Author/Editor		Bogataj, Marija
Title		Farmakokinetske in farmakodinamske interakcije statinov
Translated title		Pharmacokinetic and pharmacodynamic interactions of statins
Type		članek
Source		Farm Vestn
Vol. and No.		Letnik 54, št. Poseb št
Publication year		2003
Volume		str. 135-43
Language		slo
Abstract		Statins are effective drugs in treatment of hyperlipidemia. Adverse effects are relatively rare, but the most serions one is life-threatening rhabdomyolysis. The incidence of adverse effects increases with increasing plasma levels of aetive compounds. Thus, every factor that increases statin plasma concentration will increase the incidence of adverse effects. The interactions between statins and other drugs increase statin plasma levels very frequently. The interactions are pharmacokinetic or pharmacodynamic, but their mechanisms are not completely understood yet. Most frequently they appear during metabolic processes, but they are detected also during absorption and distribution; pharmacodynamic interactions are described less frequently. The interactions of statins depend on their properties: enzyme systems, that they are metabolised with, lipophilicity and plasma protein binding and tissue distribution, and some other processes that they are involved in. Interactions which decrease statin plasma level or affect the other drug pharmacokinetics and / or pharmacodynamics are less frequent, but serious clinical consequences may appear also in some of these cases. The mechanisms of statin interactions with the drugs from different pharmacological groups which interact with statins most frequently, are also described in the present article.
Summary		Statini so učinkovita zdravila za zdravljenje hiperlipidemij. Neželeni učinki niso pogosti, je pa med njimi tudi rabdomioliza, ki se sicer pojavlja redko, se pa lahko konča tudi s smrtjo. Pogostost neželenih učinkov narašča z naraščanjem plazemske koncentracije aktivne oblike učinkovine, zato vsak dejavnik, ki dvigne plazemsko koncentracijo, poveča možnost pojava neželenih učinkov. Interakcije med statini in drugimi zdravili plazemsko koncentracijo statinov zelo pogosto povečajo. Interakcije so lahko farmakokinetske ali farmakodinamske, pogosto pa točni mehanizmi niso popolnorna pojasnjeni. Najpogosteje potekajo na nivoju metabolizma, se pa pojavljajo tudi pri procesih absorpcije in distribucije, medtem ko so farmakodinamske interakcije opisane redkeje. Možnost pojavljanja interakcij pri posameznih statinih je odvisna od njihovih lastnosti: od encimskih sistemov, s katerimi se metabolizirajo, od lipofilnosti, vezave na plazemske proteine in prehoda v tkiva, ter od nekaterih drugih procesov, v katere so vključeni. Interakcije, ki znižajo plazemsko koncentracijo statinov, ali pa imajo posledice za drugo učinkovino, so redkejše, vendar imajo nekatere od njih tudi lahko resne klinične posledice. V prispevku so opisani mehanizmi interakcij tudi znotraj farmakoloških skupin zdravil, s katerimi statini najpogosteje stopajo v interakcije.
Descriptors		HYPERLIPIDEMIA ANTILIPEMIC AGENTS DRUG INTERACTIONS CYTOCHROME P-450 RHABDOMYOLYSIS