Indications:

• Acute cystitis, prevention of exacerbations in chronic pyelonephritis, prevention of infectious complications in urology (operations, cystoscopy, catheterization)

NB! In acute pyelonephritis, they are not used, because poorly penetrate the kidney tissue

Nifuroxazide (Enterofuril)used for intestinal infections (acute infectious diarrhea, enterocolitis). Practically not absorbed in the digestive tract. Does not disturb the normal intestinal microflora

Furazolidoneis currently used only for giardiasis as a reserve drug. NB! In combination with alcohol, it can cause a teturam-like reaction. Inhibits MAO, therefore, in combination with other MAO inhibitors, sympathomimetics, tricyclic antidepressants and tyramine-containing foods, there is a risk of developing a hypertensive crisis

Nifuratel (makmiror) used for intestinal infections (acute infectious diarrhea, enterocolitis), giardiasis, intestinal amebiasis, trichomonas vulvovaginitis

Furacilin is used as an antiseptic for treating wounds, skin, mucous membranes, for washing serous and articular cavities

Side effects

Hepatotoxicity: cholestasis, jaundice, hepatitis

Hematotoxicity: hemolytic anemia (with a deficiency of glucose-6-phosphate dehydrogenase in erythrocytes), leukopenia, agranulocytosis, thrombocytopenia

Neurotoxicity: dizziness, nystagmus, intracranial hypertension, paresthesia

Gastrointestinal tract: nausea, vomiting (taken with or after meals)

Allergic reactions

Pulmonary reactions (furadonin): bronchospasm, pulmonary edema, pulmonary fibrosis

Teturam-like effect (furazolidone)

Tyramine syndrome (furazolidone)

Ticket number 24

one). Changes in the body's reactions to medicinal substances during their repeated administration. Concepts of addiction, drug dependence, tachyphylaxis, sensitization. Cumulation of medicinal substances. Social aspects of drug abuse. The harm of self-medication.

Repeated administrations of the same drug substance can lead to a quantitative (increase or decrease) and qualitative change in the pharmacological effects.

Among the phenomena observed with repeated administration of drugs, there are cumulation, sensitization, addiction (tolerance) and drug dependence.

Cumulation (from Lat. cumulatio - increase, accumulation) - the accumulation of a medicinal substance in the body or the effects it causes.

Material cumulation - an increase in the blood and / or tissue concentration of a drug substance after each new administration in comparison with the previous concentration. Drugs that are slowly inactivated and slowly excreted from the body, as well as drugs that firmly bind to blood plasma proteins or are deposited in tissues, for example, some hypnotics from the barbiturate group, digitalis drugs, can accumulate with repeated injections. Material accumulation can cause toxic effects, which must be taken into account when dosing such drugs.

Functional cumulation is an increase in the effect of a drug with repeated injections in the absence of an increase in its concentration in the blood and / or tissues. This type of cumulation occurs with repeated intake of alcohol. With the development of alcoholic psychosis ("delirium tremens") in susceptible persons, delusions and hallucinations develop at a time when ethyl alcohol has already been metabolized and is not detected in the body. Functional cumulation is also characteristic of MAO inhibitors.

Sensitization.Many medicinal substances form complexes with blood plasma proteins, which acquire antigenic properties under certain conditions. This is accompanied by the formation of antibodies and sensitization of the body. Repeated administration of the same medicinal substances causes allergic reactions. Often such reactions occur with repeated injections of penicillins, procaine, water-soluble vitamins, sulfonamides, etc.

Addictive(tolerance, from Lat. tolerantia - patience) - a decrease in the pharmacological effect of a drug when it is repeated in the same dose. With the development of addiction, in order to achieve the previous effect, it is necessary to increase the dose of the drug. Tolerance develops to both the therapeutic and toxic effects of drugs. For example, with prolonged use of morphine, tolerance arises not only to its analgesic effect, but also to the depressing effect on the respiratory center. So, the main reason for addiction to phenobarbital is considered to be the activation of its metabolism due to the induction of liver enzymes caused by phenobarbital itself. Drug addiction can develop over days or months.

A special case of addiction is tachyphylaxis (from the Greek tachys - fast, phylaxis - protection) - the rapid development of addiction with repeated injections of the drug at short intervals (10-15 minutes). Another special case of addiction is mitridatism - the gradual development of insensitivity to the action of the drug and poisons, which occurs during their prolonged use, first in very small, and then in increasing doses.

Drug addiction - an urgent need (irresistible urge) to constantly or periodically resume the intake of a certain drug or group of substances. First, the substance is taken to achieve a state of euphoria, well-being and comfort, eliminate painful experiences, test new sensations. However, after a certain time, the need for repeated admission becomes insurmountable, which is aggravated by the withdrawal syndrome: the emergence of a severe condition associated with mental and somatic disorders (dysfunctions of organs and body systems) when the drug is discontinued. This condition is designated by the term "abstinence" (from Latin abstinentia - abstinence).

Distinguish between mental and physical drug dependence.

Psychic drug dependence is characterized by a sharp deterioration in mood and emotional discomfort, a feeling of fatigue when deprived of the drug. It occurs with the use of cocaine and other psychostimulants (amphetamine), hallucinogens (lysergic acid diethylamide, LSD-25), nicotine, Indian hemp (marijuana, hashish, plan, marijuana).

Physical drug dependence is characterized not only by emotional discomfort, but also by the occurrence of withdrawal symptoms.

Physical drug addiction develops to opioids (heroin, morphine), barbiturates, benzodiazepines, alcohol (ethyl alcohol).

Drug dependence is often combined with addiction, while increasing doses of the substance are required to obtain euphoria. The most severe drug dependence occurs in the case of a combination of mental dependence, physical dependence and addiction.