Rosuvastatin 19

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Rosuvastatin C ch tc ng: Rosuvastatin l mt cht c ch chn lc v cnh tranh trn hommes HMG-CoA réductase, l homme xc tc qu trnh chuyn i 3-hydroxy-3-méthylglutaryl coenzyme A thnh mévalonate, mt étain cht ca cholestérol. V tr tc ng CHNH ca rosuvastatine l gan, c quan ch lm gim cholestérol. La lng de Rosuvastatin lm TNG th th LDL trn b mt t bo gan, faire vy lm TNG hp thu v TNG hp VLDL de gan de d ha LDL v c ch, v vy lm gim cc thnh phn VLDL v LDL. Tc ng dc lc Rosuvastatin lm gim nng LDL-cholestérol, ton phn v triglycéride v lm TNG HDL-cholestérol. Thuc cng de gim ApoB, non HDL-C, VLDL-C, VLDL-TG v lm TNG ApoA-I. gim cc t l de LDL-C de Rosuvastatin cng / HDL-C, C tonne PHN / HDL-C, non HDL-C / HDL-C v ApoB / ApoA-I. Hiu bnh qu lm sng Rosuvastatin c chng minh c hiu qu nhm bnh nhn ngi ln TNG cholestérol mu, c foin khng c TNG triglycéride mu, bt k chng tc, gii tnh foin tui tc v nhng nhm bnh nhn c bit nh tiu ng hoc nhn TNG cholestérol mu gia nh. T cc d liu nghin cu pha III, Rosuvastatin chng tc hiu qu trong iu tr hu ht cc bnh nhn TNG cholestérol mu loi IIa v IIb (LDL-C trung bnh trc khi iu tr khong 4,8mmol / l) theo cc mc tiu iu tr ca Salut X Va Mch Mu Chu u (Atherosclerosis européenne société - EAS 1998) khong 80 bnh nhn c iu tr bng Rosuvastatin 10mg tc cc mc tiu iu tr ca EAS v nng LDL-C (5 x LNS) e nn thc hin mt xt nghim xc nh li trong vng 5-7 nGy. lp li la xc Nu xt nh nng CK trc khi iu tr vl ln hn 5 x LNS e khng nn bt u iu tr bng Rosuvastatin. Trc khi iu tr Ging nh cc cht c ch hommes HMG-CoA réductase KHC, cn THN Trng khi dng Rosuvastatin bnh nhn c cc yu t C th dn n tiu c vl nh:. Suy THN. gip NHc. bn THN hoc gia nh c bnh di truyn v de c Tin. gy c tnh de trn Tin c do cc cht c ch hommes HMG-CoA réductase fibrate KHC hoc. Nghin ru. Trn 70 tui. Cc tnh Trng c e gy ra TNG nng thuc trong huyt TNG. nhng bnh nhn ny nn cn nhc gia Nguy c v li ch ca vic iu tr v phi theo di lm sng. Nu nng CK TNG cao k ng donc vi trc khi iu tr (5 x LNS) e khng nn bt u iu tr bng Rosuvastatin. Trong khi iu tr Nn yu cu BNH nhn bo co ngay cc hin TNG au c, yu vp c hoc b khng gii thch c, bit c nu c km mt mi hoc st. Nn o nng CK nhng bnh nhn ny. Nn ngng dng Rosuvastatin nu nng CK TNG cao k ng (5 x LNS) hoc cc triu chng v c trm Trng chu hng de nGy de v gy (ngay c khi nng CK 5 x LNS). Nu cc triu chng ny khng cn na v nng CK tr li mc bnh thng nn xem xt n vic dng li Rosuvastatin hoc dng mt cht c ch hommes HMG-CoA réductase KHC liu thp nht v theo di cht ch. Vic theo di nh k nng CK cc bnh nhn khng c triu chng khng m bo pht hin bnh c. Trong cc th nghim lm sng, khng ghi nhn bnh dng nhn Rosuvastatin v cc thuc de gia TNG nh hng trn c mt de ton KHC dng ng thi. Tuy Nhin, tl mc bnh vim cv bnh c gia TNG c ta bnh nhn dng cc cht c ch hommes HMG-CoA réductase KHC ng thi vi cc dn XUT ca axt fibrique kc gemfibrozil, cyclosporine, axt nicotinique, thuc khng nm nhm azole, cc cht c ch hommes protease v khng sinh nhm macrolide. Gemfibrozil lm TNG Nguy c bnh c khi dng ng thi vi vi cht c ch hommes HMG-CoA réductase. Avez-vy, s phi hp gia Rosuvastatin v gemfibrozil khng c khuyn co. dng kt de hp Vic Rosuvastatin vi fibrates hoc niacine t c s de Thay i hn na nng lipidique nn c cn nhc k gia li ch v Nguy c c e xy ra do nhng kt hp ny. Khng de la dng Rosuvastatin cho bnh nhn c tnh Trng nghim Trng cp tnh, nghi ng ne BNH c hoc c e dn n suy THN e pht faire tiu c vl (nh Nhim khun huyt, tt huyt p, i phu, chn thng, ri LON en gii, ni tit v chuyn ha nng hoc co git khng kim SOT c). nh hng trn gan Ging nh cc cht c ch hommes HMG-CoA réductase KHC, cn THN Trng khi dng Rosuvastatin bnh nhn nghin ru nng v / hoc c bnh gan s étain. Cc e nghim chc nng gan c khuyn co thc hin trc khi iu tr v 3 thng sau khi bt u iu tr