Lovastatin ea lithethefatsi: mochini oa ts'ebetso le litlhahlobo

Bothata ba k'holeseterole e phahameng ea mali bo tšoenya batho ba bangata. Sena se bakoa ke taba ea hore boemo bo joalo bo ka lebisa ho se sebetse hantle ha pelo le tsamaiso ea methapo ea pelo ka kakaretso. Ho felisa hyperlipoproteinemia, ha ho hlokahale feela ho ja ka nepo, empa le ho sebelisa lithethefatsi tse itseng.

Mokhoa o sebetsang oa ho fokotsa cholesterol ea mali o nkuoa e le lithethefatsi "Lovastatin." Litaelo tsa tšebeliso, theko, litekolo, li-analogues le li-contraindication tsa meriana ena li tla hlahisoa ka tlase. Hape o tla ithuta ka seo litsebi li se buang ka eena le hore na bareki ba siea maikutlo afe.

Sebopeho, sebopeho, sephutheloana le litlhaloso tsa sehlahisoa sa meriana

Moriana "Lovastatin", litaelo tsa tšebeliso ea ona o kentsoeng ka lebokoseng la karete e rekisoang ka mokhoa o tšoanang oa litafole tse tšoeu le tse chitja. Motsoako o sebetsang oa moriana ona ke lovastatin. Ha e le likarolo tse thusang, li kenyelletsa lactose monohydrate, starch, cellulose, ascorbic acid, butyl hydroxyanisole, citric acid le magnesium stearate.

Moriana o fanoa ka har'a marang-rang a lisele le lipakete tsa karete.

Mokhoa oa ts'ebetso ea moriana

Molao-motheo oa ts'ebetso ea lithethefatsi "Lovastatin" ke eng? Litaelo tsa tšebeliso, tlaleho e sa sebetseng ea hore li-LP receptors tsa sebete li laola se ka har'a lipoprotein maling. Li tsoa ho eona ka ho sebelisana le li-receptors tse boletsoeng. Ka lebaka leo, cholesterol e kopantsoe le lisele tsa sebete.

Molao-motheo oa ts'ebetso ea moriana o botsoang o hlalosoa ke khatello ea 3-hydroxy-3-methylglutaryl-coenzyme A reductase. Ona ke mohopolo o nang le karolo eo karolo ea k'holeseterole e etsoang.

Ho fokotsa sebopeho sa cholesterol ho kenyelletsa keketseho e potlakileng ea palo ea li-receptor tsa LP ho hepatocytes. Ka lebaka la sena, ts'ebetso ea ho tlosa lipoprotein tse tsoang maling e potlakile, 'me k'holeseterole e tlaase, k'holeseterole e tlaase le bohareng e boetse e fokotsehile.

Litšobotsi tsa moriana

Matlapa a Lovastatin a na le thepa efe e meng? Litaelo tsa tšebeliso (theko, litekolo li hlahisoa qetellong ea sengoloa) li bonts'a hore sesebelisoa sena se khona ho fokotsa se ka hare ho apolipoprotein B le triglycerides, hammoho le ho eketsa hanyane boemo ba lipoprotein tse phahameng.

Phello ea kalafo ka mor'a ho nka moriana e hlaha kamora libeke tse peli, mme e phahameng - kamora nako e ka bang khoeli le halofo. Leha ho le joalo, e tsoela pele libeke tse tšeletseng kamora hore moriana o khaotse.

Ho sebetsa ha sethethefatsi ka tšebeliso ea nako e telele ha ho fokotsehe. Hape ho lokela ho hopoloa hore e fumanoa ho biocultures ea Aspergillus terreus le Monascus ruber.

Thepa ea Kinetic

Lovastatin e nka nako e kae? Litaelo tsa tšebeliso (theko ea sethethefatsi ha e phahame haholo) e bolela hore ho nkeloa ha sethethefatsi sena moqoqong oa tšilo ho etsahala butle. Ho feta moo, e fokotsa ho ja litafole ka mpeng e se nang letho.

The bioavailability ea moriana ona o tlase haholo (hoo e ka bang 30% ea lethal dose e nkuoeng). Kamora lihora tse ka bang 'ne, khatello e phahameng ka ho fetisisa ea moriana maling e ea fumaneha. Kamora letsatsi le leng e ea fokotseha 'me e batla e le 10% ea boholo.

Sesebelisoa seo ho buuoang ka sona ke 95% e tlamehang liprotheine tsa plasma. Ho hlakisoa ha sethethefatsi ka tekanyetso e le 'ngoe ho bonoa ka letsatsi la 3.

Litlhare tsa Lovastatin ke eng? Litaelo tsa ts'ebeliso ea litlaleho tsa hore sena ke sethethefatsi. Kamora temana ea pele ho pholletsa le sebete, e nka sebopeho se sebetsang.

Setlhare sena se tšeloa ka metsoako ea isoenzymes. Nako ea bophelo ba eona ke metsotso e 180. Sesebelisoa se sebetsang sa moriana, hammoho le li-metabolites tsa sona, se hlahisoa ke liphio le mala.

Matšoao a ho nka lipilisi

Boteng ba maemong afe bakuli ba behiloeng litafole tsa Lovastatin? Litaelo tsa tšebeliso (litlhaloso, sebopeho sa lithethefatsi li hlahisitsoe qalong ea sengoloa) li tlaleha hore setlhare sena se sebetsa haholo bakeng sa hypercholesterolemia ea mantlha (mofuta IIb le mofuta IIa lipolipoproteinemia) se nang le litaba tse phahameng tsa LDL (haeba kalafo ea lijo ho batho ba nang le kotsi e kholo ea ho ba le coronary atherosulinosis e ne e sa sebetse) , hammoho le hypertriglyceridemia le hypercholesterolemia.

Ho lokela ho hlokomeloe hore setlhare seo ho buuoang ka sona hangata se laeloa bakeng sa atherosulinosis.

