South Kazakhstan State Pharmaceutical Academy
Department of pharmacology, pharmacotherapy and clinical pharmacology
Lecture complex
044 -31/15-4
Lecture complex
Discipline
Pharmacology
code of discipline
Specialty
Farm 2209
05V110400 "Medical-preventive work"
The volume of training hours / credits
Course
Semester study
45/1 loan
2
4
2015-16 academic year
South Kazakhstan State Pharmaceutical Academy
Department of pharmacology, pharmacotherapy and clinical pharmacology
Lecture complex
044 -31/15-4
Approved at the meeting of the department
Protocol № _____ of "____", the ___________2016
Head of Department of Pharmacology, clinical pharmacology and pharmacotherapy
M.D., acting Professor
Kerimbayeva Z.A.
South Kazakhstan State Pharmaceutical Academy
Department of pharmacology, pharmacotherapy and clinical pharmacology
Lecture complex
1.
2.
3.
4.
5.
1.
2.
3.
044 -31/15-4
Lecture 1
1. Subject: General Pharmacology. The object and purpose. General laws of pharmacodynamics and
pharmacokinetics of drugs. Toxicokinetics and toxicodynamics drugs.
2. Purpose: To give an idea of how the science of pharmacology, pharmacokinetics and
pharmacodynamics of drugs.
3. Lecture Abstracts
Pharmacology - the doctrine of medicines.
General pharmacology - the basic laws of action of drugs and the body to each other (pharmacodynamics
and pharmacokinetics).
Private Pharma - effect of certain drugs on the individual organs
Pharmacodynamics - the action of drugs on the body.
Pharmacokinetics - the action of the body to the drug.
1.
suction
2.
distribution
3.
deposition
4.
biotransformation
5.
breeding
Nonpolar lipophilic compounds penetrate the membrane after diffusion into the lipid phase (easily
penetrate the cells).
Hydrophilic substances penetrate into cells:
filtration (with water through aqueous pores) or passive diffusion in an aqueous phase (only small size
molecules). This means that the hydrophilic substance (introduced, for example, intravenously) can
penetrate through the intercellular spaces in the endothelium of renal glomerular capillaries. Remarks:
In the capillaries of the brain are no gaps, formed the BBB - brain barrier. But there is one place in the
brain where the hydrophilic substances still can penetrate into the brain substance - launcher zone of the
vomiting center.
Small gaps between epithelial gastrointestinal tract, therefore the absorption of polar products difficult.
Between the epithelial tubule (but not glomerular) no intercellular spaces, thus polar compounds are not
reabsorbed.
by active transport and facilitated diffusion
Distribution.
It depends on the hydrophilic, hydrophobic properties.
Biotransformation.
Lipophilic substances are metabolized by hepatic microsomal oxidation system (enzymes of the
endoplasmic reticulum) a hydrophilic substance that is easily excreted.
Excretion:
filtration
secretion in the proximal tubules
reabsorption in the distal tubule (lipophilic substances)
For better clearance of drugs are sometimes used bad property of charged molecules diffuse through
biological membranes. For example, for the removal of phenobarbital (a weak acid) renal filtrate was
basified by the introduction of hydrogen (with forced diuresis).
Pharmacodynamics:
Pharmacological effects - changes in organs and systems with the introduction of drugs.
Mechanisms of action. Targets:
1. receptors
2. ion channels
3. enzymes (AChE inhibitors, other inhibitors)
4. Transport Systems (antidepressants, inhibitors of Na + / K + -ATPase)
receptors - Functionally active macromolecules or fragments there of that selectively interact with certain
substances (ligands), because of which there is a chain of biochemical reactions in the cell, which leads to
the development of pharmaceutical effects.
South Kazakhstan State Pharmaceutical Academy
Department of pharmacology, pharmacotherapy and clinical pharmacology
Lecture complex
044 -31/15-4
Receptor properties:
1. selectivity (defined structure)
2. lability (adjustable ligands)
3. by localization in a cell are divided into:
a) membrane
b) intracellular
Membrane receptors:
1. directly related to ion channels (N-cholinergic receptors, GABA receptors, receptor-Gly)
2. directly related enzymes (insulin receptor-related tyrosine kinase)
3. interacting with G -proteins (G s, G i -> ATPase, G q - FLS). Characterized by a cascade amplification of the
signal.
