Sodium nucleinate (the sodium salt of a nucleic acid obtained from yeast);
Pentoxyl (pyrimidine derivative);
Molgramostim (recombinant granulocyte-macrophage colony-stimulating factor);
Methyluracil (pyrimidine derivative).
Mechanism: stimulate and regulate leukopoiesis (stimulate proliferation, differentiation and function of leukocytes).
Indications: sodium nucleinate and pentoxil are used for leukopenia and agranulocytosis (agranulocytic angina, with poisoning with a number of chemicals, with radiation sickness); molgramostim - with the inhibition of leukopoiesis associated with chemotherapy of tumors, in the complex therapy of AIDS).
Side: pentoxil - dyspeptic symptoms; molgramostim - nausea, vomiting, anorexia, diarrhea, hyperthermia, allergic reactions;
Contraindications: acute and chronic leukemic forms of leukemia, lymphogranulomatosis, malignant bone marrow diseases.
Pentoxil - anabolic and anti-catabolic effect, increases cell regeneration, wound healing, increases cellular and humoral defense factors, anti-inflammatory effect. It is used only in milder forms, in severe forms it is contraindicated. Cannot be used for leukemia, bone marrow cancer.
Molgramostim, in addition to stimulating leukopoiesis, also stimulates erythropoiesis. Filgrastim - increases the proliferation and differentiation of granulocyte precursors and neutrophil activity.
four). Classification of antibiotics.
1.By chemical structure:
● b-lactam (penicillins, cephalosporins, carbapenems, monobactams)
● Macrolides and azalides
● Aminoglycosides
● Tetracyclines
● Lincosamides
● Glycopeptides
● Amphenicol
● Polymyxins
● Phosphonates
● Polyenes
● Rifamycins
2. By the nature of the action on the bacterial cell:
–Bactericidal (causing the death of bacteria)
–Bacteriostatic (stopping the growth and division of bacteria)
3. By the mechanism of action:
–Disorders of cell wall synthesis
- Violating the permeability of the cytoplasmic membrane
–Disorders of protein synthesis on ribosomes
–Disorders of RNA synthesis
4. According to the spectrum of antimicrobial action:
–Preparations of a wide spectrum of action
–Preparations with a predominant effect on Gr (+) flora
–Preparations with a predominant effect on Gr (-) flora
–Antifungal antibiotics
5. For clinical use:
–Basic antibiotics (drugs of choice)
–Reserved antibiotics (alternative)
6. By sources of receipt:
–Natural (biosynthetic)
- semi-synthetic
one). Formation and development of the Department of Pharmacology of the Kuban State Medical University (P.P. Avrorov, I.E. Akopov, A.I. Ostroumov, etc.).
The Department of Pharmacology was founded in 1922. The first head of the department was Professor Pavel Petrovich Avrorov - an outstanding scientist, teacher and public figure, widely known for his works on the study of the effect on the body of complete starvation, alcohol, as well as on the cultivation of tissues outside the body. He organized and equipped the Department of Pharmacology, providing it with everything necessary for the deployment of the educational process and scientific research. During this period P.P. Avrorov pays much attention to the pharmacodynamic study of the Psekup mineral springs of the Goryachy Klyuch resort, as well as Gelendzhik, Talgi, and others. Avrorov spent on improving the methods of experimental research. After the death of P.P. Avrorov since 1940, the department was headed by Associate Professor Ya.L. Levin. These scientists have proposed a number of improvements in the methods of pharmacological research. Since 1958, the department was headed by Professor Ivan Emmanuilovich Akopov. During this period, the main scientific problem of the department was "Pharmacology of the process of blood coagulation and hemostasis". During his scientific and pedagogical activity (1945 - 1974) I.E. Akopov has trained more than 40 candidates and 3 doctors of medical sciences. The result of scientific research was the introduction into medical practice of drugs intoxicating logachilus, which has hemostatic, sedative, antihypertensive and Akopov has trained more than 40 candidates and 3 doctors of medical sciences. The result of scientific research was the introduction into medical practice of drugs intoxicating logachilus, which has hemostatic, sedative, antihypertensive and Akopov has trained more than 40 candidates and 3 doctors of medical sciences. The result of scientific research was the introduction into medical practice of drugs intoxicating logachilus, which has a hemostatic, sedative, antihypertensive and
hyposensitizing properties. Under the leadership of I.E. Akopov, in the Kuban, the organization of an allergological service began to combat regional pathology - ragweed polynosis.
