Preferanskaya Nina Germanovna
Art. Lecturer, Department of Pharmacology, MMA them. THEM. Sechenov, Ph.D.
The duration of treatment is halved when starting treatment in the first 2 hours after the onset of the first clinical signs acute inflammatory process, whereas the beginning of treatment after only a day from the first symptoms of the disease increases both the duration of treatment and the number of drugs used. Topical drugs show a faster initial effect than systemic drugs. The use of these drugs allows early treatment, they also affect the prodramal period of the disease and have a preventive effect on patients. Recently, the effectiveness of these drugs has significantly increased, the spectrum of their activity has expanded, the selective tropism and bioavailability have improved, while maintaining their high safety.
Drugs with mucolytic and expectorant action
The evacuation of accumulated sputum and the relief of breathing are facilitated by phytopreparations containing active substances from thermopsis, marshmallow, licorice, creeping thyme (thyme), fennel, anise oil, etc. Currently, combined preparations are especially popular, plant origin. Widely used drugs: containing thyme - bronchicum(elixir, syrup, lozenges), tussamag(syrup and drops), stoptussin syrup, bronchitis; containing licorice, syrups - doctor MOM, linkas; containing guaifenesin ( ascoril, coldrex-broncho). Pertussin, has expectorant and cough softening properties: it enhances the secretion of the bronchi and accelerates the evacuation of sputum. Contains liquid thyme extract or liquid thyme extract 12 parts each and potassium bromide 1 part. Prospan, Gedelix, Tonsilgon, contain ivy leaf extract. In the assortment of pharmacies there are lozenges with sage, lozenges with sage and vitamin C. Fervex cough medicine containing ambroxol. Tussamag balm for colds, contains pine bud and eucalyptus oil. It has anti-inflammatory and expectorant action. Apply for rubbing into the skin of the chest and back 2-3 times a day.
Erespal is produced in the form of coated tablets containing 80 mg of fenspiride hydrochloride and syrup - 2 mg of fenspiride hydrochloride per 1 ml. The preparation contains licorice root extract. Erespal counteracts bronchoconstriction and has an anti-inflammatory effect in the respiratory tract, involving various interested mechanisms, has a papaverine-like antispasmodic effect. It reduces swelling of the mucous membrane, improves sputum discharge and reduces sputum hypersecretion. For children, the drug is prescribed in the form of a syrup at the rate of 4 mg / kg of body weight per day, i.e. children weighing up to 10 kg 2-4 teaspoons of syrup (10-20 ml) per day, more than 10 kg - 2-4 tablespoons of syrup (30-60 ml) per day.
These drugs are used for productive cough, for acute respiratory viral infections and influenza, as well as for complications (tracheitis, bronchitis) and for chronic obstructive respiratory diseases.
Drugs with analgesic, anti-inflammatory and anti-allergic action
Falimint, Toff plus, Agisept, Fervex, Dr. Theiss with echinacea extract and etc.
Coldrex LariPlus, combination drug prolonged action. Chlorpheniramine has an anti-allergic effect, eliminates lacrimation, itching in the eyes and nose. Paracetamol has an antipyretic and analgesic effect: it reduces the pain syndrome observed in colds - sore throat, headache, muscle and joint pain, reduces high temperature. Phenylephrine has a vasoconstrictive effect - reduces swelling and hyperemia of the mucous membranes of the upper respiratory tract and paranasal sinuses. close in composition and pharmacological action drugs Coldrex, Coldrex Hotrem, Coldex Teva.
Rinza contains 4 active ingredients: paracetamol + chlorpheniramine + caffeine + mezaton. Has a wide range of action. Applicable for colds upper respiratory tract, accompanied by fever, headache, runny nose.
Preparations with antibacterial, antimicrobial action
Bioparox, Ingalipt, Grammidin, Hexaral, Stopangin and etc.
Among antibacterial drugs, Locabiotal (Bioparox) in the form of an aerosol, a combined drug Polydex assigned to children from 2.5 years.
Gramicidin C(grammidin) polypeptide antibiotic, increases the permeability of the microbial cell membrane and disrupts its resistance, which leads to the death of microbes. Increases salivation and cleansing of the oropharynx from microorganisms and inflammatory exudate. When taking the drug, allergic reactions are possible, before use it is necessary to check for sensitivity.
Ingalipt aerosol for local application, containing soluble sulfonamides - streptocide and norsulfazol, which have an antimicrobial effect on gram "+" and gram "--" bacteria. Eucalyptus oil and peppermint oil, thymol have a softening and anti-inflammatory effect.