4. M-cholinergic receptors
5. receptors for peptide hormones
6. receptors for adrenaline
Quantitative aspects of the interaction of matter with the receptor.
Usually drugs form a non-covalent (ionic, van der Waals bonds), which determines the reversibility of the
interaction.
Bioequivalence - the ratio of the effectiveness of different preparations containing one substance in one
phase (similar bioavailability, a similar time to reach maximum concentration)
Agonists - substances that stimulate receptors that bind to them.
Antagonists - substances that bind to receptors, but do not stimulate them (prevent other substances).
Internal Activity - ability of a substance to stimulate the receptors.
Full agonists - substances having affinity and maximal intrinsic activity. Internal antagonist activity is
zero.
Partial agonists - substances having affinity but do not possess maximum intrinsic activity (maximal
intrinsic activity less).
Agonist-antagonists - stimulate and inhibit some other type of receptor subtypes (e.g. opioid receptors).
Partial agonists - antagonists are full agonists.
4. Illustrative material - slides in a Microsoft program Power Office Point
5. References Kharkevich DA Pharmacology: A textbook. - 10th ed., Ext.. and Corr. -M .: GEOTAR
Media, 2008. - 734 p.
6. Control questions (feedback)
1. What are some sources of drugs?
2. What pharmacokinetics studies?
3. What pharmacodynamics studies?
Lecture 2
1. Subject: The antiseptic and disinfectant
2. Purpose: To give an idea about drugs that have disinfectant and antiseptic properties.
3. Lecture Abstracts
History:
1. Zemelveyts I. (1847) - the use of bleaching powder as an antiseptic for the prevention of puerperal sepsis
2. Russia: bleaching powder for the treatment of hand surgery
3.
Disinfectant (antiseptic) agents
Or used externally for insertion into a body cavity; for the treatment of hands, instumentariya,
premises. They have a broad spectrum of activity (SHSD), a non-selective (act on the cells of
microorganisms, macro-organisms).
Chemotherapeutic agents (selective for microorganisms)
antibacterial
antispirohetosis
antiprotozoal
antifungal
South Kazakhstan State Pharmaceutical Academy
Department of pharmacology, pharmacotherapy and clinical pharmacology
Lecture complex
044 -31/15-4
antiviral
The antiseptic and disinfectant. Antiseptic (From the Greek "rot") is called antimicrobial agents,
which retard the growth of microorganisms, disinfectants and - substances that kill microbes. Accordingly
distinguish a bacteriostatic effect when there is a stop of the microorganisms, and bactericidal action, when
microorganisms are killed completely. Between antiseptic and disinfectant agents there is no fundamental
difference, since every antimicrobial agent, depending on the application in some cases may cause a delay
in the development of microorganisms, and in others - his death.
By means of the application means to distinguish an antiseptic effect on the skin, mucous membranes,
gastrointestinal tract, airways, urinary tract, etc. On chemical structure antiseptics allocated to classes of
chemical compounds to which they relate, which reflects their mechanism of action.
Group of halides Iodine - ash obtained from algae oil and water drilling. There are 4 groups of
iodine preparations: 1) containing elemental iodine (iodine solution of alcohol, Lugol's solution); 2)
inorganic iodide (potassium iodide, sodium iodide); 3) organic substances split off elemental iodine
(iodoform, iodinol); 4) iodine-containing organic compound (radiocontrast agent).
Topical iodine solutions are used as an antimicrobial agent for the treatment of wounds, the
preparation of the operative field, and the like, providing irritating may cause reflex changes in the
organism.
Oxidants Hydrogen peroxide (perhydrol) - a solution of hydrogen peroxide and 3% hydrogen
peroxide solution 27,3-31% (concentrated). In contact with alkalis, organic substances and hydrogen
peroxide decomposes with release of gaseous oxygen, which has antiseptic properties and contributes to the
mechanical cleaning of fabrics. Apply antiseptic rinses and washes in angina, stomatitis, otitis, as well as
the treatment of wounds in solution at the rate of 1 teaspoon or 1 tablespoon of 3% solution on a glass of
water.
