I. Means acting on the central nervous system.

• 1. Means for anesthesia. For general anesthesia in modern anesthesiology, various drugs are used. In the process of preparation for the operation, premedication is carried out, including the appointment of sedative, analgesic, homeolytic, cardiovascular and other drugs to the patient. The use of these drugs is intended to reduce the negative impact on the body of emotional stress preceding the operation, and to prevent possible side effects associated with anesthesia and surgery. The use of a modern arsenal of drugs in anesthesiology facilitates surgical operations, reduces their duration, expands the possibilities of surgical treatment of various diseases, and reduces the risk for the patient during complex operations. Means for anesthesia are divided into:
  • a) Chloroethyl (Aethylii chloridum) C 2 H 5 Cl

Chloroethyl is a powerful narcotic. Anesthesia develops quickly, within 2-3 minutes, the stage of excitation is short. Awakening comes quickly.

The main disadvantage of chloroethyl is its low therapeutic range and, therefore, the danger of overdose. Chlorethyl is rarely used for anesthesia, mainly for induction or very short-term anesthesia. Sometimes used for superficial anesthesia. Used to treat erysipelas, neutromyositis, neuralia, thermal burns.

• b) barbiturans and non-barbiturans.
• 2. Sleeping pills. Barbituric acid is the basis of the structure of numerous modern hypnotics, narcotics and anticonvulsants. In recent years, in connection with the emergence of new drugs, g.o. tranquilizers and hypnotics of the benzodiazepine series, barbiturates, due to the side effects they cause, have become less commonly used as hypnotics and sedatives. Nitrazenam and diphenhydramine are widely used as hypnotic drugs.
• 3. Psychotropic drugs. The first modern psychotropic drugs were created in the early 1950s. The main drugs used for this purpose were hypnotics and sedatives, insulin, caffeine, etc. Now, a lot of medicines, one of them is promagsan. (fig.8.)
• 4. Anticonvulsants. The anticonvulsant effect can be exerted by various substances that weaken the processes of excitation or enhance the processes of inhibition in the central nervous system. As anticonvulsants, bromides, chloral hydrate, magnesium sulfate, barbiturates, especially phenobarbital, as well as tranquilizers of the benzodiazepine group and others are used.

Central mifelaxants and curare-like drugs can also prevent and relieve convulsions.

• 5. Means for the treatment of parkinsonism. "Parkinson's disease is a chronic disease of the brain, expressed in trembling of the limbs, head, slowness of movement, general stiffness and increased muscle tone"9 For the treatment of parkinsonism, the following are used:
  • a) antiparkinsonian anticholinergic drugs
  • b) antiparkinsonian drugs that affect the dopamineric systems of the brain.

For example, Amedin (Amedinum) 2-dimethylaminoethyl ester of phenylcyclohexylglycolic acid hydrochloride:

6. Analgesics and non-steroidal anti-inflammatory drugs. Analgesics, or analgesics, are drugs that have a specific ability to reduce or eliminate the feeling of pain. Analgesic (analgesic) effect can have not only analgesics themselves, but also other substances belonging to different pharmacological groups.

According to the chemical nature, nature and mechanisms of pharmacological activity, modern analgesics are divided into two main groups:

narcotic analgesics

non-narcotic analgesics

Non-narcotic analgesics are further divided into 3 subgroups:

• a) analgesics - antipyretics. In today's medicine, medicines such as panadol (Fig. 9), Stadol (Fig. 10), Coldrex (Fig. 11) are used.
• b) non-steroidal anti-inflammatory drugs
• c) different drugs that have an anti-inflammatory effect.
• 7. Emetic and antiemetic drugs. Vomiting is often a protective act aimed at freeing the stomach from irritating and toxic substances that have entered it. In such cases, this is a physiological process, which may require the use of special drugs (emetics) to accelerate it. However, in some cases, vomiting is a concomitant process that worsens the condition of the body.

Metoclopramide (Metoclopramidum) 4Amino-5-chloro-N-(2-diethylaminoethyl)-2-2methoxybenzamide hydrochloride:

The drug has an antiemetic effect, soothes hiccups and, in addition, has a regulatory effect on the functions of the gastrointestinal tract. The tone and motor activity of the digestive organs is enhanced.

II. Drugs acting on the peripheral NS.

• 1. Means acting on peripheral cholinergic processes. Medicinal substances that enhance cholinergic neuromediation constitute a group of cholinomimetic substances; cholinomimetic effect is also exerted by anticholipester substances. Substances that weaken or block cholinergic mediation constitute a group of anticholinergic substances. Substances that block the transmission of nervous excitation in the area of ​​cholinergic endings of motor nerves include curare-like drugs.
• a) Acetylcholine and cholinomimetic substances.
• b) Anticholinesterase drugs.
• c) Anticholinergics blocking predominantly peripheral cholinergic systems.
• d) goglioblocking drugs.
• e) Curare-like drugs.
• 2. Means acting on peripheral adrenergic processes. The endogenous adrenaline formed in the body plays mainly the role of a hormonal substance that affects metabolic processes.

Norepinephrine carries out a mediator function in peripheral nerve endings and in the synapses of the central nervous system. Biochemical tissue systems that interact with norepinephrine are called adrenoreactive systems, or adrenfeeters.

Now such drugs are used: digiderut (Fig. 12) and tailed (Fig. 13)

• 3. Dophalin and dopalineric drugs. Dophalin, obtained synthetically, has recently found use as a drug. Dophalin is a biogenic amine formed from 1-tyrosane. As a neurotransmitter, it plays an important role in the activity of the central nervous system. Sun influence on dopalineric processes of the brain is associated with the mechanism of action of a number of neutron, including psychotropic drugs.
• 4. Histamine and antihistamines. Histamine is a biogenic amine formed by decarboxylation of the amino acid histadine. It is found in the body of humans and animals. It is one of the chemical factors involved in the regulation of vital functions. A lot of histamines are known in pharmacology, these are: intal plus (Fig. 14), claritin, ebastine (Fig. 15) and others.
• 5. Serotonin, serotonin-like and antiserotonin drugs. The physiological role of serotonin is not well understood. In the central nervous system, he plays the role of a mediator. The mechanism of action of a number of psychotropic drugs is associated with the influence on the biosynthesis of serotonin, its metabolism and interaction with receptors. The peripheral action of serotonin is characterized by contraction of the smooth muscles of the uterus, intestines, bronchi and other smooth muscle organs, constriction of blood vessels. It is one of the mediators of inflammation, has a pronounced edematous effect when applied topically. It has the ability to shorten bleeding time, improve the quality of platelets in peripheral blood, and increase platelet aggregation. When platelets aggregate, serotonin is released from them.

For use in medical practice, serotonin is obtained synthetically in the form of a salt with adipic acid.

III. Means that act mainly in the area of ​​\u200b\u200bsensitive nerve endings.

1. Local anesthetic drugs. Means that have a local anesthetic effect. Such: cocaine, anesthesin, novocaine, lidocaine, trimecaine, pyromecaine, dicaine, sovkaine.

Novocaine

Novocaine is widely used for local anesthesia: mainly for infiltration and spinal anesthesia and for therapeutic blockades.

• 2. Enveloping and adsorbing agents. These drugs are used for gastric ulcer, duodenal ulcer, acute and chronic hyperacid gastritis, esophagitis and other gastrointestinal diseases, in which a decrease in acidity and proteolytic activity of gastric juice is shown. Among such preparations are gitah and fimosan (Fig. 16,17).
• 3. Astringents are divided into:
  • a) herbal astringents
  • b) metal salts.
• 4. Means, the action of which is mainly associated with irritation of the nerve endings of the mucous membranes and skin:
  • a) products containing essential oils
  • b) bitterness
  • c) products containing ammonia
  • d) products containing aliphatic hydrocarbons.
  • e) products containing dichlorodiethyl sulfide and other substances that irritate the skin.
• 5. Expectorants. Expectorants are widely used to remove sputum from the pulmonary tract in various pathological processes. The drugs used for this purpose are currently divided into two main groups:
  • a) drugs that stimulate expectoration
  • b) mucolytic agents.

Means that stimulate expectoration enhance the physiological activity of the ciliated epithelium and the peristaltic movements of the bronchioles. One of the highly effective drugs for the treatment of acute chronic respiratory diseases in children and adults is ambrosan (Fig. 18).

• 6. Laxatives. The action of laxatives is associated with g.o. with reflex effects on intestinal motility, causing acceleration of its emptying. According to the mechanism of action, the main laxatives are divided into three groups:
  • a) means that cause chemical irritation of the receptors of the intestinal mucosa.
  • b) drugs that cause an increase in volume and dilution of intestinal contents
  • c) agents that help soften feces.
  • d) various laxatives and carminatives.

IV. Means acting on the cardiovascular system.

• 1. Cardiac glycoses. The main drugs that have a selective cardiotonic effect and are used to treat heart failure are preparations from plants containing cardiac glycoses.
• 2. Antiarrhythmic drugs. Substances belonging to different classes of chemical compounds and belonging to different pharmacological groups can have a normalizing effect on the disturbed rhythm of heart contractions. Means that have an antiarrhythmic effect can be divided into two main groups:
  • a) agents acting directly on the myocardium and the conduction system of the heart (quinidine, novocainamide, aymaline, ethmosine, lidocaine, potassium salts, etc.)
  • b) drugs, the activity of which is associated with an effect on the efferent innervation of the heart (anticholinergics and cholinomimetics, sympatholytics, etc.)
• 3. Vasodilators and antispasmodics. Antiaginal drugs. Spasmolytic action, i.e. lowering the tone and relieving spasms of smooth muscles of internal organs and blood vessels can be achieved with the help of various neurotropic substances and agents that have a direct effect on smooth muscles.

Antiaginal drugs are drugs used to stop and prevent angina attacks. As antiaginal agents, agents that increase the resistance of tissues to hypoxia, anabolic and other drugs are also used. For example: tanakan (Fig. 19), osmo-adalat (Fig. 20).

• 5. Drugs that improve cerebral circulation. A number of combined preparations containing papaverine, no-shpu, caffeine, dibazol, nicotinic acid, etc. are used as drugs that relieve spasms of cerebral vessels. Among the drugs that have a relatively selective cerebrovascular effect include cinnarizine, devincan, cavinton (Fig. 21), nimoton (Fig. 22)
• 6. Antihypertensive properties. Drugs used to treat hypertension include three main groups:
  • a) substances of neutron action
  • b) substances that affect the water-salt balance and reduce the volume of blood plasma.
  • c) substances that dilate peripheral vessels

Recently, calcium antagonists have also been used as hypertensive drugs. For greater effectiveness, often resort to the combined use of various antihypertensive drugs. Effective preparations: nificard (Fig. 23), Diovan (Fig. 24), monocryl (Fig. 25)

7. Antispasmodics of different groups. Painkillers. The well-known ones are used: papaverine, dibazol, dimidine, kellin, pihexin, no-shpa, siralud (Fig. 26)

Applied with spasms of the stomach and intestines, static constipation, attacks of gallstones and urolithiasis, peptic ulcer of the stomach and duodenum, as well as spasms of peripheral vessels. Sometimes I prescribe (intramuscularly) along with other antispasmodic and analgesic drugs for the relief of angina attacks. The drug is usually well tolerated.

