Indications: insomnia due to anxiety, stress; neuroses, removal of seizures, alcoholic obsession.
Side effects: drowsiness, lethargy, the phenomenon of recoil, hypoventilation, impaired coordination, decreased blood pressure, irritability, depression, allergic reactions.
Contraindications: drug addiction, myasthenia gravis, respiratory, renal failure, hepatitis, pregnancy, blood diseases. Long-term use of barbiturates causes mental and physical drug dependence.
Benzodiazepine derivatives have a sedative, hypnotic, anticonvulsant and muscle relaxant effect, in small doses they have an anti-anxiety and sedative effect, in high doses - hypnotic, anticonvulsant. shorten the phase of REM sleep, but to a lesser extent than derivatives of barbituric acid.
Preparations of different chemical structures have a selective hypnotic effect, do not cause recoil syndrome, and do not disrupt the physiological structure of sleep.
Agonists of melatonin receptors have an adaptogenic sedative hypnotic effect, normalize circadian rhythms, addiction and drug dependence do not develop, there is no recoil phenomenon, and do not disturb the physiology of sleep.
Blockers of H-histamine receptors in terms of effectiveness, the action is similar to benzodiazepine derivatives, has a daytime aftereffect, low toxicity.
Heterocyclic compounds in high doses cause anesthesia, induction of liver enzymes, material accumulation, post-somnic effect, with prolonged use - addiction, drug dependence.
Classification:
1. Inhibitors of angiotensin II synthesis (angiotensin-converting enzyme inhibitors)
Captopril, Enalapril
Mechanism of action of angiotensin 2 synthesis inhibitors: under the influence of the renin enzyme, angiotensin-I is formed from angiotensin, then the angiotensin-converting enzyme acts on it and angiotensin-2 is formed, which causes narrowing of the arterioles. ACE inhibitors block angiotensin-converting enzyme.
Side effects: allergies, tachycardia, impaired taste
Contraindications: pregnancy, cases of Quincke's edema, hypersensitivity.
2. Angiotensive receptor blockers
Losartan
Mechanism of action of angiotensive receptor blockers: are competitive antagonists of type A1 angiotensive receptors, eliminate the pressor effect of angiotensin A2.
Side effects: allergy, headache
Contraindications: pregnancy, lactation, individual intolerance.
Compare characteristics:
Captopril the action develops after 30-60 minutes for 4-8 hours, is an ambulance drug. Captopril - for hypertensive crises, the rest of the drugs - for the systematic treatment of hypertension.
Enalapril -more active than captopril and longer (day). Fewer side effects.
Losartan -Acts quickly within 2 hours, does not penetrate the BBB ..
Antiviral drugs are a group of drugs used for the prevention and treatment of viral infections.
Classification:
- antiherpetic - acyclovir, valacyclovir, penciclovir and famciclovir
- anti-cytomegalovirus - ganciclovir, valganciclovir, foscarnet and cidofovir.
- anti-influenza - amantadine, rimantadine - and viral neuroaminidase inhibitors - zanamivir, oseltamivir
- extended spectrum drugs - ribavirin, lamivudine.
- antiretroviral (for the prevention and treatment of HIV infection) - 1. Nucleoside inhibitors of HIV reverse transcriptase.
2. Non-nucleoside inhibitors of HIV reverse transcriptase.
3. Inhibitors of HIV protease.
Mechanism of action: Antiherpetic chemotherapy
Acyclovir is the ancestor of antiherpetic drugs - blockers of viral DNA synthesis. The active metabolite of acyclovir, acyclovir triphosphate, has an antiviral effect. By inhibiting viral DNA polymerase, acyclovir triphosphate blocks viral DNA synthesis.
Penciclovir in human cells affected by the virus is activated, turning into penciclovir triphosphate, which disrupts the synthesis of viral DNA.
Foscarnet forms inactive complexes with DNA polymerase of herpes viruses and cytomegaloviruses.
Anti-cytomegalovirus: Ganciclovir.
In cells affected by cytomegalovirus, ganciclovir is converted to its active form - ganciclovir triphosphate, which inhibits viral DNA polymerase.