. Acid Salicylic Acid Example used externally as an antiseptic in the powder (2-5%) and 1-10%
ointments, pastes, alcohol solutions for lubricating skin (salicyl alcohol), rubbing - to inflamed joints, to
wipe the skin - at itching, seborrhea.
Alkalis: Ammonia (ammonia) 10% ammonia solution in water. Used in surgery for hand washing
and for inhalation with fainting and alcohol intoxication.
Aldehydes Formaldehyde (formalin), clear, colorless liquid with a pungent odor. Used as a
disinfectant and deodorant for washing hands, washing the skin with excessive sweating (0.5-1%), for the
disinfection of instruments (0.5%) for douching (1: 2000 - 1: 3000). Included in the LIZOFORM.
Alcohols Ethanol (ethyl alcohol) on the pharmacological properties attributed to drugs. By acting
on the cerebral cortex, it causes a characteristic alcoholic excitement associated with the weakening of the
braking process. In medical practice, used primarily as an external antiseptic and irritant for wiping,
compresses, etc. Intravenously sometimes injected with gangrene and lung abscess in a sterile isotonic
solution. Ethanol is widely used for making tinctures, extracts and formulations for external use.
Heavy metal salts of silver nitrate (lapis) - in small concentrations astringent and Proto
vovosplitelnoe action in stronger solutions - cauterize tissue bactericidal. Apply externally with erosions,
ulcers, excessive granulation, acute conjunctivitis.
Phenols Phenol, carbolic acid. Used for disinfection of household and hospital utensils, tools,
clothes, secretions. For disinfection of premises used carbolic soap-solution. In medical practice, phenol is
used in certain skin diseases and inflammation of the middle ear (ear drops). Phenol has on the skin and
mucous membrane irritant and cauterizing effect, easily absorbed through them and in high doses can be
toxic (dizziness, weakness, breathing disorders, collapse).
Dyes Brilliant green is used externally as an antiseptic in the form of 0.1-2% alcohol or an aqueous
solution in pyoderma, blepharitis for lubricating edges century.
Tar, resin, oil products, herbal balms balm of Vishnevsky - Ingredients: 3 pieces of tar, xeroform
3 parts, 94 parts of castor oil. It is used in the treatment of wounds, ulcers, pressure sores, etc. It has
antiseptic properties, has little irritating, promotes the process of regeneration.
4. Illustrative material - slides in a Microsoft program Power Office Point
5. References
South Kazakhstan State Pharmaceutical Academy
Department of pharmacology, pharmacotherapy and clinical pharmacology
Lecture complex
044 -31/15-4
Kharkevich DA Pharmacology: A textbook. - 10th ed., Ext.. and Corr. -M .: GEOTAR Media, 2008. - 734
p.
6. Control questions (feedback)
1. What is aseptic?
2. What action have disinfectant?
3. What action have preservatives?
Lecture 3
1. Subject: Chemotherapeutics means: Antibacterial drugs.
2. Purpose: To give an idea about drugs that have antibacterial properties.
3. Lecture Abstracts
The history of the discovery of antibiotics. Classification.
1.
1929 A.Fleming discovered penicillin
2.
1944 Z.Vaksman discovered streptomycin (TB)
3.
1942 Z.V.Ermoleva received the first domestic penicillin
Classification: Antibiotics: (antibacterials)
β -lactams: penicillins (biosynthetic, semisynthetic), cephalosporins, carbapenems, monobactams
Mechanism of action: inhibition of the synthesis of the cell wall peptidoglycan during mitosis.