Contraindication bakeng sa ho nka meriana e sebelisang litlhare

Ke maemong afe moo mokuli a sa khothalletsoang ho sebelisa matlapa a Lovastatin? Litaelo tsa tšebeliso (kalafo ka sehlahisoa sena se lokela ho laeloa ke ngaka feela) e tlaleha hore sethethefatsi sena se tšoaetsanoa ha ho hlokahala mafu a sebete, ho ima kapa monyetla oa teng, ts'ebetso e eketsehang ea transaminase ea tšimoloho e sa tsejoeng, le nakong ea ho anyesa, maemong a matla a mokuli (ka kakaretso) mme a eketseha sensitivity to lovastatin.

Hape, meriana eo ho buuoang ka eona ha e khethoe lilemong tse nyane, e leng myopathy le cholestasis.

Ho thibetsoe ho kopanya tšebeliso ea lithethefatsi le joala. Ka tlhokomeliso e fetelletseng, e fuoe bakuli kamora ho fetisoa ka methapo ea methapo ea methapo.

Lithethefatsi "Lovastatin": litaelo tsa tšebeliso

Theko, li-analogues tsa sesebelisoa sena li tla nkoa ho ea pele.

Ho latela litaelo tse kentsoeng, matlapa a Lovastatin a lokela ho nooa ka molomo nakong ea lijo tsa mantsiboea hang ka letsatsi.

Boemong bo joalo ba methapo ea methapo e kang hyperlipidemia, moriana o beoa ka bongata ho 10-80 mg hang (lethal dose le ipapisitse le boima ba lefu lena).

Phekolo le moriana o botsoang o qala ka litekanyetso tse nyane. Ebe butle-butle e eketseha. Tekanyetso e phahameng ka ho fetisisa ea letsatsi le leng le le leng ea lithethefatsi, e lekanang le 80 mg, e ka nooa hanngoe kapa habeli ka letsatsi (hoseng le pele u robala). Khetho ea lethal dose ea phekolo e etsoa ka nako ea khoeli e le ngoe.

Lovastatin e tsamaisoa joang bakeng sa coronary atherosclerosis? Litaelo tsa tšebeliso li tlaleha hore ka lefu le joalo, moriana o laetsoe ka tekanyetso ea 20-40 mg. Haeba palo e boletsoeng ea moriana e ne e sa sebetse, joale e eketseha ho isa ho 60-80 mg.

Ha moriana o kopantsoe le fibrate kapa nicotinic acid, litekanyetso tsa eona ha lia lokela ho ba holimo ho 20 mg ka letsatsi.

Liketsahalo tse Fosahetseng

Na meriana ea Lovastatin e baka litla-morao? Litaelo tsa ts'ebeliso li bonts'a liketsahalo tse latelang tse bohloko:

• likatse, hlooho e bohloko,
• atrophy ea optic
• ho hloka boroko, mathata a ho robala, ho tšoenyeha, bofokoli bo akaretsang, paresthesia,
• mesifa ea mokokotlo, myalgia, myositis
• batho ba nkang nicotinic acid, Cyclosporin kapa Gemfibrozil, ba eketsa kotsi ea rhabdomyolysis,
• thrombocytopenia, hemolytic anemia,
• ho opeloa ke pelo, lefu la kahare la cholestasis, ho nyekeloa ke pelo, lefu la ho ruruha lefu la botšehali, lefutso, tatso e litšila, ho qhekella, jaundice ea cholestatic, lets'ollo,
• eketseha tšebetso ea creatine phosphokinase le transaminases ea sebete,
• keketseho ea bilirubin le alkaline phosphatase,
• Edema ea Quincke, lehare, ho hlohlona, ​​arthralgia, urticaria,
• alopecia le potency e fokotsehileng.

Ho sebelisa lithethefatsi tse ngata

Ka taolo e sa lebelloang ea litekanyetso tse phahameng tsa moriana, matšoao a itseng ha a bonoe ho mokuli.

Ha motho ea hlokometsoeng a hlokomela maemo a amanang le bophelo, o hlatsoa ka mpeng 'me a joe lipeipi tsa hae. Hape, mokuli o hlahlojoa bakeng sa mesebetsi ea bohlokoa, ts'ebetso ea sebete le ts'ebetso ea creatine phosphokinase.

Ho sebelisana le lithethefatsi

Ho sebelisoa ka nako e le 'ngoe ea lero le leholo la morara, hammoho le Gemfibrozil le Fenofibrat, ho kenya letsoho kotsing e kholo ea ho nts'etsapele myopathies.

Ho nka sethethefatsi sena ka nicotinic acid, Clarithromycin, Erythromycin, Cyclosporin, meriana ea antifungal (Itraconazole, Ketoconazole), Nefazodone le Ritonavir ho lebisa kokeletsong ea lithethefatsi maling le tšilafalo ea mesifa. tishu le kotsi ea ho ba le myopathy.

Tsamaiso e kopanetsoeng ea "Lovastatin" e nang le "Warfarin" e eketsa monyetla oa ho tsoa mali.

Moriana "Colestyramine" o fokotsa bioavailability ea moriana o botsoang. Ka hona, nako ea nako pakeng tsa lijo tsa bona e lokela ho ba bonyane lihora tse 2-4.

Litsenyehelo tsa lithethefatsi le li-analogues tsa eona

Hajoale, ho ke ke ha khoneha ho reka meriana ena litlolong tsa litlama tsa meriana le litoropong tse ling tsa Russia. Haeba ho hlokahala, e ka laeloa ka World Wide Web. Litheko tsa litlhare tse fumanehang marang-rang li fapana haholo. Setlhare sena se ka rekoa ka li-ruble tse 300-600.

Haeba ho hlokahala, sethethefatsi seo ho buuoang ka sona se ka nkeloa sebaka ke lithethefatsi tse joalo ka Apextatin, Fluvastatin, Cardiostatin, Iinvastin, Vero-Lovastatin, Pravastatin, Holetar, Lovasterol, Mevacor , Mevinacor, Lovacor.

Tlhahlobo ea lithethefatsi

Joale ua tseba hore na lipilisi tse kang Lovastatin ke eng. Litaelo, sebopeho, tšebeliso, papiso ea meriana ena li hlalositsoe sehloohong sena.

Ho latela litsebi, lithethefatsi tse fokotsang lipid li sebelisoa kalafong e rarahaneng, hammoho le thibelo ea lefu la atherosmithosis le mathata a lona.

