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Trophic ulcers of lower extremities

18 Oct 2018

The urgency of the problem of trophic ulcers in modern medicine is steadily increasing. This is due primarily to the variety of diseases leading to the formation of trophic ulcers. Trophic ulcers on the lower limbs are the result of a variety of diseases that disrupt the local hemodynamics of the arterial, venous, and lymphatic systems, including the microcirculatory level of the lesion. In addition to these factors, the cause of trophic ulcers can be various injuries of the skin, soft tissues and peripheral nerves. Medicines that affect similar pathogenetic mechanisms can be used in the treatment of trophic ulcers of virtually any etiology. The indication for the antibiotic therapy is the syndrome of the systemic inflammatory reaction, the signs of acute infectious inflammation of the soft tissues surrounding the trophic ulcer, or a high degree of its bacterial contamination. Chronic ulcers, especially against diabetes mellitus, hematological and oncological diseases, HIV infections, steroids, in addition to antimicrobial therapy, suggest the use of antifungal agents. When treating trophic ulcers, antiseptics and disinfectants are used, bandages (semipermeable films, hydrocolloids, sponges, hydrogels, alginates, super absorbents, atraumatic net dressings, atraumatic sorbing dressings) are widely used, depending on the phase of the wound process and the degree of exudation.

Actovegin. Phenazepam. Red lichen

Major medicines
Angioprotectors and microcirculation correctors: Agapurin, Actovegin, Vazonite, Doxie-Chem, Duzopharm, Solcoseryl, Troxerutin, Escuzan 20, and others.

Antiaggregants: Agapurin, Pentoxifylline, Radomin, Trenpental, Trental, Trental 400 and others.

Anticoagulants: Viatromb, Venolife and others.

Antihypoxants: Actovegin, Dimefosfon, Solcoseryl, etc.

Antibacterial agents: Baneocin, Synthomycin, Sintomycin liniment, Bonderm, Chlorophyllipt, Chlorophyllipt alcohol 1% solution, Metrogil, Argosulfan, Dermazin, etc.

Antifungal agents: Fluconazole, voriconazole, caspofungin, Sangviritrin, Sanguirithrin liniment 0.5%, etc.

Antiseptics and disinfectants: Argosulfan, Shostakovskiy Balm, Betadin, Dimefosfon, Kuriyozin, Miramistin-Darnitsa, Eplan, Olazol, Sangviritrin, Sanguirithrin liniment 0.5%, etc.

Additional medicines

Vitamins and vitamin-like drugs: Dexpanthenol-Hemofarm, calcium pantothenate, Prophylactin C and others.

Hepatoprotectors: Erbisol, Hepatofalk of the plant, Karsil and others.

Homeopathic remedies: Edas-120, Edas-201M, Edas-202M and others.

Dermatotropin funds: Biopin, Dexpanthenol-Hemofarm, Fitostimulin, Eplan, Algimaf, Algipor, Radevit and others.

Immunomodulators: Derinat, Polyoxidonium, Erbisol, and others.

Anti-inflammatory drugs: Abisil, Aspirin "York", Indovazin, etc.

Regenerants and reparants: Actovegin, Shostakovskiy Balm, D-panthenol, Dexpanthenol-Hemofarm, Xymedon, Curiosine, Metuluracil tablets 0.5 g, Solcoseryl, Fitostimulin, Eplan, Depantol, Piolizin, etc.

Regulators of water-electrolyte balance and acid-base medium: Dimefosfon et al.

Enzymes: Collagenase KK 250 ED, Collagenase KK, Iruksol, Phlogenzym, and others.


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Conjunctivitis. Than to help the inflamed eye?

16 Oct 2018

Reddened eyes, stitched eyelashes, itching and burning as if lodged under the eyelids - here they are, typical symptoms of conjunctivitis, which are able to deliver a sick person a lot of unpleasant sensations. And the longer they last, the higher the risk that acute conjunctivitis will become chronic, and cure it will be much more difficult.

Conjunctivitis. Than to help the inflamed eye. Actovegin

A few words about the problem ...
Conjunctivitis, i.e. inflammation of the connective membrane of the eye, most often occurs as a result of infection (bacterial or viral), allergic reaction, and in some cases under the influence of irritating factors (dust, smoke, contact lenses, etc.).

And although the symptoms of all forms of conjunctivitis are similar, each of them has its own characteristics, which allow one to suspect what triggered the inflammatory process.

So, for example, bacterial conjunctivitis often begins with the defeat of one eye, and only with non-hygiene spreads to the second. It is characterized by abundant mucopurulent discharge, because of which it is difficult for a patient to open his eyes, especially in the morning. Viral conjunctivitis often occurs against the background of a previous acute respiratory viral infection, accompanied by marked reddening of the eyes, lacrimation and photophobia. Allergic conjunctivitis is usually combined with allergic rhinitis, the most pronounced symptoms are itching and burning.

Treatment of conjunctivitis is selected depending on the cause of the disease, the nature of the inflammation (acute, chronic) and accompanying symptoms, but there are several general rules that should be followed in any case. First and foremost, strict hygiene is important: you can only touch the eyes with cleanly washed hands, before the symptoms disappear completely, you must change bed linen (pillowcase) and towel daily, for the instillation of solutions there must be separate pipettes for each eye. Also, careful treatment of the inflamed eye is necessary - mucopurulent discharge should be thoroughly rinsed with a solution of antiseptics (furacilin, ocystistine, potassium permanganate), and not mechanically removed. Drugs in the form of eye drops are usually used during the day, gels and ointments - overnight.

Bacterial conjunctivitis
The main method of treatment of bacterial conjunctivitis is antimicrobial therapy, for which locally acting preparations are used in the form of eye medicinal forms (drops, gels, ointments and films).

