Tulip 10

Sebopeho sa litekanyetso - matlapa a koahetsoeng ka filimi: 10 mg - e tsoeu kapa e batla e tšoeu e koahelang, HLA 10 e ngotsoe ka lehlakoreng le le leng, 20 mg e bobebe ea khoele ea filimi, HLA 20 e ngotsoe ka lehlakoreng le le leng, 40 mg - Filimi e tšoeu e nang le tint e sootho ka 'mala o mosehla, e koahelang lehlakore le le leng, "HLA 40" e ngotsoe ka ho ngoloa, matlapa a biconvex, selikalikoe - likarolo tse bosoeu (li-pcs tse 10, ka marang-rang, ka har'a pakete ea karete ea 3, 6, 9).

Letlapa la 1

• ntho e sebetsang: atorvastatin (ka sebopeho sa calcium atorvastatin) - 10, 20 kapa 40 mg,
• likarolo tse thusang: croscarmellose sodium, lactose monohydrate, polysorbate 80, hyprolose, colloidal silicon diode, magnesium stearate, boima magnesium oxide, cellcose ea microcrystalline,
• kobo ea filimi: hyprolose, hypromellose, macrogol 6000, talc, titanium dioxide, bakeng sa lethal dose ea 20 le 40 mg, ntle le moo, ironideide e putsoa.

Matšoao a ho sebelisoa

• hypercholesterolemia ea mantlha, heterozygous hypercholesterolemia ea lelapa le e kopaneng (e kopaneng) le mofuta oa IIa le IIb hyperlipidemia ho latela sehlopha sa Fredrickson - Tulip e sebelisoa hammoho le lijo tsa hypocholesterolemic ho fokotsa maemo a phahameng a cholesterol e felletseng (cholecol), density e tlase. B (apoV), thyroglobulin (TG), le ho eketsa bongata ba batho ba bangata ba nang le khatello ea methapo ea methapo ea methapo ea methapo ea methapo ea methapo (HDL-C), ha ho phekoloa feela lijo le mekhoa e meng eo e seng ea lithethefatsi ha li na thuso
• homozygous Famer hypercholesterolemia - ho fokotsa likhahla tse phahameng tsa LDL-C le cholesterol e felletseng, ha feela phekolo ea lijo le mekhoa e meng e seng ea lithethefatsi e sa sebetse ka ho lekana,
• mathata a pelo le bakuli ba se nang matšoao a lefu la pelo (CHD), empa ho na le mabaka a mang a tlisoang ke tlhabollo ea hae, joalo ka bokhoba ba nicotine, khatello ea maikutlo ea methapo ea methapo ea kutlo, retinopathy, lefu la tsoekere, albuminuria, lipalo tse tlase tsa plasma ea HDL-C, liphatsa tsa lefutso. bokamoso, ho kenyelletsa le semelo sa dyslipidemia, lilemo tse fetang lilemo tse 55 - bakeng sa thibelo ea mantlha,
• pelo le mathata a pelo ho bakuli ba nang le lefu la mokokotlo oa mokokotlo - lefu la mokokotlo la boemo ho fokotsa palo ea batho ba shoang, stroke, infraction ea myocardial, ho kenngoa sepetlele bakeng sa angina pectoris le tlhokeho ea ho nchafatsoa.

Contraindication

• ho senyeha ha sebete karolong e sebetsang,
• keketseho ea ts'ebetso ea plasma ea hepatic transaminases ea tšimoloho e sa tsejoeng ha e bapisoa le moeli o kaholimo oa tloaelehileng (VGN) makhetlo a fetang a 3,
• glucose-galactose malabsorption syndrome, ho se mamellane ha lactose, khaello ea lactase (ho kenyelletsa le lactose),
• boimana le nako ea ho anyesa (lactation),
• bana le bacha ba ka tlase ho lilemo tse 18 (katleho le polokeho ea ho nka atorvastatin sehlopheng sena sa bakuli ha li e-so theoe),
• eketsa kutloisiso ea motho ka mong bakeng sa likarolo tsa moriana.

Ka tlhokomeliso, Tulip e sebelisoa ha ho e-ba le ho leka-lekana ho hongata ha electrolyte, nalane ea lefu la sebete, tšebeliso e mpe ea joala, mafu a mesifa ea methapo le nalane ea methapo ea methapo ka lebaka la ts'ebeliso ea lithethefatsi tse ling tsa sehlopha sa HMG-CoA reductase inhibitors, metabolic le endocrine (hyperthyroidism ) mathata, ho ruruha ha methapo ea kutlo, lefu la tsoekere, ho ruruha haholo (sepsis), lefu la sethoathoa le sa laoleheng, ho buoa ka ho feteletseng, ho sithabela maikutlo, lipid tse mabifi ho fokotsa kalafo (atorvastatin ka tekanyo ea 80 mg) bakeng sa thibelo ea bobeli ea bakuli ba nang le nalane ea hemorrhagic kapa lacunar stroke.

Tekanyetso le tsamaiso

Pele a qala ts'ebeliso ea lithethefatsi Tulip, mokuli o lokela ho khothaletsa mokhoa oa ho ja oa hypocholesterolemic, o lokelang ho bonoa ho pholletsa le nako eohle ea kalafo le moriana.

Matlapa a nooa ka molomo, ho sa tsotelehe lijo.

Mofuta o khothalelitsoeng oa litekanyetso tsa letsatsi le letsatsi tsa Tulip ke 10-80 mg, lethal dose le khethehileng le khethoa ho ipapisitse le khatello ea LDL-C, sepheo sa kalafo le karabelo ea motho ka mong ea kalafo.

Tekanyetso ea pele maemong a mangata ke 10 mg ka letsatsi, e phahameng ka ho fetisisa - 80 mg ka letsatsi.

Qalong ea kalafo, kamora matsatsi a 14- 28 le / kapa ka keketseho e 'ngoe le e' ngoe ea lithethefatsi, motsoako oa plasma oa lipids o lokela ho hlahlojoa mme, ha ho hlokahala, tekanyetso ea atorvastatin e lokela ho fetoloa.

Tekanyetso e khothalletsoang:

• mantlha (heterozygous hereditary and polygenic) hypercholesterolemia (mofuta IIa) le hyperlipidemia (mofuta IIb): lethalinyana la 10 mg hang ka letsatsi hangata le lekane (matlapa a 10 le 20 mg a ka sebelisoa), haeba ho hlokahala, butle-butle eketsa litekanyetso ho 80 mg (2 matlapa a 40 mg), ho nahanisisa karabelo ea mokuli le ho bona karohano lipakeng tsa litekanyetso li eketseha ka matsatsi a 14-31, hobane phello ea kalafo e bonoa kamora matsatsi a 14, mme phello e phahameng ea kalafo e tlalehiloe kamora matsatsi a 28 mme e nka nako e telele. sefapano
• homozygous hereditary hypercholesterolemia: 80 mg (matlapa a 2 a 40 mg) nako e le 1 ka letsatsi,
• lefu la pelo le pelo (bakeng sa prophylaxis): 10 mg hang ka letsatsi, haeba khatello e nepahetseng ea plasma ea LDL e sa fihlelloe, hoa utloahala hore butle-butle eketsa tekanyetso ho 80 mg (matlapa a 2 a 40 mg), ho nka karabelo ea mokuli le ho bona karohano lipakeng tsa keketseho ea litekanyetso tsa 14 -8 matsatsi.

Ha ho na tokiso ea lethal ea Tulip e hlokahalang ho bakuli ba nang le ho hlleha ha renal le bakuli ba tsofetseng.