For the prevention of influenza and viral rhinitis, oxolinic ointment is used. 0.25% ointment lubricates the nasal mucosa in the morning and evening during the influenza epidemic and in contact with patients, the duration of use is set individually (up to 25 days).
Pharyngosept contains in 1 tablet 10 mg ambazone monohydrate, applied perlintually (sucking). The tablet dissolves slowly in the mouth. The optimal therapeutic concentration in saliva is achieved when taking 3-5 tablets per day for 3-4 days. Adults: 3-5 tablets per day for 3-4 days. Children 3-7 years: 1 tablet daily 3 times a day. Used to treat diseases of the ENT organs. It has a bacteriostatic effect on streptococci and pneumococci, has antimicrobial activity, without affecting E. coli.
Preparations with antiseptic action
Geksoral, Yoks, Lizobakt, Strepsils, Sebidin, Neo-angin N, Grammidin with an antiseptic, Antisept-angin, Astrasept, Fervex for sore throat, etc.
Septolete, lozenges for complete resorption containing benzalkonium chloride, which has a wide spectrum of action. Effective primarily against gram-positive bacteria. It also has a powerful fungicidal effect on Candida albicans and on some lipophilic viruses, pathogenic microorganisms that cause infections of the mouth and throat. Benzalkonium chloride contains the drug Tantum Verde.
Laripront for the treatment of inflammation of the mucous membranes of the mouth, throat and larynx. The composition of the drug includes two active ingredients: lysozyme hydrochloride and dequalinium chloride. Thanks to lysozyme, a natural mucosal protective factor, the drug has antiviral, antibacterial and antifungal effects. Dequalinium is a local antiseptic that increases the sensitivity of infectious agents to lysozyme and facilitates the penetration of the latter into tissues. Assign adults 1 tablet, children 1/2 tablet every 2 hours after meals, keep the tablets in the mouth until completely resorbed. Apply until the symptoms of the disease disappear. For the purpose of prevention, the dose of the drug is reduced to half or up to 1, twice a day.
original classic version Strepsils(Strepsils), containing amylmetacresol, dichlorobenzyl alcohol and oils of anise, peppermint, is available in lozenges. Has an antiseptic effect. Strepsils with honey and lemon soothes irritation in the throat. They produce Strepsils with vitamin C and Strepsils without sugar with lemon and herbs. Using a combination of menthol and eucalyptus soothes a sore throat and reduces nasal congestion.
Drugs with local anesthetic action
Strepsils plus, is a combined preparation containing the anesthetic lidocaine for rapid pain relief and two antiseptic components a wide range actions to treat the infection. Lozenges provide long-lasting local anesthetic effect - up to 2 hours, effectively relieve pain, while suppressing the activity of respiratory pathogens.
Pastilles Drill, indicated for use in adults and children over 12 years old, contain in one lozenge tetracaine hydrochloride 200 mcg as an anesthetic that soothes pain and chlorhexidine bigluconate 3 mg as an anesthetic to suppress infection.
Drugs with anti-inflammatory effect
Faringomed used as a symptomatic remedy for acute and chronic inflammatory diseases of the upper respiratory tract (tonsillitis, pharyngitis, tonsillitis). The drug reduces the severity of disorders such as sore throat, swelling of the mucous membranes, itching and irritation in the nose; facilitates nasal breathing. Take one caramel - keep in your mouth until completely dissolved. Children under 5 years of age should take the drug no more than four times a day, the rest - no more than six. In case of exacerbation of chronic tonsillitis or pharyngitis, not accompanied by high fever and acute sore throat, 2 doses of the drug per day are enough - one caramel in the morning and in the evening for 7-10 days.
Sea buckthorn, Dr. Theiss lozenges, have general strengthening properties. They contain calcium and magnesium to normalize energy metabolism, the process of formation of enzymes in the body. Blackcurrant, Dr. Theiss lozenges, have a beneficial effect on throat irritation, supplement the daily intake of vitamin C. Contain natural blackcurrant extract. Phytopastiles with Dr. Theiss honey, have a beneficial effect on coughs, throat irritation, hoarseness, upper respiratory tract colds. Refresh the mouth.
Strepfen- a drug for sore throat containing the anti-inflammatory agent flurbiprofen 0.75 mg in lozenges. Reduces the inflammatory process of the mucous membrane of the throat, eliminates pain. The duration of the effect is 3 hours.
