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No 5 (2016)

Articles

Gpubokouvazhaemye kollegi!

Fomin V.V.
Pharmateca. 2016;(5):3-3
pages 3-3 views

GLYCEMIC VARIABILITY AS A THERAPEUTIC TARGET IN THE TREATMENT OF PATIENTS WITH TYPE 2 DIABETES MELLITUS

Ametov A.S., Chernikova N.A., Demidova T.Y., Nazhmutdinova P.K.

Abstract

To date, accumulated data suggest that the use of glycemic parameters in conjunction with the glycated hemoglobin levels and other traditional risk factors can improve the accuracy of prediction of the development of vascular complications and hypoglycemia in diabetes mellitus (DM). Assessment of glycemic variability is the most promising approach to the evaluation of the effectiveness of diabetes control, and its reduction can be considered as one of the important therapeutic targets in the treatment of DM [34]. As a consequence, more and more attention is paid to the evaluation of impact of various glucose-lowering drugs on the parameters of glycemic variability, in particular dipeptidyl peptidase-4 inhibitors, which have glucose-dependent effect on the function of pancreatic β- and alpha-cells.
Pharmateca. 2016;(5):8-13
pages 8-13 views

DIABETIC ANGIOPATHY «PAINFUL» POINTS: FOCUS ON HYPERTRIGLYCERIDEMIA AND FENOFIBRATE POTENTIAL

Rujatkina L.A., Rujatkin D.S., Zemljanuhina S.A.

Abstract

The paper discusses the problem of prevention and treatment of diabetes mellitus (DM) complications. The analysis indicates that diabetic vascular complications have specific pathogenic features associated with their locations. Evidence from numerous studies showed that fenofibrate exerts anti-inflammatory and antioxidant effects by modulating the PPARγ receptor activity. Activation of vascular cell PPAR receptors reduces the activity of inflammatory markers such as C-reactive protein, tumor necrosis factor a, interleukin-6, fibrinogen and others. Given the multifaceted spectrum of fenofibrate effect, these advantages ultimately reduce the risk of development and progression of micro- and macrovascular complications of diabetes
Pharmateca. 2016;(5):14-21
pages 14-21 views

MODERN POSSIBILITIES OF OSTEOPOROSIS TREATMENT

Pashentseva A.V., Verbovoy A.F., Kosareva O.V., Sharonova L.A.

Abstract

Osteoporosis - is a chronic disease of the skeleton, leading to bone fragility and fracture and requiring long-term treatment. The article deals with the modern principles of pathogenetic therapy of osteoporosis, summarizes data on the effectiveness of the main groups of drugs.
Pharmateca. 2016;(5):22-29
pages 22-29 views

MODERN TACTICS OF MANAGEMENT OF PATIENTS WITH DIABETIC POLYNEUROPATHY

Golovacheva V.A., Parfenov V.A.

Abstract

Diabetic polyneuropathy (DPN) is one of the most common polyneuropathies. Issues of pathogenesis, early diagnosis and optimal treatment of DPN are under active discussion. This article focuses on the most common form of DPN - diabetic distal symmetric polyneuropathy (DDSPN). Modern view of the pathogenesis, diagnosis and treatment of DDSPN is presented. Glycemic control, educational program, lifestyle (diet, smoking cessation, maintenance or achievement of a normal body weight, therapeutic exercises, maintaining activities of daily living) and cognitive-behavioral therapy when indicated are effective ways to improve the course of diabetes mellitus and DDSPN. Significant successes was achieved in the pharmacotherapy of neuropathic pain in DDSPN, but this treatment does not slow down the process of peripheral nerve damage. Today special attention is paid to the search for pharmacotherapies aimed at changing the course of DDSPN. In Russia, α-lipoic acid, B vitamins, and of complex of B vitamins and biologically active substances are discussed as a possible pathogenetic therapy of DDSPN. Cocarnit is a complex preparation, containing vitamins B and metabolically active compounds. The prospects of the use of this drug are discussesd. The results of clinical studies of efficacy and safety of Cocarnit in patients with DDSPN are presented.
Pharmateca. 2016;(5):30-37
pages 30-37 views

APPLICATION OF SAXAGLIPTIN AND ITS COMBINATION WITH METFORMIN IN THE THERAPY OF TYPE 2 DIABETES MELLITUS IN ELDERLY PATIENTS

Antsiferov M.B.

