And pharmacotherapy. types of drug therapy. Drug therapy Type of therapy aimed at eliminating the causes of the disease

It is customary to distinguish between the following types of drug therapy.

1. Symptomatic therapy - i.e. aimed at eliminating certain

symptom of the disease, for example, the appointment of antitussives for

bronchitis.

2. Etiotropic therapy - elimination of the cause of the disease when medicinal

substances destroy the causative agent of the disease. For example, the treatment of infectious

diseases with chemotherapeutic agents.

3. Pathogenetic therapy -- aimed at eliminating the mechanism of development

diseases. For example, the use of painkillers for an injury when

pain syndrome entails the development of life-threatening shock.

4. Substitution therapy - restoration of natural deficiency in the body

substances formed in it (hormones, enzymes, vitamins) and taking

participation in the regulation of physiological functions. For example, the introduction of hormonal

drug in case of loss of function of the corresponding gland. substitution

therapy, without eliminating the causes of the disease, can provide vital functions in

for many years. So, insulin preparations do not affect the production of this

hormone in the pancreas, but with constant administration of it to the patient

diabetes mellitus provide a normal exchange of carbohydrates in his body.

The body's response to drugs. body cells respond to

The effect of various drugs is very uniform. Basically

change in cell functions under the influence of drugs is reduced either to an increase

(excitation), or to a decrease (inhibition) of their activity. For example, with

With the help of medicines, you can easily increase or decrease the secretion of gastric

glands and thus affect digestion. The action of some drugs

even if their concentration remains constant, it increases over time.

This may depend on their accumulation in the body (for example, strychnine) or on

summation of individual effects of an action (for example, ethyl alcohol),

repeated injections of the drug may increase sensitivity to it

organism - this phenomenon is called sensitization. Or vice versa

weaken - the body becomes accustomed to the repeated introduction of some

drugs (eg morphine, ephedrine).

Pal - differences in sensitivity to medicinal substances in individuals of different

the floor is small. In some cases, it has been experimentally found that women

more sensitive than men to some poisons, such as nicotine, but more

resistant to alcohol. But it must be borne in mind that under special conditions,

characteristic of the female body, its sensitivity to certain substances

may change: during menstruation, pregnancy, lactation.

Body weight - in some cases, for greater accuracy, the dosage of medicinal

substances is calculated per 1 kg of body weight.

Individual susceptibility - sensitivity to drugs

people vary greatly. For some it can be very high.

strong degree. In this case, one speaks of idiosyncrasy, which is based on

modern concepts are congenital enzyme deficiency, manifested

allergic reaction (see below. Complications of drug treatment).

Age - the sensitivity of children to medicinal substances is subject to

some fluctuations. For example, children are more sensitive to morphine, strychnine,

less to atropine, quinine, cardiac glycosides. Depending on age

the dosage of medicines accordingly changes.

Particular attention should be paid to poisonous and potent agents,

the therapeutic dose of which is calculated for adults (25 years). AT

in youth and childhood, it is reduced approximately like this: at 18 years old - 3/4

doses for adults, at 14 years - 1/2, at 7 years - 1/3, at 6 years - 1/4, at 4 years

1/6, at 2 years - 1/8, at 1 year - 1/12, up to 1 year - 1/24 - 1/12 of the dose for

adult. Higher doses are reduced to 3/4 and 1/2 also for persons over 60 years of age.

Importance of nutrition - in many cases when using drugs

a specific diet is needed, for example, in the treatment of diabetes

insulin, attracting some poisonings, etc.

The interaction of drugs with food should also be taken into account. It is forbidden

drink tetracycline with milk or dairy products due to their content

a large amount of calcium, with whose ions it interacts. At the same

time such drugs as acetylsalicylic acid, butadione, difenin,

indomethacin, metronidazole, iron salts, steroids, furadonin recommended

drink milk to reduce their irritating effect on the mucous membrane

food channel. Calcium chloride, calcium gluconate easily form with acetic,

oxalic, carbonic and fatty acids sparingly soluble complexes,

excreted with feces. Therefore, such drugs are recommended to be taken for 40

minutes before meals, and one tablespoon of 10% calcium chloride solution is necessary

dissolve in 1/3 cup of water to reduce its irritating effect on

mucous membrane of the stomach. Bile forms insoluble complexes with

such antibiotics as: polymyxin, neomycin, nystatin - take them

followed 30 minutes before meals. The same bile promotes absorption

fat-soluble drugs. These are vitamins, hormones - they are taken

vice versa after eating.

