Ticket 38
Basic principles of first aid for acute drug poisoning
Beta-blockers. Classification. Mechanism of action. Side effects. Contraindications Comparative evaluation of drugs.
Hormonal contraceptive drugs. Classification. Mechanism of action. Side effects. Contraindications Comparative evaluation of drugs.
Antiblastoma Wed-va. Classification. Mechanism of action. Side effects. Contraindications Comparative evaluation of drugs
1. Basic principles of first aid for acute drug poisoning.
Emergency care for acute poisoning consists in the combined carrying out of the following therapeutic measures:
- accelerated elimination of toxic substances from the body;
- specific therapy that favorably alters the transformation of a toxic substance in the body or reduces its toxicity;
- symptomatic therapy aimed at protecting and maintaining the body function that is predominantly affected by this toxic substance.
At the scene, it is necessary to establish the cause of the poisoning, find out the type of toxic substance, its amount and the route of entry into the body. If possible, find out the time of poisoning, the concentration of the toxic substance in the solution or the dosage in medicines.
In case of poisoning with toxic substances taken internally, before the arrival of the doctor, immediately begin gastric lavage to prevent further absorption of toxic substances into the blood. It is necessary to force, if possible, the victim to drink up to 5 liters. water at room temperature in portions of 300-500 ml. Drinking a lot of water causes vomiting.
If vomiting does not occur, then they resort to irritating the root of the tongue and the bottom of the pharynx with something soft. After an attack of vomiting, the patient should rinse his mouth and drink water again. This is repeated 4-5 times. Then it is recommended to put a cleansing enema.
In severe forms of poisoning in unconscious patients (poisoning with sleeping pills, etc.), the victim is placed on his stomach, in extreme cases - on his side with his head turned upside down. If there are vomit in the oral cavity, they are immediately removed (you can use a finger wrapped in a damp handkerchief) and make sure that they do not accumulate. The patient needs to be warmly covered and monitored.
When breathing stops and cardiac activity stops, immediately begin artificial respiration "mouth-to-mouth" or "mouth-to-nose" and closed heart massage. If you need to do both, then it is better to do it together.
2.
Beta-blockers.Classification.
Mechanism of action. Side effects. Contraindications Comparative
evaluation of drugs.
Mechanism of action: blockade of beta-adrenergic receptors of the heart, blood vessels, bronchi. I cause bradycardia, reduce the force of heart contractions, reduce the minute volume of the heart, blood pressure gradually decreases, the effect develops in 2-3 weeks.
Indications: paroxysm, tachycardia, atrial fibrillation, angina pectoris, hypertension.
Side effects: increase the tone of the bronchi (not possible with bronchial asthma), nausea, vomiting, bradycardia, allergies, depression.
Contraindications: bradycardia, heart failure, bronchial asthma, diabetes mellitus, pregnancy.
Anaprilin - reduces heart rate and heart rate, increases bronchial tone, can provoke bronchospasm. Blocks the metabolic effects of catecholamines.
Oxprenolol - less likely to cause bronchospasm.
Metoprolol - affects mainly the beta1-adrenergic receptors of the heart, is used orally for arterial hypertension.
Talinolol - does not affect the bronchi, does not cause orthostatic collapse.
3. Hormonal contraceptive drugs. Classification. Mechanism of action. Side effects. Contraindications Comparative evaluation of drugs.
Classification:
1) combined estrogen-gestagens,
2) drugs with microdoses of gestagens.
Of the estrogens, ethinyl estradiol is used, gestagens are different (norethindrone, norgestrel, levonorgestrel).
Estrogen-gestagens: monophasic drugs - doses of estrogens and gestagens are constant (microginon, minisiston, rigevidon, femoden), 2-phase (anteovin), 3-phase (tricvilar, triziston, triregol).
Mechanism: suppress ovulation as a result of a decrease in FSH and pituitary LH. The condition of the ovaries is similar to that of menopause. In the endometrium - regression in the 2nd phase, which prevents the implantation of the egg. Cervical mucus becomes more viscous, sperm are less active. The contraceptive effect is 100%.
Side effects: increased blood clotting, impaired liver fugation, decreased glucose tolerance, headache, engorgement of the mammary glands, changes in libido, nausea, bleeding, weight gain.
Contraindications: thromboembolism, stroke, tumors of the reproductive system and mammary glands, liver disease, diabetes mellitus, psychosis.
Microdoses of gestagens - continuin, microlut.
Mechanism: change the composition and amount of cervical mucus, reduce sperm activity, reduce the rate of transport of the egg through the fallopian tubes, endometrial regression, suppression of the hypothalamic-pituitary system. The contraceptive effect is lower. Side effects - bleeding, nausea, headache, depression.
Emergency contraception - postinor (increased dose of gestagen), escapel. Apply after intercourse (1-2 days).
Long-acting drugs - gestagen medroxyprogesterone acetate (once every 3 months) - gives bleeding, norplant (under the skin for 5 years).
For men - gossypol (inhibits spermatogenesis), side effects - hypokalemia, irreversible infertility.