Rosuvastatin (dzina lamtundu wa Crestor, wogulitsidwa ndi AstraZeneca) ndi amodzi mwa mankhwala omwe amagwiritsidwa ntchito kwambiri ndi ma statins. Monga ma statins ena, rosuvastatin imayikidwa kuti ipititse patsogolo lipids m'magazi a munthu komanso kuchepetsa chiopsezo cha mtima.

M'zaka khumi zoyambirira zomwe rosuvastatin inali pamsika, idadziwika kuti ndi "ma statin a m'badwo wachitatu," motero inali yothandiza kwambiri komanso yopangitsa kuti pakhale zovuta zochepa kuposa mankhwala ena ambiri. Zaka zapita ndipo umboni wochokera ku mayesero azachipatala wawonjezeka, chidwi chachikulu cha ma statins awa chachepetsedwa.

Akatswiri ambiri tsopano amawona kuti zowopsa ndi zopindulitsa za rosuvastatin ndizofanana kwambiri ndi za ma statins ena. Komabe, pali zochitika zingapo zamankhwala momwe rosuvastatin ingakonde.

Kugwiritsa ntchito Rosuvastatin

Ma statins adapangidwa kuti achepetse cholesterol yamagazi. Mankhwalawa amamanga mopikisana ndi enzyme ya chiwindi yotchedwa hydroxymethylglutaryl (HMG) CoA reductase. HMG CoA reductase imagwira ntchito yochepetsa kuchuluka kwa cholesterol m'chiwindi.

Poletsa HMG CoA reductase, ma statins amatha kuchepetsa kwambiri LDL ("yoyipa") ya cholesterol m'chiwindi, motero amatha kuchepetsa kuchuluka kwa cholesterol ya LDL m'magazi mpaka 60%. Kuphatikiza apo, ma statins amachepetsa kuchuluka kwa triglyceride m'magazi (pafupifupi 20-40%), ndipo amatulutsa kuchuluka pang'ono (pafupifupi 5%) m'magazi a HDL cholesterol ("cholesterol yabwino").

Kupatulapo ma PCSK9 inhibitors omwe angopangidwa kumene, ma statins ndi mankhwala amphamvu kwambiri ochepetsa cholesterol omwe amapezeka. Kuwonjezera apo, mosiyana ndi magulu ena a mankhwala ochepetsa mafuta m'thupi, mayesero a zachipatala asonyeza kuti mankhwala a statin amatha kusintha kwambiri zotsatira za nthawi yaitali za anthu omwe ali ndi matenda a mitsempha yotchedwa coronary artery disease (CAD), ndi anthu omwe ali pachiopsezo chachikulu chokhala ndi CAD. .

Ma Statin amachepetsanso kwambiri ngozi ya kudwala kwa mtima pambuyo pake, ndi kuchepetsa chiopsezo cha kufa ndi CAD. (Ma PCSK9 inhibitors atsopano awonetsedwanso m'ma RCT akuluakulu kuti apititse patsogolo zotsatira zachipatala.)

Kuthekera kumeneku kwa ma statins kuti apititse patsogolo kwambiri zotsatira zachipatala kumaganiziridwa kuti kumabwera, mwina mwa zina, kuchokera kuzinthu zina kapena zonse zomwe sizinachepetse cholesterol. Kuphatikiza pa kutsitsa cholesterol ya LDL, ma statins alinso ndi anti-inflammatory properties, anti-blood clotting effects, ndi plaque-stabilizing properties. Komanso, mankhwalawa amachepetsa kuchuluka kwa mapuloteni a C-reactive, kumapangitsa kuti mitsempha ya mitsempha igwire bwino, komanso kuchepetsa chiopsezo cha matenda a mtima omwe angawononge moyo.

Ndikotheka kuti mapindu azachipatala omwe amawonetsedwa ndi mankhwala a statin amakhala chifukwa chophatikiza kutsitsa kwawo kwa cholesterol ndi mitundu yosiyanasiyana ya zotsatira zake zopanda mafuta m'thupi.