Β-lactamase inhibitors: clavulanic acid (amoxicillin + = Augmentin), sulbactam, tazobactam
3)
a.
cephalosporins
first generation
b.
second generation
c.
third generation
d.
fourth generation











a wide range of activities - there are almost all m\o
bactericidal action
preparations: cephaloridine, cephalexin (ceporeks)
They are also Enterobacteriae
indolpozitiv Proteus
less effect on Gact on Pseudomonas aeruginosa
act mainly on T + -tsefepim
cefuroxime, cefamandole, cefoxitin, cefotaxime,
moxalactam
cephalexin and cefaclor are effective when taken orally
cefoxitin acts on Bacteroides
4)
carbapenems
Imipinem, meropenem (Meron)
5)
monobactams
aztreonam
Negative features of β-lactam:
1. allergy (cross)
2. bactericidal effect - endotoxin shock, acute reaction (temperature increase to 39-39,5 within days efficiency PV)
3. nephrotoxicity (maximum from the first-generation cephalosporins)
4. SHSD proportional possibility of superinfection: dysbiosis, candidiasis, kandidosepsis, aspergillosis
Macrolides: Erythromycin, Clarithromycin, Roxithromycin
The negative features: allergy, hepatotoxicity (impaired structural integrity of the hepatocytes), is more
active than erythromycin (2-4 p)
Azalide: Azithromycin (sumamed)
1.
High-performance with respect to G- coccs, pathogens of atypical pneumonia (mycoplasma)
2.
100 x stronger than erythromycin accumulates in phagocytes - increasing their activity
3.
1 is applied every 1-2 days (more active)
Lincosamides: lincomycin, clindamycin
South Kazakhstan State Pharmaceutical Academy
Department of pharmacology, pharmacotherapy and clinical pharmacology
Lecture complex
044 -31/15-4
Negative traits: the rapid development of resistance and mokroorganizma acts on other
anaerobic Bacteroides, accumulates in bone (osteomyelitis apply well)
Aminoglycosides: streptomycin, kanamycin, neomycin, gentamicin, tobramycin, amikacin, metilmitsin
The mechanism of action of streptomycin. Violate the early stages of protein synthesis → bactericidal
effect. Destroy the vacuole with toxic substances. Disable CPM
Tetracyclines
1. broad spectrum of activity
2.
bacteriostatic
1.
short-acting - by 20-45% bound

tetracycline
to plasma proteins

oxytetracycline
2.
Long-acting - by 80-90% bound

metacycline
to plasma proteins

doxycycline, morphocycline
Negative traits:

hepatotoxic effects (direct toxic effect on hepatocytes)
Chloramphenicol is administered by mouth, parenterally, a wide spectrum of action (edge anaerobic), the
treatment of severe intestinal infections (reserve drug)
Negative traits: toxic effects on the blood, the children metabolized slowly (as in allergies)
Polymyxin is not absorbed from the gastrointestinal tract, bactericidal effect, acts only on the T- (urinary
tract infections)
Negative traits: nephrotoxicity
Glycopeptides: bactericidal activity, reserve drugs
Vancomycin Leykoplakin
 act on G + coccs, Clostridium
 It penetrates through the BBB
 applied parenterally
Fusidic acid is a narrow spectrum of activity - G + organisms
Side effects of antibiotics
1)
effect on the immune system
2)
chemotherapeutic
3)
toxic effects on organs and tissues
4)
mixed character
А. Effects on immune system
1. allergy (GNT) - cross within the same group of drugs
2. suppression of cell-mediated immunity (immunosuppressants) (bakteritsiidnoe less bacteriostatic effect
when irrational use)
А.Chemotherapeutic effects
1.superinfection (BSA)
2.acute response (bactericidal antibiotic)
a.
Toxic Organotropic effect:

tetracyclines (are also chelating compounds - bind Ca 2+ in the
Hepatotoxic action
bones - causes increasing ossification violation of tooth formation)

Polymyxin
Nephrotoxicity

aminoglycosides

cephalosporins
aminoglycosides reversible effect on the hair cells (also operate their
Ototoxicity
metabolites) → produced by the action of aminoglycosides NO, O 2 →
→ reduction of oxidative stress release of glutamate (the primary
mediator)
cortical deafness (incorrect perception of sounds) → abolition of
aminoglycosides
They can also cause:
South Kazakhstan State Pharmaceutical Academy
Department of pharmacology, pharmacotherapy and clinical pharmacology
Lecture complex
044 -31/15-4


vancomycin
erythromycin at long appointment
Prevention of negative features - rational antibiotic therapy:
 BSA prescribe antibiotics, bactericidal
 select the optimal duration of use
 Combined medication (but not bactericidal + bacteriostatic)
4. Illustrative material - slides in a Microsoft program Power O ffice Point
5. References
Kharkevich DA Pharmacology: A textbook. - 10th ed., Ext.. and Corr. -M .: GEOTAR Media, 2008. - 734
p.