Abstract

The article discusses the features of the course of diabetes mellitus (DM) in elderly patients, hypoglycemic therapy in which has its own characteristics. The use of antidiabetic drugs with a minimum dose frequency during the day and a low risk of side effects - nephrotoxicity, hepatotoxicity and hypoglycemia - is an important principle of treatment of such patients. Prospects of use of dipeptidyl peptidase-4 inhibitor saxagliptin in elderly patients with type 2 diabetes are considered. Currently, there are 6 international, placebo-controlled studies of efficacy and safety of this drug in DM2 patients over age 65 years. Their results suggest that the therapy with saxagliptin and combination of saxagliptin+metformin in elderly DM2 patients is is sufficiently safe and effective in relation to the risk of hypoglycaemia and cardiovascular events.
Pharmateca. 2016;(5):38-44
pages 38-44 views

INCRETIN SYSTEM AS PROMISING PHARMACOLOGICAL TARGET FOR HYPOGLYCEMIC THERAPY

Kurkin D.V., Volotova E.V., Bakulin D.A., Lomkina E.M., Tyurenkov I.N.

Abstract

Incretin system remains a potential target for the creation of effective and safe anti-diabetic drugs. To date, two pharmacological approaches influencing incretin system are implemented: the use of resistant to degradation glucagon-like peptide-1 (GLP-1) analogues and the extension of the lifetime of own incretins. Due to the development of concepts of this system, fundamentally new approach has been proposed. It involves the stimulation of secretion of GLP-1 and glucose-dependent insulinotropic polypeptide through the activation of receptors on intestinal enteroendocrine L- and K-cells. These receptors belong to the GPRs family and also are located on pancreatic β-cells. It is proved that their activation increases the secretion of incretins and insulin in the presence of glucose. In this regard, GPR40 and GPR119 receptors are of the greatest interest. Creation of their selective agonists will be a new approach to the regulation of carbohydrate metabolism.
Pharmateca. 2016;(5):45-50
pages 45-50 views

EMPAGLIFLOZIN: ENHANCEMENT OF POTENTIALS OF THE TREATMENT OF TYPE 2 DIABETES MELLITUS

Biryukova E.V.

Abstract

Effective pharmacotherapy for type 2 diabetes mellitus is one of the main problems of diabetology. Empagliflozin - an sodium-glucose cotransporter type 2 (SGLT2) inhibitor preventing the reabsorption of glucose in the proximal renal tubules and not allowing glucose already filtered by the kidneys to fall back into the blood stream and accelerating its excretion in the urine at different stages of disease therapy; its application makes the achievement of long-term glicemic control and reduction of cardiovascular risk as a very real purpose, and is crucial for improving the prognosis of type 2 diabetes mellitus.
Pharmateca. 2016;(5):51-61
pages 51-61 views

PATHOGENETIC THERAPY OF DIABETIC POLYNEUROPATHY

Badalyan O.L., Savenkov A.A.

Abstract

Along with the eye and kidney lesions, diabetic neuropathy is one of the most common (90-95%) and dangerous complications of diabetes mellitus. It deteriorates the quality of life of patients, increases the risk of death, and represents the main cause of diabetic foot, which is fraught with subsequent limb amputation. The use of derivatives of thioctic acid in diabetic polyneuropathy is pathogenetically substantiated, and its effectiveness is proved by the results of major randomized, double-blind, placebo-controlled studies. The results of the large multicenter randomized trials and meta-analyzes demonstrating the efficacy of thioctic acid in patients with diabetes mellitus are presented in the article.
Pharmateca. 2016;(5):62-65
pages 62-65 views

EFFICIENCY OF MULTICOMPONENT THERAPY IN THE TREATMENT OF TYPE 2 DIABETES MELLITUS (CLINICAL CASE)

Koteshkova O.M., Molina L.P.

Abstract

Recently, glucagon-like peptide-1 agonists (GPP-1-a) are actively applied in the treatment of type 2 diabetes mellitus (DM2). To assess the effectiveness of exenatide treatment, multicentric international studies were conducted that have proven highly effective addition of the drug to metformin, sulfonylureas, and combinations thereof. A clinical experience of exenatide for the intensification of DM2 treatment, which showed that exenatide can be recommended for DM2 patients with overweight, glycated hemoglobin levels >7%, in case of ineffectiveness of the previous combination therapy.
Pharmateca. 2016;(5):66-70
pages 66-70 views

POTENTIALS FOR THE IMPROVEMENT OF TREATMENT OF PATIENTS WITH TYPE 1 DIABETES MELLITUS USING HUMAN ULTRA-LONG INSULIN ANALOGUE DEGLUDEC IN OUTPATIENT SETTINGS

Kalashnikova M.F., Zilov A.V., Yazykova D.R., Likhodey N.V., Fadeev V.V.

