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Trophic ulcers: a complex problem without simple solutions

25 Jul 2018

The problems associated with the occurrence of ulcers on the skin, worries humanity for more than one century. And, unfortunately, it is still impossible to completely solve them. Moreover, in our time, issues of treatment and prevention of such a violation as trophic ulcers become more urgent. This is primarily due to the growing number of vascular diseases, leading to blood flow disorders. So, in the USA and Western Europe, up to 25% of the population suffer from one or another form of varicose veins. In general, chronic venous insufficiency (CVI) of the lower limbs - one of the main causes of the appearance of trophic ulcers - is observed in about 10-15% of the adult population of the planet, in developed countries this figure is increased to 20%. In Russia, the same picture is observed - about 38 million people suffer from CVI, recently there has been an increase in the incidence, and about 5 million people have trophic ulcers, mainly feet and shins.

Actovegin. Trophic ulcers

What it is?
A trophic ulcer is a defect in the skin or mucous membrane, as well as under the tissues located under them, resulting from a disturbance in their normal nutrition, most often due to a deterioration in the blood supply, or, more rarely, of nervous trophism. These disorders can lead to various diseases and injuries, but the result is a violation of microcirculation in this or that area of the skin with subsequent necrosis of soft tissues. The dead part is rejected, and an ulcer is formed on the skin - chronic, long (months, and sometimes even years), not healing, after healing prone to re-opening. In addition to complicating the situation (up to sepsis), infection of ulcers by various microorganisms can occur and is relatively rare (up to 3.5% of cases), but extremely dangerous cancer degeneration of trophic ulcers.

More than half of the trophic ulcers - 52% - occur as a result of varicose veins, 7% - with thrombophlebitis CVI, 14% of trophic ulcers - "arterial" origin, and they arise as a result of chronic arterial insufficiency, for example, with obliterating atherosclerosis. Mixed violation of blood supply (when both venous and arterial insufficiency develop simultaneously) gives 13% of cases of trophic ulcers. Post-traumatic ulcers (resulting from infection of wounds, burns, frostbite on the ground, etc.) account for 6% of the total statistics, neurotrophic (resulting from a non-blood supply, and nervous trophism - for example, spinal injuries that cause nerve impulses and loss of sensitivity in any zone) - 1%. A special problem is considered to be diabetic trophic ulcers (5% of cases) that appear in diabetic patients (usually on the foot and toes) as a result of specific lesions of microcirculation and nerve conduction. The remaining 2% of cases of trophic ulcers have a variety of etiologies: hypertensive (Martorell syndrome), infectious (syphilitic, tubercular, leprosy), occur in vasculitis, some metabolic syndromes, etc.

Regardless of the causes that caused the trophic ulcer, its treatment is a long process (sometimes, especially with frequent relapses, and lifelong), in which surgical methods, and physiotherapy, and, of course, various drugs, both local and and general action.

How to treat?
Treatment of the ulcer itself will be effective only if the cause that caused the trophism of the skin is eliminated simultaneously - without this, even if local treatment is successful and the ulcer is completely closed, relapses, the appearance of new ulcers on other skin areas, etc. are possible. In most cases, the direct cause is a violation of microcirculation, so in the complex therapy of trophic ulcers it is necessary to use agents that improve the rheological properties of the blood, increase the tone of the vessels (phlebotonics), prevent the formation of thrombi (fibrinolytics) and improve cell nutrition. Depending on the specific indications and contraindications, the patient can be assigned heparin and its derivatives, spasmolytics (drotaverin, nicotinic acid, papaverine), acetylsalicylic acid (Aspirin) and other drugs. One of the means widely used for the treatment and prevention of trophic ulcers of various etiologies is pentoxifylline, which has a complex effect: mild fibrinolytic, pronounced venotonic, lymphodrene; In addition, it positively affects the rheological characteristics of the blood. In some cases, pentoxifylline is prescribed together with prostaglandin E1 preparations, which promote the enhancement of capillary blood flow and prevent thrombogenesis. To improve cellular nutrition and respiration, Actovegin is used in clinical practice, which significantly increases oxygen consumption in cells, contains a significant amount of nutrients and microelements, and accelerates the processes of metabolism and, consequently, healing.

An important component of the complex treatment of trophic ulcers is the use of broad-spectrum antibiotics and antiseptic agents. Antibiotics are used not only for ulcers of infectious etiology, but also with such a frequent complication as the inflammation of the tissues surrounding the ulcer: in many cases they are caused by the drift of various microorganisms - both bacteria and fungi, therefore, if necessary, antimycotic preparations may be prescribed. To prevent infection of ulcers, regular antiseptic treatment and the application of aseptic coatings are required.

The problem of treatment of trophic ulcers is one of the most difficult in their treatment, since for the successful treatment it is necessary to remove both necrotic tissues and exudate and fibrin film (which along with the dead tissue can serve as a substrate for the development of microorganisms), and at the same time it is necessary to preserve as much as possible connective tissue components responsible for regeneration. To do this, use local remedies (mainly ointments) containing various proteolytic enzymes, for example collagenase (as part of the Iruksol ointment, etc.), selectively cleaving collagen at the border of dead and living tissues. This selectivity is due to the fact that the collagen of normal tissues is protected by mucopolysaccharides, which are absent on necrotic sites. Other collagenolytic enzymes are also used - for example, ultralizin or terrylitin, usually in complex preparations, which also contain antiseptics and sorbents. After the ulcer is cleared (both medically and by surgical methods), local anti-inflammatory, analgesic and wound-healing agents are used.