• 8. Substances affecting the angiotensin system. Angiotensins are peptides formed in the body from angiotensinosen β-globulin. For example: angiotensinamide.
• 9. Angioprotectors. A number of drugs that improve microcirculation, normalize vascular permeability, reduce swelling of vascular tissues and improve metabolic processes in the walls of blood vessels, have recently found wide application in the treatment of various angiopathy: diabetic angiopathy, vascular permeability disorders in rheumatoid diseases, atherosclerotic vascular lesions, venous diseases with congestive and inflammatory phenomena, with trophic ulcers, permeability disorders associated with an overdose of anticoagulants, etc.

Angioprotective action is exerted by preparations of the vitamin P group, ascorbic acid, anti-inflammatory substances, especially non-steroidal ones, etc.

Recently, parmidine, etamsylate, dobesilate-calcium, tribenoside have been used as very effective angioprotectors.

v. Drugs that enhance the excretory function of the kidneys.

1. Diuretics. Diuretics, or diuretics, are substances that cause an increase in the excretion of urine from the body and a decrease in the fluid content in tissues and serious body cavities.

Modern diuretics are divided mainly into three groups:

• a) saluretics
• b) potassium-sparing
• c) osmotic diuretics.
• 2. Means that promote the excretion of uric acid and the removal of urinary calculi. This group includes uricosuric drugs (which increase the excretion of uric acid in the urine) and drugs that help remove urinary calculi due to their ability to "dissolve" these calculi or facilitate their passage through the urinary tract.

Etamide (Aethamidum)

It is used for chronic gout, polyarthritis with impaired purine metabolism, urolithiasis with the formation of urates. Etamide has the ability to delay the excretion of penicillin and other substances by the kidneys.

The drug is contraindicated in severe diseases of the liver and kidneys.

VI. Choleretic agents. Choleretic agents are usually divided into two groups: agents that enhance the formation of bile, and agents that promote the release of bile from the gallbladder into the intestines.

Most choleretic agents have a combined effect, increasing the secretion of bile and facilitating its entry into the intestines.

VII. Drugs affecting the muscles of the uterus (uterine drugs)

Means that stimulate the muscles of the uterus.

Means that relax the muscles of the uterus. In recent years, the arsenal of uterine funds has expanded significantly. There are new highly active drugs that stimulate the myometrium (from the group of prostaglandins), and new drugs that inhibit the contractile activity of the uterus (mainly from the group of agonists), called "tocolytics"

Thus, at present, uterine agents are divided into two main groups:

a) drugs that stimulate the muscles of the uterus.

Isoverin (Isoverinum)

In terms of pharmacological properties, it is close to spherophysin, blocks ganemia of the autonomic nervous system, lowers blood pressure, increases tone and increases uterine muscle contraction, increases the sensitivity of the uterus to pituitirine.

It is used as a labor accelerating agent and to stimulate contraction of the muscles of the uterus in the postpartum period. In connection with the hypotensive effect, isoverin can be prescribed to women in labor suffering from late toxicosis of pregnancy, accompanied by hypertension.

Enter intramuscularly.

b) drugs that lower the tone and contractile activity of the uterus.

Ritodrin (Ritodrinum).

They are used as a tocolytic agent for the threat of premature termination of pregnancy.

VIII. Means that affect metabolic processes.

1. Hormones, their analogues and antihormonal drugs. Hormones are chemicals produced by the endocrine glands. They play an important role in the humoral regulation of various functions of organisms.

According to the chemical structure, hormonal preparations belong to the following groups:

• 1) substances of protein and polypeptide structure - preparations of hormones of the pituitary gland, parathyroid and pancreas. These hormonal preparations are obtained from the bovine pituitary and blue lobes.
• 2) derivatives of amino acids - preparations of thyroid hormones.

Diiodotyrosine (Diijdthyrosinum)

L--Amino--(3,5-diiodo-4hydroxyphenyl)-propionic acid.

Diiodotyrosine has no pronounced hormonal activity; it inhibits the production of the anterior pituitary hormone, which activates the activity of the thyroid gland.

For medical use, it is obtained synthetically.

Diyondtyrosine is used for diffuse toxic goiter, hyperthyroid forms of endemic and sporadic goiter and other diseases accompanied by thyrotoxicosis, mainly with mild and moderate severity of the latter; with thyrotoxicosis in pregnant women, thyrotoxic exorthalmos.

In severe thyrotoxicosis and with significant exophthalmos, diiodothyrosine is used together with mercasolite.

Diiodotyrosine is also used in preparation for surgery in patients with toxic goiter.

• 3) steroid compounds - preparations of hormones of the adrenal cortex and gonads. The adrenal cortex produces more than forty steroids. Many of them play an important biological role. In medical practice, the drug Celeston, the corticosteroid betamethasone is used (Fig. 27)
• 2. Vitamins and their analogues. Our body constantly needs vitamins, because. the body does not get enough food with the necessary factors for full development, then vitamins are used. To date, vitamins are known: A1, B1, B2, B6, B12, C, D, E, F, P and others. Many drugs are used in medicine, based on these vitamins, such as triovit. (fig.28)

Enzyme preparations and substances with antienzymatic activity. Enzyme preparations are widely used in the treatment of diseases accompanied by purulent-necrotic processes, thrombosis and thromboembolism, digestive disorders, etc. Enzyme preparations are also used to treat oncological diseases.

One of these fibrinolysis inhibitor drugs is Amben (Ambenum) para-(Aminomethyl)-benzoic acid:

"White crystalline powder, odorless. Difficult and slowly soluble in water.

Antifibrinolytic agent. By structure and mechanism of action, it is close to aminocaproic acid, inhibits fibrinolysis by competitive inhibition of the plasminogen-activating enzyme and inhibition of plasmin formation.

Used to stop bleeding associated with pathologically enhanced fibrinolysis.

Assign intravenously, intramuscularly and inside. When injected into a vein, it acts quickly, but for a short time, after 3 hours it is not detected in the blood.

4. Means that affect blood coagulation. One such remedy is clivarin. (fig.29)

Preparations of hypocholesterolemic and hypolithoproteinemic action. "In connection with the important role attached to the violation of cholesterol metabolism in the pathogenesis of atherosclerosis, searches for hypocholesterolemic substances were undertaken. It has now been established that cholesterol penetrates into the wall of blood vessels as part of lipoproteins and that the development of atherosclerosis is associated with the formation in the body of lipoproteins with atherogenic properties.

The "anti-sclerotic" drugs proposed so far have a different mechanism of action, and for their rational use, one should take into account the peculiarities of their effect on the content of lipoproteins in the body. "12

The drugs used in some forms of atherosclerosis also include lipantil. (fig.30)

Atherosclerosis is a narrowing of blood vessels, the growth of plaques of a fatty substance on their walls.

6. Amino acids. Based on amino acids, new drugs are being produced.

Methionine (Methioninum)

D, L--Amino--methylthiobutyric acid:

"White crystalline powder with a characteristic odor and slightly sweet taste. It is difficult to dissolve in water.

Methionine is one of the essential amino acids needed to maintain growth and nitrogen balance in the body. The special significance of this amino acid in metabolism is due to the fact that it contains a mobile methyl group (-CH 3), which can be transferred to other compounds; it participates, thus, in the process of displacement, which is very important for the life of the organism.

With the ability of methionine to donate a methyl group, its lipotropic effect is associated, i.e. the ability to remove excess fat from the liver. Giving a mobile methyl group, methionine promotes the synthesis of choline, with insufficient formation of which is associated with a violation of the synthesis of phospholipids from fats and the deposition of neutral fat in the liver.

Methionine is involved in the synthesis of adrenaline, keratin and other biologically important compounds, it activates the action of hormones, vitamins, enzymes. By methylation and transsulfonation, methionine neutralizes various toxic products.

Methionine is used to treat and prevent diseases and toxic liver damage; liver cirrhosis, liver damage by arsenic preparations, chloroform, benzene and other substances, chronic alcoholism, diabetes, etc. The effect is more pronounced with fatty infiltration of liver cells. In viral hepatitis, the use of methionine is not recommended. Methionine is also used to treat dystrophy resulting from protein deficiency in children and adults after dysentery and other infectious diseases.

The introduction of methionine in atherosclerosis causes a decrease in the content of cholesterol in the blood and an increase in the content of phospholipids.

7. Plasma-substituting solutions and means for parenteral nutrition. In order to replace plasma in acute blood loss, shock of various origins, microcirculation disorders, intoxication and other processes associated with hemodynamic disturbances, so-called plasma-mixing solutions are often used.

According to their functional properties and purpose, plasma-substituting solutions are divided into a number of groups:

• a) hemodynamic
• b) detoxification
• c) regulators of water-salt and acid-base balance.

Rondex (Rondex). Hemodynamic drug. It is used as a therapeutic (in order to restore blood pressure and circulating plasma volume) and a prophylactic agent for blood loss and shock of various origins.

• 8. Drugs used to correct the acid-base and ionic balance in the body. Drugs are divided into several groups:
  • a) alkalis and acids
  • b) calcium preparations
  • c) potassium preparations
  • d) preparations containing iron
  • e) preparations containing cobalt
  • e) preparations containing iodine
  • g) preparations containing forsor
  • h) preparations containing fluorine
  • i) preparations containing arsenic
  • j) preparations containing gold.

Krizanol (Crysonolum). Mixture containing 70% aurothiopropanol - calcium sulfonate and 30% calcium gluconate. Contains 33.5% gold.

Krizanol is used mainly for the treatment of rheumatoid arthritis as a basic drug; are also used in the treatment of lupus erythematosus, for the treatment of fresh forms of tuberculosis of the lungs and larynx. Enter intramuscularly. When using krizanol, especially in case of overdose, various side effects are possible. Krizanol is contraindicated in kidney disease, diabetes, decompensated heart disease, cachexia, miliary tuberculosis, fibro-cavernous processes in the lungs.

• 9. Various drugs that stimulate metabolic processes.
• a) pyrimidine and thiazolidine derivatives.
• b) derivatives of adrenosine and hypoxanthine
• c) preparations of different chemical groups.
• d) sugar
• e) oxygen
• f) biogenic stimulants
• g) various biogenic preparations
• h) preparations containing poisons of bees and snakes.

IX. Medicines that modulate the processes of immunity ("immunomodulators"

• 1. Drugs that stimulate immunological processes. In recent years, much attention has been paid to the development and study of specific agents that stimulate or suppress (modulate) the body's immune responses. One of these drugs is levamisole (Levamisolum)
• 2,3,5,6,-Tetrahydro-6-phenylimidazo--thiazole hydrochloride:

White amorphous or crystalline powder. Let's slightly dissolve in water.

The drug is very effective: as an antihelminthic agent, with some diseases, strotiloidosis, an agent for immunotherapy, with rheumatoid arthritis, chronic nonspecific lung diseases.