Having a mixed, combined effect
Pharyngosept, Carmolis, Solutan, Faringopils, Carmolis lozenges, Foringolid, Travesil and etc.
The complex bronchosecretolytic drug Bronchosan contains in its composition essential oils, which have an antiseptic and anti-inflammatory effect, and anise and fennel oil enhance the expectorant effect of bromhexine, increasing the activity of the ciliated epithelium and the evacuation function of the respiratory tract.
Anti-angin, has a bactericidal, antifungal, local anesthetic and general tonic effect due to its active components: chlorhexidine is an antiseptic from the group of bis-biguanides that have a bactericidal effect against a wide range of gram-positive and gram-negative bacteria (streptococci, staphylococci, pneumococci, corynebacteria, influenza bacillus, klebsiella). Chlorhexidine also suppresses some groups of viruses. Tetracaine is an effective local anesthetic that quickly relieves or reduces the sensation of pain. Ascorbic acid plays an important role in the regulation of redox processes, carbohydrate metabolism, blood clotting, tissue regeneration, participates in the synthesis of corticosteroids, collagen, and normalizes capillary permeability. It is a natural antioxidant, increases the body's resistance to infections.
The arsenal of drugs used for topical use in diseases of the upper respiratory tract is quite diverse and the sooner the patient starts using them, the faster he will cope with the infection without possible subsequent complications.
46-47. RESPIRATORY DISEASES
In children, respiratory diseases are much more common than in adults, they are more severe, due to the peculiarity of the anatomical and physiological characteristics of children and the state of immunity.
Anatomical features
The respiratory organs are divided into:
1. Upper respiratory tract (AP): nose, pharynx.
3. Lower DP: bronchi and lung tissue.
Respiratory diseases
Diseases of the upper respiratory tract: The most common are rhinitis and tonsillitis.
Angina- an infectious disease that affects the palatine
tonsils. The causative agent is most often streptococcus and viruses.
There are acute angina and chronic.
The clinical picture of acute tonsillitis:
Symptoms of intoxication: lethargy, muscle pain, lack of appetite.
Fever
Pain when swallowing
The appearance of raids on the tonsils
Principles of therapy:
Antibacterial therapy! (The drug of choice is penicillin (amoxicillin)).
Plentiful drink (V \u003d 1.5-2 l)
Vitamin C
Gargling with disinfectant solutions.
Clinical picture of chronic tonsillitis:
The main symptom: repeated exacerbations of angina.
Symptoms of intoxication may be present, but to a lesser extent
Frequent nasal congestion
Bad breath
Frequent infections
Prolonged subfebrile condition
Principles of therapy:
Washing of lacunae, tonsils with antiseptic solutions (course 1-2 r / per year).
Local antiseptics: ambazon, gramicidin, hepsetidine, falimint.
General strengthening measures
Regular spa treatment
Vitamin-rich nutrition (vit. C at a dose of 500 mg per day)
Phytotherapy: tonsilgon for children 10-15 drops x 5-6 times a day for 2-3 weeks.
Acute rhinosinusitis- an infectious disease, the causative agent is most often viruses. Depending on the type of pathogen, rhinosinusitis is divided into catarrhal (viral) and purulent (bacterial).
Clinical picture:
Difficulty in nasal breathing
Headache
Discharge from the nose (may be mucous - with a viral infection, and purulent - with a bacterial one).
Less common: increased body temperature, cough
Principles of therapy:
In mild flow, early stages diseases, it is effective to wash the nose with a warm solution (saline, furatsilin), hot foot baths, moisturizing sprays (to thin the mucus) - Aquamoris or mucolytic agents.
Mucolytic drugs: rinofluimucil for 7-10 days.
Vasoconstrictor drugs are prescribed for a period of not more than 7-10 days.
In severe viral rhinitis, bioparox is effective.
Antibacterial drugs are prescribed only in the presence of purulent discharge (the drug of choice is amoxicillin, in the presence of an allergy to penicillin - sumamed (macropen)).
Diseases of the middle respiratory tract
Of the lesions of the SDP, laryngotracheitis is the most common.
Acute laryngotracheitis – acute illness, the causative agent of which is most often viruses, but can be allergens.
Clinical picture:
Sudden onset, usually at night
Noisy wheezing and shortness of breath
Less common: increased body temperature
Principles of therapy:
Distraction therapy (hot foot baths, mustard plasters on the calf muscles, plenty of warm drinks).