Ka ts'ebetso ea sebete e senyehileng, ho tlosoa ha atorvastatin 'meleng ho ea fokotseha, ka hona ho khothalletsoa ho e sebelisa ka hloko, nako le nako ho lekola ts'ebetso ea li-transaminase tsa hepatic: aspartate aminotransferase (ACT) le alanine aminotransferase (ALT).

Litlamorao

• tsamaiso ea methapo: hangata - hlooho ea hlooho, khafetsa - ho tšoenyeha ha boroko (ho kenyelletsa ho hloka boroko le ho luma bosiu, ho tsekela, ho hlaseloa ke lefutso, ho senyeha ha maikutlo, ho fokola hoa moea, bofokoli, ho lahleheloa ke mohopolo / tahlehelo, maikutlo a senyehileng a tatso, hangata - - neuropathy
• Litho tsa maikutlo: hangata - pono e fifalitsoeng, tinnitus, ka seoelo - ho senyeha ha pono, ka seoelo haholo - tahlehelo ea kutlo,
• tsamaiso ea tšilo ea lijo: hangata - - ho ruruha, ho sokela, ho nyekeloa, ho nyekeloa, lets'ollo, khafetsa - ho hlatsa, ho hlohlona, ​​hepatitis, pancreatitis, belching, bohloko ba ka mpeng, ka seoelo - cholestatic jaundice (ho kenyelletsa le mathata), hangata - ho hloleha ha sebete,
• tsamaiso ea musculoskeletal: hangata - ho ruruha ha manonyeletso, myalgia, arthralgia, bohloko bo kopaneng, mesifa ea mesifa, bohloko ba mokokotlo, hangata - bohloko bo ka har'a mesifa ea molala, myasthenia gravis, myositis e sa tloaelehang, myopathy, rhabdomyolysis, tendinopathy (ka linako tse ling pele ho mokokotlo oa tendon), khafetsa ho sa feleng - linyeoe tsa myopathy e sa sebetseng hantleng,
• Letlalong la letlalo le mokokotlo: hangata - - lekhopho la letlalo, ho hlohlona, ​​urticaria, alopecia, ka seoelo - rashous, le angioedema, erythema multiforme (ho kenyeletsoa Stevens-Johnson syndrome) le lefu la Lyell (le nang le chefo e matla).
• hematopoietic system: khafetsa - thrombocytopenia,
• metabolism: khafetsa - hyperglycemia, hangata - hypoglycemia,
• Sistimi ea phefumoloho: khafetsa - 'metso o bohloko, nasopharyngitis, nosebleeds,
• sesole sa mmele: khafetsa - li-hypersensitivity reaction, ka seoelo - anaphylaxis,
• matšoao a laboratori: khafetsa - keketseho ea tšebetso ea serum creatine phosphokinase (CPK), keketseho ea tšebetso ea ALT le AST, hangata - leukocyturia, khafetsa le sa lekanyetsoang - keketseho ea bongata ba hemoglobin ea glycosylated,
• maikutlo a mang: khafetsa - ho tepella ho eketsehileng, ho se sebetse hantle ha bohloko ba mokokotlo, ho senyeha ha pelo, ho opeloa ke sefuba, ho nona haholo, seoelo haholo - lefu la tsoekere, gynecomastia, empa ho na le bopaki bo amanang le ts'ebeliso ea atorvastatin. metheho e sa tsejoeng - khafetsa e sa tsejoeng - lefu la lipakeng la lipakeng (haholo-holo ts'ebeliso e telele), khatello ea maikutlo, ho hloka thobalano.

Tabeng ea mofuta o mongata oa Tulip, kalafo ea matšoao e ea hlokahala. Atorvastatin ha e na antidote e ikhethileng, mme hemodialysis ha e sebetse ka lebaka la tlamo ea bohlokoa ea lithethefatsi ho liprotheine tsa plasma tsa mali.

Litaelo tse khethehileng

Tulip, joalo ka li-statins tse ling (HMG-CoA reductase inhibitors), e ka eketsa ts'ebetso ea serum ea enzymes ea ACT le ALT ka makhetlo a fetang a 3 ha a bapisoa le VGN. Ka hona, ho hlokahala hore ho hlahlojoe matšoao a ts'ebetso ea sebete pele a sebelisa moriana, kamora libeke tse 6 le tse 12 ho tloha qalong ea kalafo le ka keketseho ea tekanyetso ea eona. Ho hlokomela li-indices tsa ts'ebetso ea sebete le hona hoa hlokahala ha matšoao a kliniki a lesion ea eona a hlaha. Ka ts'ebetso e ntseng e eketseha ea ACT le ALT, matšoao a lokela ho beoa leihlo ho fihlela boleng bo lekana, haeba keketseho e phahame makhetlo a 3 ho feta VGN mme e phehella, ho khothalletsoa ho fokotsa tekanyo kapa ho khaotsa ho sebelisa moriana.

Ts'ebeliso ea lithethefatsi Tulip e ka baka kholo ea myalgia. Ho bakuli ba nang le bothata ba ho nyekeloa ke myalgia, bofokoli ba mesifa kapa ho opeloa ke pelo le / kapa keketseho e kholo ea ketsahalo ea CPK, ho ka khothaletsoa myopathy. Tabeng ena (boteng ba myopathy e netefalitsoeng / e belaelloang), kalafo ea atorvastatin e lokela ho khaotsa.

Ka lebaka la kotsi e eketsehileng ea myopathy ka tšebeliso e tšoanang ea tulip e nang le immunosuppressants, fibrate, lithethefatsi tsa azole antifungal, erythromycin, nicotinic acid (lipid-lipilisi tse fokolisang lipilisi tse fetang 1 g ka letsatsi), kalafo ea lithethefatsi e qala feela kamora tlhahlobo e hlokolosi ea karo ea melemo e lebelletsoeng ea kalafo ka monyetla oa litlamorao tse matla. karabelo. Haeba ho hlokahala, ho kopantsoe kalafo e kopaneng ho nahana ka monyetla oa tokiso ea litekanyetso tsa pele le tsa tlhokomelo ea meriana ena molemong oa phokotso.

Nakong ea phekolo, ts'ebetso ea CPK le khatello ea serum glucose e lokela ho betoa leihlo nako le nako.

Bakuli ba lokela ho tsebisoa ka tlhokahalo ea ho ea ngakeng hang-hang haeba ho e-na le bohloko bo sa hlalosoang le / kapa bofokoli ba mesifa, haholoholo bo tsamaeang le ho fokola ka kakaretso le feberu.

Maemo a sa tloaelehang a rhabdomyolysis le nts'etsopele ea ho hloleha ha reefoleng ka lebaka la myoglobinuria ka lebaka la ts'ebeliso ea lithethefatsi Tulip, hammoho le li-statins tse ling (HMG-CoA reductase inhibitors) li hlalositsoe.

Haeba ho na le matšoao a hore na myopathy e ka ba teng kapa kotsi ea ho ba le ho se sebetse hantle ha masapo (arterial hypotension, ts'oaetso e matla ea ka mpeng, ho sithabela maikutlo, ho kenella ka bongata ts'ebetsong, ts'ebetso e kholo ea metabolic, endocrine le electrolyte, ho tsitsipana ho sa laoleheng) ha u ntse u nka rhabdomyolysis, atorvastatin e lokela ho emisoa kapa kalafo e lokela ho emisoa.

Nakong ea kalafo le Tulip, ho hlokahala tlhokomeliso ha ho khanna makoloi le ho etsa mefuta e meng e ka bang kotsi, e hlokang ho tsepamisa maikutlo le ho potlaka ha maikutlo a psychomotor.

