No 4 (2016)

Tiotropium is the drug of first-line supporting treatment of chronic obstructive pulmonary disease (COPD), the efficacy and safety of which is supported by higher level evidence and broad experience of the use in medical practice. Many pharmacoeconomic studies have shown that the clinical benefits of tiotropium compared with placebo and active comparators lead to its economic advantages, primarily by reducing the cost of hospitalization, and allow to consider the tiotropium as a drug of choice for the supporting treatment of COPD.

The article discusses the modern approaches to the treatment of influenza and pneumonia - one of the most dangerous complications of influenza infection. The etiopathogenesis and clinical manifestations of influenza and pneumonia are described; the order of diagnosis and care for patients with these diseases, as well as practical advice on the management of patients with influenza and pneumonia are presented.

The article provides an overview of the studies on the role of tiotropium bromide in the treatment of bronchial asthma (BA); the prerequisites for the application of long-acting anticholinergics in bronchial asthma are disclosed, and pharmacological properties of tiotropium bromide are discussed. Currently, it is proved that the addition of tiotropium to standard therapy of patients with severe uncontrolled BA results in improved lung function and reduced risk of relapses. Ongoing studies of the drug can extend the range of its indications in bronchial asthma.

The article is devoted to the treatment of acute sinusitis in childhood with emphasis on the rational choice of systemic antibacterial therapy, taking into account the experience of Russian and foreign authors.

Objective: to study the frequency of aspiration processes in children admitted with respiratory complaints; to evaluate the effectiveness of different treatments of microaspiration syndrome. Methods: for detecting the frequency of aspiration syndrome in infants and young children with acute lower respiratory tract lesions without neurological disorders, monitoring of 162 children in the period 2013-2015 was conducted. The comparison group consisted of 24 children with aspiration on the background of an organic lesion of the central nervous system. Results: Of 162 children surveyed, signs of aspiration were revealed in 27 cases, accounting for 16.7%. Aspiration syndrome incidence was highest in the first six months of life; of the 67 children admitted to hospital with acute lower respiratory tract lesions without concomitant neurologic disease before the age of 6 months, aspiration was detected in 17 cases (25%). Gastroesophageal reflux (GER) occurred in 4 children in the first six months of life, which was not different from the frequency of GER in healthy children. Of 88 children in the latter six months, only 3 children had signs of microaspiration (3.5%). Of the 47 neurologically healthy children, recurrent symptoms of broncho-pulmonary diseases were observed in 20 children. Conclusion: These data show that the food microaspiration is sufficiently frequent cause of respiratory syndrome, especially among infants. Respiratory syndrome in children with the food microaspiration syndrome is characterized by repeated episodes of cough, obstruction with a trend towards prolonged duration due to the continuing aspiration.

This article is dedicated to the analysis of the results of clinical studies on the efficacy and safety of ambroxol hydrochloride. Classification and mechanism of action of mucolytics are considered in details. Current evidence on the effectiveness of ambroxol against bacterial films is analyzed that attaches special importance in the present conditions of antibiotic resistance. A comparative evaluation of pharmacokinetic and pharmacodynamic characteristics of the drug compared with bromhexine is performed. It is emphasized that ambroxol has higher bioavailability as compared with bromhexine, allowing to regard this drug as the most effective in this pharmacotherapeutic group.