Molao-motheo oa ketso ea moriana ona ke ho fokotsa litaba tsa lipoprotein tsa atherogenic maling

Ho latela lingaka, hajoale ho na le boiphihlelo bo bongata bo fumanoeng ts'ebelisong ea Lovastatin. Ke e 'ngoe ea litlhare tse sireletsehileng ka ho fetisisa. Setlhare sena se na le mamello e ntle nakong ea phekolo ea nako e telele.

Litletlebo tsa litla-morao li fumaneha seoelo litlhahlobo tsa mokuli. Ka nako e 'ngoe moriana ona o ka baka lefufuru, lets'ollo, bohloko ba ka mpeng, ho sokela, ho hloka boroko le bohloko ba mesifa. Ka tloaelo, likarabelo tse joalo li nyamela kamora libeke tse peli kamora ho qala kalafo kapa ka lebaka la phokotso ea litekanyetso.

Lovastatin ea lithethefatsi: mochini oa ts'ebetso le litlhahlobo

Sehlopha sa statins (lithethefatsi tse theolelang cholesterol) se kenyelletsa Lovastatin e sebetsang. Setlhare ha se sebelisoe feela kalafong ea hypercholesterolemia, hyperlipoproteinemia, empa hape le thibelong ea mafu a pelo.

Setlhare se tlameha ho sebelisoa hammoho le lijo tse khethehileng, boikoetliso le phetoho ea boima ba 'mele. Sengoliloeng sena, o ka ithuta ho eketsehileng ka Lovastatin, litaelo tsa tšebeliso, theko, litekolo, li-analogues.

Litaelo tsa tšebeliso ea lithethefatsi

Lovastatin 20 mg kapa 40 mg e hlahisoa ka sebopeho sa tafole, motsoako o sebetsang oa eona o nang le lebitso le tšoanang. Lintho tse ling tsa lithethefatsi ke lactose monohydrate, starch, cellulose, magnesium stearate, butylhydroxyanisole, citric le ascorbic acid.

Setlhare se rekisoa feela ha motho a fuoa lengolo la ngaka le eena. Ha o reka sethethefatsi, mokuli o lokela ho ela hloko se kenyelelitsoeng. Taeo e na le lipontšo tse 'maloa tsa ts'ebeliso ea lithethefatsi tsena:

• kalafo ea mofuta oa mantlha oa hypercholisterinemia IIa le IIb,
• hyperlipoproteinemia therapy (e rarahaneng ka lefu la tsoekere le nephrotic syndrome),
• kalafo ea coronary atherosulinosis (hammoho le kalafo ea vithamine le acid e sa mafura),
• thibelo ea methapo ea pelo,
• hypertriglyceridemia kalafo.

Ts'ebeliso ea matlapa e tlameha ho etsoa nako e le 'ngoe ka letsatsi nakong ea lijo tsa mantsiboea. Litekanyetso tsa lithethefatsi li itšetlehile ka lefu lena. Kahoo, ka hyperlipidemia, ho fanoa ka tekanyetso e le 'ngoe ea 10-80 mg.

Phekolo ea psychology e qala ka litekanyetso tse nyane, ka tumello ea ngaka, li ka eketseha butle butle. Ho khothalletsoa ho khetha litekanyetso ka mor'a libeke tse 'ne.

Tekanyetso e phahameng ka ho fetisisa (80 mg) e ka aroloa ka tekanyetso tse peli - hoseng le mantsiboea.

Ka kalafo ea coronary atherosclerosis, litekanyetso tse nepahetseng ke 20 mg mg. Haeba phekolo e sa sebetse, keketseho ea ho fihlela ho 60-80 mg ea khonahala. Haeba mokuli a ntse a nka fiber kapa nicotinic acid ka nako e le 'ngoe, Lovastatin ha ea lokela ho sebelisoa ho feta 20 mg ka letsatsi. Hape, litekanyetso li lokela ho fokotsoa maemong a joalo:

1. Ts'ebeliso e ts'oanang ea li-immunosuppressants.
2. Ts'ebeliso ea litlhare tse thibelang likokoana-hloko.
3. Pheko ka lithethefatsi tsa antifungal.
4. Phekolo ea mafu a sebete a etiology e itseng kapa e akaretsang.
5. Tšebeliso ea lithethefatsi tse nang le li-anticoagulants.

Hoa hlokahala ho boloka moriana ka mocheso o sa feteng 25 degrees Celsius.

Kamora letsatsi la ho felloa ke nako, e leng lilemo tse 2, ho thibetsoe ho sebelisa sehlahisoa.

Contraindication le litla-morao

Lovastatin e na le lenane le lenyane la li-contraindication. Ts'ebeliso ea lithethefatsi ha ea lumelloa ho lefu la myopathy (lefu le sa foleng la mokokotlo oa mokokotlo), boimana, cholestasis, ho senyeha ha sebete, ka tlase ho lilemo tse 18 le hypersensitivity ea motho ka mong ho likarolo.

Moriana o lokela ho sebelisoa ka hlokolosi ho bakuli ba fetileng mokokotlong oa mokokotlo oa mokokotlo o fetang ka potlako. Ha ho na joalo ha u lokela ho sebelisa meriana ka joala.

Maemong a mang, moriana o ka baka litlamorao. Har'a bona, ho bohlokoa ho totobatsa:

• Lintho tse amanang le mosebetsi oa pampitšana ea ka mpeng: litlhaselo tsa ho nyekeloa ke pelo, ho chesoa ke pelo, ho eketseha ha khase, phetoho ea tatso, lets'ollo, ho nkeloa sebaka sa ho sokela.
• Mathata a tsamaiso ea methapo e ka hare: hlooho e bohloko, boroko bo fokolang, ho tšoenyeha, ho tsekela, paresthesia, myositis, mesifa ea mokokotlo le myalgia. Ha u sebelisa cyclosporine, gemfibrozil kapa nicotinic acid, ho na le monyetla oa ho rhabdomyolysis.
• Reaction of biliary system: ts'ebetso e eketsehileng ea bilirubin, alkaline phosphatase, sebete transaminases le creatine phosphokinase. Ka linako tse ling hepatitis, cholestatic jaundice le biliary cholestasis lia khoneha.
• Litla-morao: Ho hlohlona, ​​lekhopho la letlalo, urticaria, angioedema, arthralgia.
• Ho sitisoa ha lintja tsa mahlo: atrophy ea methapo ea kutlo le nts'etsopele ea likatse.
• Litlamorao tse ling: potency e fokotsehile, malaise ka kakaretso, alopecia.