Ho sebelisana le lithethefatsi

• cyclosporine, erythromycin ,cacithromycin, immunosuppression, antifungal drug (azole derivatives): eketsa kotsi ea myopathy ha e sebelisoa ka nako e le ngoe le HMG-CoA reductase inhibitors ka lebaka la keketseho e ka bang teng ea serum mahloriso a atorvastatin,
• indinavir, ritonavir (HIV proteinase inhibitors), fibrate le nicotinic acid (ka tekanyetso e fokotsang ea lipid tse fetang 1 g ka letsatsi): eketsa kotsi ea ho ba le myopathy,
• li-inhibitors tsa CYP3A4 isoenzyme (ho kenyeletsa le protease inhibitors): keketseho ea plasma ea li-atorvastatin e khonahala,
• OATP1B1 ea liprotheine tsa liprotheine tsa inthanete (mohlala: cyclosporine): li ka eketsa bioavailability ea atorvastatin,
• erythromycin le clarithromycin: eketsa bongata ba atorvastatin plasma ea mali (ka 40% le 56%, ka ho latellana),
• diltiazem: ka tekanyo ea 240 mg ka 40 mg ea atorvastatin e eketsa mahloriso a morao ho plasma ea mali,
• cimetidine: ha ho ts'ebelisano e kholo ea kliniki le atorvastatin e fumanoeng,
• itraconazole: ka tekanyo ea 200 mg ka 20-25 mg ea atorvastatin, boleng ba AUC ba atorvastatin makhetlo a 3 bo eketseha,
• lero la morara: ka lilithara tse fetang 1,2 ka letsatsi bakeng sa matsatsi a 5 ho ka baka keketseho ea plasma ea atorvastatin,
• li-inducers tsa CYP3A4 isoenzyme (mohlala, efavirenz kapa rifampicin): li ka lebisa ho fokotseha hoa khatello ea atorvastatin ka plasma ea mali, hobane rifampicin ke ntho e thibelang isoenzyme CYP3A4 'me ka nako e le ngoe e thibelletse ts'ebetso ea protheine ea 1 ea ts'oaetso ea ts'oaetso ea 1, ha e tsamaisana le ts'ebetso ea bobeli.
• li-antacid: tsamaiso ea molomo e kopaneng ea ho emisoa e nang le li-hydroxide tsa magnesium le magnesium tse nang le atorvastatin ho fokotsa khatello ea plasma ea ho qetela

35%, empa tekanyo ea ho fokotseha ha khatello ea LDL-C ha e fetohe,

Litšoantšo tsa Tulip ke tsena: Anvistat, Atomax, Ator, Atorvastatin, Atoris, Atorvoks, Vazator, Lipoford, Liptonorm, Liprimar, Torvazin, Novostat, Torvalip, Torvakard, Torvas le ba bang.

Foromo ea litekanyetso

Matlapa a koahetsoeng ka filimi.

Letlapa le 1 le koahetsoeng ka filimi le na le: ntho e sebetsang: calcium atorvastatin calcium 41.43 mg (ho latela atorvastatin 40.00 mg), Baeti: microcrystalline cellulose 284.97 mg, lactose monohydrate 69.60 mg, croscarmellose sodium 38.40 mg, hyprolose 4.00 mg, polysorbate 80 5.20 mg, boima ba magnesium oxide 52,00 mg, colloidal silicon diode 2.40 mg, magnesium stearate 2.00 mg, Ho hlophisoa ha khetla: hypromellose 5.952 mg, hyprolose 1.488 mg, titanium dioxide 2.736 mg, macrogol 6000 1,200 mg, talc 0,600 mg, iron oxide e mosehla E 172 0,024 mg.

Tlhaloso

E tšoeu e nang le 'mala o botala bo bosehla bo bosehla, matlapa a biconvex a chitja, a koahetsoeng ka filimi, a ngotsoe ka "HLA 40" ka lehlakoreng le leng.
Shebella phomolong: matlapa a masoeu.