Interaction of drugs. Very often with this or that disease

take not one, but two, or even more different drugs.

It is necessary to know the mechanism of their action. Medicinal substances can

act in one direction, and then the effect they exert is, as it were,

summed up. If the drugs you take act in opposite directions

directions, such cases are referred to as antagonism ("struggle" effects). AT

medical practice, the simultaneous administration of several drugs is

increasing use, since such a combined method leads to

enhancing therapeutic treatment or reducing and preventing side effects

events and complications. So, in the treatment of hypertension, they are simultaneously used

cardiac vasodilator glycosides and diuretics, thus

complexly influencing various parts of a single circulatory system.

Drugs affect each other at any stage of passage through the body: when

absorption, transport phase, metabolism (intracellular metabolism),

excretion from the body.

It is not rational to use adsorbents (aluminum hydroxide, almagel, magnesium

sulfate) together with alkaloids, glycosides, enzyme preparations,

dyes, antibiotics. Physical and chemical properties are not compatible in

one syringe of bepzylnenicillium with levomycetin, chlorpromazine, genarin,

tetracycline, vitamins of group B.

Routes of administration of drugs into the body.

To achieve a pharmacological effect, medicinal substances must

enter the body or apply to its surface. Medicines are injected into

body in different ways, and each way is different in its own way.

features. The following are of the greatest practical importance.

1. Inside through the mouth (enterally) drugs are administered in the form

solutions, powders, tablets, capsules, pills. The introduction through the mouth is

in the simplest and most convenient way, but not without drawbacks, since

absorption of the drug through the intestines into the blood is not amenable to accurate

quantitative accounting, some drugs are destroyed in the intestines, as well as

in the liver, and thus lose their activity. Therefore, it is necessary

or water, etc.).

2. The use of drugs under the tongue (sublingually). Advantages of this method:

medicinal substances, not decomposed by gastric juice, quickly enter the

systemic circulation, thereby ensuring the development of the desired effect.

Disadvantages: irritation of the oral mucosa.

3. Introduction to the rectum (rectal). Avoids annoying

effects on the stomach, as well as use drugs in cases where it is difficult

or fail to take them by mouth (nausea, vomiting, spasm or obstruction

esophagus). Rectal is administered suppositories and liquids using enemas.

4. Parenteral (outside the gastrointestinal tract) use of drugs:

various options for injection, inhalation, electrophoresis and surface application

them on the skin and mucous membranes. a) Intravenous injections, intraarterial,

intramuscular, subcutaneous. Advantages: fast onset of effect, accuracy

therapeutic dose, the possibility of introducing substances that are not absorbed from

gastrointestinal tract. Precautions: Do not administer medication until

there is no belief that the needle is in the vein. Entry of the drug into

perivenous space can cause severe irritation, up to

tissue necrosis. It can be dangerous if the needle accidentally gets into other

blood vessels. Some drugs must be given slowly

avoid severe complications. Injection is not made near the nerve

trunks, damage to which can cause severe pain, sometimes muscle paresis.

b) inhalation. Inhalation of medicinal substances in the form of aerosols, gases and

powders are quickly absorbed and have a local and general effect. in)

Superficial (external) application - ointments, lotions, powders, compresses, etc.

used for local effect. d) Electrophoresis. The method is based on

the use of galvanic current for the transfer and implementation of medicinal

substances from the surface of the skin to deep tissues.

Medicinal substances and their decay products are excreted from the body with feces,

urine, excretion with air, sweat, saliva and lacrimal

liquid.

Kidneys. Most drugs are excreted by the kidneys, regardless of

concentration in the blood by filtration in the glomeruli.

Digestive tract. In this way, as a rule, many alkaloids are isolated and

heavy metals.

Leather. Skin glands are able to secrete bromine, iodine, arsenic and some others.

substances.

Airways. Through them, gaseous and volatile compounds are released.

Milk glands. Possibility of excretion of drugs by these glands

must be considered from two points of view. First, this can

use for the introduction of drugs into the child's body, but, on the other

side, the noted fact represents a danger of possible poisoning

breastfed child.

The most common and simplest method of treatment for diseases is drug therapy. The doctor will prescribe medications using various routes of administration: it is important to strictly follow the recommendations of a specialist without trying to change the therapy regimen on your own. Medicinal preparations can be part of a complex therapy used according to indications in various types of traditional treatment of diseases.

