Polynereropathy lower extremities - This is a common problem of humanity. Many familiar knows the feeling of zrayability, cooling stop, numbness and crawling of goosebumps on the legs, seizures in the ion muscles. And all this is nothing more than the manifestation of the polyneeropathy of the lower extremities. And, unfortunately, not always, having similar symptoms, a person appeals for medical help. In the meantime, Paulineiropathy, meanwhile, do not sleep and slowly progresses. Muscles gradually weaken, gait is disturbed, trophic skin changes arise. At this stage, the disease becomes more difficult, but still possible. The main emphasis in the treatment of this state, modern medicine does on drug therapy in combination with physiotherapy techniques. In this article we will talk about drugs capable of eliminating or minimizing the symptoms of the polyneeropathy of the lower extremities.

In many ways, the treatment of polyneuropathy depends on the immediate cause of the disease. For example, if the cause is the abuse of alcohol, it is necessary first of all to completely abandon the use of alcoholic beverages. If the basis of the disease is diabetes, then it is necessary to achieve a reduction in blood sugar levels to normal. If Paulineeropathy is lead, you need to stop contact with lead and so on. But due to the fact that under various types of polyneuropathy there are similar pathological processes In the nerve fibers themselves, then there is a general approach to the treatment of this state. This approach is based on the fact that under the polyneeropathy of the lower limbs suffer from damaging factors the longest nerves of the body, and either the outer sheath of the nerve fiber is destroyed, or its inner rod - axon. To eliminate the symptoms of polyneuropathy, the structure of the nerve fiber should be restored, improved its blood supply. For this use various drugs. Depending on their belonging to a particular chemical group or from the direction of their action, it is customary to divide drugs into several groups:

• metabolic drugs;
• funds affecting blood flow;
• vitamins;
• anesthetics;
• tools that improve the nervous impulse.

We will get acquainted with each group of drugs in more detail.

These groups of drugs are among the most basic in the treatment of polyneuropathy. And in most cases, the mechanism of action of one drug is not limited only, for example, a metabolic effect. Almost always, the medicine works in several directions at the same time: and "fights" with free radicals, and improves the nutrition of the nerve fiber, and helps strengthen the blood flow in the damaged nerve area, and helps healing. Due to this multifaceted effect, as they say, one shot is killed even not two, but several hare! But there are pitfalls. Not all metabolic preparations are effective in the treatment of polyneeropathy of the lower extremities. To the means, the restorative effect of which is most studied include the preparations of tilomic acid, Actovegin, Instenon. Recently, the cerebralizin, cytochrome C, mexidol and cytooflavin, calcium pantothenate, have become increasingly used. Usually, preference is given to some one drug (the choice is based on the true cause of the polyneeropathy of the lower extremities). For example, with diabetic polyneuropathy, the main fighter is tilting acid, with the subrming atherosclerosis of the lower limb vessels, the preference is given to the actovegin. When appropriate any metabolic preparation, it is necessary to observe the application deadlines, since the restoration of nerve fibers is a long process. That is why in most cases the drug has to take for quite a long time, at least 1 month, and more and longer. Now let's talk in more detail about each of the drugs.

Tioktic acid is a powerful antioxidant, its effect in the treatment of polyneuropathy is recognized worldwide. Apply the medicine is necessary from one month to six. At first, 14-20 days is necessary intravenous infusion of the drug (at a dose of 600 mg per day), and then you can go to tableted forms. The same 600 mg, but already in the form of tablets, taken half an hour before meals in the morning. When treating it is important to understand that the effect of the drug will not be noticeable in the first days of reception. This does not testify from the absence of the result. You just need time to make the drug to eliminate all metabolic problems at the level of nerve fibers. Tioctic acid on the pharmaceutical market is presented very widely: octolipen, alpha-lipoic acid, Berlition, Espa Lipon, thiocutacid, neurolypon, tyoga.

Actovegin is a product obtained from the blood of calves. Do not be afraid of the words "blood" in this case. From it in actovegin, only the most necessary components of cell mass and serum remain in the actovegin. In this case, for the treatment of Aktovegin, the first time is necessary to use intravenously drip at 10-50 ml (dose depends on the severity of polyneuropathy symptoms). Usually intravenous infusion lasts 10-15 days, and then the patient continues the therapy in the form of tablets (2-3 tablets 3 times a day) for another 2-3-4 months. The complex effect of the drug allows you to simultaneously treat not only peripheral nerves, but also "problems" of the brain, limb vessels. Abroad Actovegin is not as actively used as in the CIS countries and Russia, and in the United States and Canada is even prohibited. This is primarily due to the fact that numerous studies have not been conducted.

Inspenon is a complex preparation containing 3 actors. It expands the vessels, has an activating effect on neurons, contributes to improving the transfer of pulses between them. It ensures the strengthening of blood flow in tissues suffering from lack of oxygen. Due to this, the nutrition of nerve fibers is improved, and they are faster "recover". The effect gives coursework: the contents of the 1st ampoule (2 ml) are injected intramuscularly every day for 14 days. In the future, Instenon is taken inside 1 tablet 3 times a day for another 1 month.

Cerebricizin is a protein preparation obtained from a pig brain. It is considered a powerful neurometabolic preparation. It suspends the process of destruction in nervous cells, increases protein synthesis inside them, is able to protect them from the harmful effects of various substances. Cerebrolysin has a pronounced neurotrophic effect, which favorably affects the functioning of the entire nervous system. Cerebrolysin increases the chances of nerve cells to stay alive in a lack of nutrients. It is allowed both intramuscular and intravenous administration of the drug (5 ml and 10-20 ml, respectively) within 10-20 days. Then take a break for 14-30 days and, if necessary, repeat the course.

Calcium Pantothenate is a drug that stimulates regeneration processes, that is, recovery (healing) peripheral nerves and not only them. Apply it for 1-2 tablets 3 times a day by courses for 1 month. Slowly, but confidently the drug will "patch" defects in the shells of nerves, contributing to the restoration of their function.

