Simgal yog cov tshuaj uas yog rau cov pab pawg lipid-txo qis, uas yog, txo cov roj (cholesterol). Nws muaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj pinkish puag ncig, convex ntawm ob sab, thiab hauv zaj duab xis. Simgal lub ntsiab khoom xyaw ua ke yog simvastatin, los ntawm qhov nws tuaj yeem nkag siab tias cov tshuaj no yog koom nrog cov pab pawg tshuaj hu ua statins. Qhov ntau npaum li cas ntawm cov tshuaj yog txawv - 10, 20 thiab 40 milligrams.
Ntxiv rau simvastatin, Simgal kuj tseem muaj cov tshuaj ntxiv xws li ascorbic acid (vitamin C), butyl hydroxyanisole, pregelatinized hmoov txhuv nplej siab, citric acid monohydrate, magnesium stearate, microcrystalline cellulose thiab lactose monohydrate.
Lub plhaub nws tus kheej muaj cov xim liab opadra, uas, nyeg, muaj cov dej cawv polyvinyl, titanium dioxide, rov qab zoo li qub, lecithin, oxide liab, daj oxide thiab indigo carmine raws li cov kua roj vanish.
Cov hauv paus ntawm pharmacodynamics Simgala
Pharmacodynamics yog cov nyhuv uas cov tshuaj muaj rau tib neeg lub cev. Simgal, los ntawm nws cov biochemical xwm, yog anticholesterolemic - nws txo qis qhov kev coj ua ntawm "tsis zoo" cov roj (cholesterol), uas tau tso ncaj qha rau ntawm cov phab ntsa ntawm cov hlab ntsha thiab cov ntawv sau ua plahaum. Raws li koj paub, atherosclerosis pib tsim nyob rau hauv cov hluas, thiab yog li ntawd nws yog qhov tsim nyog los tswj cov qib roj cholesterol hauv lub sijhawm no.
Simgal yog ib qho inhibitor ntawm ib qho enzyme hu ua HMG-CoA reductase. Yog tias piav qhia hauv kev nthuav dav ntxiv, nws inhibits kev ua haujlwm ntawm no enzyme ntau li ntau tau. HMG-CoA reductase yog lub luag haujlwm rau kev hloov pauv ntawm HMG-CoA (hydroxymethylglutaryl-coenzyme A) rau mevalonate (mevalonic acid). Qhov tshuaj tiv thaiv no yog thawj thiab txuas tseem ceeb hauv kev tsim cov roj (cholesterol). Hloov chaw, HMG-CoA hloov mus rau acetyl-CoA (acetyl coenzyme A), uas nkag rau lwm qhov, tsis muaj txheej txheem tseem ceeb hauv peb lub cev.
Simgal tau txais qhov siv cov tshuaj Aspergillus tshwj xeeb (hauv Latin, lub npe tseeb yog Aspergillusterreus). Aspergillus yog fermented ntawm cov khoom noj tshwj xeeb nruab nrab, los ntawm cov tshuaj tiv thaiv cov khoom tsim. Nws yog los ntawm cov tshuaj tiv thaiv cov tshuaj uas muab cov tshuaj synthetically.
Nws paub tias hauv tib neeg lub cev muaj ntau yam lipids (rog). Qhov no yog cov roj (cholesterol) cuam tshuam nrog cov qis lipoproteins, cov roj ntsha lipoproteins ntau, triglycerides thiab chylomicrons. Qhov phom sij tshaj plaws yog cov roj ntsig ua cov lipoproteins uas tsis muaj ntau, nws hu ua "tsis zoo", thaum cuam tshuam nrog lipoproteins ntau ntom, ntawm qhov tsis sib xws, suav tias yog "zoo". Simgal pab txo qis cov roj triglycerides, ntxiv rau cov roj (cholesterol) cuam tshuam nrog lipoproteins ntshav qis thiab tsawg. Tsis tas li ntawd, nws nce qhov siab ntxiv ntawm cov roj cholesterol ua ke nrog cov lipoproteins ntau ntom ntom.
Cov nyhuv thawj ua pom tau ob lub lis piam tom qab pib kev siv ntawm Simgal, cov txiaj ntsig siab tshaj plaws tau pom tom qab ib hlis dhau los.
Txhawm rau kom ua tiav qhov tshwm sim, cov tshuaj yuav tsum tau noj tas li, txij li yog tias txoj kev kho mob raug txiav tawm yam tsis tuaj yeem, cov roj (cholesterol) yuav rov qab mus rau qhov pib thawj zaug.
Tsim los ntawm Pharmacokinetics
Pharmacokinetics yog cov kev hloov uas tshwm sim hauv lub cev nrog rau cov tshuaj. Simgal tau zoo heev nyob rau hauv txoj hnyuv me.
Qhov siab tshaj plaws ntawm cov tshuaj yog pom tom qab ib thiab ib nrab rau ob teev tom qab nws siv, txawm li cas los xij, tom qab 12 teev txij li thawj zaug tsom, tsuas yog 10% nyob.