The air in the room should be cool and humid.
Inhalation of bronchodilators (ventolin) through a nebulizer.
In the absence of effect - hospitalization of the patient.
Diseases of the lower respiratory tract
Of the lesions of the upper respiratory tract, the most common are:
Airway obstruction
Bronchitis
pneumonia
Bronchial asthma
Obstructive bronchitis appear more often in children of the first 2 years of life
due to the anatomical features of the respiratory tract: narrow
bronchial lumen. Obstruction is associated either with a narrowing of the lumen or with blockage of the airways with thick sputum. The causative agent in 85% are viruses.
Clinical picture:
At the beginning of the disease, a clinic of acute respiratory disease (runny nose, malaise, there may be a temperature). Later, a cough joins: at the beginning dry, but then turning into a wet one. Subsequently
there is shortness of breath, characterized by difficulty inhaling and exhaling
with a characteristic whistling, pecking breath or noise heard on
distance, rapid breathing, retraction of all compliant places
chest (jugular fossa, intercostal spaces).
Principles of therapy:
For mild cases, outpatient treatment:
Frequent ventilation of the room
Inhalation through a nebulizer or spacer with bronchodilators:
berodual, ventolin, soda-salt inhalations.
Bronchial drainage and vibration massage
Acute bronchitis- characterized by inflammation of the bronchial mucosa and are accompanied by hypersecretion of mucus. The cause of the disease is most often viruses.
Clinical picture:
In the first days of illness, the acute respiratory disease clinic: malaise, runny nose, there may be an increase in body temperature
Dry cough, subsequently (after 2-5 days) moistened
Principles of therapy:
Plentiful warm drink ( mineral water, decoction of expectorant herbs)
With dry, hacking cough - antitussives (libeksin, sinekod)
Mustard plasters, jars - not shown (because they injure the skin and can cause an allergic reaction).
Acute pneumonia- an infectious disease in which inflammation of the lung tissue occurs. The causative agent in 80-90% is the bacterial flora, much less often - viruses or fungi.
Clinical picture:
Symptoms of intoxication are expressed: body t > 38-39, lasting more than 3 days; lethargy, weakness,
May be vomiting, abdominal pain
Lack of appetite
Rapid breathing (shortness of breath) without signs of obstruction.
Principles of therapy
In mild forms, treatment can take place on an outpatient basis; in severe cases, as well as children under 3 years of age, hospitalization is indicated:
Antibacterial therapy: Amoxicillin is the drug of choice for mild cases.
Expectorants (ambroxol, lazolvan, acetylcysteine)
Plentiful drink (mineral water, fruit drink, decoctions).
Bed rest during the first days of illness
From the fifth day of illness - breathing exercises
Vitamins (aevit, vit. C)
Physiotherapy
Bronchial asthma is a chronic allergic disease of the respiratory tract, characterized by intermittent attacks of shortness of breath or suffocation. The cause of the disease in the vast majority of cases are allergens. Factors that aggravate the effect of causative factors are: SARS, tobacco smoke, strong odors, cold air, exercise, food coloring and preservatives.
Clinical picture:
Shortness of breath associated with wheezing
Dry, paroxysmal cough
Possible sneezing, nasal congestion
The deterioration usually worsens over several hours or
days, sometimes within minutes.
In addition to the classic features bronchial asthma there are likely signs of the disease:
The presence of frequent episodes of paroxysmal cough and wheezing
The absence of a positive effect from the ongoing antibacterial
Coughing at night
Seasonality of symptoms
Detection of allergies in the family
The presence of other allergic reactions in the child (diathesis)
Principles of therapy
Preventive therapy is the prevention of exacerbation attacks, i.e. elimination of contact with the allergen;
Symptomatic therapy includes the appointment of prophylactic or anti-inflammatory drugs;
Pathogenetic therapy - is aimed at the cause of the disease, i.e. if elimination of the allergen is not possible, then specific immunotherapy (allergic vaccination) is indicated.
The main cause of most acute and chronic respiratory diseases are inflammatory processes infectious nature, most often caused by viruses and bacteria.
Viral and bacterial infections
Viral infection. Viruses are a special kind of tiny (much smaller than microbes) non-cellular particles, consisting only of a nucleic acid (the genetic material of DNA or RNA) and a protein shell.