2. Immunosuppressive drugs (immunosuppressants).

"Antilimpholin - KR" (Antilimpholinum Kr). An immunosuppressive drug derived from rabbit blood proteins immunized with human thymus lymphocytes. Used to prevent transplantation immunological reactions in patients with transplanted alloid organs and tissues.

With a significant immunosuppressive effect, infectious complications are possible, therefore it is recommended to use the drug in combination with antibiotics or other antibacterial drugs.

x. Preparations of various pharmacological groups.

1. Anorexigenic substances (substances that suppress appetite). Anorexigenic substances are compounds that can reduce appetite and are used by G.O. in the complex treatment of obesity.

Desopimon (Desopimon) 1-(para-Chlorophenyl)-2-methyl-2-aminopropane hydrochloride:

"White crystalline powder. Easily soluble in water.

According to the chemical structure and pharmacological properties, the drug is similar to phenamine and fenpropane. It has an anorexigenic effect, without causing a pronounced excitation of the central nervous system and only slightly increasing blood pressure. "14

Treatment should be carried out under the close supervision of a physician.

The drug is contraindicated in pregnancy, with advanced forms of hypertension, severe disorders of cerebral and coronary circulation, myocardial infarction, thyrotoxicosis, glaucoma, tumors of the pituitary and adrenal glands, diabetes mellitus, increased nervous excitability, epilepsy, psychosis, severe sleep disturbances.

• 2. Specific antidotes: complexones. The weakening of the action of one compound by another can be carried out chemically or physico-chemically (neutralization of acids by alkalis, adsorption of substances by animal coal, etc.). Such an effect is called antidotes. These preparations are divided into two groups: a) preparations containing thiol groups and other sulfur-containing compounds.
• b) complexing compounds
• 3. Preparations for the prevention and treatment of radiation sickness syndrome.

"Radiation sickness occurs when the body is exposed to ionizing radiation in doses exceeding the maximum allowable. In humans, fulminant, acute, subacute and chronic radiation sickness is possible. It is manifested mainly by damage to the hematopoietic organs of the nervous system, gastrointestinal tract and others." 15

Mexamine (Mexaminum) 5-methoxytriptaline hydrochloride:

Creamy white crystalline powder. Easily soluble in water, difficult in alcohol.

Mexamine causes contraction of smooth muscles, constriction of blood vessels. It also has a sedative effect, enhances the effect of sleeping pills and analgesics. One of the important features of maxamine is its radioprotective activity. In patients undergoing radiotherapy for malignant neoplasms, prior oral administration of mexamine reduces the effects of radiation reaction.

The drug is usually well tolerated. In some cases, mild nausea, dizziness, pain in the epigastric region, and less often vomiting are possible. Side effects may decrease with the use of caffeine.

Contraindicated in severe sclerosis of the vessels of the heart and brain, cardiovascular insufficiency, bronchial asthma, kidney disease with impaired function, during pregnancy.

4. Photosensitizing drugs.

Photosensitization - giving non-photosensitive substances the ability to photochemical transformations. Photosensitization is due to the presence of light-sensitive impurities or special additives, which, when irradiated into an excited state, cause a chemical reaction.

Ammifurin (Ammifurinum). Contains a mixture of three furocoumarins: isopimpenellin, bergantene and xanthotoxin.

The use in medical practice is based on the property of various furocoumarins to sensitize the skin to the action of light and stimulate the formation of malanin pigment by malanocytes when it is irradiated with ultraviolet rays.

The drug is contraindicated in case of individual intolerance, acute gastrointestinal diseases, hepatitis, liver cirrhosis, acute and chronic nephritis, diabetes, hypertension, tuberculosis and others.

5. Special means for the treatment of alcoholism.

One of the means of teturamum (Teturamum).

Tetroethyluram disulfide:

It is taken orally for the treatment of chronic alcoholism in cases where it is not possible to obtain a therapeutic effect by other methods of treatment.

Contraindications: endocrine diseases, psychosis, cardiosclerosis, atherosclerosis of cerebral vessels, with stomach ulcers, cirrhosis of the liver, central nervous system, gastritis and others.

• 1. Chemotherapeutic agents. Drugs that have a specific damaging effect mainly on pathogens of infectious diseases or tumor cells. Chemotherapeutic agents are divided into groups:
  • a) antibiotics
  • b) sulfa drugs
  • c) quinoxaline derivatives
  • e) derivatives of 8-oxaquinoline and 4-oxaquinoline.
  • f) thiosemicarbazone derivatives
  • g) anti-tuberculosis drugs
  • h) naphthyridine derivatives
  • i) anti-leprosy drugs
  • j) preparations for the treatment of protozoal infections
  • k) antisyphilitic preparations containing arsenic and bismuth.
  • l) preparations for the treatment of fungal diseases of the skin
  • m) antihelminthics
  • o) antiviral drugs

Antibiotics are organic substances formed by microorganisms and have the ability to kill microbes. One such effective antibiotic is netromycin (Fig. 31)

• 2. Antiseptics. The products have an antimicrobial effect and are mainly used for disinfection, lubrication of the skin and mucous membranes, irrigation of wounds and cavities. Antiseptic preparations are divided according to the following principle:
  • a) a group of halides
  • b) oxidizers
  • c) acids and bases
  • d) aldehydes
  • e) alcohols
  • e) salts of heavy metals
  • g) phenols
  • h) dyes
  • i) detergents
  • j) tar, resins, petroleum products, mineral oils, synthetic balms; preparations containing sulfur.
  • k) various antibacterial preparations of natural origin

Intetrix - intestinal antiseptic (Fig. 32)

XII. Drugs used to treat malignant neoplasms.

• 1. Chemotherapeutic agents.
• a) Bis-(-chloroethyl)-amine derivatives
• b) compounds containing ethylamine groups
• c) esters of disulfonic acids and drugs similar in action
• d) antitumor cytostatic drugs of different groups.
• e) antimetabolites
• e) antitumor antibiotics
• g) alkaloids and other substances of plant origin that have an antitumor effect.

The anticancer antibiotic olivomycin (Olivomycinum) is an antibiotic substance produced by the radiant fungus Actinomyces olivoreticuli.

Intravenously, olivomycin is used for testicular tumors (semions, embryonic cancers, teratoblastons) in the stage of generalization (with metastases), for tonsillar tumors (lymphoepithelioma, reticulosarcoma, etc.), for reticulosarcomas with lesions of peripheral nodes, for chorionepithemioma of the uterus, for cancer of the cervix and uterus.

When using olivomycin, nausea, vomiting, and fever may occur.

During treatment with olivomycin, it is necessary to monitor the cardiovascular system and the blood picture.

Due to possible cardiotoxicity, the drug is contraindicated in severe diseases of the cardiovascular system, as well as in case of severe exhaustion of the patient and in the terminal stages of cancer.

• 2. Enzyme preparations used to treat cancer.
• 3. Hormonal drugs and inhibitors of hormone formation, used primarily in the treatment of tumors. Hormonal preparations, especially estrosenes, androgens and corticosteroids, are relatively widely used in the complex therapy of oncological diseases. It is believed that the mechanism of these drugs is based on their ability to change the hormonal balance in the body.

Chlortrianisen (Chlortrianisenum).

1,1,2-Trianisil-2-chloroethylene:

Chlortrianisene is a synthetic drug with estrogenic activity. Low toxicity. It is mainly used in the treatment of patients with prostate cancer.

When applied, sometimes swelling and pain in the mammary gland appear, quickly pass.

XIII. diagnostic tools.

1. Radiocontrast agents. Various means of a chemical substance that, when introduced into the body, improve the image of the object under study.

Barium sulfate for fluoroscopy (Barii sulfas pro roentgeno)

Applied inside in the form of a suspension in water as a contrast agent for x-ray examination of the esophagus, stomach and intestines.

The suspension is prepared in distilled water immediately before use.

2. Various diagnostic tools.

Gravimun is a drug containing lyophilized antiserum with antibodies against human chorionic gonadotropin.

Used for immunological detection of pregnancy. The test is based on the reaction of inhibition of hemasgmotination.

The concept of infectious diseases means the reaction of the body to the presence of pathogenic microorganisms or their invasion of organs and tissues, manifested by an inflammatory response. For treatment, antimicrobial drugs are used that selectively act on these microbes in order to eradicate them.

Microorganisms that lead to infectious and inflammatory diseases in the human body are divided into:

• bacteria (true bacteria, rickettsia and chlamydia, mycoplasmas);
• mushrooms;
• viruses;
• protozoa.

Therefore, antimicrobial agents are divided into:

• antibacterial;
• antiviral;
• antifungal;
• antiprotozoal.

It is important to remember that one drug can have several types of activity.

For example, Nitroxoline ® , prep. with a pronounced antibacterial and moderate antifungal effect - called an antibiotic. The difference between such an agent and a “pure” antifungal is that Nitroxoline ® has limited activity against certain types of Candida, but it has a pronounced effect against bacteria, which the antifungal agent will not work at all.

In the 1950s, Fleming, Chain, and Flory received the Nobel Prize in Medicine and Physiology for the discovery of penicillin. This event has become a real revolution in pharmacology, completely turning the basic approaches to the treatment of infections and significantly increasing the patient's chances for a full and quick recovery.

With the advent of antibacterial drugs, many diseases that caused epidemics that previously devastated entire countries (plague, typhus, cholera) have turned from a “death sentence” into an “effectively treatable disease” and are practically not found at present.

Antibiotics are substances of biological or artificial origin that can selectively inhibit the vital activity of microorganisms.

That is, a distinctive feature of their action is that they affect only the prokaryotic cell without damaging the cells of the body. This is due to the fact that human tissues do not have a target receptor for their action.

Antibacterial agents are prescribed for infectious and inflammatory diseases caused by the bacterial etiology of the pathogen or for severe viral infections, in order to suppress the secondary flora.

When choosing an adequate antimicrobial therapy, it is necessary to take into account not only the underlying disease and the sensitivity of pathogenic microorganisms, but also the age of the patient, the presence of pregnancy, individual intolerance to the components of the drug, comorbidities, and the use of drugs that are not combined with the recommended medication.

Also, it is important to remember that in the absence of a clinical effect of therapy within 72 hours, the drug is changed, taking into account possible cross-resistance.

For severe infections or for empiric therapy with an unspecified pathogen, a combination of different types of antibiotics is recommended, taking into account their compatibility.

According to the effect on pathogenic microorganisms, there are:

• bacteriostatic - inhibiting the vital activity, growth and reproduction of bacteria;
• bactericidal antibiotics are substances that completely destroy the pathogen, due to irreversible binding to the cellular target.

However, such a division is rather arbitrary, since many antibes. may exhibit different activity, depending on the prescribed dosage and duration of use.

If the patient has recently used an antimicrobial agent, its repeated use should be avoided for at least six months - to prevent the emergence of antibiotic-resistant flora.

How does drug resistance develop?

Most often, resistance is observed due to a mutation of the microorganism, accompanied by a modification of the target inside the cells, which is affected by varieties of antibiotics.

The active substance of the prescribed substance penetrates the bacterial cell, but cannot contact the necessary target, since the key-lock binding principle is violated. Therefore, the mechanism of activity suppression or destruction of the pathological agent is not activated.

