Ticket 17.

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 violations of the physiological functions of the body.

The toxic effect of medicinal substances develops, 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 drugs 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 non-specific (as opposed to allergy) stimuli.

2. Analeptics. Classification. Mechanism of action. Indications for use. Side effects. Contraindications Comparative evaluation of drugs.

Analeptics are a group of drugs that primarily excite the centers of the medulla oblongata - vasomotor and respiratory.

Classification:

1. Analeptics of direct action: caffeine, cordiamine, bemegrid, camphor, etymizole.

2.Analeptics of reflex action: cititon, lobelin.

Mechanism of action: Analeptics increase the excitability of the respiratory center. Its sensitivity to humoral stimuli and nerve stimuli increases. In some analeptics, the central action is complemented by a reflex one (from the chemoreceptors of the carotid sinus zone). Analeptics excite not only the respiratory, but also the vasomotor center. They lead to an increase in the total peripheral vascular resistance and an increase in blood pressure.

Camphor, in addition to its analeptic properties, can also have a number of effects. Locally: irritating effect on the skin and mucous membranes, improving blood circulation, if it enters the gastrointestinal tract, it has a weak deodorizing, choleretic, antimicrobial effect. After absorption: improves tissue respiration, metabolic processes; displaces toxic substances from the surface of cells; constricts peripheral vessels, dilating the vessels of the lungs and heart; inhibits platelet aggregation.

Indications: 1. Respiratory depression, asphyxia of newborns.

2. Poisoning with drugs, sleeping pills.

3. Acute and chronic circulatory disorder.

4. Shock state

5. To speed up the urge after anesthesia.

Side effects: Bemegrid: nausea, vomiting, convulsions.

Etimizole: nausea, dyspepsia

Contraindications: Tendency to seizures.

Comparative characteristics: 1. A solution of camphor in oil reflexively acts from the injection site

2.Cityton reflex action from chemoreceptors of the carotid sinus zone,

3. Caffeine-sodium benzoate dilates blood vessels, bicyclic ketone (terpene) constricts blood vessels.

4.Cordiamin has a greater effect on the vasomotor center

5. Bemegrid has a greater effect on the respiratory center.