bng Rosuvastatin. Nn ngng hoc gim liu Rosuvastatin nu nng transaminase huyt thanh gp 3 ln gii hn trn ca mc bnh thng. nhng bnh nhn TNG cholestérol huyt e pht do thiu nng Tuyn gip hoc salut chng THN h, th nhng bnh ny phi c iu tr trc khi bt u DNG Rosuvastatin. Chng tc Cc nghin cu dc ng hc cho ton c s gia TNG mc pointe xc vi thuc tnh theo nng v thi gian bnh nhn Nht bn v Trung quc donc vi ngi da Trng PHNG Ty. nh hng ln kh nng li xe v vl hnh mon: Cc nghin cu xc nh nh hng ca Rosuvastatin trn kh nng li xe v vn hnh ma cha c thc hin. Tuy Nhin, da trn nhng c tnh dc lc th Rosuvastatin khng th nh hng trn cc kh nng ny. Khi li xe hoc vl hnh mon nn lu rng chng mt c e xy ra trong thi gian iu tr. LC C THAI V LC NUI CON B Rosuvastatin chng ch nh trn ph n c thai v cho con b. Ph n c e dng cc bin php nga thch thai hp mang thai nn. V cholestérol v cc sn phm sinh TNG hp cholestérol KHC l cn thit cho s pht trin bo thai, nn Nguy c tim TNG faire la chim de c ch hommes HMG-CoA réductase u e hn li ch ca vic iu tr bng Rosuvastatin trong SUT thi gian thai mang. Cc nghin cu trn ng vt cho ton c nhng bng chng gii hn v c tnh trn h sinh sn. Nu bnh nhn c thai trong khi iu tr bng Rosuvastatin e nn ngng thuc ngay lp tc. Chut, rosuvastatine bi tit qua sa. Khng c d liu TNG ng v s bi tit qua sa ngi. Tng tc thuc: Cyclosporine: Dng ng thi Rosuvastatin vi cyclosporine, cc gi tr AUC ca rosuvastatine cao hn trung bnh gp 7 ln donc vi tr s ny ngi tnh nguyn kho mnh. Dng ng thi Rosuvastatin v cyclosporine khng nh hng n nng cyclosporine trong huyt TNG. Cc cht i khng vitamine K: Ging nh cc cht c ch hommes HMG-CoA réductase KHC, khi bt u iu tr hoc TNG liu Rosuvastatin bnh nhn iu tr ng thi vi cc cht i khng la vitamine K (nh warfarine) c e lm TNG tr INR. Ngng dng hoc gim liu Rosuvastatin c e lm gim INR. Trong nhng Trng hp nh vy, nn theo di tr s INR. Gemfibrozil: Ging nh cc cht c ch hommes HMG-CoA réductase KHC, dng ng thi Rosuvastatin vi gemfibrozil lm TNG gp Cmax v AUC s 2 ln cc ch ca rosuvastatine. Thuc acide khng: Dng Rosuvastatin ng thi vi hn dch thuc acide khng cha nhm v magi hydroxid lm gim khong 50 nng rosuvastatine trong huyt TNG. Khi ung thuc khng acide cch 2 gi sau khi dng Rosuvastatin e nng rosuvastatine trong huyt TNG s gim t hn. Mi TNG quan v mt lm sng ca TNG tc cha r ny. Érythromycine: dng ng thi Rosuvastatin vi érythromycine lm gim 20 AUC (0-t) v 30 Cmax ca rosuvastatine. Tng tc ny c e l faire érythromycine lm TNG nhu ng rut. Thuc vin ung nga thai / liu php Thay th hormone (HRT): dng ng thi Rosuvastatin vi thuc vin ung nga thai lm TNG 26 AUC ca éthinylestradiol v 34 AUC ca norgestrel. Nn lu n mc TNG nng cc cht ny trong huyt TNG khi chn thuc ung nga thai. Cha c d liu dc ng hc trn nhng bnh nhn dng ng thi Rosuvastatin v HRT v v vy khng e tr kh loi nng c tc ng TNG t. Tuy Nhin, s dng rng ri ph n trong cc de kt hp c th nghim lm sng v c fiente np tt. Cc thuc KHC Da trn cc d liu tcc cu nghin v TNG tc thuc bit chuyn cho ton khng c TNG tc ng k v mt lm sng khi dng chung vi fénofibrate digoxine hoc. Gemfibrozil, gim de lipides de cc fibrate KHC v niacine (acide nicotinique) cc liu (1g / nGy) lm TNG Nguy c bnh c khi dng ng thi vi vi cht c ch hommes HMG-CoA réductase, c e lv nhng cht ny gy bnh khi lvc bague dng l. Hommes cytochrome P450: kt qu t th nghim in vitro v in vivo chng t rng rosuvastatine khng phi l cht c ch hoc cm ng hommes cytochrome P450. Hn na, rosuvastatine l cht nn yu cho cc enzyme ny. Khng ghi nhn c TNG tc ng k v mt lm sng gia rosuvastatine vi fluconazole (cht c ch CYP2C9 v CYP3A4) hoc kétoconazole (cht c ch CYP2A6 v CYP3A4). Dng ng thi itraconazole (cht c ch CYP3A4) v ​​rosuvastatine lm TNG 28 AUC ca rosuvastatine. S TNG ny khng c xem l c Ngha v mt lm sng. V vy, khng c TNG tc thuc ne s chuyn ha qua trung gian cytochrome P450.