Tablets - a simple and effective method of treatment

Drug Therapy - Forms of Drugs

The most common dosage forms for traditional therapy are tablets. Habitual and frequently used drugs are always available in the home first aid kit. In addition to tablets, depending on the doctor's prescription, drug therapy involves the use of the following dosage forms:

capsules;
dragee;
syrup;
tincture;
powders (sachets);
candles (suppositories);
solution for injections (injections);
ointment, gel or cream;
patch on the skin;
liquid for oral administration;
solution for douching or injection into the rectum (microclyster);
gaseous substance for inhalation (aerosol).

It all depends on the diagnosis and method of treating the disease: the main goal of the therapeutic effect is the entry of a medicinal substance into the blood or a local effect on the human body. It is necessary to use the atraumatic form of administration of the dosage form to the maximum in order to minimize the risk of complications and side effects.

Routes of drug administration

For each patient, the doctor selects the best way to administer the drug. The main ones are 3 types of therapy:

local;
Enteral (through the intestines);
Parenteral (bypassing the gastrointestinal tract).

Each treatment option has indications and contraindications, advantages and disadvantages: the doctor knows all the nuances, pros and cons of the drug effect, so you must follow the doctor's recommendations without trying to use alternative therapeutic methods.

Local therapy

The impact on the outer integument and nearby mucous membranes refers to local methods of treatment. For skin diseases, the doctor will prescribe creams, ointments, powders, pastes, patches. A variety of local therapy are special preparations:

vaginal suppositories;
eye drops;
nasal spray;
drops in the ears;
aerosols.

In each case, drug therapy is selected individually, depending on the diagnosis and complexity of the disease.

enteral route

The introduction of drugs through the gastrointestinal tract involves the use of the following routes:

oral (by mouth);
rectal (candles in the rectum).

Oral tablets are the simplest, most affordable and effective method of therapeutic action, but one must take into account the risk of possible complications and side effects associated with the negative effect of the drug on the mucous membranes of the stomach and intestines.

parenteral administration

The most effective way of introducing a drug into the human body is injection: during an injection, the drug quickly enters the bloodstream, bypassing the aggressive environment of the stomach. Injections can be done:

subcutaneously;
intramuscularly;
intravenously (stream or drip).

The main disadvantage of the technique is that invasive exposure requires certain conditions, experience and knowledge from the person who performs the injection, so it is advisable to do the injections only in a hospital setting.

Injections must be done in a hospital setting

Medical treatment options

Treatment for each disease is selected individually. There are the following methods of pharmacotherapy:

antimicrobial (drugs to get rid of infection);
anti-inflammatory (fighting the inflammatory process);
hormone therapy (correction of endocrine imbalance);
chemotherapy (suppression of metastatic foci);
(targeted impact on certain mechanisms and causes of the formation of the disease);
immunotherapy (correction of immunity);
enzyme therapy (use of special enzyme preparations);
vitamin therapy (replenishment of deficiency of vitamins and minerals important for life);
symptomatic (elimination of unpleasant and dangerous symptoms).

Almost always, drug therapy is combined - the doctor will prescribe various drugs to influence different factors of the disease.

Medication dosage

The medicine can become poison if the dosage is incorrect - exceeding the dose several times, you can harm your own body. If the amount of the drug is insufficient, the effect of the treatment will be low (or there will be no effect). It is important to strictly follow the recommendations of a specialist, carefully taking the medicine at the right dosage.

Side effects of therapy

Each person is individual, so the reaction to the drug will not always be typically positive. There are 3 types of side effects:

allergic;
Toxic;
Medicinal.

An allergy can occur to absolutely any drug form. Poisoning is more common with an overdose. Typical adverse reactions due to the pharmacological action of the drug include:

vascular reactions with a drop in blood pressure (headache, dizziness, weakness, fainting, vomiting, tachycardia);
dyspepsia (nausea, heartburn, belching, vomiting, diarrhea);
shortness of breath, cough.

Taking a medicine is a strong and pronounced effect on the body: one should not take drugs lightly, taking antibiotics or hormones orally with occasion and without need. Drug therapy is a method that a doctor uses in the fight against a disease: pharmacotherapy can only be started after an examination and finding out the cause of the disease, be sure to follow the prescription of a specialist in terms of dosage and combination of drugs.

Pharmacoprophylaxis is the prevention of diseases with the help of medicines. For prophylactic purposes, antiseptic and disinfecting drugs are used (to prevent the spread of infectious diseases), vitamin preparations (to prevent hypovitaminosis), iodine preparations (to prevent endemic goiter), etc.