Mexidol (mexicor, mexiprim, neuroks) is a powerful antioxidant. This is a drug that works at the membrane level. It contributes to the restoration of the normal structure of the membranes of nervous cells, thereby providing their normal operation, because all nerve impulses are carried out through the membranes. Mexidol increases the stability of nerve cells to negative stressful effects of the environment. Dose of the drug, the method of administration and the duration of use is very variable depending on the initial level of neurological disorders. If necessary, begin with intravenous or intramuscular administration of 5 ml, and then go to tablets (125-250 mg 3 times a day). The total treatment time is 1.5-2 months. The drug has good tolerability. In intravenous administration, it can cause a throat, a desire to dance. These sensations quickly pass and less often occur if the drug is injected drip (by 0.9% sodium chloride solution), and not inkjano.

Citooflavin is another complex antioxidant drug. Complementing each other, the components of the drug improve the energy exchange in neurons, confront the effect of free radicals, help the cells "stand out" under the conditions of nutrient deficiency. For treatment, 2 tablets are applied 2 times a day for half an hour before meals for 25 days.

Many of the above-described antioxidant drugs are not popular, if you can express it, in the treatment of polyneeropathy of the lower limbs. Tiocac acid, actovegin is used more often. The remaining neurometabolic preparations are more often used with "problems" with the central nervous system, but we should not forget that they have a positive effect on the periphery. Some drugs have a slight "experience" of use (for example, mexidol), and all spheres of their influence are not yet sufficiently studied.

The most common drug to improve blood flow during damage to the nerves of the lower extremities is pentoxyphyllyn (Vazonitis, Trental). The drug improves blood supply in the smallest vessels of the whole organism as a whole due to their expansion. With a strengthened blood current to neurons, more nutrients fall, which means an increase in the chance of recovery. The standard application of pentoxifyilline looks like this: intravenously drip 5 ml of the preparation, pre-dissolved in 200 ml of 0.9% sodium chloride solution for 10 days. Then pills 400 mg 2-3 times a day to 1 month. For most drugs used for the treatment of polyneuropathy, such a rule works: the small severity of symptoms is the tableted forms of drugs. Therefore, if the symptoms of the disease are non-veins, it is quite possible to do with a tableted monthly course of pentoxifyline, passing the injection.

Treatment of polyneuropathy of the lower limbs never costs without the use of vitamins. The most effective are vitamins of groups B (B1, B6 and B12). One of their deficiency in food itself can cause symptoms of the defeat of peripheral nerves. The enhancement effects of each other, while using these preparations, contribute to the restoration of peripheral nerve shells, have an anesthetic effect, to some extent are antioxidants. Combined forms (when the composition of one drug includes all three vitamin) is preferable, rather than one-component. There are injectable forms, and tableted. Some injection forms (Milgamma, Combiliphene, a compligator, Vitakson, Vitagamma) contain additionally lidocaine, which enhances the effect of anesthesia. Such drugs like neuromulitivitis and neurobion contain a "pure" complex of group vitamins in without lidocaine. In treatment, it is often resorted to a combination of injection forms of vitamins at the beginning of treatment and tableted - subsequently. On average, group vitamins are used at least 1 month.

Relatively recently in the treatment of peripheral nerves began to use a complex drug Keltikan. This is a biologically active additive. It contains uridin monophosphate, vitamin B12, folic acid. The drug provides building components to restore peripheral nerve shells. Apply Keltikan 1 capsule 1 time per day for 20 days.

Medicate treatment of a treaty depends on the stage of the course of the disease, the structure of the defect, the mental and somatic status of the child and is directed to:

1. termination of intrauterine-based inflammatory primary and secondary autoimmune processes, if they took place;
2. preventing scar-and-bearing processes arising from the balance of mechanical generic injury and hemorrhages; The consequences of asphyxia, including chronic metabolic acidosis;
3. the intensification of metabolic processes in the nervous tissue, primarily the redox and protein metabolism;
4. ensuring energy processes in the brain;

Medical treatment of the cerebral palsy is aimed at creating favorable conditions for a more successful conduct of therapeutic physical education.

Medical treatment of cerebral palsy in the residual period includes the appointment of means of lowering muscle tone, which improve the conduct of nerve pulses in synapses that reduce hypercines, normalizing the flow of metabolic processes in the nervous tissue, as well as anticonvulsant (with seizures) dehydrating (with hypertensive-hydrocephallated syndrome) and generalifying funds.

Preparates fromdenigrating m.sneye tone (The cells of the reticular formation are inhibited, block mono- and postsynaptic spinal reflexes, have a central and peripheral cholinolitic effect): Middokalm, Baclofen, Surdolit, Amino, Norakin, Cyclodol, Tropacin, Sanitary C, Leveodop, Nakom, Sinimet, etc. These drugs are prescribed In gradually increasing dosage. It has been established that 40-60 minutes after receiving one of the listed means there comes a decrease in muscle tone and at this time it is recommended to carry out physical leam.

Preparations Improving neuromuscular conductivity

Preparations that improve nervous muscular conductivity: Prezero, Galanamin, Nivalin, Kalimin, Oksazil Dibazol. They do not act on the dead nervous cells, but only on those areas of nervous tissue, which are in a state of oppression for a long time. It must be remembered that in relation to neuromuscular transmission of excitement of prozero and its analogues are antagonists of the path and other drugs from the Atropin group, so they cannot be assigned simultaneously.

Tranquilizers and neuroleptics

To reduce hypercines, drug treatment PPC includes t.rancvilizers (Elnyium, amizil, phenibut, noofen, relaignation, phenazepam, etc.), neuroleptics, less likely - atropine-containing drugs (cyclodol, ortan, tropacine), as well as pyridoxine. In some cases, in the ineffectiveness of conservative treatment, it is resorted to the so-called stereotoxic operations on the basal ganglia brain. At the same time, a neurolitical mixture is introduced into the pale ball area or some nuclei (usually with Mayodil). In this literary data, in 70% of cases, hypercines are ceased and muscle tone is reduced in 80% of cases. Hemopallidectomy is carried out only with neuroshurgeons in specialized branches.