Matšoao a bosholu ba joala ha u sebelisa litekanyetso tse kholo tsa moriana ha li bonoe. Motheo oa phekolo ke ho felisoa ha Lovastatin, sefuba se tsoang ka mpeng, tšebeliso ea litlolo (ts'ebetso ea khase e entsoeng ka matla, Smecta, Polysorb, Atoxil) taolo ea mesebetsi ea bohlokoa, ts'ebetso ea sebete le ts'ebetso eaine ea phosphokinase.

Ho sebelisana le mekhoa e meng

Lovastatin ha ea lokela ho sebelisoa le lithethefatsi tsohle, hobane ho sebelisana le bona ho ka lebisa ho se ts'oaneng ha 'mele. Ho feta moo, meriana e meng e ka eketsa khatello ea ntho e sebetsang, 'me e meng e ka fokotseha.

Kotsi e kholo ea ho senyeha ha mesifa le myopathy, hammoho le keketseho ea litaba tsa karolo e sebetsang, e baka tšebeliso e tšoanang ea Lovastatin hammoho le nicotinic acid, Cyclosporine, Ritonavir, Erythromycin, Nefazodone le Clarithromycin.

Tšebeliso e rarahaneng ea lithethefatsi e nang le lero la grapefruit, fenofibrate, gemfibrozil le eona e eketsa menyetla ea myopathy.

Monyetla oa ho tsoa mali o eketseha ka tšebeliso e tšoanang ea warfarin. Bioavailability ea lovastatin e fokotseha ha u sebelisa colestyramine. E le hore bioavailability ea moriana e lule e tloaelehile, hoa hlokahala ho sebelisa lithethefatsi ka karohano ea lihora tse 2-4.

Ka mafu a kopaneng, mokuli o lokela ho buisana le ngaka mabapi le ho sebelisa meriana.

Tse ling tsa tsona ha li lumellane le Lovastatin, ka hona, ts'ebeliso e ikemetseng ea lithethefatsi e thibetsoe ka thata.

Litsenyehelo, analogues le tlhahlobo ea mokuli

Ka bomalimabe, hajoale ha ho khonehe ho reka Lovastatin hobane Ha e hlahisoe Russia.

Likhamphani tsa meriana tse kang Lekpharm (Belarus), Replekpharm AD (Macedonia) le Kievmedpreparat (Ukraine) ke baetsi ba lithethefatsi.

Mabapi le sena, ngaka e ka fana ka analog ea Lovastatin, e nang le thepa e tšoanang ea kalafo.

Meriana e tsebahalang haholo ke:

1. Holetar. E na le karolo e sebetsang - lovastatin, ka hona e ts'oana ha Lovastatin. Setlhare se na le matšoao a tšoanang, li-contraindication le maikutlo a mabe joaloka Lovastatin.
2. Cardiostatin. Sethethefatsi se seng se tsebahalang ke se tšoanang ho Lovastatin, hobane e na le motsoako o tšoanang. Ha o nka Cardiostatin, kalafo e boletsoeng e bonoa libeke tse peli, 'me e phahameng kamora libeke tse' ne tse tšeletseng tsa moriana. Theko e tloaelehileng ke li-ruble tse 290 (ka paketeng ea matlapa a 30 a 20 mg).
3. Pravastatin. E na le ts'ebetso e mengata. Motsoako o sebetsang ke pravastatin. Setlhare sena se sebelisetsoa hypercholesterolemia ea mantlha le dyslipidemia, hammoho le thibelo ea lefu la pelo la ischemic. Ts'ebeliso ea Pravastatin e ka khonahala e le tšireletso ea bobeli bakeng sa infarction ea myocardial, angina pectoris le hyperlipidemia ea post-transplant.
4. Zokor. Ntho e sebetsang ea lithethefatsi ke simvastatin. Letšoao le ka sehloohong la lithethefatsi ke kalafo ea hypercholesterolemia. Zokor e boetse e sebelisoa e le prophylactic ho thibela nts'etsopele ea methapo ea pelo. Litsenyehelo tse tloaelehileng ke li-ruble tse 380 (matlapa a 28 a 10 mg) le li-ruble tse 690 (matlapa a 28 a 20 mg).

Ho ea ka Vyshkovsky Index, baetapele ba 'marakeng oa meriana oa Russia ke Cardiostatin, Mevacor, Holetar le Rovacor.

Likarabo mabapi le Lovastatin, ka bobeli ho tsoa ho bakuli le lingaka li ntle. Moriana o bolokehile hape o mamelloa hantle ke bakuli, leha o sebelisoa ka nako e telele.

Lintho tse amanang le lefu la dyspeptic ka linako tse ling li hlaha qalong ea phekolo. Kamora libeke tse peli, ha mmele o tloaela ho susumetsa karolo e sebetsang, matšoao a emisa. Nako le nako, maemo a ALT le AST a eketseha, ka hona ho hlokahala ho laola litaba tsa bona.

Kamora likhoeli tse 1.5 ho tloha ha ho qala kalafo, ho etsoa tlhahlobo ea tlhahlobo. Ha e le molao, ho na le tšekamelo e ntle litekanyetsong, i.e. lipid mahloriso ea fokotseha.

Mokhoa oa ho fokotsa cholesterol e hlalositsoe videong ena.

Tšoaea tsoekere ea hau kapa u khethe botona bakeng sa likhothaletso Ho Batla ha ho fumanoe Ho batla ha ho fumanoeKe Ho Batla ha ho fumanehe

Sokolla foromo le sebopeho

Mofuta oa litekanyetso tsa ho lokolloa hoa Lovastatin ke matlapa: selika-likoe se chitja, se sesoeu se nang le 'mala o moputsoa, ​​se nang le bevel (ka kh'outeng ea mekotla e meraro ea li-1-3 contour cell tsa 10, 15 kapa 20).

Letlapa la 1

• ntho e sebetsang: lovastatin - 20 kapa 40 mg (ho latela 100% e omileng),
• likarolo tse thusang: colloidal silicon dioxide, magnesium stearate, starch ea poone, butylhydroxyanisole, cellcose ea microcrystalline, tsoekere ea lebese.