Nruj heev, cov tshuaj nkag mus rau hauv kev sib cuag nrog cov plasma protein (kwv yees 95%). Lub ntsiab hloov Simgal undergoes nyob rau hauv daim siab. Nyob rau ntawd, nws tau hloov kho hydrolysis (sib xyaw nrog dej lwg dej), uas ua rau muaj kev tsim cov beta-hydroxymetabolites, thiab qee qhov txuas ntxiv nyob rau hauv daim ntawv tsis voos. Nws yog cov metabolites uas nquag ua haujlwm uas muaj cov ntsiab ntawm Simgal.
Ib nrab-lub neej ntawm cov tshuaj (lub sijhawm uas lub siab ntawm cov tshuaj nyob rau hauv cov ntshav tsawg dua ob zaug) yog txog ob teev.
Nws tshem tawm (i.e. kev tshem tawm) yog nqa nrog kev quav, thiab tseem ib feem me me yog tawm los ntawm ob lub raum hauv ib daim ntawv uas tsis muaj zog.
Kev taw qhia thiab contraindications rau kev siv tshuaj
Simgal yuav tsum siv tsuas yog tsim los ntawm koj tus kws kho mob.
Hauv kev siv tshuaj, kws kho mob cov lus pom zoo thiab cov lus qhia rau kev siv yuav tsum ua raws cai.
Feem ntau nws tau sau tseg raws li kev kuaj pom, thaum lub sijhawm cov roj (cholesterol) siab dua li tus qauv (2.8 - 5.2 mmol / l).
Simgal yog qhia nyob rau hauv cov teebmeem hauv qab no:
- Thaum thawj qhov mob hypercholesterolemia ntawm yam thib ob, nyob rau hauv rooj plaub thaum noj zaub mov nrog cov roj tsawg hauv kev ua ke nrog kev tawm dag zog thiab kev poob phaus ua rau tsis muaj txiaj ntsig, uas yog qhov tshwj xeeb tshaj yog rau cov neeg mob uas muaj feem ntau txhim kho atherosclerosis ntawm cov hlab ntshav txhaws.
- Nrog kev sib xyaw hypercholesterolemia thiab hypertriglyceridemia, uas tsis yog qhov zoo rau kev kho mob nrog kev noj haus thiab qoj ib ce.
Hauv kev mob plawv coronary (CHD), cov tshuaj tau raug txwv kom tiv thaiv kev txhim kho ntawm myocardial infarction (necrosis ntawm lub plawv mob leeg); txo txoj kev pheej hmoo uas yuav ua tau sai tuag; Kev maj mam nthuav tawm ntawm cov txheej txheem ntawm atherosclerosis; txo cov kev pheej hmoo ntawm cov teeb meem thaum lub sij hawm sib txawv ntawm kev kho mob ntawm revascularization (rov pib dua ntawm cov ntshav ntws hauv cov hlab ntsha);
Hauv cov kab mob cerebrovascular, ib qho kev kho mob yog kho rau cov mob stroke lossis cov sij hawm hloov pauv ntawm cov mob hlwb (hloov chaw ischemic).
Cov Tshuaj Tiv Thaiv:
- Biliary pancreatitis thiab lwm yam kab mob siab hauv lub siab ntu.
- Qhov tseem ceeb tshaj dhau ntawm qhov ntsuas ntawm daim siab kuaj tsis pom tseeb.
- Lub sijhawm ntawm cev xeeb tub thiab lactation.
- Muaj menyuam yaus.
- Keeb kwm kev fab tshuaj rau simvastatin lossis qee yam tshuaj ntxiv, lossis lwm yam tshuaj uas yog koom nrog pawg pharmacological ntawm statins (kev fab tshuaj rau lactose, lactase tsis haum, tsis haum rau lwm tus HMG-CoA reductase inhibitors).
Nrog huab ceev faj, Simgal yuav tsum tau kho nyob rau hauv xws li mob:
- haus cawv ntau dhau mus;
- cov neeg mob uas nyuam qhuav hloov cev ntawm hloov khoom nruab nrog, vim tias lawv raug yuam kom siv tshuaj tiv thaiv kab mob rau lub sijhawm ntev;
- lossi txo qis ntshav siab (hypotension);
- cov mob hnyav, tshwj xeeb tshaj yog cov nyom;
- metabolic tsis txaus thiab hormonal tsis txaus;
- tsis txaus ntawm dej thiab electrolyte sib npaug;
- tsis ntev los no ua haujlwm hnyav lossis raug mob;
- myasthenia gravis - ua tau mob leeg tsis muaj zog;
Tshwj xeeb yuav tsum tau ceev faj thaum kws kho mob muab tshuaj rau cov neeg mob qaug dab peg.
Cov lus qhia rau kev siv tshuaj
Kev siv cov tshuaj yuav tsum tsuas yog pib tom qab kev soj ntsuam ntxaws ntawm nws cov lus qhia (annotation). Ua ntej siv, nws yog ib qho tsim nyog yuav tsum tau sau cia cov khoom noj kom tsis haum rau tus neeg mob, uas yuav pab txo qis cov roj "tsis zoo" sai dua. Qhov kev noj haus no yuav tsum tau ua raws txoj hauv kev thoob plaws ntawm txoj kev kho.
