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More about bad habits

29 Oct 2018

The scale and depth of the problem require an abundance of information, so that the truth about alcohol, smoking, drugs and substance abuse, the factors that contribute to them, reached everyone.

bad habits. Phenazepam. Phenibut

According to the World Health Organization, the problems associated with the use of alcohol, nicotine, and drugs have ceased to be today the medical or moral problems of only individuals, they affect the health, well-being and safety of the entire population, and, moreover, affect national development.

Over the past decade, all of the above problems have sharply escalated in our country. And despite the active propaganda of a healthy lifestyle in the media, the issuance of numerous books, magazines, posters, booklets under the slogans "no - drug addiction!", "Life without needles", etc., as well as large-scale actions to combat "bad habits ", Morbidity, disability, mortality, including childhood, have reached a catastrophic level.

It seems to me that the problem of "bad habits" is the most urgent in our time, and combating them is not only the task of the state as a whole, but of every single citizen.

The necessary prevention of "bad habits" is, first of all, information about their harmful effect on the human body, especially on the organism of the growing up person. And the sooner we begin the prevention of "bad habits" among the younger generation, the faster we can avoid the sad consequences (serious diseases, disability, destroyed families, suicides, etc.), increase the birth rate, preserve the number of our nation.

"Smoking is bad for health"
Tobacco smoking is one of the most common bad habits, sometimes leading to serious health problems.
When smoking occurs, dry distillation of tobacco and paper under the influence of high temperature (about 300 C). At the same time, a huge number of various harmful substances are released: about 1200 of them are known!

Among them - derivatives of almost all classes of organic substances: marginal hydrocarbons, ethylene and acetylene compounds, aromatic hydrocarbons, sterols, alcohols, ethers, alkaloids (among them - nicotine).

There are also inorganic compounds of arsenic, copper, iron, lead, polonium (including radioactive polonium), there are carbon monoxide, nitrogen oxides, hydrocyanic acid in tobacco smoke. No wonder they say that the list of substances contained in tobacco smoke, makes you shudder: this is an entire guide to harmful substances.

The toxic properties of nicotine are proved simply: a leech delivered to a smoker, soon falls off in cramps and dies of sucked-up blood containing nicotine.

The list of harmful consequences of smoking is also very large. Scientists are finding more and more reasons for the connection of smoking with various diseases.
The life expectancy of smokers is 7 to 15 years less than that of non-smokers.

It is estimated that smoking is responsible for 90% of deaths from lung cancer, 75% from bronchitis and 25% from coronary heart disease in men under the age of 65 years.

If you compare the incidence of smokers and non-smokers, then the first it is several times higher. Smoking reduces physical strength, slows down the reaction, worsens memory, markedly reduces sexual potency. Smokers often have incomplete offspring more often than non-smokers. Scientists have found an increase in the frequency of spontaneous abortions, increased mortality in the prenatal and postnatal periods, a decrease in the body weight of newborns, impaired mental capacity in surviving children, the birth of children with developmental abnormalities, etc.

It should be noted that the offspring is affected not only by active, but also by the so-called passive smoking, when non-smoking pregnant women are forced to inhale tobacco smoke.

Smoking can be the cause of persistent spasm of the vessels of the lower limbs, which contributes to the development of the obliterating endarteritis, which affects mainly men. This disease leads to eating disorders, gangrene and eventually to amputation of the lower limb.

From substances contained in tobacco smoke, the digestive tract suffers, primarily teeth and mucous membranes of the mouth. Nicotine increases the secretion of gastric juice, which causes aching pain in the pitcher, nausea and vomiting. These signs can be a manifestation of gastritis, gastric ulcer, which smokers are more likely to develop than non-smokers. So, for example, among men, a stomach ulcer disease, 96 - 97% smoked. Smoking can cause nicotine amblyopia. In a patient suffering from this disease, partial or complete blindness occurs. This is a very formidable disease, in which even vigorous treatment is not always successful.

Every smoker should remember that smoking tobacco harms not only the state of his own health, but also the health of those who surround him at home, at work, in public places.

Most smokers are surprisingly unceremonious towards others. But out of a thousand smokers, no one is ashamed of letting in an unhealthy smoke in a room where non-smoking women, children, breathe air, without feeling the slightest reproof.
The need for smoking is not given to man initially. It is produced by each individually. Smoking exists as a social phenomenon, which is part of the habitual elements of the way of life of most peoples of the world.

In the process of socialization, adolescents who enter adulthood greedily look at and assimilate the "adult" norms of life activity. Imitating the elders, young people become attached to smoking, eventually become the source of imitation for others.
So, after 20 years, only 10.7% of men start smoking. The rest - much earlier. Smokers, as a rule, can not formulate exactly why they reached for a cigarette. Their answers are very vague: curiosity, desire to try, pampering, imitation, etc.
Can I quit smoking? Of course, yes, although it is not easy. But most smokers can stop smoking on their own, without any medical help. (Tabex and other medicines for quit smoking)

This is evidenced by the data of the Committee of Experts of the World Health Organization to combat smoking, confirming that among those who quit smoking about 85% "... did it on their own initiative ..."

It is very difficult to get out of smoking women, nevertheless, almost 80% of those who quit smoking did it without the help of a doctor. The statistics are very unanimous: almost all those who quit smoking took this step at the expense of volitional efforts, self-discipline, self-organization, without resorting to medication. Many heavy smokers develop dependence on nicotine - a disease in which nicotine is included in the process of metabolism of the body, being thus necessary their participant. When a person quits smoking, there is a kind of "shortage" of nicotine in metabolic processes. Absence of nicotine is manifested in a whole complex of very unpleasant for a person physical ailments and psychological experiences. These phenomena are called narcology by the abstinence syndrome. All this allows us to say: "To smoke - to harm health!"

Alcohol does not spare any internal organ

What is the effect of alcohol on the human body?
Alcohol is not only a narcotic substance, but also a poison for the liver. It has a negative effect on various types of metabolism in the body. Along with the disorders of metabolic processes (carbohydrate, fat, etc.), the functions of the endocrine organs (sex glands, etc.) also suffer. People who abuse alcohol, the ability of the liver to render harmless toxic products, participate in the metabolism, immunological and other protective reactions of the body.
Only 10-11% of people consuming alcoholic beverages did not show significant violations in the liver. In 50% of patients, replacement of active liver cells - hepatocytes - with an inert connective tissue was diagnosed, 35% had a fattening of the liver and 8% had a serious disease - cirrhosis of the liver.
In the liver, carbohydrate metabolism is disturbed, which can manifest itself in a disease resembling diabetes mellitus. Violated other types of metabolism. Reduces the ability of blood to clot; increases the permeability of small vessels. Perhaps the appearance of hemorrhages under the membranes of the brain. The antitoxic protective function of the liver is violated. The initial stages of liver damage sometimes do not appear externally. Then the patient has a decrease in appetite, nausea, a feeling of weakness, lethargy. Next, new symptoms are added. The liver increases in size, while the patient begins to lose weight. Drawing attention to the yellowness of the skin, eyeballs. Fatty degeneration of the liver gradually turns into alcoholic hepatitis, and then into cirrhosis. (Heptral and cyanocobalamin are very helpfull for this).

Severe and brighter acute alcoholic hepatitis. The patient loses appetite, vomiting, diarrhea, pain in the right upper quadrant of the abdomen and under the pit of stomach. The temperature rises sharply, to 38-39 C. Next appears jaundice of the skin, itching of the skin. The liver increases in size, there is soreness when probing. In the case when the patient continues to take alcohol, the transition of the disease to the most difficult option is possible - cirrhosis of the liver.

The liver, afflicted with cirrhosis, is always different from normal, healthy. With cirrhosis, the organ looks dense, often changed in size, tuberous, has a yellowish-red color, which is caused by a delay in bile. The disease becomes life-threatening, when fluid accumulation occurs in the free abdominal cavity (ascites). Since the appearance of ascites, the disease lasts from six months to two years and leads to death. Incidentally, it should be noted that cirrhosis often develops not only in people who consume vodka and wine, but also those who regularly drink beer.
The pancreas in the body performs a dual function: as an exocrine gland, it throws the digestive juice into the duodenum, and the body of internal secretion, producing hormones - insulin and glucagon. Insulin is a protein hormone that increases the rate of glucose uptake in tissues, which leads to a decrease in the level of sugar in the blood. Deficiency in the body of insulin leads to the development of diabetes mellitus. Glucagon performs the opposite regulatory function - increases blood sugar.

How does alcohol abuse affect the work of the pancreas? Alcohol disrupts the intrasecretory and externally secretory functions of the pancreas. The negative effect on the iron of alcohol can occur in various ways, changing the nervous regulation of its work, directly affecting the tissue of the gland. When drinking alcohol in the stomach, the content of hydrochloric acid, a stimulant of the pancreas, decreases, which affects its work. Alcohol, entering the blood, first irritates the pancreas, as a result of which the production of insulin is stimulated. But with repeated alcohol intake, the pancreas is depleted, insulin production is sharply reduced. Often, diabetes mellitus in alcoholics occurs in a latent form. Patients with increased thirst, frequent urination, an increase in the daily volume of excreted urine. Patients complain of dry mouth. Appetite is usually elevated. There is a itchy skin, there are furuncles.

