2. Sympatholytic agents. Classification. Mechanism of action. Indications for use. Side effects. Contraindications Comparative evaluation of drugs.

Sympatholytic agents - agents that disrupt the transmission of excitation at the level of varicose thickening of adrenergic fibers, act presynaptically.

Mechanism of action classification:

one. Emptying the transmitter depot: reserpine, octadine.

2. Mediator ejection obstruction: Ornid.

3. Violation of the synthesis of the mediator: methyldopa.

Indications: octadine and reserpine treatment of hypertension, glaucoma.

Side effects: diarrhea, bradycardia, pain in the parotid gland, fluid retention in the body, collapse, drowsiness.

Contraindications: organic diseases of the cardiovascular system, renal failure, peptic ulcer; octadine is not recommended for pheochromocytoma.

• Reserpine-reduces the content of norepinephrine in the heart, blood vessels, adrenal medulla, central nervous system. Depressing effect on the central nervous system. Has sedative properties, enhances the effect of drugs for anesthesia.

• Octadine gradually lowers blood pressure, reduces cardiac output, causes bradycardia, narrows the pupil, lowers intraocular pressure, enhances intestinal motility, and is administered orally.

• Ornid - lowers blood pressure, antiarrhythmic action.

• Methyldopa - lowers blood pressure.

3. Preparations of pancreatic hormones. Synthetic hypoglycemic agents. Classification. Mechanism of action. Indications for use. Side effects. Contraindications Comparative evaluation of drugs.

Classification:

one. to replacespecial therapy (insulin);

2. increase the output of endogenous insulin (sulfonylurea derivatives);

3. increase the flow of glucose into tissues and glycolysis (biguanides);

four. reduce the absorption of glucose in the small intestine (acarbose).

Insulin - lowers blood glucose levels; increases the utilization of glucose and the energy value of metabolism; increases the synthesis and reduces the breakdown of proteins, fats. Indications: diabetes mellitus, cachexia. Contraindications: hypoglycemia, acute hepatitis, cirrhosis, nephritis, renal amyloidosis, peptic ulcer disease, heart defects.

Synthetic hypoglycemic:

one) sulfonylurea derivatives (butamide, chlorpropamide);

2) biguanide derivatives (buformin, metformin).

Mechanism: I - stimulation of beta cells and insulin release; decreased protein binding and degradation by insulinase; increased formation of pancreatic cells.

Side effects - decreased blood formation. It is used for milder forms of diabetes in the elderly. II - glucose supply to muscles, normalization of protein metabolism.

Glucagon is an increase in blood glucose due to the conversion of glycogen.

Mechanism: 1) activation of adenylate cyclase and formation of cAMP; 2) activation of phosphorylase and conversion of glycogen to glucose. Action: increases the breakdown of fat, the formation of free fatty acids, as a source of energy.

4. Anti-spirochete drugs. Classification. Mechanism of action. Indications for use. Side effects. Comparative characteristics.

Anti-spirochetes are a group of drugs used to treat diseases caused by spirochetes.

Classification: short-acting (benzylpenicillin sodium or potassium salt)

Long-acting: (novocaine benzylpenicillin salt, bicillins)

Mechanism: block thiol enzymes containing sulfhydryl groups.

Indications: Used for spirochetosis and syphilis.

Side effects: headache, vomiting, fainting, collapse, dermatitis, erythema, fever, euphoria, convulsions, liver damage.

Organic bismuth preparations: biloquinol, bismoverol, pentabismol. Only for syphilis. Cumulate in parenchymal organs, in the central nervous system. Mechanism: block sulfhydryl groups of thiol enzymes. The nature of the action: treponemostatic. Side effects - gingivitis, stomatitis, nephropathy. Contraindications: liver, kidney, oral cavity diseases.