3. Glycosidic intoxication. Preventive and emergency measures.

Poisoning: 1) cardiac symptom - a sharp bradycardia (vagus), then tachycardia (the vagus is excited, but sharply ↑ myocardial automatism), extrasystole (loss of K +), bifurcation of the rhythm, partial or complete block (the ventricles have their own rhythm - fibrillation and flickering); 2) gastrointestinal tract - loss of appetite, nausea, vomiting; 3) CNS - anxiety, hallucinations, ↓ vision; 4) diuresis ↓ sharply; 5) shortness of breath ↑.

Assistance measures: 1. Cancellation of the drug or dose reduction; 2. Introduction of potassium preparations; 3. Binding of calcium ions (sodium citrate, EDTA-disodium salt); 4. Introduction of donors of sulfhydryl groups (unitiol, cysteine, taurine); 5. Decrease in myocardial excitability (anaprilin); 6. Control of arrhythmias by specific means (diphenin, lidocaine); 7. Preparations of vitamins B and E; 8. Metabolic agents - succinic acid and its derivatives (sufan), riboxin (inosine); 9. Camphor; 10. Cholesteramine, activated carbon; 11.Atropine sulfate (for blockages); 12. Blood transfusion; 13. Oxygen therapy.

4. Antibiotics of the penicillin group. Classification. Mechanism of action. Action character. Spetr of action. Indications for use. Side effects. Contraindications Indications. Comparative evaluation of drugs.

Classification: Natural (biosynthetic)

Parenteral: short-acting (3-4 hours) benzylpenicillin sodium salt

long-acting (depot-penicillin): benzylpenicillin novocaine salt, bicillin 1.5

Oral: phenoxymethylpenicillin

Semi-synthetic: a) resistant to penicillase: oxacillin, nafcillin, cloxocillin.

b) Broad spectrum of action: ampicillin, amoxicillin

c) A broad spectrum of action with antipseudomonal activity: carbenicillin

d) Inhibitor-protected: amoxiclav, trifamox, tazocin, tymentin.

e) Combined: ampiox.

Mechanism: inhibit the synthesis of cell wall components, prevent the formation of peptide bonds.

Mode of action: bactericidal, affect only dividing cells.

Spectrum e: gram (+) predominantly staphylococci, streptococci, meningococci, gonococci, spirochetes, clostridia, causative agents of diphtheria, anthrax, listeria.

Indications: upper respiratory tract infections (scarlet fever), erysipelas, rheumatism, pneumonia, meningitis, endocarditis, syphilis, leptosporosis, anaerobic infections.

Side effects: allergies, dysbiosis, glossitis, stomatitis, dyspepsia.

Contraindications: individual intolerance, allergies.

Benzylpenicillins act briefly (3-4 hours), bicillin - long-term (once every 7-14 days, months). Oxacillin is resistant to penicillinase, it is destroyed in an acidic environment. Nafcillin penetrates the BBB. Ampicillin is destroyed by penicillinase, acid-resistant. Carbenicillin is destroyed in an acidic environment and by penicillinase.

Benzylpenicillin is widely used in pediatrics because low toxicity, it can be administered in large doses. Not effective when taken by mouth, even in young children with low gastric acidity. Penicillin is a GABA antagonist and can cause seizures when given in large doses. The younger the child, the greater the risk of developing seizures. Ampicillin, when administered orally, causes diarrhea in a third of children. Oxacillin is capable of impairing liver function.