Kodi Rosuvastatin Ndi Yosiyana Bwanji?

Rosuvastatin ndi mankhwala atsopano, otchedwa "m'badwo wachitatu" statin mankhwala. Kwenikweni, ndiye mankhwala amphamvu kwambiri a statin pamsika.

Mphamvu yake yocheperako imachokera ku mawonekedwe ake amankhwala, omwe amalola kumangiriza mwamphamvu ku HMG CoA reductase, motero kumapangitsa kuletsa kwathunthu kwa enzyme iyi. Molekyulu ya molekyulu, rosuvastatin imatulutsa LDL-cholesterol-kutsitsa kuposa mankhwala ena a statin. Komabe, kuchulukitsa kofananako kotsitsa kolesterol kumatha kutheka pogwiritsa ntchito Mlingo wokwera wa ma statins ena ambiri.

Pamene chithandizo cha statin "champhamvu" chikufunika kuti muchepetse mafuta m'thupi momwe mungathere, rosuvastatin ndiye mankhwala opita kwa madokotala ambiri.

Kuchita bwino kwa Rosuvastatin

Rosuvastatin yadziwika kuti ndi yothandiza kwambiri pakati pa ma statins, makamaka potengera zotsatira za mayeso awiri azachipatala.

Mu 2008, kufalitsidwa kwa kafukufuku wa JUPITER kudachititsa chidwi akatswiri amtima kulikonse. Mu kafukufukuyu, anthu opitilira 17,000 athanzi omwe anali ndi milingo yabwinobwino ya LDL cholesterol m'magazi koma okwera CRP adasinthidwa mwachisawawa kuti alandire 20 mg patsiku la rosuvastatin kapena placebo.

Panthawi yotsatiridwa, anthu osankhidwa mwachisawawa ku rosuvastatin sanangochepetsa kwambiri LDL cholesterol ndi CRP, komanso anali ndi zochitika zochepa kwambiri za mtima (kuphatikizapo matenda a mtima, sitiroko, kufunikira kwa njira yobwezeretsanso mitsempha monga opaleshoni ya stent kapena bypass, ndi kuphatikizika kwa matenda a mtima, kapena kufa kwa mtima), komanso kuchepetsa kufa kwa zifukwa zonse.

Kafukufukuyu anali wodabwitsa osati chifukwa chakuti rosuvastatin inasintha kwambiri zotsatira zachipatala mwa anthu omwe amaoneka kuti ali ndi thanzi labwino, komanso chifukwa chakuti anthuwa analibe mafuta a kolesterolini okwera panthawi yolembetsa.

Mu 2016, kuyesa kwa HOPE-3 kudasindikizidwa. Kafukufukuyu adalembetsa anthu opitilira 12,000 omwe ali ndi chiopsezo chimodzi cha matenda a atherosclerotic vascular disease, koma osapitilira CAD. Omwe adatenga nawo gawo adasinthidwa mwachisawawa kuti alandire rosuvastatin kapena placebo. Kumapeto kwa chaka, anthu omwe amamwa rosuvastatin adachepetsa kwambiri zotsatira zake (kuphatikiza matenda amtima osapha kapena sitiroko, kapena kufa ndi matenda amtima).

M'mayesero onsewa, kusasinthika kwa rosuvastatin kwasintha kwambiri zotsatira zachipatala za anthu omwe anali ndi chiwopsezo chimodzi kapena zingapo, koma palibe zizindikiro za matenda amtima.

Tiyenera kuzindikira kuti rosuvastatin inasankhidwa m'mayeserowa osati chifukwa chakuti inali mankhwala amphamvu kwambiri a statin, koma (makamaka makamaka) chifukwa mayeserowa adathandizidwa ndi AstraZeneca, wopanga rosuvastatin.