Abstract

The study was aimed to the evaluation of of the therapeutic potential of using insulin degludec as a part of basal-bolus insulin therapy in patients with type 1 diabetes mellitus compared with insulin glargine on the basis of the dynamics of indicators of glycemic control, frequency and severity of hypoglycemic conditions and susceptibility to hypoglycemia, as well as assessment of changes of health-related quality of life and mental and emotional status. The study included 46 patients aged >18 years with non-target glycemic control previously treated with insulin glargine for a long time. The main group included 25 patients treated with insulin degludec, control group -21 patients receiving insulin glargine. The observation period lasted for 3 months. The frequency and severity of hypoglycemic episodes, psycho-emotional status of the patients and quality of life were evaluated. The results showed that main group was able to achieve better control of hypoglycemia episodes that supposedly reflected in a higher quality of life and psycho-emotional status of patients. All of this allows to recommend insulin degludec as an effective and safe drug of basal-bolus insulin therapy.
Pharmateca. 2016;(5):71-78
pages 71-78 views

EVALUATION OF THE EFFICACY OF THERAPY OF OSTEOPOROSIS IN PATIENTS WITH EXTRA-ARTICULAR FRACTURES OF THE PROXIMAL FEMUR

Stafeev D.V., Kochish A.Y., Ivanov S.N.

Abstract

The article presents the results of a comparative clinical study conducted for a year among two groups of patients (48 and 47 women, respectively) aged over 50 years with extra-articular fractures of the proximal femur against the background of severe involutive osteoporosis (OP); patients received surgical treatment (osteosynthesis using PFN fixators) or combined surgical and antiosteoporotic treatment with two different drug regimens. It was established that the severe OP with X-ray densitometry T-test values below the threshold level (less than -3,3 SD) can be considered as a risk factor for osteosynthesis complications associated with the implant, and risk is increased by 23.6 times. In such patients, drug therapy of involutive OP using only calcium and vitamin D3 is useful, but does not prevent a significant reduction in bone mineral density after 6 months after the surgery. Antiosteoporotic therapy with the addition of strontium ranelate in calcium and vitamin D allows almost stabilize the rate of bone mineral density by the deadline at the level marked in the period of implementation of the osteosynthesis operation. Complex treatment of patients with extra-articular fractures of the proximal femur on the background of involutive OP with osteosynthesis using PFN fixators and 6-month therapy with calcium, vitamin D3 and strontium ranelate using tested scheme provides better functional outcomes one year after surgery compared with similar groups of patients, receiving only calcium and vitamin D3, and not receiving specific antiosteoporotic therapy.
Pharmateca. 2016;(5):79-85
pages 79-85 views

INCREASED THYROID-STIMULATING HORMONE LEVEL AS A MARKER OF PROGRESSION OF HEART FAILURE IN CARDIAC PATIENTS

Adamchik A.S., Panchenko D.I.

Abstract

The study including 42 patients has investigated the relationship of subclinical hypothyroidism (SH) with the development and progression of heart failure in patients with coronary heart disease and hypertension. It was found that SH (increased thyroid-stimulating hormone level) is accompanied by maladaptive restructuring of the left ventricle and its dilation, which is a prerequisite for an earlier development and progression of chronic heart failure in cardiac patients. These data suggest the presence of the negative impact of the SH on the dilation of the left atrium and development of atrial fibrillation, which requires a large-scale studies on the subject. They also put on the agenda the question of whether screening for thyroid disorders in cardiac patients and earlier initiation of hormone replacement therapy for the SH will reduce the risk and progression of heart failure.
Pharmateca. 2016;(5):86-88
pages 86-88 views

OVERVIEW OF PHARMACOECONOMIC STUDIES OF INSULIN PUMP THERAPY IN DIABETES MELLITUS

Tolkushin A.G.

Abstract

The economic component of insulin pump therapy (IPT) is a major factor for the lack of use of insulin pumps in Russia. Since the introduction of insulin pumps into practice in different countries, clinical and economic analysis of their use was carried out. Targeted search in the available sources, including MedLine/PubMed, has revealed 9 foreign pharmacoeconomic studies, 2 domestic pharmacoeconomic studies, and 4 foreign research reviews. Analysis of the sources detected by their content allowed to determine the general trend of research and their special aspects. Most economic studies of IPT came to the conclusion about economic justification of IPT, despite the higher cost of the insulin pump and its accessories. The use of continuous subcutaneous insulin infusion in certain subgroups of patients with type 1 diabetes mellitus is the most cost-effective.
Pharmateca. 2016;(5):89-95
pages 89-95 views

VNIMANIYu AVTOROV!

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Pharmateca. 2016;(5):95-95
pages 95-95 views

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