Melemo ea pharmacological

Pharadodynamics
Atorvastatin ke inhibitor e ikhethileng ea enjine ea HMG-CoA e fokotsang 3-hydroxy-3-methylglutaryl coenzyme A ho mevalonic acid, e leng moetapele oa li-sterols, ho kenyelletsa le cholesterol.
Triglycerides (TG) le cholesterol li kenyellelitsoe ho hlophisoa ha lipomprotein tse fokolang haholo (VLDL) nakong ea motsoako ka har'a sebete, li kenella ka har'a plasma ea mali 'me li tsamaisoa ka lisele tsa thipa. Li-density lipoproteins tse tlase (LDL) li thehoa ho tsoa ho VLDL nakong ea tšebelisano le li-receptor tsa LDL.
Boithuto bo bonts'itse hore ho eketsa bongata ba cholesterol e akaretsang ho plasma, LDL le apolipoprotein B (Apo-B) ho kenya letsoho kholisong ea atherosclerosis mme ke tse ling tsa lisosa tsa lefu la pelo, ha ho ntse ho eketsoa khatello ea methapo ea methapo ea methapo ea methapo (HDL) e fokotsa kotsi. nts'etsopele ea maloetse a pelo le pelo.
Atorvastatin e fokotsa mokokotlo oa cholesterol le lipoprotein maling a mali ka lebaka la thibelo ea HMG-CoA reductase inhibitor, motsoako oa cholesterol bokong le keketseho ea palo ea li-receptor tsa "LERL" LDL karolong ea sele, e lebisang ho ho nyoloheng le ho ata ha LDL.
Atorvastatin e fokotsa ho kopana le khatello ea cholesterol ea LDL, k'holeseterole e felletseng, Apo-B ho bakuli ba nang le homozygous le heterozygous Famer hypercholesterolemia, hypercholesterolemia ea mantlha le hyperlipidemia e kopaneng.
E boetse e baka ho fokotseha ha palo ea cholesterol-VLDL le TG le keketseho ea khatello ea cholesterol-HDL le apolipoprotein A (Apo-A).
Ho bakuli ba nang le dysbetalipoproteinemia, khatello ea lipoprotein ea methapo e mahareng ea cholesterol-LBP ea fokotseha.
Atorvastatin ka tekanyetso ea 40 mg e fokotsa mokokotlo oa cholesterol e felletseng ka 37%, LDL - ka 50%, Apo-B - ka 42% le TG - ka 29%, e baka keketseho ea khatello ea cholesterol ea HDL le Apo-A.
Motsoako o thehiloeng ka tekanyetso o fokotsa bongata ba LDL ho bakuli ba nang le homozygous Famal hypercholesterolemia, e hananang le kalafo ka litlhare tse ling tse fokotsang lipid.
Ha e na phello ea carcinogenic le mutagenic.
Phello ea kalafo e fetoha libeke tse 2 kamora ho qala kalafo, e fihla hofihlella kamora libeke tse 4 mme e tšoarella nakong eohle ea kalafo.
Mofumahali
Ho fahla le ho tsamaisa. Ho chona ho phahameng. Khatiso e kholo ho plasma (Cmax) kamora ho tsamaisoa ka molomo e fihlelloa kamora lihora tse 1 - tse peli. Сmax ho basali e phahame ka 20%, sebaka se tlas'a khatello ea nako ea khatello (AUS) se tlase ka 10% ho banna, se nang le bohlokoa ba bongaka. Сmax ho bakuli ba nang le cirrhosis ea joala bo tahang (sehlopha sa B ho sekhahla sa bana) ke makhetlo a 16, mme AUS - makhetlo a 11 ho feta e tloaelehileng.
Ho ja hanyane ho fokotsa lebelo le tekanyo ea ho amoheloa ha moriana (ka 25% le 9%, ka ho latellana), leha ho le joalo, ho fokotsa cholesterol ea LDL ho tšoana le ha atorvastatin ntle le lijo tse ngata ka nako e tšoanang.
Kamora ho tsamaisoa ha molomo ka atorvastatin ka shoalane, khatello ea plasma e tlase (Cmax le AUC ka hoo e ka bang 30%) ho feta ka mor'a tsamaiso hoseng, leha ho le joalo, ho fokotseha ha khatello ea cholesterol ea LDL ha hoa itšetleha ka nako ea letsatsi leo moriana o nooang ka lona.
Kamano ea linear pakeng tsa tekanyo ea ho amoheloa le lethalinyana la lithethefatsi e ile ea senoloa.
Bioavailability ke 12%, systemic bioavailability ea mesebetsi e thibelang khahlanong le HMG-CoA reductase e ka bang 30%. Bioavailability e tlase e bakoa ke tšusumetso ea "metabolism" methapong ea mpa (GIT) le nakong ea "ntlha ea mantlha" ka sebete.
Bophahamo bo boholo ba kabo ke 381 l, khokahano le liprotheine tsa mali tsa mali ke 98%.
Karolelano ea mahlakore a atorvastatin liseleng tse khubelu tsa mali / lero la mali a ka bang 0,25, ke hore, atorvastatin ha e kenelle hantle liseleng tse khubelu tsa mali.
Metabolism le excretion. Atorvastatin e tšelisoa haholo-holo ka har'a sebete ka ketso ea li-isoenzymes CYP3A4, CYP3A5 le CYP3A7 ka sebopeho sa li-metabolites tse sebetsang tsa kemiso (ortho- le para-hydroxylated, lihlahisoa tsa beta-oxidation). In vitro ortho- le parahydroxylated metabolites li na le phello e thibelang ho fokotsoa ha HMG-CoA, ho bapisoa le atorvastatin. Matla a thibelo ea lithethefatsi khahlanong le HMG-CoA reductase e batla e le 70% e khethiloeng ke ts'ebetso ea li-metabolites tse potileng, tse phehellang lihora tse ka bang 20 ho isa ho tse 30, ka lebaka la boteng ba tsona.
Liphetho tsa lipatlisiso in vitro fana ka maikutlo a hore sebete CYP3A4 isoenzyme e bapala karolo ea bohlokoa ho metabolism ea atorvastatin. Sena se netefatsoa ke keketseho ea khatello ea atorvastatin maling a mali ha a ntse a nka erythromycin, eo hape e thibelang khanya ena.
Patlisiso in vitro e boetse e bonts'a hore atorvastatin ke inhibitor e fokolang ea CYP3A4 isoenzyme.
E tšeloa haholo ka popelong ka mor'a hore a sebelisoe ka hepatic le / kapa metabolism e eketsehileng (sethethefatsi ha se phatlalatsoe). Half-life (T1 / 2) ke lihora tse 14. Ka tlase ho 2% ea tekanyetso ea molomo e behiloe ka har'a moroto.
Ha e qhekelloe nakong ea haemodialysis ka lebaka la ho tlama liprotheine tsa plasma haholo.
Cmax le AUC ea lithethefatsi ho bakuli ba tsofetseng (ba lilemo tse 70 le ho feta) ba 40 le 30%, ka ho latellana, li phahame ho feta ho bakuli ba banyenyane, empa sena ha se na bohlokoa ba kliniki.
Ts'ebetso e sa sebetseng ea renal ha e ame ho kenella ha moriana ho plasma ea mali.

Sebelisa nakong ea bokhachane le nakong ea ho anyesa

Setlhare sa Tulip ® se kopantsoe nakong ea kemero.
Kaha cholesterol le lintho tse kopantsoeng ho tloha ho cholesterol li bohlokoa holima nts'etsopele ea bokhachane, kotsi e ka bang teng ea ho thibela phallo ea HMG-CoA e feta melemo ea ho sebelisa lithethefatsi nakong ea kemolo.
Haeba ho ima ho fumanoa nakong ea kalafo le Tulip ®, tsamaiso ea eona e lokela ho emisoa kapele kamoo ho ka khonehang, mme mokuli o lokela ho lemosoa ka kotsi e ka bang teng ho lesea.
Tulip ® ea lithethefatsi e ka sebelisoa ho basali ba lilemo tsa ho tsoala haeba feela menyetla ea bokhachane e le tlase haholo, mme mokuli a tsebisoa ka kotsi e ka bang teng ho lesea nakong ea kalafo.
Basali ba lilemo tsa ho ba le bana ba lokela ho sebelisa mekhoa e tšepahalang ea ho thibela pelehi nakong ea kalafo le Tulip ®.
Atorvastatin e pepesitsoe lebeseng la matsoele, ka hona e kopantsoe hore e sebelisoe nakong ea ho anyesa, haeba ho hlokahala hore u sebelise lithethefatsi Tulip ® nakong ea ho anyesa, matsoele a lokela ho emisoa.

Tekanyetso le tsamaiso

Pele o sebelisa lithethefatsi Tulip ®, mokuli o lokela ho khothaletsa lijo tse tloaelehileng tsa hypocholesterolemic, tseo a lokelang ho tsoela pele ho li latela nakong eohle ea kalafo.
Ho khothalletsoa ho sebelisa lithethefatsi Tulip ® ka hare ho sa tsotelehe nako ea lijo.
Tekanyetso ea Tulip ® e fapana ho tloha ho 10 mg ho isa ho 80 mg ka letsatsi, 'me e khethiloe ho latela khatello ea mantlha ea LDL cholesterol, sepheo sa kalafo le karabelo ea motho ka mong ea phekolo.
Bakeng sa bakuli ba bangata, tekanyetso ea pele ke 10 mg hang ka letsatsi (hoa khoneha ho sebelisa atorvastatin ea lithethefatsi ka foromo ea litekanyetso: matlapa a 10 le 20 mg).
Qalong ea kalafo le / kapa nakong ea keketseho ea tekanyetso ea Tulip ®, ho hlokahala hore ho be le leihlo la ho phahama ha lipids ho plasma e 'ngoe le e' ngoe ka libeke tse peli ho isa ho tse 'ne le ho fetola tekanyetso ea lithethefatsi joalo.
Tekanyo e phahameng ea letsatsi le letsatsi ke 80 mg / letsatsi.
Hypercholesterolemia ea mantlha (heterozygous hereditary and polygenic) hypercholesterolemia (mofuta IIa) le hyperlipidemia (mofuta IIb) e tsoakiloeng
Tekanyetso ea pele ea 10 mg ea moriana oa Tulip ® 1 nako ka letsatsi (hoa khoneha ho sebelisa atorvastatin ea lithethefatsi ka foromo ea litekanyetso: matlapa a 10 le 20 mg). Ha ho hlokahala, keketseho ea butle-butle ea lethal dose e ea ho 80 mg (matlapa a mabeli a 40 mg) e ka khonaha, ho latela ts'ebetso ea mokuli ka karohano ea libeke tse peli ho isa ho tse nne, hobane phello ea kalafo e bonoa kamora libeke tse 2, le phello e phahameng ea kalafo kamora libeke tse 4. Ka kalafo ea nako e telele, matla ana a phehella. Homozygous hereditary hypercholesterolemia
Litlhare tsa Tulip ® maemong a mangata li sebelisoa ka tekanyetso ea 80 mg (matlapa a mabeli a 40 mg) hang ka letsatsi.
Phokotso ea litheko tsa lithethefatsi Tulip ® ho bakuli ba nang le ts'ebetso ea mokokotlo oa mokokotlo le ho bakuli ba tsofetseng ha e hlokehe.
Thibelo ea Maloetse a amanang le pelo le pelo
Tulip ® e sebelisoa ka tekanyetso ea 10 mg hang ka letsatsi. Haeba khakanyo ea LDL ea plasma e nepahetseng e sa fihlelloe, ho ka etsahala hore o eketse tekanyetso ea moriana ho 80 mg ka letsatsi, ho latela karabelo ea mokuli ka karohano ea libeke tse peli ho isa ho tse nne.
Bakeng sa bakuli ba nang le ts'ebetso ea sebete e sa sebetseng hantle, excretion ea atorvastatin e tsoang 'meleng e lieha ho theoha, ka hona ho khothalletsoa ho e sebelisa ka hloko ka ho lekola nako le nako ts'ebetso ea li-transaminase tsa "sebete": aspartate aminotransferase (AST) le alanine aminotransferase (ALT). Haeba keketseho e bonoang ea ts'ebetso ea AST kapa ALT ka makhetlo a fetang a 3 ha e bapisoa le moeli o ka holimo oa ts'ebetso e tloaelehileng (VGN), ho khothalletsoa ho fokotsa tekanyetso kapa ho hlakola lithethefatsi Tulip ®.