Pharadodynamics

Lovastatin ke ntho e thibelang tlhaho ea cholesterol e ka har'a sebete. Ntho e 'meleng ka sebopeho sa lactone e sa sebetseng e kenngoa ka mokhoa o ikhethileng ka sebopeho se lumellanang se sebetsang sa kalafo, se sebetsang joalo ka inhibitor ea 3-hydroxy-3-methylglutaryl-coenzyme-A reductase (HMG-CoA reductase). Ona ke mohopolo o khothaletsang phetoho ea HMG-CoA ho mevalonate, e leng mohato oa pele ho cholesterol biosynthesis.

Litlamorao tse ka sehloohong tsa lovastatin:

• Ho fokotseha hoa cholesterol e felletseng ea mali le cholesterol ho LDL le VLDL (lipoprotein tse fokolang haholo le lipoprotein tse fokolang haholo),
• ho fokolisa ho fokotseha hoa se ka hare ho apolipoprotein B, khatello ea li-triglycerides maling a mali le keketseho e leka-lekaneng ea mahloriso a HDL (high density lipoproteins),
• ho tsitsa, ho ntlafatsa ts'ebetso ea endothelial, antithrombogenic le anti-inflammatory athari (kenya letsoho phello ea antiatherosranceotic).

Phello e boletsoeng ea kalafo ea lovastatin e hlaha matsatsing a 14, mme e phahameng ka mora likhoeli tse 1-1,5 tsa tsamaiso e hlophisitsoeng. Ka nako e tšoanang ka mor'a ho tlohela kalafo, phello e phehella. Ka tšebeliso ea nako e telele (ho fihlela lilemo tse 5), ts'ebetso ea lovastatin ha e fokotsehe.

Mofumahali

Lovastatin e kenella kahare ho tšilo ea lijo (gastrointestinal pampiri) butle ebile e sa sebetse - e ka bang 30% ea lethal dose. Ha ho nkoa ka mpeng e se nang letho, ho monya ho fokotseha ka 1/3 ha ho bapisoa le ts'ebeliso le lijo.

Tmax (nako ea ho fihlela boholo ba mahloriso) e tsoa lihora tse peli ho isa ho tse 'nè, Cmax (boholo ba mahloriso) ke 7.8 le 11.9 ng / ml (bakeng sa lovastatin le beta-hydroxyacids), ebe mahloriso a plasma a fokotseha ka potlako. Kamora lihora tse 24, ke 10% ea boholo bo phahameng. Puisano le liprotheine tsa plasma ea mali - 95%. Ka tekanyetso e le 'ngoe bosiu, tumello ea lovastatin le metabolites ea eona e sebetsang e fihlella ka mor'a lihora tse 48-72.

E kenella ka har'a mali-bokong le ka sehikeng sa placental.

Ha a feta ka har'a sebete ka lekhetlo la pele, lovastatin e feta metabolism e matla, oxidates ho beta-hydroxy acid, 6-hydroxy derivative ea eona le metabolites tse ling, tse ling tsa tsona li bonts'a ts'ebetso ea pharmacological (ba thibela HMG-CoA reductase). Li-isoenzymes tsa CYP3A4, CYP3A7 le CYP3A5 li kentse letsoho ho metabolism ea lovastatin.

T_1/2 (halofo ea bophelo) ke lihora tse 3. 83% ea lethal dose e lutla ka mala, 10% - ke liphio.

Matšoao a ho sebelisoa

• maemo a phahameng a serum ea cholesterol e felletseng, LDL cholesterol le triglycerides e serum ea mali ho bakuli ba nang le hypercholesterolemia ea mantlha (ho latela mefuta ea Fredrickson mefuta IIa le IIb), ho kenyelletsa hyperlipidemia ea setho sa lelapa, polygenic hypercholesterolemia le heterozygous hypercholesterolemia toast in the end of theatin mehato e meng e seng ea lithethefatsi
• coronary atherosclerosis ho bakuli ba nang le lefu la pelo (coronary pelo lefu la pelo): kalafo e etsoa ho fokotsa tsoelo-pele ea eona.

Hyperlipidemia

Motsoako oa letsatsi le letsatsi oa Lovastatin o khothalelitsoeng ke 10-80 mg hang ka letsatsi.

Ho bakuli ba nang le hypercholesterolemia e leka-lekaneng, lethal dose la pele hangata le ba 20 mg hang ka letsatsi mantsiboea, ka tlhaiso ea lefu lena (plasma kakaretso cholesterol maling - ho tloha ho 7.8 mmol / l) - 40 mg. Ho fihlella maemo a cholesterol a lebisitsoeng, tekanyetso e ka eketsoa ho 80 mg (boholo) ka tekanyetso e le 'ngoe kapa ho feta (hoseng le mantsiboea).

Fetola lethal dose le likotsi nako e ka etsang libeke tse 4. Haeba tekanyo ea mahloriso a cholesterol e felletseng ka plasma ea mali e theohela ho 140 mg / 100 ml kapa cholesterol ea LDL ho 75 mg / 100 ml, tekanyo ea Lovastatin e ka fokotsoa. Ha e kopantsoe le cyclosporine, fibrate kapa nicotinic acid (ho tloha ho 1000 mg ka letsatsi), lethaliti ha lea lokela ho feta 20 mg ka letsatsi. Bakeng sa bakuli ba nang le bothata bo matla ba ho phekola ba le reisine ka tumello e tlase ho 30 ml / min, moriana o beoa tlasa tlhokomelo ea bongaka (lethal dose le phahameng - 20 mg ka letsatsi).

Lovasterol - litaelo tsa tšebeliso

Babali ba rona ba sebelisitse Aterol ka katleho ho theola cholesterol. Ha re bona sehlahisoa sena se tsebahala, re nkile qeto ea ho e ela hloko.

Leqepheng lena: litlhaloso tsa lithethefatsi Lovasterol, litla-morao tsohle, li-contraindication le litaelo tsa ho sebelisa lithethefatsi Lovasterol li nkoa.

