ọrịa obi na akụrụngwa na nnukwu nsogbu nke ọrịa obi, a na-atụ aro ọgwụgwọ maka ebumnuche ndị a maka mmezi akwara: cholesterol na-erughị 5 mmol / l (ma ọ bụ n'okpuru 190 mg / dl) na LDL cholesterol erughị 3 mmol / l (ma ọ bụ n'okpuru 115 mg) / dl).

N'ihe banyere imeju imeju, onye ọrịa nwere ike ịchọrọ iwepụta obere doses ma ọ bụ kwụsị ọgwụ ahụ.

Na ọdịda akụrụngwa, a chọghị imegharị ọgwụ iji gwọọ ya, ebe ọgwụ a anaghị agbanwe ndọpụ na plasma ọbara.

Nsonaazụ

site na sistem ụjọ: ọtụtụ mgbe - isi ọwụwa, ugboro ugboro - imebi mmetụta dị ụtọ, ọgbụgba, ehighị ụra nke ọma, paresthesia, amnesia, ụra abalị, hypesthesia, adịkarịghị - neuropathy akụkụ, oge amaghi - nkụda mmụọ, ncheta ma ọ bụ mfu, nsogbu ụra,
site na usoro ahụ ji alụso ọrịa ọgụ: ọtụtụ mgbe - mmeghachi omume nfụkasị ahụ, ọ na-adịkarị obere - ujo anacticlactic, angioedema,
site na akwara afọ: mgbe niile - ọgbụgbọ, dyspepsia, afọ ọsịsa, flatulence, afọ ntachi, oge na - afọ mgbu, belching, pancreatitis, vomiting,
site na usoro akwara na uru ahụ: mgbe mgbe - ihe mgbu na aka, ihe na-efegharị na nkwonkwo, myalgia, mgbu azụ, arthralgia, spasm muscle, ugboro ugboro - adịghị ike akwara, olu olu, adịkarịghị - rhabdomyolysis, myopathy, myositis, tendonopathy ya na ngwara, aka amaghi ugboro ole - immuno-mediated necrotizing myopathy,
site na sistemụ ịba ọcha n'anya: ugboro ugboro - ịba ọcha n'anya, adịkarịghị - cholestasis, ọ dịkarịghị - ọdịda imeju,
Site na sisitemu na sistemụ ọbara: adịkarịghị - thrombocytopenia,
site na sistem iku ume, obi na akụkụ akụkụ ahụ: mgbe niile - imi imi, mgbu na mpaghara pharyngeal-laryngeal, nasopharyngitis, ugboro ole amaghi ama - ọrịa ọnya na - efe efe.
ndị na - egosi ụlọ nyocha: ọtụtụ mgbe - mmụba na ọrụ serine creatine kinase, hyperglycemia, ugboro ugboro - hypoglycemia, leukocyturia, mụbara ọrụ nke enzymes imeju, a maghị ugboro ole - mụbara ọkwa nke mkpokọta gemocosylated.
n’akụkụ anụ ahụ nke ịnụ ihe, nsogbu nke labyrinth: ugboro ugboro - tinnitus, adịkarịghị - nti ịnụ ntị,
na akụkụ ahụ nke ọhụụ: na mgbe mgbe - mbelata idoanya nke ọhụụ, adịkarịghị - mmebi nke ịhụ ụzọ,
mmeghachi omume nke akpukpo aru akpukpo aru: okpukpo aru - itching skin, fash, alopecia, urticaria, notus - erythema multiforme, bullous dermatitis, very slight - toxic epidermal necrolysis, Stevens-Johnson syndrome,
site na usoro ọmụmụ: adịkarịghị - gynecomastia, ugboro ole amaghi ama - ọnụnọ mmekọahụ,
nsogbu niile: adịghị ala ala - adịghị ike, asthenia, ahụ ọkụ, obi mgbu, akụkụ oke, oke ibu, lethargy, anorexia.

Ntụziaka pụrụ iche

Na mbu, ekwesiri igbali hypercholesterolemia ịchịkwa usoro nri, ịba ụba nke arụ ọrụ, yana na ndị ọrịa buru oke ibu, oke ibu na ọgwụgwọ nke ọnọdụ ndị ọzọ.

Ojiji nke Atorvastatin-Teva na-enye ihe nlere nke nri hypocholesterol nke dọkịta na-enye n'otu oge iji ọgwụ ahụ.