Of the antibiotics, the most commonly used drugs are the aminoglycoside group (gentamycin, tobramycin), fluoroquinolones (norfloxacin, ofloxacin), as well as levomycetin, which have a broad spectrum of action and can be used without an exact definition of the causative agent of conjunctivitis.

In some cases, antimicrobial therapy is complemented by the appointment of sulfacetamide, which has a bacteriostatic effect.

If necessary, for example in severe infection, for the treatment of bacterial conjunctivitis, combined drugs are prescribed, which, in addition to the antibiotic, includes a corticosteroid component. These can be preparations based on gentamicin and betamethasone or dexamethasone, neomycin preparations with dexamethasone and polymyxin, as well as drugs of gramicidin with dexamethasone and Framicetin. They have a pronounced anti-inflammatory, antibacterial and antiallergic effect, quickly reduce the acute symptoms of conjunctivitis.

Also, with bacterial conjunctivitis, antiseptics must be used for regular maintenance and treatment of the inflamed eye. The most widely prescribed preparations are decamethoxin, boric acid, zinc sulfate, sodium tetraborate, which have a disinfectant and antiseptic effect. With severe symptoms of inflammation (edema and hyperemia) and contraindications to the use of glucocorticosteroids, antibiotic therapy is supplemented with local forms of NSAIDs, for example, diclofenac preparations in the form of eye drops.

In the acute period of conjunctivitis - the first 3-5 days, antimicrobial drugs (drops) are used every 2-4 hours. After the symptoms of inflammation begin to decrease, the incidence of instillation is reduced to 3-6 times a day. The course of treatment, on average, is 7-10 days.

If the disease was severe, with superficial marginal keratitis, then after the disappearance of acute symptoms, drugs that stimulate the natural mechanisms of regeneration (gel Solcoseril or Actovegin) are prescribed.

Viral conjunctivitis
In most cases, the cause of viral conjunctivitis is adenovirus, the second most common causative agent is the herpes simplex virus - it affects the eyes much less often. On the background of adenovirus infection, inflammation of the conjunctiva develops 2-4 days after the appearance of the first symptoms of acute respiratory viral infection, and proceeds in the form of pharyngoconjunctival fever or epidemic keratoconjunctivitis (more severe form with corneal involvement).

Specific (etiotropaya) therapy with viral conjunctivitis is used today mainly in herpetic infection (acyclovir in the form of an ointment, a solution of idoxuridine). With adenoviral conjunctivitis, antimetabolites (oxoline and tebrofen ointment, florenal ointment) can be used, but their effectiveness leaves much to be desired.

As an alternative to antiviral agents, locally acting interferon preparations (a solution of recombinant interferon alfa-2b) or drugs that stimulate the formation of intrinsic interferons (poludane, aminobenzoic acid) are sometimes prescribed. In general, symptomatic therapy is carried out.

When lesions of the cornea (keratoconjunctivitis) use drugs that improve tissue regeneration: a solution of taurine or retinol acetate, Solcoseryl gel or Actovegin, dexpanthenol, a solution of riboflavin and ascorbic acid.

Antibacterial drugs are not effective against viruses, but in severe viral conjunctivitis, as well as in weakened patients, locally acting drugs of levomycetin, ocystistine, piclosidine may be prescribed to prevent the attachment of a secondary bacterial infection. After the symptoms of acute inflammation begin to subside, a short course of topical glucocorticosteroids (dexamethasone) or combined drugs - corticosteroids and antibiotics (neomycin + dexamethasone + polymixin) is prescribed. If contraindications to the appointment of corticosteroids can be used diclofenac solution.

To reduce painful and uncomfortable sensations, vasoconstrictive drugs (phenylephrine, atropine) can be used - a short course, dazzles (Vidisik, Systein, Oftagel) - for long-term daily use.

Allergic conjunctivitis
Allergic conjunctivitis can be both year-round and seasonal (pollinosis), and in most cases is accompanied by other symptoms of allergy. Therefore, for treatment of all types of allergic conjunctivitis, not only locally acting drugs are used, but also systemic therapy.

With seasonal conjunctivitis, first-line drugs are locally acting antihistamines - azelastine, opatanol, as well as preparations of cromoglycic acid. As a symptomatic therapy, local vasoconstrictors - nafazolinum, diphenhydramine, which are prescribed by short courses (no more than 5 days) are used. With a moderate and severe course of conjunctivitis, corticosteroids are added to the main treatment: eye drops and gels with dexamethasone, hydrocortisone. If allergic inflammation is complicated by the attachment of a bacterial infection, combined drugs (an antibiotic with a corticosteroid) are used.

Systemic therapy is prescribed either in severe pollinosis, or in the case of year-round allergic conjunctivitis, which is resistant to the use of locally acting drugs. In this case, antihistamines of the second generation - ebastine, loratadine, cetirizine, fexofenadine, etc. are prescribed. Alternatively, ketotifen preparations may be used.

With timely treatment and compliance with all medical recommendations, most of the acute conjunctivitis (both infectious and allergic) go without unpleasant consequences and complications within 2-3 weeks. The main thing is not to start the inflammatory process.


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Homeopathy and pregnancy: effectiveness and safety

15 Oct 2018

The fact that each drug has not only indications for use, but a list of contraindications (sometimes quite extensive), is well known to every Apothecary. Limit the possibility of appointment can not only the properties of the drug itself, but also the peculiarities of the patient's condition: the presence of chronic diseases, individual tolerability of drugs, age, etc. And, of course, we must not forget that a serious contraindication to the use of many drugs is such an important period in a woman's life, like pregnancy.