Modernity and prospects
Recently, more and more often local remedies are used not only in the form of traditional ointments, pastes, gels, etc., but also in the form of various wound coverings (bandages, films, patches, sponges, etc.) that provide a complex effect for a combination of the properties of the carrier material and various substances either impregnating the base material or included in its composition. Such coatings provide aseptic coverage of the ulcer and an optimum level of temperature and humidity of the healing surface, promote the elimination of toxins, the rejection of dead tissue (when proteolytic enzymes are included), drain excess exudate, and the like. Depending on the condition of the ulcer, the presence of pus, exudate, signs of inflammation, etc. various types of treatment coatings can be chosen. Unlike traditional bandages (paste impregnated with pastes, etc.), modern coatings do not dry up on the wound surface, therefore they are replaced without pain, irritation and trauma to the healing surface. In addition, the use of such products with different properties at different stages of treatment makes it possible to create an optimal environment for regeneration: recently specialists are inclined to believe that trophic ulcers should heal in a moist environment, which not only helps cicatrize the ulcer, but also allows the full restoration of tissues with proliferation and differentiation of cells, the formation of new microcapillaries, etc.

A promising area in the therapy of trophic ulcers is the use of biologics containing certain growth factors that selectively affect specific components of connective tissue. In addition, work is underway to create new-generation drugs based on specially grown cell cultures - however, while most of these drugs are too expensive for mass production, it is not always convenient to use and is used primarily in clinical experiments.


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Diabetic foot

24 Jul 2018

The diabetic foot syndrome is a complex of pathological changes in the peripheral nervous system, arterial and microcirculatory bed, which directly threaten ulcerative necrotic processes and foot gangrene in diabetic patients.

Diabetic foot. Actovegin buy

The syndrome of diabetic foot occurs in 4-10% of patients with diabetes mellitus. Mortality in elderly and senile patients with purulent-necrotic complications and gangrene of the extremities in diabetes mellitus reaches 20%. The factors of ulcerative-necrotic and purulent complications of feet are:

  • the presence of neuropathy and angiopathy;
  • deformities and swelling of the foot;
  • skin condition - dryness, atrophy, turgor, cracks, hyperemia;
  • ulcerative-necrotic complications in the anamnesis;
  • diabetic retinopathy and nephropathy;
  • elderly age;
  • lonely residence of the patient;
  • overweight;
  • smoking and alcohol abuse;
  • the presence of concomitant pathology, its severity and relationship with underlying pathology.

Prevention of complications of diabetic foot suggests:
- compensation for diabetes mellitus;
- early detection of patients with an increased risk of developing a diabetic foot syndrome;
- the risk rises with age and duration of the disease;
- inspections by a specialist for urgent measures;
- training of patients with the rules of foot care;
- examination by the dermatologist of the skin of the lower extremities of the patient with diabetes mellitus in order to detect mycosis at least once a year;
- Improve skin trophism and protect the skin barrier from external influences.

Fixed assets

Angioprotectors and correctors of microcirculation: Trental 400, Actovegin, Memoplant, Ginkoum, Doxilek, Calcium dobezilate tablets 250 mg, Complenamine, xanthinal nicotinate, Xanthinal nicotinate injection 15%, Agapurin, Agapurin 600 retard, Agapurin retard, Agapurin SR, Vazonite, Pentamon , pentoxifylline, Radomin, Trenpental, Trental, Troxerutin Lechiva, Dicynon, Angiovit, Solcoseryl, and others.

Antiaggregants: Ralofect, Raloect 300 N, etc.

Anticoagulants: Piyavit, Wessel Douay F, et al.

Carbapenems: Invanz et al.

Quinolones / fluoroquinolones: Avelox, Heinemox, Ciprolet A, Cyphran ST, etc.

Cephalosporins: Zeftera and others.

Hypoglycemic synthetic and other agents: Reclid, et al.

Calcium channel blockers: Cynedyl, cinnarizine, Cinnasan, and others.

n-anticholinergics: Midokalm, Midokalm-Richter, and others.

Serotonergic drugs: Serotonin, Serotonin adipate, etc.
Additional resources

Alpha-blockers: Redergin, Nicergolin, etc.

Antioxidants: Vitamin E, ascorbic acid, Mexidol and others.

Antiseptics and disinfectants: Betadin et al.

Dermatotropona funds: Balsamed intensiv balm for intensive daily care for dry sensitive skin of feet, Balsamed balm for daily care for sensitive skin of feet, Milgamma cream for foot care, Flexitol balm for foot care, etc.

Substitutes of plasma and other components of blood: Infukol GEK et al.

Immunomodulators: Derinat, Erbisol, Polyoxidonium, etc.

Correctors of cerebral circulation disorders: Cinnarizin Sopharma et al.

Enzymes and antiferments: Izodibut et al.


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Ladasten - fast and safe treatment of asthenia

24 Jul 2018

The saturation of modern life often takes away almost all the strength from people. Up to 40% of patients turn to general practitioners with complaints about the state of general frustration, emptiness, a sense of chronic fatigue. Such conditions are manifestations of asthenic syndrome, which is not always amenable to effective correction with the help of the usual methods: rest, playing sports, taking vitamins and nootropics. For a long time there was no available specific asthenia therapy. And only recently appeared the first anti-asthenic drug Ladasten.

Ladasten - bromantane

- Why did you start developing a drug against asthenia?

