3). Gastroprotectors. Classification. Mechanism of action. Indications for use. Side effects. Contraindications Comparative evaluation of drugs.

Gastroprotectors- funds acting directly on the gastric mucosa and reducing or preventing the effects of chemical and physical factors on it. Designed for the treatment of gastric ulcer and duodenal ulcer.

Classification:

1.Preparations that create mechanical protection of the mucous membrane:Bismuth tripotassium dicitrate (de-nol); Sucralfate (Venter, Antepsin, Ulcermin); Smecta

2. Drugs that increase the protective function of the mucous barrier and the resistance of the mucous membrane to the action of damaging factors:Carbenoxolone (biogastron); Misoprostol (Cytotec, Sayotech); Enprostil

Mechanism of action: reduce or prevent the damaging effects of irritating substances (by creating mechanical protection of the mucous membrane, by increasing the secretion of mucus).

Indications: peptic ulcer and duodenal ulcer.

Side effects: nausea, vomiting, stool disturbances, epigastric discomfort, dizziness.

Contraindications: severe renal failure (De-Nol), pregnancy, arterial hypertension, heart and renal failure (carbenoxolone).

Bismuth tripotassium dicitrate (De-nol, ulkavis)

is a colloidal suspension that, under the action of hydrochloric acid, forms a precipitate with a high affinity for the glycoproteins of the mucous membrane, especially the necrotic tissues of the ulcerative surface. As a result, the ulcer is covered with a protective layer. An important feature of the drug is its antimicrobial action against Helicobacter pylori.

Sukralfat (Venter)

at pH <4.0, i.e. in an acidic environment it polymerizes and forms a polyanion with many free negative bonds, which binds to positively charged radicals of the ulcerated surface of the gastric mucosa, forming a protective polymer film for 6 hours. Considering that hydrochloric acid is an activator of sucralfate polymerization, it cannot be combined with antisecretory and antacid agents.

Smecta - a medicinal product of natural origin with an enveloping ability, which forms a physical barrier that protects the mucous membrane from aggressive factors

Carbenoxolone (biogastron)isolated from licorice root, stimulates the secretion of thick, viscous mucus, increases the content of sialic acids in it, increases the life span of the integumentary epithelium of the gastric mucosa and its regenerative capacity. It should be remembered that carbenoxolone is similar in chemical structure to aldosterone, therefore it can retain sodium and water in the body and, as a result, cause edema, hypertension, hypokalemia and hypomagnesemia

Misoprostol (cytotec)

It is a synthetic analogue of prostaglandin E1, therefore, it increases the resistance of the mucous membrane to damaging factors by increasing microcirculation (trophism), increasing the production of thick, viscous mucus, increasing the formation of Na bicarbonate and reducing the production of HCl.

It is used mainly for the causal prevention of gastric and duodenal ulcers associated with the use of NSAIDs and glucocorticoids

four). The concept of antiseptic and disinfecting action. Conditions that determine the antimicrobial activity of drugs. Nitrofuran derivatives. Classification. Mechanism of action. The nature of the action. Spectrum of action. Indications for use. Side effects. Contraindications Comparative evaluation of drugs.

Disinfecting action is the action of drugs aimed at destroying pathogens in the external environment (neutralizing patient care items, rooms, clothing).

Antiseptic action is the action of drugs aimed at pathogens on the surface of the human body (skin, mucous membranes, wounds).

Conditions that determine the antimicrobial activity of drugs:

- establishing an accurate bacteriological diagnosis, establishing the sensitivity of a microorganism to various drugs.

- early start of treatment.

- creation and maintenance of a constant effective concentration of the antimicrobial drug in the body.

- it is desirable to use antimicrobial agents in combination (preventing the development of resistance).

- correct determination of the duration of treatment.

- in the complex of treatment, use means that increase the body's resistance (vitamins, serums).

Nitrofurans

Furadonin, Furagin, Furazolidone, Furacilin,

Nifuroxazide (enterofuril), Nifuratel (makmiror)

The nature of the action - bactericidal

Mechanism of action - violation of protein synthesis

Spectrum of activity - wide

Gr (+) cocci: streptococci, staphylococci (except MRSA),

enterococci are insensitive

Gr (-) coli: E. coli, salmonella, shigella, klebsiella, enterobacteria

The simplest: lamblia, Trichomonas (furazolidone, nifurantel), amoeba (nifurantel)

Resistant anaerobes, Pseudomonas aeruginosa, Proteus, Serrata, acinetobacters

Nitrofuran resistance is rare.

Furadonin and furagin create high concentrations in the urine, while the antimicrobial activity increases with an acidic reaction of urine and weakened - with an alkaline