Lebitso la machaba leo e seng la tšireletso la ntho e sebetsang ke tlhaiso-leseling ea mantlha mabapi le lithethefatsi. Taba ke hore, joalo ka molao, lithethefatsi tse nang le ntho e le 'ngoe e sebetsang li hlahisoa tlas'a mabitso a fapaneng a khoebo, ke hore, ena ke moriana o le mong, empa o hlahisoa ke lik'hamphani tse fapaneng. Ke INN e thusang lingaka ho khetha sesebelisoa se nepahetseng ho tsoa palo e kholo ea lithethefatsi tse fumanehang 'marakeng oa litlama.

Foromo ea tokollo:

Lipilisi
1 tab
lovastatin
20 mg
Li-pcs tse 10 - Liphutheloana tsa lithutsoana (3) - lipakete tsa karete.

Lipilisi
1 tab
lovastatin
10 mg
Li-pcs tse 10 - Liphutheloana tsa lithutsoana (3) - lipakete tsa karete.

Lipilisi
1 tab
lovastatin
40 mg
Li-pcs tse 10 - Liphutheloana tsa lithutsoana (3) - lipakete tsa karete.

tab. 20 mg: li-pcs tse 30.

tab. 10 mg: li-pcs tse 30.

tab. 40 mg: li-pcs tse 30.

Lefu la Cerebrovascular: mefuta, lisosa, matšoao, tlhahlobo ea mali, mokhoa oa ho phekola

Lefu la Cerebrovascular (CVB) ke lefu la methapo ea methapo, le isang ho ischemia, hypoxia le tlolo ea mesebetsi e fapaneng ea 'mele. Tlas'a tšusumetso ea lintho tse mpe tsa kantle le tlhaho, likepe tsa likhoerekhoere lia senyeha, 'me ho potoloha ha lisele ho a senyeha.

Lefu la cerebrovascular le lebisa nts'etsopele ea discirculatory encephalopathy - lefu le tsoelang pele le phela ka lesapo la mokokotlo le bakoang ke ho haella ha methapo ea methapo. Pelehi ena e ne e nkuoa e le bothata ba batho ba tsofetseng. Hajoale, ho haella ha "calbrovascular" ke "nyane": lefu lena le ntse le eketseha ho batho ba ka tlase ho lilemo tse 40. Sena se bakoa ke bophelo bo seng kotsi, tikoloho e mpe, phepo e nepahetseng.

Lefu la Cerebrovascular hajoale ke bothata bo boholo ba bongaka. O boemong ba boraro ka sebopeho sa batho ba shoang ka mor'a lefu la pelo le lefu la pelo. CVI ke sesosa sa ho otloa le ho holofala nako e telele.

Tlhomamiso

Mafu a amanang le ho ruruha - mafu a tsamaiso ea potoloho, a kenyeletsang:

• Hemorrhagic le stroke.
• Ramatiki e sa feleng ea kelello - bokong le vasospasm, arteritis, aneurysm.
• Intracranial hemorrhage.
• Lefu la khatello ea methapo ea pelo - atherosselotic and hypertensive encephalopathy.

Lisosa tse ka sehloohong tsa lefu lena:

1. Lits'oants'o tsa methapo ea methapo ea methapo ea methapo li lebisa ho keneng k'holeseterole, ho thehoa hoa litokomane, ho fokotseha ha tsona le ho phatloha ha tsona, 'me kamora nako e' ngoe ke tlolo ea molao ea phepelo ea mali ea mokokotlo, trophism ea boko le ts'ebetso ea kelello.
2. Ho se sebetse hantle ha tsamaiso ea methapo ea mali, thrombosis le thromboembolism hangata ho baka ho hloka taolo ha methapo ea methapo.
3. Spasm ea lebota la arterial moo ho nang le khatello ea mali e sa foleng e fokotsa phallo ea mali a methapo.
4. Vasculitis e sitisa phepelo ea mali ho ea bokong.
5. Osteochondrosis e ka lebisa ho se lekane ha vertebro-basilar le mathata a nakoana a ho potoloha ha lisele.

Lintlha tse hlahisang nts'etsopele ea pathology:

Babali ba rona ba sebelisitse Aterol ka katleho ho theola cholesterol. Ha re bona sehlahisoa sena se tsebahala, re nkile qeto ea ho e ela hloko.

• Lefu la tsoekere
• Boloetse
• Hypercholesterolemia, dyslipidemia,
• Ho Nona Haholo
• Phaello ea mali
• Lefu la pelo ea Ischemic,
• Khatello ea maikutlo
• Bohloko bo hlokofatsang bokong
• Tšebeliso ea nako e telele ea lithibela-pelehi tsa molomo,
• Ho tsuba
• Mokhoa oa bophelo bo iketlileng
• Boholo.

Matšoao a matšoao

Lefu la cerebrovascular qalong ea kholo ea lona le hlaha ka matšoao a latelang a kliniki:

1. Ts'ebetso e fokotsehileng, mokhathala o eketsehileng,
2. Ho teneha, ho ferekana, ho hloka botsitso maikutlong,
3. Ho tšoenyeha ho feteletseng
4. Ho hloka boroko
5. Ho utloa mocheso
6. Molomo o omileng
7. Asthenia
8. Lipelo tsa pelo.

Bokamosong, ha hypoxia ea boko e eketseha, ho hlaha mathata a kotsi 'me ho hlaha matšoao a tebileng: ho sitoa ho tsepamisa mohopolo, ho se tsebe hantle hantle kelellong, ho nahana ka mokhoa o sa nepahalang, ho beha mabaka, ho hokahana, ho opa hlooho khafetsa, ho fokotsa ts'ebetso ea kelello.

Ho bakuli, khatello ea maikutlo e etsahala, bohlale bo fokotseha, neurosis le psychosis, phobias le tšabo li nts'etsapele, egocentrism, ho phatloha, pelo e fokolang e hlaha. Bakuli ba fetoha hypochondriacal le ho se sireletsehe. Maemong a tebileng, ho thothomela, ho thothomela, ho se tsitsinyehe, puo e sa tsitsang, ho sisinyeha le kutloelo-bohloko liphatong tsa maoto le matsoho lia ntlafala, 'mele o oa fela,' me litho tsa pono lia ameha.

