Vol 8, No 5 (2020)


Mumps: achievements, problems and ways of solution

Semerikov V.V., Yuminova N.V., Postanogova N.O., Sofronova L.V.


The aim. The article highlights the current state of the problem of mumps in the world and the Russian Federation.

Materials and methods. The materials of the study were electronic resources WHO infection control, Cohrane, Elsevier, ScienceDirect, CDC infection diseases database, PubMed, eLibrary, CyberLeninka. The research methods were the analysis and generalization of scientific literature. The assessment is presented by the immunological structure of the population in different age groups to mumps (n = 593) in the study area (2018) according to the data of the Center for Hygiene and Epidemiology in the Perm Territory.

Results. The spread of mumps is found to be widespread and uneven in different regions of the world in the form of sporadic cases and large epidemic outbreaks, despite the world practice of vaccine prevention of mumps. Analysis of the immunological structure to mumps in different age groups revealed a fairly high number of seronegative individuals (the largest number was found among adults aged 20–39 years) in the study area (2018). A decrease in the tension of post-vaccination immunity is the main cause for the emergence of an outbreak among the adult population, in addition to vaccination failures among vaccinated children. The immune defenses created by the vaccine strain do not have the same intensity and duration as with natural infection, and some genotypes of “wild” variants of the mumps virus can break through the immune barrier and cause disease. Antigenic differences between vaccine and circulating strains, low inoculation dose can weaken immunity and reduce the effectiveness of mass vaccine prevention.

Conclusion. Ways of solving the problem were proposed to forestall an unfavorable epidemic situation with mumps.

Pharmacy & Pharmacology. 2020;8(5):296-303
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Correction of morphofunctional disorders in experimental preeclampsy by combined use of trimetazidine and purified micronized flavonoid fraction as well as their combinations with methylampsy

Antsiferova O.E., Teleschenko M.P., Tsuverkalova Y.M., Pokrovsky M.V., Gureev V.V., Zatolokina M.A., Gureeva A.V.


The aim of the experiment was to determine the effectiveness of the combined use of trimetazidine and a purified micronized flavonoid fraction, as well as their combinations with methyldopa, in comparison with monotherapy with the same drugs in the correction of morphofunctional disorders arising in the conditions of experimental preeclampsia.

An integrated/multimethodology approach is the most effective way of treatment for preeclampsia. Therefore, an urgent task of modern pharmacology is to study the effectiveness of new drugs when used in combinations, as well as the drugs included in the standards for treatment.

Materials and methods. The study was carried out at the Research Institute of Pharmacology of Living Systems of Belgorod State National Research University. The experiment was performed on 200 female Wistar rats, weighing 250–300 g, in which an ADMA-like model of preeclampsia had been reproduced. To assess the degree of correction of emerging morphological and functional disorders, the following parameters were involved: blood pressure, a coefficient of endothelial dysfunction, microcirculation in the placenta, proteinuria, fluid contents in the greater omentum, morphometric indicators of placental tissues and fetal height and weight parameters.

Results. The combined use of trimetazidine (Preductal® MB) 6 mg/kg and a purified micronized flavonoid fraction (Detralex®) 260 mg/kg, as well as their combination with methyldopa (Dopegit®) 86 mg/kg, leads to a more pronounced decrease in the blood pressure, compared with a decrease in the coefficient of endothelial dysfunction by 2.22, 2.19 and 1.94 times, respectively, in relation to “untreated” animals. There was an increase in microcirculation indices in the placenta by 2.35, 2.21 and 2.03 times, respectively. In addition, there was an improvement in morphological parameters in the placenta and fetuses.

Conclusion. The results of the study showed a greater effectiveness of the combined use of the studied drugs in experimental preeclampsia compared to their monotherapy. This indicates the prospects for the use of trimetazidine and purified micronized flavonoid fraction in the complex therapy for preeclampsia and the need for further research in this direction.

Pharmacy & Pharmacology. 2020;8(5):304-315
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Сomparative analysis of drug efficacy in the treatment for COVID-19 severe forms, based on attribute-based statistic methods and analysis of drug interactions

Zhukova O.V., Kagramanyan I.N., Khokhlov A.L.