Ndị na-egbochi HMG-CoA reductase nwere ike emetụta mgbanwe mgbanwe biochemical nke ọrụ imeju n'oge usoro ọgwụgwọ. Ya mere, usoro ọgwụgwọ kwesịrị ijikọ ya na usoro nlele nke imeju yana oge na-esote: tupu ịmalite usoro ọgwụgwọ, mgbe mkpụrụ ọgwụ nke ọ bụla na-abawanye, mgbe ahụ ka izu isii na izu iri na abụọ gachara, ka ọnwa isii ọ bụla gasịrị. Dọkịta ga-enyocha ndị ọrịa nwere ọkwa enzyme dị elu ruo mgbe ọkwa ahụ ga-alaghachi na nkịtị. Ọ bụrụ na ụkpụrụ aspartate aminotransferase (AST) na alanine aminotransferase (ALT) karịrị okpukpu atọ karịa oke nke ụkpụrụ, ekwesịrị ibelata ma ọ bụ kagbuo dose ahụ.

Mmepe nke myopathy nwere ike ịbụ mmetụta na-adịghị mma nke ịnakwere atorvastatin, ihe mgbaàmà ya gụnyere mmụba na creatine phosphokinase (CPK) nke ugboro 10 ma ọ bụ karịa ma e jiri ya tụnyere oke nke ụkpụrụ ahụ na njikọta na mgbu na adịghị ike na akwara. Ekwesịrị ịgwa ndị ọrịa banyere mkpa ọ dị ịkpọtụrụ dọkịta ozugbo enwere mgbu na adịghị ike na-enweghị ike ịkọwapụta na akwara, yana ahụ ọkụ na ọrịa na-arịa. Ekwesịrị ịhapụ usoro ọgwụgwọ ahụ ka ị na-enwe mmụba akpọrọ na ọrụ KFK ma ọ bụ ọnụnọ nke myopathy na-enyo enyo ma ọ bụ gosipụtara.

Na-emegide nzụlite nke atorvastatin, mmepe nke rhabdomyolysis na nnukwu akụrụ akwara n'ihi myoglobinuria ga-ekwe omume. N'ihe banyere nnukwu ọrịa ọrịa, akwara hypotension, ịwa ahụ nke ukwuu, trauma, metabolic siri ike, endocrine na ọgba aghara electrolyte, ọdịdọ a na-achịkwaghị achịkwa ma ọ bụ ọdịdị nke ihe ndị ọzọ dị ize ndụ maka ọdịda akụrụngwa n'oge rhabdomyolysis, a na-atụ aro ịkwụsị ọgwụ Atorvastatin-Teva.

Theakingụ ọgwụ ahụ anaghị emetụta ikike onye ọrịa ịnya ụgbọ na usoro.

Mkparịta ụka ọgwụ ọjọọ

Nchikota nke HMG-CoA reductase inhibitors na fibrates, cyclosporine, ọgwụ mgbochi macrolide (gụnyere erythromycin), nicotinic acid, ndị na-emegide antizoung azole na-abawanye ihe ize ndụ nke myopathy ma ọ bụ nwee ike ịkpata ọrịa rhabdomyolysis, tinyere myoglobinuria metụtara renal ọdịda. Ya mere, a na-atụ aro ka ọ bụrụ n ’ụzọ kwesịrị ekwesị, atụnyere uru na ọghọm nke ọgwụgwọ, mee mkpebi na nhọpụta nke atorvastatin n’otu oge na ọgwụ ndị a.

Na oke ịkpachapụ anya, a na-atụ aro ịkọ ya na cyclosporine, nje protease inhibitors, ọgwụ nje macrolide (gụnyere erythromycin, clarithromycin), ọgwụ azole antifungal, nefazodone na ndị ọzọ na-egbochi CYP3A4 isoenzyme, ebe ọ bụ na ọ ga-ekwe omume ịbawanye mkpocha nke ọnya ọnya ọbara na ọnụọgụ na-ahụ maka ọnụnọ ọbara na plaorastastma. .