Abuse of alcohol can lead to chronic pancreatitis. Negative effects produce alcohol on the stomach and intestines. The stomach first perceives the effect of a concentrated portion of alcoholic beverage.

What does this lead to? The main manifestation of this effect is the development of the so-called alcoholic gastritis. Alcohol remains in the stomach for a long time. The consequences of the "chemical burn" and poisoning here are particularly pronounced. First of all, it should be noted that this gastritis (inflammation of the stomach) is noted in the vast majority of people who abuse alcohol. Initially, a form of gastritis is noted, accompanied by increased release of hydrochloric acid in the stomach, which later changes to an acid-free form of gastritis. Violated the formation of pepsin - an enzyme of gastric juice, which contributes to the breakdown of food proteins. In this regard, the alcoholic develops protein starvation. These changes disrupt the process of assimilation of foods entering the stomach, which affects the general state of the body. With prolonged consumption of alcoholic drinks, the excretory function of the stomach suffers. Acute alcohol poisoning can be manifested by vomiting.

The patient complains of tense sensations in the abdomen, burning sensation, pain in the pit of stomach, eructation, etc. Chronic alcohol gastritis is accompanied by a feeling of general weakness, decreased performance, an unpleasant aftertaste in the mouth, aching pains in the pit of stomach, nausea, diarrhea, in the morning, on an empty stomach vomiting with scanty content. Chronic gastritis can be accompanied by the development of duodenal ulcer. Violated the activity of the small and large intestine (enterocolitis). The clinical picture of alcoholic enterocolitis is characterized by diarrhea that occurs in the morning or soon after eating. Diarrhea can alternate with constipation. There is an increase in body temperature, weight loss patients. If you continue to take alcohol, then the disease can progress and end tragically.
Alcoholism also affects the kidneys - the organs involved in the regulation of water-salt metabolism, in maintaining acid-base balance, in the isolation of various slags. Permanent long-term intake of alcohol causes chronic kidney disease (nephritis, nephrolithiasis, pyelitis, etc.). Small doses of alcohol increase urination, which is associated with the irritating effect of alcohol on the kidney tissue, with its effect on the cardiovascular system, with an increase in the filtration capacity of the kidneys.

Chronic alcohol intoxication is manifested by excessive sweating, development of edema. Due to the gradual destruction of the cells of the renal tissue, the dead cells are replaced by a connective tissue, the kidneys shrink and wrinkle. It is understandable that the noted significant changes in the nervous system, liver, gastrointestinal tract, kidney and other organs do not pass without a trace and shorten the life expectancy, lead to premature death of both women and men who abuse alcohol.

It should be taken into account that alcohol significantly reduces the body's resistance to the effects of infectious agents and toxic substances and thereby contributes to the increase in the incidence of drinkers. Against the backdrop of alcoholism, various diseases are more severe, especially chronic (tuberculosis, syphilis, etc.), infectious-oallergic (bronchial asthma, rheumatism) and cardiovascular. Mortality among alcoholics in somatic diseases is 3-5 times higher than mortality among people who do not consume alcohol.

Deserves a separate consideration of the effect of alcohol on the sex glands and the sex cells they produce - male (sperm or spermatozoon) and female (oocyte). They are carriers of genetic (hereditary) information, on their condition depends the health of future children, i.e. future generations.

Chronic alcohol intoxication is manifested by excessive sweating, development of edema. Due to the gradual destruction of the cells of the renal tissue, the dead cells are replaced by a connective tissue, the kidneys shrink and wrinkle. It is understandable that the noted significant changes in the nervous system, liver, gastrointestinal tract, kidney and other organs do not pass without a trace and shorten the life expectancy, lead to premature death of both women and men who abuse alcohol.

It should be taken into account that alcohol significantly reduces the body's resistance to the effects of infectious agents and toxic substances and thereby contributes to the increase in the incidence of drinkers. Against the backdrop of alcoholism, various diseases are more severe, especially chronic (tuberculosis, syphilis, etc.), infectious-oallergic (bronchial asthma, rheumatism) and cardiovascular. Mortality among alcoholics in somatic diseases is 3-5 times higher than mortality among people who do not consume alcohol.

Deserves a separate consideration of the effect of alcohol on the sex glands and the sex cells they produce - male (sperm or spermatozoon) and female (oocyte). They are carriers of genetic (hereditary) information, on their condition depends the health of future children, i.e. future generations.

Alcohol can affect the offspring in several ways: the first - on the sex glands and sex cells they produce, the second - on the fetus (embryo) and the fetus, the third - on the development of the child.

Especially unfavorable is the effect of alcohol on the development of the male sex glands (testes) and the spermatozoa produced by them. Therefore, many spermatozoa do not fully ripen and are immature (or immature at all) as they fall into seminal fluid. Such spermatozoons often have different anomalies - lack of a head, tail, change in the structure of the body, etc. - and not able to fertilize eggs.

If fertilization also occurs, then such eggs, as a rule, die or (very rarely) give inferior offspring. Usually, after 6-7 months of alcohol administration in animals (for example, in rats) reproduction of spermatozoa stops, the spermatic tubules atrophy (die), the tissue between them swells and the male becomes barren.

Alcoholics-men also experience similar phenomena, but usually after a longer (several years) period of time. They have decreased libido (impulse), impotence (incapacity for sexual intercourse and fertilization), decreases the size of the sexual glands, decreases the number of spermatozoa or they completely disappear, often only dead sperm. There comes male infertility. In this case, the signs characteristic of the female body (growth of the mammary glands, reduction of the hair) are often developed, which is explained by alcohol suppression of the production of male hormones (testosterones) and partial conversion into female hormones (estrogens).

The frequency and degree of impairment of the function of the male sex glands are dependent on the number and duration of alcohol use.
In moderately alcohol consuming disorders of the sexual glands are found, approximately, in 30% of cases, in explicit alcoholics - in 80-90% 5. After recovery in approximately 40% of men, these phenomena persist, that is, they remain sexually inferior and can not have full-fledged offspring, and sometimes even remain fruitless. At 40-45% of men in general the ability to engage in sexual intercourse is lost.

The most dramatic disruption of sexual function in men immediately after the white fever - the highest stage of alcoholism, which is characterized by delirium, hallucinations, and sometimes convulsions.

Alcohol is dangerous not only for cells of testes that reproduce spermatozoa, but also for the function of the pituitary gland, the medullary appendage that acts with its hormones (gonadotropins) on both the male and female gonads (gonads).
Gonadotropins stimulate the testes and ovaries. Under the influence of gonadotropins, the maturation of spermatozoa and oocytes occurs and the production of male (testosterone) and female (estrogen) sex hormones in the sex glands.

The inhibition of the function of the pituitary gland by alcohol leads to a decrease in the production of hormones by the sex glands and to a violation of maturation of the sex cells (spermatozoa and oocytes). Consequently, the effect of alcohol on the sex glands and the pituitary gland leads to male and female infertility. Long-term exposure to alcohol not only inhibits puberty, prevents the correct function of the sex glands and the production of sex cells, slows and distorts the menstrual cycle, but also often leads to an irreversible reduction in the weight (mass) of the ovaries, uterus and vagina. It has long been known that pairs of alcohol reduce the egg production of chickens, and many eggs do not sit out chickens. Alcohol also prevents the correct transition of eggs from the ovaries, where they are produced, into the fallopian tubes. As a result, there are phenomena of infertility, since eggs are fertilized usually in the fallopian tubes. Under the influence of alcohol, even fatty degeneration of the ovaries may occur, in which they produce only immature oocytes or completely stop their production.

Alcohol reduces the sexual feeling in women (sometimes, with slight intoxication, it can intensify). Alcoholics often have promiscuous sexual intercourse, infection with sexually transmitted diseases, and a feeling of maternity. Although alcoholism relatively rarely affects ovulation (egg yield from the ovary) and on the ability to conceive, still in alcoholics in 40-60% there are violations of the ovarian function, manifested by amenorrhea (lack of menstruation), oligomenorrhea (rare and weak menstruation) or hypermenorrhoea (abundant and prolonged menstruation).

Approximately 8-10% of alcoholics come premature menopause (ie, aging of women with a violation, and then the termination of menstrual function). This is observed in alcoholics already in 35-40 years, although usually the phenomenon of menopause occurs in 45-48 years. In general, many scientists noted that alcoholism leads to premature aging of the whole organism. The skin becomes wrinkled, flabby, often puffiness of the face, loss of turgor (tone) of the mammary glands, the sexual function weakens, emotional reactions are lost, frigidity (coldness in sexual intercourse) appears.

Sexual life early loses its importance for them, often the childbearing function is violated, as well as the internal need for caring for children, which contributes to the violation of the emotional sphere in children and the formation of crime in them.

Drug - "White Death"
In the broadest sense, drug addiction is a painful attraction or addiction to narcotic substances used in a variety of ways (swallowing, inhalation, intravenous injection) in order to achieve a stupefying condition. To do this, use different substances, for example such authentic strong-acting drugs as opium, morphine, heroin, and weak-acting cocaine, marijuana.

A similar effect also has some medicines not classified as narcotic. Abuse of them can be called medication.

All the used intoxicating substances (both real drugs and other drugs of plant origin or obtained chemically) are strong poisons, that is, toxins, so the desire for a stupefying condition with the help of non-narcotic substances should be called, as already accepted, a substance abuse.