With cerebellar forms of cerebral palsy, when the muscle tone is reduced, duplex, securine, echinopsin, stimulants of the mediator series are prescribed.

Stimulation of metabolic processes

Preparates fromtimulant exchange processes In the nervous system (activate protein and carbohydrate exchange, at the same time removing the toxic decay products, increase the respiratory activity, energy processes in the brain tissue, improve blood supply, contribute to the differentiation of nerve cells, the myelination of conductive paths, improves the functionality of the brain): glutamic acid, aminal, nootropyl , piracetam, encefablaball, cerebralizin, diabitol, lipoic acid, kogitum, prefraffsis, carnitine, pantogam, pyridoxine, cyancobolmine, neuromenin and more. In convulsions, stimulating drugs should be administered carefully, gradually increasing the dose, in combination with anticonant and sedatives.

Preparations improve microcirculation

Prteaching w.the best m.icrocirculation (reinforce the brain and peripheral blood circulation, improve the rheological properties of blood, activate metabolic processes): Theronicic, Ksantinol, Trental, Cavinton, Actovegin, Emoxipin.

Regeneration stimulants in the nervous system

Preparations possessing resolution deiism and fromtimulant Regeneration (Reduce productive and stimulate regenerative processes in the nervous system, increase the permeability of tissues and improve their trophy): aloe, lidase, pyrogenal, propermal.

Dehydration drugs

Medical treatment of cerebral palsy includes degitulating drugs. D.e.gitrate preparations (reinforce diuresis, reduce liquor products): magnesium sulfate, diakarb, triampur, hypothiazite, furosemide, Laziks, glycerin and more.

Anticonvulsant tools in the treatment of cerebral palsy

In the presence of epileptic seizures, medical treatment of cerebral palsy requires appointment anticonposts fromrest (phenobarbital, diphenine, antheltexin, carbamazepine, valprooic acid derivatives - depair, convulsofin, etc.). Anticonvulsant therapy with patients with cerebral paralymps are prescribed individually taking into account the characteristics of the main disease, the nature of epileptic paroxysms, their frequency, time of occurrence during the day. Anticonvulsant drugs must be taken continuously, for a long time (3-5 years of effective therapy), followed by gradual cancellation.

In addition to such differentiated drug treatment, it is recommended to periodically take pharmacological agents governing the metabolism in the nervous tissue and increases the body's resistance to adverse external influences. These are phosphorus preparations.

The possibility of successful treatment of children with impaired psychoneurological development is based on the following properties of the child's body and its nervous system:

1. The regenerative abilities of the neuron itself, its processes and neuronal networks included in the functional systems. The slow transport of the cytoskeleton in the nervous cell processing rates at a speed of 2 mm / day causes the regeneration of damaged or underdeveloped neuron processes at the same speed. The death of a part of neurons and their deficiency in the neural network is more or less fully compensated by the launch of the aczo-dendrit branching of the preserved nerve cells to form new additional interneururous ties.
2. Compensation of damage to neurons and neuronal networks in the brain due to the connection of neighboring neural groups to the execution of the lost or underdeveloped function. Healthy neurons, their axons and dendrites, both actively working and reserved, in the struggle for the functional territory "capture" liberated by the dead nerve communication cells. For the early stages of the development of the nervous system, polyvalence cells of the cortex of large hemispheres are characterized. At an early childhood, they have not yet specialized and are not absolutely connected with a specific function, which makes it easy to make the functional duties of related and more distant affected brain departments.
3. The relatively high readiness of the functional brain systems to the restructors in the early stages of the development of the nervous system after birth. The age of the first months of life is saturated with replacing each other critical development periods. The brain of a child of an early age is characterized by the redundancy of the functional use of neurons (including future reserve), redundancy of their dendritic branching and connections in neuronal networks (the final selection of the functionally most effective neurons and their connections has not yet occurred). This determines the greater ductility of brain structures and functional systems than younger child.

It is important to note that in violations of the development of psychoneurological functions, a kind of "vicious circle" arises: the functional inaction caused by a violation of the child's development is in itself inhibits its development, exacerbating functional failure. Even the functional systems that are amazed in the smallest extent, show a functional deficit, being as it were in the inhibited, sleepy state. In these cases, rehabilitation therapy has a stimulating effect, raising these functional systems and launching them into operation. In addition, the child has already been lagging behind not only from the peers, but also from its own development program, and to solve rehabilitation tasks, you need to "set" an accelerated rate of formation of regulatory skills, that is, initiate (launch) out-ofgradable critical periods of learning or development.

Improvement in the state of patients can occur in different times after the start of active stimulating rehabilitation therapy:

1. in the first hours and days there may be noticeable positive shifts in a state due to the disordering of low-effective, but not affected functional systems (the child first begins to turn over in the crib, or say words and phrases, or to do first independent steps and the like);
2. 2-3 months after the start of treatment, its contribution to the improvement makes the launch of compensatory mechanisms in the preserved neurons and functional systems;
3. after 6-9 months and later, the implementation of the regenerative, the most slow processes (the growth of new nerve fibers, the restoration of the conductivity of pulses by nerves) is coming, with which further improvement is due to patients.

Drug therapy. The main direction of the drug influence on the child with a violation of the development of psychoneurological functions is to normalize or improve the metabolism in the affected brain, which allows to activate the preserved structures, to stimulate the processes of aczo-dendritic branching, the formation of new interneurone ties, initiate the reorganization of functional systems.

For this purpose, biogenic stimulants are widely used in modern neurological practice - substances that have a direct activating effect on the regenerative abilities of nerve cells. They have a positive effect on metabolic and bioenergy processes in the brain: improve the consumption of oxygen and the absorption of glucose by nerve cells in oxygen deficiency conditions. The drugs of this group contribute to the restoration of the membranes of neurons and their receptors, activate protein synthesis and RNA in the brain, increase the rate of exchange of information macromolecules. These drugs include nootropyl, piracetam, encephibol, kogitum, pantogam, semamam, meclofenoxate, as well as neuromidine, Ipidakrin, Glyatilin, Cerenton, Cerepro, etc.