Pharmacotherapy (drug therapy) is the treatment of diseases with the help of medicines. For future pharmacists, pharmacotherapy corresponds to the academic discipline "clinical pharmacology" and is the next step after general and private pharmacology in mastering the science of the interaction of drugs with living organisms.

The use of medicines for the prevention and treatment of diseases is based on knowledge of: the causes and conditions for the occurrence of diseases; mechanisms of disease development; external manifestations of disease.

There are the following types of drug therapy.

Etiotropic (causal) therapy (from the Greek. aethia- cause, tropos- direction and from lat. causa- cause) is aimed at eliminating or limiting the cause of the disease. Medicines that eliminate the cause of the disease are called etiotropic. These include chemotherapeutic agents that suppress the vital activity of pathogenic microorganisms that cause infectious diseases, antidotes that bind toxic substances that cause poisoning.

Pathogenetic therapy (from the Greek. pathos- disease, genesis- origin) is aimed at limiting or eliminating the mechanisms of disease development. Medicines used for this purpose are called pathogenetic. So, antihistamines eliminate the effect of histamine released during an allergic reaction, but they do not stop the body's contact with the allergen and do not eliminate the causes of the development of an allergic reaction. Cardiac glycosides increase myocardial contractility in heart failure, but do not eliminate the causes that caused it.

Replacement therapy is aimed at filling the lack of endogenous substances in the body. For this purpose, hydrochloric acid is used.

acid and enzyme preparations for insufficient function of the digestive glands, hormonal preparations for hypofunction of the endocrine glands, vitamin preparations for hypovitaminosis. Substitution therapy drugs do not eliminate the cause of the disease, but reduce or eliminate the manifestations of a deficiency of a particular substance necessary for the life of the body. As a rule, such drugs are used for a long time.

Symptomatic therapy is aimed at limiting or eliminating individual undesirable manifestations (symptoms) of the disease. Medicines used for this purpose are called symptomatic. These drugs do not affect the cause and mechanisms of the disease. For example, painkillers and antipyretics reduce pain and fever, which are symptoms of various diseases, including infectious diseases.

concept drug therapy has been a wide, multifaceted and most important “stratum” in the field of medicine for countless centuries. Perhaps this therapy is one of the most ancient "methods" of treating people. This form of therapy may also be referred to as drug therapy, pharmacotherapy, or biological therapy (biotherapy). During its long history, biotherapy had different names, methods and forms of application, and even the most harmful substances were sometimes considered medicines. As an example: for many decades, the “pseudo-doctors” of the Middle Ages convinced people that mercury is a “unique medicine” for hundreds of diseases, although only mercury vapor is a terrible poison that is practically not excreted from the human body.

But today, medicines, pharmaceuticals and other therapeutic and prophylactic drugs are one of the main "bases" for treating people. Although therapy is considered conservative for some reason, and some doctors even consider it secondary, auxiliary! And not as effective as more modern healing techniques, the most sophisticated devices, medical equipment and other "automatic robots".

Today, pharmacology is a very important and highly significant science for human health, which researches and develops drugs of natural or chemically synthesized origin.

And all medications- medicinal forms in a form ready for use in the treatment of people. Depending on many specific, purely medical aspects, drug therapy is carried out by introducing into the patient's body in a variety of ways and in the form of a very wide range of drug forms themselves.

And each medicine- a “special substance” or a special mixture of several substances with an already obvious pharmacological effect on the disease and its own special “healing activity”. All medicines go through the strictest multi-level control and testing before entering the "drug market".

Forms of drug therapy

Modern dosage forms used in biological therapy, can (although rather "sparsely conditionally") be classified according to different principles and specific features of the boundless drug therapy. Here are just a few of them:

They can be divided into groups of different dosage forms.
Medicines are classified according to their state of aggregation.
There is a classification of drugs, depending on the method of their specific use or methods of dosing drugs.
The classification of various drugs is very important and in demand, which is directly dependent on their specific method of introduction into the human body.

For example, the classification of drugs according to their state of aggregation consists of solid forms, liquid, soft, even gaseous, and so on.

Particularly complex and extremely diverse is the “classification division” of drugs according to the principle of their effect on certain functions of specific organs, body systems and the treatment of certain ailments. This is a “separate science” and knowing it thoroughly and correctly is extremely important for the professionalism of every ordinary doctor and a high-level doctor.