Site na iji Atorvastatin-Teva na-eme n'otu oge:

cimetidine, ketoconazole, spironolactone na ọgwụ ndị ọzọ na-ebelata mkpokọta homonụ steroid endogenous, na-abawanye ohere nke mbelata nke ọkwa nke homonụ steroid endogenous,
ọgwụ mgbochi okike nke nwere ethinyl estradiol na norethisterone na-eme ka ịta ụba nke ihe ndị na-arụ ọrụ n'ime plasma ọbara,
ihe mgbochi nwere hydro hydro hydro alide na magnesium na-ebelata (ihe dị ka 35%) ịta atorvastatin na plasma, na-enweghị ịgbanwe ogo mbelata na LDL,
digoxin nwere ike ime ka ịtawanye plasma ya,
warfarin na-ebute ntakịrị ntakịrị na oge prothrombin na mmalite ọgwụgwọ, n'ime ụbọchị 15 na-esote, a na-eweghachi akara ahụ na nkịtị,
cyclosporin na ndị ọzọ na-egbochi P-glycoprotein nwere ike ịbawanyewanye bioavailability nke atorvastatin,
terfenadine agbanweghi itinye uche na plasma ọbara.

Ngwakọta ọgwụ na colestipol nwere mmetụta pụtara ìhè na lipids karịa ị eachụ ọgwụ ọ bụla iche, n'agbanyeghị na ọkwa nke atorvastatin dị na plasma ọbara na-ebelata ihe dịka 25%.

Iri ihe ọ juiceụpeụ mkpụrụ osisi grape n'oge ọgwụgwọ kwesịrị ịbụ nke a kpaara ókè, ebe ọ bụ na nnukwu mmiri ihe ọ juiceụ increasesụ na-eme ka mkpokọta atorvastatin dị na plasma.

Ọgwụ a anaghị emetụta ọgwụ ọgwụ nke phenazone na ọgwụ ndị ọzọ metabolized otu cytochrome isoenzymes.

Nsiozi nke rifampicin, phenazone, na CYP3A4 ndị ọzọ na ewebata nhazi isoenzyme na Atorvastatin-Teva edobebeghị.

Ekwesịrị ịtụle mmekọrịta dị egwu na iji ọgwụ ọgwụ antiarrhythmic nke klas III (gụnyere amiodarone).

Ọmụmụ ihe ekpugheghị njikọta nke atorvastatin na cimetidine, amlodipine, ọgwụ antihypertensive.

Eme ọgwụ ọgwụ nke atorvastatin teva

Ọgwụ a bụ nke ndị na - anabatabeghị na - egbochi ụdị enzyme HMG-CoA reductase, nke na - ejikọ njikọ mevalonic acid, kọmpụta cholesterol na sterol ndị ọzọ.

Triacylglycerides (abụba) na cholesterol na imeju na-ejikọ ọnụ nke ukwuu lipoproteins dị ala, ebe ọbara na-ebufe ya na akwara na anụ ahụ adipose. N'ime ndị a, n'oge lipolysis, a na-ekepụta lipoproteins dị ala (LDL), nke a na-ekewa site na mmekorita ya na ndị na-anabata LDL.

Omume nke ọgwụ a chọrọ iji belata ego nke abụba na cholesterol n'ime ọbara site na igbochi ọrụ Hzy-CoA reductase enzyme, cholesterol biosynthesis na imeju na ịba ụba nke ndị na-anabata LDL nke na-akwalite mmelite na catabolism nke lipoproteins dị ala.

Nsonaazụ ọgwụ a dabere na nha a takenụrụ ma mejupụtara na iwelata ogo lipoproteins dị ala na ndị ọrịa nwere oke mmebi nke cholesterol metabolism (hypercholesterolemia), nke enweghị ike idozi ya na ọgwụ ndị ọzọ iji belata lipids ọbara.

Theakingụ ọgwụ ahụ na-eduga na ọkwa nke:

cholesterol dum (30-46%),
cholesterol na LDL (41-61%),
apolipoprotein B (34-50%),
triacylglycerides (14-33%).

N'otu oge, ọkwa cholesterol na nchịkọta nke lipoproteins dị elu (HDL) na apolipoprotein A na-abawanye A na-ahụ mmetụta a na ndị ọrịa nwere ọrịa na hypercholesterolemia, ụdị agwakọta dyslipidemia, gụnyere ụdị ọrịa shuga 2 nke ọrịa mellitus. Mmetụta ọgwụ ọgwụ ọgwụ a na-ebelata ohere nke ọrịa obi na egwu nke ọnwụ na njikọ ha.

Dabere na ọmụmụ banyere ọgwụgwọ, nsonaazụ nke iji ọgwụ ọjọọ eme ihe na ndị ọrịa metụtara afọ adịghị iche na nchekwa yana ịdị mma na ụzọ na-adịghị mma na nsonaazụ ọgwụgwọ nke ndị ọrịa nke afọ ndị ọzọ.