Another effective method of protection against drugs is the synthesis of enzymes by bacteria that destroy the basic structures of antibes. This type of resistance most often occurs to beta-lactams, due to the production of beta-lactamase by the flora.

Much less common is an increase in resistance, due to a decrease in the permeability of the cell membrane, that is, the drug penetrates inside in too small doses to have a clinically significant effect.

As a preventive measure for the development of drug-resistant flora, it is also necessary to take into account the minimum concentration of suppression, expressing a quantitative assessment of the degree and spectrum of action, as well as the dependence on time and concentration. in blood.

For dose-dependent agents (aminoglycosides, metronidazole), the dependence of the effectiveness of the action on the concentration is characteristic. in the blood and the focus of the infectious-inflammatory process.

Time-dependent drugs require repeated administrations throughout the day to maintain an effective therapeutic concentration. in the body (all beta-lactams, macrolides).

Classification of antibiotics by mechanism of action

• drugs that inhibit the synthesis of the bacterial cell wall (antibiotics of the penicillin series, all generations of cephalosporins, Vancomycin ®);
• destroying the normal organization of cells at the molecular level and interfering with the normal functioning of the tank membrane. cells (Polymyxin ®);
• Wed-va, contributing to the suppression of protein synthesis, inhibiting the formation of nucleic acids and inhibiting protein synthesis at the ribosomal level (Chloramphenicol preparations, a number of tetracyclines, macrolides, Lincomycin ® , aminoglycosides);
• inhibition ribonucleic acids - polymerases, etc. (Rifampicin ® , quinols, nitroimidazoles);
• inhibitory processes of folate synthesis (sulfonamides, diaminopyrides).

Classification of antibiotics by chemical structure and origin

1. Natural - waste products of bacteria, fungi, actinomycetes:

• Gramicidins ® ;
• Polymyxins;
• Erythromycin ® ;
• Tetracycline ® ;
• Benzylpenicillins;
• Cephalosporins, etc.

2. Semi-synthetic - derivatives of natural antibiotics:

• Oxacillin ® ;
• Ampicillin ® ;
• Gentamicin ® ;
• Rifampicin ® etc.

3. Synthetic, that is, obtained as a result of chemical synthesis:

• Levomycetin ® ;
• Amikacin ® etc.

Classification of antibiotics according to the spectrum of action and purpose of use

Mainly active on:		Antibacterial agents with a wide spectrum of action:	Anti-tuberculosis drugs
Gram+:	Gram-:
biosynthetic penicillins and 1st generation cephalosporins; macrolides; lincosamides; drugs Vancomycin ® , Lincomycin ® .	monobactams; cyclic polypeptides; 3rd pok. cephalosporins.	aminoglycosides; chloramphenicol; tetracycline; semi-synthetic extended spectrum penicillins (Ampicillin ®); 2nd pok. cephalosporins.	Streptomycin ® ; Rifampicin ® ; Florimycin ® .

Modern classification of antibiotics by groups: table

Main group	Subclasses
Beta lactams
1. Penicillins	natural; Antistaphylococcal; Antipseudomonal; With an extended spectrum of action; inhibitor-protected; Combined.
2. Cephalosporins	4 generations; Anti-MRSA cephems.
3. Carbapenems	—
4. Monobactams	—
Aminoglycosides	Three generations.
Macrolides	Fourteen-membered; Fifteen-membered (azoles); Sixteen members.
Sulfonamides	Short action; Average duration of action; Long acting; Extra long; Local.
Quinolones	Non-fluorinated (1st generation); Second; Respiratory (3rd); Fourth.
Anti-tuberculosis	Main row; reserve group.
Tetracyclines	natural; Semi-synthetic.

Not having subclasses:

• Lincosamides (lincomycin ® , clindamycin ®);
• Nitrofurans;
• Oxyquinolines;
• Chloramphenicol (this group of antibiotics is represented by Levomycetin ®);
• Streptogramins;
• Rifamycins (Rimactan ®);
• Spectinomycin (Trobicin®);
• Nitroimidazoles;
• Antifolates;
• Cyclic peptides;
• Glycopeptides (vancomycin ® and teicoplanin ®);
• Ketolides;
• Dioxidine;
• Fosfomycin (Monural®);
• Fusidans;
• Mupirocin (Bactoban ®);
• Oxazolidinones;
• Everninomycins;
• Glycylcyclines.

Groups of antibiotics and drugs in the table

Penicillins

Like all beta-lactam drugs, penicillins have a bactericidal effect. They affect the final stage of the synthesis of biopolymers that form the cell wall. As a result of blocking the synthesis of peptidoglycans, due to the action on penicillin-binding enzymes, they cause the death of pathological microbial cells.

The low level of toxicity to humans is due to the absence of target cells for antibes.

The mechanisms of bacterial resistance to these drugs have been overcome by the creation of protected agents enhanced with clavulanic acid, sulbactam, etc. These substances inhibit the action of the tank. enzymes and protect the drug from degradation.

Natural Benzylpenicillin Benzylpenicillin Na and K salts.

Group	According to the active substance, preparations are isolated:	Titles
Phenoxymethylpenicillin	Methylpenicillin ®
With prolonged action.
Benzylpenicillin procaine	Benzylpenicillin novocaine salt ® .
Benzylpenicillin/ Benzylpenicillin procaine/ Benzathine benzylpenicillin	Benzicillin-3 ® . Bicillin-3 ®
Benzylpenicillin procaine/Benzathine benzylpenicillin	Benzicillin-5 ® . Bicillin-5 ®
Antistaphylococcal	Oxacillin ®	Oxacillin AKOS ® , sodium salt of Oxacillin ® .
penicillinase-resistant	Cloxapcillin ® , Alucloxacillin ® .
Spread Spectrum	Ampicillin ®	Ampicillin ®
	Amoxicillin ®	Flemoxin solutab ® , Ospamox ® , Amoxicillin ® .
With antipseudomonal activity	Carbenicillin ®	Disodium salt of carbenicillin ® , Carfecillin ® , Carindacillin ® .
	Uriedopenicillins
	Piperacillin ®	Picillin ® , Pipracil ®
	Azlocillin ®	Sodium salt of azlocillin ® , Securopen ® , Mezlocillin ® .
inhibitor-protected	Amoxicillin/clavulanate ®	Co-amoxiclav ® , Augmentin ® , Amoxiclav ® , Ranklav ® , Enhancin ® , Panklav ® .
	Amoxicillin sulbactam ®	Trifamox IBL ® .
	Amlicillin/sulbactam ®	Sulacillin ® , Unazine ® , Ampisid ® .
	Piperacillin/tazobactam ®	Tazocin ®
	Ticarcillin/clavulanate ®	Timentin ®
Combination of penicillins	Ampicillin/oxacillin ®	Ampiox ® .

Cephalosporins

Due to low toxicity, good tolerance, the ability to use by pregnant women, as well as a wide spectrum of action, cephalosporins are the most commonly used antibacterial agents in therapeutic practice.

The mechanism of action on the microbial cell is similar to penicillins, but is more resistant to the action of the tank. enzymes.

Rev. cephalosporins have high bioavailability and good digestibility for any route of administration (parenteral, oral). They are well distributed in internal organs (with the exception of the prostate gland), blood and tissues.

Only Ceftriaxone ® and Cefoperazone ® are able to create clinically effective concentrations in bile.

A high level of permeability through the blood-brain barrier and effectiveness in inflammation of the meninges are noted in the third generation.

The only sulbactam-protected cephalosporin is Cefoperazone/Sulbactam®. It has an extended spectrum of effects on the flora, due to its high resistance to the influence of beta-lactamase.

The table shows the groups of antibiotics and the names of the main drugs.

Generations	Preparation:	Name
1st	Cefazolinam	Kefzol ® .
	Cephalexin ® *	Cefalexin-AKOS ® .
	Cefadroxil ® *	Durocef ® .
2nd	Cefuroxime ®	Zinacef ® , Cefurus ® .
	Cefoxitin ®	Mefoxin ® .
	Cefotetan ®	Cefotetan ® .
	Cefaclor ® *	Ceklor ® , Vercef ® .
	Cefuroxime-axetil ® *	Zinnat ® .
3rd	Cefotaxime ®	Cefotaxime ® .
	Ceftriaxone ®	Rofecin ® .
	Cefoperazone ®	Medocef ® .
	Ceftazidime ®	Fortum ® , Ceftazidime ® .
	Cefoperazone/sulbactam ®	Sulperazon ® , Sulzoncef ® , Bakperazon ® .
	Cefditorena ® *	Spectracef ® .
	Cefixime ® *	Suprax ® , Sorcef ® .
	Cefpodoxime ® *	Proxetil ® .
	Ceftibuten ® *	Cedex ® .
4th	Cefepima ®	Maximim ® .
	Cefpiroma ®	Caten ® .
5th	Ceftobiprol ®	Zeftera ® .
	Ceftaroline ®	Zinforo ® .

* They have an oral release form.

Carbapenems

They are reserve drugs and are used to treat severe nosocomial infections.

Highly resistant to beta-lactamases, effective for the treatment of drug-resistant flora. With life-threatening infectious processes, they are the primary means for an empirical scheme.

Allocate teacher:

• Doripenem ® (Doriprex ®);
• Imipenem ® (Tienam ®);
• Meropenem ® (Meronem ®);
• Ertapenem ® (Invanz ®).

Monobactams

• Aztreonam ® .

Rev. has a limited range of applications and is prescribed to eliminate inflammatory and infectious processes associated with Gram-bacteria. Effective in the treatment of infections. processes of the urinary tract, inflammatory diseases of the pelvic organs, skin, septic conditions.

Aminoglycosides

The bactericidal effect on microbes depends on the level of concentration of the medium in biological fluids and is due to the fact that aminoglycosides disrupt the processes of protein synthesis on bacterial ribosomes. They have a fairly high level of toxicity and many side effects, however, they rarely cause allergic reactions. Practically ineffective when taken orally, due to poor absorption in the gastrointestinal tract.

Compared to beta-lactams, the level of penetration through tissue barriers is much worse. They do not have therapeutically significant concentrations in bones, cerebrospinal fluid and bronchial secretions.

Generations	Preparation:	Bargain. title
1st	Kanamycin ®	Kanamycin-AKOS ® . Kanamycin monosulphate ® . Kanamycin sulfate ®
	Neomycin ®	Neomycin sulfate ®
	Streptomycin ®	Streptomycin sulfate ® . Streptomycin-calcium chloride complex ®
2nd	Gentamicin ®	Gentamicin ® . Gentamicin-AKOS ® . Gentamycin-K ®
	Netilmicin ®	Netromycin ®
	Tobramycin ®	Tobrex ® . Brulamycin ® . Nebtsin ® . Tobramycin ®
3rd	Amikacin ®	Amikacin ® . Amikin ® . Selemycin ® . Hemacin ®

Macrolides

They provide inhibition of the process of growth and reproduction of pathogenic flora, due to the suppression of protein synthesis on cell ribosomes. bacterial walls. With an increase in dosage, they can give a bactericidal effect.