Homeopathy and pregnancy

Pregnancy: drug safety regulations
As you know, any substances that can penetrate the placental barrier, one way or another affect the development of the fetus and the course of pregnancy. The state of the baby's health is affected by everything that affects the mother's body: the emotional atmosphere in the family, the ecology of the modern city, the inner experiences of the woman, as well as the food she has eaten and medications taken. Proceeding from this, ideally a baby should be fully healthy woman in a calm environment, away from urban stress. But, unfortunately, it is almost impossible to implement such recommendations, the future baby has to experience the influence of various risk factors, among which the most common is the use of a pregnant woman with medicines.

The most dangerous period in this respect is the first trimester of pregnancy, especially in cases where a woman does not immediately realize her condition and takes any toxic drugs that can disrupt the correct formation of the baby's organs. But in the next two trimester, many medicinal substances can also cause serious problems during pregnancy and further development of the child.

All of the above compels doctors to be as cautious as possible in prescribing a course of treatment for a future mother. Employees of pharmacies should also take extremely responsive to the recommendation of any medications to pregnant women, and first of all it applies to cases when the customer appeals to the pharmacist for the OTC drug not prescribed by the attending physician.

Of course, categorically dissuade the visitors from acquiring a drug of interest to them, there is no sense - a woman can just buy it in another pharmacy, where not so scrupulous employee works. The optimal way out in this situation will be to offer a safer means, thus the pharmacist will not only provide qualified assistance, but also establish a more trusting relationship with buyers.

One of the safest and effective medical methods of treatment during pregnancy has long been considered homeopathy. Even our conservative official medicine admitted that the use of homeopathic medicines allows not only to improve the condition of a pregnant woman, but also to maintain the health of an unborn baby. It is worth mentioning that homeopathy can help not only exacerbate any chronic disease in a future mother, but also facilitate the course of pregnancy, and also eliminate a number of specific for this time ailments.

Bearing a baby is a serious burden for the female body and is often accompanied by various problems that worsen the quality of life of patients, and in due course can move into quite dangerous and even threatening conditions. Therefore, the modern approach to medical management of pregnancy involves drug support for this process at all stages. However, each of the traditional medicines has an impressive list of side effects, so doctors try to limit their use to the maximum and appoint them only in cases when the benefits of treatment objectively exceed the possible risk for the mother and fetus. In fact, it turns out that before the emergence of typical clinical symptoms, the body of a pregnant woman must independently cope with the beginning of impairments. In order to stop the further development of the pathological process and normalize the state of health of the future mother and her baby, today various non-invasive methods of treatment are used, among which homeopathy occupies an important place.

Homeopathy: indications for use
Recommending that any pregnant woman should have a homeopathic remedy, the pharmacist should remind them that homeopathy presupposes an individual approach to each patient, and only a qualified doctor can prescribe an adequate treatment taking into account all the characteristics of the body. Self-management of homeopathic remedies will help to cope with unpleasant symptoms, but not always allows to completely eliminate their cause, and therefore, even starting treatment at home, do not give up the advice of a specialist.

I must say that homeopathic remedies can be recommended to a woman not only after the joyful news of the imminent addition to the family is confirmed. Acquaintance with homeopathy is better to start while preparing for pregnancy. It's no secret that the reproductive health of modern women leaves much to be desired: menstrual irregularities, problems with the hormonal background, dysbiosis of the vagina and vaginosis can not only become an indirect obstacle to conception, but also adversely affect the course of pregnancy. Even in the treatment of infertility, homeopathy can be of considerable help. It will not be superfluous for homeopathic support also in those cases when the future mother suffers from any chronic diseases, and even more so to patients who had previous pregnancies with miscarriages.

Classic pregnancy problems in the form of nausea, hypersensitivity to odors, motion sickness in transport, as well as heartburn and intestinal motility disorders will help solve complex and monotherapy drugs including Nux vomica, sulfuric and phosphoric acids (Acidum sulphuricum and Acidum phosphoricum) , as well as Bryonia alba (white steppe), Ignatia amara (beans of St. Ignacy), Alumina (alumina, alumina). Of course, such ailments, although they give a lot of unpleasant sensations, but do not pose a great danger to the health of the woman and the course of pregnancy, and therefore gynecologists are accustomed to recommending dietary treatment for their elimination, but not in all cases a simple correction of nutrition is sufficiently effective.

Another common problem of pregnancy are various pathologies of the venous walls, among which hemorrhoid and varicose veins of the lower extremities are most often encountered. If the violation has managed to go far enough, then it is likely that after the pregnancy it will be necessary to fight its consequences. Therefore, the pharmacist should remind his customers about the need for early prevention of such problems and recommend products containing Aconitum napellus (wrestler), Atropa belladonna (belladonna), Sulfur (elemental sulfur), as well as Carbo vegetabilis (charcoal), Hamamelis virginica virgin walnut), Licopodium clavatum (clown planown).

Among the drugs that are prescribed for every pregnant woman, include multivitamin and mineral complexes - a growing fruit daily consumes a fairly large amount of these important substances, the only source for which is the mother's body. And in this case homeopathic preparations of calcium, iron, magnesium and other important macro- and microelements are the best alternative to traditional remedies. much easier to digest, do not lead to an overdose and completely cover the needs of both mom and her baby.

Homeopathy is able to cope with the most serious violations of pregnancy, including. threat of interruption. Properly selected drugs will help increase the elasticity of the uterine walls, eliminate hypertonia, strengthen the attachment of the placenta and solve the problem of partial presentation, and in some cases even stop the beginning of premature detachment of the placenta.

A few words to end the conversation ...
In one article it is impossible to tell about all the ailments and problems with which homoeopathic drugs effectively cope, or even simply list their main components. But this is not necessary. The main thing that a pharmacist should do when recommending a remedy for his customers is to remind him of the need for a follow-up consultation with a homeopathic doctor or at least an obstetrician-gynecologist.