Since the words "drug addiction", "drugs", "drug addicts" are widespread, you can use them, whether it's about substance abuse or addiction. This is all the more justified, that true drug addiction among young people is rare, because real drugs are expensive and difficult to access. Young people, addicted to drug addicts, usually use more accessible substances or they prepare by handicraft various drugs from poppy.

It does not really matter how to call this trouble - a habit or a painful addiction to drugs, although a bad habit to win is still easier than a painful addiction.

Addiction
In this case, a person, although feeling a strong desire to take a drug, does not yet have an irresistible physical need for a narcotic dope. He does not need to increase the dose of the drug. In this case, there is still no physical dependence on drugs: depriving a person of drugs does not cause him symptoms of the so-called withdrawal syndrome, and taking them, although adversely affecting the psyche and overall health, does not yet have a serious impact on behavior in the home and in the public life.

The habit of narcotic dope after a while becomes a painful attraction, addiction. This is already a far-reaching state, when the strong need for the use of narcotic substances does not stop, caused by mental and physical dependence on them, it becomes necessary to constantly increase doses, poisoning the body.

Narcotic Stramonium
All narcotic substances are stupefying. Then, the ever-increasing narcotic hunger, which indicates the emergence of dependence; as the use of drugs progresses the physical and mental exhaustion of the body, which eventually leads to premature death.

People who take drugs differently perceive their stupefying effect. Depending on the drug taken, excitement or inhibition of activity occurs. An excited person has a feeling of freshness, lightness, physical dexterity, it seems to him that he is full of strength and desire to act, capable of unprecedented creative accomplishments. Of course, all this is just an illusion, a game of imagination, caused by the impact of a drug.

Deceleration is usually felt as a relaxation and complete indifference to all life's misfortunes and vicissitudes of fate.
A drug addict in a state of excitement by his behavior resembles a drunken man who, as they say, is tipsy, and the hindered drug addict becomes like a very drunk, and this impression is strengthened by the incoherence of his speech.

Narcotic drugs cause a variety of disorders of consciousness.

Some drug addicts experience depression, inexplicable fear, sometimes panicking, or they are tortured by some terrible visions.

Drug addiction.
Usually a person already after several drug addicts develops a strong, irresistible attraction to a stupefying condition, called psychic dependence on drugs.

There is another, much deeper dependence, called physical. It consists in the fact that drugs, as they are used, enter the chemical composition of the body tissues, as a result, habituation arises and drugs become a necessary condition for preserving the biological and chemical balance of the whole organism.

After the physical dependence has been formed, the absence of drugs causes a so-called abstinence syndrome in the person (withdrawal syndrome). The addict is forced to systematically take drugs and increase their dose to cause a dope.

The lack of a drug causes increasing irritability, nervousness, difficulty in concentrating attention, fatigue. There is great anxiety, gradually fear becomes unbearable, leads to despair, a sense of hopelessness, and often - to the thought of suicide.

A person who experiences an abstinence syndrome is not able to do anything, perform any work. His only desire is to get a drug at any cost. This concentrates all his thoughts and actions, often the drug becomes more important to him than food. This condition is accompanied by bodily ailments: severe headaches, nervous trembling, numbness of the extremities, muscle cramps, etc.

These are the symptoms of the onset of a person's mental and physical dependence on drugs. That's when he becomes their slave.
So, the prolonged absence of drugs leads to the emergence of an abstinence syndrome. It usually begins with the growth of an irresistible need for a drug, which is somewhat comparable to that of an inveterate smoker who wants to smoke, but does not have cigarettes. Then there is anxiety, a sharp yawn, profuse sweating, a disruption of the nasopharynx function, resembling a strong cold. Pupils dilate and do not respond to light. Appear "goosebumps" and chills, like at high temperature, acute pain in the stomach, lower back and hips. Then - dizziness, nausea and vomiting, muscle trembling until life-threatening seizures and circulatory and breathing disorders.
These symptoms appear in different combinations and sequences, appear with varying intensity.

Abstinence syndrome can also be accompanied by delirium, various visual and auditory hallucinations or manifestations of depression, apathy, complete indifference to the environment.

Taking the drug almost immediately eliminates these ailments, but this improvement is temporary, because after a few hours the effect of the drug will stop and symptoms of withdrawal symptoms will appear again. (Phenotropil can cope with it).

Consequences
Drug use, in addition to mental and physical dependence, always leads to an irreversible gross violation of the vital functions of the organism and the social degradation of the addict. It is these consequences that are the greatest danger to human health and life.
First, chronic poisoning of the body with narcotic drugs leads to irreversible changes in the nervous system, the disintegration of the personality. As a result, the addict loses some higher feelings and moral restraint. Appearance arrogance, dishonesty, fading life aspirations and goals, interests and hopes. A person loses kinship, attachment to people and even some natural attractions. This is especially tragic when it comes to young people, about only the emerging individualities that are most valuable to society. Narcotic intoxication and serious ailments, withdrawal symptoms make it impossible to study and work, so drug addicts usually get parasitic.

Under the influence of public opinion, the addict is forced to hide his vice. He seeks support in any group that would accept him.

Usually it is the dregs of society: when they join them, the drug addict himself excludes himself from the previous collective.
Secondly, developed or just developing malformation requires more frequent use of drugs in ever increasing doses. The constant need to get them pushes drug addicts to the path of crime: thefts, burglary of pharmacies, forgery of prescriptions, debauchery, even murder are increasing - all for the money to buy drugs.

Finally, thirdly, drug addiction leads to extreme exhaustion of the body, a significant loss of body weight and a noticeable decline in physical strength. The skin becomes pale and dry, the face acquires an earthy tint, there are also disturbances in balance and coordination of movements, which can be mistaken for alcoholic intoxication (usually drug addicts avoid alcohol, although this is not the rule).

Poisoning the body becomes the cause of illness of internal organs, especially the liver and kidneys.

Additional complications arise from intravenous drug injections with dirty needles and syringes. Drug addicts often have purulent skin lesions, thromboses, inflammation of the veins, as well as various infectious diseases, such as hepatitis.

Often cases of drug overdose, especially when after the abstinence syndrome the body's immunity to its action decreases, which the addict usually does not know. As a result - severe poisoning, accompanied by delirium and coma.

In recent years, the number of people who systematically increase drug doses has increased. Cases of abstinence syndrome and acute poisoning and death among young drug addicts have become more frequent.

Sometimes even ten to twelve-year-old children are stupefying themselves with drugs, moreover they use especially dangerous preparations, mainly from poppies, which quickly develop an addiction in the body. These dangerous substances, made by handicraft, contain a large proportion of toxic contaminants.

It is also noted that schoolchildren often use medications that quickly lead to sustained changes in the brain.


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Medicinal drugs addiction

25 Oct 2018

At present, among people who apply to us for help, the number of people with drug addiction has increased. In this connection, the idea of writing this article arose. We tried to figure out why this is related to the difference in dependence on drugs from dependence on "traditional" drugs (opiates, stimulants, hallucinogens) and to consider the directions of effective care.

Medicinal drugs addiction

In our opinion, now the state has begun to pay more attention to the fight against drug addiction, work in this area of law enforcement bodies has improved. The consequence of this was a reduction in the number of drug traffickers, an increase in drug prices and an increased risk of their transportation and use. This, in turn, causes the transition of many drug addicts to medical drugs, as well as the emergence of a number of illusions associated with medical drug addiction.

Availability
Indeed, many medicinal drugs can be bought in pharmacies, often without prescriptions. In fact, the fact that many commercial and sometimes state pharmacies violate the rules for the sale of drugs containing substances that cause drug dependence does not make these substances non-narcotic.

Harmlessness
Widespread illusion that drugs that change consciousness, are less harmful than "traditional" drugs, because used for medical purposes for treatment. Indeed, the use of these drugs does not do much harm to the body, provided that the dosages prescribed by the doctor and the duration of treatment are observed, as well as when applied by the manufacturer's method. In fact, when drug addiction is disrupted both dosages, and, often, ways of using drugs, which leads to irreversible destructive and sometimes tragic consequences (brain and nervous system damage, cardiovascular system, tissue necrosis, death ). It is not necessary to talk about the observance of the duration of the course for drug addiction.

Relief of withdrawal symptoms
There is an illusion that you can "get off" drugs with the help of the above medicines. Indeed, these drugs change consciousness and, accordingly, can "stifle" the problems associated with the abolition of the drug, but not cure dependence. In fact, one drug is being replaced by another. Moreover, the abstinence syndrome after the abolition of drug drugs is more severe than after the "traditional".

Drugs that have a narcotic effect
The following drugs are contraindicated for people who have a chemical dependence. For other people, their use is only possible under the supervision of a doctor and strictly in the recommended dosage.

Baclofen
Buterate
Dextromethorphan
Doxepin
Zaldiar
Corvalol
Coaxyl
Kodelak
Combismatism
Nalbuphine
Nurofen
Paxil
Reductil
Sedal M
Sibutramine
Terpincode
Tramadol
Tramal
Trigan D
Tussin Plus
Phenazepam
Phenibut
Phentermine
Ephedrine


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Alzheimer's disease: when the brain is in danger

24 Oct 2018

Alzheimer's disease (or, more precisely, senile dementia of the Alzheimer's type) is one of the most common diseases of the old age: around the world, about 30 million people are affected by this ailment, and by 2050, according to the estimates of UN demographers, this number can grow in 4 times. Approximately half of the cases (specific indicators in different countries and even localities can differ significantly) of senile dementia after the examination is put exactly this diagnosis. Especially increases (approximately twice every 5 years) the risk of developing this disease after reaching the age of 65 years, reaching 20% by 80 years. Up to age 65, senile dementia of the Alzheimer's type is considered to be early.