Since 1974, the department has been headed by one of I.E. Akopov professor Arkady Ivanovich Ostroumov. During this period, along with the study of the pharmacology of blood coagulation and hemostasis, pharmacotherapy of allergic diseases becomes one of the main problems of the department. In Krasnodar and many other cities of the region, allergological centers are being created, which are still functioning. A large research work carried out by A.I. Ostroumov, nominated him among the leading allergists in our country and Europe.
In 1980 - 1981, the duties of the head of the department were performed by Professor Vera Mikhailovna Yadrova. During this period, studies were continued on the problem of "Pharmacology of blood coagulation and hemostasis", a lot of educational and methodological work was carried out.
In 1981, Professor Pavel Alexandrovich Galenko-Yaroshevsky was elected to the post of head of the Department of Pharmacology.
CLASSIFICATION OF NARCOTIC (OPIOID) ANALGESTS BY ORIGIN
Herbal preparations:Opium tincture and extract
Novogalenic drugs:Omnopon (contains 5 opium alkaloids)
Opium alkaloids:Morphine, Codeine
Promedol, fentanyl, sufentanil, alfentanil, methadone, pentazocine, nalbuphine, butorphanol, buprenorphine, tramadol, etc.
CLASSIFICATION BY TYPE OF ACTION ON OPIOID RECEPTORS
Agonists - stimulate all types of opioid receptors (μ> κ = δ).
Antagonist agonists and partial agonists - simultaneously stimulate one type of opioid receptor and block others.
Opioid receptor antagonists - block receptors.
MECHANISMS OF ANALGESIC ACTION OF NARCOTIC ANALGETICS
1. Inhibition of the conduction of pain impulses in the afferent pathways of the central nervous system (impaired transmission of impulses from the endings of the primary afferents to the intercalary neurons of the spinal cord).
2. Strengthening the inhibitory effect of the descending antinociceptive system on the conduction of pain impulses in the afferent pathways of the central nervous system.
3. Change in emotional assessment of pain.
SIDE EFFECTS
1. Nausea, vomiting.
2. Respiratory depression.
3. Bradycardia.
4. Intestinal colic, constipation.
5. Arterial hypotension.
6. With repeated use - addiction, drug dependence.
7. Retention of urination.
8. Increased intracranial pressure.
CONTRAINDICATIONS
1. Children under 1 year of age (morphine - for children under 3).
2. Severe exhaustion.
3. Respiratory failure.
4. Traumatic brain injury (risk of cerebral edema).
5. Paralytic, spastic and obstructive gastrointestinal diseases.
6. Hypertrophy of the prostate
7. Intracranial hypertension.
8. Pregnancy.
9. Fentanyl is contraindicated: during caesarean section (before fetal extraction) and other obstetric manipulations, severe hypertension in the pulmonary circulation, pneumonia, atelectasis, pulmonary infarction, bronchial asthma, parkinsonism (increases muscle stiffness).
10. Butorphanol and pentazocine are not prescribed for patients with coronary artery disease and heart failure.
Comparative characteristics of drugs.
Morphine - acts on the central nervous system, depresses the respiratory center, does not disturb the ventilation of the lungs, depresses the cough center, the vomiting center, stimulates the center of the vagus (bradycardia), increases the tone of smooth muscles, reduces intestinal secretion and diuresis, reduces the basal metabolism, causes hyperglycemia, lowers body temperature.
Promedol weaker than morphine in analgesic effect, less inhibits the respiratory center, does not affect uterine contractions during childbirth, does not spasm smooth muscles, acts for 3-4 hours.
Fentanyl - 100 times more active than morphine in terms of analgesic effect, inhibits the respiratory center, pain relief after 1-3 minutes for 30 minutes, is used for neuraleptanalgesia.
ANAGONISTS OF NARCOTIC ANALGETICS
Agonist antagonists - nalorphine (blocks μ- and stimulates κ- and δ-receptors)
Antagonists - naloxone, naltrexone (block all types of opioid receptors).
