Torvacard yog yeeb tshuaj uas yog koom nrog pawg tshuaj pharmacological ntawm cov tshuaj hu ua statins. Nws muaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj dawb, me ntsis convex ntawm ob sab, uas tau them nrog ib zaj duab xis membrane ntawm sab nraud.
Torvacard muaj cov khoom tseem ceeb ntawm Atorvastatin, thiab ib tug xov tooj ntawm cov khoom siv pabcuam, uas suav nrog magnesium oxide, magnesium stearate, hydrodroplosanose hloov pauv, colloidal silicon dioxide, titanium dioxide, lactose monohydrate, talc, croxarmellose sodium.
Pharmacological kev txiav txim ntawm Torvacard
Torvacard yog yeeb tshuaj uas zwm rau ib pawg tshuaj lipid-txo cov tshuaj. Qhov no txhais tau hais tias nws txo qis cov lipids hauv cov ntshav, thiab ua ntej txhua yam, txo cov roj (cholesterol).
Lipid-txo cov tshuaj tau muab faib, nyeg, mus rau ntau pawg, thiab Torvakard belongs rau ib pawg hu ua statins. Nws yog xaiv kev sib tw inhibitor ntawm HMG-CoA reductase.
HMG-CoA reductase yog ib qho enzyme uas ua lub luag haujlwm rau kev hloov pauv ntawm 3-hydroxy-3-methylglutaryl coenzyme A rau mevalonic acid. Mevalonic acid yog ib hom tshuaj tua kab mob sib ntxiv.
Tus txheej txheem ntawm kev ua haujlwm ntawm Torvacard yog tias nws inhibits, uas yog, inhibits qhov kev hloov pauv no, sib tw nrog thiab thaiv HMG-CoA reductase. Nws paub tias cov roj (cholesterol), thiab triglycerides, suav nrog cov qauv ntawm lipoproteins uas tsis muaj ntau, uas tom qab ntawd tig mus rau hauv cov lipoproteins uas muaj tsawg, cuam tshuam nrog lawv cov receptors tshwj xeeb.
Cov tshuaj sib xyaw ua ke ntawm Torvacard, atorvastatin, muaj lub luag haujlwm rau kev txo qis cov roj cholesterol thiab lipoproteins tsawg thiab muaj tsawg kawg nkaus, thiab pab ua kom cov lipoprotein tsawg zog txais qis hauv daim siab, ntawm lub ntsej muag ntawm tes, uas cuam tshuam rau kev nrawm ntawm lawv kev txhim kho thiab tawg.
Torvacard txo kev tsim cov lipoproteins uas tsis muaj ntau ntau hauv cov neeg mob uas raug mob los ntawm ib tug kab mob xws li homozygous tsev neeg hypercholesterolemia, uas yog feem ntau nyuaj kho nrog tshuaj ntsuab.
Cov tshuaj kuj tseem pab txhawb ntxiv kom muaj pes tsawg leej ntawm lipoproteins uas yog lub luag hauj lwm rau kev tsim cov roj "zoo".
Pharmacokinetics thiab cov chaw muag tshuaj
Pharmacokinetics yog cov kev hloov pauv uas tshwm sim nrog cov tshuaj nws tus kheej hauv tib neeg lub cev. Qhov nws nqus tau, uas yog, kev nqus, yog qhov siab. Tsis tas li, cov tshuaj sai heev ncav cuag nws qhov kev xav ntau hauv cov ntshav, tom qab kwv yees li ib mus rau ob teev. Ntxiv mus, nyob hauv cov poj niam, tus nqi ntawm kev ncav cuag qhov siab tshaj plaws yuav nrawm dua li 20%. Hauv cov neeg muaj kev txom nyem los ntawm kev mob siab rau daim siab vim yog cawv cawv, qhov kev cia siab nws tus kheej yog 16 npaug dua siab dua li cov cai, thiab tus nqi ntawm nws qhov ua tiav yog 11 zaug.
Qhov nqus ntawm Torvacard yog ncaj qha ntsig txog kev noj zaub mov, vim tias nws ua rau qis nqus, tab sis tsis cuam tshuam rau qhov txo qis ntawm lipoprotein cov roj cholesterol kom tsawg. Yog tias koj noj tshuaj thaum yav tsaus ntuj, ua ntej yuav mus pw, ces nws cov tshuaj lom hauv cov ntshav, tsis zoo li cov tshuaj noj thaum sawv ntxov, yuav qis dua. Nws kuj tau pom tias muaj ntau dua qhov ntau ntawm cov tshuaj, nws ceev dua nws yooj yim dua.
