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No 11 (2010)
- Year: 2010
- Articles: 18
- URL: https://journals.eco-vector.com/2073-4034/issue/view/6690
Articles
Chronic hepatitis C in elderly patients
Abstract
The present article discusses the epidemiology, the course and complications of chronic hepatitis C (CHC) in elderly patients. Indications and possible contraindications to antiviral therapy (AVT) in this category of patients are presented. It is noted that in elderly patients with chronic hepatitis C unsatisfactory results of AVT have been frequently reported, perhaps due to a combination of a number of adverse factors (progressive hepatic fibrosis, genotype 1 HCV infection, high viral load, presence metabolic and alcoholic steatohepatitis, low adherence to AVT due to poor tolerability of treatment, etc.). The problem of advisability of AVT in elderly patient with chronic hepatitis C adjusted for risk-benefit ratio should be resolved in each case individually, taking into account all factors (comorbidity, activity of chronic hepatitis C and stage of disease, etc.).
Pharmateca. 2010;(11):10-17
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New options for beta-adrenoblockers use: specific carvedilol's properties
Abstract
The features of the mechanisms of action and indications for use of carvedilol are discussed. Its pharmacological properties, not directly associated with beta-adrenoblocking action, are considered. Carvedilol have peripheral vasodilator effect, caused by concomitant antagonism to alpha1-adrenoreceptors. Its special feature is the ability to bind free radicals (trapping phenomenon). The data for controlled clinical studies, which evaluated the efficacy and safety of carvedilol, are presented.
Pharmateca. 2010;(11):18-23
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Prehypertension (increased normal blood pressure): to treat or to observe?
Abstract
The present article discusses the clinical and prognostic significance of prehypertension (increased normal blood pressure). The medical approaches to this condition are considered. If prehypertension is accompanied by high risk of complications and/or signs of target organ lesions, administration of antihypertensive drugs, in the first place, obviously, ACE inhibitors or angiotensin II receptor blockers should be discussed.
Pharmateca. 2010;(11):24-30
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Autonomous neuropathy in diabetes mellitus: clinical manifestations, diagnostics and treatment
Abstract
The article deals with problems of onychomycoses - fungal nail infections which are most prevalent and often resistant to treatment in dermatology. The data for the epidemiology, etiology, pathogenesis, clinical characteristics and principles of therapy of dermatoses are presented. Indications and contraindications to the systemic, local and combined therapy of onychomycosis are discussed. The particular attention is focused on the local therapy as definitive treatment of onychomycoses due to its high safety, accessibility and usability. The current evidences of the efficacy and safety of local therapy of onychomycoses with 8 % Ciclopirox nail lacquer based on numerous foreign and domestic studies are presented.
Pharmateca. 2010;(11):32-37
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Pneumonia in persons more than 60 years old: diagnostics and treatment
Abstract
The problem of pneumonia occurring in elderly and senile patients is discussed. The difficulties and errors of diagnosis, peculiarities of pathogenic flora and clinical manifestations of disease are described. The absence of specific characteristic for routine laboratory tests is marked. The program of treatment of pneumonia according to on the terms, severity and etiology of the disease is presented. Early diagnosis and timely optimal therapy reduce the likelihood of severe outcomes of pneumonia in elderly and senile patients.
Pharmateca. 2010;(11):38-41
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Successful use of inhaled form of Fluimucil-antibiotic IT in the complex therapy of respiratory infectious and inflammatory diseases
Abstract
The use of combined drug - thiamphenicol glycinate acetylcysteinate (TGA), consisting of the universal mucolytic (N-acetylcysteine) and broad-spectrum antibiotic (thiamphenicol) at a dose of 500 mg in infectious-inflammatory diseases of the respiratory system is justified. Outlined case history of the use of TGA in the treatment of exacerbation of bronchiectatic disease demonstrated high therapeutic efficacy of the drug. The advantages of nebulizer route of administration of TGA is emphasized.