Often, visitors to the pharmacy are interested in which of the dosage forms of homeopathic medicines is more effective, because the modern pharmacy has an impressive arsenal: water and alcohol drops for ingestion, sugar balls, granules and resorption tablets, ointments, oils and even sprays and injections. There is practically no significant difference in the effectiveness of such forms, the choice primarily depends on the individual ease of use. Some experts believe that the reception of pellets and granules allows you to more accurately observe the required dosage, and alcohol solutions and oils give a slightly higher risk of adverse reactions to the solvent. But all this is only the opinion of some homeopaths, which does not have any proven confirmation.

In general, it can be said that even complex homeopathic medicines that are not individually calculated are much safer than most traditional drugs and, with strict adherence to instructions, are not inferior to them in efficiency.


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How to treat a dysbacteriosis?

12 Oct 2018

Dysbacteriosis is a qualitative change in the composition of bacteria (microbiota) of the skin. For the prevention and treatment of this condition, drugs with different composition and mechanism of action are used.

How to treat a dysbacteriosis

In order to fill the deficit, normoflora is prescribed by living microorganisms, or probiotics. The most popular probiotic medicines include preparations of lacto-and bifidobacteria: Linex, Bifiform, Bifidumbacterin, Acipol, Lactobacterin, etc., for example, on yeast cultures - Enterol. Compared to the previous year, sales of Enterol increased by 61%. The share of the leader - Linex - accounts for 43% of sales of the entire group of drugs in value terms and 31.8% - in bulk.

Prebiotics include carbohydrates, which are not digested and not absorbed in the upper parts of the digestive tract; selectively fermented by the microflora of the colon, causing an active growth of beneficial bacteria. TOP10 includes prebiotics based on lactulose, a synthetic disaccharide used as a drug for the treatment of constipation and hepatic encephalopathy, and lignin, which also compensates for the lack of natural dietary fiber in human food, positively affecting the microflora of the large intestine and non-specific immunity. The sales volume of the lignin-based filter was up 2.1% in USD and 3.4% in packs. The increase in sales of lactulose preparations - Dufalac and Normase - reached a level of 35-36% in value terms.

Synbiotics, or combination preparations containing probiotics and prebiotics, are still in the role of outsiders in the market of drugs for the treatment of dysbacteriosis. For example, the share of Florin Fort does not exceed 0.3% - for this reason the drug did not get into the "top ten".

Top 10 drugs for the treatment of dysbacteriosis
1) Linex
2) Dufalac
3) Bifiform
4) Bifidumbacterin
5) Acipole
6) Bactisubtil
7) Enterol
8) Filter
9) Lactobacterin
10) Normaze


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Cirrhosis of the liver

11 Oct 2018

For the first time this term appeared in the literature in 1819. In our time, cirrhosis develops in 1-1.5% of the population of the Slavic countries. At what most often it is men in the age of 40 years. In 80-85% of cases, the main cause is alcoholism and viral hepatitis. Cirrhosis of the liver is a chronic liver disease that progresses rapidly and leads to the development of functional organ failure and portal hypertension (increased pressure in the system of vessels coming from the internal organs to the liver).

Cirrhosis of the liver Heptral, Layennec

When cirrhosis is formed, the liver cells die and replace them with a connective tissue (similar to the scars on the skin), the blood vessels of the liver are modified. This leads to the fact that the liver stops performing its usual functions.

Stages of cirrhosis of the liver
Currently, there are several different classifications of liver cirrhosis, which are based on different aspects of the disease.

Classification by morphological features:
- Micronodular, or small-node cirrhosis - the diameter of the nodules varies in the interval 1-3 mm;
- Macronodular, or coarse nodular cirrhosis - diameter of nodules from 3 mm or more;
- Mixed cirrhosis - a combination of nodules of various shapes;
- Incomplete septal cirrhosis.

Classification of cirrhosis due to its occurrence:
- Viral cirrhosis - develops against the background of viral hepatitis B or C;
- Alcoholic cirrhosis of the liver - develops from long consumption of a large amount of alcohol, which first leads to fatty liver, followed by alcoholic hepatitis, and at the end - cirrhosis;
- Medicinal cirrhosis - arises from the long-term use of certain medicinal substances, which in large quantities can adversely affect the liver cell (for example, some antibiotics);
- Secondary biliary cirrhosis;
- Congenital - develops in children in the absence of bile ducts;
- Stagnant, cardiac cirrhosis of the liver - in case of circulatory failure, which arises in case of heart disease;
- Syndrome and Badd-Chiari disease - patients are concerned about pain in the liver area (under the right hypochondrium), abdominal enlargement, fever, minor jaundice, very large liver, lower edge painful, spleen slightly enlarged, frequent bleeding from esophageal veins. For this form, the defeat of the posterior surface of the liver and the changes in the vessels are most characteristic;
- Alimentary cirrhosis - with diabetes mellitus, obesity;
- Cirrhosis with an unclear reason:

Cryptogenic cirrhosis of the liver is extremely rare. But has a tendency to rapid development of clinical symptoms and the onset of complications. Is a direct indication for a liver transplant.

Children's Indian.

Primary biliary cirrhosis - the main complaints with this form are pronounced itching of the skin and intense jaundice, later the weakness in the whole body, weight and pain in the area of bones are added. Complications occur later than with other forms of the disease.

Classification by stages of cirrhosis:
- Compensated cirrhosis of the liver;
- Subcompensated cirrhosis of the liver;
- Decompensated cirrhosis of the liver.

Classification by clinical course:
- Subacute cirrhosis is a transient phase between hepatitis and cirrhosis. Lasts from 5 months to 1 year.
- Rapidly progressive cirrhosis - complications and a vivid clinical picture develop very quickly. Life expectancy is about 5-6 years after the onset of the disease.
- Slowly progressive cirrhosis - symptoms gradually develop gradually, and there is a long-lasting absence of complications. The duration of this variant of the disease is more than 11 years.
- Sluggish - there are practically no clinical symptoms, changes in the analyzes are minimal. The duration of this form is more than 16 years.
- Latent cirrhosis of the liver - there is no change in the analyzes, no complaints, and there are no complications. Life expectancy does not depend on this cirrhosis. The diagnosis is made by chance, when diagnosing other diseases.