Stimulation of the restoration of the functions of neurons and the formation of receptor bonds between cells contributes to the use of gangliosides, which is an option for neuronal membrane receptors. In the nervous system, gangliosides are involved in the conduct of a nervous impulse between neurons, the formation of nervous bonds, obtaining information supplied to neuronate neurotransmitters and hormones. At certain stages of the development of the nervous system, they play the role of nerve cell growth factors. It is remarkable that artificially synthesized gangliosides (with their intravenous or intramuscular introduction to the body) circulate on the circulatory system, find "their" nerve cells and, embedded in their membranes, begin to "live" as their own membrane neuron receptors. They are rearranged in accordance with the specific tasks of the nervous cell, interact with other receptors and other membrane structures, increase the readiness of the cell to? The formation of intercellular contacts. The use of drugs of this group (GM1, Kródissal, Bosinax, Sigen) U? Patients with violation of the development of psychoneurological functions confirms their influence on the pace of restoration of neurological functions.

A special place in the treatment of violations of the development of psychoneurological functions occupy hydrolyzed drugs obtained by enzymatic hydrolysis of brain tissues. Enzymatic hydrolysis of brain tissues makes it possible to obtain amino acids and peptides, which are products of the decay of neuron protein and glial cells. The introduction into the body of these elements of hydrolysis as it fits the nervous cell with abandoned information about the excessive destruction, which is a powerful incentive to the launch of the synthesis of DNA, protein, and, it means, to the launch of growth and regenerative processes. The effect of hydrolyzate drugs is tissue-specific (i.e., selectively affects the cells of a certain unit of the nervous system). They reduce the need of the brain in oxygen, reinforce the stability of nerve cells to the effects of various adverse factors (in particular, to hypoxia and ischemia), stimulate biosynthesis in protein neurons, as well as mediators providing a nervous impulse.

Enzymatic hydrolysis may be subject to various brain structures, which ensures specific effects of drugs and the different directions of their action. The Austrian Cerebricsine preparation is a hydrolyzate of the brain of pigs and stimulates the development of motor, intellectual and behavioral functions in patients with damage to the central nervous system, it helps to reduce the severity of disorders during epilepsy, neurasthenia. The domestic drug cerebrolyzate is a hydrolyzate of the cerebral cortex of large cattle. According to the pharmacological properties and biological action, it is similar to cerebrolview, but much more efficiently the latter in the treatment of patients with disorders of the CKNS cortical functions.

We, together with prof. A.V. Karyakin developed cerebrolyzate M, which is similar to cerebrolyzate hydrolysis technology, but it is not obtained from the cortex of the brain, but from the structures of the cerebellum and stem departments. This drug specifically activates the biochemical processes in the cerebellar, which significantly improves the motorcycles in children with cerebellays of children's cerebral paralysis, with the abnormalities of cerebellum development, reduces the severity of violations of behavior and mental development.

In St. Petersburg, a polypeptide drug Cortexin, obtained from the cortex of the calf brain, was developed. A balanced mixture of biologically active peptides included in the preparation has a total multifunctional effect on the cells of the nervous system. Cortexin stimulates mental activity, regulates the ratio of brake and exciting effects, helps to restore the shells of nerve conductors, reduces the level of fragile preparedness of the brain.

When transplanting the embryonic tissues of the brain (obtained from the embryo), a transplant 6-8 fragments of the embryonic nervous tissue 9 weeks of the embryos in? Motor zones of the patient's brain cortex. Embryonic fabric contributes to improving the trophic (nutrition) of the brain, supports the functioning of damaged neurons, stimulates the differentiation of nerve cells. In case of surgical transplantation of the embryonic nervous tissue in the patient's brain, a decrease in mental deficit is noted, improving the main motor functions. The stimulating effect is provided mainly contained in the injected suspension factors for the growth of nerve cells. However, the conduct of a rather complex neurosurgical operation is often accompanied by only a short-term effect, which requires repeated administrations. In addition, complications associated with the reaction of tissue incompatibility are possible, especially when the suspension is introduced into the Likvorn space spinal cord. Also, the introduction of the suspension of fetal tissues into the liquor spinal cord space of the suspended tissue of the human embryo brain is also described, followed by intranasal administration for 7 days, as well as the introduction to the subcutaneous fat layer of the anterior abdominal wall.

The above methods of drug influence on the metabolism of the nervous tissue contribute to compensation of disturbed psychoneurological functions by stimulating the regeneration of damaged neurons, connecting to the fulfillment of the lost function of neighboring neuronal groups, however, neuronal deficiency in patients with psychoneurological disabilities. In addition, part of the data from the birth of nerve cells compromised by false or insufficient bonds is destroyed by the mechanism of apoptosis, which ensures the stability of the nervous system. Neurologists steadily continue to search for the paths of replenishment of neurons.

A new direction in the treatment of severe diseases of the nervous system can be the use of stem cells. Theoretically stem cells, getting into a particular brain department, are able to transform, taking over the structural and functional features characteristic of local neurons, and thus replenish the quantitative shortage of nervous and glial cells. A number of authors note the role of stem cells in providing surrounding brain tissues by Rostov factors. There is an unresolved problem of controlling the reference of stem cell transformation during their differentiation, or? Also overcoming the possible immune incompatibility of them with the tissue of the recipient brain. Attempts to use stem cells of blood from bone marrow (own or from close relatives), which could be transformed in the brain into nervous cells. Methods for obtaining stem cell culture from a small number of neurons predecessors in some brain deposits, in which the ability to continue the formation of nerve cells after birth and even in adults (postnatal neurogenesis) is being developed.

Recently, work appeared indicating the immunosuppressor properties of stem cells, stimulating trophic and regeneration of cerebral tissue and? Blocking scar formation processes. However, it should be recognized that at the present stage, the methods of treating disorders of the development of psycho-neurological functions by administering fetal tissues and stem cells are experimental.