6. Control questions (feedback)
1. What are the features of the natural penicillins?
2. Why is the use of antibiotics is necessary to adhere to the principles of chemotherapy?
3. Each group of antibiotics has a characteristic is their side effects. List.
Lecture 4
1. Subject: chemotheurapeutics means: antiparasitic agents
2. Purpose: To give an idea of drugs, have antiprotozoal and anthelmintic properties.
3. Lecture Abstracts
Antiamoebic drugs
Amebiasis is caused by intestinal amoebas. Parasitic amoeba in the intestinal lumen, in the intestinal
wall, or in other organs (e.g., bile ducts in the liver, lungs). When intestinal amebiasis drugs are introduced
into at extra-intestinal amebiasis - parenterally.
Classification:
1. Drugs used in amebiasis any location - metronidazole, tinidazole, niridazole.
2. Drugs used in the form of intestinal amebiasis: hydroxyquinoline derivatives (hiniofon,
meksaform, intestopan).
3. at localization of amoebas in the liver - hingamin.
4. tissue forms amebiasis amoebae localization in the gut wall or hepatic - emetine hydrochloride,
bismuth iodide.
Metronidazole (Trichopolum), tinidazole (fasizhin) - easily penetrates the simplest cells, which
causes a disturbance of the DNA of parasites. The drug is readily absorbed from the gastrointestinal tract
and penetrates into all tissues and fluids excreted by the kidneys. It is used to inhibit the activity of
amoebae, giardia, trichomonas’s. Side effects: metallic taste, nausea, vomiting, headache. Contraindicated
during pregnancy and lactation, as well as in violation of blood formation. Metronidazole not combine with
alcohol, as alcohol slows down the destruction of the body.
Antilyambliosis funds.
Giardia parasites in the bile ducts and duodenum 12. The most common use of metronidazole and
furazolidone.
Furazolidone - suppresses life Giardia and Trichomonas. It inactivates enzymes lamblia, and
causes the formation of the simplest of toxic substances. Side effects: dyspepsia, in people with reduced
kidney function may cause damage to the optic nerve and decrease the sensitivity of nerve endings.
Antimalarial
Malaria - caused by plasmodium. Malaria is on the patient to a healthy person is transmitted by the
female anopheles mosquito species.
Malaria occurs in several stages. In this connection, preparations are also used depending on the stage of
the disease.
1.drugs that destroy the Plasmodium parasites in red blood cells - quinine, quinacrine, hingamin, hloridin.
2.drugs which destroy the death of protozoa in liver cells - hloridin, primaquine, hinotsid.
The causative agent of trichomoniasis - Trichomonas vaginalis - exerts its effect vulvovaginitis,
obesity, urethritis. The drug of choice is metronidazole. The group also includes metronidazole tinidazole
South Kazakhstan State Pharmaceutical Academy
Department of pharmacology, pharmacotherapy and clinical pharmacology
Lecture complex
1.
2.
3.
4.
044 -31/15-4
(fazizhin), which is effective for amebiasis and giardiasis and operates longer than metronidazole. Of the
other drugs used trihomonotsid (aminoquinoline derivative) nitazol, furazolidone and ornidazole (tiberal).
The causative agent of toxoplasmosis - Toxoplasma gondii - causing intestinal lymph nodes, lungs
and other organs. For the treatment used hloridin (antimalarial drug), sulfa drugs, and antibiotics
(clindamycin and spiramycin).
Pathogen balantidiasis (Balantidium coli) affects the colon. For the treatment of antibiotic used
monomitsin and antibiotics of the tetracycline group drugs protivoamebiaznye hiniofon and yodohinol and
metronidazole.
Drugs used in the treatment of Leishmaniosis
There cutaneous leishmaniasis caused by Leishmania tropica, and the visceral form, caused by
Leishmania donovani (kala-azar). Treatment of visceral form is carried out pentavalent antimony drugs
which are administered parenterally and are well tolerated. Side effects: nausea, headache, agranulocytosis.