Litla-morao

Ho ea ka Mokhatlo oa Lefatše oa Bophelo (WHO), litlamorao tse sa batleheng li thathamisoa ho latela khafetsa ea tsoelo-pele ea tsona ka tsela e latelang: khafetsa (> 1/100, 1/1000, 1/10000, ho tsoa sesole sa 'mele
khafetsa: karabelo
ka seoelo: anaphylaxis.
Ho tsoa sebakeng sa tsamaiso ea methapo e bohareng le e poteletseng
khafetsa: hlooho e bohloko
khafetsa: letsoalo, likhathatso tsa boroko, ho kenyelletsa ho hloka boroko le litoro tsa "bosiu", bofokoli ba kelello, bofokoli, khatello ea maikutlo, khatello ea maikutlo, ho haelloa ke tatso, ho lahleheloa kapa ho fokotseha ha mohopolo,
ka seoelo: peripheral neuropathy.
Ho tsoa ho tšilo ea lijo
khafetsa: ho sokela, ho hlapoloha, dyspepia, ho nyekeloa, lets'ollo,
khafetsa: ho ipolaisa tlala, ho hlatsa, pancreatitis, hepatitis, bohloko ba ka mpeng, belching,
ka seoelo: cholestatic jaundice (ho kenyeletsa e thibelang),
ka seoelo: ho hloleha ha sebete.
Ho tsoa ho tsamaiso ea musculoskeletal le lisele tse sebetsanang
khafetsa: myalgia, arthralgia, “ho ruruha” ha manonyeletso, bohloko bo kopaneng, bohloko ba mokokotlo, mesifa ea mesifa,
khafetsa: bohloko ba mesifa molaleng, bofokoli ba mesifa,
ka seoelo: myopathy, myositis, rhabdomyolysis, tendinopathy (ka linako tse ling e thatafatsoa ke ho phatloha ha tendon),
maqhubu a sa tsejoeng: immune-Mediated necrotizing myopathy.
Ho tsoa lithong tsa kutlo
khafetsa: tinnitus, pono e fifalitsoeng,
ka seoelo: ho sitisoa hoa pono
ka seoelo: tahlehelo ya kutlo.
Karolong ea letlalo le mafura a subcutaneous
khafetsa: urticaria, lekhopho la letlalo le ho hlohlona, ​​alopecia,
ka seoelo: angioedema, rash e ngata, polymorphic exudative erythema (ho kenyeletsa le Stevens-Johnson syndrome), chefo e matla ea cyermal necrolysis (lefu la Lyell).
Ho tloha ka lehlakoreng la metabolism
khafetsa: hyperglycemia
khafetsa: hypoglycemia, phaello ea boima.
Ho tsoa lithong tsa hemopoietic
khafetsa: thrombocytopenia.
Ho tsoa ts'ebetsong ea phefumoloho
khafetsa: nasopharyngitis, 'metso, matšoafo.
Matšoao a laboratori
khafetsa: mosebetsi o eketsehileng oa serum creatinine phosphokinase (CPK), ts'ebetso e eketsehang ea transaminase ea "sebete",
khafetsa: leukocyturia,
maqhubu a sa tsejoeng: keketseho e ngata ea hemoglobin ea glycosylated.
Tse ling:
khafetsa: mokhathala, potency e sa senyeheng, ho hloleha ha renal, feberu, bohloko ba sefuba, edema ea thipa.
ka seoelo: gynecomastia, lefu la tsoekere. Ho na le litlaleho tse arohaneng mabapi le nts'etsopele ea atonic fasciitis (khokahano le tšebeliso ea atorvastatin ha e thehiloe ka nepo).
maqhubu a sa tsejoeng: khatello ea maikutlo, lefu la matšoafo a pakeng (haholo-holo ka kalafo e telele), ho se sebetse hantle ka thobalano.

Bongata

Ha ho na le litlhare tse tobileng bakeng sa kalafo ea bongoana bo bongata.
Haeba ho na le overdose, kalafo ea matšoao e lokela ho etsoa.
Hemodialysis ha e na thuso (hobane lithethefatsi li tlama liprotheine tsa plasma haholo).

