3. Antihypertensive agents affecting water-salt exchange. Classification. Mechanism of action. Side effects. Contraindications. Comparative evaluation of preparations.

ANTI-HYPERTENSIVE DRUGS- blood pressure lowering agents.

Classification:

1) Saluretics :, dichlothiazide, furosemide, cyclomethiazide, hygroton, ethacrynic acid, triampur, amiloride.

Mechanism of action: Reduce the volume of extracellular fluid, Reduce cardiac output, gradually reduce OPS, blood pressure decreases. increase the excretion of sodium, chlorine and water ions in the urine.

Side effects: hypokalemia, hypomagnesemia, accumulation of uric acid in the blood.

Contraindications: renal, hepatic failure, hypokalemia.

2) Aldosterone antagonists: spironolactone (veroshpiron)

Mechanism of action: increase urinary excretion of sodium, chlorine, water ions, but does not cause hypokalemia and uric acid accumulation.

Side effects: vomiting, headache, with prolonged use of gynecomastia, allergies.

Contraindications: Addison's disease, severe renal failure, pregnancy.

Dichlothiazide - works for several hours.

Spironolactone - taken orally.

Furosemide - acts when administered intravenously up to 3 hours, inside - 4-8 hours. Active when there is resistance to other diuretics.

4. Antiseptics of aromatic and aliphatic series. Classification. Mechanism of action. Indications for use. Side effects. Contraindications. Comparative evaluation of preparations.

Classification:

Organic antiseptics: aromatic (phenol group, nitrofuran production, dyes), aliphatic (formaldehyde group, alcohols, detergents).

Phenol group - phenol, resorcinol, birch tar. Nitrofuran derivatives - furacilin. Dyes - brilliant green, ethacridine lactate, methylene blue. Formaldehyde group - formalin, lysoform. Alcohols - ethyl alcohol. Detergents - chlorhexidine, cerigel, roccal

The mechanism of action of different antiseptics is not the same, it is aimed either at protein denaturation, violation of the permeability of the plasma membrane, inhibition of enzymes important for the vital activity of microorganisms.

Detergents (for example, cerigel) disrupt the structure of the cell membrane, cause denaturation of proteins, inhibition of enzymes. Used for processing hands, tools

Nitrofurans with a broad spectrum of action, are destructive for gram-positive and g- (treatment of wounds, mucous membranes, for washing serous, articular cavities) side: sometimes causes sensitization, dermatitis

Phenols: for vegetative forms of bacteria and fungi. (Disinfection of tools, household items) side: headache, collapse, shortness of breath.

Resorcinol - less antiseptic, keratoplastic and keratolytic action; with skin diseases.

Tar - antimicrobial, keratoplastic, keratolytic, irritating effect; for skin diseases, scabies.

Furacilin - antibacterial action; for treating wounds, washing cavities.

Dyes - antiseptic effect, antidote for cyanide poisoning; outwardly for the treatment of wounds.

Formalin, lysoform - disinfectant and deodorizing for sweating, for washing hands.

Hexamethylenetetramine (urotropine) is an antiseptic for diseases of the urinary tract.

Alcohols - for disinfection of instruments, treatment of the hands of the surgeon and the operating field.