From nucleic acids and proteins, new viral particles are assembled and released by destroying the host cell. Newborn viruses infect more and more cells, causing the progression of the disease, and are released into the environment, infecting new hosts.
Ways of transmission of a viral infection
- airborne
- oral
- hematogenous (through the blood)
- alimentary (with food)
- contact
- sexual
bacterial infection. Bacteria are single-celled organisms. Unlike viruses, they are able to reproduce on their own (most often by fission) and have their own metabolism. Bacteria use the "host" only as a food product and a fertile environment for life and reproduction.
Many bacteria that are normally safe for a person and live on his skin, in the intestines, mucous membranes, with a general weakening of the body or impaired immunity, can be pathogenic. At the same time, they damage ("digest") cells and tissues with their enzymes and poison the body with waste products - toxins. All this leads to the development of the disease.
For a bacterial infection, the so-called gate is characteristic - the path through which it enters the body. As with viruses, there are also many modes of transmission. For example, bacteria can enter the body through mucous membranes, with the bite of insects (transmissible) or animals.
Having penetrated into the human body, bacteria begin to actively multiply, which will be considered the beginning of a bacterial infection. Clinical manifestations of this disease develop depending on the localization of the microorganism.
Comparison of viral and bacterial infections. For viral infection a general lesion of the body is characteristic, while the bacterial one most often acts locally. Incubation period with a viral infection is from 1 to 5 days, for a bacterial infection - from 2 to 12 days. Viral infection begins acutely with a rise in temperature to 39 ° C or more. At this point, there is a general weakness and intoxication of the whole organism. Bacterial infection begins insidiously with more severe symptoms and temperatures up to 38 °C. Sometimes its appearance is preceded by a viral infection, in which case it is customary to talk about the "second wave" of the disease.
Know the difference between viruses and bacterial infections primarily necessary due to the fact that these infections are treated differently.
If antibiotics are used in the absence of appropriate indications, the formation of resistant bacteria is possible. Also, side effects are often caused by antibiotics, including the development of a violation of the quantitative and quality composition intestinal microflora. In addition, there are reliable data on an increased risk of bronchial asthma and atopic dermatitis in children treated with antibiotics at preschool age.
So remember: Bacterial infections are treated with antibiotics: Viral infections are not treated with antibiotics because these drugs do not work on them.
SARS and influenza
Despite the fact that influenza and its varieties belong to the category of acute respiratory viral infections, in medicine these diseases are usually distinguished from all viral infections.
SARS- acute respiratory viral infection, which includes all diseases of the respiratory tract with viral etiology. The route of transmission of the infection is airborne, while it spreads quite quickly and affects more than 80% of people who have been in contact with the diseased. The reason is the impossibility human body develop immunity to a viral infection, since every year viruses mutate and mutate.
Almost every person suffers from ARVI several times (from 4 to 15 times or more) a year, mainly in the form of mild and subclinical (latent) forms.
Signs and symptoms of SARS
- most often the disease develops gradually and begins with general weakness and runny nose
- increase in body temperature
- headache
- the next day after the onset of the disease, a dryish cough may appear, which eventually transforms into a wet (expectorant)
SARS treatment
- antipyretic drugs (Coldrex, Theraflu, Aspirin)
- cough and phlegm preparations
- anti-inflammatory, decongestant, vasoconstrictor drugs and nasal saline solutions
- multivitamins, ascorbic acid
- drugs that support and increase immunity (interferon, aflubin, immunal)
- plentiful drink
Fever. This is an increase in body temperature, without which almost no SARS can do. As a rule, fever is a reason for the use of antipyretics, but in many cases it is unreasonable, because fever is a protective reaction: many bacteria and viruses die when elevated temperature. Against its background, the body gives a full-fledged immune response. It has been proven that when the temperature drops to subfebrile (about 37.5 ° C) or normal level production of protective factors in the body decreases.
Flu- is caused by the influenza virus and is considered one of the most insidious infectious diseases spreading around the planet in the form of epidemics and pandemics, which annually claim from 250 to 500 thousand human lives.
Currently, scientists have identified more than 2,000 varieties of the virus, the most famous of which are H1N1 - swine flu, A/H1N1 - Spanish flu, as well as bird flu, famous all over the world.
Local remedies for the treatment of diseases of the nasopharynx. They can be conditionally divided into several groups: antiseptics (hexoral, stopangin, cameton, inhalipt); antibiotics (bioparox); local anesthetics (Tantum Verde) and combined means with antiseptic and analgesic action (TeraFlu Lar, Strepsils, Anti-Angin, NovaSept preparations from medicinal plants).