"We have been working on the creation of a whole new group of psychotropic drugs for a long time. Back in the 1980s, it became clear to us that the existing tranquilizers of the benzodiazepine series have their limitations for use, and existing psychostimulants are practically banned. There are numerous immunostimulating agents, but they do not have other properties. Therefore, we are developing new medicines, with new mechanisms of action to bypass all the negative aspects that existing drugs have. And we have achieved some success. Ladasten (Bromantane), developed in our institute, does not have the negative effects of psychostimulants and tranquilizers and at the same time has high anti-asthenic activity.

- What is the drug Ladasten?
- Ladasten is a derivative of adamantane, which was invented in our institute long enough - back in the 70s. The primary idea of this drug was in the creation of a drug that would have actoprotective action. Actoprotectors are substances that must provide increased performance in extreme conditions. For the first time this preparation was synthesized under the guidance of prof. B.M. Pyatin, his further study was conducted by prof. I.S. Morozov. It was shown that this drug (then it was called bromantane) possesses psycho-stimulating and immunostimulating properties. Therefore, he immediately began to study in various pharmacological experiments. And when he was considered as a psychostimulant and compared with sidnocarb (a typical representative of this group of drugs), it turned out that Ladasten is much inferior to sindocarb in general stimulating properties, so further work with this drug was discontinued.

The drug received a new life when we began to study its psycho-stimulating properties from the pharmacogenetic positions. In the 1980s, we developed a model that allowed the most standardized inbred mice to see genetic differences in their reactions to emotional stress (for mice, such a stress is, for example, the transition from darkness to a brightly lit area). It turned out that one group of mice responds very well to standard psychostimulants (for example, amphetamine and sydnocarb), to which another group of animals does not respond. And on bromontane (Ladasten), the stimulation of behavior was answered by both groups of animals. This fact was difficult enough to explain. But we began to study this problem and realized that out of stress, stimulation only occurs in those animals that respond to traditional psychostimulants, and in those animals that do not respond, stimulation does not occur without stress. This led us to the unequivocal conclusion that the stimulation of the behavior of Ladasten is carried out in two ways - in addition to a mild psycho-stimulating action, this drug has an anxiolytic (anti-anxiety) effect, which prevents the reaction of fear. It was very interesting, because we got the world's first compound with psycho-stimulating and anti-anxiety action. Immunostimulating properties of the drug were also shown earlier.

- Why does Ladasten show such unique properties?
- We conducted very serious biochemical and neurochemical studies. Even involved a French firm that conducts a full complex of receptor analysis. We could not find the receptor on which Ladasten acts. Therefore, we studied various intracellular processes and saw that the secondary system of signal molecules plays an important role in the effect of the drug. The next stage was pharmacogenomic research. We studied the influence of Ladesten on the expression of 1116 genes and found a change in the activity of 16 genes. All the detected genes are associated with the functioning of the cells of the nervous system. Among these 16 genes, two were identified, the change in activity of which completely explained the observed pharmacological effects. Thus, Ladasten increases the expression of the tyrosine hydroxylase gene. This is a key enzyme that provides synthesis of catecholamines. This means that Ladasten, by increasing the activity of the tyrosine hydroxylase gene, increases the amount of this enzyme, which leads to the synthesis of more dopamine. This very well explains his mild psycho-stimulating effect. If you enter a typical psychostimulant, then there is a powerful psycho-stimulating effect, and then a strong exhaustion. When using Ladasten, the psychostimulating effect is weaker, but there is no depletion. Typical psychostimulants affect the release of dopamine from the storage vesicles and interact with the reverse dopamine transporter in the synaptic cleft. And Ladasten increases the synthesis of mediators associated with stimulation of the psyche. Thus, we are talking about an entirely new mechanism of action.

Analysis of other genes showed that Ladasten reduces the expression of the GABA transporter gene. This leads to an increase in the GABA content in the synaptic cleft, which in turn explains the anxiolytic (anti-anxiety) effect of the drug, since GABA is the main inhibitory mediator of the central nervous system of man.

Thus, pharmacogenomic studies have shown that the pharmacological effects of the drug are very well explained by the observed changes in gene expression. Now there is a clear idea that Ladasten affects the level of regulation of the activity of the genome of nerve cells. Studies continue, and it has already been shown that Ladasten increases the expression of the tyrosine hydroxylase gene, causing demethylation of its promoter site, and a transcription factor determining this effect is also revealed.

Thus, there is a sufficient understanding of what changes in cells causes Ladasten. And this confirms our confidence that the world's first drug has been obtained, which simultaneously causes an anti-anxiety and psychostimulating effect. Obviously, such a preparation fully meets the tasks of treating asthenic conditions.

- What side effects are possible with Ladasten?
- This issue was studied very deeply. Evaluation of toxicological characteristics of Ladasten showed that the drug is low-toxic. It does not have a locally irritating, allergic, mutagenic, teratogenic effect. Ladasten does not have a negative effect on the generative functions of rats, the growth and development of their offspring. Also, there were no effects that could indicate the possibility of developing a pathological predilection for him. The pharmacokinetics of the drug is well studied, and the dosage regimen is determined by data on its half-elimination from the body.

In clinical trials, all adverse events had only "possible" or "probable" connection with Ladasten therapy, were not significantly expressed and not.


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Periodontitis

24 Jul 2018

Parodontitis - inflammation of periodontal tissues, characterized by the destruction of periodontal, bone tissue of the alveoli. Periodontitis, as a rule, is a consequence of gum disease. After 35 years in 50% of cases, the cause of tooth loss are periodontal diseases, incl. periodontitis. Removal of unchanged teeth due to periodontal pathology is almost 5 times greater than their loss from caries and its complications.

Solcoseryl. Periodontitis.

