Ticket 35

1) Hometopathy, basic principles. Assessment of the homeopathic method.

2) Nootropics. Classification. Mechanism of action. Indications for use. Side effects. Contraindications Comparative characteristics

3) Drugs used in myocardial infarction. Classification. Mechanism of action. Side effects. Contraindications Indications for use. Comparative characteristics

4) Antibiotics for the group of macrolides and aminoglycosides. Classification. mechanism of action, indications for use. contraindications. side effects. comparative characteristic.

6. Homeopathy, basic principles. Evaluation of the homeopathic treatment method.

Homeopathy- a system of treatment with small doses of drugs. Proposed at the end of the 18th century by the German physician Hahnemann. He proved that the paradoxical fact of curing the disease with "similarly acting" drugs has a certain pattern. Hahnemann called this pattern "the law of similarity." This is how homeopathy arose - a method of treating diseases through the use of similar agents.

After homeopathic exposure, five prediction options are possible:

1. Preservation of health (absence of diseases)

2. Rapid improvement of well-being and recovery

3. A short-term (up to several days) intensification of the manifestations of the disease for which homeopathic treatment was used is an option for the correct treatment of chronic diseases (skin, joints, nervous system, etc.), followed by an improvement in the patient's condition ("convalescence", " remission "), or recovery.

4. Lack of effect for several days after taking homeopathic remedies - possibly after taking "slow" drugs (heavy metal salts)

5. Deterioration of well-being, the appearance of new, unfamiliar and unusual symptoms for the patient - indicates improper treatment that requires immediate correction.

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

Nootropic drugs (Greek noos - soul. Thought, tropos - direction) - a group of drugs that have a selective mnemotropic effect, improve the higher integrative functions of the brain - intelligence, attention, short- and long-term memory, creating the ability to quickly reproduce information, accelerating learning, as well as weakening the perception of stressful situations and increasing the brain's resistance to harmful influences.

Classification

1. Means affecting specific neurotransmitter systems

∙ Catecholaminergic drugs PIRIBEDIL

(pronoran,)

GUANFACIN

(estulik)

∙ GABAergic agents: ∙ GABA AMINALON

(gammalon, ganervin)

∙ GABA + nicotine acid PICAMILON

∙ phenyl derivative of GABA PENIBUT

2. Drugs with neurometabolic action

∙ Animal origin ACTOVEGIN

∙ Plant origin EXTRACT

LEAVES

GINKGO BILOBA

(tanakan, ginos,

bilobil, memoplant)

∙ Synthetic: ∙ amino acids GLYCINE (glycol)

∙ analogue of coenzyme Q10 IDEBETON (noben)

∙ pyrrolidone derivatives PIRACETS

(nootropil)

(cyclic derivatives of GABA) EPIRACETS

AMERACETS

OXYRATE

POLSIRACETAM

∙ pyridoxine derivatives PYRIDITOL (enerbol,

pyritinol, ecephabol)

GLUTAMINE ∙ ∙ dimethylamineethanol derivatives DEMANOL

ECLIDAN

ACEFEN

∙ HOPANTHENIC ACID (pantogam)

3. Drugs with neurotrophic action

CORTEKSIN

Cerebrolysin

4. Funds with vasoactive action

∙ Ca² antagonists + CINNARIZINE (stugerone, vertizin)

∙ Derivatives of alkaloids DIHYDROERGOCRYPTIN

ergot NITSERGOLIN (sermion)

∙ Derivatives of alkaloids CAVINTON (vinpocetine)

periwinkle VINKAMIN (oxybral)

VINCANOR

5. Combined funds

FESAM (PIRACETS + CINNARIZINE)

Mechanisms of action

1. Improving the bioenergetics of the brain.

Nootropic drugs increase the synthesis of ATP and cAMP, glucose utilization, increase glycolysis and aerobic respiration, and promote an increase in the activity of adenylate cyclase (for aging and neuropsychiatric diseases, energy deficiency and a decrease in the activity of adenylate cyclase in neurons are characteristic).

2. Increased synthesis and release of neurotransmitters.

Nootropic drugs activate the synthesis, release and turnover of dopamine, norepinephrine, acetylcholine, inhibit MAO, increase the formation of β - adrenergic receptors, cholinergic receptors and neuronal uptake of choline. In the mechanism of neurotransmitter release, the blockade of potassium channels is important, which facilitates membrane depolarization.

3. Increase in protein synthesis and membrane phospholipids.

Nootropic drugs improve the regeneration of neurons, activate their genome and increase the synthesis of informational neuropeptides, enhance the metabolism of phosphatidylcholine and phosphatidylethanolamine.

4. Improvement of cerebral blood flow and hemorheological parameters.

Nootropic drugs dilate cerebral vessels, improve blood flow in areas of cerebral ischemia, prevent the development of cerebral edema, block platelet aggregation, thrombus formation, improve the elasticity of erythrocytes and microcirculation. Nicotinic acid in PICAMILON has a direct vasodilating and anti-sclerotic effect.

5. Antioxidant action.

Nootropic drugs, inhibiting free radical peroxidation, protect against destruction of phospholipids of neuronal membranes, which facilitates the fixation of memory traces. Lipid peroxidation increases in the brain during organic diseases, aging and stress.

6. Potentiation of non-tropic effects of memory neuropeptides

PIRACETAM, whose pyrrolidone ring does not open to form a linear GABA molecule, is an agonist of receptors that receive signals from memory neuropeptides (fragments of ACTH, vasopressin, substance P). In terms of chemical structure, PIRACETS is similar to the cyclic form of the terminal amino acid of memory neuropeptides - pyroglutamate and affects receptors as an exogenous ligand. Probably, the most important for the mnemotropic action of PIRACETAM is the activation of AMPA - glutamic acid receptors.