Combined agents are more preferable for patients, as they immediately alleviate the condition, providing an analgesic effect, and also help to avoid taking antibacterial drugs.
Upper respiratory tract infections tend to spread to the mucous membranes of the nasopharynx and larynx, provoking the development of unpleasant symptoms. An antibiotic for the upper respiratory tract should be selected by a specialist, taking into account sensitivity to it. pathogenic microflora. Also, the chosen drug should accumulate in the respiratory epithelium, thus creating an effective therapeutic concentration.
Indications for use and the principle of choosing antibiotics
Antibiotics are used when a bacterial origin of the disease is suspected. Indications for their appointment are:
After an accurate diagnosis is made, the specialist determines the appropriateness of antibiotic therapy. Before prescribing a particular drug, bacteriological examination. The basis for its implementation is the patient's biomaterial taken from the back wall of the oropharynx or nasopharynx. The study of the smear allows you to determine the degree of sensitivity of pathogens to the action medicines, and do right choice drug.
If the pathological process in the upper respiratory tract is caused by a viral or fungal infection, the use of antibiotics will not be able to provide the necessary therapeutic effect. In such cases, the use of such drugs can aggravate the situation and increase the resistance of pathogens to drug therapy.
Commonly prescribed antibiotics
The main task of antibiotics is to help the patient's immune system in the fight against pathogens. For this purpose, antibiotics for the treatment of the upper respiratory tract are used as follows:
- penicillins;
- macrolides;
- cephalosporins;
- fluoroquinolones;
- carbapenems.
Among the drugs penicillin series the most relevant are Flemoxin and Augmentin. Frequently prescribed macrolides are Sumamed and Azithromycin. Of the cephalosporins in the treatment of adults, Ceftriaxone and Zinnat are in demand.
Antibiotics for viral infections of the respiratory tract, represented by fluoroquinolones and carbapenems, are prescribed for a complex course of the disease. In adults, drugs such as Ofloxin, Tsiprinol, Tienam, Invanz are used.
Flemoxin and Augmentin
Flemoxin can be used in the treatment of diseases of the upper respiratory tract at any age. The dosage of the drug is set by the doctor, guided by the age of the patient and the characteristics of the course of the disease.
According to generally accepted treatment regimens, the drug is taken as follows - adults and patients over 10 years old - 500-750 mg (2-3 tablets) orally twice in 24 hours (the dose can be divided into 3 doses per day).
Flemoxin has a minimum of contraindications. The main among them are individual hypersensitivity to the composition of the drug, severe renal and hepatic pathologies. Side effect medications can manifest as nausea, dizziness, vomiting, headaches.
Augmentin is a combination of amoxicillin and clavulanic acid. Many pathogenic bacteria are sensitive to the action of this medication, which include:
- Staphylococcus aureus.
- Streptococcus.
- Moraxell.
- Enterobacteria.
- Escherichia coli.
The drug is widely used in the treatment of respiratory diseases. Augmentin tablets are recommended for adults. This category of patients is prescribed the drug at a dose of 250-500 mg every 8-12 hours. In severe cases of the disease, the daily dose increases.
The drug is not recommended for use in persons prone to developing an allergy to penicillins who have a diagnosis of " Infectious mononucleosis", or severe illness liver. Sometimes the drug causes side effects, among which nausea, vomiting, allergic dermatitis. It can also have a negative effect on the functioning of the liver.
In addition to Flemoxin and Augmentin, among the effective penicillin products for diseases of the upper respiratory tract, drugs with the following names can be prescribed - Flemoclav, Ranklav, Arlet, Klamosar, Amoxicomb.
Treatment with macrolides
Sumamed is often prescribed in case of bronchitis, accompanied by wheezing in chest. Also, this antibiotic is indicated for various diseases of the upper respiratory tract and pneumonia caused by an atypical bacterial pathogen.
Adults Sumamed is prescribed in the form of tablets (capsules). The drug is taken 1 time within 24 hours, 250-500 mg 1 hour before meals or 2 hours after the next meal. For better absorption, the medicine is washed down with a sufficient amount of water.
Azithromycin is effective for sinusitis, inflammation of the tonsils, various forms ah bronchitis (acute, chronic, obstructive). The tool is intended for monotherapy.