Severe and critical forms of COVID-19 are beset by the development of a “cytokine storm”, which is characterized by increased secretion of proinflammatory cytokines. Therefore, one of leading strategies for treating patients with severe forms of COVID-19, is the reduction of concentration of proinflammatory cytokines and leveling out their effect on the patient. Among the drugs aimed at reducing the concentration of proinflammatory cytokines, IL-6 inhibitors, IL-1 inhibitors, JAK inhibitors and systemic glucocorticosteroids have been found useful in COVID-19. All of these drugs are currently prescribed off-label.

The aim of the work is a comparative analysis of the data from the literature sources in the PubMed system, devoted to the clinical efficacy and safety of IL-6, IL-1, JAK inhibitors and systemic glucocorticosteroids in the treatment for severe forms of COVID-19.

Materials and Methods. In the treatment for severe forms of COVID-19, materials for the comparative analysis were the data from the literature sources in the PubMed system, on the studies devoted to the use of the systemic glucocorticosteroid dexamethasone, IL-6 inhibitor tocilizumab, IL-1 inhibitor anakinra, and JAK inhibitor ruxoliniteb. The analysis was performed by statistical evaluation of the effect of the drugs on the 28th-day survival rate among the patients with severe COVID-19. Attribute-based statistics was used as a statistical tool. The safety of the drug use was assessed by analyzing potential drug interactions. The information about potential drug interactions, was obtained from a specialized website – Drugs.com. Knowmore. Besure (https://www.drugs.com/interaction/list/).

Results. As a result of the analysis, it has been established that tocilizumab has the highest efficacy rates. In this respect, it is followed by dexamethasone. The attributive efficacy rates and 95% confidence interval values for the both drugs, were statistically significant. The indices of relative and population attributive kinds of efficacy, were also higher for tocilizumab, but a 95% confidence interval of these indices, get into the range of statistically insignificant values, requiring additional evidence of their efficacy. According to the data obtained, tocilizumab efficacy is higher than that of the other drugs compared: NNT (dexamethasone) – 32; NNT (tocilizumab) – 4, NNT (ruxolitinib) – 7; NNT (anakinra) – 35.

Conclusion. The choice of a drug should be based on the patient’s condition, comorbidities, and medications used in therapy to minimize the risk of undesirable drug interactions.

Against the background of the lowest efficacy among the compared drugs, a high efficacy for the patients with concomitant hepatobiliary disorders and DIC syndrome, has been established for the inhibitor IL-1 anakinra, which makes it the drug of choice among the patients with these diseases and under these conditions in the development of a “cytokine storm”.

Pharmacy & Pharmacology. 2020;8(5):316-324
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Effect of the GABA derivative succicard on the lipid and carbohydrate metabolism in the offspring of rats with experimental preeclampsia in early and late ontogeny

Muzyko E.A., Perfilova V.N., Nesterova A.A., Suvorin K.V., Tyurenkov I.N.


Maternal preeclampsia can bring about metabolic disorders in the offspring at different stages of ontogeny. Up to date, no ways of preventive pharmacological correction of lipid and carbohydrate metabolism disorders developing in different periods of ontogeny in the children born to mothers with this pregnancy complication, have been developed.

The aim of the experiment was to study the effect of the gamma-aminobutyric acid derivative succicard (22 mg/kg) and its reference drug pantogam (50 mg) administered per os in the course of treatment in puberty (from 40 to 70 days after birth), on the parameters of lipid and carbohydrate metabolism in the offspring of the rats with experimental preeclampsia, in different periods of ontogeny.

Materials and methods. To assess the activity of lipid and carbohydrate metabolism in the offspring, an oral glucose tolerance test was performed at 40 days, 3, 6, 12 and 18 months of age. The level of glycosylated hemoglobin was measured at the age of 6, 12, and 18 months, and the concentrations of total cholesterol, high-density lipoprotein cholesterol and triglycerides were tested at 40 days, 3, 6, 12, and 18 months of age.

Results. The offspring of the rats with experimental preeclampsia, were found out to have lipid and carbohydrate metabolism disturbances during early (40 days and 3 months of age) and late (6, 12, and 18 months of age) ontogeny. In comparison with the offspring of healthy females, these disturbances were manifested by significantly higher levels of glucose revealed during the oral glucose tolerance test, by high glycosylated hemoglobin in males, and with elevated concentration of total cholesterol and triglycerides and a low level of high-density lipoprotein cholesterol in the negative control rats. Both the gamma-aminobutyric acid derivative succicard and its reference drug pantogam, reduced the negative effect of experimental preeclampsia on lipid and carbohydrate metabolism in the offspring in late ontogeny (6, 12 and 18 months of age). The effectiveness of succicard was either higher or comparable with pantogam.