And, despite the fact that there is no single official classification of medicines according to these “parameters”, doctors still divide them according to the principle of their “positive effect” on healing from specific groups of diseases. Let us give, for an illustrative example, only a hundredth (if not a thousandth of them):

Medicines that affect the "central nervous system".
Affecting the "peripheral nervous system".
Medications that act favorably on "sensitive nerve endings."
Medicines used in cases of cardiovascular problems in humans.
Medicines that affect the normalization of the functions of the kidneys, liver, and other organs. Choleretic drugs.
Medicines that affect the improvement and strengthening of immunity.
Medicines and specialized drug therapy for the treatment of malignant cancers.

And this list can be continued for a very long time. I cited a tiny part of it only so that it would become more clear to ignorant people: how incredibly much doctors need to know and be able to give exceptionally correct diagnoses and, accordingly, the best and most effective " medical methods» treatment of specific diseases. Physicians actively and effectively use drug therapy in your daily practice. The main thing is to know well the interaction of medicines (components of a drug) with the biology of each individual person, since drugs can act differently on different people. I believe that there are no bad medicines, there is a bad knowledge of the doctor and not the ability to choose the right medication part of the treatment individually.

Quality control of drug therapy

But along with this drug therapy must be under the strictest daily, hourly (or even much more often!) Control, both by doctors and all support staff of health facilities (Medical and Preventive Institutions).

This unshakable "medical principle" implies a constant analysis and a quick, extremely correct assessment of both the expected "positive results" of healing, and unexpected, but very likely "side results" as a result of the application of various techniques. drug therapy.

To do this, the medical staff must know how to almost instantly correct the chosen treatment tactics using various replacement or resuscitation procedures.

And in accordance with this principle of treatment, it is necessary to carefully consider the entire “healing strategy” and its possible “unexpected consequences”. This, of course, is very difficult, but this is the work of a doctor from the “heart and God” ...

tablets, capsules for oral administration;
solutions for intravenous, subcutaneous, intramuscular injections;
external agents (solutions, creams, ointments);
candles, medicinal pencils;
aerosols, sprays;
plasters, etc.

Nosological classification identifies groups of drugs for the treatment of various diseases. There are separate groups of medicines for the treatment of mental disorders, addictions, endocrine, cardiological, neurological diseases, diseases of the gastrointestinal tract, OPD, organs of vision, and other internal organs and systems.

Pharmacology indicates the action, the purpose of the drug. There are 16 main groups in total. Subgroups of preparations are allocated in almost each. In anti-relapse treatment can be used:

non-narcotic analgesics and NSAIDs to relieve pain;
hormones and antagonists to maintain a stable hormonal background in case of disruption of the endocrine system;
immunotropic drugs for disorders of the immune system;
metabolism to improve the general condition of the body;
neurotropic drugs for anti-relapse treatment of mental disorders;
organotropic drugs for correction, improvement of the functioning of internal organs, etc.

Anti-relapse drug therapy in the center "Panacea"

Medical Center "Panacea" recommends that you apply for the appointment of drug therapy to your doctor or specialist. Self-treatment with any medication can be dangerous with immediate complications and worsening health in the future. In our center, drug therapy is prescribed after a preliminary examination, taking into account:

results, which help to assess the potential susceptibility of the body to active substances, the level of their tolerance, the likelihood of side effects, the expected benefits from the use of a particular drug;
patient history: history of his illness, data on the current state of health. This information is important for the correct, safe selection of drugs;
the proposed organization of anti-relapse treatment (may affect the form of release, dosage, frequency of use of selected drugs).

We follow certain principles when prescribing medicines:

medicines are used only when other options for anti-relapse therapy are ineffective, and the expected benefit justifies their use;
compliance with the recommended dosages, taking into account the age of the patient, his state of health, susceptibility to the components of the drugs;
compatibility of drugs with each other (all drugs taken by the patient are evaluated). Separately, recommendations are formed on compatibility with alcohol, certain foods, diet correction, lifestyle, etc.;
minimal side effects. If they may appear, the doctor must inform the patient in advance;
safety, proven efficacy. Our medical center prescribes only drugs that have been certified in the Russian Federation, have proven effectiveness, and have successfully passed tests and trials. In some cases, if necessary, taking into account the patient's state of health, experimental means can be used (the doctor must provide the patient with full information about them).

In order for drug therapy to be effective, the Panacea Medical Center recommends that you follow the dosages prescribed by the doctor and the regimen for taking medications (daily dosage, number of doses per day, time of taking medications, etc.), as well as other recommendations related to anti-relapse treatment and