With mild and moderate disease, the drug is prescribed in capsules. The dosage is determined by the doctor in each case. In accordance with the recommendations of the instructions for use for adults, it can be:
- the first day of therapy - 500 mg;
- 2 and 5 days - 250 mg.
The antibiotic must be taken once a day, 1 hour before a meal or 2 hours after a meal. The course of application is set individually. The minimum duration of therapy is 5 days. Azithromycin can also be given as a short course (500 mg once daily for 3 days).
The list of contraindications to treatment with marolide antibiotics includes impaired liver and kidney function, ventricular arrhythmia. The drug is not prescribed to patients with a tendency to allergies to macrolides.
Severe cases of upper respiratory tract disease require injection of macrolides. Injections can only be performed in a medical institution, at a dosage indicated by the attending physician.
Ceftriaxone and Zinnat
The drug is intended for intramuscular or intravenous administration. The bioavailability of the drug is 100%. After the injection, the maximum concentration of the drug in the blood serum is observed after 1-3 hours. This feature of Ceftriaxone provides its high antimicrobial efficacy.
Indications for intramuscular injection drug development favors:
- acute bronchitis associated with a bacterial infection;
- sinusitis;
- bacterial tonsillitis;
- acute otitis.
Before administration, the drug is diluted with injection water and an anesthetic (Novocaine or Lidocaine). Painkillers are required, as antibiotic injections are notable for tangible pain. All manipulations must be performed by a specialist, under sterile conditions.
In accordance with the standard scheme for the treatment of respiratory diseases, developed for adults, Ceftriaxone is administered once a day at a dosage of 1-2 g. In severe infections, the dosage is increased to 4 g, divided into 2 injections within 24 hours. The exact dose of the antibiotic is determined by the specialist, based on the type of pathogen, the severity of its course, and the individual characteristics of the patient.
For the treatment of diseases that are relatively easy, a 5-day course of therapy is sufficient. Complicated forms of infection require treatment for 2-3 weeks.
Side effects of treatment with Ceftriaxone can be hematopoietic disorders, tachycardia, diarrhea. Headaches and dizziness, changes in renal parameters, allergic reactions in the form of itching, urticaria, fever. In debilitated patients during therapy, the development of candidiasis is observed, requiring the parallel administration of probiotics.
Ceftriaxone is not used in case of individual intolerance to cephalosporins by the patient.
Zinnat is a 2nd generation cephalosporin. The bactericidal effect of the drug is achieved due to the entry into its composition of the antimicrobial component of cefuroxime. This substance binds to proteins involved in the synthesis of bacterial cell walls, depriving them of their ability to recover. As a result of this action, the bacteria die, and the patient recovers.
For the treatment of adults, Zinnat is prescribed in tablets. The duration of the therapeutic course is determined by the severity of the pathological process, and takes from 5 to 10 days. The treatment regimen for respiratory infections involves taking 250 mg of Zinnat twice a day.
During antibiotic treatment, the following may occur: side effects:
- digestive disorders;
- dysfunction of the liver and biliary tract;
- rashes on the skin;
- thrush of the intestine or genital organs.
Zinnat tablets are contraindicated in case of poor tolerance to cephalosporins, kidney pathologies, serious illnesses organs of the gastrointestinal tract.
How is fluoroquinolone therapy administered?
Of the broad-spectrum fluoroquinolones, with the development of bronchitis, pneumonia or sinusitis, Ofloxin or Tsiprinol can be prescribed. Ofloxin provides destabilization of the DNA chains of pathogens, thereby leading to the death of the latter.
The drug in tablet form is prescribed 200-600 mg every 24 hours. Dosages less than 400 mg are intended for single oral administration. If the patient is shown more than 400 mg of Ofloxacin per day, the dose is recommended to be divided into 2 doses. During intravenous administration drip method the patient receives 200-400mg twice a day.
The duration of the course is determined by the doctor. On average, it can be from 3 to 10 days.
Tsiprinol has in many respects the principle of application, the list of contraindications and side effects similar to Ofloxacin. With the development of infectious processes in the upper respiratory tract, it is prescribed twice a day, orally, at a dosage of 250 to 750 mg.
Effective carbapenems - Tienam and Invanz
Tienam is an antibiotic carbapenem administered intramuscularly. The drug is characterized by a pronounced bactericidal effect against many types of pathogens. These include gram-positive, gram-negative, aerobic and anaerobic microorganisms.
The drug is prescribed in cases of diagnosing a patient with moderate and severe infections that develop in the upper and lower respiratory tract:
- Nasopharynx.
