Ticket 50

1. Side and toxic effects of medicinal substances. Allergic and non-allergic side effects. Toxicity. Teratogenicity. Embryotoxicity. Carcinogenicity. Idiosyncrasy.

Side effects - the rest (except for the main one, that is, beyond the scope of the purpose for which the medicine is prescribed), the effects of the drug when it is used in a therapeutic dose.

• Toxicity - the ability of a substance to cause disturbances in the physiological functions of the body. Toxic effect - medicinal substances develop, as a rule, with the growth of toxic doses of the substance into the body (in case of an overdose).

In case of an absolute overdose (with an absolute excess of single, daily and course doses), excessively high concentrations are created in the blood and tissues. Toxic effect also occurs with a relative overdose of the drug, with the appointment of medium therapeutic doses to patients who have a reduced detoxification function of the liver or excretory function kidney, with long-term treatment with medicinal substances capable of cumulation.

• Allergic reactions (allos-other, ergon-action) - These reactions, which occur when drugs are re-administered, are based on immune mechanisms. Drugs in this case act as allergens. Allergic reactions do not depend on the dose of the administered substance and are varied in their own way nature and severity: from mild skin manifestations to anaphylactic shock. • Teratogenic action (teras-freak) - develops during 4-8 weeks of pregnancy. At this time, the formation of the skeleton and the laying of internal organs occurs. At this stage of pregnancy, organs and tissues are most sensitive to the action of damaging factors. Therefore, the use of medicinal substances can lead to anomalies in the development of the skeleton and internal organs. • Embryotoxic effect (embryon - embryo) - drugs develops in the first 12 weeks of pregnancy. In the early stages of pregnancy (1-3 weeks), this is a consequence of the action of medicinal substances on the zygote and blastocysts located in the lumen of the fallopian tubes and uterus (before implantation), as well as on the process of implantation of the embryo into the uterus. • Carcinogenic decree (canser-cancer) - the ability of drugs to cause the development of malignant neoplasms.

• Idiosyncrasy is a genetically determined hypersensitivity that occurs in some people in response to certain nonspecific (as opposed to allergies) stimuli.

2. Ganglion blocking agents. Classification. Mechanism of action. Indications for use. Side effects. Contraindications. Comparative evaluation of the drug.

Ganglion blockers - These are drugs that selectively block the H-cholinergic receptors in the autonomic ganglia (sympathetic and parasympathetic). In addition, ganglion blockers block the H-cholinergic receptors of the chromaffin cells of the adrenal medulla (reducing the release of catecholamines), as well as the H-cholinergic receptors reflex arousal of respiratory and vasomotor)

Classification:

1. Short-acting: Gigronium (12-20 min.), Arfonad (15-20 min.), Imekhin (4-10 min.)

2.Medium duration: Pentamin (1-2 hours), benzohexonium (2-4 hours), Pachikarpin (4-6 hours)

3. Long-term action: Camphonium (6-8 hours), Pyrylene (8-12 hours) - an unfavorable effect on the central nervous system.

Mechanism of action: Ganglion blockers block sympathetic and parasympathetic ganglia, as well as n-cholinergic receptors of the cells of the adrenal medulla and the carotid glomerulus, they are referred to as antidepolarizing substances.

Pharmacological effects: sedative effect on the central nervous system, dilated pupil, decreased IOP, tachycardia, dilates blood vessels, lowers blood pressure, dilated bronchi, decreased tone of smooth muscles and peristalsis in the gastrointestinal tract, decreased tone of the bladder.

Indications: "Controlled" hypotension hypertensive crisis edema of the lungs, brain, trophic ulcers, burns open-angle glaucoma, peptic ulcer, bronchospasm.

Side effects: 1. Orthostatic collapse; 2.Hypotension; 3.Tachycardia; 4.Reduction of intestinal peristalsis; 5.Photophobia; 6. Atonic constipation.

Contraindications: 1.BP less than 100/60 mm Hg. 2.Gastrointestinal atony 3. Atony of the urinary tract; 4. Angle-closure glaucoma; 5.Adenoma of the prostate; 6 myocardial infarction

Pyrylene is well absorbed from the gastrointestinal tract, well penetrates the blood-brain barrier, has a stimulating effect on the myometrium.

Pentamine - high activity, pronounced selectivity, poorly absorbed in the gastrointestinal tract, so it is advisable to administer it intravenously.