Anti-influenza:
The antiviral effect of amantadine and remantadine is realized by blocking special ion channels of the M2-channels of the influenza A virus, and therefore its ability to penetrate cells and release ribonucleoprotein is impaired. Thus, the most important stage of viral replication is inhibited.
Extended spectrum drugs: RIBAVIRIN.
The mechanism of antiviral action has not yet been clarified. It is assumed that ribavirin causes a decrease in the intracellular pool of guanosine triphosphate and, thus, indirectly decreases the synthesis of viral nucleic acids.
Lamivudine.
In cells affected by the virus, it is activated, turning into lavimvudine triphosphate, which inhibits hepatitis B virus DNA polymerase and HIV reverse transcriptase.
Antiretrovirals: The structure of all nucleic reverse transcriptase inhibitors is based on one of the analogs of the natural nucleoside (thymidine, adenine, cytidine or guanine), which determines the general properties of the metabolites of each drug to block HIV reverse transcriptase and selectively inhibit viral DNA replication. Under the action of appropriate enzymes, drugs are metabolized to form triphosphates, which exhibit pharmacological activity. The ability of drugs in this group to inhibit HIV reverse transcriptase is hundreds of times higher than the ability to inhibit human DNA polymerase. Nucleoside reverse transcriptase inhibitors are active in HIV-infected T cells and macrophages, inhibiting the early stages of the virus life cycle.
Nature and spectrum of action: Antiherpetic: Acyclovir - Spectrum of action: Herpes symplex types 1 and 2, Varicella-zoster, cytomegalovirus (470 times less sensitive to acyclovir than HSV type 1). Mode of action: virucidal.
Anti-cytomegalovirus
Ganciclovir
Spectrum of activity: cytomegalovirus (activity is 10-50 times higher than that of acyclovir), herpes viruses. Character: virucidal
Anti-influenza drugs
Remantadine
Spectrum of action - type A influenza virus. Nature: virucidal.
Extended-spectrum antivirals
Ribavirin
Structurally similar to the guanosine nucleotide. Possesses a wide spectrum of activity against many DNA and RNA viruses. Highly toxic. Character: virucidal.
INDICATIONS:
Antiherpetic: Valacyclovir:
- infections of the skin and mucous membranes;
- ophthalmic herpes (only acyclovir);
- genital herpes;
- herpetic encephalitis;
- neonatal herpes.
Anti-cytomegalovirus: cytomegalovirus infection
Anti-influenza: Amantadine and rimantadine- Treatment of influenza caused by virus A.
Prevention of influenza (if the epidemic is caused by the A virus). Efficiency - 70 - 90%.
Extended spectrum drugs: Ribavirin - Respiratory syncytial virus infections (only serologically confirmed): severe bronchiolitis and pneumonia in infants and young children at risk of death (congenital heart disease, immunodeficiency, bronchopulmonary dysplasia), in the background severe cystic fibrosis or pulmonary hypertension.
Antiretrovirals:
Non-nucleoside reverse inhibitors
HIV transcriptase
Combination therapy for HIV-1 infection (nevirapine, efavirenz).
Prevention of mother-to-newborn transmission of HIV-1 infection (nevirapine).
Chemoprophylaxis of parenteral HIV infection (efavirenz).
Side effects:
Antiherpetic: Acyclovir: Local:
- burning sensation when applied to mucous membranes, especially when applied vaginally;
- phlebitis when administered intravenously.
Systemic:
Gastrointestinal tract: pain or discomfort in the abdomen, nausea, vomiting, diarrhea;
Anti-cytomegalovirus: Ganciclovir: Hematological reactions (up to 40%): neutropenia, anemia, thrombocytopenia. Cases of severe persistent neutropenia complicated by fatal infection have been reported. Risk factor: AIDS.
Gastrointestinal tract: diarrhea (44%), anorexia, vomiting.
Anti-influenza:
Gastrointestinal tract: abdominal pain, impaired appetite, nausea.
CNS: when using amantadine - in 14% of patients, remantadine - in 3 - 6%: drowsiness, insomnia, headache, dizziness, visual disturbances, irritability, paresthesia, tremors, convulsions.
Extended spectrum drugs: Ribavirin: Hematological reactions: anemia, hemolytic anemia, leukopenia, neutropenia, granulocytopenia, trombocytopenia. Control methods: clinical blood test every 2 weeks.