Lub bioavailability ntawm Torvacard yog 12% vim nws txoj kev kis los ntawm cov qog ua kua ntawm lub plab zom mov thiab dhau los ntawm daim siab, qhov twg nws yog qee qhov kho.
Cov tshuaj yuav luag 100% ua txhua yam rau cov ntshav protein. Tom qab hloov kho ib nrab hauv daim siab vim kev txiav txim ntawm isoenzymes tshwj xeeb, cov metabolites nquag tau tsim, uas muaj cov nyhuv tseem ceeb ntawm Torvacard - lawv inhibit HMG-CoA reductase.
Tom qab qee yam hloov pauv hauv lub siab, cov tshuaj nrog bile nkag mus rau txoj hnyuv, dhau los ntawm qhov nws kiag li tshem tawm los ntawm lub cev. Ib nrab-lub neej ntawm Torvacard - lub sijhawm thaum lub siab ntawm cov tshuaj nyob rau hauv lub cev txo qis raws nraim 2 zaug - yog 14 teev.
Cov nyhuv ntawm cov tshuaj pom tau rau kwv yees li ib hnub vim kev ua ntawm cov metabolites ntxiv. Hauv cov zis, ib qho me me ntawm cov tshuaj muaj peev xwm kuaj pom.
Nws yog tsim nyog xav tias thaum lub sijhawm hemodialysis nws tsis ua kom pom.
Kev qhia rau kev siv tshuaj
Torvacard muaj qhov ntau ntawm cov cim.
Nws yuav tsum raug sau tseg tias cov tshuaj muaj tag nrho cov npe ntawm cov cim qhia rau siv, coj mus rau hauv tus account thaum sau ntawv yuav siv cov tshuaj.
Cov lus qhia rau kev siv qhia txhua kis ntawm kev siv tshuaj.
Ntawm lawv, cov tseem ceeb muaj li hauv qab no:
- Torvacard tau raug txo los txo cov theem ntawm cov roj (cholesterol) tag nrho, nrog rau cov lipoproteins uas tsis muaj tsawg, kom txo qis apolipoprotein B, kuj triglycerides, thiab nce cov nyiaj lipoprotein ntau rau cov neeg mob ntshav qab zib rau cov neeg uas muaj kev tiv thaiv heterozygous los yog thawj hypercholesterolemia, nrog rau hom II lipid lipidemia Cov. Cov nyhuv yog pom tsuas yog thaum noj zaub mov.
- Tsis tas li, thaum kev noj haus, Torvard yog siv rau hauv kev kho mob ntawm tsev neeg endogenous hypertriglyceridemia ntawm plaub yam raws li Frederickson, thiab rau kev kho mob ntawm dysbetalipoproteinemia ntawm yam thib peb, nyob rau hauv uas noj tsis tau zoo.
- Cov tshuaj no yog siv los ntawm ntau tus kws tshaj lij txhawm rau txo qib ntawm tag nrho cov roj (cholesterol) thiab cov lipoproteins uas tsis tshua muaj nyob hauv cov kab mob xws li homozygous tsev neeg hypercholesterolemia, yog tias kev noj zaub mov noj thiab lwm txoj kev siv tshuaj tsis zoo los kho tsis muaj cov nyhuv xav tau. Feem ntau raws li cov tshuaj thib ob.
Ib qho ntxiv, cov tshuaj no yog siv rau cov mob plawv thiab mob ntshav hauv cov neeg mob uas muaj kev pheej hmoo txaus rau kev mob plawv mob plawv. Qhov no muaj hnub nyoog ntau dua 50 xyoos, mob ntshav siab, haus luam yeeb, sab laug ventricular hypertrophy, mob ntshav qab zib mellitus, raum, mob voos, nrog rau cov mob ntshav plawv hauv cov neeg hlub.
Nws yog qhov tshwj xeeb tshaj yog rau concomitant dyslipidemia, vim nws tiv thaiv kev txhim kho ntawm lub plawv nres, mob ntshav nce hlwb, thiab tuag taus.
Txoj kev tiv thaiv kom tsis txhob siv tshuaj
Tseem muaj ntau yam sib kis rau kev siv Torvacard.
Coob tus contraindications ua rau txiav npluav ntawm yus tus kheej-tshuaj ntawm cov tshuaj.
Qhov ntau npaum li cas thiab qhov tseeb yog txiav txim tau tsuas yog txiav txim siab los ntawm tus kws kho mob tuaj koom.
