No 13 (2014)

The results of numerous epidemiological studies indicate that arterial hypertension (AH) is a major risk factor for stroke. The degree of increase in blood pressure (BP) determines the severity of the stroke and the development of its fatal complications. According to various studies, 95 % of patients who died from stroke, suffered from arterial hypertension. Given the importance of the renin-angioten-sin-aldosterone system in the development of stroke, angiotensin converting enzyme inhibitors and angiotensin receptor II antagonists are drugs of choice in the treatment of stroke patients.

This review discusses the fundamental biological processes of neuroprotection, neurorestoration, and neurogenesis. Natural pathways of activation of protective mechanisms, counteracting damaging factors are described. Based on principles of evidence-based medicine, the possibility of pharmacological modulation of neurodegeneration/ neurorestoration, and prevention of apoptotic mechanisms are considered. Information on the effectiveness of the neuropeptide drug Cellex (polypeptides of the brain of pig embryos) in the treatment of stroke patients is provided. It is emphasized that the proposed mechanism of action of the drug enhances its therapeutic use: the time of his appointment to the patient with ischemic stroke is not limited to the first minutes or hours from onset, and extended for a much greater period of time.

The article presents the main reasons for the development of venous thromboembolism and its complications, and describes the main risks of thrombosis. The results of studies forming the evidence base for the use of direct factor Xa inhibitor rivaroxaban for treatment of deep venous thrombosis, prevention of recurrent thrombosis, prevention of venous thromboembolism in patients undergoing orthopedic surgery and having atrial fibrillation, are discussed in detail.

The study was aimed to the analysis of rationality of the use of antihypertensive drugs in pregnant women in three subjects of the Central Federal District of the Russian Federation. For this purpose, we conducted an analytical study of regulatory guidelines and documents, and assessment the expert opinions on the use of antihypertensive agents in pregnant women. The results lead to the following conclusion: in the national guidelines for the treatment of arterial hypertension in this category of patients of various countries, preference in the choice of second-line drugs is following: United States - labetalol; WHO experts, Australia - oxprenolol and pindolol; European Union - atenolol, metoprolol, pindolol and oxprenolol; Russian cardiologists - propranolol and atenolol. Experts of Central Federal District showed sufficient, good or very good degree of familiarity with the recommended antihypertensive drugs.

Attention deficit hyperactivity disorder (ADHD) previously was considered as a disease of children and adolescents, but studies have shown that symptoms undergo a transformation and continue to be found in adulthood approximately in 50 % of patients. The article discusses the changes in the ADHD diagnostic criteria according to the DSM-V classification, where for the first time the threshold number of ADHD symptoms for adults is presented, and age dynamics of its manifestations is reflected. Treatment for ADHD should be prolonged enough and planned on the basis of assessment of the main ADHD symptoms and comorbid disorders manifestations. When selecting pharmacotherapy, drugs, which, when administered as monotherapy, may have a positive effect both on the ADHD manifestations and comorbid disorders should be preferred. The potentials for the use of atomoxetine hydrochloride, hopantenic acid, and some other neuroprotective drugs in ADHD are considered.

The article is devoted to the evaluation of drugs used for the treatment of low back pain (BP), and the problem of choosing of effective treatment strategies. The results of studies that suggest the undoubted benefits of the use of meloxicam [Amelotex] in patients with LBP compared with other drugs, and effectiveness of combination therapy (for example, the simultaneous use of meloxicam (Amelotex) and B vitamins) are presented.

Important problems of treatment of patient with low-back pain (LBP) include the elimination of pain and reversion of patient to normal life. Drugs are widely used for pain relief, primarily analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs). Nimesulide is one of the drugs, which have long been used for the treatment of patients with pain syndromes caused by diseases of the musculoskeletal system, including LBP. Drugs that can provide structurally modifying effect, which not only eliminate the most important symptoms, but also affect the course of the disease, in particular slow the disease progression, are of justified interest. One of these drugs is chondroitin sulfate sodium (Chondrogard), and significant clinical experience of its use is gained.