CNS: asthenic syndrome, headache, insomnia, fatigue, irritability.
Antiretrovirals:
• Diarrhea
• Fatigue
• Headache
• Liver problems
• Upset stomach (nausea), stomach pain, vomiting, decreased appetite
Contraindications: Antiherpetic: Valacyclovir: Allergic reactions, hypersensitivity to the drug.
Anti-cytomegalovirus: Undesirable side effects in 1/3 of patients are the reason for drug withdrawal
Anti-influenza: Arbidol.
Allergic reaction to arbidol.
Age up to 2 years (in children from 2 to 6 years, it is used only for the treatment of influenza).
Extended spectrum drugs: Ribavirin: Hypersensitivity to ribavirin.
Severe hepatic and / or renal impairment.
Anemia
Hemoglobinopathy.
Severe heart failure.
Pregnancy.
Antiretrovirals: STAVUDIN (D4T).
- hypersensitivity to stavudine;
- peripheral neuropathy;
- lactation;
- age up to 3 months;
- liver failure;
- severe renal failure
1) Hometopathy, basic principles. Assessment of the homeopathic method.
2) Nootropics. Classification. Mechanism of action. Indications for use. Side effects. Contraindications Comparative characteristics
3) Drugs used in myocardial infarction. Classification. Mechanism of action. Side effects. Contraindications Indications for use. Comparative characteristics
4) Antibiotics for the group of macrolides and aminoglycosides. Classification. mechanism of action, indications for use. contraindications. side effects. comparative characteristic.
Homeopathy- a system of treatment with small doses of drugs. Proposed at the end of the 18th century by the German physician Hahnemann. He proved that the paradoxical fact of curing the disease with "similarly acting" drugs has a certain pattern. Hahnemann called this pattern "the law of similarity." This is how homeopathy arose - a method of treating diseases through the use of similar agents.
After homeopathic exposure, five prediction options are possible:
1. Preservation of health (absence of diseases)
2. Rapid improvement of well-being and recovery
3. A short-term (up to several days) intensification of the manifestations of the disease for which homeopathic treatment was used is an option for the correct treatment of chronic diseases (skin, joints, nervous system, etc.), followed by an improvement in the patient's condition ("convalescence", " remission "), or recovery.
4. Lack of effect for several days after taking homeopathic remedies - possibly after taking "slow" drugs (heavy metal salts)
5. Deterioration of well-being, the appearance of new, unfamiliar and unusual symptoms for the patient - indicates improper treatment that requires immediate correction.
Nootropic drugs (Greek noos - soul. Thought, tropos - direction) - a group of drugs that have a selective mnemotropic effect, improve the higher integrative functions of the brain - intelligence, attention, short- and long-term memory, creating the ability to quickly reproduce information, accelerating learning, as well as weakening the perception of stressful situations and increasing the brain's resistance to harmful influences.
Classification
1. Means affecting specific neurotransmitter systems
∙ Catecholaminergic drugs PIRIBEDIL
(pronoran,)
GUANFACIN
(estulik)
∙ GABAergic agents: ∙ GABA AMINALON
(gammalon, ganervin)
∙ GABA + nicotine acid PICAMILON
∙ phenyl derivative of GABA PENIBUT
2. Drugs with neurometabolic action
∙ Animal origin ACTOVEGIN
∙ Plant origin EXTRACT
LEAVES
GINKGO BILOBA
(tanakan, ginos,
bilobil, memoplant)
∙ Synthetic: ∙ amino acids GLYCINE (glycol)
∙ analogue of coenzyme Q10 IDEBETON (noben)
∙ pyrrolidone derivatives PIRACETS
(nootropil)
(cyclic derivatives of GABA) EPIRACETS
AMERACETS
OXYRATE
POLSIRACETAM
∙ pyridoxine derivatives PYRIDITOL (enerbol,
pyritinol, ecephabol)
GLUTAMINE ∙ ∙ dimethylamineethanol derivatives DEMANOL
ECLIDAN
ACEFEN
∙ HOPANTHENIC ACID (pantogam)
3. Drugs with neurotrophic action
CORTEKSIN
Cerebrolysin