Akatswiri ambiri a lipid amakhulupirira kuti zotsatira za mayesowa zikadakhala zofanana ngati statin ina ikadagwiritsidwa ntchito pamlingo wokwanira, ndipo, zowona, malingaliro omwe alipo pazamankhwala a statin nthawi zambiri amalola kugwiritsa ntchito mankhwala aliwonse a statin bola Mlingo umakhala wokwera kwambiri kuti ukwaniritse pafupifupi mulingo womwewo wa kutsitsa mafuta m'thupi monga momwe ungafikire ndi mlingo wochepa wa rosuvastatin. (Kupatulapo pa lamuloli zimachitika pamene pakufunika “mankhwala owonjezera a ma statins”. Kuchiza kwa ma statins kumatanthawuza kuti mlingo waukulu wa rosuvastatin kapena atorvastatin wochuluka, womwe ndi wotsatira wamphamvu kwambiri.)

Koma chifukwa rosuvastatin inalidi statin yomwe idagwiritsidwa ntchito m'mayesero awiri ofunikirawa, madokotala ambiri alephera kugwiritsa ntchito rosuvastatin ngati statin yawo yomwe amasankha.

Zizindikiro Panopa

Chithandizo cha Statin chimasonyezedwa kuti chiwongolere kuchuluka kwa lipids m'magazi (makamaka, kuchepetsa LDL cholesterol ndi/kapena triglyceride), komanso kupewa matenda amtima. Ma Statin amalimbikitsidwa kwa anthu omwe ali ndi matenda a atherosclerotic amtima, odwala matenda ashuga, komanso anthu omwe ali pachiwopsezo chazaka 10 chokhala ndi matenda amtima ndi 7.5% mpaka 10%.

Ngakhale, nthawi zambiri, mankhwala a statin amatengedwa kuti ndi osinthika malinga ndi mphamvu zawo komanso chiwopsezo chawo choyambitsa zovuta, pakhoza kukhala nthawi yomwe rosuvastatin ingakonde. Makamaka, ngati chithandizo cha "high-intensity" statin therapy ndi cholinga chochepetsa cholesterol ya LDL mpaka yotsika kwambiri, mwina rosuvastatin kapena atorvastatin pamilingo yawo yokwezeka nthawi zambiri amalimbikitsidwa.

Asanatenge

Musanatumizireni mankhwala aliwonse a statin, dokotala wanu adzayesa mayeso owopsa kuti ayese chiwopsezo chanu chokhala ndi matenda amtima komanso kuyeza kuchuluka kwa lipids m'magazi anu. Ngati muli ndi matenda amtima kapena muli pachiwopsezo chokulirapo, dokotala wanu angakulimbikitseni mankhwala a statin.

Mankhwala ena odziwika bwino a statin ndi atorvastatin, simvastatin, fluvastatin, lovastatin, pitavastatin, ndi pravastatin.

Crestor, dzina la mtundu wa rosuvastatin ku US, ndiokwera mtengo kwambiri, koma mitundu yanthawi zonse ya rosuvastatin ilipo. Ngati dokotala akufuna kuti mutenge rosuvastatin, funsani ngati mungagwiritse ntchito generic.

Ma statins sayenera kugwiritsidwa ntchito mwa anthu omwe sagwirizana ndi ma statins kapena chilichonse mwazinthu zawo, omwe ali ndi pakati kapena oyamwitsa, omwe ali ndi matenda a chiwindi kapena aimpso, kapena omwe amamwa mowa mopitirira muyeso. Kafukufuku akuwonetsa kuti rosuvastatin itha kugwiritsidwa ntchito mosamala mwa ana opitilira zaka 10.

Mlingo wa Rosuvastatin

Rosuvastatin ikagwiritsidwa ntchito kuchepetsa kuchuluka kwa cholesterol ya LDL, nthawi zambiri Mlingo wocheperako umayamba (5 mpaka 10 mg patsiku) ndikusinthidwa kupitilira mwezi uliwonse kapena iwiri ngati pakufunika. Mwa anthu omwe ali ndi mabanja a hypercholesterolemia, madokotala nthawi zambiri amayamba ndi Mlingo wokulirapo (10 mpaka 20 mg patsiku).