Pharmateca. 2010;(11):42-45
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Back-pain in general medical practice: understand and treat
Abstract
Back pain is one of the most frequent causes of chronic pain syndrome. Despite the high prevalence of the primary causes of lower back pain, it is necessary to exclude life-threatening diseases. Our multicenter epidemiological study was aimed to evaluation of features of management of patients with pain syndrome in the practice of medical therapeutic specialties, neurologists and surgeons. Results have shown that patients with back pain have registered pain an average of 17 days a month. The intensity of the pain syndrome was not significantly different from the intensity of postoperative pain. According to doctors, the most effective nonsteroidal antiinflammatory drugs are Lornoxicam, original diclofenac sodium, and ketorolac. The majority of patients also indicated the effectiveness of these drugs.
Pharmateca. 2010;(11):46-50
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Leflunamide use in the treatment of rheumatoid arthritis in the patient with end stage chronic renal insufficiency at the background of secondary AA amyloidosis
Abstract
Renal impairment substantially limits the choice of basal antirheumatic therapy (BART) of rheumatoid arthritis (RA). Elderly age and presence of renal disease on the background of a long course of RA are the risk factors for side effects of BART. Thus, rheumatologist in practice often solve nonconventional challenge of searching the golden mean between the need for early initiation of aggressive BART and minimizing the risk of adverse effects against the background of its administration. Leflunomide is a unique basis antirheumatic drug, which can be used in patients with chronic renal insufficiency, including those on program hemodialysis.
Pharmateca. 2010;(11):51-56
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Ciprofloxacin role in the treatment of uncomplicated lower urinary tract infections
Abstract
Urinary tract infections (UTI) are very common urological diseases, which are most often occurring in women. Against the background of the emergence of atypical forms of microorganisms and the general immunodeficiency of population UTI are often being grounded in chronic forms. Currently, the main method of treatment of acute and chronic cystitis is the antibiotic therapy, and the fluoroquinolones play the leading role. Ciprofloxacin - one of the first synthesized fluoroquinolone. However, it remains a drug of choice in treatment of cystitis due to its high efficiency and small number of side effects compared with other fluoroquinolones and antibiotics of other groups.
Pharmateca. 2010;(11):57-60
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Peculiarities of articular syndrome treatment in elderly persons with arterial hypertension
Abstract
The article is dedicated to the problem of adverse effects by cardiovascular system against the background of use of nonsteroidal anti-inflammatory drugs (NSAIDs) in elderly patients, particularly in patients with osteoarthritis in combination with arterial hypertension. In this case, use of non-selective NSAIDs is associated with increased risk of cardiovascular complications and leads to significant limitation of administration of antihypertensive drugs. Selective NSAID nimesulide (Nise) has no such effects, therefore it can be considered as a drug of choice for the management of acute and chronic joint syndrome in patients with arterial hypertension.
Pharmateca. 2010;(11):62-65
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Intraintestinal metabolism disturbances in malabsorption syndrome in children: general regularities and ways of correction
Abstract
Disorders of intestinal absorption associated with changes in the function of intestinal mucosa of different origin lead to significant changes in intestinal metabolism, particularly determining the development of the main symptom of this condition - the violations of stool consistency. Meanwhile, in bowel lumen the metabolism of carbohydrates, proteins, fats and bile acids is violated, that causes secondary disorders of the digestive function, and aggravates the course of primary pathological process. Treatment of the causes of malabsorption in combination with substitution therapy, including highly active preparations of pancreatic enzymes, is the main way in the correction of previously mentioned conditions.
Pharmateca. 2010;(11):66-71
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Role of the long-acting somastatin analogue Sandostatin Lar in the treatment of acromegaly
Abstract
The article is dedicated to the effectiveness and safety of long-acting analogue of somatostatin - Sandostatin Lar in long-term use (up to 5 years) in 163 patients with acromegaly in the active stage, the possibility of its use as a primary therapy of acromegaly. It was shown that Sandostatin LAR as a safe medicine can reduce the secretion of somatotrophic hormon (STH) and insulin-like growth factor (IGF-1) in 93,3 % of patients, and provides a safe levels of STH and normal level of IGF-1 in more than half of patients. The drug is effective and safe as an independent mean of medical therapy for acromegaly, and allows controlling the size of pituitary tumors in most patients.