Also, there are combined prep .:

1. Pylobact ® is a complex agent for the treatment of Helicobacter pylori. Contains clarithromycin ® , omeprazole ® and tinidazole ® .
2. Zinerit ® is an external agent for the treatment of acne. The active ingredients are erythromycin and zinc acetate.

Sulfonamides

They inhibit the processes of growth and reproduction of pathogens, due to the structural similarity with para-aminobenzoic acid, which is involved in the life of bacteria.

They have a high rate of resistance to their action in many representatives of Gram-, Gram +. They are used as part of the complex therapy of rheumatoid arthritis, retain good antimalarial activity, and are effective against toxoplasma.

Classification:

Silver Sulfathiazole (Dermazin ®) is used for local use.

Quinolones

Due to the inhibition of DNA hydrases, they have a bactericidal effect and are concentration-dependent media.

• The first generation includes non-fluorinated quinolones (nalidixic, oxolinic and pipemidic acids);
• Second pok. represented by Gram-means (Ciprofloxacin ® , Levofloxacin ® etc.);
• The third is the so-called respiratory agents. (Levo- and Sparfloxacin ®);
  Fourth - Rev. with antianaerobic activity (Moxifloxacin ®).

Tetracyclines

Tetracycline ® , whose name was given to a separate group of antibiotics, was first obtained by chemical means in 1952.

Active ingredients of the group: metacycline ® , minocycline ® , tetracycline ® , doxycycline ® , oxytetracycline ® .

On our site you can get acquainted with most groups of antibiotics, complete lists of their drugs, classifications, history and other important information. For this, a section "" has been created in the top menu of the site.

B (list of potent drugs)- a group of medicines, in the appointment, use, dosage and storage of which care should be taken.

List B includes medicinal raw materials, galenic (tinctures, extracts) and novogalenic preparations, as well as finished drugs (in tablets and ampoules) containing alkaloids and their salts, hypnotics, antipyretics, analgesics, anesthetics and heart drugs, sulfonamides, sex hormone preparations , some vitamins, etc.

In pharmacies, list B medicines and ready-made products containing them are stored in separate lockable cabinets with the inscription “B - Heroica” (strong); in medical institutions - in special cabinets under lock and key. In control and analytical laboratories, list B drugs can be stored together with non-potent ones, and stocks of reagents related to list B can only be kept under lock and key. In pharmacy warehouses and in the pharmaceutical industry, potent substances are stored in separate rooms or in locked cabinets.

List B drugs are dispensed by prescription with the seal of a medical institution or a personal medical seal, without fail indicating the method of application. When prescribing potent substances in doses exceeding the highest, be sure to indicate the amount of the substance in words with an exclamation point. Paramedics and midwives can prescribe potent drugs in accordance with the range approved for them. The release of medicines containing potent substances from pharmacy stores, kiosks and pharmacy points of the 2nd group is allowed within the approved range.

The rules for prescribing, dispensing and storing potent drugs are set out in the order of the Minister of Health of the USSR No. 523 of July 3, 1968 and in the annexes to the order.

List B is included in the State Pharmacopoeia; all additions and changes to the list are made on the basis of directive documents of the USSR Ministry of Health.

The list of potent drugs, as well as the highest or average therapeutic doses, see tables 1, 2.

Table 1

LIST OF POTENT MEDICINES AND HIGHER OR AVERAGE THERAPEUTIC DOSES (CONCENTRATIONS) FOR ADULTS BY DIFFERENT METHODS OF ADMINISTRATION in grams or (where indicated) in milliliters, drops or action units (U) *1 (according to the State Pharmacopoeia X)

Name of the medicinal product		Method of administration	Highest or average (indicated by *3) therapeutic doses (concentrations)
Russian*2	latin			daily
Adonizide - see Adonis				120 drops
Adrenaline hydrotartrate - see. Adrenalin	Adrenalini hydrotartras
Adrenaline hydrochloride - see Adrenalin	Adrenalini hydrochloridum
Amidopyrine
amyl nitrite		For inhalation	0.1 ml (6 drops)	0.5 ml (30 drops)
Aminazine
		Intramuscular
Analgin
		Under the skin, intramuscularly and in a vein
Anestezin
Antipyrine
Apressin
		Under the skin and intramuscularly
Barbamil
Barbital
barbital sodium	barbitalum sodium	under the skin and intramuscularly
Benzylpenicillin potassium salt - see Penicillins (semi-synthetic)	benzylpenicillin-kalium	Intramuscularly and under the skin		1,500,000 units*3
Benzylpenicillin sodium salt - see Penicillins (semi-synthetic)	benzylpenicillin sodium	Intramuscularly and under the skin	50,000 -300,000 units*3	200,000-1,500,000 units*3
Benzylpenicillin novocaine salt - see Penicillins (semi-synthetic)	Benzylpenicillin novocainum	Intramuscular
Benzohexonium
Benzonal
Bigumal
Bromisoval
Butadion
		Intramuscular
Gangleron
		Under the skin and intramuscularly
Hexamidine
Hexenal
Hexobarbital
Griseofulvin
Desoxycorticosterone acetate. Desoxycorticosterone	Desoxycorticosteroni acetas	Intramuscular
Diazolin
Digalen-neo - see foxglove			0.65 ml (20 drops)	1.95 ml (60 drops)
Diiodotyrosine - see Iodtyrosines
		Under the skin and intramuscularly
Diphenhydramine
		Intramuscular
Diprazine
		Intramuscular
Diprofillin
		In a vein and intramuscularly
Ditrazine citrate - see Ditrazine	Ditrazini citras
Diethylstilbestrol	Diaethylstilboestrolum	Inside and intramuscularly
Diethylstilbestrol propionate - see Diethylstilbestrol	Diaethylstilboestroli propionas	Intramuscular	0.05 (1 time in 3-4 days)**
Isoniazid - see Isonicotinic acid hydrazide
		Intramuscular
Kanamycin monosulfate - see Kanamycin	Kanamycini monosulfas
Narbromal
Quateron
Nicotinic acid - see Nicotinic acid	Acidum nicotinicum
		By vein (as sodium salt)
Hydrochloric acid diluted	Acidum hydrochloricum dilutum		(40 drops)	(120 drops)
Codeine phosphate - see Codeine	codeini phosphas
		Inside, under the skin and in a vein
Korglikon - see Lily of the valley
Cordiamin		Inside and under the skin
		Under the skin and in a vein in case of drug poisoning
Cortisone acetate - see Cortisone	Cortisoni acetas
Corticotropin for injection - see Adrenocorticotropic hormone	Corticotropinum pro injectionibus	Intramuscular
Cotarnine chloride - see. Cotarnin	Cotarnini chloridum
Caffeine-sodium benzoate - see Caffeine	Coffeinum-natrii benzoas
Lantoside - see. Digitalis			0.5 ml (25 drops)	1.5 ml (75 drops)
Levomycetin
bleached sheet - see Henbane	Folium Hyoscyami
Datura leaf - see Medicinal plants	Folium Stramonii
belladonna leaf - see Belladonna	Folium Belladonnae
Foxglove leaf - see Digitalis	Folium digitalis
Copper, sulfate - see. Copper			0.5 (once as an emetic)
		Under the skin and intramuscularly
Meprotan
Mercazolil
Methandrostenolone	methandrostenolonum
Methylandrostenediol - see Anabolic steroids	Methylandrostendiolum	Inside and POYA LANGUAGE
Methyltestosterone	Methyltestosterone
Methylthiouracil	Methylthiouracilum
Methicillin sodium salt. Methicillin	Methicillinum sodium	Intramuscular
belladonna tincture - see belladonna	Tinctura belladonnae		0.5 ml (23 drops)	1.5 ml (70 drops)
Opium-benzoic tincture	Tinctura Opii benzoica
Chilibuha tincture	Tinctura Strychni		0.3 ml (15 drops)	0.6 ml (30 drops)
sodium nitrite
Naftamon
Neomycin sulfate - see Neomycins	Neomycini sulfas
Nitranol
Nitroglycerine			4 drops (1.5 tablets)	16 drops (6 tablets)
Novobiocin sodium salt - see Novobiocin	Novobiocinum-natrium
Novocaine
		Intramuscularly (2% solution)
		In a vein (0.25% solution)
		For infiltration anesthesia	The first single dose at the beginning of the operation is not more than 1.25 when using a 0.25% solution and 0.75 when using a 0.5% solution. In the future, for each hour of the operation, not more than 2.5 when using a 0.25% solution and 2.0 when using a 0.5% solution
Novocainamide	Novocain amid u m
norsulfazol
Norsulfazol-sodium - see.	Norsulfazolum-natrium
norsulfazol			0.5-2.0 (10-20 ml of 5 - 10% solution) * "
Oxacillin sodium salt. Oxacillin	Oxacillinum sodium
Oxylidine		Inside, under the skin and intramuscularly
Oxytetracycline hydrochloride - see Oxytetracycline	Oxytetracyclini hydrochloridum
Oxytetracycline dihydrate - see Oxytetracycline	Oxytetracyclini dihydras
Octestrol - see Synthetic nonsteroidal estrogens
Papaverine hydrochloride - see Papaverine	papaverini hydrochloridum
		Under the skin, in a vein and intramuscularly
Paracetamol
Pachycarpine hydroiodide - see Pachycarpine	Pachycarpini hydroiodidum
Pentamine		Intramuscular
Prednisolone
Prednisone
Progesterone		Intramuscular
Propazine
		Intramuscular
Alcohol iodine solution 5%	Solutio Iodi spirituosa 5%
Alcoholic iodine solution 10%	Solutio Iodi spirituosa 10%
Salsolin hydrochloride - see Salsolin	Salsolini hydrochloridum
Sinestrol
		Intramuscularly in malignant neoplasms
Ergot
Streptomycin sulfate - see Streptomycins	Streptomycini sulfas	Intramuscular
streptocide
Sulfadimezin
Sulfacyl sodium - see Sulfacyl	Sulfacylum-natrium
Spherofizin benzoate - see Spherofizin	Sphaerophysini benzoas
		Under the skin and intramuscularly
Theobromine
Theophylline		Inside and rectally
Testosterone propionate - see Testosterone	testosteroni propionas	Intramuscular
Tetracycline - See tetracyclines
Tetracycline hydrochloride - see Tetracyclines	Tetracyclini hydrochloridum
		Intramuscular
Thiopental sodium	Thiopentalum-natrium
Thyroidin
Adonis grass - see. Adonis	Herba Adonidis vernalis
Lily of the valley grass - see. Lily of the valley	Herba Convallariae
Thermopsis grass - see Thermopsis	Herba Thermopsidis
Trimetin
Triftazin
Trichomonacid
Urosulfan
Phenacetin
Phenobarbital
Phenoxymethylpenicillin	Phenoxymethylpenicillin
Ftalazol
Ftivazid
Furadonin
Furazolidone
Furacilin
Hingamin
chiniophon
Chloral hydrate	Chloralum hydratum	Inside and in an enema
Chloracizin
Chloroform
Chlorpropamide
Chlortetracycline hydrochloride - see Chlortetracycline	Chlortetracyclini hydrochloridum
Chlortrianisen	Chlortrianisenum
belladonna extract thick - see. Belladonna	Extractum belladonnae spissum
Dry belladonna extract - see. Belladonna	Extractum Belladonnae siccum
Male fern extract thick - see male fern	Extractum Filicis maris spissum		8.0 (once)
Emetine hydrochloride - see Emetine	Emetini hydrochloridum	Under the skin and intramuscularly
Ergotal - see. Ergot
				0 ,0005- 0,001**
Erythromycin
Etazol sodium - see Etazol	Aethazolum-natrium
			0.5-2.0 (5-10 ml of 10-20% solution)**
Ethacridine lactate - see Ethacridine	Aethacridini lactas
Etaminal sodium	Aethaminalum-natrium
Ethinylestradiol	Aethinyloestradiolum
Eufillin		Inside, intramuscularly and rectally
Ephedrine hydrochloride - see Ephedrine	Ephedrini hydrochloridum	Inside and under the skin
Medical ether - see Ethyl ether	Aether medicinalis		0.33 ml (20 drops)	(60 drops)

*1 When calculating the highest doses for people over 60 years old, individual sensitivity to different groups of drugs is taken into account:

a) doses of drugs that depress the central nervous system (hypnotics, bromides), as well as cardiac glycosides, diuretics are reduced to 1/2 of the dose indicated in the table;

b) doses of other potent drugs should be 2/3 of the dose indicated in the table;

c) doses of antibiotics, sulfa drugs and vitamins are usually the same for all adults.