Factors contributing to the onset and development of periodontitis:

- Microorganisms that reproduce in dental plaques that adhere closely to the surface of the tooth;
- increase in the viscosity of saliva and a decrease in salivation, which is observed, for example, when taking some drugs, etc .;
- presence of carious cavities;
- Features of the materials from which the seals and dentures are made;
- anomalies in the development of the dentoalveolar system and soft tissues of the vestibule of the mouth;
- hypovitaminosis;
- diseases of the digestive tract, cardiovascular and endocrine systems (especially diabetes mellitus).

Modern therapy of periodontitis involves the use of conservative methods of etiotropic and anti-inflammatory therapy. As a means of etiotropic treatment, broad-spectrum antibiotics are used that are active against Gram-positive and Gram-negative bacteria, anaerobes and other microorganisms - Lincocine, Dalacin C, doxycycline, Arlet, Mettogil Denta professional, Cyphran ST, Sanguirythrin 0.2% solution, Lingezin and others. It is also rational to use also antiseptic agents (Dentamet, Stomatophyte, Stomatophyte A, Elyugel, Miramistin, Dr. Thysse Sage, Eludril, Hexicon), sulfonamides (Bactrim), etc. Simultaneously, vogribkovyh drugs - nystatin, fluconazole, etc.

Anti-inflammatory therapy - use of non-steroidal anti-inflammatory drugs (OCI, Holysal, etc.).

Complex therapy of periodontitis involves the use of other drugs and goods of pharmacy range:

Angioprotectors and microcirculation correctors: Solcoseryl dental adhesive paste, etc.

Correctors of bone and cartilage tissue metabolism: Piaascledin 300,

Regenerants and reparants: Solcoseril dental adhesive paste, Ximedon and others.

Immunomodulators: Imudon, CYCLOPHERON liniment, Ginseng tincture, Eleutherococcus extract, etc.

Antihypoxants and antioxidants: Solcoseryl dental adhesive paste, Ascorutin and others.

Vitimins and vitamin-like substances: Ascorbic acid, alpha-Tocopherol acetate, etc.

Adsorbents: Polyphepanum, Enterosgel, Sorbogel, Enterosorb and others.

Biologically active additives: Polibacterin, Neovitin, Artromax, Calcium Active, Primadofilus and others.

Means of oral hygiene: therapeutic and therapeutic-prophylactic toothpastes, special rinses, reducing the deposition of tartar, as well as tooth floss, toothbrushes, etc.


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Letís go to Sleep

23 Jul 2018

Insomnia (insomnia) can be considered as one of the most common clinical syndromes, along with headache and back pain. it occurs in half of the world's population.

Phenazepam buy. Insomnia

Traditionally, in our country for the treatment of insomnia from all prescription drugs prescribe benzodiazepine derivatives (brotizolam, midazolam, triazolam, nitrazepam, oxazepam, temazepam, phenazepam). The combined preparation Reladorm is widely used. However, with long-term use of benzodiazepine drugs as hypnotics, their negative effects come to the fore: the development of addiction (the need for increasing the dose), the dependence (the emergence of withdrawal symptoms on the background of withdrawal), the behavioral toxicity (memory loss, attention, coordination deterioration), daytime sleepiness . If suspected of having sleep apnea syndrome (in patients with snoring), benzodiazepine hypnotics are contraindicated.

In clinical practice, non-benzodiazepine hypnotics are also used: cyclopyrrolone derivatives (zopiclone), imidazopyridine (zolpidem), pyrozolopyrimidine (zaleplon). The minimal affinity for the subtypes of the benzodiazepine GABA-receptor complex, which are responsible for the development of side effects of drugs of the previous generation (benzodiazepines), provides a high safety profile. However, the use of these hypnotic drugs is also not possible in the presence of sleep apnea syndrome. This category of patients is prescribed, for example, an antagonist of H1-histamine receptors - doxylamine.

To improve sleep, you can recommend the following:

Angioprotectors and microcirculation correctors: Bilobil, Bilobil forte, Tanakan, etc.

Sedatives of plant origin: Lalabi, Fitorelaks, sedative (sedative) collection 2, sedative collection # 3, Fito Novo-Sed, Tsirkulin dragée valerian, Valdispert, Valerian tincture, Dormiplant, Nervoflux, Persen, Sanason, and others.

Sedatives combined: Valocordin, Corvaldin, Corvalol, Barbowal, and others.

Antidepressants of vegetable origin: Gelarium, Deprim, Deprim forte, Doppelgerz Nervotonik, Negrustin, and others.

Spasmolytics: Clostrafau MELISANA, Barbowal, and others.

Micro- and macro elements: Drops Beresh Plus, Menopace, etc.

Vitamins and vitamin-like products: Biovital elixir, Menopace, etc.

Homeopathic medicines: Valerianachel, Homeostress, Passidorm, Passionflower Edas-111, Passiflora Edas-911, Nervochel, Somnogen, etc.

Dietary supplements: Phytohypnosis, Sonnorm Life formula, Morpheus, Mystic, Yantavit, Lecithin, ALPHABET Biorhythm, MONOPAUSE Day - Night Lady's formula, Passilate, Repin, Golden Ginkgo Biloba, etc.


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Actovegin pills

23 Jul 2018

The same medicine can be produced in the form of a powder, in the form of tablets or a solution for injection, in the form of a gel or in the form of a candle.

Actovegin is not an exception: it is produced both in the form of tablets and in the form of solutions for intravenous, intramuscular, intra-arterial injections, as an ointment, as well as a gel (and here) and cream.