In case of poisoning with narcotic analgesics, respiratory depression is eliminated, all systemic effects of opioid analgesics, including euphoria, are eliminated, causing withdrawal symptoms in drug addicts.
Gastroprotectors- funds acting directly on the gastric mucosa and reducing or preventing the effects of chemical and physical factors on it. Designed for the treatment of gastric ulcer and duodenal ulcer.
Classification:
1.Preparations that create mechanical protection of the mucous membrane:Bismuth tripotassium dicitrate (de-nol); Sucralfate (Venter, Antepsin, Ulcermin); Smecta
2. Drugs that increase the protective function of the mucous barrier and the resistance of the mucous membrane to the action of damaging factors:Carbenoxolone (biogastron); Misoprostol (Cytotec, Sayotech); Enprostil
Mechanism of action: reduce or prevent the damaging effects of irritating substances (by creating mechanical protection of the mucous membrane, by increasing the secretion of mucus).
Indications: peptic ulcer and duodenal ulcer.
Side effects: nausea, vomiting, stool disturbances, epigastric discomfort, dizziness.
Contraindications: severe renal failure (De-Nol), pregnancy, arterial hypertension, heart and renal failure (carbenoxolone).
Bismuth tripotassium dicitrate (De-nol, ulkavis)
is a colloidal suspension that, under the action of hydrochloric acid, forms a precipitate with a high affinity for the glycoproteins of the mucous membrane, especially the necrotic tissues of the ulcerative surface. As a result, the ulcer is covered with a protective layer. An important feature of the drug is its antimicrobial action against Helicobacter pylori.
Sukralfat (Venter)
at pH <4.0, i.e. in an acidic environment it polymerizes and forms a polyanion with many free negative bonds, which binds to positively charged radicals of the ulcerated surface of the gastric mucosa, forming a protective polymer film for 6 hours. Considering that hydrochloric acid is an activator of sucralfate polymerization, it cannot be combined with antisecretory and antacid agents.
Smecta - a medicinal product of natural origin with an enveloping ability, which forms a physical barrier that protects the mucous membrane from aggressive factors
Carbenoxolone (biogastron)isolated from licorice root, stimulates the secretion of thick, viscous mucus, increases the content of sialic acids in it, increases the life span of the integumentary epithelium of the gastric mucosa and its regenerative capacity. It should be remembered that carbenoxolone is similar in chemical structure to aldosterone, therefore it can retain sodium and water in the body and, as a result, cause edema, hypertension, hypokalemia and hypomagnesemia
Misoprostol (cytotec)
It is a synthetic analogue of prostaglandin E1, therefore, it increases the resistance of the mucous membrane to damaging factors by increasing microcirculation (trophism), increasing the production of thick, viscous mucus, increasing the formation of Na bicarbonate and reducing the production of HCl.
It is used mainly for the causal prevention of gastric and duodenal ulcers associated with the use of NSAIDs and glucocorticoids
four). The concept of antiseptic and disinfecting action. Conditions that determine the antimicrobial activity of drugs. Nitrofuran derivatives. Classification. Mechanism of action. The nature of the action. Spectrum of action. Indications for use. Side effects. Contraindications Comparative evaluation of drugs.
Disinfecting action is the action of drugs aimed at destroying pathogens in the external environment (neutralizing patient care items, rooms, clothing).
Antiseptic action is the action of drugs aimed at pathogens on the surface of the human body (skin, mucous membranes, wounds).
Conditions that determine the antimicrobial activity of drugs:
- establishing an accurate bacteriological diagnosis, establishing the sensitivity of a microorganism to various drugs.
Naloxone lasts for about 1-3 hours, and it must be re-injected, since narcotic analgesics work for a long time. Administered intravenously or intramuscularly. When administered intravenously, it normalizes breathing in 1-2 minutes. In addition, the drug is used for alcoholic coma, shock conditions, and some mental illnesses.
Naltrexone acts like naloxone, but for a longer period - up to 24-40 hours, is used orally, in tablets, the effect occurs after 1-2 hours.
Nalorphine is rarely used in case of an overdose of narcotic analgesics.