بسم الله الرحمن الرحيم
نبدا باذن الله موضوعنا وهو مخصص لطلبة كليات الصيدلة خصوصا اللى بيدرب او بيشتغل فى صيدلة ونعدكم بتوفير كل يوم على الاقل دواء جديد
نبدا مع LIPITOR® ------------------- ليبيتور
atorvastatin calcium --------------------- المادة الفعالة
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لتقليل نسبة الدهون فى الدم
يوجد فى اربعة تركيزات
10مجم : 40جنيه
و 20 مجم : 60 جنيه
و 40 مجم: 90 جنيه
و 80 مجم: 105جنيه
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Mechanism of action:
Inhibits HMG-CoA reductase. Reduces total LDL, cholesterol, serum
triglyceride levels. There is little if any effect on serum HDL levels.
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Indications/dosage/route: Oral only.
• Hyperlipidemia
Ð Adults: Initial: 10 mg/d. Maintenance: 10–80 mg/d.
• Homozygous familial hypercholesterolemia
Ð Adults: 10–80 mg/d.
Adjustment of dosage
• Kidney disease: None.
• Liver disease: None.
• Elderly: None.
• Pediatric: Limited data available.
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Food: No restriction.
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Pregnancy: Category X—contraindicated.
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Lactation: Appears in breast milk. Contraindicated.
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Contraindications:
Hypersensitivity to statins, active liver disease or unexplained
persistent elevations of serum transaminase, pregnancy, lactation.
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Warnings/precautions
• Use with caution in patients with the following conditions:
renal insufficiency, history of liver disease, alcohol abusers.
• Discontinue if drug-induced myopathy develops. This is characterized
by myalgia, creatinine kinase levels >10x normal. 64 ATORVASTATIN
May cause acute renal failure from rhabdomyolysis. May occur more frequently when drug is combined with gemfibrozil or niacin.
• Discontinue drug if patient experiences severe trauma, surgery, or serious illness.
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Advice to patient
• Avoid alcohol.
• Use of OTC medications only with approval from treating physician.
• Exercise regularly, reduce fat and alcohol intake, and stop smoking.
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Adverse reactions
• Common: None.
• Serious: myopathy, rhabdomyolysis, neuropathy, cranial nerve
abnormalities, hypersensitivity reactions, pancreatitis, hepatic injury
including hepatic necrosis and cirrhosis, lens opacities.
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Clinically important drug interactions
• Drugs that increase effects/toxicity of HMG-CoA reductase inhibitors:
gemfibrozil, clofibrate, erythromycin, cyclosporin, niacin,
clarithromycin, itraconazole, protease inhibitors.
• HMG-CoAreductase inhibitors increase effects/toxicity of oral anticoagulants.
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Parameters to monitor
• Total cholesterol, LDL and HDL cholesterol, triglycerides.Values
should be obtained prior to and periodically after treatment begins to
ascertain drug efficacy.
• Serum BUN and creatinine.
• Monitor liver enzymes before beginning therapy, at 3, 6, and 12 months thereafter, and semiannually afterward.
• Signs and symptoms of myopathy: unexplained skeletal muscle pain,
muscle tenderness or weakness particularly when accompanied by fever or
fatigue. Check creatinine kinase levels. If these are markedly elevated
or patient is symptomatic, discontinue drug.
• Discontinue drug if transaminase levels exceed three times
normal values. It may be advisable to take a liver biopsy if
transaminase elevation persists after drug is discontinued.
• Patient’s ophthalmic state should be evaluated once a year following
treatment. If lens opacity occurs, consider discontinuing
drug.
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Editorial comments: Current literature suggests that the most
effective reduction of total and LDL cholesterol occurs with a
combination of exercise, weight reduction, low-fat diet, and
lipid-lowering agents.