Conclusion. Thus, the negative impact manifestations of experimental preeclampsia on lipid and carbohydrate metabolism, are revealed in the offspring in early (40 days and 3 months) and late (6, 12 and 18 months of age) ontogeny. The gamma-aminobutyric acid derivative succicard reduces the negative effect of experimental preeclampsia. Based on this finding, the drug implies the possibility of the development of a safe and highly effective medicine for preventive correction of lipid and carbohydrate metabolism disorders in the children born to mothers with preeclampsia.

Pharmacy & Pharmacology. 2020;8(5):325-335
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Comparative review of methodologies for estimating the cost of adverse drug reactions in the Russian Federation and Brazil

Syraeva G.I., Kolbin A.S., Matveev A.V., Panezhina V.S.


The aim of the review article was to highlight the methodologies for assessing the financial costs of adverse drug reactions exemplified by the Russian Federation and Brazil.

Materials and methods: for a comparative analysis, materials from open sources were used. The study of the experience of methods used for assessing the burden of adverse drug reactions, was carried out using the system for calculating payments for medical care by clinical-statistical and clinical-profile groups, the methodology for assessing the severity of adverse events of the US National Cancer Institute, drug-associated problems, and “the decision tree” model.

Results. When comparing the costs of ADR management in the Russian Federation and Brazil, the following results have been obtained: in the Russian Federation, the “cost” of reaction can be estimated only for a limited number of nosological groups that are regulated by the classification of diseases by clinical and statistical groups; in Brazil, when predicting the costs of adverse reactions management, the combination of “the decision tree” method and the Delphi method is used. In the Russian Federation, the cost of the 3rd and above severity adverse event (according to CTCAE v. 4.03), varies from 26,849.22 up to 26,196.37 RUB in the North-West region (St. Petersburg). In Brazil, the cost of ADR ranges from 13 USD (the best scenario for the patient) to 574 USD (the worst scenario for the patient), which is about 975 and 43,000 RUB, respectively. The introduction of methods that make it possible to predict the development and potential outcomes of adverse drug reactions, as well as taking into account the experiences of foreign colleagues in their modeling, will reduce economic costs in the Russian Federation at the federal level.

Conclusion: for the economic value analysis and further forecasting, an improvement of existing methodologies is required. The models used in the Russian Federation (“the decision tree”, classification of diseases by clinical groups, Markov model) do not take into account the time factor, therefore, when planning the analysis of potential costs for adverse reactions, it is necessary to reinforce the methods with such tools as QALY, YLL, and YLD.

Pharmacy & Pharmacology. 2020;8(5):336-344
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Hemorheological properties of the 5-HT2a-antagonist of the 2-methoxyphenyl-imidazobenzimidazole derivative of the RU-31 compound and cyproheptadine, in comparison with penthoxyphylline

Yakovlev D.S., Naumenko L.V., Sultanova K.T., Spasov A.A.


Migraine and its comorbid conditions are pathogenetically associated with many factors, including hemorheological disorders. A class of drugs with a 5-HT2A antagonistic mechanism of action, is promising for the prevention and treatment of migraine attacks and concomitant pathologies.

The aim of the research is to study and compare a hemorheological activity of anti-migraine drugs, antagonists of 5-HT2A receptors of cyproheptadine, and a new drug that completed preclinical studies of the 1-(2-diethylaminoethyl)-2-(4-methoxyphenyl)-imidazo[1,2-a]benzimidazole derivative of the RU- 31 compound.

Materials and methods. The study of the hemorheological activity of the RU-31 compound and cyproheptadine, was carried out using an experimental model of rabbit blood hyperthermia in vitro. Pentoxifylline was used as a reference drug. In the course of the work, the parameters of blood viscosity, aggregation and deformability of erythrocytes were recorded.

Results. It has been established that in the concentration of 1 μM, the RU-31 compounds reduce blood viscosity by 17% at high shear rates, which is comparable with pentoxifylline in the concentration of 100 μM on the activity level. In the concentration of 1 μM, cyproheptadine also causes a general tendency to reduce blood viscosity at high shear rates, being inferior in activity to the RU-31 compound and pentoxifylline.

