3. Antitussives. Classification Mechanism of action Indications for use Side effects Contraindications Comparative assessment of drugs

Classification: 1) Central type of action: A) Narcotic type of action: CODEIN; CODEINE PHOSPHATE; ETHYLMORPHINE HYDROCHLORIDE; DEXTROMETORFAN

C) Non-narcotic action: GLAUCIN HYDROCHLORIDE; OXELADIN; LADY; BITIDION; BUTAMIRAT

2) Peripheral type of action: Prenoxidiazine; LEVODROPROPEZIN

3) Mixed action type: BITHIODINE

• Mechanism: centrally acting HP-inhibit dts. Peripheral action - associated with anesthetic effect on the mucous membrane of the upper respiratory tract, as well as bronchodilator properties.

• Indication: bronchitis; pneumonia; tracheitis; tracheobronchitis; pleurisy; bronchial asthma in various forms; whooping cough; lungs' cancer; tuberculosis

• Side effects: Dizziness; nausea; weakness; decrease in blood pressure; allergic reactions.

Contraindications: Hypersensitivity arterial hypotension myocardial infarction hyperproduction of sputum.

Codeine has a pronounced antitussive activity, in addition, it has a weak analgesic effect. In terms of the effect on the cough center of ethylmorphine hydrochloride, it is similar to codeine, but somewhat more active.

4. Antibiotics of the cephalosporin group. Classification. Mechanism of action. The nature of the action. Spectrum of action. Indications for use. Side effects. Contraindications Comparative evaluation of drugs.

Classification:

a) Generation I (highly active against G + bacteria): cefazolin, cephalothin, cefapirin, cefradine, cephalexin

b) Generation II (highly active against G-bacteria): cefamandol, cefuroxime, cefaclor, cefoxitin, cefmetazole

c) III generation (with high activity against Pseudomonas aeruginosa): cefotaxime, ceftazidime, cefoperazone, cefixime

d) IV generation (active against bacteroids and other anaerobes): cefpirome

Mechanism: inhibit the synthesis of peptidoglycan of the cell wall, inhibit the synthesis of murein. prevent the formation of peptide bonds due to transpeptidase.

Character: bactericidal action.

I - act on gram (+) and some gram (-) and do not act on Pseudomonas aeruginosa, Proteus, bacteroids

II - act on gram (+) and some gram (-), proteus and enterobacteria, do not act on Pseudomonas aeruginosa

III - stronger by gram (-), penetrate the BBB;

IV - act on gram (+), Pseudomonas aeruginosa, gram (-)

Spectrum: wide. Penicillinase resistant, but destroyed by beta-lactamase (I).

IndicationsI:

• urinary, respiratory tract infections

• meningitis

• prevention of septic complications during surgery

• pyelonephritis, cystitis

• streptococcal tonsillopharyngitis

• exacerbation of chronic bronchitis

• community-acquired pneumonia requiring hospitalization

• community-acquired infections of the skin and soft tissues of mild to moderate severity

• infections against the background of neutropenia and immunodeficiency states

• sepsis

Side effects:

• allergies

• kidney damage

• diarrhea

• bleeding

• thrombocytopenia

• dysbiosis

• pseudomembranous colitis

Contraindications:

• hypersensitivity

• pregnancy

• breast-feeding

• gastrointestinal diseases

• bleeding

Cefazolin - penetrates the placental barrier, lasts 6-8 hours.

Cefuroxime - resistant to beta-lactamases, penetrates the BBB, lasts 6-8 hours.

Ceftriaxone - resistant to beta-lactamases, penetrates the BBB, acts for 24 hours.

Cefepim - resistant to beta-lactamases, penetrates the BBB, lasts 12 hours