Memantine and Alzheimer's disease

German psychiatrist Alois Alzheimer and described in 1906 a case of early progressive dementia and memory loss in a woman at the age of 50. For a long time, the diagnosis of "Alzheimer's disease" was raised only in patients with dementia at the age of 45-65 years. Only in 1977 it was finally established that presenile (early) and senile (senile) dementia in the clinical and pathological picture do not differ from each other, and in the presence of characteristic symptoms and developmental features the diagnosis of "Alzheimer's disease" was started regardless of age patient.

How does it manifest itself?
In the early stages, Alzheimer's disease is rarely recognized - usually the changes occurring with the patient are first explained by either recently experienced severe stress, or old age. The first one suffers memory - a person begins to learn information worse, is not able to remember what he learned more recently. It is the inability to reproduce the information, which was learned shortly before the verification, often distinguishes the early stages of the disease from the "usual", absent-mindedness, but for the detection of this feature, special (albeit uncomplicated) testing should be carried out - and the relatives and friends, of course, to check the memory of an elderly person.

Moreover, often in the early stages of Alzheimer's disease (and even more often with its development), the patient begins to "spoil the character": irritability, rudeness, capriciousness and selfishness appear - or, conversely, indifference to what is happening around and to others. There are often cases of suspicion, reaching the delirium, the patient believes that he "all the only hinders" or his "no one likes to want to get rid of." In the best case, the person is constantly in a bad mood, he can not be distracted and entertained, the depression is gradually developing.

Usually the elderly and suddenly become irritable and depressed person relatives try to leave alone, they hope that this mood "will pass by itself" is a big mistake! If such symptoms occur (especially if a noticeable memory impairment is observed simultaneously with the depressive state), it is necessary to consult with specialists and, if possible, to conduct a medical examination: a check of thinking, an electroencephalogram, a tomography, and some biochemical analyzes. It is early diagnostics that allows to slow down the development of Alzheimer's disease, to alleviate both the condition of the elderly person and his life close to him.

With the further development of the disease, at the middle stage, the brain damage manifests itself in the loss of orientation in space (the patient may get lost even in his own apartment), time (does not remember the date, sometimes can not correctly determine the time of day), the correct perception of the connections between objects and concepts - for example, the patient does not recognize relatives or understands that they are close people, but can not say who they are to him. Frequent violations of speech - both written (lost the skills of writing and reading), and oral - patients do not perceive the meaning of sentences, their speech loses coherence, turns into a set of separate, often unrelated words. Approximately at the same stage appears apraxia - the loss of the ability to produce habitual actions. Violation of perception can lead to hallucinations, and bright, "authentic" for the patient.

At a late stage, the ability to make meaningful and consistent actions is lost - a patient without outside help can not dress, wash, eat, using cutlery. Sometimes patients are able to perceive speech and realize that they are addressing them exactly - but they can not remember who they are anymore, what their names are, etc. And, finally, the final stage of Alzheimer's disease is a general deep dementia, in which the patient is only capable of reflex reactions and actions - swallowing, sucking, meaningless sounds, etc. However, death usually does not occur due to brain damage, but for concomitant reasons - because of pneumonia, pressure ulcers and other diseases typical of recumbent weakened patients.

What happens in this case?
Modern medicine can not offer treatment of Alzheimer's disease, which allows to completely stop its development and return the lost brain functions to the patient.

At present, a single proven theory, fully revealing the causes and development of Alzheimer's disease, still does not exist. It is known that this disease is characterized by the loss of neurons and synapses between them in the cerebral cortex and subcortical areas, in the middle and late stages of MRI (and subsequently at autopsy), marked atrophy and degeneration of the affected areas (most often frontal cortex, temporal and parietal lobes) due to mass cell death. A brain biopsy and subsequent microscopy of the drugs show a characteristic pattern - the presence of amyloid plaques (dense deposits formed from beta-amyloid - a fragment of one of the proteins - and the cellular material of neurons) and neurofibrillary tangles - convoluted and twisted fibers of fibers inside nerve cells. Both plaques and tangles are formed in small numbers in many elderly people, but in Alzheimer's disease these formations are found in noticeably large amounts and, above all, in affected areas - for example, temporal lobes.

One of the first hypotheses about the causes of Alzheimer's disease was cholinergic, which explained changes in the nervous tissue by a decrease in the synthesis of acetylcholine, but treatment with drugs that corrected the deficiency of this important neurotransmitter was not very effective. The following hypothesis, amyloid, the main cause of the disease is the formation of plaques based on beta-amyloid. Studies have shown that in people with a genetic predisposition to Alzheimer's disease, the formation and accumulation of excess amyloid in the brain tissues begins even before the first symptoms of the disease appear, but experiments with a vaccine capable of clearing the brain of plaques at an early stage have shown that the development of dementia slows down slightly. In addition, the direct connection between plaque accumulation and the loss of nerve cells has not been proven.

The third hypothesis relates Alzheimer's disease to changes in the structure of the tau protein, one of the proteins associated with intracellular microtubules. According to this hypothesis, it is the tau protein strands that form neurofibrillary tangles in neurons, as a result of which microtubules (which are part of the "transport system" of the nerve cell) decay, followed by a disruption of signaling between neurons and cell death.

How to treat Alzheimer's disease?

Unfortunately, modern medicine can not offer treatment for Alzheimer's disease, which allows to completely stop its development and return the lost brain functions to the patient. However, this does not mean that the drugs and methods offered by psychiatrists are completely useless - they make it easier for the patient and his relatives, primarily by slowing the appearance of new mental disorders and partial compensation for what is happening. Treatment is prescribed strictly individually, after a comprehensive examination and detection of contraindications, with the earlier the disease is identified, the more effectively it can slow down its development.

Non-pharmacological, neuropsychological methods are the main ones and are aimed primarily at training the memory, maintaining the brain's working capacity and at the same time teaching the patient how to partially compensate for lost abilities and skills: creating and maintaining a system of "resembling" records (eg diary and plans for the near future), suppressing inadequate reactions, the ability to distribute complex actions, divide them into simpler and more accessible stages, and so on. For the improvement of the patient's condition, creating comfortable conditions for him and general relaxation, aromatherapy, herbal medicine, music therapy and, of course, the correct actions and reactions of people caring for the patient are used - this, too, must be taught by specialists.

Drug therapy complements neuropsychological therapy and allows (especially in the early stages) to slow down the progression of the disease and reduce the severity of its symptoms. For this purpose, primarily use drugs from the group of cholinesterase inhibitors, recommended are donepezil, galantamine, rivastigmine. The use of these drugs improves memory and affects the patient's ability to perform cohesive actions. In addition to this group of drugs, memantine, a glutamate antagonist, is also prescribed. Regulation of glutamate activity allows to reduce its effect on neurons and contributes to their longer preservation. Influence on preservation of abilities to thinking (cognitive) joint reception of memantine and donepezil is noted.

In addition to the drugs of these groups, antidepressants, anticonvulsants are prescribed symptomatically (and strictly individually!), In case of inadequate behavior, which is a problem for others, neuroleptics are also used, but the latter should be used only to relieve acute conditions: with constant use, they aggravate memory problems and cognitive abilities, and with prolonged administration of neuroleptics in patients with Alzheimer's disease, there is an increased mortality.


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Fainting. Causes and first aid

23 Oct 2018

Fainting or loss of consciousness is one of those unpleasant surprises that almost everyone can face. But how to behave in this situation? How to understand that someone is getting alongside and what help can be provided?

According to the definition, fainting is a sudden and short-term manifestation of cerebral blood supply deficiency, manifested in loss of consciousness and sensitivity disorder.

Diabetic foot. Actovegin buy

Causes of loss of consciousness can be a variety of factors - from fatigue and cardiovascular disease to increased intracranial pressure and poisoning, but in any case, we can distinguish the three main mechanisms for the onset of syncope:

- violation of blood supply;
- a significant decrease in the amount of oxygen in the arterial blood;
- marked decrease in serum glucose levels.

All faints can be conditionally divided into several types for reasons of origin: neurogenic, cardiogenic and hyperventilation.

The most frequent are neurogenic syncope, which can also occur in completely healthy people as a reflex response to stress (severe pain, fright), sudden changes in body position (orthostatic syncope), or an increase in intrathoracic pressure. Hyperventilation faints arise as a result of unconscious rapid (and deep) breathing - with fear, vegetative crisis, bradycardia, etc. Cardiogenic syncope is more common in patients with cardiovascular disease, but can also be in a healthy person if the load on the heart is too high (for example, when working in hot weather).

Symptoms and precursors
As a rule, loss of consciousness during fainting is not as sudden as it is commonly believed-most often this is preceded by characteristic symptoms, which the person himself characterizes as poor health, faintness, weakness. There may be noise in the ears, mild nausea, a feeling of dizziness, lack of air and darkness in front of the eyes. With the slow development of fainting, this condition can last from 2-3 minutes to half an hour, if the violation of blood supply to the brain develops rapidly, the pre-memory period lasts no more than 10-30 seconds.