*2 Typed in italics are published as independent articles.

*3 Average therapeutic doses are indicated.

V. P. Kalashnikov.

Adrenolytic agents- medicinal adrenoceptor blocking agents that weaken or prevent the effects of adrenaline, norepinephrine and other adrenomimetic agents due to a violation of the interaction of the mediator with the corresponding receptors.

Adrenomimetic means- medicinal substances that cause effects similar to the effects of norepinephrine, adrenaline, and irritation of the sympathetic nervous system.

Adsorbents- finely divided water-insoluble powders; are used for skin diseases in the form of powders and orally for poisoning and some gastrointestinal diseases.

nitrogen mustards- a group of organic substances; in terms of general toxic and strong blistering action, they are similar to mustard gas. Some derivatives of nitrogen mustards that suppress cell division are used as anticancer drugs.

Analeptics- medicinal substances that stimulate the respiratory and vasomotor centers of the medulla oblongata (cordiamin, etc.).

Analgesics- drugs that eliminate or reduce pain. They are divided into two groups: narcotic and non-narcotic (analgin, etc.).

Anesthetics- medicinal substances used for artificial anesthesia; oppress various types of sensitivity, primarily pain.

Anorectic agents- drugs that suppress appetite. In combination with a low-calorie diet, it is used to treat obesity.

Antacids- Medicinal substances that neutralize the hydrochloric acid of gastric juice (for example, with peptic ulcer of the stomach and duodenum).

Antianginal agents- drugs used to treat angina pectoris.

Antidepressants- different in chemical structure and mechanism of action psychotropic drugs that improve mood, relieve anxiety and stress, increase mental activity; used to treat mental depression.

Antidotes (antidotes)- medicines intended for the neutralization of poisons that have entered the body.

Anticoagulants are drugs that reduce blood clotting.

Antimetabolites are natural or synthetic substances that are similar in chemical structure to normal metabolic products (metabolites) and prevent their transformation in the body. Used as medicines (eg, in case of metabolic disorders).

Antiseptics- substances with antimicrobial activity and used mainly for disinfection, lubrication of the skin and mucous membranes, irrigation of wounds and cavities (for example, brilliant green).

Carminatives- medicinal substances that reduce the formation of gases in the gastrointestinal tract and contribute to their discharge during flatulence.

Ganglion blocking agents- medicinal substances that disrupt the transmission of nerve excitation in the synapses of the autonomic ganglia. It is used to treat diseases accompanied by spasms of blood vessels or internal organs.

Antihypertensive drugs- drugs that lower blood pressure. Used for arterial hypertension.

Hormonal drugs- medicines containing hormones or their synthetic analogues. Used for hormone therapy.

Desensitizers- medicinal substances that prevent or reduce the manifestations of allergies (for example, antihistamines).

Antipyretics- medicinal substances that lower elevated body temperature by influencing the processes of thermoregulation; They also have analgesic and anti-inflammatory effects.

Cholagogue- medicinal substances that enhance the formation of bile or facilitate its release into the intestinal lumen.

Immunosuppressants- drugs that suppress the immune response of the body. Used in transplantation of organs and tissues to prevent their rejection, for the treatment of autoimmune diseases.

Interferons are protective proteins produced by the cells of the human body against infection with viruses; nonspecific factors of antiviral immunity. Used to prevent and treat viral diseases (for example, influenza).

Corticosteroids- Animal and human hormones produced by the adrenal cortex. They regulate mineral metabolism (mineralocorticoids - aldosterone, cortexone) and the metabolism of carbohydrates, proteins and fats (glucocorticoids - hydrocortisone, cortisone, corticosterone, which also affects mineral metabolism). They are used in medicine when they are deficient in the body (for example, with Addison's disease), as anti-inflammatory and anti-allergic agents.

Curare-like drugs (muscle relaxants of peripheral action)- medicinal substances that disrupt the transmission of impulses in neuromuscular synapses and, therefore, cause relaxation of the striated muscles. They are mainly used in surgical operations.

Uterine remedies- medicinal substances that increase the tone and contractile activity of the muscles of the uterus. Used to enhance labor activity and uterine bleeding.

Muscle relaxants - medicinal substances that cause relaxation of striated muscles; the action is central (inhibition of the structures of the central nervous system that regulate the tone of the striated muscles) or peripheral.

Miotics- medicinal substances that cause constriction of the pupil (miosis); this usually improves the outflow of fluid from the chambers of the eye, which leads to a decrease in intraocular pressure. Used for glaucoma.

Diuretics (diuretics)- medicinal substances that increase the excretion of urine by the kidneys and thereby contribute to the removal of excess water and sodium chloride from the body.

Antipsychotics- medicinal substances that have a depressing effect on the functions of the central nervous system and are able to eliminate or alleviate some symptoms of psychosis (delusions, hallucinations).

Enveloping products- medicinal substances that form colloidal solutions with water, which protect the nerve endings of the mucous membranes and skin from the action of irritating substances and make their absorption difficult. Used for diseases of the stomach, intestines, skin.

Expectorants- medicinal substances that facilitate the excretion (expectoration) of sputum by increasing the secretion of the bronchial glands (sputum thinning) or by strengthening the peristaltic contractions of the muscles of the bronchi and the activity of the ciliated epithelium.

Anti-inflammatory drugs- medicinal substances that prevent, eliminate or reduce inflammation (acetylsalicylic acid).

Anticonvulsants- medicinal substances that can prevent or interrupt seizures of various origins (for the treatment of epilepsy or parkinsonism).

Psychostimulants- medicinal substances that stimulate the activity of the central nervous system, primarily higher nervous activity; temporarily increase mental and physical performance.

Psychotropic drugs- medicinal substances that have a predominant effect on the mental functions of a person: antidepressants, neuroleptics, psychostimulants and sedatives, tranquilizers.

Sedatives- psychotropic sedatives (eg bromides, valerian preparations).

cardiac glycosides- substances of plant origin, related to glycosides and having a selective effect on the heart muscle, the most important manifestation of which is an increase in heart contractions. Found in hellebore, lily of the valley, foxglove. In medicine, cardiac glucosides are used mainly in heart failure only in small doses and under strict medical indications. Hellebore glycosides are more toxic and their use in pharmacology is not allowed.

Sympatholytic agents- medicinal substances that prevent the transfer of excitation from sympathetic nerves to effectors (for example, to the muscles of the vascular wall, which causes vasodilation).

Laxatives- medicinal substances that promote bowel movement by increasing peristalsis, thinning and facilitating the movement of its contents.

Sleeping pills- drugs that improve sleep.

Vasodilators- medicinal substances that cause relaxation of the smooth muscles of blood vessels and thereby increase their lumen. Used mainly for the treatment of hypertension, angina pectoris.

Vasoconstrictors- medicinal substances that cause contraction of the smooth muscles of blood vessels, which leads to a decrease in their lumen, an increase in resistance to blood flow, and an increase in blood pressure. Applied with collapse, locally - to stop bleeding, etc.

Antispasmodics- medicinal substances that relieve spasms of smooth muscles of internal organs, etc. They are used for bronchial asthma, renal colic, etc.

Sulfonamides are chemotherapeutic agents derived from sulfanilic acid. Used in the treatment of infectious diseases.

tranquilizers- psychotropic drugs that reduce the feeling of tension, anxiety, fear.

Chemotherapeutic drugs - drugs that have a specific damaging effect mainly on pathogens of infectious diseases or tumor cells (eg, sulfonamides, antibiotics).

Anticholinergics- drugs that block the effects of acetylcholine (for example, drugs of the atropine group).

Cholinomimetics- medicinal substances, the action of which is similar to the effect of excitation of cholinergic receptors - the biochemical systems of the body with which acetylcholine reacts (eg, pilocarpine).

Cephalosporins are natural and semi-synthetic antibiotics. Effective against bacteria (staphylococci) resistant to penicillins. Used to treat pneumonia, sepsis, meningitis and other infectious diseases.

Cytostatic agents- medicinal substances that block cell division, suppress immune responses. Used mainly for the treatment of malignant tumors, autoimmune diseases.

CHAPTER 7. CLASSIFICATION OF MEDICINES (PHARMACEUTICAL SUBSTANCES). DOSES

CHAPTER 7. CLASSIFICATION OF MEDICINES (PHARMACEUTICAL SUBSTANCES). DOSES

The active substances are diverse in strength of pharmacological activity and composition. In terms of composition, pharmaceutical substances can be in the form of individual medicinal substances, medicinal plant or animal raw materials, or the sum of active substances. Among the drugs, depending on the pharmacological activity, 3 groups are distinguished: substances of list A (poisonous), substances of list B (strong) and non-strong.

Such their separation is important to prevent the risk of overdose in the process of manufacturing drugs and their use.

7.1. CLASSIFICATION OF MEDICINES (PHARMACEUTICAL

SUBSTANCES) BY THE NATURE OF ORIGIN

By nature of origin medicines are classified into mineral and organic (obtained by chemical or biological synthesis, including from animal or vegetable raw materials).

7.2. CLASSIFICATION OF MEDICINES DEPENDING ON

FROM PHARMACEUTICAL ACTIVITY

Active substances and pharmaceutical preparations are divided into 3 types:

1) medicines (List A);

2) medicines (list B);

3) non-potent.

List A funds - medicines, the dosing and use of which requires special care due to their high toxicity. These lists also include drugs that can cause addiction.

List B funds - medicinal products for which therapeutic, higher single and daily doses have been established and which are stored with caution in order to avoid possible complications.

Non-strong remedies - an extensive group of drugs, relatively safe, used in various therapeutic doses.

To poisonous (venena) and potent (heroica) include those drugs that are included in lists A and B, established by order of December 31, 1999? 472 "On the list of medicines of lists A and B".