An example of a diagnosis: cirrhosis of the liver in the stage of decompensation, micronodular, alcoholic etiology, grade C according to Child-Pugh, varicose veins of the esophagus of the 2nd degree, hepatic encephalopathy of the first stage.

Symptoms and signs of liver cirrhosis
Symptoms of cirrhosis include pronounced general weakness, unmotivated memory impairment, fever, pain in the right upper quadrant, weight loss, nausea, abdominal enlargement, dry skin.

The signs that the doctor discovers during examination include the enlargement of the liver and spleen, red palms, smooth and bright red tongue, vascular "sprouts", veins on the abdomen ("jellyfish head"), scalp and inguinal region, jaundice, various hemorrhages in the body, varicose veins.

Treatment of cirrhosis of the liver
The main measures for treatment include: remove the effect of the causative factor; compliance with diet (refusal of alcohol, from fatty, fried, spicy food, from certain food products); treatment of the disease that caused cirrhosis (sorbents, hepatoprotectors – Heptral, Layennec, detoxification therapy, antiviral and others- Phenotropil, Phenazepam).


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Cardiac medicines

10 Oct 2018

Pharmaceutical market overview of the ATC group C01EB - drugs for the treatment of heart diseases (others) in the retail commercial sector of the pharmaceutical market.

To maintain the heart in working order is simple - you just need to look after him, like the engine of your favorite car. Timely carry out diagnostics, fill in quality motor oil and warm up before the start. That is, visit preventive examinations with doctors, rationally distribute physical activities and, if necessary, use drugs that support cardiac activity - increasing oxygen supply to the muscles, improving metabolism, helping the heart to contract.

Cardiac medicines. Meldonium. Riboxin. Trimetazidine

Hawthorn and meldonium
For drugs for the treatment of heart diseases in 2016 in the drugstores of the country was spent 7.76 billion rubles.2, for which 43.52 million packs of drugs were purchased.

The average price for packaging of cardiac funds over the past two years has grown significantly, and the reason for this was the drugs, which include hawthorn and meldonium. Sales of relatively expensive Meldonium in the anti-doping scandal increased by 56%, and sales of cheap drugs with hawthorn (including its tinctures) fell by 12% on the next precedent associated with its misuse. Due to these changes, the price for conditional packing of the drug in the segment increased.
Cheap funds for 99% (in monetary terms) are represented by unbranded drugs with trimetazidine from different manufacturers; In the middle price range, Trimetazidin-Biocom MV ("Farm Center") holds a 58% share, in another range with a 44% share is leading Deprenorm MV ("Canonfarma Production"), Antisthene MB ("Ozone") occupies 59% of the drug segment with at a price of 450 to 600 rubles., a niche of drugs with a price above belongs solely to Preductal MV (Servier).

TOP 5 drugs for the treatment of heart disease
1) Trimetazidine is an antihypoxic agent: (ischemic heart disease, angina prophylaxis, chorioretinal vascular disorders, dizziness, cochlear-vestibular disorders of ischemic nature)
2) Meldonium - Metabolic agent: (combined therapy of ischemic heart disease, cerebral circulation disorders, decreased work capacity, overstrain, withdrawal syndrome)
3) Ivabradine - Antianginal agent (stable angina, chronic heart failure)
4) Hawthorn thorny - Cardiotonic (functional disorders of cardiac activity, cardialgia, climacteric syndrome, astheno-neurotic states)
5) Riboxin (Inosine) - Metabolic agent (complex treatment of myocardial infarction, ischemic heart disease, heart rhythm disturbances, liver diseases, isolated kidney operations)

When the heart is starving
Most often, to support their "fiery motor", pharmacy visitors choose antihypoxic agents with INN trimetazidine, which optimize the metabolism and function of cardiomyocytes and neurons of the brain, increase the energy potential of cells and rationalize oxygen consumption. Also, agents with metabolic components (meldonium and inosine), antianginal and cardiotonic agents are popular.


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Neurotic dysfunction of the gastrointestinal tract

09 Oct 2018

The emergence of some somatic pathologies is directly related to the negative impact of the everyday psycho-emotional stress that a modern person is exposed to. A few decades ago, official medicine did not consider stress a serious risk factor, but today the results of numerous studies have confirmed the validity of the joke saying that "all diseases are from nerves."

Patients with disguised neuroses and their various manifestations, as a rule, consult therapists, cardiologists and gastroenterologists. Functional disorders of the cardiovascular system and the gastrointestinal tract are considered the most frequent consequence of mental trauma, prolonged experiences and depressive conditions. So, for example, in 80% of patients with functional disorders of the digestive system, the basis of the disease is psychogenic disorders and emotional overstrain.

Neurotic dysfunction of the gastrointestinal tract. Phenazepam

In this case, even a qualified specialist does not always succeed in immediately revealing the true cause of the pathological condition, since Clinico-instrumental studies do reveal various variants of morphofunctional disorders-usually minor, in the form of superficial gastritis, motor abnormalities of the gastrointestinal tract, refluxes, and so on. To think about the neurotic nature of a patient's condition most often causes complete ineffectiveness of the prescribed treatment, the absence of any connection between the course of the disease and the patient's diet, and also some features of his behavior.

Neuroses of the gastrointestinal tract: mechanisms of formation and features of the course
A common opinion on the mechanisms of formation of systemic neuroses, incl. - with gastroenterological symptoms, among specialists for today there. It is almost impossible to predict in advance which organ or system of organs will be more unstable to the negative impact of psychoemotional stress. The variant of the course of the neurosis, the peculiarity of its symptomatology, largely depends not only on the psychological characteristics of each patient, but also on the functional state of various systems of its organism, lifestyle and hereditary predisposition.