Mukamagwiritsa ntchito rosuvastatin kuti muchepetse chiwopsezo cha matenda amtima mwa anthu omwe ali pachiwopsezo chokwera, mlingo woyambira nthawi zambiri umakhala 5 mpaka 10 mg patsiku. Kwa anthu omwe chiwopsezo chawo chimawonedwa ngati chachikulu (makamaka, chiopsezo chawo chazaka 10 chikuyembekezeka kukhala choposa 7.5%), chithandizo champhamvu kwambiri chimayamba, ndi 20 mpaka 40 mg patsiku.

Ngati rosuvastatin ikugwiritsidwa ntchito kuti muchepetse chiopsezo cha zochitika zina zamtima mwa munthu yemwe ali ndi matenda amtima omwe akhazikitsidwa kale, chithandizo chamankhwala nthawi zambiri chimagwiritsidwa ntchito ndi 20 mpaka 40 mg patsiku.

Kwa anthu omwe amamwa cyclosporine kapena mankhwala a HIV/AIDS, kapena mwa anthu omwe ali ndi vuto la impso, mlingo wa rosuvastatin uyenera kusinthidwa pansi, ndipo nthawi zambiri sayenera kupitirira 10 mg patsiku.

Anthu amtundu waku Asia amakonda kukhala okhudzidwa kwambiri ndi mankhwala a statin komanso omwe amakhala ndi zotsatira zoyipa. Nthawi zambiri tikulimbikitsidwa kuti rosuvastatin iyambike pa 5 mg patsiku ndikuwonjezeka pang'onopang'ono mwa odwala aku Asia.

Rosuvastatin amatengedwa kamodzi patsiku, ndipo amatha kutengedwa m'mawa kapena usiku. Mosiyana ndi mankhwala ena ambiri a statin, kumwa madzi ochepa a mphesa sikukhudza kwambiri rosuvastatin.

Zotsatira zoyipa za Rosuvastatin

M'zaka zomwe rosuvastatin itangopangidwa, akatswiri ambiri adaganiza kuti zotsatira zoyipa za ma statin sizingatchulidwe kwambiri ndi rosuvastatin, chifukwa Mlingo wocheperako ungagwiritsidwe ntchito kuti muchepetse cholesterol yokwanira. Panthawi imodzimodziyo, akatswiri ena adanena kuti zotsatira za statin zidzakulitsidwa ndi mankhwalawa, chifukwa anali amphamvu kwambiri kuposa ma statins ena.

M'zaka zapitazi, zakhala zowonekeratu kuti palibe zonena zomwe zinali zolondola. Zikuwoneka kuti mtundu ndi kukula kwa zovuta zake nthawi zambiri zimakhala zofanana ndi rosuvastatin monga momwe zimakhalira ndi mankhwala ena a statin.

Ma Statin, monga gulu, amalekerera bwino kuposa mankhwala ena ochepetsa cholesterol. Mu meta-analysis yomwe idasindikizidwa mu 2017 yomwe idayang'ana mayeso 22 osankhidwa mwachisawawa, 13.3% yokha ya anthu omwe adangomwa mankhwala a statin adasiya kumwa mankhwalawa chifukwa cha zotsatira zoyipa mkati mwa zaka 4, poyerekeza ndi 13.9% ya anthu omwe adasinthidwa mwachisawawa ku placebo.

Komabe, pali zotsatirapo zodziwika bwino zomwe zimachitika chifukwa cha mankhwala a statin, ndipo zotsatirazi nthawi zambiri zimagwira ntchito pa rosuvastatin komanso ma statin ena aliwonse. Zodziwika kwambiri mwazotsatirazi ndi izi:

