Vol 8, No 3 (2020)

The aim of the study is to assess the efficacy and safety of the Favipiravir (Areplivir) drug, compared to the standard etiotropic therapy in the patients hospitalized with COVID-19.

Material and methods. The research was conducted as a part of an open, randomized, multicenter comparative study of the efficacy and safety of Areplivir, 200 mg film-coated tablets (“PROMOMED RUS” LLC, Russia), in the patients hospitalized with COVID-19. The dosing regimen of Favipiravir was 1600 mg twice a day on the 1^st day and 600 mg twice a day on days 2–14. Thirty nine patients were enrolled into the study with a laboratory-established diagnosis of a new type of Coronavirus infection caused by SARS-CoV-2 (confirmed) of moderate severity, with pneumonia. The group of comparison (22 patients) received standard etiotropic therapy, prescribed in accordance with the current version of the temporary guidelines for the diagnosis and treatment of COVID-19, represented mainly by Hydroxychloroquine with the dosage regimen of 800 mg on the 1^st day, then 400 mg on days 2–7, and Azithromycin 500 mg once a day for 5 days. The main group (17 patients) received Favipiravir (Areplivir) as etiotropiс therapy.

Results. In the main group, the time period until fever disappeared was found to be 1.36 days shorter than in the group of comparison (p<0.05); there was a higher rate of the reduction of inflammatory changes in the lungs according to the computer tomography data (38.4% vs 14.9%, p<0.05). By the end of the treatment, there was also a lower lactate level in the blood (27.1%, p<0.05) than in the patients of the group of comparison. The evaluation of the drug efficacy ассording to the Categorical Ordinal Scale of Clinical Improvement and measurements of oxygen saturation in the blood, manifested similar positive dynamics in the patients treated ассording to various etiotropic therapy regimens. By the end of the treatment, the RNA SARS-CoV-2 tests were also negative in all the patients. As for the overall frequency of adverse events (AEs), no relevant distinctions were found between the groups. A greater part of AEs was related to hepatotoxicity, with a predominantly clinically relevant increase in alanine aminotransferase (ALT). A clinically relevant prolongation of the corrected QT interval on the standard ECG was found to occur in the standard-therapy group on day 5, while no serious AEs were registered in the main group. No serious adverse reactions were registered in patients of the main group.

Conclusion. The efficacy of the Favipiravir (Areplivir) therapy for the novel coronavirus infection has proved to be superior to the efficacy of the standard etiotropic therapy in a number of aspects. Basing on the obtained findings, Favipiravir (Areplivir) drug can be recommended for treating patients with the novel coronavirus infection of moderate severity.

The correction of free radical oxidation processes is one of the most promising strategies of neuroprotection in acute cerebrovascular disorders.

The aim of the study is an experimental study of the neuroprotective effects of 3-hydroxypyridine and erythropoietin derivatives, as well as their combined use.

Materials and methods. The study was performed on 109 male Wistar rats. The neuroprotective effect of the substances was studied on a hemorrhagic stroke model. The study drugs were administered to the animals intraperitoneally. Carbamylated darbepoetin was administered three times in advance at the dose of 100 µg/kg within intervals of 3 days, the last injection took place 1 hour before the operation (the total dose was 300 mg/kg). Etoxidol was administered once 1 hour before the surgery at the dose of 50 mg/kg. The survival rate, behavioral features and the state of the animals on the 1^st, 3^rd, 7^th and 14^th days were recorded, and the morphological assessment of the brain was carried out.

Results and discussion. The investigated substances had a positive effect on both the survival rate of the animals during the first day and on the 14^th day. The best survival rates on the 14^th day were recorded in the group of a combined use of ethoxydol and carbamylated darbepoetin (75%). Thus, in this group of rats, a faster recovery of neurological disorders was already distinguished from the first day on. By the 7^th day, more than 50% of the rats receiving the combination of the studied drugs, had had a slight neurological deficit (up to 3 points on the McGrow scale); by the 14^th day there had been only minor changes in the neurological status in the rats of this group. A pronounced neuroprotective effect of the combination of 3-hydroxypyridine and erythropoietin derivatives has been confirmed by a histological examination of brain slices – a more rapid decrease in the size of perifocal edema and microcirculation disorders, less damage to neurons and glial elements, and faster processes of resorption and organization of hemorrhage. A macroscopic examination of the brain sections stained with triphenyltetrazolium chloride of the dying rats, showed that perifocal necrosis had been the main cause of high mortality in the control group after the 3^rd day.

Conclusion. As a result of the experiment, the nephroprotective effect of the studied derivatives of 3-hydroxypyridine and erythropoietin has been proved. Moreover, the combination of these drugs has shown a greater neuroprotective activity than their isolated use. The additive effect of these drugs was due to their action mechanism resulting from the synergism of various structures and components of the cells.

Public health protection is the most important law of the development of a civilized society. As participants in the health care system, pharmaceutical specialists must take upon themselves certain preventive tasks aimed at strengthening and maintaining the health of the population.

The aim of the work was to substantiate and develop a methodology for implementing the professional role of pharmaceutical specialists in public health protection.

Materials and methods. The search for information was carried out using the methods of address, thematic and factual search in the Scopus, The Cochrane Library, Pubmed, eLibrary databases. The analyzed body of information included systematic reviews, retrospective and randomized studies, and other applied developments on the topic of publication. The depth of the bibliographic search for scientific publications is about 20 years (2000-2019). The following keywords were used for the search: “a pharmacist in health protection”, “prevention of adverse drug reactions”, “functions of a pharmacist”, “pharmaceutical care”, “sanitary competence”, “a pharmacist’s role in the prevention of diseases”, “pharmacy services”, “patient compliance”, “collaboration in health care”, etc.

Results. On the basis of the analysis, the demand for pharmacists in the health protection activities has been substantiated, the scientific and applied methodology of using pharmaceutical knowledge in the protection of public health has been updated and the necessary professional competencies (PC) of a pharmacist have been proposed for their implementation. The relevance of the preventive approach in the implementation of information and consultancy activities of a pharmacist has been substantiated, the essence of which is to prevent undesirable events associated with the use of medicinal preparations (MPs) and preventive health care in the society. The proposed methodology is based on the concept of “a pharmaceutical vigilance”, the practical implementation of which is proposed in the publication. The need for pharmacists to perform certain professional functions aimed at preserving and strengthening the health of the population has been updated, the functions have been proposed and the list of possible pharmaceutical services for the practical implementation of the proposed functions in the health care system has been provided.

Conclusion. The following pharmaceutical services have been identified as relevant: pharmaceutical enlightenment of the population, patient-oriented pharmaceutical counseling and patronage of patients, pharmaceutical informing of medical specialists about drugs and social prevention of the problems affecting the public health. The definitions of pharmaceutical services have been specified, the methodology for providing the services has been substantiated, the efficiency of their provision has been updated and the professional competencies of pharmacists for their implementation in practical healthcare have been formed.