Actovegin pills, actovegin tablets

And yet most of the drugs are produced today in the form of tablets. Ordinary tablets Actovegin (as well as tablets of other drugs) consist of the main (active) substance and from auxiliary substances (neutral additive). The Actovegin tablet falls into the stomach, dissolves, passes into the blood vessels and reaches the liver. There are a number of transformations, and the medicine is carried through your body with blood. So the therapeutic effect is achieved.

What is Actovegin in tablets?

Pharmacotherapeutic group (Actovegin tablets): stimulator of tissue regeneration.
Form and composition: tablets covered with greenish-yellowish bud. Table. p / o 200 mg fl., N.50 (and also issued N.30 and N.10). Round tablets.


Pharmacological properties of Actovegin tablets
Actovegin in tablets - hemoderivat from blood calves - stimulates the exchange of substances in the cells of tissues, thereby increasing the resistance of tissues to hypoxia (increased consumption of oxygen) and improving their consumption of glucose. With hypoxia and ischemia, it is of inestimable value.

Indications for use of Actovegin in tablets / instructions
Strokes (ischemic, hemorrhagic), encephalopathy, craniocerebral trauma. Actovegin in tablets is used for peripheral circulatory disorders (both venous and arterial), encephalopathies, angiopathy (including diabetic); burns of different genesis.
Actovegin in tablets is also used to heal wounds (ulcers of various etiologies, pressure ulcers, radiation neuropathy, radiation damage to tissues and mucous membranes, as well as to prevent these lesions, disruption of wound healing process).
With the disturbed metabolism and blood supply of the brain (dementia, for example), the transfer and utilization of glucose by brain tissues is disrupted. Actovegin eliminates the violations, and the brain begins to consume oxygen.

Similarly actovegin in tablets and with peripheral disorders of blood supply (venous, arterial) and with the consequences of these disorders (angiopathy, ulcers of the lower extremities).

Diabetics (type 2 diabetes mellitus) experience some reduction in pain and burning in the lower extremities, improvement of paresthesia (sensitivity) after taking Actovegin tablets.
Burns (up to 4 degrees), the consequences of using radiation exposure, ulcers, bedsores:
Actovegin is of great importance in all these cases; the concentration of hydroxyproline, hemoglobin, DNA and other biochemical parameters increases.

A slight result of the Actovegin tablets begins to appear only half an hour after the intake and the maximum reaches an average of 3 hours (2-6 hours).

Tablets Actovegin is prescribed as a supplement to the main treatment (as an auxiliary)!

Application and dosage of Actovegin tablets / instructions
1-2 tab. - before meals three times a day for four to six weeks or as directed by a specialist (drink a small amount of water, do not chew!).


Special instructions
When polyneuropathy caused by type 2 diabetes, treatment is recommended to begin with an intravenous infusion of a solution of Actovegin at a dose of 2 g / day 3 weeks. and continue the treatment with tablets Actovegin (2-3 tablets per day - 4-5 months).

Side Effects of Actovegin Tablets / Instruction

The side effects of tableted Actovegin are identical to the potential side effects of Actovegin in other forms.

Individual intolerance.
Just like other drugs, Actovegin in tablets can cause side reactions.

Possible reactions to tableted Actovegin for allergies:
1. Digestive tract - nausea, vomiting, pain in epigastrium.
2. Cardiovascular system - arterial hypertension and hypotension, skin pallor, tachycardia, dyspnea, acrocyanosis, pain in the heart.
3. Respiratory system - sore throat, suffocation, shortness of breath and swallowing.
4. Immune system - rash, itching, hyperemia, urticaria, fever or chills, angioedema.
5. Nervous system - weakness or agitation, headache.
6. The musculoskeletal system - pain in the lower back, in the muscles and joints.

INDICATIONS: patients with intolerance to fructose, impaired absorption of sucrose or glucose Actovegin can not be taken, because it contains sucrose. Particular caution is needed when prescribing Actovegin in case of giporgidration, heart failure of the second and third stages, oliguria, hyperglycemia, pulmonary edema, diabetes mellitus.
Antihistamines are prescribed for allergies to Actovegin in tablets.
Pregnancy and lactation: before using Actovegin tablets, consult a doctor.
Children: Actovegin, including tableted, in pediatrics is not recommended, but in practice it is used in exceptional cases.
If, say, have assigned 1/4 table. Actovegin to a newborn, it is necessary to crush the tablet to the consistency of the powder and mix it with boiled warm water (approximately 1 / 2hl.): You can use a syringe without a needle (for the baby's cheek). In most cases, children are injected with Actovegin parenterally. Read more about this here.
Interaction: the results of the combination of Actovegin with other medications are not known (as they are written in official instructions, although in practice Actovegin successfully combines with a variety of medications).

Transport management: there is no data on the effect of Actovegin tablets on vehicle management.

Conditions of storage of Actovegin tablets: at a temperature not higher than 25 į, protected from light and inaccessible to children.

Perhaps you want to get acquainted with the general instructions to Actovegin, reviews of our readers about Actovegin and its analogue, the price of Actovegin (and the manufacturers of the drug), as well as a number of other questions about Actovegin on our site.
Be sure to read parenteral application of Actovegin (injections): here you will find out why injections in some cases are better than tablets.

You can see the use in the complex treatment of diabetic and alcoholic polyneuropathy and other drugs, for example, Mexidol or, say, Instenone in the treatment of diabetic encephalopathy, etc.

Actovegin is also used in sports by quite healthy people, and in veterinary medicine.