Ho sebelisana le lithethefatsi tse ling

Kotsi ea myopathy nakong ea kalafo le li-inhibitors tsa HMG-CoA reductase e eketseha ka tšebeliso e tšoanang cyclosporine, erythromycin ,cacithromycin, immunosuppression, lithethefatsi tsa antifungal (lihlahisoa tsa azole) ka lebaka la keketseho e ka bang teng ea khatello ea atorvastatin e serum ea mali.
Ka ts'ebeliso e tšoanang Li-inhibitors tsa HIV tsa protease - indinavir, ritonavir - menyetla ea ho ba le myopathy ea eketseha.
Tšebelisano e tšoanang e ka etsahala ka tšebeliso e tšoanang ea atorvastatin le fibrate le nicotinic acid ho lipid fokotsa litekanyetso (tse fetang 1 g / letsatsi).
CYP3A4 Isoenzyme Inhibitors
Kaha atorvastatin e tšeloa metsoako e sebelisa isoenzyme CYP3A4, tšebeliso ea lithethefatsi Tulip ® e na le li-inhibitors tsa isoenzyme ena e ka lebisa keketseho ea khatello ea atorvastatin plasma ea mali. Tekanyo ea ho sebelisana le phello ea ho eketsa bongata ba atorvastatin e khethoa ke phapang ea phello ho CYP3A4 isoenzyme.
OATP1B1 liprotein inhibitors
Atorvastatin le metabolites ea eona ke likarolo tsa protheine ea lipalangoang OATP1B1.
Li-inhibitors tsa OATP1B1 (mohlala, cyclosporine) li ka eketsa bioavailability ea atorvastatin. Kahoo, ts'ebeliso ea atorvastatin ka tekanyo ea 10 mg le cyclosporine ka tekanyo ea 5,2 mg / kg / letsatsi e lebisa keketseho ea khatello ea atorvastatin ka plasma ea mali ka makhetlo a 7.7.
Erythromycin / clarithromycin
Ka tšebeliso e tšoanang ea atorvastatin 10 mg le erythromycin (500 mg makhetlo a 4 ka letsatsi) kapa clarithromycin (500 mg makhetlo a 2 ka letsatsi), e thibelang isoenzyme ea cytochrome CYP3A4, ho na le keketseho ea khatello ea atorvastatin ho plasma ea mali (ka 40% ha e sebelisoa le erythromycin le 56% - ha e sebelisoa lecacithromycin).
Protease inhibitors
Ts'ebeliso ea nako e tšoanang ea atorvastatin e nang le li-inhibitors tsa cytechrome CYP3A4 isoenzyme e tsamaisana le keketseho ea khatello ea atorvastatin ka plasma ea mali (ts'ebeliso e le 'ngoe ka erythromycin, Cmax ea atorvastatin e eketseha ka 40%).
Diltiazem
Ts'ebeliso e kopaneng ea atorvastatin ka tekanyo ea 40 mg e nang le diltiazem ka tekanyo ea 240 mg e lebisa hoketseho ea khatello ea atorvastatin plasma ea mali.
Cimetidine
Ha ho na ts'ebelisano e kholo ea ts'ebelisano ea atorvastatin e nang le cimetidine e fumanoeng.
Itraconazole
Tšebeliso e tšoanang ea atorvastatin ka tekanyetso ho tloha 20 mg ho isa ho 40 mg mme itraconazole ka lethal dose ea 200 mg e lebisa keketseho e menahaneng ea 3 ea AUC ea atorvastatin.
Lero la morara
Kaha lero la morara le na le karolo e le 'ngoe kapa tse fetang tse thibelang CYP3A4 isoenzyme, tšebeliso ea eona e feteletseng (ho feta lilithara tse 1,2 ka letsatsi bakeng sa matsatsi a 5) e ka baka keketseho ea plasma ea atorvastatin.
CYP3A4 Isoenzyme Inductors
Ts'ebeliso e kopaneng ea atorvastatin e nang le li-inducers tsa isoenzyme CYP3A4 (mohlala, efavirenz kapa rifampicin) e ka lebisa ho fokotseha ha khatello ea atorvastatin ho plasma ea mali. Ka lebaka la ts'ebetso e kopanetsoeng ea ho sebelisana le rifampicin (inducer ea CYP3A4 isoenzyme le hepatocyte transport protein inhibitor OATP1B1), ts'ebeliso e ts'oanang ea atorvastatin le rifampicin ha e khothaletsoe, kaha ho liehise ho tsamaisoa ha atorvastatin kamora rifampicin ho lebisa ho fokotseheng ho hoholo ha mali ho potang ka bongata maling.
Li-antacid
Ka ts'ebeliso e tšoanang ea atorvastatin le ho emisoa ho nang le li-hydroxides tsa magnesium le aluminium kahare, khatello ea li-atorvastatin ka har'a plasma e fokotseha ka 35%, leha ho le joalo, tekanyo ea ho fokotseha ha mahloriso a cholesterol ea LDL ha e fetohe.
Phenazone
Atorvastatin ha e ame li-pharmacokinetics tsa phenazone, ka hona, ho sebelisana le lithethefatsi tse ling tse ntlafalitsoeng ke isoenzymes e tšoanang ha hoa lebelloa.
Colestipol
Phello e fokotsang lipid ea ho kopanya le colestipol e phahame ho seo ho moriana ka mong ka thoko, leha ho le joalo, ho fokotsehile ka 25% khoebong ea atorvastatin ha e sebelisoa ka mokhoa o tšoanang le colestipol.
Fusidic asiti
Lithuto mabapi le tšebelisano ea atorvastatin le fusidic acid ha li e-so etsoe. Joalo ka li-statins tse ling, lithuto tsa morao-rao tsa ts'ebeliso e kopaneng ea atorvastatin le fusidic acid li tlalehile litlamorao ho mesifa, ho kenyelletsa le rhabdomyolysis. Mokhoa oa tšebelisano ha o tsejoe. Bakuli ba joalo ba hloka ho hlahlojoa ka hloko mme, mohlomong, ho khaoloa ha nakoana ka atorvastatin.
Colchicine
Leha lithuto tsa ts'ebelisano ea atorvastatin le colchicine li e-so ka li etsoa, ​​linyeoe tsa myopathy li tlalehiloe ha li sebelisoa hammoho le colchicine, 'me tlhokomeliso e lokela ho sebelisoa ha ho ntse ho fanoa ka atorvastatin le colchicine.
Digoxin
Ka tšebeliso e sa khaotseng ea digoxin le atorvastatin ka tekanyo ea 10 mg, mokokotlo o lekanang oa digoxin ka plasma ea mali ha o fetohe. Leha ho le joalo, ha u sebelisa digoxin hammoho le atorvastatin ka tekanyo ea 80 mg / ka letsatsi. Keketseho ea digoxin maling a mali e eketseha ka hoo e ka bang 20%. Bakuli ba nkang digoxin hammoho le atorvastatin ba hloka ho hlahlojoa ha leqhubu la digoxin maling a mali.
Azithromycin
Ka tšebeliso e tšoanang ea atorvastatin ka tekanyetso ea 10 mg 1 nako / letsatsi le azithromycin ka tekanyo ea 500 mg 1 nako / ka letsatsi, khatello ea atorvastatin ka plasma ea mali ha e fetohe.
Lithibela-mafu tsa molomo
Ka tšebeliso e tšoanang ea atorvastatin le kemiso ea molomo e nang le norethisterone le ethinyl estradiol, ho na le keketseho e kholo ho AUC ea norethisterone le ethinyl estradiol ka 30% le 20%, ka ho latellana, e lokelang ho nahanoa ha u khetha lithibela-pelehi tsa molomo.
Terfenadine
Atorvastatin e sebelisoang ka mokhoa o kopaneng le terfenadine ha e na phello e matla tleliniking ho pharmacokinetics ea terfenadine.
Warfarin
Ho bakuli ba nkang warfarin nako e telele, atorvastatin ka lethal dose ea 80 mg ka letsatsi ka nako e itseng e khutsufatsa nako ea prothrombin matsatsing a pele a ts'ebeliso e kopaneng. Tšusumetso ena e nyamela kamora matsatsi a 15 a ts'ebeliso ea lithethefatsi tsena ka nako e tšoanang. Le ha linyeoe tsa liphetoho tsa bohlokoa tsa kliniki ka phello ea anticoagulant li tlalehiloe ka seoelo, nako ea prothrombin e lokela ho ikemisetsa ho bakuli ba nkang li-anticoagulants tsa pele le hangata tse lekaneng qalong ea kalafo le atorvastatin ho netefatsa hore ha ho na liphetoho tse kholo tsa nako ea prothrombin. Hang ha nako e tsitsitseng ea prothrombin e se e tlalehiloe, e ka hlahlojoa ka linako tse ling tse tloaelehileng ho bakuli ba nkang li-anticoagulants tsa coumarin. Haeba o fetola tekanyetso kapa o emisa kalafo, mehato ena e lokela ho phetoa. Ha ho na kamano pakeng tsa ts'ebeliso ea atorvastatin le ho tsoa mali kapa liphetoho nakong ea prothrombin ho bakuli ba sa nkeng li-anticoagulants.
Amlodipine
Ka tšebeliso e tšoanang ea atorvastatin ka tekanyo ea 80 mg le amlodipine ka tekanyo ea 10 mg, pharmacokinetics ea atorvastatin ka ho lekana ha e fetohe.
Lithethefatsi tse ling tse fokotsang lipid
Ka tšebeliso e tšoanang ea atorvastatin e nang le lithethefatsi tse ling tsa hypolipidemic (mohlala, ezetimibe, gemfibrozil, derivative ea fibroic acid) ho fokotsa litekanyetso, menyetla ea ho ba le rhabdomyolysis ea eketseha.
Pheko e 'ngoe e kopaneng
Ka tšebeliso e kopaneng ea atorvastatin e nang le lithethefatsi tsa antihypertensive le estrogens (joalo ka kalafo e tlosang phetoho), ha ho ts'ebelisano e kholo ea kliniki e fumanoeng.