The faint itself may be somewhat different in its manifestations. In the easiest case, a person does not even lose consciousness completely, rather feels stunned, can not stand on his feet due to severe dizziness and weakness, his skin becomes pale and becomes sweaty, hands and feet become cold. This condition can both go through 2-3 minutes, and lead to a loss of consciousness.

Classical syncope also begins with confusion and clouding of consciousness, and then the person completely "disconnects", all his muscles relax, become sluggish, and he slowly settles. I want to pay special attention to this feature, because if a person falls sharply ("flat"), his limbs and muscles are strained, then it is a question of some more dangerous state, and not a simple fainting. During fainting, blood pressure usually decreases, breathing becomes shallow, the pulse weak (do not grope for it), then within 20-30 seconds (maximum 1-2 minutes) a person gradually regains consciousness. Some time after the loss of consciousness - up to 1-2 hours - may feel a sense of weakness and weakness.

The most unpleasant option is the so-called. convulsive fainting, in which single muscle contractions or generalized convulsions (reminiscent of an epileptic seizure) join the usual clinical picture for loss of consciousness. Passes such a faint too quickly, within 2-3 minutes, and without any consequences.

Suddenly, a person can fall not only with fainting, but also with a drop-attack. In this case, the fall is not accompanied by loss of consciousness, although there may be a feeling of severe weakness in the legs and dizziness. As a rule, this happens because of short-term, but intensive compression or ischemia of the brain stem.

First aid - what you need and do not need to do
The first thing you need to do is to find someone who is close to a person who has lost consciousness - to support him, not letting him fall, and gently arrange in a horizontal position. It's best to just put the injured on your back - without throwing your head back and putting nothing under it (your head and body should be on the same level). In extreme cases, you can try to plant a person with a reliable support for the back.

Then all present should calm down and do not arrange unnecessary fuss, fainting - a short-term condition, and when restoring the blood supply to the brain (when it comes to a healthy person) goes by itself. This process can be eased with cold water - moisten the forehead and whiskey to the victim, spray his face or put a wet handkerchief / towel on his forehead. Also, you need to provide free air access: unfasten the collar and press on the belly strap.

After the consciousness begins to return, it is important that the person does not get up within 10-15 minutes, so as not to provoke a new attack. It is necessary to try to calm him, tk. nervous tension causes a spasm of blood vessels, as a result of which the blood supply of the brain weakens. You can give a drink with a weak sweet tea, but do not give coffee or other tonic drinks. they increase the burden on the heart. And of course, one should not offer a person alcohol, which in such cases is often used as a sedative, because even a small dose of ethyl alcohol dilates the peripheral vessels, depriving the brain of normal blood supply. It is not necessary to bring a person to life with the help of ammonia, he only reflexively excites the respiratory center, but does not improve blood supply.

It is highly desirable, within 30-60 minutes after fainting, to avoid smoking, taking LP, increasing and lowering the pressure or increasing the heart rate, as well as any activity related to nervous tension (for example driving a car) or physical activity (especially slopes and sit-ups).

In addition, if a person who has lost consciousness has any cardiovascular, endocrine or neurological diseases, you should always call a doctor.

What's next?

Even if the faint was single and did not cause any consequences, it is best not to leave this incident without attention and take care of your health and prevent possible relapses. It is best to find time to visit a doctor and undergo a primary diagnosis that will allow you to determine exactly whether there are any prerequisites for repeated fainting. This is especially important for people over 40, who often have inconspicuous chronic diseases at the initial stages.

For example, ECG and echocardiography should be done to exclude such dangerous causes of syncope, as arrhythmia, cardiomyopathy, pathologies of the heart valves and coronary vessels. To identify endocrine and metabolic disorders, which could cause a syncope, you can donate blood to the main biochemical indicators (blood glucose, hemoglobin, electrolytes, creatine kinase). If you suspect a neurological fainting, it is recommended to take a radiograph of the skull and cervical spine.

If no abnormalities have been detected and some special treatment is not required, drugs that improve the blood supply to the brain (ginkgo biloba, etc.), as well as metabolism in nerve cells (glycine, etc.) can be advised to prevent repeated fainting. You can also use preparations based on plant adaptogens (eleutherococcus, ginseng, aralia, magnolia vine), levocarnitine preparations, vitamins of group B, agents that improve the tone and elasticity of blood vessels (rutozide, Actovegin, diosmin).

But it is important not to forget that independent medication prophylaxis should be carried out only after consultation with the doctor and in the absence of contraindications.


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Disorders of cerebral circulation

22 Oct 2018

Briefly about the disease

Causes: chronic disorders of cerebral circulation (CNMK) are caused by persistent narrowing of the lumen of the main arteries of the head, for example due to atherosclerotic disorders. Also, the deterioration of the blood supply to the brain tissue can develop due to the lesion of small vessels (microangiopathy) in arterial hypertension (AH), diabetes mellitus (DM). All this is accompanied by chronic ischemia and hypoxia of various parts of the brain, i.e. a discrepancy between their needs for oxygen and glucose and the real intake of these substances.

Disorders of cerebral circulation

Symptoms: they release several degrees of severity of HNMK. The characteristic initial signs of disorders of "cerebral nutrition" (stage I of discirculatory encephalopathy), which usually cause the primary treatment for medicinal products, include:

- "Dull" headaches, dizziness, noise in the head (autonomic disorders);

  • decreased memory and performance, absent-mindedness (cognitive impairment);
  • irritability, tearfulness, depressed mood (psycho-emotional problems).

Rx zone
Most drugs used in the complex pharmacotherapy of HNMK belong to the prescription list: they are prescribed only by a doctor (neurologist, therapist), taking into account the cause, the course of the disease, the prevailing symptomatology, etc. The competence of the first person is informing the pharmacy client about the properties of these medicines, if there are several identical drugs in the pharmacy, the selection of trade names according to the INNs issued.


Antiaggregants
Purpose of application: primary and secondary prevention of strokes.

Principle of action: suppression of platelet aggregation, improvement of rheological properties and microcirculation of blood in areas of cerebral ischemia.

Representatives of the group: dipyridamole (Curantil, etc.), dipyridamole + acetylsalicylic acid (Agrenoks), clopidogrel (Plavix, Zilt, Clopidogrel-Teva, Lopirel, Plagril, etc.), clopidogrel + acetylsalicylic acid (Coplavix, Plagril A).

Features of the group
The most famous antiaggregant - acetylsalicylic acid in the range of doses of 50-300 mg - is allowed to leave without a prescription. More about it - in the section "OTC-zone".
According to the Orange Book FDA, from the imported clopidogrel, registered in Russia, the therapeutically equivalent to the reference preparation (Plavix) are the genera Delplat-75, Cardutol, Clopidogrel-Teva, Clopilelet, Lopirel, Plagril (therapeutic equivalence code AB) ². EMA refers to the same category of generic Zilt, Clopidogrel-TAD3.


Statins
Purpose of the application: reduction of "bad" cholesterol in the blood, prevention of atherothrombotic complications of CNMK (including stroke).

Principle of action: inhibition of the enzyme that regulates the synthesis of cholesterol in the liver.

Representatives of the group: atorvastatin (Liprimar, Atoris, Tulip, etc.), rosuvastatin (Krestor, Akorta, Mertenil, etc.), simvastatin (Zokor, Vazilip, Simgal, Sincard, etc.)

Features of the group
Statins-generics, therapeutically equivalent (AB) to referent drugs (according to the FDA version):

atorvastatin (referent - Lipimar) - Torvas, Tulip;
simvastatin (referent - Zokor) - Simgal, Sincard.


Means that improve cerebral circulation
The purpose of the application: restoration of the damaged blood supply to the brain, reduction of cognitive, emotional, vegetative symptoms of HNMK.

Principle of action: selective expansion of cerebral vessels, improvement of microcirculation in ischemic zones, optimization of oxygen and glucose delivery.

Representatives of the group: vinpocetine (Cavinton, Cavinton comfort, Cavinton forte, Telekton, etc.), nimodipine (Nimotop, Nimopin), pentoxifylline (Trental, Agapurin, Vazonit, etc.), cinnarizine (Stugeron, Cinnarizin)

Features of the group
To improve cerebral circulation, ginkgo biloba preparations are also widely used, permitted for leave without a prescription (see section "OTC zone").


Nootropics
The purpose of the application: improvement of brain functions, reduction of cognitive-emotional, vegetative disorders.

The principle of action: increasing the intake of glucose and oxygen by brain tissues, optimizing blood circulation, increasing the resistance of neurons to hypoxia, improving the conduct of nerve impulses.

Representatives of the group: pyracetam (Nootropilum, Lucetam, etc.), phenotropil (Fentropil), choline alfoscerate (Gliatilin, Cerepro, etc.), Cerebrolysin, and others.

Metabolic means
The purpose of the application: increasing the resistance of brain tissue to hypoxia, reducing cognitive, autonomic symptoms.

Principle of action: optimize the processes of energy formation in the ischemic zones, promote the improvement of cerebral blood supply.
Representatives of the group: acetylcarnitine (carnitine), ethylmethylhydroxypyridine succinate (Mexidol, Mexident, Mexicor, etc.), Actovegin, Solcoseryl, and others.