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Phenylpiracetam side effects

23 Jul 2018

Various pathologies in the activity of the brain and the central nervous system are quite common. Not always these conditions violate the adequacy of a person, they can simply affect the mood, the processes of memory and memorization. But in any case, the appearance of symptoms of impaired brain activity requires close attention and adequate correction under the supervision of a qualified doctor. Therapy of such conditions is often carried out using nootropic drugs. Just to such means belongs Phenylpiracetam.

phenylpiracetam side effects

What is the composition of Phenylpiracetam?
Phenylpiracetam is a nootropic drug, the main constituent of which is N-carbamoyl-methyl-4-phenyl-2-pyrrolidone. This substance is also called phenotropil or phenyloxopyrrolidinylacetamide.

For what Phenylpiracetam is used for?
Phenylpiracetam refers to neuromodulators, it affects most of the neurotransmitter circuits in the brain. Such a tool has pronounced antiamnestic qualities, it can improve the integrative properties of the brain, stimulate memory consolidation, and optimize concentration and mental activity in general. The action of Phenylpiracetam allows us to facilitate learning processes and accelerate the transfer of information between the right and left hemispheres of our brain.

In addition, such a tool is able to increase the resistance of the brain cells to the influence of aggressive factors (hypoxia, toxins, etc.). It possesses anticonvulsant qualities, is characterized by anxiolytic activity. Action Phenylpiracetam well regulates the activity of the central nervous system, affecting the processes of inhibition and activation, and also improves mood.

Also, Phenylpiracetam has other qualities:

- improves metabolism and circulation in the brain;

- activates the oxidation and reduction processes;

- increases the energy potential of the whole body;

- activates the regional blood flow in the ischemic areas of the brain;

- increases the amount of norepinephrine, serotonin and dopamine in the brain;

- increases physical efficiency;

- improves mood, has analgesic qualities, as it increases the threshold of pain sensitivity;

- has adaptogenic qualities (increases the resistance of the organism to a variety of aggressive effects);

- promotes vision improvement;

- has a positive effect on the blood supply of the lower limbs;

- has immunostimulating qualities.

For what Phenylpiracetam is indicated for?
Since the drug is characterized by a wide list of positive properties, it can be used to correct a variety of pathological conditions. In the testimony of Phenylpiracetam, the abstract includes such cases:

- With CNS ailments, which have different origins. The drug is especially effective in vascular pathologies, as well as in disorders related to metabolism and intoxications, in which the intellect is impaired and motor activity is reduced.

- In violation of the training process.

- With depressive conditions, which can have different severity (especially mild and moderate).

- With psychoorganic syndromes.

- With convulsions.

- With obesity, which has an alimentary-constitutional origin.

- To prevent hypoxia and to increase stress resistance.

- To achieve adaptogenic effect when in extreme conditions (if necessary, prevent fatigue and improve efficiency).

- To normalize the daily biorhythms.

- When correcting chronic alcoholism.

What are the contraindications for use of Phenylpiracetam?
The only absolute contraindication for Phenylpiracetam is the individual intolerance of its components. Nevertheless, the drug is not used in pediatric practice, as well as in the treatment of pregnant and lactating women because of the inadequacy of safety data for such therapy.

What are the side effects of Phenylpiracetam?
The medicine can cause insomnia if taken in the afternoon. In some patients, the first three days of taking Phenylpiracetam can trigger the occurrence of psycho-excitation, redness of the skin, arterial hypertension and a feeling of hot flushes.


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Actovegin

20 Jul 2018

Actovegin is available in pills / tablets and ampules / injections.

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Actovegin is a highly filtered extract obtained from calf blood which enhances aerobic oxidation in mammals. It is also rich in iron, manganese, amino acids, and other nutrients that are important in achieving the physiological transformations that dopers are seeking to achieve.

On-label indications:
Treatment of peripheral artery disease and strokes
Treatment of cognitive disturbances after stroke to ulcers

In research studies, Actovegin has been shown to exert insulin-like activity, such as stimulating the transport of glucose in the body, as well as glucose oxidation. This supplement is supposed to be similar in its effects to insulin. Because it is one of the most anabolic substances known to man, insulin is banned in sports (for non-diabetics) and exceedingly dangerous - even fatal - in high dosages. Therefore, Actovegin is considered as a significant performance-enhancing drug for athletes, e.g. Lans Armstrong and Tiger Woods.

Currently, Actovegin is NOT on the World Anti-doping Agency's (WADA) prohibitied substance list. However, WADA does ban injections of any substance, including Actovegin, exceeding 50 ml every six hours.

Who uses it?
Track and Field Current / Former World Record Holders:
Paula Radcliffe (for over two decades)
Usain Bolt (since he was 16)
Kenensia Bekele
Meseret Defar
Patrick Makau
Maurice Greene

Other prominent persons:
Michael Jordan
Christiano Ronaldo
Ronaldo
Andy Murray
Vladimir Klitschko
Luciano Pavoratti
Bono


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Buy Phenotropil

20 Jul 2018

In our time, the rabid rhythm of life, maximum loads, nervous shocks, it just needed to help your body cope and function to the fullest, especially when the talk is about brain work and emotional balance.

Buy Phenotropil is a nootropic drug of a new generation, original in its kind. It improves the functioning of the brain, stimulates mental abilities and memory. Buy Phenotropil helps in learning and learning new material. It lifts the mood and brings thoughts into a positive direction.

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At the background of taking Phenotropil noted improvement in vision, in particular, increases the severity and brightness of vision. Also, buy Phenotropil has a beneficial effect on metabolic processes, dulling the feeling of hunger, which in turn, will contribute to the process of weight loss.