Keketseho e 'ngoe ea liphetoho tsa morphological liseleng tsa boko li lebisa ponahalong ea manonyeletso a tsebahalang le a hlokomelehang haholo - likotsi tsa likhoerekhoere, marang-rang le litho tsa litho tsa maoto, likhathatso tsa pelvic, dysphagia, litšeho tse mpe le ho lla.

Matšoao ana a kliniki a teng ho bakuli letsatsi lohle a bontša tlolo ea molao ea ho potoloha ha lets'ollo - stroke. Haeba li nyamela ka nako e khuts'oane, ho belaelloa ho hlasela nakoana.

Li-degree tsa 3 tsa mafu a amanang le lefu la letsoai li khethollotsoe:

• CVB ea degree ea pele ha e bonoe. Matšoao a eona a ka litsela tse ngata tse tšoanang le matšoao a mafu a mang kapa likotsi.
• Sekala sa bobeli se bonahatsoa ke mathata a kelello. Lefu lena ke sesupo sa ho bontša ho holofala, empa mokuli oa itšebeletsa.
• Karolo ea boraro ke phetoho ea methapo ea methapo ea methapo ea methapo ea methapo ea methapo. Mokuli ha a khone ho tsamaea le ho tsamaea sepakapakeng; o hloka thuso le tlhokomelo ea batho ba mo potileng. Boitšoaro ba bakuli ba joalo bo lokela ho laoloa.

Mathata a atileng haholo a CVB ke: ho otloa, ho hlaseloa ha nakoana ke khatello ea kelello, khatello ea maikutlo, ho ferekana kelellong.

Ts'oaetso

Ho khetholla le ho phekola lefu la methapo ea methapo e amanang le methapo ho kenyelletsa litsebi tsa methapo ea kutlo le lingaka tse sebetsanang le methapo. Ba khetha mekhoa ea phekolo ho latela litšobotsi tsa lefu lena, boemo ba mokuli le ho ba teng ha bokuli bo kopaneng.

Tlhahlobo e akaretsang ea bakuli ba nang le CVI e kenyeletsa:

1. Teko ea mali a Clinical
2. Khemistri ea mali
3. Qeto ea index ea prothrombin,
4. Karabelo ea serological ho syphilis,
5. ECG
6. Urinalysis
7. Se-x-ray.

Mekhoa e etselitsoeng tlhahlobo e felletseng le e phethahetseng ea ts'ebeliso ea mafu a amanang le lefu la letsoele:

• Duplex kapa triplex angioscanning e etselitsoe ho fumana tšoaetso ea mantlha ea CVB. Ke eona e sireletsehileng ka ho fetisisa, e potlakileng ebile e theko e tlaase. Ka tsela ena, likepe tse amehang li ka hlahlojoa khafetsa ntle le ho senya bophelo bo botle.
• Angiography ke mokhoa oa phapanyetsano ea x-ray ea methapo ea mali, e lumellang ho tseba hore na boemo ba bona bo sebetsang, ho ba teng ha ts'ebetso ea methapo ea methapo le bolelele ba eona. Cerebral angiography e etsoa ka mor'a ho tsamaisoa ha moemeli ea fapaneng le mali. E lumella mokuli ho tseba ho ba teng ha thrombosis, lesapo la mokokotlo le vasoconstriction, oncopathology, hematoma le aneurysm.
• Brain scintigraphy ke mokhoa o bonolo ebile o sa hlaselleng lipatlisiso oo ho oona ho se nang likhohlano ebile o sa bake mathata. Ho hlahlojoa ha nyutlelie ke tsela e tebileng le e rutang ea ho fumana kotsi ea methapo ea methapo. Sethethefatsi se sebetsanang le radioacological se kenngoa mothapong, 'me kamora metsotso e 15 ho etsoa scan ninete. Nako ena e lekane hore radioisotope e hasane hohle ho pholletsa le 'mele le ho bokellana ka lithane tse fetotsoeng. Letšoao le na le lethal dose ea mahlaseli a kotsi a seng kotsi 'meleng.
• Transcranial Doppler ultrasound ke mochini o hlahang ka har'a methapo ea methapo e lekang lebelo la phallo ea mali le ho senola litšitiso tsa hemodynamic.
• Ha ho na thuso e kholo ho fumanoeng ha CVB ke MRI le CT.

Ho thata ho tsebahatsa le ho phekola lefu la sethoathoa. Ke setsebi se nang le boiphihlelo se nang le tsebo, se ithutileng litletlebo tsa mokuli le ho mo hlahloba ka botlalo, ke sona se tla fana ka kalafo e nang le bokhoni. Phekolo e lekaneng le e nakong e tla ntlafatsa boleng ba bophelo ba mokuli le ho fokotsa kotsi ea ho ba le boemo bo behang bophelo kotsing - stroke.

Morero oa mantlha oa kalafo ea lefu lena ke ho felisoa ha litšitiso tsa mesebetsi ea boko. E le ho felisa ka botlalo lefu la "cerebrovascular pathology", ho hlokahala hore ho khetholloe le ho felisa sesosa sa eona. Ntle le ho fana ka litlhare, litsebi li fa bakuli litlhahiso tsa bohlokoa: fetola tsela eo ba phelang ka eona, ba fokotse boima ba 'mele, ba se ke ba tsuba kapa ba sa noe joala, ja hantle le ka tekano.

Phekolo ea lithethefatsi

Phekolo e phethahetseng ea lefu la ho ferekanya kelello hangata e etsoa lefapheng la methapo. Litsebi li tlosa mabaka a kotsi ka ho khetheha: fana ka litlhare tse thibelang mafu, lithethefatsi, hypoglycemic. Ke feela kamora hore khalemelo ea metabolism ea mantlha e tsoele pele ho kalafo e tobileng ea methapo.