Ketso ea Pharmacological ea Tulip

Ho latela litaelo tsa Tulip, motsoako o sebetsang oa lithethefatsi ke atorvastatin. Litlatsetso tse hlahisang matlapa ke magnesium stearate, colloidal silicon dioxide, magnesium oxide e ngata, croscarmellose sodium, polysorbate 80, cellroose ea hydroxypropyl, lactose monohydrate, cellulose ea microcrystalline.

Tulip ke inhibitor e ikhethileng ea HMG-CoA reductase le enzyme e amehang phetohong ea 3-hydroxy-3-methylglutaryl coenzyme A ho mevalonate, e leng selelekela sa li-steroid.

Phello ea sethethefatsi e etselitsoe phokotso e kholo:

• synthetic le dikahare tsa k'holeseterole e felletseng,
• palo le mofuta oa likaroloana tsa LDL maling,
• boemo ba TG le apolipoprotein B,
• kotsi ea ho ba le mathata a ho tšoaroa ke pelo le mafu a pelo.

Tulip e kenya letsoho ho fumaneng boemo ba tlhaho ba likaroloana tsa HDL le apolipoprotein A.

Litlhare li theola litekanyetso tsa LDL ho batho ba nang le lefu la homozygous hypercholesterolemia e hananang le lithethefatsi tse ling tse fokotsang lipid.

Ha e tsamaisoa, Tulip e phela hantle ebile e kenella ka potlako. Palo e phahameng ea plasma e fihla kamora lihora tse peli. E na le bioavailability e tlase mme e amana hantle le liprotheine tsa mali. E tšeloa ka har'a sebete le ho etsoa ka li-metabolites tse 'maloa tse sebetsang tsa' mele. Nako ea ho tlosoa ha moriana ka botlalo 'meleng ke lihora tse 28. E epolloa ka mala.

Tekanyetso le tsamaiso ea tulip

Pele a qala kalafo, mokuli o lokela ho fetisetsoa lijong le cholesterol e tlase. Tulip e nkuoa ka molomo nako e le 'ngoe ka letsatsi, ho sa tsotelehe lijo tse ngata.

Tekanyetso ea moriana e khethoa ke ngaka e eang ka bonngoe ho mokuli ka mong, ho latela sepheo sa kalafo le boemo ba LDL-C. Ha e le molao, tekanyetso ea Tulip e fapana ho tloha ho 10 ho isa ho 80 mg. Phetoho ea litekanyetso li etsoa ka nako e le ngoe ho libeke tse 4.

Mofumahali

Ho kenngoa ha moriana ho phahame. Ts'oarello e phahameng ka ho fetisisa ea plasma ea mali e ka lemohuoa lihora tse 1-2 kamora ho qeta moriana. Haeba u sebelisa lithethefatsi ka shoalane, khatello ea eona maling e tla ba tlase ha e bapisoa le e tlalehiloeng ka plasma ea mali kamora ts'ebetso ea hoseng.

Bioavava e fumaneha ho 12-14%. Excretion ke ka mala, ka tlasa 2% ea moriana o ts'oere moroto.

Ka tlhokomelo

Maemong a mang, kopano e lokela ho etsoa ka hloko. Hona ke ho ba teng ha maemo a latelang:

• khaello e matla ea electrolyte,
• mafu a tsamaiso ea mesifa
• lefu la tsoekere
• mathata a endocrine le metabolic,
• lefu la sethoathoa
• hypotension
• sepsis
• nalane ea lefu la hemorrhagic.

Tulip e sebelisoa ka hlokolosi ho lefu la sethoathoa.
Setlhare se fanoa ka hloko ho lefu la tsoekere.
Moriana o fanoa ka hloko ho bakuli ba nang le nalane ea lefu la hemorrhagic stroke.

Joang ho nka tulip?

Pele o qala kalafo, o hloka ho fa mokuli litlhahiso mabapi le mokhoa oa ho latela lijo tse reretsoeng ho theola cholesterol ea mali. Mokuli ka mong o lokela ho ithuta litaelo tsa ho li sebelisa.

Ke litekanyetso life tse tla khethoa ho latela hore na cholesterol e kae maling, lilemo tsa mokuli le hore na lefu le ntse le mo nyonya hakae.

U hloka ho nka litafole kahare, ho ja ha ho ame bokhoni ba ho monya ha tsona.

Litekanyetso li ka ba 10 ho isa ho 80 mg ka letsatsi. Motsoako oa pele ke 10 mg. Kamora libeke tse 2 ho ea ho tse ling tsa bongaka, ngaka e hlokomela litaba tsa lipids maling a mokuli. Sena se etsoa ka sepheo sa ho etsa qeto mabapi le phetoho ea litekanyetso.

U hloka ho nka litafole kahare, ho ja ha ho ame bokhoni ba ho monya ha tsona.

Ho thibela ho hlaha hoa mafu a pelo, ho sebelisoa moriana oa 10 mg ka letsatsi. Ka kalafo ea homozygous hereditary hypercholesterolemia, ho bontšoa ho nka matlapa a mabeli a 40 mg ka letsatsi, ke hore ona ke litekanyetso tsa 80 mg.

Phekolo ea ka mpeng

Matšoao a tloaelehileng ke ho nyekeloa ke pelo, ho hlatsa le lets'ollo, ho pepeseha le ho sokela. Matšoao a sa tloaelehang ke ho hlatsa, pancreatitis, belching le bohloko ka mpeng.

Matšoao a khafetsa ka mor'a ho nka litafole a nkuoa e le ho nyekeloa ke pelo, ho hlatsa.
Ha o sebelisa moriana, o ka kopana le lipontšo tse mpe joalo ka bohloko ka mpeng.
Ponahatso e atileng haholo kamora ho sebelisa matlapa e lokela ho nkuoa e le hlooho.

Ho tsoa ts'ebetsong ea phefumoloho

Mohlomong nts'etsopele ea nasopharyngitis, ponahalo ea ho tsoa madi ho tsoa nko le ho opeloa ke 'metso.

Hape, mokuli a ka ba le bothata ba hemorrhage ea mahlo le ho fokolloa ke pono.
Ho tloha ts'ebetsong ea ho phefumoloha, ho tsoa mali ho tsoa nko hoa khoneha.
Kamora ho sebelisa lithethefatsi, mokuli a ka ba le bothata ba urticaria le rash.

Ho tsamaisana le joala

Se ke oa nooa joala nakong ea kalafo le moriana.

Ho fana ka litlhare nakong ea gestation ha ho khonehe.
Se ke oa nooa joala nakong ea kalafo le moriana.
Nakong ea kalafo ka moriana, tlhokomeliso e eketsehileng e lokela ho sebelisoa ha u khanna koloi.
Kaha ntho e sebetsang e fetela lebeseng, ha ua tšoanela ho anyesa lesea nakong ea kalafo.