Usage of Phenotropil for weight loss

Recall that the main function of Phenotropil - improvement of cerebral circulation, memory and activation of internal reserves, it is thanks to these effects that the drug has also proved itself as a means for losing weight. It helps to get rid of depression, gives strength and energy, just a more mobile way of life and helps to reduce weight.

But it is worth to clarify that Phenotropil does not break down fats, but reduces appetite and dulls the feeling of hunger due to the substances contained in it.

Efficacy of Buy Phenotropil in Losing Weight
Phenotropil, like many drugs, will be much more effective if you follow a certain diet. But plus it is that it dulls the feeling of hunger, thereby even very strict diet to transfer much easier. It also causes an easy diuretic effect, which also contributes to weight loss, since fluid retention in the body often gives excess weight. The effectiveness of this drug is quite high and is confirmed by many studies.

Danger of using Phenotropil for weight loss
The first and most important thing that is worth observing is the reception of the drug only after consulting a doctor. Only he can prescribe the necessary course of treatment for you. In any case, you can not exceed the prescribed dosage, otherwise the drug will lead to insomnia, apathy and addiction.

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Indications for use of buy Phenotropil
- Decreased memory, constant fatigue, lethargy and dad;
- Depressive conditions, mild and moderate severity;
- alimentary obesity;
- convulsions;
- schizophrenia (sluggish-apathic course);
- with the preventive purpose at stressful situations and at an overstrain;
- chronic alcoholism;
- the complexity and disruption of learning processes;
- correction of sleep - wake mode inverting;
- prevention of oxygen starvation.

Side Effects of Phenotropil
Applications of phenotropil can lead to the following side effects:
- sleep disturbances (when taking tablets after 15.00);
- increase arterial pressure;
- psychomotor agitation;
- redness of the skin;
- sensations of a rush of heat throughout the body;
hallucinations and delirium;
- trembling of limbs;
- with long-term admission, the effectiveness of the drug is reduced.
With a single admission in a dose of 500 mg of Phenotropil and higher causes a state of confusion and panic. It is also not recommended to take the drug immediately before physical exertion. The case of an overdose of the drug did not occur. If any signs of side effects occur, symptomatic treatment is prescribed.

Reviews of doctors about buy Phenotropil

Dietitian: "As a dietician, I offer my patients to buy Phenotropil, It really helps in the fight against excess kilograms." It does not work like all the targeted means for obesity, but it reduces the appetite and gives you energy, which leads to weight loss. "

Nutritionist: "Phenotropil, like any medicine, for each person, acts in its own way. Someone is satisfied with the result immediately, someone has the effect of reducing weight, achieved in a few weeks. But, definitely, the drug is worthwhile. " Some patients complain that the drug is expensive, but in the end, the drug is so justified that the price goes to the wayside.

Phenotropil can strengthen the effects of drugs that stimulate the central nervous system, nootropics and antidepressants, and also relaxes the processes of alcohol intoxication and its consequences. Phenotropil has a small analgesic effect, which increases the pain threshold.
Another advantage is the easy tolerability of the drug, the effect manifests itself after the first receptions.

Neurologist: "It is important to note that the overwhelming majority of people who have experienced Phenotropil, notes improvement in mood and memory, the appearance of good and light thoughts, dulling of the appetite and as a consequence of losing weight." Many people notice that by the end of 1-2 weeks of taking the drug appears lightness and sensation that you can turn mountains, you want to move, to make dreams come true and conquer new peaks. You can not ignore the fact of tests that provide information that when asthenic conditions accompanied by increased fatigue, Phenotropil proved excellent in 100% of cases. "

Nootropist: "I recommend to buy Phenotropil, it is very good for overwork, prolonged depressions and chronic fatigue. The main thing is doctor's consultation and the right appointment. But we must not forget about the so-called" withdrawal syndrome ", since the drug raises all the reserves of the body, and after stopping the intake it may not be the most pleasant moment - lethargy and fatigue appear, and the longer the drug is taken, the longer the recovery period after Phenotropil will last longer. "Follow all the rules and regulations and everything will be all right."

Conclusion

  • Phenotropil is successfully used to fight overweight, most people taking the drug, note a decrease in appetite, a feeling of saturation from small portions of food, and as a consequence, weight reduction. Patients become more active, always at work, because there is a desire for movement, some simply forget about food, and subsequently observe weight loss.
  • Phenotropil proved to be quite good for asthenic manifestations (lethargy, weakness, psychological and physical exhaustion). Especially in patients with organic and psychogenic asthenia.
  • Also, Phenotropil is noted for good tolerability, in rare cases it gives such reactions as headache and anxiety. Phenotropil does not have a carcinogenic effect.
  • Phenotropil can also be used by healthy people to supplement mental and physical activity, increase the stability and level of life in various situations (stress, hypoxia, intoxication, sleep disorders, trauma, physical and mental overwork, overwork).
  • A huge amount of research was carried out on the superiority of Phenotropil over other nootropic drugs. As a result, it was found that Phenotropil has several advantages. It gives a more pronounced neuropsychotropic effect and quickly manifests itself positively, giving the patient a quick enough result.
  • For people suffering from diseases of the central nervous system, Phenotropil is really a godsend.
    Perhaps, at the moment it is one of the best nootropic drugs, which allows to significantly improve the effectiveness of treatment and the quality of life of patients.


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Actovegin solution for injections

19 Jul 2018

"What is Actovegin?"

"How to use Actovegin?"
Such questions are asked to us by readers in their letters.

Actovegin solution for injections

Actovegin is an antihypoxic, i.e. a drug that improves oxygen delivery to tissues. Due to the ability to increase metabolism in tissue cells, the latter effectively absorb glucose and oxygen. Thanks to injections of Actovegin, the energy of the cell is improved, especially with ischemia and hypoxia. Clinical studies have shown that the maximum effect of Actovegin in ampoules occurs in 2-6 hours.

