No 11 (2009)

The authors studied clinical advantages of antibiotics modified release oral formulation, which are very important for clinical practice. Such antibiotics include azithromycin ER and clarithromycin ER. These formulations have special pharmacokinetic feature - delayed absorption in distal areas of gastrointestinal tract, what decreases the contact with motilin receptors and improves antibiotics tolerability. Because of the high tissue penetration optimal tissue concentration of such antibiotics are preserved for a long time. Modified release oral formulations allows to achieve better clinical results, increase tolerability and decrease the frequency of antibiotis dosing, that result in better patients compliance.

Peculiarities of antihypertensive therapy in metabolic syndrome and diabetes mellitus The prevalence of hypertension (HP) and associated with it cardiovascular risk, disability and premature death of the patients increasing. It is known that HP is frequently associated with such conditions as metabolic syndrome (MS) and type II diabetes. In patients with MS and diabetes prevalence of HP then in general population. In 80% of cases development of HP precedes to development of diabetes. Treatment of HP have in these patients have some specifics. First of all, it is necessary to achieve blood pressure goals, metabolic control and prevention of complications.

Mexidol, characterized be multifactor mode of action is widely used in the complex treatment of the patients with a acute cerebrovascular accidents, dyscirculatory encephalopathy with hypertension, vertebrobasilar insufficiency and other conditions with tissue hypoxia. Besides of antioxidant characteristics, it has antihypoxic, antiatherogenic, nootropic, gamma-aminobutyric acid protective effects. The efficiency of using Mexidol in therapy of stroke and other nervous system diseases, accompanied by increasing lipid peroxidation, hypoxia, disturbances of the brain metabolism.

Treatment of chronic heart failure (CHF) by diuretics begins only if the clinical signs of congestion in pulmonary circulation and systemic circulation. Thiazide and loop diuretics are mainly used. Effective and safe diuretic torasemide has additional effects of renin-angiotensin-aldosterone system blockage. It can improve of prognosis of patients with CHF, that why this modern diuretic is the drug of choice, especially during the long period treatment and clinical decomposition.

Gastroesophageal reflux disease (GERD) is a chronic, relapsing disease, caused by the disturbances of motor and evacuator functions of gastroesophageal zone, characterized by spontaneous and regularly regurgitation of gastric and/or duodenum content to esophagus, with specific symptoms which not depends on morphologic changes of esophagus mucosa. According to Genvald guidelines GERD is divided on endoscopic-negative GERD, endoscopic-positive GERD and Barrett esophagus. Treatment depends on the disease form. Artile includes the modern algorithms of GERD management. The most effective drugs for GERD treatment are proton pomp inhibitors.

The study included 84 patients with paroxysmal atrial fibrillation (AF) and hypertension of different degrees. We evaluate the influence of antihypertensive therapy by calcium antagonists (CA) and inhibitors of angiotensin-converting enzyme (ACE) on the clinical course of paroxysmal AF in patients with hypertension and structural and functional remodeling of the myocardium. It was shown that the efficiency of blood pressure (BP) lowering by CA and ACE inhibitors is similar. BP control leads to significant decreasing of the frequency of AF paroxysm compared this using only classic ant arrhythmic drug. ACE inhibitors characterized by stable anti-relapsing activity, but protective effect CA decreased on 7,9% after 12 months. Compared with CA therapy by ACE inhibitors led to decreasing of structural and functional remodeling of the myocardium and reduction of AF paroxysm frequency on 61,5%, what can be caused by specific blockage of renin-angiotensin-aldosterone system.