• Zochitika zoyipa zokhudzana ndi minofu. Kuwopsa kwa minofu kumatha chifukwa cha ma statins. Zizindikiro zingaphatikizepo myalgia (kupweteka kwa minyewa), kufooka kwa minofu, kutupa kwa minofu, kapena (nthawi zambiri, zowopsa) rhabdomyolysls. Rhabdomyolysis ndi kulephera kwaimpso kwakukulu komwe kumachitika chifukwa cha kusweka kwa minofu. Nthawi zambiri. Zotsatira zoyipa zokhudzana ndi minofu zimatha kuwongoleredwa posinthira ku ma statin ena. Rosuvastatin ndi amodzi mwa mankhwala a statin omwe amawoneka kuti amayambitsa kawopsedwe kakang'ono ka minofu. Mosiyana ndi zimenezi, lovastatin, simvastatin, ndi atorvastatin ndizovuta kwambiri kuyambitsa mavuto a minofu.
• Mavuto a chiwindi. Pafupifupi 3% ya anthu omwe amamwa ma statins amakhala ndi kuchuluka kwa michere ya chiwindi m'magazi awo. Ambiri mwa anthuwa, palibe umboni wa kuwonongeka kwenikweni kwa chiwindi, ndipo tanthauzo la kukwera kwakung'ono kumeneku kwa michere sikudziwika bwino. Mwa anthu ochepa kwambiri, kuvulala kwakukulu kwa chiwindi kwanenedwa; sizikudziwikiratu, komabe, kuti chiwopsezo cha kuvulala kwakukulu kwa chiwindi ndi chachikulu mwa anthu omwe amamwa ma statins kusiyana ndi anthu ambiri. Palibe zowonetsa kuti rosuvastatin imatulutsa zovuta zachiwindi kuposa ma statin ena.
• Kusokonezeka kwachidziwitso. Lingaliro lakuti ma statins angayambitse kusokonezeka kwa chidziwitso, kukumbukira kukumbukira, kukhumudwa, kukwiya, chiwawa, kapena zotsatira zina zapakati zamanjenje zakwezedwa, koma sizinawonetsedwe bwino. Pakuwunika malipoti amilandu omwe adatumizidwa ku FDA, zovuta zakuzindikira zomwe zimagwirizanitsidwa ndi ma statins zikuwoneka kuti ndizofala kwambiri ndi mankhwala a lipophilic statin, kuphatikiza atorvastatin, fluvastatin, lovastatin, ndi simvastatin. Mankhwala a hydrophilic statin, kuphatikiza rosuvastatin, sakhala okhudzidwa pafupipafupi ndi zomwe zingachitike.
• Matenda a shuga. M'zaka zaposachedwa, kuwonjezeka pang'ono kwa matenda a shuga kumalumikizidwa ndi chithandizo cha statin. Kusanthula kwa 2011 kwa mayeso asanu azachipatala kukuwonetsa kuti vuto limodzi la matenda ashuga limapezeka mwa anthu 500 aliwonse omwe amalandila ma statins amphamvu kwambiri. Nthawi zambiri, chiwopsezochi chimawonedwa ngati chovomerezeka bola ngati ma statins akuyembekezeka kuchepetsa kwambiri chiwopsezo chamtima.

Zotsatira zina zomwe zanenedwa kawirikawiri ndi mankhwala a statin ndi monga nseru, kutsegula m'mimba, ndi kupweteka pamodzi.

Kuyanjana

Kumwa mankhwala ena kumatha kukulitsa chiwopsezo chokhala ndi zotsatira zoyipa ndi rosuvastatin (kapena ma statin aliwonse). Mndandandawu ndi wautali, koma mankhwala odziwika kwambiri omwe amalumikizana ndi rosuvastatin ndi awa:

• Gemfibrozil, omwe si a statins omwe amatsitsa cholesterol
• Amiodarone, yomwe ndi mankhwala oletsa arrhythmic
• Mankhwala ambiri a HIV
• Maantibayotiki ena, makamaka clarithromycin ndi itraconazone
• Cyclosporine, immunosuppressant mankhwala

Mawu Ochokera kwa Verywell

Ngakhale rosuvastatin ndiye ma statin amphamvu kwambiri omwe amapezeka, nthawi zambiri, magwiridwe ake komanso mawonekedwe ake kawopsedwe amafanana kwambiri ndi ma statin ena onse. Komabe, pali zochitika zingapo zamankhwala momwe rosuvastatin ingakondedwe kuposa mankhwala ena a statin.