Of particular importance are the way of processing / experiencing negative emotions, the presence of an unconscious conflict, the basic protective mechanisms and the type of psychotrauma that has occurred. In the formation of a pathological condition, the absence of vegetative disturbances, as well as the acquired features of the affected system - past illnesses, injuries, etc., can not be avoided.

It is believed that psychosomatic patients with a gastroenterological variant of a neurosis according to the peculiarities of its course can be conditionally divided into three groups:

- neurotic disorders associated with chronic gastrointestinal diseases (and complicating their course);
- directly neurotic disorders of the functions of the digestive system;
- neurotic fixation (a tendency to exaggerate) the existing minor dysfunction of the digestive system.

In addition, depending on the form of the neurosis itself, the clinical picture of gastroenterological disorders also varies significantly. So, for example, in patients with hysterical neurosis, there are often bright descriptions and demonstrative manifestations of problems with the digestive system. As a rule, they are prone to numerous additional studies (and the "most serious" diagnosis) and may even insist on performing surgical treatment.

A patient with neurasthenia usually has the opposite picture: the desire to be convinced of the absence of serious diseases of the gastrointestinal tract provokes them for all new examinations and consultations with different specialists. Such patients try to be hospitalized on a regular basis or to be on a dispensary record in order to exclude even the slightest possibility of diseases and disorders.

For obsessive-compulsive neuroses, a classic manifestation is the physical processing of gastrointestinal complaints, a fanatical adherence to various health-improving diets and treatment methods (usually from the field of "folk" medicine), as well as a tendency to unmotivated carcinophobia.

"Gastric" manifestations of neuroses
The clinical symptomatology of gastrointestinal disorders in neuroses is diverse and multifaceted. The most common neurotic dysfunction of the stomach, which previously described as functional dyspepsia, pseudo-ulcer syndrome, irritable stomach syndrome. This disorder, as a rule, is manifested by neurotic vomiting - hysterical, appearing in the event of any conflict or stressful situations, or habitual - arising from the experience of the patient's state, communication with sick people and suppression of negative emotions.

An important diagnostic feature of neurotic vomiting is the ease of the entire process, almost not accompanied by previous nausea and painful straining. In addition, with psychogenic vomiting, there are usually no signs of vegetative disorders (pallor, sweating, excessive salivation).

Not less frequent variant of a stomach neurosis is considered and gastralgia - a pain, feeling of gravity and raspiranija in an epigastric area, a burning sensation. Here, a diagnostic criterion can be a direct relationship between strong experiences and the appearance of uncomfortable gastric symptoms. At the same time, the patient practically does not have any negative reaction to the eaten food.

But the gastric manifestations of neuroses do not end there. Long or acute stress can manifest itself in a variety of monosymptomatic disorders: nausea, swallowing, etc. So, one of the well-known signs of a neurosis is psychogenic esophagospasm, in which the patient experiences serious problems with swallowing liquid or solid foods. If, at the appearance of dysphagia, the patient was not immediately diagnosed and an adequate treatment is not prescribed, then in due course esophagospasm will begin to manifest not only during food intake, but also out of touch with food. It can lead to the appearance of pressing or burning pain behind the sternum and cause a suspicion of angina. A kind of esophagospasm is the sensation of a foreign body in the throat, which patients describe as a pressing lump or a burning sensation in the neck that temporarily weakens during meals. This symptom is especially common in young women.

A more rare type of neurotic reactions is a false sensation of a sick person emanating from him (from the mouth) unpleasant odor. It is not always possible to convince the patient of the mistakenness of his sensations. The arising obsession can gradually develop into a more serious mental disorder, when a person fixes on their experiences / feelings, begins to avoid contact with others and tries to self-isolate. Sometimes this symptom is accompanied by a disorder of taste - a false sense of bitterness in the mouth, not dependent on food intake and not associated with any organic pathologies. In some cases, the symptom complex is supplemented by a burning sensation and tingling sensation in the tongue.

"Intestinal" neurotic symptoms
Neurotic disorders of the intestine have received the generalized name of irritable bowel syndrome (in some cases - dyskinesia of the intestine, etc.). In addition to the neurotic disorders proper, no less frequent are cases when neurosis only aggravates the already existing bowel disease.

Most often, patients complain of painful abdominal cramps (burning, stitching, aching, etc.), which appear spontaneously, and with nervous tension intensify. Also, intestinal neuroses are characterized by peculiar intestinal crises in the form of acute painful attacks accompanied by flatulence and urge to defecate. Often the patient is so fixed on his condition that he is forced to give up his usual daily activities, limit his communication with others and visit public places.

Among the neurotic intestinal symptoms include intestinal motility disorder, manifested by chronic constipation, psychogenic diarrhea (the so-called "bear disease"), and the alternation of these disorders. Such patients are characterized by increased attention to the peculiarities of their condition, excessive care for the act of defecation and exaggeration of the severity of their condition, up to the development of hypochondriacal depression.

In addition to gastric and intestinal disorders, gastroenterological neuroses are also referred to as aerophagia (occurs with hysterical neurosis) and pathology of eating behavior - anorexia nervosa and pathological overeating (bulimia).

Complex therapy options
Treatment of patients with neurotic disorders of the gastrointestinal tract primarily involves eliminating the root cause of the disease, i.e. a neurosis. Only in this case it is possible to normalize the patient's condition and prevent possible relapses.

The most important role is assigned to psychotherapeutic methods, both individual and group. Their goal is to understand the patient's existing psychological problems and the connection of his illness with stress, and, if possible, switching the attention of a person to solving conflict situations, etc.