Features of the group
Individual metabolics shown with symptoms of HNMK are allowed to be dispensed without a prescription (see section "OTC zone").

OTC zone
Over-the-counter products used in the complex therapy of HNMK are often included in the list of appointments of a doctor. At the same time, most of them can be independently recommended by the pinnacle with a direct complaint of the client to the initial symptoms of HNMK. In this case, of course, it is necessary to advise the visitor at the first opportunity to go to the doctor.


Angioprotectors - preparations of ginkgo biloba
Rationale recommendations: normalize the blood supply to the brain, reduce the "viscosity" of blood, increase the absorption of oxygen, glucose, brain resistance to hypoxia. Reduce cognitive impairment, dizziness, tinnitus.

Variants of the offer: Tanakan, Bilobil, Vitrum Memori, Ginkoum, Ginos, Memoplant, etc.

Features of the group
Tanakan, Vitrum Memori, Ginkoum, Ginos and Memoplant contain standardized extracts of leaves of ginkgo biloba. In other words, the percentage range of the content of bioactive substances (flavonol glycosides, ginkgolides-bilobalides) that determine the pharmacological effects of this medicinal plant is specified in them precisely. However, only Tanakan and Memoplant include the extract of ginkgo biloba brand EGb 761, in relation to which the largest international evidence base of effectiveness for HNMK5 has been accumulated.
Preparations of ginkgo are contraindicated in pregnant and lactating women. They are used with caution in AH - a frequent companion of KhMNC.To treat the symptoms of HNMK, ginkgo biloba preparations take 40 mg 3 times a day for at least 3 months. The possibility of increasing the dose and conducting repeated courses should be agreed with the doctor.
When using the patient antiagregantov not recommended parallel reception of ginkgo biloba because of increased risk of bleeding.
In 2015, the extract of ginkgo biloba entered TOP10 appointments (by INN) by neurologists with discirculatory encephalopathy4.


Antiaggregants - cardioaspirines (50-300 mg)
Rationale for the recommendation: by suppressing platelet aggregation, reduce the "viscosity" of the blood. They are used for long-term prophylaxis of thrombosis and strokes.

Variants of the offer: Aspirin Cardio, Cardi ASK, Cardiomagnolo, Trombo ACC and others.

Features of the group
Initially, low-dose preparations of acetylsalicylic acid (ASA) are prescribed to the patient by a doctor who determines an adequate daily dose (can range from 50 to 300 mg). If the patient already uses this remedy, the pharmacist can recommend ASA to him on an "on-call" dose to replenish his home supplies, because with NHMK, aspirin is used on an ongoing basis.
ASA should not be taken in parallel with ginkgo biloba.


OTC Nootropics
Rationale for the recommendation: increases brain resistance to hypoxia, improves interneuronal nerve conduction, normalizes blood viscosity. It improves memory processes, helps to reduce headaches, psychoemotional disorders.

Variants of the offer: Noopept.

Features of the group
Noopept is contraindicated in pregnancy and lactation.
In the absence of contraindications, we allow an independent intake of the drug at a dose of 20 mg per day by a course of 1.5-3 months. An increase in the daily dose, the possibility of combining Noopept with other neurotropic drugs should be agreed with the doctor.


Metabolic drugs - glycine preparations
Rationale for the recommendation: glycine normalizes nerve conduction, reduces excitation processes in the central nervous system, helps to increase mental performance and reduce psychoemotional disorders.

Variants of the offer: Glycine, Glycine-Bio, etc.

Features of the group

Glycine has no restrictions on reception during pregnancy and lactation, it is compatible with any medications.
Mode of glycine intake with a decrease in mental capacity - 100 mg 2-3 times a day under the tongue 14-30 days.


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Trophic ulcers of lower extremities

18 Oct 2018

The urgency of the problem of trophic ulcers in modern medicine is steadily increasing. This is due primarily to the variety of diseases leading to the formation of trophic ulcers. Trophic ulcers on the lower limbs are the result of a variety of diseases that disrupt the local hemodynamics of the arterial, venous, and lymphatic systems, including the microcirculatory level of the lesion. In addition to these factors, the cause of trophic ulcers can be various injuries of the skin, soft tissues and peripheral nerves. Medicines that affect similar pathogenetic mechanisms can be used in the treatment of trophic ulcers of virtually any etiology. The indication for the antibiotic therapy is the syndrome of the systemic inflammatory reaction, the signs of acute infectious inflammation of the soft tissues surrounding the trophic ulcer, or a high degree of its bacterial contamination. Chronic ulcers, especially against diabetes mellitus, hematological and oncological diseases, HIV infections, steroids, in addition to antimicrobial therapy, suggest the use of antifungal agents. When treating trophic ulcers, antiseptics and disinfectants are used, bandages (semipermeable films, hydrocolloids, sponges, hydrogels, alginates, super absorbents, atraumatic net dressings, atraumatic sorbing dressings) are widely used, depending on the phase of the wound process and the degree of exudation.

Actovegin. Phenazepam. Red lichen

Major medicines
Angioprotectors and microcirculation correctors: Agapurin, Actovegin, Vazonite, Doxie-Chem, Duzopharm, Solcoseryl, Troxerutin, Escuzan 20, and others.

Antiaggregants: Agapurin, Pentoxifylline, Radomin, Trenpental, Trental, Trental 400 and others.

Anticoagulants: Viatromb, Venolife and others.

Antihypoxants: Actovegin, Dimefosfon, Solcoseryl, etc.

Antibacterial agents: Baneocin, Synthomycin, Sintomycin liniment, Bonderm, Chlorophyllipt, Chlorophyllipt alcohol 1% solution, Metrogil, Argosulfan, Dermazin, etc.

Antifungal agents: Fluconazole, voriconazole, caspofungin, Sangviritrin, Sanguirithrin liniment 0.5%, etc.

Antiseptics and disinfectants: Argosulfan, Shostakovskiy Balm, Betadin, Dimefosfon, Kuriyozin, Miramistin-Darnitsa, Eplan, Olazol, Sangviritrin, Sanguirithrin liniment 0.5%, etc.

Additional medicines

Vitamins and vitamin-like drugs: Dexpanthenol-Hemofarm, calcium pantothenate, Prophylactin C and others.

Hepatoprotectors: Erbisol, Hepatofalk of the plant, Karsil and others.

Homeopathic remedies: Edas-120, Edas-201M, Edas-202M and others.

Dermatotropin funds: Biopin, Dexpanthenol-Hemofarm, Fitostimulin, Eplan, Algimaf, Algipor, Radevit and others.

Immunomodulators: Derinat, Polyoxidonium, Erbisol, and others.

Anti-inflammatory drugs: Abisil, Aspirin "York", Indovazin, etc.

Regenerants and reparants: Actovegin, Shostakovskiy Balm, D-panthenol, Dexpanthenol-Hemofarm, Xymedon, Curiosine, Metuluracil tablets 0.5 g, Solcoseryl, Fitostimulin, Eplan, Depantol, Piolizin, etc.

Regulators of water-electrolyte balance and acid-base medium: Dimefosfon et al.

Enzymes: Collagenase KK 250 ED, Collagenase KK, Iruksol, Phlogenzym, and others.


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Conjunctivitis. Than to help the inflamed eye?

16 Oct 2018

Reddened eyes, stitched eyelashes, itching and burning as if lodged under the eyelids - here they are, typical symptoms of conjunctivitis, which are able to deliver a sick person a lot of unpleasant sensations. And the longer they last, the higher the risk that acute conjunctivitis will become chronic, and cure it will be much more difficult.

Conjunctivitis. Than to help the inflamed eye. Actovegin

A few words about the problem ...
Conjunctivitis, i.e. inflammation of the connective membrane of the eye, most often occurs as a result of infection (bacterial or viral), allergic reaction, and in some cases under the influence of irritating factors (dust, smoke, contact lenses, etc.).

And although the symptoms of all forms of conjunctivitis are similar, each of them has its own characteristics, which allow one to suspect what triggered the inflammatory process.

So, for example, bacterial conjunctivitis often begins with the defeat of one eye, and only with non-hygiene spreads to the second. It is characterized by abundant mucopurulent discharge, because of which it is difficult for a patient to open his eyes, especially in the morning. Viral conjunctivitis often occurs against the background of a previous acute respiratory viral infection, accompanied by marked reddening of the eyes, lacrimation and photophobia. Allergic conjunctivitis is usually combined with allergic rhinitis, the most pronounced symptoms are itching and burning.

Treatment of conjunctivitis is selected depending on the cause of the disease, the nature of the inflammation (acute, chronic) and accompanying symptoms, but there are several general rules that should be followed in any case. First and foremost, strict hygiene is important: you can only touch the eyes with cleanly washed hands, before the symptoms disappear completely, you must change bed linen (pillowcase) and towel daily, for the instillation of solutions there must be separate pipettes for each eye. Also, careful treatment of the inflamed eye is necessary - mucopurulent discharge should be thoroughly rinsed with a solution of antiseptics (furacilin, ocystistine, potassium permanganate), and not mechanically removed. Drugs in the form of eye drops are usually used during the day, gels and ointments - overnight.

Bacterial conjunctivitis
The main method of treatment of bacterial conjunctivitis is antimicrobial therapy, for which locally acting preparations are used in the form of eye medicinal forms (drops, gels, ointments and films).