The modern doctor has quite extensive effects on the nervous system: stimulate protein synthesis in neurons, the transmission of the nervous impulse, stabilize the membranes of the nervous cell. However, these therapeutic techniques do not provide local impact on the structure of the central nervous system, having damage or functional failure. There is a challenging delivery task medicinal preparation To neuron. Oral (through the mouth), intramuscular or intravenous drug administration has an impact, primarily on the whole organism, and the brain is separated from it by a hematorecephalic barrier, which performs a protective function, fencing the brain from unwanted effects. An attempt to overcome the hematostephalic barrier was made in the development of a method for administering drugs directly into cerebrospinal fluid through the cerebrospinal channel. However, such an introduction of drugs was not entrenched in modern neurology due to the unpredictability of the brain reaction to such a therapeutic intervention.

In the 80s of the last century, under the direction of Professor I.A.Skvortsov, at the Moscow Scientific and Therapeutic Center for the Prevention and Treatment of Psychoneurological Disability (NTC PNI) developed an original method of treating children with a violation of the development of psychoneurological functions. It provides for injection or non-profile (dot microelectrophoresis, pharmacomassage) introduction of biologically active drugs for metairene or segmental body zones, which provides strictly local address exposure to segmental structures of the central nervous system.

The segmental structure of the human body is formed in the early stages of the development of the nervous tube and is ensured, first of all, the segments of the brain barrel and the spinal cord. Each segment innervates 6 metairene tissue leaflets: Nervera (segmental structures of the nervous system), dermatomer (leather and subcutaneous fiber), Miouter (muscles), Vasometer (vessels), scleromer (connecting and enclosures - periosteum, tendons, ligaments and others) and Vysteromer (segmental affiliation of internal organs). Specific molecular agents introduced into metairene leaflets are captured by cells of the autonomic nervous system and are launched in segmental neurons a set of reactions that stimulate their growth due to the branching of its processes and the formation of new connections. Specific molecular components of hydrolyzate preparations, with which a stimulating effect on the nervous system is carried out, regulatory peptides, amino acids, receptor ganglioside elements. Thus, the question of the address "delivery" of drugs into the nervous system is solved.

At the same time, the stimulation of protein synthesis, DNA and growth potency in neurons, the branching of their processes only prepare the functional systems to the "restructuring", the nature of which should determine the external influences, "images", taken by various analyzer brain systems in the form of sensory information from the external environment . Therefore, treatment provides for a combination of directional metairene drug impact, meta-camera muscle dystonia correction (scleromeric massage), with excessive sensory stimulation aimed at all major areas of life of the child's nervous system: movement (imitation of regulatory motor acts), perception (stimulation of visual, auditory, tactile perception ), Communication and speech (psychological and speech therapy correction).

Vitamins, nutritional supplements. Most of the vitamins in the body are not synthesized, and their source is food products of plant and animal origin, microorganisms are normal inhabitants of the gastrointestinal tract. The increased need for vitamins occurs with diseases, severe physical work, sports, during intensive growth. Some vitamins are widely used in the treatment of diseases of the nervous system.

Vitamin B1 (thiamine) affects the metabolism in the nervous tissue, carrying out nervous excitation in cholinergic synapses. The active form of vitamin B1 is a cocarboxylase, which plays an important role in carbohydrate, protein and fat exchange, especially in nervous and muscle tissues. With tiamine insufficiency, the functions of the CNS are violated, especially memory. Vitamin B6 (pyridoxine) is actively involved in the metabolism of amino acids, in the synthesis of neurotransmitters, limits the excitability of the CNS. Vitamin B12 (Cyanocobalamin) activates the exchange of carbohydrates, lipids, providing a favorable effect on the function of the nervous system. It is necessary for the synthesis of amino acids that are part of myelin - structural protein of the shell of nerve fibers, for normal blood formation and ripening of red blood cells. Alpha tocopherol (vitamin E) and vitamin C (Vitamin C) have a stabilizing effect on the membranes of nerve cells.

Currently, a number of complex vitamin preparations have been created. Milgamma Contains high doses of group vitamins B, has analgesic properties, it helps strengthen the blood flow, the normalization of the work of the nervous system and blood formation (vitamin B12). Neuromulivitis It is a complex of vitamins B1, B6, B12 for intake. It has a positive effect on metabolic processes in the nervous tissue. In recent years, a number of drugs have been developed comprising, along with vitamins, and trace elements necessary for the functioning of the central and peripheral nervous system: duovit, complivit, Magne-B6, Magnelakt et al. For the correction of metabolic processes, use a natural substance related to the vitamins of the group in - L-carnitine (ElKar, Carniten). The drug is shown in hypotension, muscle atrophy, muscle weakness, psychomotor disorders. Vitamin-like compound, stimulating the production of the main energy molecule of the cell (ATP), is the drug ubiquinonwhich enhances protein synthesis and nerve growth factor in the brain, stimulates the development of psycho-neurological functions.

In recent years, the complex of treatment, along with vitamins, includes Cellular Metabolism Correctors: Tanacanan Immunocorrector (Chlorochin), Ceurson, Mexidol, combining antioxidant, antihypox and nootropic properties, etc.

Widespread use in the correction of neurological disorders found drugs of natural origin, normalizing nutrient balance in the body, accelerating the process of recovery - biologically active additives for food (BAA). Their appearance was the result of the accumulation of knowledge about therapeutic opportunities of natural sources, the development of technologies for obtaining natural origin. Many dietary supplies contain substances that stimulate the protective forces of the body, increase overall stability and vital tone, physical and mental performance, reduce the negative impact of the environment and stress. Such properties have drawers from various plants, organs of animals, elixirs and drugs from medicinal herbs, beekeeping products. In nutritional supplements, the above components are described, as a rule, in a complex with vitamins, minerals, fiber and other substances. To restore the function of a damaged nervous system, a cerebrammin is used, which is obtained from the cortex of a cattle brain and is a protein complex and? Nucleoproteins with a selective action on brain cells. It contributes to the acceleration of regenerative processes in the brain, restoration of psychomotor and intellectual functions.

