4. Differences between chemotherapeutic agents and antiseptics. Basic principles of ht. Criteria for evaluation.

Antiseptic agents are used to affect pathogens on the surface of the human body.

Chemotherapeutic agents are drugs of various chemical groups with antimicrobial and antiviral properties that suppress the vital activity of pathogens in the human body. By retarding the growth or causing the death of pathogens, they should not disrupt the basic functions of the human body (macroorganism).

Chemotherapy drugs must necessarily come into contact with the causative agent of the disease in the patient's body.

Basic principles of chemotherapy

1. Establishing an accurate bacteriological diagnosis, rational choice of a chemotherapeutic drug, determining the sensitivity of a microorganism

2. If it is impossible to carry out appropriate studies - the appointment of drugs with a wide spectrum of action.

3. Early start of treatment.

4. Creation and maintenance in the body of a constant effective concentration of the chemotherapeutic substance

5. To prevent the development of resistant strains of microorganisms, it is recommended to use chemotherapeutic agents in combination

6. Correct determination of the duration of treatment.

7. Along with the appointment of chemotherapeutic agents, measures should be taken to enhance the defenses of the macroorganism

Evaluation criteria - high activity, pronounced selectivity of action, antimicrobial spectrum, bactericidal nature of action, permeability through biological membranes (BBB), effectiveness in different biological media, development of resistance in microbes, sensitization of a macroorganism, absence of side effects, minimal toxicity, breadth of therapeutic action, as well as technical availability of manufacturing, low cost.

Ticket 40.

1. Conditions affecting the manifestation of the action of medicinal substances in the body. The importance of the psychogenic factor in the effectiveness of drug treatment; the word of the doctor and the prescription of drugs. The ethical side of the advertising of new drugs.

Age - there is perinatal pharmacology (from 24 weeks of the fetus to 4 weeks of newborn), newborns differ from adults (deficiency of enzymes, kidney function, ↑ BBB permeability, underdevelopment of the central nervous system). There is pediatric pharmacology - doses per kg of body weight. There is geriatric pharmacology - in people of age, the doses should be ↓ (since ↓ absorption, metabolism, excretion by the kidneys).

Gender - men are less sensitive to a number of substances than women (strychnine, nicotine).

Genetic factors - enzyme deficiency, atypical reactions (idiosyncrasy). Studying pharmacogenetics.

The state of the body - pharmacokinetics changes with illness, pregnancy, obesity.

Circadian rhythms (circadian) - studies chronopharmacology. The effect of substances changes qualitatively and quantitatively (pronounced effect during the period of maximum activity). Absorption, metabolism change during the day.

Psychogenic factor - if the patient is committed to treatment, trusts the doctor, follows the recommendations, the treatment will be effective. Otherwise, the effect of the treatment cannot be expected.

The word of the doctor is the therapeutic effect of the word of the doctor on the patient.

Ethics:

Ethical issues of drug advertising are relevant due to the following factors in the modern market:

low awareness of consumers about the features of medical products or services. Over-the-counter drugs put significantly more people in danger each year than all illicit drugs put together; conflicting conditions of competition in the pharmaceutical market, imperfection of legislative and regulatory acts that do not take into account all the nuances of a modern market economy (for example, experts point out that some parts of federal laws allow advertising of medicines, but with some restrictions, while other parts prohibit this advertising everywhere);

increased influence of suppliers on consumers by use in the pharmaceutical market, imperfection of legislative and regulatory acts that do not take into account all the nuances of a modern market economy (for example, experts point out that some parts of federal laws allow advertising of medicines, but with some restrictions, and other parts prohibit this advertisement everywhere);

increasing the influence of suppliers on consumers using new methods of pressure: forced distribution, imposing and incorrect anamnesis on the part of doctors involved in drug promotion, - leads to a significant complication of drug promotion among honest manufacturers and healthy competition.

2. Tranquilizers. Classification. Mechanism of action. Indications. Side effects. Contraindications Comparative assessment of drugs Possibility of developing dependence. The concept of "Daytime" tranquilizers.

Tranquilizers are substances that have a depressing effect mainly on the central nervous system. Eliminate negative emotional reactions (feelings of fear, anxiety).

Classification:

a) Benzodiazepine derivatives (benzodiazepines)

1.Closepide 9.Estazolm

2.Sibazone 10.Clorazepate

3.Phenazepam 11.Klobazam

4.Nosepam 12.Alprozolam

5.Lorazepam 13.Tetrazepam

6.Bromazepam 14.Tofisopam

7. Mezapam

8.Hidazepam

b) Carbamine ethers of substituted

propanediol

1.Meprotan

c) Diphenylmethane derivatives

1.Amisil 2.Hydroxyzine

d) Tranquilizers of different chemical groups

1.Buspirone 3.Mebikar

2.Oxidiline

Mechanism of action: for benzodiazepines - they inhibit the anxiety zone in the hypothalamus, impulses stop, inhibit the limbic system and reticular pharmacy. Characterized by a sedative effect, a decrease in skeletal muscle tone, a hypnotic effect, a decrease in aggressiveness, an anticonvulsant.

Indications: situational anxiety states, borderline states, insomnia, skeletal muscle spasms, relief of status epilepticus, premedication, ataralgesia.

Side effects: allergies, drowsiness, dizziness, uneven gait.

Contraindications: acute liver and kidney disease, myasthenia gravis, pregnancy, not for drivers.

Buspirone - a pronounced anxiolytic effect, no sedative, anticonvulsant, relaxing effect, no addiction.

Phenazepam is more active than diazepam in terms of anxiolytic and hypnotic action.

Dependence - with prolonged use of benzodiazepines, mental and physical drug dependence.

"Daytime" tranquilizers - mezapam, pronounced anxiolytic effect and no sedative-hypnotic effect.