Pheko e khethehileng

Lihlopheng tse ka sehloohong tsa lithethefatsi tse ntlafatsang ho potoloha ha kokoana-hloko 'me li reretsoe kalafo ea ho hloka khaello ea phepo e ntle ea kelello:

1. Lithane tsa calcium calcium li ntlafatsa phallo ea mali a khubung, lebelo le tlaase la ho sisinya, ho hokahana ha liplatelete le ho ntlafatsa sebopeho sa mali. Lithethefatsi tse thehiloeng ho nifedipine li theola lijana tsa bokong - Corinfar, Kardipin, lithethefatsi tse tsoang sehlopheng sa diltiazem Dilzem, Kardil. Cinnarizine le tse tsoang ho eona, Verapamil, le tsona ke karolo ea li-blockchain tsa calcium calcium.
2. Li-antioxidants. Antioxidant e matla e laetsoeng lefu la "cerebrovascular", "stroke" le "encephalopathy" ke Cerebrolysin. Ntle le eona, Cerebrocurin le Actovegin hangata li sebelisoa.
3. Li-antihypoxants li fanoa bakeng sa lefu la cerbrovascular - Ketoprofen, Imidazole, Mekaprin.
4. Metabolics - "Cavinton", "Sermion", "Vinpocetine", "Tanakan".
5. Li-anticoagulants tse tobileng - "Heparin", "Fraxiparin" le tse sa tobang - "Phenilin", "Sincumar", "Warfarin".
6. Pheko ea antiplatelet - "Acetylsalicylic acid", "Curantyl".
7. Meriana e nang le ts'ebetso ea hypocholesterolemic, li-statins - "Lovastatin", "Lipostat", "Probucol", "Tykveol".
8. Lithethefatsi tsa Nootropic - Omaron, Piracetam, Pantogam, Glycine, Phenibut.
9. Meriana e tlotsang lijana tsa boko - Pentoxifylline, Trental, Agapurin.
10. Antispasmodics - "Papaverine", "Eufillin", "Dibazol."

Phekolo ea mantlha

Phekolo ea mantlha ea CVB ke ho nolofatsa ts'ebetso ea ho hema ka ntle, tsamaiso ea methapo ea pelo, ho boloka homeostasis le neuroprotection.

• Ho etsa sena, etsa hore moea o kenelle hantle, kenella ka hare ho "trachea", 'me u kenye moea o mongata oa matšoafo.
• PHa matšoao a ho hloleha ha pelo le edema ea pulmonary e hlaha, ho sebelisoa “Lasix” le “Pentamine”.
• Phekolo ea antiarrhasmic e bontšoa ho bakuli ba pelo ea pelo. Khafetsa lithethefatsi tse khahlanong le lefu la antianginal, glycosides ea pelo - Strofantin, Korglikon, antioxidants.
• "Seduxen", "Haloperidol", "diphenhydramine", "sodium oxybutyrate" e tla thusa ho emisa mesebetsi ea limela.
• Ho loants'oa edema ea "cerebral edema" - ho sebelisoa li-opmotic diuretics - Mannitol, Furosemide.
• Ho tsitsisa khatello ea mali, Atenolol, Enalapril, Nifedipine, Dibazol li laetsoe.
• Khalemelo ea mathata a metabolic e etsoa ka ho pheta bophahamo ba mokelikeli oa extracellular ka tharollo ea Ringer, plasma, glucose.
• Phekolo ea matšoao e kenyelletsa lithethefatsi tse sebelisang anticonvulsant le psychotropic, restreshon ea mesifa, analgesics - "Analgin", "Ketorol", "Promedol".

Hyperbaric oxygenation ke mokhoa oa phekolo oa physiotherapeutic o fanang ka oksijene ea mali le ho kena ha eona liseleng tsa boko tse amehang. Mokuli o ka kamoreng e khethehileng 'me o phefumoloha oksijene e hloekileng. Hyperbaric oxygenation e tlosa mokoloto oa oksijene oa lisele mme e busetse glycolysis ea aerobic. Ts'ebetso ena e ntlafatsa boleng ba bophelo ba bakuli, e fokotsa matšoao a pathology mme e thibela nts'etsopele ea mathata a maholo.

Phekolo ea kalafo

Mefuta e matla ea lefu la kelello, le sa fumaneheng hantle bakeng sa khalemelo ea bongaka, e hloka ts'ebetso ea bongaka. Bakuli ba tlosoe mali le methapo ea methapo ea methapo methapong, ba phahamisa khanya ea likepe ba sebelisa catheter le balune, 'me masenke a kenngoa methapong e bolokang lumen ea sekepe e bulehile.

Maloetse a cerebrovascular a ka fuoa kalafo ea ho buoa: arterial aneurysms le hemorrhages ea intracerebral.

Motsoako oa batho

Moriana oa setso o sebelisoang haholo kalafong ea lefu la qoqotho:

• Motso oa peony o omisitsoe, fatše mme o tšeloa ka metsi a belang. Tsitlella pheko bakeng sa hora, hlatsoa 'me u nke makhetlo a 5 ka letsatsi bakeng sa khaba.
• Ka grinder ea nama, lilamunu tse 2 le lemone tse peli li sithabetse, boima bo kopantsoe le mahe a linotši a metsi ebe li tsoakane. Tsitlella ka letsatsi le batang, 'me u nke khaba makhetlo a 3 ka letsatsi.
• Li-needle tsa phaene li tšolleloa ka metsi a belang, li tsitlella le ho eketsa lero la halofo ea linoko ho moro. Nka moriana ona ka mpeng e se nang letho bakeng sa likhoeli tse tharo.
• Tinate ea Celandine e nooa ka mpeng e se nang letho makhetlo a mararo ka letsatsi bakeng sa libeke tse peli.

Phekolo ea setso ke tlatsetso e ntle phepong ea mantlha ea psychology.

Thibelo le bokuli

Mehato ea ho thibela nts'etsopele ea lefu la qoqotho:

1. Normalization ea khatello ea mali
2. Phekolo ea nako ea li-pathologies tse tšoanang
3. Ho loantša mekhoa e mebe
4. Boikoetliso bo bobebe
5. Phepo e nepahetseng
6. Khethollo ea mosebetsi le phomolo
7. Khalemelo ea boima ba 'mele.

Bakeng sa sepheo sa prophylactic, bakuli ba fuoa lithethefatsi tse ntlafatsang ho potoloha ha methapo ea mali le khatello ea mali.

Haeba lefu le phekoloa ka potlako le ka nepo, ho ka etsahala eseng feela ho ntlafatsa bophelo ba mokuli, empa le ho fokotsa kotsi ea ho otloa ke lefu la stroke le mathata a mang a tebileng.