The use of correction of disorders of psychoneurological development in children using amino acid metabolic therapy (method of Khokhlov) is recommended with a wide range of neurological and psycho-neurological disorders (with autism, children's cerebral paralysis and other CNS diseases). With static-motor failure in children, various amino acid compositions are recommended: glucprim, aminosil, quadro, Evit and others. The food additive of the amino acid composite "Conduct" contributes to the restoration of the transfer of nerve impulses.

Preparations that optimize microcirculation in the nervous system. Diseases of the nervous system are usually accompanied by insufficient cerebral circulation, which requires the use of drugs that improve blood circulation in small brain vessels. The action of most such drugs is due to the expansion of brain vessels, improving blood flow in brain capillaries. They prevent or eliminate vessel spasms, optimize oxygen transport to tissues, enhance glucose metabolism, improve the portability of the brain cells to hypoxia, which stabilizes the functional state of brain neurons. Such drugs include zinnarizin, Cavinton, Sermion, Trental, et al. The combined drugs are also used, in the structure of which is combined with nootropic (stimulating mental activity) and vasoactive substances (peylon, paes).

TO psychostimulators The group of psychotropic drugs, which increase mental and physical performance, improve the ability to perceive external irritations (exacerbate vision, rumor, accelerate responses), normalize mood, relieve fatigue (pantogam, encephibol, pyracetam, cerebrolysis, cerebrolizat, cortexin, etc.) .

The severity of anxiety, fear, emotional stress reduces drugs from the group tranquilizers (soothing). The impact of these medicines It is manifested by a decrease in the excitability of subcortical regions of the brain responsible for the implementation of emotional reactions, as well as a decrease in psychomotor excitability, relief of sleep and increase its duration, relaxation of skeletal muscles.

The restoration of disturbed static-motor and psychorecamic functions contributes to drugs affecting the selection of a biochemical intermediary for a nervous pulse (mediator) to the sinaptic slot between neurons of the biochemical intermediary. These drugs (they include amyridine, neuromidine, glutin, axamon, cerebro, cerentone, glutamic acid, Cleragel, Nak and others) are well penetrated through the hematorecephalic barrier, contribute to the biosynthesis of some mediators, improve the carrying out of the nerve impulse, contribute to improved memory and training Increase the motor and mental activity of patients, improve the ability to concentrate attention.

The spasticity of the muscles in children's cerebral paralymps is due to an anomalous increase in the activity of tonic motor neurons, which comes to the muscles an excessive impulse, increasing muscle tone. Miorolaxanta (Middokalm, Baclofen, Sirdalud, etc.) reduce muscle tone, painful muscle spasms, muscle contractures, improve motor functions. Sometimes in patients learned by independent movement, Miorlaxants may temporarily worsen standing and walking at the expense of some muscle weakness, so an individual approach to their intended purpose is required. Start with a minimum dose, then it is slowly raised to achieve effect.

One of the methods of reducing the increased muscle tone is the intramuscular administration of drugs toxin of botulism type A. The mechanism of its action is reduced to? The blockade of signal transmission from the nerve to the muscle, as a result of which the spastic muscle relaxes. The functional denervation of muscles contributes to the activation of the synthesis of neurotrophic factors and the development of additional axon processes, the formation of new neuromuscular synapses. The introduction of preparations of toxin botulism in spastic muscles corrects pathological positions and prevents fixation in the memory of the brain "images" of incorrect limbs. The duration of the reduction of muscle tone after the administration of the drug is individual and can reach 3-6 months, in some patients - 18 months.

Homeopathic drugs are successfully used for the treatment of disorders of psychoneurological development in children. The main effect of homeopathic drugs is aimed at stimulating protective-adaptive functions, restoring adaptation mechanisms and is implemented through mental, neuro-vegetative, endocrine, metabolic and immunist system. In the complex treatment of children with violations of the development of psychoneurological functions, Hell (Germany) were well established: cerebra composites, Ubiquinon composites, tramel C, goal, discus, etc.

With all the extensive possibilities of drug therapy of violations of the development of psychoneurological functions in children, it is not enough. For the "removal" of the nervous system of a sick child from a stable pathological state, a complex of active external influences is needed, including therapeutic physical culture, massage, instrumental methods of kinesiotherapy and perceptual stimulation, psychological and pedagogical correction.

Massage, Healing Physical Culture, Manual and Tool Methods. An important role in the restorative treatment of violations of the development of stico-motor functions in children belongs to physical rehabilitation methods. These include various methods of massage, medical physical education, manual correction, orthopedic events, physiotherapy, reflexology.

Massotherapy - Is the method of mechanical impact on the surface tissue of the human body, during which blood circulation, lymph circulation, metabolic processes in muscles, joints and their tissues are improved. The pulses of tissues undergoing massage come in the dorsal and brain, correcting their functional activity and indirectly affecting the state of the internal organs. There are several types of medicinal massages.

Classic massage Uses four main techniques: stroking, rubbing, kneading and vibration. Stroking (slow, rhythmic movements, when executing which the hand of a massage therapist should slide on the skin, without shifting it) causes a soothing and pain relief effect, reduces muscle tone. Rubbing is accompanied by a displacement or stretching of the skin together with? Subject to tissues. Reception enhances metabolic and trophic processes, blood circulation, helps to reduce pain syndrome, reduces nerve excitability. The kneading causes the extension of the vessels in the depths of the tissues (including small), increases the muscle tone, enhances their contractile ability. Vibration Depending on the frequency and strength, there is a different effect on the body: weak - increases muscle tone, strong - lowers muscle tone, has an anesthetic effect, improves muscle trophy bone tissue.

Acupressure - based on the principles of needleflexotherapy. The impact on the point may be sedative or exciting. The selection of points is carried out depending on the clinical syndromes of the disease. Spot massage is carried out in a certain sequence, depending on clinical and physiological disease syndromes. This type of massage can be used independently and in combination with other types of massage.