A na-etinye ọgwụ ọgwụ ngwa ngwa mgbe nchịkwa ọnụ gasịrị. A na-edebanye uche kachasị n'ime ọbara mgbe awa 1-2 gachara. Iri nri na-eji nwayọ nwayọ nwayọ n’onwe gị, mana anaghị emetụta arụmọrụ ya. Igwu nri bara uru bu 12%. Bioavailability nke ihe inhibitory na-emetụta ya na enzyme HMG-CoA reductase bụ 30%, nke a na-akpata site na mbido metabolism na ngụgụ nri na akwara. Ọ na - egbochi ihe nchebe ọbara site na 98%.

A na - ekewa ihe ahụ na - arụ ọrụ n'ime metabolites (ortho- and para-hydroxylatederi, beta-oxidation products) maka akụkụ kachasị na imeju. A na-agbanwe ya biotrans n'okpuru ọrụ nke isoenzymes CYP3A4, CYP3A5 na CYP3A7 nke cytochrome P450. Ọrụ inhibitory nke onye na-ahụ maka ọgwụ ọgwụ metụtara enzyme HMG-CoA reductase bụ 70% na-adabere na omume nke metabolites na-esite na ya.

Mwepu nke metabolites ikpeazụ na-apụta tumadi site na bile, ọ bụ naanị akụkụ na-adịghị mkpa (Ihe ngosi maka iji atorvastatin teva

Mgbochi ọrịa nke ọrịa obi

n'ime ndị okenye na otu ma ọ bụ karịa otu dị iche iche: agadi, ọbara mgbali, ndị na-ese anwụrụ, ndị mmadụ nwere HDL belatara ma ọ bụ ajọ ihe nketa n'ihi ọrịa obi na ọrịa vaskụla,
n'ime ndị ọrịa nwere ụdị ọrịa shuga 2 nke nwere proteinuria, retinopathy, ọbara mgbali elu,
n'ime ndị ọrịa nwere ọrịa obi (iji zere mmepe nke nsogbu).

Ọgwụ nke hyperlipidemia:

ya na hypercholesterolemia nke mbu (enwetara ma ketara eketa, gụnyere ụdị ụdị hypercholesterolemia ụdị - na heterozygous) - a na-eji ọgwụ ahụ eme ihe dị ka ngwa nnwere onwe yana akụkụ nke usoro ọgwụgwọ dị mgbagwoju anya na ụzọ ndị ọzọ e si agbasa egbugbu (LDL apheresis),
tinyere ọrịa dyslipidemia,
n'ime ndị ọrịa nwere nnukwu triglycerides n'ọbara (ụdị nke IV dịka Fredrickson),
n'ime ndị ọrịa nwere isi dysbetalipoproteinemia (ụdị Fredrickson III) na usoro ọgwụgwọ nri anaghị arụ ọrụ.

Etu ị ga-esi

Usoro ubochi n’eme ka onodu cholesterol buru uzo puta kwa onwa nke 10-80 mg. Na mbu, a na-enye 10 mg otu ugboro n'ụbọchị n'oge ọ bụla n'ụbọchị, na-enweghị aha banyere nri oriri. Imeghari usoro a dabere na ngosipụta nke cholesterol ọbara, nke a ga-ebu ụzọ nyocha ya kwa izu abụọ, emesia kwa izu anọ.

Standardụ ọ dailyụ kwa ụbọchị maka ndị okenye:

ya na hypercholesterolemia nke mbu yana hyperlipidemia agwakọtara: 10 mg otu ugboro kwa ụbọchị (a na-edekọ nsonaazụ ọgwụgwọ mgbe ụbọchị 28 gachara site na mmalite ọgwụgwọ, yana ọgwụgwọ ogologo oge ihe a rụpụtara ihe kwụsiri ike)
ya na heterozygous hereditary hypercholesterolemia: 10 mg 1 oge kwa ụbọchị (usoro izizi nwere mgbazinye ozokwa na iweta ya 40 mg kwa ụbọchị),
ya na hyzycholesterolemia nke homozygous: 80 mg 1 oge kwa ụbọchị.

Ọrịa ntaramahụ ahụ adịghị emetụta ntinye uche nke ihe na - arụ ọrụ n'ime ọbara ma ọ bụ arụmọrụ nke Atorvastatin-Teva. Enweghị mkpa maka ịmeghari usoro onunu ogwu n'ihi ọrịa akụrụ. N'ọnọdụ arụ ọrụ na-arụ ọrụ, imeghari dose dị mkpa dabere na arụ ọrụ nke akwara. N'okwu ikpe, akagbuo ọgwụgwọ ọgwụ.