Cov txheej txheem tshuaj rau noj Simgal yog ib zaug ib hnub nyob rau ntawm kev mus pw, vim hais tias nws yog thaum hmo ntuj uas tau tsim cov roj (cholesterol) ntau tshaj plaws, thiab cov tshuaj tam sim no yuav zoo tshaj. Nws yog qhov zoo dua kom noj nws ua ntej lossis tom qab noj hmo, tab sis tsis yog thaum nws, vim tias qhov no tuaj yeem me ntsis rau kev cuam tshuam cov metabolism hauv cov tshuaj.
Hauv kev kho mob txhawm rau txo cov neeg kawm ntawm hypercholesterolemia, Sigmal pom zoo kom noj rau hauv cov tshuaj ntau npaum li 10 mg rau 80 mg ib zaug ib hmo ua ntej yuav mus pw. Pib kev loj hlob nrog 10 mg. Qhov siab tshaj plaws tau tso cai rau noj txhua hnub yog 80 mg. Nws raug nquahu kom kho cov tshuaj nyob hauv thawj plaub lub lis piam los ntawm kev pib kho. Feem ntau ntawm cov neeg mob feem ntau yuav noj ntau dua li 20 mg.
Nrog rau kev kuaj mob xws li homozygous kab mob hypercholesterolemia, nws yog ib qho muaj kuab tshuaj los kho ib cov tshuaj ntawm ib koob 40 mg ib hnub twg thaum tsaus ntuj lossis 80 mg faib ua peb zaug - 20 mg thaum sawv ntxov thiab yav tav su, thiab 40 mg thaum hmo ntuj.
Rau cov neeg mob uas tau mob plawv los yog muaj kev pheej hmoo siab los tsim nws, kev noj ntau npaum li 20 txog 40 mg rau ib hnub yog qhov zoo tshaj.
Yog tias cov neeg mob tau txais tib lub sijhawm Verapamil lossis Amiodarone (cov tshuaj tiv thaiv rau cov ntshav siab thiab arrhythmias), ces tag nrho cov tshuaj txhua hnub ntawm Simgal yuav tsum tsis pub tshaj 20 mg.
Kev phiv los ntawm Simgal
Kev siv ntawm Simgal tuaj yeem ua rau qhov tshwm sim ntawm ntau cov kev phiv hauv lub cev.
Txhua qhov kev cuam tshuam tshwm sim los ntawm kev siv cov tshuaj tau piav qhia txhua yam nrog cov lus qhia rau kev siv txuas nrog rau cov tshuaj.
Cov kev mob tshwm sim hauv qab no ntawm cov tshuaj los ntawm ntau yam khoom hauv nruab nrog cev yog paub:
- Lub plab zom mov: mob mob hauv plab, zoo nkaus li xeev siab, ntuav, tso quav, tso cov kua hauv daim tawv nqaij thiab lub siab, muaj cov pa roj ntau dhau, muaj kev soj ntsuam daim siab ua haujlwm, creatine phosphokinase thiab alkaline phosphatase;
- Nruab nrab thiab mob ntawm lub paj hlwb: asthenia, mob taub hau, pw tsaug zog, kiv taub hau, tactile rhiab heev, mob pathology, poob lub zeem muag, saj tsis sib luag;
- Cov leeg mob ua ke: cov kab mob ntawm txoj leeg ua ke, mob plab, mob leeg, qhov kev xav ntawm lub zog tsis tuaj yeem, yaj ntawm cov leeg nqaij (rhabdomyolysis);
- Cov kab mob hauv lub raum: mob raum tsis ua haujlwm;
- Cov ntshav cov ntshav: txo cov ntshav platelet, ntshav liab thiab ntshav theem;
- Kev ua xua cuam tshuam: kub taub hau, nce ntxiv ntawm kev txo qis ntawm cov qe ntshav liab, eosinophils, urticaria, liab ntawm daim tawv nqaij, o, mob rheumatic;
- Cov tawv nqaij sawv cev: hypersensitivity rau lub teeb, tawv nqaij ua pob khaus, khaus, focal baldness, dermatomyositis;
- Lwm tus: ua pa ceev thiab lub plawv dhia, txo qis libido.
Cov tshuaj yuav tuaj yeem tau yuav hauv txhua lub tsev muag tshuaj yam tsis muaj kws kho mob sau ntawv yuav. Tus nqi qis tshaj los ntawm cov tuam ntxhab hauv tsev yog tsis ntau tshaj 200 rubles. Koj tseem tuaj yeem xaj cov tshuaj hauv Is Taws Nem nrog kev xa mus rau lub tsev muag tshuaj xav tau lossis tsev. Muaj ntau ntau cov analogues (hloov pauv) ntawm Simgal: Lovastatin, Rosuvastatin, Torvakard, Akorta. Kev ntsuas tus neeg mob txog Simgal feem ntau yog qhov zoo.
Cov kws tshaj lij yuav tham txog cov statins hauv kev yees duab hauv kab lus no.