Of the antibiotics, the most commonly used drugs are the aminoglycoside group (gentamycin, tobramycin), fluoroquinolones (norfloxacin, ofloxacin), as well as levomycetin, which have a broad spectrum of action and can be used without an exact definition of the causative agent of conjunctivitis.

In some cases, antimicrobial therapy is complemented by the appointment of sulfacetamide, which has a bacteriostatic effect.

If necessary, for example in severe infection, for the treatment of bacterial conjunctivitis, combined drugs are prescribed, which, in addition to the antibiotic, includes a corticosteroid component. These can be preparations based on gentamicin and betamethasone or dexamethasone, neomycin preparations with dexamethasone and polymyxin, as well as drugs of gramicidin with dexamethasone and Framicetin. They have a pronounced anti-inflammatory, antibacterial and antiallergic effect, quickly reduce the acute symptoms of conjunctivitis.

Also, with bacterial conjunctivitis, antiseptics must be used for regular maintenance and treatment of the inflamed eye. The most widely prescribed preparations are decamethoxin, boric acid, zinc sulfate, sodium tetraborate, which have a disinfectant and antiseptic effect. With severe symptoms of inflammation (edema and hyperemia) and contraindications to the use of glucocorticosteroids, antibiotic therapy is supplemented with local forms of NSAIDs, for example, diclofenac preparations in the form of eye drops.

In the acute period of conjunctivitis - the first 3-5 days, antimicrobial drugs (drops) are used every 2-4 hours. After the symptoms of inflammation begin to decrease, the incidence of instillation is reduced to 3-6 times a day. The course of treatment, on average, is 7-10 days.

If the disease was severe, with superficial marginal keratitis, then after the disappearance of acute symptoms, drugs that stimulate the natural mechanisms of regeneration (gel Solcoseril or Actovegin) are prescribed.

Viral conjunctivitis
In most cases, the cause of viral conjunctivitis is adenovirus, the second most common causative agent is the herpes simplex virus - it affects the eyes much less often. On the background of adenovirus infection, inflammation of the conjunctiva develops 2-4 days after the appearance of the first symptoms of acute respiratory viral infection, and proceeds in the form of pharyngoconjunctival fever or epidemic keratoconjunctivitis (more severe form with corneal involvement).

Specific (etiotropaya) therapy with viral conjunctivitis is used today mainly in herpetic infection (acyclovir in the form of an ointment, a solution of idoxuridine). With adenoviral conjunctivitis, antimetabolites (oxoline and tebrofen ointment, florenal ointment) can be used, but their effectiveness leaves much to be desired.

As an alternative to antiviral agents, locally acting interferon preparations (a solution of recombinant interferon alfa-2b) or drugs that stimulate the formation of intrinsic interferons (poludane, aminobenzoic acid) are sometimes prescribed. In general, symptomatic therapy is carried out.

When lesions of the cornea (keratoconjunctivitis) use drugs that improve tissue regeneration: a solution of taurine or retinol acetate, Solcoseryl gel or Actovegin, dexpanthenol, a solution of riboflavin and ascorbic acid.

Antibacterial drugs are not effective against viruses, but in severe viral conjunctivitis, as well as in weakened patients, locally acting drugs of levomycetin, ocystistine, piclosidine may be prescribed to prevent the attachment of a secondary bacterial infection. After the symptoms of acute inflammation begin to subside, a short course of topical glucocorticosteroids (dexamethasone) or combined drugs - corticosteroids and antibiotics (neomycin + dexamethasone + polymixin) is prescribed. If contraindications to the appointment of corticosteroids can be used diclofenac solution.

To reduce painful and uncomfortable sensations, vasoconstrictive drugs (phenylephrine, atropine) can be used - a short course, dazzles (Vidisik, Systein, Oftagel) - for long-term daily use.

Allergic conjunctivitis
Allergic conjunctivitis can be both year-round and seasonal (pollinosis), and in most cases is accompanied by other symptoms of allergy. Therefore, for treatment of all types of allergic conjunctivitis, not only locally acting drugs are used, but also systemic therapy.

With seasonal conjunctivitis, first-line drugs are locally acting antihistamines - azelastine, opatanol, as well as preparations of cromoglycic acid. As a symptomatic therapy, local vasoconstrictors - nafazolinum, diphenhydramine, which are prescribed by short courses (no more than 5 days) are used. With a moderate and severe course of conjunctivitis, corticosteroids are added to the main treatment: eye drops and gels with dexamethasone, hydrocortisone. If allergic inflammation is complicated by the attachment of a bacterial infection, combined drugs (an antibiotic with a corticosteroid) are used.

Systemic therapy is prescribed either in severe pollinosis, or in the case of year-round allergic conjunctivitis, which is resistant to the use of locally acting drugs. In this case, antihistamines of the second generation - ebastine, loratadine, cetirizine, fexofenadine, etc. are prescribed. Alternatively, ketotifen preparations may be used.

With timely treatment and compliance with all medical recommendations, most of the acute conjunctivitis (both infectious and allergic) go without unpleasant consequences and complications within 2-3 weeks. The main thing is not to start the inflammatory process.


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Homeopathy and pregnancy: effectiveness and safety

15 Oct 2018

The fact that each drug has not only indications for use, but a list of contraindications (sometimes quite extensive), is well known to every Apothecary. Limit the possibility of appointment can not only the properties of the drug itself, but also the peculiarities of the patient's condition: the presence of chronic diseases, individual tolerability of drugs, age, etc. And, of course, we must not forget that a serious contraindication to the use of many drugs is such an important period in a woman's life, like pregnancy.

Homeopathy and pregnancy

Pregnancy: drug safety regulations
As you know, any substances that can penetrate the placental barrier, one way or another affect the development of the fetus and the course of pregnancy. The state of the baby's health is affected by everything that affects the mother's body: the emotional atmosphere in the family, the ecology of the modern city, the inner experiences of the woman, as well as the food she has eaten and medications taken. Proceeding from this, ideally a baby should be fully healthy woman in a calm environment, away from urban stress. But, unfortunately, it is almost impossible to implement such recommendations, the future baby has to experience the influence of various risk factors, among which the most common is the use of a pregnant woman with medicines.

The most dangerous period in this respect is the first trimester of pregnancy, especially in cases where a woman does not immediately realize her condition and takes any toxic drugs that can disrupt the correct formation of the baby's organs. But in the next two trimester, many medicinal substances can also cause serious problems during pregnancy and further development of the child.

All of the above compels doctors to be as cautious as possible in prescribing a course of treatment for a future mother. Employees of pharmacies should also take extremely responsive to the recommendation of any medications to pregnant women, and first of all it applies to cases when the customer appeals to the pharmacist for the OTC drug not prescribed by the attending physician.

Of course, categorically dissuade the visitors from acquiring a drug of interest to them, there is no sense - a woman can just buy it in another pharmacy, where not so scrupulous employee works. The optimal way out in this situation will be to offer a safer means, thus the pharmacist will not only provide qualified assistance, but also establish a more trusting relationship with buyers.

One of the safest and effective medical methods of treatment during pregnancy has long been considered homeopathy. Even our conservative official medicine admitted that the use of homeopathic medicines allows not only to improve the condition of a pregnant woman, but also to maintain the health of an unborn baby. It is worth mentioning that homeopathy can help not only exacerbate any chronic disease in a future mother, but also facilitate the course of pregnancy, and also eliminate a number of specific for this time ailments.

Bearing a baby is a serious burden for the female body and is often accompanied by various problems that worsen the quality of life of patients, and in due course can move into quite dangerous and even threatening conditions. Therefore, the modern approach to medical management of pregnancy involves drug support for this process at all stages. However, each of the traditional medicines has an impressive list of side effects, so doctors try to limit their use to the maximum and appoint them only in cases when the benefits of treatment objectively exceed the possible risk for the mother and fetus. In fact, it turns out that before the emergence of typical clinical symptoms, the body of a pregnant woman must independently cope with the beginning of impairments. In order to stop the further development of the pathological process and normalize the state of health of the future mother and her baby, today various non-invasive methods of treatment are used, among which homeopathy occupies an important place.

Homeopathy: indications for use
Recommending that any pregnant woman should have a homeopathic remedy, the pharmacist should remind them that homeopathy presupposes an individual approach to each patient, and only a qualified doctor can prescribe an adequate treatment taking into account all the characteristics of the body. Self-management of homeopathic remedies will help to cope with unpleasant symptoms, but not always allows to completely eliminate their cause, and therefore, even starting treatment at home, do not give up the advice of a specialist.

I must say that homeopathic remedies can be recommended to a woman not only after the joyful news of the imminent addition to the family is confirmed. Acquaintance with homeopathy is better to start while preparing for pregnancy. It's no secret that the reproductive health of modern women leaves much to be desired: menstrual irregularities, problems with the hormonal background, dysbiosis of the vagina and vaginosis can not only become an indirect obstacle to conception, but also adversely affect the course of pregnancy. Even in the treatment of infertility, homeopathy can be of considerable help. It will not be superfluous for homeopathic support also in those cases when the future mother suffers from any chronic diseases, and even more so to patients who had previous pregnancies with miscarriages.