Actovegin in ampoules is effective in patients with such concomitant diseases as renal or hepatic insufficiency. Also, ampoule Actovegin is used in patients of advanced age and newborns, in patients with type 2 diabetes with diabetic polyneuropathy. Actovegin is used in neurology, endocrinology, cardiology, etc.

Actovegin in ampoules / Instruction

Description / Actovegin in ampoules
Transparent solution in glass ampoules. Weak yellow solution.

Composition / Actovegin in ampoules
The main substance: dry deproteinized calf blood calves. Auxiliary components: sodium chloride, water for injections, glucose anhydrous.

Indications for use of Actovegin in ampoules / Instruction
1. Vascular and metabolic disorders of the brain (ischemic stroke, cerebral insufficiency, encephalopathy, craniocerebral trauma).

2. Peripheral vascular disorders, as well as their consequences.
Diabetic polyneuropathy, radiation neuropathy, arterial angiopathy.

3. Actovegin in ampoules is used for poorly healing wounds, as well as in the following cases:
bedsores, ulcers of different etiology, burns (chemical and thermal lesions of the nervous tissue, skin, mucous membranes), radiation damage to mucous membranes and skin.

Contraindications / Actovegin in ampoules
Individual allergic intolerance to injections of Actovegin and similar medicines. For infusion solutions - heart failure in the stage of decompensation, oliguria, pulmonary edema, fluid retention in the body, anuria.
For those suffering from diabetes it is very important to take into account the concentration of glucose in the solution for infusions of Actovegin with dextrose.

Way of application of Actovegin parenteral / Instruction
Actovegin is used intravenously, intramuscularly or intraarterially in ampoules of 10-20 ml or as an infusion with Actovegin, and then - 5 ml IV or IM daily or several times a week. In / m - enter no more than 5ml, because the solution is hypertonic.
With the introduction of Actovegin in the form of infusions - 10-50 ml are diluted in 200-300 ml of sodium chloride or 5% of glucose.

Dosage of Actovegin in ampoules / Instruction

Disorders of blood circulation and metabolism: first injections of ampoules of Actovegin IV in 10 ml every day for two weeks, then iv 5-10 ml several times a day for four weeks. Stroke ischemic: 20-50ml solution of Actovegin in 200-300 ml of the base solution, applied daily or several times within two to three weeks.

Arterial angiopathy: 20-50 ml of Actovegin in 200-300 ml of the basic r-ra, in / a or / in a daily or several times a week (approximately, for four weeks).

Burns of different etiology: iv in 10 ml of Actovegin or in / m of 5 ml of Actovegin daily or several times a day.

A solution of Actovegin for IV or IV administration / Instruction
Enter Actovegin from 250 ml per day in / in or in / a to 500 ml. The speed is approx. 2 ml / min. Usually prescribe 10-20 injections of Actovegin.

Disorders of the metabolism and circulation of the brain: intravenously 250-500 ml / day (for two weeks), then 250 ml several times a week (at least four weeks).

Actovegin with ischemic stroke: in / in 250-500 ml of Actovegin apply daily or several times a week (for two to three weeks).

Arterial angiopathy: iv or 250 ml of Actovegin daily or several times a week (four weeks).

Actovegin with ulcers, burns: in / in 250ml daily or several times a week.

Radiation damage to the skin, mucous membranes: intravenously 250 ml - 1 day before the start of radiotherapy and two weeks - after the end of therapy.

Additional Instructions for Use of Actovegin / Instruction
1. When administering Actovegin in / m, do not exceed the dose in 5 ml of the solution, t. it is hypertonic (concentrated).
2. It is always necessary to carry out a trial reaction of Actovegin (2 ml of solution) in connection with possible anaphylactic reactions.
3. The solution of Actovegin is compatible with solutions of sodium chloride and 5% glucose solution. It is not recommended to mix with other solutions.

Side effects of Actovegin / Instruction
Actovegin is usually well tolerated, rarely allergic reactions occur, anaphylactic shock.
Side effects of Actovegin may manifest themselves in a variety of ways:
1. Immune system: rash, itching, skin hyperemia, urticaria, increased sweating, swelling of the mucous membranes and skin, angioedema edema, chills, fever.
2. Nervous system: headache, agitation, weakness, tremor, paresthesia, fainting.
3. Musculoskeletal system: pain in the joints, lower back, muscles.
4. Digestive tract: pain in epigastrium, diarrhea, nausea, vomiting.
5. Cardiovascular system: tachycardia, dyspnea, pain in the heart, acrocyanosis, arterial hypertension or hypotension, pallor of the skin.
6. Respiratory system: asthma attack, sore throat, rapid breathing, difficulty swallowing, tightening in the chest.
7. Possible reactions at the site of administration of Actovegin.

Actovegin during pregnancy and lactation
The use of the drug Actovegin during pregnancy is only for the purpose of the attending physician and under his supervision according to vital indications (for example, with pathological pregnancy, which you can also learn here).

Children: Actovegin, according to the instruction, is not used in pediatrics (because of lack of evidence base). But in practice Actovegin is used in exceptional cases (according to vital indications).

Compatibility
Actovegin is compatible with a variety of drugs.
Transport management with the use of Actovegin
There are no studies of the effect of Actovegin on the reaction rate when driving vehicles. However, one should consider the possibility of negative effects of Actovegin on the nervous system.

Overdose: cases of an overdose of Actovegin are unknown.


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