Pharmateca. 2010;(11):72-76
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Folates and lipoic acid content in the hepatoprotector Prohepar
Abstract
Prohepar is a hepatoprotector drug, based on the hydrolyzate of animal liver. The enrichment of the liver extract with standardized amounts of cyancobalamin, cysteine, choline and inositol enhances hepatoprotective properties of the drug. Since the is multi-component composition, the experimental study of its composition is important for understanding the foundations of hepatoprotective effect of the drug. In the present work we studied the vitamin content of Prohepar. It was found that the drug contains significant amounts of lipoic acid and tetrahydrofolic acid - the endogenous and the safe form of folates. Lipoic acid, as well as tetrahydrofolic acid have strong hepatoprotective properties. The study confirmed the presence of cyancobalamin in the drug in the amounts specified by the manufacturer. The presence of small amounts of other vitamins (especially vitamins C, E, B6 and B1) indicates soft conditions of the Prohepar production, which help to preserve biological activity of peptides, lipoic acid and tetrahydrofolic acid in Prohepar.
Pharmateca. 2010;(11):77-82
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Depressions in patients with psoriasis
Abstract
The present article is dedicated to the results of the study aimed to examination of efficacy of new methodology for the evaluation of the pathogenesis and clinical presentation of depression using US Center for Epidemiologic Studies Depression Scale (CES-D - Center for Epidemiologic Studies - Depression). The study enrolled 105 patients with psoriasis and two control groups of patients with other dermatoses and somatic diseases (n = 153 and n = 2053, respectively). According to the results of study, findings were as follows: CES-D scale should be used for the diagnosis of depression in patients with psoriasis; the secondary depression which appear linked to the main disease is dominated in patients with psoriasis; use of antidepressants is necessary given that depression adversely affect on the course of psoriasis. Heptral (ademetionine) may be recommended as the drug of choice due to antianxiety properties, because anxiety is one of the most pronounced manifestations of depression in patients with psoriasis. Moreover, this drug is effective in the treatment of concomitant functional hepatobiliary disorders and hepatotoxicity caused by immunosuppressive drugs in patients with psoriasis. Heptral also has an impact on affected cartilaginous tissue with mild variants of psoriatic arthritis; serotonin 2A receptors inhibiting the activity of tumor necrosis factor, which is one of the key inflammation mediators; beta2-adrenergic receptors of immune cells providing their proliferation.
Pharmateca. 2010;(11):84-90
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Dyspepsia: types, causes, algorithms of diagnostics and treatment
Abstract
The present article is dedicated to clinical syndrome of dyspepsia as a result of violations of the digestive processes and motor activity of the gastrointestinal tract. The basic mechanisms of pathogenesis of dyspeptic manifestations of primary nature (functional dyspepsia) and secondary origin are discussed, approaches to treatment in accordance with the mechanisms of digestive disorders are described. Much attention is paid to the role of modern polyenzyme preparations and prokinetics in the correction of dyspeptic symptoms, current algorithms of diagnosis and treatment of this disease, including cases with a refractory course, are presented.
Pharmateca. 2010;(11):91-100
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How to ensure juridical adequacy of patient's information while conducting medicinal therapy
Abstract
One of the most urgent problems of the legitimacy of professional activity of health workers is execution of patient's informed consent for conservative treatment. This article discusses the available options (verbal and written) to inform the patient before medical intervention, including drug therapy. The advantages of combined method using the standard (unified) forms, which would allow explain the nature of the problem by specialist and clearly document patient's decision, are accented.
Pharmateca. 2010;(11):102-106
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St. John's wort (Нуреricum реrfоrаtum)
Abstract
The potentials for medical use of St. John's wort as external antiseptic agent, and for the treatment of depression and gastrointestinal diseases are presented. The basic active substances of herb Hypericum perforatum are condensed anthracene derivatives - hypericin and pseudohypericin. The article is concerned with current St. John's wort herbal preparation, and side effects and drug interactions limiting the therapeutic application are discussed.
Pharmateca. 2010;(11):107-109
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Lefgren syndrome
Abstract
The article presents history of the description, clinical and prognostic significance of Loefgren syndrome. This syndrome is associated with an acute course of sarcoidosis. Its main symptom is erythema nodosum. Erythema nodosum, as well as Loefgren syndrome - is marker of favorable course of sarcoidosis with low risk of progression of pulmonary interstitial lesions.
Pharmateca. 2010;(11):110-111
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