Contraindications suav nrog:
- mob siab hauv theem nquag lossis nce siab ntawm daim siab ua piv txwv los ntawm ntau dua peb zaug rau cov tsis paub;
- tsis txaus ntseeg ntawm hepatic zog;
- cov kab mob caj ces ntawm hom lactose tsis kam lossis tsis muaj lactase - ib qho enzyme uas ua lub luag haujlwm rau cov piam thaj ntawm cov mis ua kua, qhov no yog vim qhov tseeb tias cov tshuaj muaj lactose;
- cev xeeb tub
- lub sijhawm pub niam mis;
- cov yeeb tshuaj yog txwv tsis pub noj los ntawm cov poj niam uas muaj hnub nyoog yug me nyuam, tab sis tsis ua raws li cov kev tiv thaiv kom tsim nyog;
- cov menyuam yaus hnub nyoog qis dua 18 xyoo, vim tias tsis paub txog kev ua haujlwm zoo thiab kev nyab xeeb;
- Kev tsis haum tshuaj rau qee yam ntawm cov tshuaj.
Kev saib xyuas tshwj xeeb yuav tsum tau saib xyuas cov kab mob hauv qab no, kev mob thiab kab mob:
- Kev haus cawv mus ntev
- Kab mob siab rau txhua yam keeb kwm.
- Kev ua txhaum ntawm kev sib pauv dej thiab electrolytes.
- Hormonal tsis txaus.
- Kev ntshaib plab metabolic.
- Tsis tu ncua txo lub siab (hypotension).
- Sepsis yog qhov pom muaj cov kab mob nyob hauv cov ntshav, yog ib qho kev cuam tshuam loj tshaj plaws ntawm cov kev kis tau.
- Kho tsis tau mob qaug dab peg.
- Pathologies ntawm cov leeg ua haujlwm.
- Mob ntshav qab zib mellitus ntawm thawj thiab hom thib ob.
- Ncua kev ua haujlwm ntau.
- Kev raug mob nyas.
Nws yog qhov tsim nyog los ntsuas kev pheej hmoo txaus siv kev pheej hmoo Torvacard thaum cev xeeb tub thiab thaum pub niam mis. Nyob rau thawj peb lub hlis thaum cev xeeb tub, tso ntawm cov txheej txheem tseem ceeb tshaj plaws ntawm cov nruab nrog cev thiab cov nqaij ntawm cov menyuam hauv plab. Rau cov txheej txheem no, cov roj cholesterol thiab cov tshuaj uas tau tsim tawm los ntawm nws yog qhov tsim nyog heev.
HMG-CoA reductase inhibitors muaj qhov tsis zoo rau lub cev kev loj hlob ntawm tus me nyuam hauv plab, tuaj yeem ua rau lub hnub yug ntawm tus menyuam muaj mob tsis xws luag, xws li atresia (tsis tuaj, tsis kho) ntawm lub qhov quav, pob txha deformities, fistula (los ntawm lub qhov) nruab nrab ntawm txoj hlab pas thiab txoj hlab pas.
Yog tias tus neeg mob noj Torvacard muaj menyuam hauv plab, ces cov tshuaj yuav tsum tau txiav tam sim ntawd. Nyob rau hauv kev tshwm sim uas tus poj niam tab tom pub niam mis, pub mis rau noj kuj tseem pom zoo kom tsum, vim tias qhov tsis xav ua hauv cov menyuam yaus ntawm Torvacard tsis to taub tag nrho.
Cov poj niam yuav tsum tau qhia paub txog qhov ua tau kom muaj qhov tsis zoo ntawm cov tshuaj ntawm cov menyuam hauv plab thiab pom zoo kom siv txoj hauv kev txhim kho kom muaj txiaj ntsig.
Cov lus qhia siv Torvacard
Lub hom phiaj ntawm cov tshuaj yuav tsum yog ua ke nrog kev kho kev noj haus tsom ncaj qha rau txo qis roj. Torvacard tuaj yeem siv sijhawm txhua lub sijhawm ntawm hnub, ua ntej lossis tom qab noj mov.
Pib noj nrog li 10 mg ib hnub twg. Qhov siab tshaj plaws pub siv tau yog 80 mg rau ib hnub. Kev noj tshuaj txhua hnub tuaj yeem hloov kho raws li cov ntsuas pom muaj ntawm cov cholesterol, triglycerides thiab qis thiab siab lipoproteins, nrog rau kev suav txog cov txiaj ntsig ib tus neeg twg rau txhua tus neeg mob. Thaum noj Torvacard txhua ob rau plaub lub lis piam, nws raug nquahu kom soj ntsuam cov lipid profile.
Rau kev kho mob ntawm cov kab mob xws li thawj hypercholesterolemia thiab sib xyaw hyperlipidemia, noj ntau npaum li 10 mg ib hnub twg siv feem ntau siv. Cov nyhuv tseem ceeb pib tshwm tom qab ob lub limtiam, thiab qhov siab tshaj plaws - tom qab plaub lub lis piam. Kho mus sij hawm ntev yog qhov pom zoo.