In the concentration of 1 μM, the RU-31 compound has a pronounced effect on the aggregation ability of erythrocytes in autologous plasma, reducing the aggregation rate by 70%, while the level of activity is not inferior to the drug compared to pentoxifylline in the concentration of 100 μM, and surpasses the drug cyproheptadine. For the RU-31 compound and cyproheptadine, no significant effect on the deformability of erythrocytes has been shown.

Conclusion. The capacity of cyproheptadine and the RU-31 compound to influence the rheological properties of blood by reducing blood viscosity and aggregation of erythrocytes has been revealed.

Pharmacy & Pharmacology. 2020;8(5):345-353
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Problems of responsible self-medication of allergy symptoms and farmaceutical counseling

Izrafilova V.A., Egorova S.N., Garifullina G.K., Akhmetova T.A.


Cure of allergy symptoms reported by a patient with the help of non-prescription antiallergic drugs, is one of the important aspects of a responsible self-medication.

The aim of the study is to assess the peculiarities of consumers’ behavior as pharmacy visitors, when choosing non-prescription antiallergic drugs, and to identify potential problems of pharmaceutical counseling for allergy symptoms regarding the responsible self-medication.

Materials and methods. Sociological survey in the form of a questionnaire; graphoanalytical and comparative analyses.

Results. The profile of an over-the-counter antiallergic drugs buyer in the pharmacies of Kazan was assessed in the following way: it is a woman aged 18–44 of a middle level of income, having a family of 3–4 people, ready to spend from 101 to 500 rubles on the purchase of antiallergic drugs, buying anti-allergic drugs not for the first time. The main reasons to seek for treatment were skin rash, redness and itching, which had also been observed in the past. The allergic nature of the disease had already been confirmed by the doctor. For the average consumer of over-the-counter antiallergic drugs, the most important criteria for choosing a medicine were: efficiency, safety, the doctor’s recommendations and price. The medicines were purchased for the visitors themselves or their children. The customers were satisfied with the choice of non-prescription antiallergic medicines available in the pharmacy. The visitors generally trusted the pharmacists’ advice and recognized them as health professionals, but considered that the main goal was not only to provide a pharmaceutical care, but also to profit from the sale of the drugs. The following flaws of pharmaceutical counseling when dispensing non-prescription antiallergic drugs, were identified: an improper diagnosis by a pharmaceutical specialist, the lack of recommendations to consult a doctor, incomplete provision of information on the use, storage, and the possibility of interaction with other drugs and food.

Conclusion. Misdiagnosis and incomplete provision of information by pharmaceutical specialists on antiallergic the drugs that are approved for the over-the-counter dispensing, require the implementation of a pharmaceutical consultation algorithm for the visitors contacting a pharmacy with allergy symptoms.

Pharmacy & Pharmacology. 2020;8(5):354-361
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Analysis of industrial practice of drug quality risk management in russian pharmaceutical enterprises

Kashirina A.B., Aladysheva Z.I., Pyatigorskaya N.V., Belyaev V.V., Beregovyh V.V.


The aim of the research was to study the current industrial practice of drug quality risk management in Russian pharmaceutical enterprises, including the assessment of the main problems during the implementation of the risk management system and its compliance with the accepted international approaches.

Materials and methods. In the period from 6 April to 10 May 2020, an online survey of the leading employees in the field of quality assurance of Russian manufacturers was conducted. In the survey, the questionnaire was based on the results of the authors’ analysis of the national regulatory legal acts of the Russian Federation, the European Union countries, international guidelines of the EAEU, ICH and WHO in this area. 111 people took part in the survey, the return of questionnaires was 11.5%.

Results. The data obtained indicate the prevalence of a superficial approach to quality risk management in the Russian pharmaceutical industry, the presence of objective and subjective reasons that hinder the effective implementation of these methods, the fragmentation of the systems used and, in most cases, their ineffective use. The respondents believe that the most significant reasons for the difficulties in implementing this methodology, are the lack of recommendations from the Ministry of Industry and Trade of Russia on creating an effective quality risk management system and a shortage of the specialists who are ready to work in the area of this industry. The survey revealed rather large gaps in the deployment of a risk management system at the enterprise and separation from the established international practice.

Conclusions. The data obtained indicate the extreme urgency of developing recommendations for a quality risk management system, which should be based upon and supported by Russian regulatory legal acts and international experience in this area. The authors propose highlights for these recommendations.

Pharmacy & Pharmacology. 2020;8(5):362-376
pages 362-376 views

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