Periosteal (perceivers) massage Designed in 1929, P.Vogel and G.Kraus, which established the connection of trophic changes in the internal organs with trophic changes in the periosteum. It is proposed to influence the periosteum in order to reflex the correction of violations of the functions associated with the internal organs.

Especially for children with violations of the development of stico-motor functions, for the correction of muscle tone in patients with children's cerebral paralysis, we have developed a method of segmental sclerical massage.

The activity of muscle groups is ensured by the agreed work of the nerve cells located in the spinal cord segment. The segment is a relatively independent and autonomous department of the nervous system, innervating specific areas of the skin, muscles, connecting educations (periosteum, ligaments and tendons), blood vessels and internal organs. All these departments are combined with each other in a single source of innervation, painful changes in one department inevitably affect others. Painful changes in spastic muscles form foci of excessive impulse in the periosteum, as a result of which the substance P is accumulated in it - the pain mediator. Under these conditions, an excessive flow of pain pulses that support is directed to the motor neurons of the spinal cord. high level Tonic activity in neurons. Thus, the vicious circle is closed: the pathological muscular spasticity through the reflected intra-segmental impulses increases itself.

The irritation of the "reflected" scleromeric zones during the massage of the periosteum, tendons and ligaments is accompanied by the release of "opiate" substances, braking the release of substance P and blocking an excessive impulse from this connective tissue of the metairic zone, including pain and increasing muscle tone. A sharp decrease in the flux of pain pulses to the spinal cord, which should occur as a result of a regular curler massage, reduces the anomalous functional activity of tonic neurons and eliminates or reduces muscle spasticity. Massage is carried out by the terminal phalanges of the first or third fingers, a special massage stick can also be used.

For segmental scleromeric massage The focus of pathological arousal in the tissues innervated by one segment of the spinal cord is eliminated - in the skin, muscles, connecting formations (periosteum, ligaments, tendons, muscle fiber shells), vessels, nerve endings, in internal organs. Therefore, the action of a segmental massage is complex and covers all metairic sheets.

Segmental pharmacomassage Using special ointments containing cerebrolyzate and "conductor" delivering a hydrolyzed drug deep in? Massageable tissues, developed in NTC PNI. It allows you to combine the impact of the massage itself with the introduction of hydrolyzate drugs into massive segmental areas of the skin, muscles, connective tissue ligaments and periosteum, as well as in the course of the main nerves of the limbs and the body. Growth factors or their analogues entered in this way are captured by the nerve endings of segmental somatic and vegetative neurons and during the first hours are delivered to segmental centers of the head and spinal cord, stimulating their structural and functional restructuring.

Manual therapy Normalizes the disturbed interjection of bone, ligament and muscle elements, improves spinal cord trophy. The manual correction method for children's cerebral paralysis with the help of special techniques of impact on the spine segments allows to eliminate the foci of stress in the occasional muscles, and leads to a decrease in the increased muscle tone. The method of manual therapy affects not only peripheral separations of the engine device, but also improves the functions of the central nervous system.

Treatment of motion (Therapeutic physical education or kinesiotherapy) is the most important method in the correction of violations of the development of stico-motor functions.

Neuromotor education. Parakey and paralysis in children with children's cerebral paralysis are not identical to the paralicles and paralymps arising from focal lesions of the brain in adults, and mainly a consequence of fixing in the memory of the brain of anomalous motor stereotype, which is generated by maintaining early automatic reactions (posotonic reflexes, synclosis). In order to eliminate the motion recorded in the brain in the brain, it is necessary to prevent the child to reproduce this movement correctly, that is, imitate it, which will help to form and consolidate the normal motor "image" in the memory of the brain, which is necessary for the implementation of normal movements.

Simulation stimulation Basis of automatism for motor development and poses was developed in the middle of the last century by Glen Doman with employees and includes imitation of crawling and walking. Stimulation of stepper automatism must be started with simulation of crawling, since the step combines the agreed movements not only the legs, but also torso, and the hands, and head.

When simulating crawl, the child is in a horizontal position on the stomach. Mother holds the child's body on the weight, and the massage therapy and instructor of therapeutic physical culture (LFC) at this time consistently alternately rearrange the hands and feet of the child with an underlined support on the hand and knees, imitating the walking of animals. Classes should be held 4-5 times a day for 20-30 minutes. With steady perseverance, even in cases where the child does not sit independently, it is not worth it. After repeated repetitions of sessions, the child appears independent movements of crawling.

The next step is crawling along the inclined surface, when mastering the child of this exercise, the angle of inclination is reduced to the horizontal plane. After mastering the child, the skill of independent crawling, which indicates the rehabilitation of step reflex, go to the study of walking. These classes must also be carried out with patients independently moving with stored pathological poses and limb installations.

The simulation stimulation of walking requires the participation of two or three people: the mother holds a child in a vertical position on the floor and monitors the correct vertical setting of the head, preventing its tilt forward, and the massage therapist and instructor straighten the lower limbs of the child in hip and knee joints, counteracting the so-called "triple flexion" in the pelvic belt and legs. At the same time, they carry out the child's legs slow stepper movements with an emphasis of support on a complete foot and heel. As you progress step by step, the mother carries the baby's body forward, also trying to strengthen the support on the foot.

In 1946, Kebot proposed a method for strengthening the volitional muscular reduction by stimulating the nerve endings of the muscles itself carrying information on the position of the limb in space. The stimulation of the nerve endings located in the muscle with special exercise, which is based on the principle of changing spastic muscles and their antagonists, creates a relief of muscle contraction. The essence of the method consists in the maximum excitation of the relevant departments of the brain cortex.

In the NTC PNI, methods of simulation therapy are systematized and obtained further development. Modified development of the group of Domana on simulation stimulation of crawling and walking, perceptual insufficiency (visual, auditory, tactile). Special devices and devices for imitation stimulation of walking, electrical stimulation of difficult limbs movements are developed. Applications of stimulation of visual perception are used, as well as special "glasses" with a programmed stimulation of the movements of eyeballs and vision.

The imitation of normal motor acts and poses requires a huge physical effort from personnel and parents, but it allows you to significantly weaken the anomalous imaginary stereotypes characteristic of children's paralysis, facilitate the transition to vertical walking on the full foot.