Nrog homozygous tsev neeg hypercholesterolemia, kev siv cov tshuaj ntawm ib koob ntawm 80 mg rau ib hnub tuaj yeem txo qib theem ntawm cov roj (cholesterol) thiab qis lipoproteins ntau dua los ntawm ntau dua kaum tsib feem pua.
Qhov ntau npaum ntawm cov tshuaj rau cov neeg mob kev txom nyem los ntawm lub raum tsis tas yuav tsum muaj kev kho kom haum, ntxiv rau cov laus.
Kev phiv tshuaj los ntawm kev siv cov tshuaj
Thaum siv cov tshuaj hauv tus neeg mob, tag nrho cov kev phiv tshuaj tsis zoo yuav tshwm sim.
Qhov tshwm sim uas tshwm sim ntawm qhov tshwm sim tsis zoo yuav tsum tau txiav txim siab thaum sau ntawv tshuaj.
Coob tus ntawm cov kev mob tshwm sim thaum siv cov tshuaj ua rau categorical txiav npluav ntawm kev tswj hwm tus kheej ntawm cov tshuaj thaum kho. Tsuas yog ib tus kws kho mob muaj cai sau ntawv tshuaj, suav txog tus yam ntxwv ntawm tus neeg mob lub cev.
Thaum siv tshuaj Torvakard, cov kev mob tshwm sim hauv qab no tshwm sim:
- Lub hauv nruab nrab thiab nruab nrab lub paj hlwb - mob taub hau, kiv taub hau, qaug zog, pw tsaug zog, npau suav phem, nco puas, poob qis lossis tsis hnov qab lub cev tsis zoo, kev nyuaj siab, ataxia.
- Lub plab zom mov - cem quav lossis zawv plab, ib qho kev xav ntawm xeev siab, ditch, ntau dhau lawm, mob hauv thaj av epigastric, qhov tsis txaus siab poob qis, ua rau tus mob anorexia, nws yog lwm txoj kev puag ncig, nws nce ntxiv, cov txheej txheem mob siab rau hauv lub siab thiab lub raum, daj ntseg vim stagnation ntawm cov kua tsib;
- Musculoskeletal system - feem ntau muaj mob ntawm cov leeg nqaij thiab pob qij txha, mob myopathy, mob ntawm cov leeg nqaij, rhabdomyolysis, mob nraub qaum, mob ua tsis ncaj ntawm cov leeg ceg;
- Kev ua xua cuam tshuam - khaus thiab tawm pob rau ntawm daim tawv nqaij, urticaria, kev tsis haum tshuaj tam sim (anaphylactic ceeb), Stevens-Johnson thiab Lyell syndromes, angioedema, erythema;
- Kuaj qhov ntsuas - kev nce lossis txo qis hauv ntshav qabzib, nce ntxiv ntawm cov kev ua ntawm creatiphosphokinase, alanine aminotransferase thiab aspartate aminotransferase, kev nce qib hauv glycated hemoglobin;
- Lwm tus - mob hauv siab, o ntawm sab hauv thiab sab saud, impotence, focal alopecia, hnyav, dav dav tsis muaj zog, txo cov ntshav txhaws, kev ua haujlwm hauv lub raum tsis ua haujlwm.
Kev phiv tshuaj tiv thaiv cov yam ntxwv ntawm txhua qhov tshuaj ntawm cov pab pawg neeg statin kuj muaj qhov sib txawv:
- txo qis libido;
- gynecomastia - kev loj hlob ntawm cov qog mammary nyob hauv tus txiv neej;
- kev cuam tshuam ntawm cov leeg;
- Kev Nyuaj Siab
- tsis tshua muaj kab mob ntsws nrog rau kev kho mob ntev ntev;
- cov tsos mob ntshav qab zib.
Kev saib xyuas tshwj xeeb yuav tsum tau saib xyuas thaum noj Torvacard thiab cytostatics, fibrates, tshuaj tua kab mob thiab tshuaj tua kab mob, vim tias lawv tsis zoo tas li. Qhov no kuj siv rau mob glycosides, tshwj xeeb tshaj yog Digoxin.
Cov analogues ntawm Torvacard yog tsim tawm xws li Lovastatin, Rosuvastatin, Vasilip, Liprimar, Akorta, Atorvastatin, Zokor.
Kev tshuaj xyuas txog cov tshuaj feem ntau yog qhov zoo, vim tias statins yog pab pawg zoo tshaj plaws ntawm cov tshuaj uas txo cov roj cholesterol.
Cov kws tshaj lij yuav tham txog cov statins hauv kev yees duab hauv kab lus no.
