3. Antihypertensive drugs of central neurotropic action. Classification. Mechanism of action. Side effects. Contraindications Comparative evaluation of drugs.

Classification:

I GENERATION:

1) Central alpha-2 receptor stimulants:

-CLOFELINE

-GUANFACIN

2) Centrally acting sympatholytics:

-METHYLDOPA

-RESERPINE

Side effects: Drowsiness, lethargy, depression.

II GENERATION:

1) Stimulants of central imidazoline receptors:

-MOXONIDINE

Side effects: To a lesser extent, they depress the central nervous system, less often cause dry mouth, weakness, dizziness.

Mechanism of action: Reduces the activity of the vasomotor center and hypothalamic centers of vascular regulation.

Contraindications: hepatitis, liver cirrhosis, depression, parkinsonism.

Moxonidine - used once a day, there is no sedative effect.

Methyldopa - dilates blood vessels, slows the heart rate, improves cerebral circulation, sodium and water retention.

Reserpine - Slow action, maximum 2-4 weeks.

4. Antibiotics of the penicillin group... Classification. Mechanism of action. Side effects. Contraindications Comparative evaluation of drugs.

Classification: Natural (biosynthetic)

Parenteral: short-acting (3-4 hours) benzylpenicillin sodium salt

long-acting (depot-penicillin): benzylpenicillin novocaine salt, bicillin 1.5

Oral: phenoxymethylpenicillin

Semi-synthetic: a) resistant to penicillase: oxacillin, nafcillin, cloxocillin.

b) Broad spectrum of action: ampicillin, amoxicillin

c) A broad spectrum of action with antipseudomonal activity: carbenicillin

d) Inhibitor-protected: amoxiclav, trifamox, tazocin, tymentin.

e) Combined: ampiox.

Mechanism: inhibit the synthesis of cell wall components, prevent the formation of peptide bonds.

Mode of action: bactericidal, affect only dividing cells.

Spectrum e: gram (+) predominantly staphylococci, streptococci, meningococci, gonococci, spirochetes, clostridia, causative agents of diphtheria, anthrax, listeria.

Indications: upper respiratory tract infections (scarlet fever), erysipelas, rheumatism, pneumonia, meningitis, endocarditis, syphilis, leptosporosis, anaerobic infections.

Side effects: allergies, dysbiosis, glossitis, stomatitis, dyspepsia.

Contraindications: individual intolerance, allergies.

Benzylpenicillins act briefly (3-4 hours), bicillin - long-term (once every 7-14 days, months). Oxacillin is resistant to penicillinase, it is destroyed in an acidic environment. Nafcillin penetrates the BBB. Ampicillin is destroyed by penicillinase, acid-resistant. Carbenicillin is destroyed in an acidic environment and by penicillinase.

Benzylpenicillin is widely used in pediatrics because low toxicity, it can be administered in large doses. Not effective when taken by mouth, even in young children with low gastric acidity. Penicillin is a GABA antagonist and can cause seizures when given in large doses. The younger the child, the greater the risk of developing seizures. Ampicillin, when administered orally, causes diarrhea in a third of children. Oxacillin is capable of impairing liver function.