Classic pregnancy problems in the form of nausea, hypersensitivity to odors, motion sickness in transport, as well as heartburn and intestinal motility disorders will help solve complex and monotherapy drugs including Nux vomica, sulfuric and phosphoric acids (Acidum sulphuricum and Acidum phosphoricum) , as well as Bryonia alba (white steppe), Ignatia amara (beans of St. Ignacy), Alumina (alumina, alumina). Of course, such ailments, although they give a lot of unpleasant sensations, but do not pose a great danger to the health of the woman and the course of pregnancy, and therefore gynecologists are accustomed to recommending dietary treatment for their elimination, but not in all cases a simple correction of nutrition is sufficiently effective.

Another common problem of pregnancy are various pathologies of the venous walls, among which hemorrhoid and varicose veins of the lower extremities are most often encountered. If the violation has managed to go far enough, then it is likely that after the pregnancy it will be necessary to fight its consequences. Therefore, the pharmacist should remind his customers about the need for early prevention of such problems and recommend products containing Aconitum napellus (wrestler), Atropa belladonna (belladonna), Sulfur (elemental sulfur), as well as Carbo vegetabilis (charcoal), Hamamelis virginica virgin walnut), Licopodium clavatum (clown planown).

Among the drugs that are prescribed for every pregnant woman, include multivitamin and mineral complexes - a growing fruit daily consumes a fairly large amount of these important substances, the only source for which is the mother's body. And in this case homeopathic preparations of calcium, iron, magnesium and other important macro- and microelements are the best alternative to traditional remedies. much easier to digest, do not lead to an overdose and completely cover the needs of both mom and her baby.

Homeopathy is able to cope with the most serious violations of pregnancy, including. threat of interruption. Properly selected drugs will help increase the elasticity of the uterine walls, eliminate hypertonia, strengthen the attachment of the placenta and solve the problem of partial presentation, and in some cases even stop the beginning of premature detachment of the placenta.

A few words to end the conversation ...
In one article it is impossible to tell about all the ailments and problems with which homoeopathic drugs effectively cope, or even simply list their main components. But this is not necessary. The main thing that a pharmacist should do when recommending a remedy for his customers is to remind him of the need for a follow-up consultation with a homeopathic doctor or at least an obstetrician-gynecologist.

Often, visitors to the pharmacy are interested in which of the dosage forms of homeopathic medicines is more effective, because the modern pharmacy has an impressive arsenal: water and alcohol drops for ingestion, sugar balls, granules and resorption tablets, ointments, oils and even sprays and injections. There is practically no significant difference in the effectiveness of such forms, the choice primarily depends on the individual ease of use. Some experts believe that the reception of pellets and granules allows you to more accurately observe the required dosage, and alcohol solutions and oils give a slightly higher risk of adverse reactions to the solvent. But all this is only the opinion of some homeopaths, which does not have any proven confirmation.

In general, it can be said that even complex homeopathic medicines that are not individually calculated are much safer than most traditional drugs and, with strict adherence to instructions, are not inferior to them in efficiency.


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How to treat a dysbacteriosis?

12 Oct 2018

Dysbacteriosis is a qualitative change in the composition of bacteria (microbiota) of the skin. For the prevention and treatment of this condition, drugs with different composition and mechanism of action are used.

How to treat a dysbacteriosis

In order to fill the deficit, normoflora is prescribed by living microorganisms, or probiotics. The most popular probiotic medicines include preparations of lacto-and bifidobacteria: Linex, Bifiform, Bifidumbacterin, Acipol, Lactobacterin, etc., for example, on yeast cultures - Enterol. Compared to the previous year, sales of Enterol increased by 61%. The share of the leader - Linex - accounts for 43% of sales of the entire group of drugs in value terms and 31.8% - in bulk.

Prebiotics include carbohydrates, which are not digested and not absorbed in the upper parts of the digestive tract; selectively fermented by the microflora of the colon, causing an active growth of beneficial bacteria. TOP10 includes prebiotics based on lactulose, a synthetic disaccharide used as a drug for the treatment of constipation and hepatic encephalopathy, and lignin, which also compensates for the lack of natural dietary fiber in human food, positively affecting the microflora of the large intestine and non-specific immunity. The sales volume of the lignin-based filter was up 2.1% in USD and 3.4% in packs. The increase in sales of lactulose preparations - Dufalac and Normase - reached a level of 35-36% in value terms.

Synbiotics, or combination preparations containing probiotics and prebiotics, are still in the role of outsiders in the market of drugs for the treatment of dysbacteriosis. For example, the share of Florin Fort does not exceed 0.3% - for this reason the drug did not get into the "top ten".

Top 10 drugs for the treatment of dysbacteriosis
1) Linex
2) Dufalac
3) Bifiform
4) Bifidumbacterin
5) Acipole
6) Bactisubtil
7) Enterol
8) Filter
9) Lactobacterin
10) Normaze


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Cirrhosis of the liver

11 Oct 2018

For the first time this term appeared in the literature in 1819. In our time, cirrhosis develops in 1-1.5% of the population of the Slavic countries. At what most often it is men in the age of 40 years. In 80-85% of cases, the main cause is alcoholism and viral hepatitis. Cirrhosis of the liver is a chronic liver disease that progresses rapidly and leads to the development of functional organ failure and portal hypertension (increased pressure in the system of vessels coming from the internal organs to the liver).

Cirrhosis of the liver Heptral, Layennec

When cirrhosis is formed, the liver cells die and replace them with a connective tissue (similar to the scars on the skin), the blood vessels of the liver are modified. This leads to the fact that the liver stops performing its usual functions.

Stages of cirrhosis of the liver
Currently, there are several different classifications of liver cirrhosis, which are based on different aspects of the disease.

Classification by morphological features:
- Micronodular, or small-node cirrhosis - the diameter of the nodules varies in the interval 1-3 mm;
- Macronodular, or coarse nodular cirrhosis - diameter of nodules from 3 mm or more;
- Mixed cirrhosis - a combination of nodules of various shapes;
- Incomplete septal cirrhosis.

Classification of cirrhosis due to its occurrence:
- Viral cirrhosis - develops against the background of viral hepatitis B or C;
- Alcoholic cirrhosis of the liver - develops from long consumption of a large amount of alcohol, which first leads to fatty liver, followed by alcoholic hepatitis, and at the end - cirrhosis;
- Medicinal cirrhosis - arises from the long-term use of certain medicinal substances, which in large quantities can adversely affect the liver cell (for example, some antibiotics);
- Secondary biliary cirrhosis;
- Congenital - develops in children in the absence of bile ducts;
- Stagnant, cardiac cirrhosis of the liver - in case of circulatory failure, which arises in case of heart disease;
- Syndrome and Badd-Chiari disease - patients are concerned about pain in the liver area (under the right hypochondrium), abdominal enlargement, fever, minor jaundice, very large liver, lower edge painful, spleen slightly enlarged, frequent bleeding from esophageal veins. For this form, the defeat of the posterior surface of the liver and the changes in the vessels are most characteristic;
- Alimentary cirrhosis - with diabetes mellitus, obesity;
- Cirrhosis with an unclear reason:

Cryptogenic cirrhosis of the liver is extremely rare. But has a tendency to rapid development of clinical symptoms and the onset of complications. Is a direct indication for a liver transplant.

Children's Indian.

Primary biliary cirrhosis - the main complaints with this form are pronounced itching of the skin and intense jaundice, later the weakness in the whole body, weight and pain in the area of bones are added. Complications occur later than with other forms of the disease.

Classification by stages of cirrhosis:
- Compensated cirrhosis of the liver;
- Subcompensated cirrhosis of the liver;
- Decompensated cirrhosis of the liver.

Classification by clinical course:
- Subacute cirrhosis is a transient phase between hepatitis and cirrhosis. Lasts from 5 months to 1 year.
- Rapidly progressive cirrhosis - complications and a vivid clinical picture develop very quickly. Life expectancy is about 5-6 years after the onset of the disease.
- Slowly progressive cirrhosis - symptoms gradually develop gradually, and there is a long-lasting absence of complications. The duration of this variant of the disease is more than 11 years.
- Sluggish - there are practically no clinical symptoms, changes in the analyzes are minimal. The duration of this form is more than 16 years.
- Latent cirrhosis of the liver - there is no change in the analyzes, no complaints, and there are no complications. Life expectancy does not depend on this cirrhosis. The diagnosis is made by chance, when diagnosing other diseases.

An example of a diagnosis: cirrhosis of the liver in the stage of decompensation, micronodular, alcoholic etiology, grade C according to Child-Pugh, varicose veins of the esophagus of the 2nd degree, hepatic encephalopathy of the first stage.

Symptoms and signs of liver cirrhosis
Symptoms of cirrhosis include pronounced general weakness, unmotivated memory impairment, fever, pain in the right upper quadrant, weight loss, nausea, abdominal enlargement, dry skin.

The signs that the doctor discovers during examination include the enlargement of the liver and spleen, red palms, smooth and bright red tongue, vascular "sprouts", veins on the abdomen ("jellyfish head"), scalp and inguinal region, jaundice, various hemorrhages in the body, varicose veins.

Treatment of cirrhosis of the liver
The main measures for treatment include: remove the effect of the causative factor; compliance with diet (refusal of alcohol, from fatty, fried, spicy food, from certain food products); treatment of the disease that caused cirrhosis (sorbents, hepatoprotectors Heptral, Layennec, detoxification therapy, antiviral and others- Phenotropil, Phenazepam).


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