Cutaneous leishmaniasis is also treated with drugs antimony. Locally appointed quinacrine,
aminoglycosides (monomitsin) and less toxic metronidazole and ketoconazole.
Drugs used in the treatment of trypanosomiasis
Germs - Tripanosoma gambiense, Triponosoma rhodesiense, which cause sleeping
sickness; Tripanosoma cruzi causes Chagas disease development. The therapy is used melarsonol (arsenic
compound, which is the drug of choice), eflornithine, pentamidine and suramin. The latter two drugs are
used in the early stages of disease (they do not penetrate the blood-brain barrier). In Chagas' disease using
primaquine (antimalarial drug), puromycin, benzindazol, nifurtimox.
Drugs used in the treatment of intestinal helminths
nematosis:
1.ascariasis - mebendazole, pyrantel pamoate, albendazole, levamisole, piperazine adipate, naftomon;
2.Enterobiasis (pinworms) - mebendazole, pyrantel pamoate, albendazole, piperazine adipate, pirviniya
pamoate;
3.trichocephalosis - mebendazole, albendazole;
4.hookworm - mebendazole, pyrantel pamoate, albendazole, levamisole, naftomon, ethylene tetrachloride;
5.strongyloidosis - mebendazole, albendazole, piperazine adipate, praziquantel;
6.trihostrongiloidosis - pyrantel pamoate, albendazole, levamisole, piperazine adipate, naftomon.
cestodosis:
diphyllobothriasis - fenasal, prazinkvantel, trihlorofen, aminoakrihin;
taeniasis - praziquantel, trihlorfen;
teniarinhoza - praziquantel, fenasal, trihlorfen, aminoakrihin;
hymenolepiasis - praziquantel, fenasal, trihlorfen, aminoakrihin.
Trematodozy:
1.metagonimoz - ethylene tetrachloride.
4. Illustrative material - slides in the program Microsoft Office Power Point
5. References: Kharkevich DA Pharmacology: A textbook. - 10th ed., Ext.. and Corr. -M .: GEOTAR
Media, 2008. - 734 p.
6. Control questions (feedback)
1. What are the indications for the purpose of chloroquine?
2. The patient was appointed antimalarial drug. After some time, he drew attention to the loss of
vision. Specify the reception of antimalarial drug may be linked to this side effect.
3. What preparation is used in all forms of amoebiasis.
Determine the preparation of the following properties:

It has a wide spectrum anthelmintic action

It causes generalized muscle contraction helminths, passing in persistent paralysis

used in trematodosis, tsistodosis, diphyllobothriasis and others.
 well tolerated
South Kazakhstan State Pharmaceutical Academy
Department of pharmacology, pharmacotherapy and clinical pharmacology
Lecture complex
044 -31/15-4
Lecture 5
1. Subject: Basic principles of treatment of acute poisoning drugs and poisons. The toxic effects of
medicinal raw materials and drugs on the body of employees of medical institutions and
pharmaceutical companies
2. Purpose: To give an idea of urgent measures at the pre-hospital drug poisoning.
3. Lecture Abstracts
The mortality rate in cases of poisoning drugs reaches 1 - 4%. In severe poisoning up to 15%.
Stage poisoning
Toxigenic 1 - characterized by a specific action of the drug in the form of membrane functions
disorders, enzymes etc. Intensity of this stage is directly dependent on the content of the substance in the
blood plasma.
2 somatogenically - development of typical pathological processes and the formation of non-specific
reactions, the poison had already launched or destroyed, does not depend on the severity of the substance in
plasma.
Action on the CNS Toxic coma, convulsions, toxic psychoses.
Toxic coma in high doses substances cause inhibition of CNS functions - anesthesia (drugs,
barbiturates, antipsychotics, tranquilizers, alcohol). After waking up - asthenic conditions up to several
months. Recovery.
. Seizures may be due to a specific effect of the drug, but more often - the manifestation of the
nonspecific reaction (cerebral hypoxia result).