- bronchi.
- Lungs.
Adult patients receive the drug at a dosage of 500-750 mg every 12 hours for 7-14 days.
Invanz is administered once every 24 hours by intramuscular or intravenous route. Before performing the injection, 1 g of the drug is diluted with a 0.9% sodium chloride solution intended for infusion. Therapy is carried out for 3-14 days.
Side effects of the use of carbapenems can manifest themselves in the form of:
- allergic reactions ( skin rash, itching, Stevens-Johnson syndrome, angioedema);
- language color changes
- staining of teeth;
- convulsions;
- nosebleeds;
- dry mouth;
- increased blood pressure;
- discoloration of feces;
- muscle weakness;
- decrease in the level of hemoglobin in the blood;
- insomnia;
- mental status changes.
Both antibacterial drug contraindicated in diseases of the gastrointestinal tract, central nervous system, individual intolerance to the composition. Increased caution must be observed in the treatment of patients over 65 years of age.
What antibiotics are allowed during pregnancy
With the development of diseases of the upper respiratory tract in pregnant women, a ban on the use of most antibiotics is inevitable. If the intake of such drugs becomes mandatory, the following types of drugs may be prescribed:
- In the first trimester of gestation - antibiotics of the penicillin series (Ampicillin, Amoxicillin, Flemoxin Solutab).
- In the second and third trimesters - in addition to penicillins, the use of cephalosporins (Cefuroxime, Cefixime, Zinacef, Cefixime) is possible.
In order to treat acute infectious processes developing in the respiratory tract, the use of the inhaled antibiotic Bioparox (fusafungin) is often recommended. This remedy is characterized by a local therapeutic effect, a combination of anti-inflammatory and antimicrobial activity, and the absence of a systemic effect on the body. Such properties of the drug exclude the possibility of penetration of its components into the placenta, and a negative impact on the developing fetus.
For the treatment of throat or other pathologies, Bioparox is sprayed several times a day (with 4-hour breaks). Inhalation is carried out in the mouth or nasal cavity, performing 4 injections at a time.
In cases where the use of antibiotics becomes impossible, intoxication is removed, the impaired function of the respiratory system is restored.
The last days of summer are ending and school time is beginning, and along with this, in the fall, as everyone knows, the general morbidity of the population also increases. It is time for seasonal diseases, most of which are represented by infections of the upper respiratory tract and diseases of the upper respiratory tract.
General characteristics of diseases
To inflammatory diseases upper respiratory tract infections include infections of the larynx and nasopharynx. As a rule, the entrance gate for infection is the mucous membrane of the oropharynx and nose, where viruses, bacteria settle and then with the blood stream, as well as lymphatic system are distributed throughout the body. A particularly vulnerable category is, of course, children.
Considering the anatomical and physiological features of the structure of the respiratory tract of the child's body and the immaturity of all links immune system, development infectious process can be lightning fast. Therefore, special attention should be paid to preventive measures among children. The most common diseases of the upper respiratory tract are: acute nasopharyngitis, tonsillitis, laryngitis, adenoiditis.
Causes of morbidity
In the nasal cavity during normal nasal breathing, the body is in constant contact with the surrounding air. In the presence of various aggressive external factors, the mucous membrane of the respiratory tract is exposed to microbes, chemicals, viruses, various allergens and other negative factors. As a result, inflammation develops in a particular area of the upper respiratory tract.
As a rule, an increase in the incidence is observed in the autumn-spring period. It is at this time that hypothermia, a decrease in immunity can be noted, and in conditions of high contact in children's organized institutions, they become key factors in the development of inflammatory diseases.
The incubation period is several days. The disease begins acutely, the child becomes lethargic, weak, there is a decrease in appetite, and in some cases the child refuses to eat at all, the temperature rises to febrile numbers. Preschool children and school age may also complain of dizziness and fatigue. At the end of the first day, a sore throat appears, sneezing is observed, and at the end of the 2nd day, abundant mucous discharge from the nose, dry frequent cough, which then becomes wet, are noted. More than half of the children with infections of the upper respiratory tract may develop conjunctivitis, otitis media.
Diagnosis of respiratory infections
Diagnosis of upper respiratory tract infections is established on the basis of the clinical picture and results. laboratory examinations. Clinical picture different forms of diseases of the upper respiratory tract has much in common and it is always necessary to differentiate one nosology from another. The diagnosis is established by a pediatrician, an otolaryngologist.