Drug therapy for neuroses involves the appointment of tranquilizers (diazepam, chlordiazepoxide, Sibazone, meprobamate, Relanium) or, in more severe cases, small doses of neuroleptics (thioridazine, chlorprotixen, fluspirilene).

In case of prevalence of neurasthenic symptoms, the combined use of tranquilizers with nootropics (Phenibut, etc.) or Aminalone is indicated. In severe sleep disorders, sedatives (nitrazepam, phenazepam) are recommended.

And, of course, given the presence of gastroenterological manifestations, the patient needs a set of therapeutic measures aimed at eliminating the main symptoms.

Necessity in strict dietary restrictions, as a rule, no, except for cases with concomitant chronic pathology of the gastrointestinal tract. Nutrition of the patient must be physiological, containing a sufficient number of high-grade proteins and vitamins. In patients with anorexic phenomena, it is possible to temporarily administer parenteral nutrition or additional intake of multivitamin complexes.

As symptomatic treatment of gastroenterological disorders, depending on the nature of the course of neurosis, antacid preparations, gastroprotectors, antispasmodics and enzymatic agents can be prescribed. They will not only help to quickly repair existing violations, but also have a psychotherapeutic effect on the patient, which in turn will help to eliminate the underlying cause of the disease more quickly.


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Actovegin ointment and Actovegin gel. Indeed - an ambulance!

08 Oct 2018

The mythical hero Hercules for a long time could not cope with the Lernea hydra, because at the place of the severed head three immediately grew up. As you know, Hercules managed to make his second feat and win the same malignant amphibian. But the ability of the hydra to restore the lost, frankly, impressed. At first sight, in ordinary, non-mythical life, such miracles do not occur. But if we could, with the help of some magical gadget, see how the body repairs damaged tissue, in particular the skin, it would probably agree that it looks like a miracle. By the way, in the treatment of skin lesions, there is a mythology. We'll talk about this now.

Actovegin ointment and Actovegin gel

MYTH
Each wound, abrasion or cut is an open gate for infection. Therefore, cuts and abrasions should be treated as quickly and carefully as possible with iodine or alcohol, without missing a millimeter of the damaged area.


TRUE
If it is not a small surface abrasion, then use alcohol-containing solutions should be very carefully. Iodine, alcohol treat only the edges of the wound. The ingress of these funds to the wound surface further injures the tissues and causes a burn which will increase the number of dead cells and delay the normal healing process. Therefore, treat the wound better antiseptic, not causing burns - a solution of hydrogen peroxide or chlorhexidine. And then - in order to avoid re-infection of the wound and in order to speed up the healing process, it is useful to apply gel on the wound surface of Actovegin. It creates a breathable but insurmountable film on the wound and activates regenerative processes, stimulating blood circulation and improving the nutrition of tissues. And after the wound is delayed, you need to continue treatment with cream and ointment Actovegin - so that the skin does not form a coarse scar.


MYTH
Burns, incl. and solar, it is necessary to treat with alcohol or smear with oil.


TRUE
If the burnt skin is treated with alcohol, then a chemical burn is added to the thermal burn. As for oil, its use in the treatment of burns is not recommended for 2 reasons: oil forms a film on the surface of the burn which prevents the evaporation and cooling of the damaged area. In addition, the oil can not be attributed to sterile substances. Therefore, the probability of infection is high. To effectively treat burns, you can use Actovegin. With thermal burns with a wetting surface, Actovegin gel is suitable, with sunlight and thermal burns without wetting, help is provided by Actovegin cream. It has a light texture, it is easy to apply to damaged skin without causing additional pain. Cream Actovegin will accelerate skin regeneration, moisturize and soften irritated and inflamed skin.

MYTH
To heal skin damage, you can use natural remedies - plantain or yarrow, for example. And no "chemistry" is needed.

TRUE
Psyllium and yarrow, of course, can be used in marching conditions, if at hand there are no other effective means of help. But nevertheless it is necessary to consider, that such means can become a source of an infection. Therefore, it is better to use proven pharmacies in camping conditions: antiseptic and the means of the Actovegin line. This is not a "chemistry", but a set of natural factors that help to trigger natural metabolic processes. The main active substance is the deproteinized haemoderivat of the blood of young healthy calves. Included in the composition of drugs Actovegin substances improve skin nutrition, supplying cells of the affected tissue with oxygen, microelements and nutrients: amino acids and carbohydrate-lipid complexes, stimulate blood circulation.

MYTH
There is no point in spending money on various dosage forms of Actovegin. It is enough to buy either a gel, or a cream, or an ointment. After all, the active substance is the same everywhere.

TRUE
Actovegin is the only external preparation for 3-step therapy of wounds, abrasions, scratches and other superficial skin lesions. For each stage of healing is its Actovegin.

On a fresh wound with a wet antiseptic after separation, a 20% gel is applied. It covers the wound with a thin film, thereby reliably protects it from infection, and immediately starts the process of initial active healing. After 1-4 days, as soon as a fresh granular tissue (granulate) is formed in the wound, it is better to switch to 5% cream of Actovegin to accelerate the further healing. In the final phase of regeneration, for the full healing at the epithelization stage, the use of the Actovegin ointment is recommended. It is with this approach that the crusts will quickly disappear and the wound will heal without scars.


MYTH
If the drugs Actovegin contain the blood of calves, then these drugs need special storage conditions. And the shelf life of them, most likely, is small.

TRUE
Well, firstly, in the preparations Actovegin contains not blood, but deproteinized haemoderivat, containing only physiological substances - amino acids, oligopeptides, nucleosides, oligosaccharides and other useful trace elements. Due to this composition, Actovegin has antihypoxic, antioxidant and metabolic effects on damaged tissues. Secondly, all drugs Actovegin can be stored under normal conditions. They can be taken with them on a trip or on a summer residence. In this case, Actovegin has a long shelf life: the gel has 3 years, and the cream and ointment have 5 years.