Toxic psychosis. Delirium and deliriomentives states characterized by visual hallucinations and
impaired orientation in time, space and identity.
Toxic damage the cardiovascular system. Exotoxin shock - not a very frequent phenomenon. It is
characterized as an acute, persistent violation of tissue blood perfusion. A syndrome of small emission,
decreased blood pressure and decreased venous return accompanies it.
Rhythm and conduction disturbances: In case of overdose of atropine may develop sinus tachycardia,
or paroxysmal. Especially effects on the central nervous system is characteristic of tricyclic antidepressants
(amitriptyline). They selectively accumulate in the myocardium.
Election cardiotoxicity: sodium channel blockade, arrhythmias to atrial fibrillation. Conduction
abnormalities leading to blockades, characterized by a negative inotropic effect.
hypoxia
Hypoxic 1: the neurogenic form, the central action.
2 Aspiration-obstructive: aspiration of mucus or vomit, the tongue.
3 Parenchymal form - pneumonia
4 histotoxic form (tissue).
Basic principles of treatment of poisoning drugs
1 Stabilization of the patient's condition
Remove cramps, to clear the upper airways by foreign bodies.
2 Termination of further poison into the organism
When ingestion - enteral gastric lavage, regardless of how long ago the adoption of poison. Then repeated lavage - the poison could come from the intestine after the reverse peristalsis. Use vomiting only
effective after a short time after the poisoning. Ipecac syrup is used. Purification of the small intestine is
also performed using a probe.
1 Forced diuresis
2 Dialysis.
3 Acceleration of excretion has grown deep poison
There are several types of it. When blood enters the dialyzer, toxic substances enter the dialysis
fluid. Early dialysis used in toxicology. By its application, there are certain requirements:
Data requirements ideal barbiturates, besides an early hemodialysis used in the treatment of poisoning
with methyl and ethyl alcohols, ethylene glycol, etc. Early hemodialysis is ineffective in case of poisoning
benzodiazepine drugs, tricyclic antidepressants.
Contraindication to hemodialysis - a persistent reduction in blood pressure.
South Kazakhstan State Pharmaceutical Academy
Department of pharmacology, pharmacotherapy and clinical pharmacology
Lecture complex
044 -31/15-4
Peritoneal dialysis. Technically, more simple, it is the only method used at exotoxic shock.
Hemosorption - adsorption on sorbents (natural - activated carbon, various artificial). The device
connects via arteriovenous shunt on the forearm. The advantage - the possibility of pre-hospital
(toxicological teams have devices for hemosorption)
Also used plasmapheresis and ultrafiltration.
4 antidote pharmacotherapy.
On the mechanism of drugs are divided into physical (neutralize the poison with the help of physical
interaction) and chemical (neutralize poison by chemical neutralization). Among the natural antidotes
widespread chelators (adsorb the poison in the gut - Vaumen, polifepam, Lignosorb).
These drugs adsorb the poison in the gut - reducing the amount of poison in the body - increases the
relative content of the plasma - the poison enters the intestine. Enterosorbents: absorb water - it can lead to
dehydration, violate the motility of the intestine, aspiration - may be a coal pneumonia.
The sorbents are used in conjunction with a saline laxative, for the prevention of vomiting (aspiration)
- antiemetics. Ingested parenterally.
There are also biochemical and antidotes.
The phases of detoxification:
1 using microsomal oxidation reactions (more polar become monooxygenase). In this case the by free
radicals appear and participate in lipid peroxidation.
2 conjugation reactions
3 System antitoxic protection.
For example, paracetamol may cause hepatotoxicity. Under normal conditions, a sulfate and
conjugated with glutathione.
By the antioxidants are vitamins A, E, a water-soluble selenium.
Actually antidotes (pharmacological antidote or antidote)
There are competitive and non-competitive.
It can be applied: if only one further poison in the body 2 only in accurate diagnosis of
poisoning. There may be side effects of their own
toxic
RECEPTOR
antidote
substances
Atropine
M-holinoretseptorov
Aminostigmin,
Physostigmine,
Galantomin (AChE inhibitors)
Narcotic
Mu, delta opioid receptors
Naloxone
analgesics
Benzodiazepine
benzodiazepine receptors
flumazenil
s
1.