7.3. CLASSIFICATION OF MEDICINES FROM THE POSITION OF ORDERS OF THE MINISTRY OF HEALTH OF THE RUSSIAN FEDERATION IN REGARD TO

PRESCRIPTION

From the standpoint of the orders of the Ministry of Health of the Russian Federation regarding prescriptions medicines divided into 3 types:

Included in the list of medicines dispensed by prescription of a doctor (paramedic) when providing additional free medical care to certain categories of citizens eligible for state social assistance, approved by order of the Ministry of Health and Social Development of the Russian Federation No.

September 28, 2005? 601;

Included in the list of medicines dispensed without a doctor's prescription, approved by order of the Ministry of Health of the Russian Federation No.

September 13, 2005? 578;

Included in the list of medicines subject to quantitative accounting, approved by order of the Ministry of Health of the Russian Federation of December 14, 2005 785 "On the order of leave ...".

7.4. CLASSIFICATION FROM THE POSITION OF THE ORDER OF THE MINISTRY OF HEALTH OF THE RUSSIAN FEDERATION IN REGARD TO

STORAGE ORGANIZATIONS

From the standpoint of the order of the Ministry of Health? 377 11/13/1996 "On approval of requirements for the organization of storage ..." all drugs, depending on the physical and physico-chemical properties, the impact on them of various environmental factors are divided into 8 types:

Requiring protection from light;

Requiring protection from moisture;

Requiring protection from volatilization and drying;

Requiring protection from exposure to elevated temperatures;

Requiring protection from exposure to low temperatures;

Requiring protection from exposure to gases contained in the environment;

odorous, coloring;

Disinfectants.

7.5. CLASSIFICATION FROM THE POSITION OF THE FEDERAL CONTROL SERVICE

FOR DRUG TRAFFIC

From the standpoint of the Federal Drug Control Service, medicinal funds are divided into 3 classes:

1. Narcotics(NS) - substances of synthetic or natural origin, preparations, plants included in the list of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation, in accordance with the legislation of the Russian Federation, international treaties of the Russian Federation, including the United Convention on Narcotic Drugs 1961

2. Psychotropic substances(PV) - substances of synthetic or natural origin, preparations, natural materials included in the list of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation, in accordance with the legislation of the Russian Federation, international treaties of the Russian Federation, including the Convention on psychotropic substances 1971

3. Precursors of narcotic drugs and psychotropic substances

(hereinafter - precursors) - substances frequently used in the production, manufacture, processing of narcotic drugs and psychotropic substances, included in the list of narcotic drugs, psychotropic substances and their precursors, subject to control in the Russian Federation, in accordance with the legislation of the Russian Federation, international treaties of the Russian Federation, including the 1988 United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances.

7.6. CLASSIFICATION UNDER THE NARCOTIC DRUGS ACT

According to federal law? 3-FZ "On narcotic drugs and psychotropic substances" all narcotic substances, depending on the control measures applied by the state, are included in the following lists:

2. List of narcotic drugs and psychotropic substances, the circulation of which in the Russian Federation is limited and in respect of which control measures are established in accordance with the legislation of the Russian Federation and international treaties of the Russian Federation (List II).

4. List of precursors whose circulation in the Russian Federation is limited and for which control measures are established in accordance with the legislation of the Russian Federation and international treaties of the Russian Federation (List IV).

Circulation of substances whose names are included in the List of Narcotic Drugs, Psychotropic Substances and Their Precursors Subject to Control in the Russian Federation, approved

Decree of the Government of the Russian Federation of June 30, 1998? 681 is considered from the standpoint of Art. 234 of the Criminal Code of the Russian Federation.

7.7. DOSES OF DRUGS

Dose- a certain amount of a drug (active substance) introduced into the body.

toxic (dosis toxica);

Lethal (dosis letalis);

Therapeutic or curative (dosis curativa).Therapeutic or curative doses are divided into 3 types (dosis cu-

rativa):

1) threshold (cause the initial action of the substance);

2) maximum - higher (cause the greatest or limiting action);

3) medium (cause the pharmacological action of an average degree). The average dose is about 1/3 or 1/2 of the maximum (highest) dose. It is usually contained in a unit dosage form (tablet, ampoule, capsule).

For substances included in lists A and B, state bodies (Pharmacological, Pharmacopoeia committees) establish the highest (maximum) and therapeutic doses:

single dose ( pro dose) for children, adults and animals;

Daily intake (pro die) for children and adults (hereinafter

VRD and VSD).

7.8. RULES FOR CALCULATION OF DOSE ACCORDING TO AGE

Rule 1

Therapeutic doses are established based on the intake of drugs by an adult of middle age and weight

70 kg.

Rule 2

For patients older than 60 years, the dose of medicinal substances is reduced by 1/2-1/3 of the adult dose.

Rule 3

Children are prescribed a dose:

According to the table of GF doses by age;

Recalculated for 1 kg of body weight according to the formula:

7.9. DOSE RULES

IN SPEECH IN THE RECIPE

An employee of a pharmacy institution is obliged to give the patient a medicinal product in the amount and dose prescribed by the doctor.

By order of the Ministry of Health and the SR? 110 dated February 12, 2007, it was established that single, daily and course doses when prescribing medicines are determined by the attending physician based on the age of the patient, the severity and nature of the disease in accordance with the standards of medical care. When prescribing a narcotic drug or psychotropic substance of lists II and III, other medicinal products subject to quantitative accounting, the dose of which exceeds the highest single dose, the doctor must write the dose of this drug or substance in words and put an exclamation mark. A recipe that does not meet this requirement is considered invalid.

If it is possible to clarify the dosage and compatibility with the doctor who wrote the prescription, the pharmacy worker can release the drug to the patient.

Rule 4

Changes in the composition of dosage forms (if necessary) should be made only with the consent of the doctor, with the exception of cases established by the current State Pharmacopoeia, orders and instructions of the Ministry of Health of Russia, and should be noted on the requirement, prescription (copy of the prescription, label).

In the absence of the indicated mark on the requirement, prescription (copy of the prescription, label), the manufacturing quality of the dosage form is assessed as "Unsatisfactory". Changes in the quantity of the dispensed medicinal product or the dispensing of tablets instead of powders should also be noted on the requirement, prescription (copy of the prescription, label).

Rule 5

When issuing medicines of the HC, PV, A and B lists in the written control passport and on the reverse side of the prescription, the persons who issued and received the substance sign, date, indicate the name, mass or volume received in words.

Issued by: Atropini sulfatis 0.9 (nine decigrams) Date... Signature... Received by: Atropini sulfatis 0.9 (nine decigrams) Date... Signature...

Rule 6

If the prescription exceeds the dispensing rate, the pharmacy must reduce the number of doses of the dosed drug or the volume (weight) of the undosed drug in order to maintain the dispensing rate.

The norms for dispensing medicines are presented in the order

MOH? 110.

Rule 7

Pharmaceutical substances are dosed in units by mass (gram, milligram, microgram), volume units (milliliter, drops) and in the form of activity units (IU - international or IE - international units).

The definition of units of action for various medicinal substances is indicated in the relevant articles of the pharmacopoeia. When dosing by weight, doses of medicinal substances are indicated in the decimal system of measurement (the unit of mass is 1 g). When dosing substances weighing less than 1 g (1.0), the following designations are used:

0.1 - 1 decigram;

0.01 - 1 centigram;

0.001 - 1 milligram;

0.0001 - 1 decimilligram;

0.00001-1 centi-milligram;

0.000001 - 1 microgram.

7.10. DOSE VERIFICATION

7.10.1. The masses of substances in the prescription are written out in a distributive way

Check algorithm:

1. Find the highest single dose (WFD) and the highest daily dose (VD) according to the GF, respectively. The highest single and daily doses for adults, children and animals are established in the Global Fund X, p. 1021, 1037, 1045 respectively.

2. Compare the found WFD with a single dose (RD) prescribed in the prescription.

3. Compare the found IRR with the daily dose (DM) prescribed in the prescription.

4. In case of exceeding the RD and SD without an appropriate prescription compared to the WFD and VVD, the pharmacy employee contacts the doctor and clarifies the dose and conditions of admission; correct RD and SD. It is recommended in this case to accept the RD equal to half of the GF WFD.

Rule 8

Order M3 and SR RF? 110 dated February 12, 2007, it was established: “If it is possible to clarify with the doctor or other medical worker who issued the prescription, the name of the drug, its dosage, compatibility, etc., the employee of the pharmacy institution (organization) may release the drug to the patient” .

Example 1

Rp.: Atropini sulphatis 0.002 Sacchari 0.25

M. ut f. pulv. D.t.d. ? 10

1. WFD of atropine sulfate under the skin and inside is 0.001.

2. The IRR of atropine sulfate is 0.003.

3. The RD of atropine sulfate is 0.002.

4. SD of atropine sulfate is 0.002. 3 = 0.006.

5. Single and daily doses are too high (without a proper prescription by a doctor).

As a result of a consultation between the pharmacist and the doctor, it was decided to give the patient atropine sulfate at a dose equal to half the highest single dose.

6. The corrected RD is equal to: WFD:2 = 0.00:2 = 0.0005.

7. The corrected SD is: 0.0005. 3 = 0.0015.

Rp.: Atropini sulphatis 0.0005 Sacchari 0.25 M. ut f. pulv. D.t.d. ? 10

S. 1 powder 3 times a day.

7.10.2. The masses of substances in the prescription are written out in a separating way

A. Dosing per single dosage form

Solution algorithm:

1. Find the highest single dose (WFD) and the highest daily dose (VD) according to the GF, respectively.

2. Determine the RD for one reception. To do this, divide the prescribed amount of the medicinal substance by the number of prescribed doses (powders, suppositories, pills, etc.).

3. SD is determined. For this, the RD is multiplied by the number of doses per day.

4. Compare RD and SD with WFD and VSD.

5. In case of excess of RD and SD in comparison with WFD and VVD, agree on the dose with the doctor; correct RD and DM and calculate the mass of the medicinal substance that must be taken to prepare the dosage form. To do this, multiply the corrected RD by the number of prescribed doses (powders, suppositories, pills, etc.).

Example 2

Rp.: Novocain 6.0

Ol. cocoa 60.0

M. ut f. supp.

Div. in p. aeq. ? twenty

1. The WFD of novocaine is 0.2.

2. The IRR of novocaine is 0.6.

3. RD is 6.0:20 = 0 3.

4. SD is 0.3. 2 = 0.6.

5. RD is overestimated compared to the pharmacopoeial, SD is not overestimated.

6. The RD corrected in agreement with the doctor is equal to half

WFD: 0.2:2 = 0.1.

To prepare candles, you need to take novocaine 0.1. 20 = 2.0.

Recipe view after correction:

Rp.: Novocaini 2.0

Ol. cocoa 60.0

M. ut f. supp.

Div. in p. aeq. ? twenty

D.S. 1 candle in the morning and evening.