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Addiction to antidepressants

05 Oct 2018

Among the "normal" people there is an opinion that "antidepressants are very harmful", "they can go crazy", "get used to them for life", etc. Is this true? Of course, there is no smoke without fire, but fire is the cost of Soviet psychiatry, when strong remedies "just in case" were prescribed in large doses with the corresponding results. In the rest of the world, the attitude towards drugs is completely different. To date, about 65 percent of the US population is taking psychotropic drugs (primarily antidepressants and tranquilizers).

Addiction to antidepressants

There is a stereotype that taking antidepressants is a manifestation of a weak character. But at the same time, people who suffer from other diseases, such as hypertension or polyarthritis, take medication during periods of exacerbations and this is considered normal. For example, aspirin is not able to cure polyarthritis, but it can relieve pain in the joints and thereby alleviate the physical suffering of the patient. Unfortunately, in our society there is still a stereotype that depression is weak-willedness, non-assortment, and only a few understand that depression is the same disease that requires treatment. Yes, antidepressants can not always relieve depression, but they can reduce pain. Only not physical, but spiritual.

For many, the issue of addiction to antidepressants is important. Will not the body demand and after the release of depression another portion of the pills of joy? You can answer more than unequivocally - the drugs used to date in the treatment of depression, do not cause addiction, regardless of the duration of treatment. They only help the body to restore those mechanisms that were disturbed by depression.

Those people whose work is related to creativity, often worried about the question, will the antidepressant drug use interfere with the processes that are responsible for creativity? In most cases, depression does not have the best effect on creativity, but most often makes it impossible. Antidepressants are able to restore a broken inner world and restore the ability to create a person's ability to create, because most often creativity contributes to mental health.

The task of a psychiatrist is to select the right preparations. Only half of the patients experience improvement after the first course of therapy, so that the selection of drugs can be called trial and error. A doctor can prescribe several drugs before he finds the most effective one. In many clinics, it is practiced to prescribe free drugs to persons who are on psychiatric records. Since the cost of the drugs of the last generations can reach $50-100, and they can be written down several types, imagine how much it can cost. Although - they say that over the past 30 years nothing better and stronger than the good old amytriptilin has not been invented. New drugs basically differ in contraindications (they are much less) and at a price (it is much higher).

The effect of the drug is not immediately apparent - usually between the time of the beginning of the reception and the appearance of a positive effect is not less than 2-3 weeks, although in some cases, positive mood changes may appear in one week. For someone, drugs are a panacea, and a person who has tried to escape from depression for many months unsuccessfully comes to life right before our eyes. Someone they are able to remove only some of the depressive symptoms. But there are people on whom drug therapy does not affect. Do not rush to rank yourself in the last category - everything is very individual, and in some cases a stable result can come only after a few months.

Often drugs are prescribed together with other methods of treatment. Antidepressants are most often unable to fill the inner world with light and completely rid themselves of depressive experiences, but they are able to give at least some feeling of stability, to ease the symptoms of depression.

Another important point is the name of the drugs. For example, fluoxetine, which is by far the most popular drug both in America and in Europe, is represented on the Russian market by almost 20 pharmaceutical companies. This means that the same drug is sold under 20 different names. And if the recipe simply says "fluoxetine", then you have to focus on the ratio of "price / quality." The cheapest are Russian and Indian drugs, but they often have a lot of side effects. Drugs produced by Western pharmacists are more expensive, but the side effects are not as pronounced.

Mary, 32 years: “For several years I have to take antidepressants. At first they really "help the body to restore those mechanisms that were disturbed by depression." Rather, they even make the body (in particular, the brain) what it should do by itself.

And he gets so used to it that he refuses to work after the drug is discontinued. Even if you cancel the medicine according to all the rules, with the exact calculation of dosages.

I tried to cancel antidepressants several times, in different ways, under the supervision of doctors. As a result, the brain simply refuses to work.”


Many will say that an untreated disorder simply returns again in its entirety. This is not so: before going to the drugs I felt much better - at least, I could walk and talk.

In practice, I have come across many people who have been suffering from depression for years and often in severe form, but have never been treated with antidepressants. Many of them have a stereotype that "like as long as I am without drugs - I can consider myself normal, and it is only necessary to start ..." And what, what will happen next? See what is already happening to your life. I repeat - the drugs are not addictive, and you can stop the therapy at any time even if you sit on drugs for many years, without prejudice to your health. Often, it is the depression that does not use any of the techniques in this section, because in order to try something, you need strength and a sense of stability, and depression takes it all away. Drugs are able to give the necessary foundation, change your attitude, ease depression, and then, while taking medications, you can go jogging, go to a therapist, practice sleep deprivation and do many other things. I myself took antidepressants for many years and they played an important role in the therapy of my depression, and years later, when I managed to deal with depression, and its symptoms became much weaker, I just stopped taking them. Do you understand?


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Rating of hypnotics and sedatives

03 Oct 2018

Most sedatives are combined medicines and herbal products. The leader of the segment by the volume of pharmacy sales for the third year in a row is Novo-Passit (Teva), the II place with 11.72% share of sales belongs to Valocordin, and the top three tablets Corvalol (producer - "Pharma Start"). "Traditional" Corvalol (in the form of drops) takes the 4th line of the rating of sedatives.

Rating of hypnotics and sedatives

In addition to Corvalol, Valoserdin is a popular sedative for Russian production, which is also used as a cardiac remedy for rhythm disturbances. Over the past year, its sales grew by 5%.

TOP 10 hypnotics and sedatives

1) Novo-Passit
2) Valocordin
3) Corvalol drops
4) Corvalol tablets
5) Persen forte
6) Valoserdine
7) Persen
8) Melaxen
9) Valerian
10) Motherwort extract


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Actovegin injection 400mg 5 vials