Sebelisa nakong ea bokhachane le pelehi

Ho fana ka litlhare nakong ea gestation ha ho khonehe. Haeba mosali a ima nakong ea phekolo, hoa hlokahala ho tsebisa ngaka ka sena kapele kamoo ho ka khonehang le ho emisa kalafo ka moriana. Kaha ntho e sebetsang e fetela lebeseng, ha ua tšoanela ho anyesa lesea nakong ea kalafo.

Sebelisa botsofaling

Phetoho ea lethal dose e khothalelitsoeng ha e hlokahale.

Kaha ts'ebetso le polokeho ea meriana bakeng sa bana ba ka tlase ho lilemo tse 18 ha e so thehoe, ho sebelisa moriana ona lilemong tsena ha ho khothalletsoe.

A na nka reka ntle le lengolo la ngaka?

Ha ho bonolo ho reka meriana ntle le lengolo la ngaka.

U ka reka sethethefatsi sena litlamareng tsohle tsa 'Muso oa Russia.
O ka nkela sethethefatsi ka moriana o kang Atoris.Torvacard ke sethethefatsi se tšoanang.
Boloka moriana mocheso oa kamoreng.
Litsenyehelo tsa sehlahisoa li qala ho tloha li-ruble tse 300.

Litsenyehelo tsa sehlahisoa li qala ho tloha li-ruble tse 300.

Litlhahlobo tsa Tulip

Litlhahlobo mabapi le sesebelisoa li ntle haholo.

A.Zh. Delikhina, ngaka e akaretsang, Ryazan: "Sesebelisoa se u lumella ho fihlela sephetho se setle sa ho loana le cholesterol e phahameng maling a bakuli."

E.E. Bengina, Endocrinologist, Perm: “Setlhare sena se laeloa bakeng sa kalafo ea ka ntle. Ho feta moo, lipalo tsa mali tsa mokuli li lula li beiloe leihlo ke ngaka. ”

Torvacard: analogues, litekanyetso, litaelo tsa tšebeliso Atorvastatin.

Karina ea lilemo li 45, Omsk: “Sesebelisoa se thusitse ho tlosa mathata ka tsamaiso ea pelo le pelo. Ke leboha lingaka bakeng sa ho fana ka moriana ona. Litsenyehelo li tloaelehile. ”

Ivan ea lilemo li 30, Adler o re: “Setlhare sena sea sebetsa ha ho e-na le cholesterol e ngata maling. Hangata bothata bona bo hlaha ka lebaka la lijo tse se nang phepo tse nang le lijo tse ngata tse halikiloeng. Ha fela ha eba joalo. Ke ile ka tlameha ho bona ngaka, ho etsa liteko tse hlokahalang le ho fumana kalafo ka moriana. ”

Pharadodynamics

Karolo e sebetsang ea lithethefatsi ke atorvastatin, e leng moemeli oa inhibitory ea limolek'hule tsa HMG-CoA. Reductase e ikarabella ho bopeng mevalonic acid, e leng karolo ea sterols le molek'hule ea cholesterol.

Limolek'hule tsa cholesterol le triglyceride ke karolo ea limolek'hule tsa lipoprotein tsa methapo e fokolang haholo ea limolek'hule, tse kopaneng nakong ea ho hlophisoa ha tsona liseleng tsa sebete.

Ha limolek'hule tsa VLDLP li kopantsoe le li-receptor tsa LDL, li-triglycerides li tsoa lipoprotein tse tlase haholo le lipoprotein tse tlase tsa limolek'hule.

Limolek'hule li kena maling 'me li tsamaisoa ka mali ho ea likarolong tsohle tsa' mele oa motho.

Mabitso a mang a Tulip

Ka keketseho ea khatello ea mali plasma ea cholesterol e felletseng, hammoho le karoloana ea boima ba limolek'hule le limolek'hule tsa apoliprotein B, ho na le kotsi ea ho theha tsamaiso ea methapo ea methapo ea methapo.

Hape, keketseho ea karoloana ea lipoprotein tse boima ba limolek'hule li eketsa kotsi ea ho nts'etsapele methapo ea methapo ea pelo le tsamaiso ea phallo ea mali, mme keketseho ea lipoprotein tse phahameng tsa boima ba 'mele e fokotsa kotsi ea li-pathologies tsena.

Karolo e sebetsang ea atorvastatin e theola khatello ea limolek'hule tsa cholesterol maling, hape ka ho eketsa palo ea li-receptor tsa LDL tse eketsang catabolism ea cholesterol e tlase ea boima ba 'mele, e e fokotsa.

Karolo e sebetsang ea atorvastatin e bonts'a phello e ntle ea lithethefatsi kalafong ea:

• Homozygous hereditary hypercholesterolemia,
• Heterozygous liphatsa tsa lefutso le lelapa la hypercholesterolemia,
• Psychology ea hypercholesterolemia,
• Psology e tsoakiloeng ea hyperlipidemia.

Ho nka Tulip ho eketsa bongata ba limolek'hule tse phahameng tsa boima ba 'mele, le limolek'hule tsa apoliprotein A1 maling.

Litlhare tsa Tulip tse nang le litekanyetso li-milligram tse 120,0 le li-milligram tse 20,0 li theola khatello ea mali maling:

• Kakaretso ea limolek'hule tsa cholesterol ho — 29,0% — 33,0%,
• Limolek'hule tsa LDL li butsoe — 39,0% — 43,0%,
• Limolek'hule tsa APO B li butse — 32,0% — 35,0%,
• Ho Triglycerides ho — 14,0% — 26,0%.

Ho sebelisana le lithethefatsi tse ling

• Meriana ea antacid e theola khatello ea tulip maling le ka 35.0%,
• Ha e nkuoa ka digoxin, ho na le kotsi ea ho holofala ha methapo ea litho tsa pelo le mathata mokhoeng oa tsamaiso ea mali,
• Li-antibiotic tsa sehlopha sa erythromycin le sehlopha sa clearithromycin, li eketsa mahloriso a plasma a sehlahisoa sa Tulip,
• Tsamaiso e kopanetsoeng ea lithethefatsi tse tlosang li-hormone le tulip lia lumelloa.

Qeto

U ka phekoloa ka li-statins feela joalokaha u laetsoe ke ngaka 'me u se ke ua lebala hore ho theola index ea cholesterol ho hlokahala hore u sebelise mokhoa oa ho ja le ho phela bophelo bo botle. Ke ka phekolo e kopaneng feela moo ho ka fokotsoang khatello ea cholesterol le nts'etsopele ea atherosclerosis e ka thibeloang.

Ha o sebelisa Tulip joalo ka thibelo ea bobeli, menyetla ea ho hlaseloa ke pelo le lefu ho tsoa lipatseng tsa khoerese le pelo li fokotsehile.

Oksana ea lilemo tse 39: Ke ne ke laetsoe Tulip ha cholesterol ea ka e ne e le 7.3 mmol ka litha, empa ho na le litla-morao tse ngata. Ke qetile likhoeli tse 4 ke ntse ke nka setsi sena. K'holeseterole ea ka e khutletse ho tloaelehileng, ke bophelo ba ka bo sa kang ba ntlafala.

George ea lilemo li 58: Ke fumanoe ke cholesterol e phahameng ka lilemo tse 14. Ke nkile lithethefatsi tse fapaneng tsa li-statin le li-fibrate.

Ke na le lefu la tsoekere, kahoo k'holeseterole e lula e tlōla. Ho ipapisitsoe le atorvastatin, esale ke nka lilemo tse peli tsa Tulip.

Palo ea lipid e tloaelehile ebile bophelo ba ka bo botle haholo. Ena ke moriana oa pele o sa bakeng ho opeloa ke 'mele oa ka.