B. Dose testing in liquid non-dosage dosage forms taken with spoons

Solution algorithm:

1. Find WFD and VSD by GF.

2. Determine the RD of the medicinal substance for 1 dose. To do this, set the number of doses of the drug (NPLS) by dividing the volume of the dosage form by the volume of the spoon (the volume of a tablespoon is 15 ml, the volume of a dessert spoon is 10 ml, the volume of a teaspoon is 5 ml); find the RD of the medicinal substance by dividing its mass (volume) by the number of doses.

3. Determine the SD of the medicinal substance. For this, the RD is multiplied by the number of doses per day.

4. Compare the found RD and SD with tabular values

VRD and VSD.

5. In case of excess of RD and SD in comparison with WFD and VVD, the dose is agreed with the doctor. Accordingly, the RD and SD are corrected. Calculate the amount of medicinal substance (pharmacist-

tic substance), which must be taken to prepare the dosage form. To do this, multiply the RD of the drug by the number of doses of the drug.

Example 3

Rp.: Apomorphini hydrochloridi 2.5 Aq. pur. 100 ml

Solution algorithm:

1. WFD of apomorphine hydrochloride is 0.01.

2. VSD - 0.03.

3. The number of doses of the drug (NPLS) is 100 ml / 10 ml = 10 dessert spoons (10 ml in 1 spoon of water).

4. The RD of apomorphine hydrochloride is 2.5:10 = 0.25>0.01 (WRD).

5. The SD of apomorphine hydrochloride is 0.25. 3 = 0.25>0.03 (VSD).

6. RD and DD are overestimated without proper prescription.

By agreement with the doctor, take a single dose equal to half the highest single dose; correct RD and SD.

7. The corrected RD (corr.) for apomorphine hydrochloride is 0.01/2 = 0.005.

8. The corrected SD is 0.005. 3 = 0.015.

9. Calculation of the corrected mass of the medicinal product:

to prepare the dosage form, you need to take apomorphine hydrochloride:

RD (correct) x number of doses of the drug: 0.005. 10 = 0.05.

Recipe view after correction: Rp.: Apomorphini hydrochloridi 0.05 Aq. pur. 100 ml

M.D.S. 1 dessert spoon 3 times a day.

B. Checking doses of liquid potent or poisonous substances prescribed in a mixture with other liquids and taken in drops

Solution algorithm:

1. Find WFD and VSD by GF.

2. Determine the number of drops in 1 ml of the drug according to the table of drops (see Table 6.3).

3. Determine the total number of drops in the dosage form.

4. Determine the number of doses of the drug (NPLS) by dividing the number of drops in the entire dosage form by the number of drops of 1 dose.

5. Find the RD of the drug by dividing its amount in drops by the number of doses of the drug.

6. Determine the SD of the medicinal substance. For this, the RD is multiplied by the number of doses per day.

7. Compare the found RD and SD with WFD and VSD.

8. In case of excess of RD and DM in comparison with the WFD, the ERR, in agreement with the doctor, correct the RD and DM.

9. Calculate the amount of the medicinal substance that must be taken to manufacture the dosage form.

Rule 9

The number of drops in the entire dosage form is equal to the sum of the drops of each ingredient.

Example 4

Rp.: Tinct. conv. Tinct.

Val. ana 10 ml Tinct.

Belladonnae 40 ml Mentholi 0.2 M .D.S.

40 drops 3 times a day.

1. WFD of belladonna tincture is 23 drops, VSD is 70 drops.

2. According to the drop table (see Table 6.3), determine: 1 ml of lily of the valley tincture - 50 drops; 10 ml of lily of the valley tincture - 500 drops; 1 ml of valerian tincture - 51 drops; 10 ml of valerian tincture - 510 drops; 1 ml of belladonna tincture - 44 drops; 40 ml belladonna tincture - 1760 drops. The total number of drops is: 500+510+ +1760 = 2770 drops.

3. The number of doses of the drug is: 2770:40 = 69.

4. RD of belladonna tincture is (40.44): 69 = 1760:69 = 25 drops.

5. SD of belladonna tincture is 25. 3 = 75 drops.

6. SD and RD are overestimated compared to WFD and VSD.

7. A modified dose was agreed with the doctor (S from the highest single dose). The corrected RD is 23:2 = 11.5 drops.

8. Corrected SD is 13. 3 = 39 drops.

9. Then you need to change the total amount of belladonna tincture so that for 1 dose it was 11.5 drops, i.e. 11.5. 69/44 = 18 ml.

The single dose dosage form contains:

belladonna tinctures - 12 drops (see above);

Lily of the valley tinctures - 500/69 = 7.3 drops;

Valerian tinctures - 510/69 = 7.4 drops.

Thus, a mixture of tinctures of belladonna, valerian and lily of the valley for 1 dose should be prescribed: 11.5 + 7.3 + 7.4 = 26.2 drops.

Recipe view after correction: Rp.: Tinct. conv. Tinct. Val. ana 10 ml Tinct. Belladonnae 20 ml Mentholi 0.2

M.D.S. 26 drops 3 times a day.

7.11. REQUIREMENTS FOR THE DESIGN OF INDICATIONS ON STANDLASSES

In pharmacy, it is customary to store medicines in glass, tightly closed containers (shtanglas). On the side of the barbell, an inscription with the designation of the contents is pasted or engraved.

Rule 10

Barbells with poisonous medicinal substances (list A) must have white inscriptions on a black background. Be sure to indicate the highest single and daily doses.

On barbells with potent substances (list B), the inscriptions are made in red on a white background. Indicate single and daily doses of the substance.

Rule 11

In the storage rooms of a pharmacy, on all barbells with medicines, the following must be indicated: the serial number of the manufacturer, the analysis number of the control and analytical laboratory (the center for quality control of medicines), the expiration date, the date of filling and the signature of the person who filled out the barbell. The number of units of action in 1 g of medicinal plant material or in 1 ml of the medicinal product should be indicated on the barbells with medicinal products containing cardiac glycosides.

In the assistant's rooms on all the barbells with medicinal substances must be indicated: the date of filling, the signature of the person who filled out the barbell and verified the authenticity of the medicinal substance. The highest single and daily doses must be indicated on the A&B lists of medicinal substances, and the warning label “For sterile dosage forms” must be on the medicinal substances on the shelves intended for the manufacture of sterile dosage forms.

Barrels with solutions, tinctures and liquid semi-finished products should be provided with normal dropmers or empirical pipettes. The number of drops in a certain volume must be determined by weighing 5 times a mass of 20 drops and indicated on the label.

test questions

1. What is the need for classification of medicines?

2. For what purpose is the classification of medicines used in terms of accounting and storage?

3. What is the significance of the classification of medicines from the point of view of the PKKN?

4. What groups are medicines divided into depending on the strength of action?

5. How are medicines stored and what inscriptions should be on the barbells?

Tests

1. By nature of origin, drugs are classified into:

1. Mineral.

2. Synthetic.

3. Organic (obtained by chemical or biological synthesis, including from animal or vegetable raw materials).

2. List A means are:

1. Medicines, dosing and use of which require special care due to their high toxicity.

2. These lists also include drugs that can cause addiction.

3. List B drugs are medicines:

1. For which therapeutic doses have been established.

2. For which higher single doses are established.

3. For which daily doses are established.

4. Stored with care to avoid possible complications.

5. Listed as potent substances.

4. Depending on the physical and physico-chemical properties, the impact on them of various environmental factors, drugs are classified into:

1. Requiring protection from light.

2. Requiring protection from moisture.

3. Requiring protection from volatilization and drying.

4. Requiring protection from exposure to elevated temperatures.

5. Requiring protection from low temperatures.

6. Requiring protection from exposure to gases contained in the environment.

7. Odorous, coloring.

8. Disinfectants.

5. According to federal law? 3-FZ "On Narcotic Drugs and Psychotropic Substances", all narcotic substances, depending on the control measures applied by the state, are included in the following lists:

1. List of narcotic drugs and psychotropic substances, the circulation of which is prohibited in the Russian Federation in accordance with the legislation of the Russian Federation and international treaties of the Russian Federation (List I).

2. List of narcotic drugs and psychotropic substances, the circulation of which in the Russian Federation is limited and for which control measures are established in accordance with the legislation of the Russian Federation and international treaties of the Russian Federation (List II).

3. List of psychotropic substances whose turnover in the Russian Federation is limited and for which the exclusion of certain control measures is allowed in accordance with the legislation of the Russian Federation and international treaties of the Russian Federation (List III).

4. List of psychotropic substances, the circulation of which is permitted in the Russian Federation and for which the exclusion of certain control measures is allowed in accordance with the legislation of the Russian Federation and international treaties of the Russian Federation (List III).

5. List of precursors whose turnover in the Russian Federation is limited and for which control measures are established in accordance with the legislation of the Russian Federation and international treaties of the Russian Federation (List IV).

6. Dose - a certain amount of a drug:

1. Introduced into the body.

2. Causing a positive effect on the course of the disease.

7. Depending on the strength of the pharmacological action of the dose, there are:

1. Toxic (dosis toxica).

2. Lethal (dosis letalis).

3. Therapeutic or curative (dosis curativa).

4. For children and adults.

8. Therapeutic or therapeutic doses are divided into 3 types:

1. Threshold (cause the initial action of the substance).

2. Maximum - the highest (cause the greatest or limiting action).

3. Medium (cause the pharmacological action of an average degree).

9. Changes in the composition of dosage forms should be made only with the consent of:

1. Pharmacist-technologist.

2. Doctor.

10. All changes in the composition of the medicinal product should be noted on:

1. Requirements.

2. Prescription.

3. Copies of the prescription.

4. Label.

5. Passport of written control.

11. When issuing medicines of the NA, PV, A and B lists in the written control passport and on the back of the prescription l And those who issued and received the substance put:

1. Signature.

2. Date.

3. Specify the name.

4. The mass or volume of the funds received in words.

12. 0.00001 is:

1. 1 milligram.

2. 1 decimilligram.

3. 1 centigram.

13. In case of exceeding the dosage of the medicinal product without appropriate registration, the employee of the pharmacy institution:

1. May dispense the drug to the patient.

2. Cannot release the drug.

3. Can dispense a drug in a dose equal to 1/2 of the highest single dose.

14. The number of drops in the entire dosage form is:

1. The amount of drops of each ingredient.

2. The sum of the volumes of medicines divided by the sum of the drops of each ingredient.

15. In the assistant's rooms, on all barbells with medicinal substances, the following must be indicated:

1. Date of completion.

2. Signature of the person who completed the barbell.

3. Signature of the authenticator of the medicinal substance.

4. Number of analysis according to the packing work log.

16. On the barbells with medicinal substances of lists A and B, the following must be indicated:

1. Higher single and daily doses.

2. Name of the manufacturer and date of manufacture.

17. On the barbells with medicinal substances intended for the manufacture of sterile dosage forms, there must be a warning inscription:

1. Sterile.

2. Non-pyrogenic.

3. For sterile dosage forms.

18. Barbells with poisonous medicinal substances (List A) must bear the following inscriptions:

19. Barbells with potent substances (List B) must have the following inscriptions:

1. Black color on a white background.

2. Red color on a white background.

3. White color on a black background.

4. Be sure to indicate the highest single and daily doses.