2.
3.
4.
5.
5 Symptomatic therapy
Means as with other forms of pathology
Treatment effects (asthenia) - nootropics.
4. Illustrative material - slides in the program Microsoft Office Power Point
5. References : see Annex №1
Орманов, Н. Ж. Фармакология. 1-кітап : оқулық - Алматы : Эверо, 2013. - 656 бетОрманов, Н. Ж. Фармакология. 2-кітап : оқулық - Алматы : Эверо, 2013. - 512 бетОрманов, Н. Ж. Жалпы рецептура. Жалпы фармакология : оқу құралы - Алматы : Эверо, 2012.
- 102 бет
Орманов, Н. Ж. Фармакология кесте мен сызбада : оқу-әдістемелік құрал / Н. Ж. Орманов, Л. Н.
Орманова ; ОҚМФА. - Алматы : Эверо, 2011. - 368 бет
Сұлтанов М. Ә. Фармакология: оқу құралы. - Шымкент, 2008.
6. Kharkevich DA Pharmacology to the recipe: a textbook. - 3rd ed, App. P. and ext. - M., 2009. - 464 p.
7. Kharkevich , D, A. Pharmacology: studies. for high schools. - 10th ed.. and ext. - M., 2008. - 752 p. 50
South Kazakhstan State Pharmaceutical Academy
Department of pharmacology, pharmacotherapy and clinical pharmacology
Lecture complex
044 -31/15-4
8. Kharkevich, D. Fundamentals of Pharmacology: a textbook for high schools. - M: F EOTAR - Media,
2008. - 720 p.
Additional :
1. Mashkovskii, M.D Medicines: A Guide for Physicians / MD Mashkovskii. - 16 th ed., Revised. and
ext. - M.: New Wave, 2012 - 1216 with
2. Drugs in Kazakhstan: a handbook. - 5 th ed. Ispra.. and ext. - Almaty AstraF Armservis, 2008. - 944
with
3. Kryzhanovsky SA Modern medicines. More than 10,000 Naim ments: sprav.- Moscow, 2008.
4. May, V.V. Pharmacology general formulation [electronic resource]: a textbook for honey. schools and
colleges. - 3rd ed., Ext. and rev. - Electron. text given. (36.1 MB). - M.: Publishing group "GEOTARMedia", 2011. - 240 p. e. wholesale.disk (CD-ROM) .5. Kharkevich D.A. Pharmacology [electronic resource]: a textbook. - 10th ed., Revised. and ext. Electron. text given. (62.1 MB). - M.: Publishing house. group "GEOTAR-Media", 2010 7 52. e. wholesale. disk (CD-ROM).
6. Alyautdin , R.N. Pharmacology [electronic resource]: a textbook for middle prof. education. Electron. text given. (44.6 MB). - M: And Mr. "GEOTAR- Media", 2010. - 704 p. e. wholesale. disk (CDROM)
7. Electronic medication encyclopedia [Electronic resource]: Encyclopedia. - Electron. text given. (52.7
MB). - M.: KNORUS 200 9. - el. wholesale. disk (CD-ROM).
8. Kharkevich , D. Fundamentals of Pharmacology [electronic resource]: a textbook . - 10th ed.,
Revised. and ext. - Electron. text given. (54.3 MB). - M: And Mr. "GEOTAR- Media", 2008. - 720
p. e. wholesale. d suit (CD-ROM).
6. Control questions (feedback) :
1. In the intensive care unit delivered a boy of 5 years. Complaints of abdominal pain, nausea,
vomiting, diarrhea with blood. In a conversation with my parents found out that the child is playing with
his sister, "the clinic" took a few pills of iron preparation. Caused by ambulance, the child is
hospitalized. Objectively: skin is pale with a cyanotic shade, learning breathing; blood pressure is lowered,
marked lethargy, drowsiness. Condition is regarded as serious. What urgent measures should be carried out
in cases of poisoning drugs iron? What medication is used to bind iron and enhance its elimination from the
body? Specify the mechanism of action?
2. Do I need to wash the stomach of the patient being in a state of unconsciousness?
3. Give examples of antidote pharmacotherapy.