An important role in the prevention of contractures in the joints is allocated by passive movements performed by a massage therapist or an instructor of the FFC. For the restoration of muscular strength, several techniques are offered: the work of the muscle with overcoming resistance to its reduction, the muscle stretching, which facilitates the subsequent volitional movement, and the combination of some pathological reflexes with the patient's volitional efforts to expand its motor capabilities. Certain schemes and types of exercises allow the most fully intensifying the fibers of the cutting muscles. Multiple repetition of classes can lead to the creation of new motor connections or to restore motor conductivity.

Highly efficient for children of the first years of life The method of therapeutic physical culture of Karel and Berta Bobats, developed in the 50s of the twentieth century.

The method is to supplement pathological tonic reflex activity by selecting for a particular patient some poses blocking the reproduction of pathological motor automatism (reflex-prohibitive positions). For example, the "Embryo Pose" is used, during the reproduction of which is significantly reduced by the tone of the muscles of the body and limbs. In a similar position, the preserved diseases of the child are blocked by the child, which contributes to his learning to the right movement. The formation of statics and locomotion of arbitrary movements is carried out in the order of their sequential development in the postpartum period. The pressure on the joints and parts of the body, their stroking and the rubbing of the massage therapist makes it possible to maximize the pulsation from the sensitivity receptors to the centers of the brain, carrying information about the position of the body and its individual parts in space. Thus, the correct movements are brought up, and their "image" is fixed in the cortical centers of the brain.

With violations of motor development, kinesiotherapy according to the method of Czech neurologist V.Vota is also successfully applied. The basis of the method is to stimulate the movements of turns and crawling, playing an important role in the further motorcy of the child (see chapter 4).

In addition to the upbringing of the proper motor stereotype, kinesiotherapy has a multilateral impact on the entire body. Dosage muscle loads have a common toning effect, activate the activities of a series of internal secretion glands, cardiovascular, respiratory systems, increase the metabolism. In the muscles participating in the movements, the trophic processes and regeneration processes are improved, the influx of blood to them increases. Improving trophy (nutrition) tissues due to physical exertion prevents the development of secondary changes in bone tissue, as well as fibrosis and muscle contractures. Patients enhances the mood and a desire for cognitive activity appears.

In recent years, new instrumental methods of kinesiotherapy appeared, providing for the active involvement of the patient into the rehabilitation process. Intensive development of computer technologies, improving medical equipment made it possible to carry out a thorough analysis of the causes of motor disorders. For example, modern methods of research of the gait allow you to record and analyze all its components, the electromyography gives information about the normal operation of the muscles at every moment of movement when walking and allows you to compare with these data the results of the patient's research. New opportunities have formed the basis for the creation of a number of multichannel computer complexes, which are aimed at stimulating the movements of certain muscle groups forming new motor acts. At the same time, the principle of successful treatment with the help of modern equipment of violations of the development of stico-motor functions in children remains the same - persistent stimulation of the sensing systems of the motor analyzer: the recreation of regulatory pose of the body, imitation of normal crawling and walking on the full foot, as well as direct and reflex physiotherapeutic effects on the structures of the head and spinal cord.

Much popularity as a method forming in children a positive motivation to classes, the desire to actively participate in the medical process to acquire horseback ridingapplied as a means of medical rehabilitation, psychological correction and social adaptation of patients with motor and psycho-emotional disorders. At the same time, the movement of the horse and psycho-emotional contact with it are used with therapeutic goal.

This method provides for the "merger" of a person and an animal while driving. As you know, the body's body with horse riding makes the same movements as when walking (the function of the rider feet takes on the legs of the horse). Three-dimensional horses back vibrations with different allyrs contribute to the development of reactions of straightening and equilibrium, inhibit incorrect postures and making incorrect movements with a sick child. In addition, contact with large animals self defines a special, raised mental state of a patient sitting on a horse rider directly feeling the warmth of its body (the temperature of the horse's body is higher than ours) and the vibration of the back.

A child learns to save a symmetrical pose, control the position of the head and torso, maintain balance in the sitting position. Horse riding contributes to the development of mobility in the limbs and coordinated muscle work, improves visual-motor coordination, trains the vestibular analyzer. The horse and gear are selected specifically for each child, since the wrong choice of an animal and the saddle leads to complications, for example, excessive muscle stretching or an increase in muscle tone.

Against the background of rehabilitation activities involving a horse in patients, patients have a positive dynamics in the form of an increase in the volume of active and passive movements in the limbs, muscle strength, a number of psychological indicators and even a tendency to change social status. Regular conducting correctional classes requires parents and patients of large emotional and physical efforts. To facilitate this process can form a positive motivation in a child, desire for classes.

Task music electrostimulation In patients with children's cerebral paralysis, mainly reproducing the effective reduction in antagon muscle, few capable of resisting spastic muscles (GTM). It activates pulsation flows inside the spinal cord segment and towards the brain, improves blood supply and muscle trophic, increases muscle strength in weakened and atrophied muscles and reflectically reduces the tone of GTM, as a result of which the pathological settings of the limbs are corrected, relieves the restoration of full-fledged arbitrary movements. In spastic tetraprez, the posture of "triple flexion" in the legs is reduced, it is easier and improved walking, significantly increases the volume of thin movement of the brush. With muscle hypotension syndrome, motor activity and muscle strength increase.

Currently on the basis of modern computer technology developed multichannel programmable electrostimulation of muscles. The computer complex provides accurate recreation of the sequence of contractions of individual muscle groups when driving, duration and strength of muscle contractions when playing a step or movement of the hand. The device simulates normal reductions in the muscles of the lower extremities at normal walking and hands when manipulating, which facilitates the gradual formation in the brain "healthy way of movements" and enshrines it, displacing an abnormal "image of movements", associated with an anomalous walking on "spastic legs" and abnormal movements " spastic hands. " As a result of the sensory tributary from working muscles, there is a restructuring of the activities of the head and spinal cord in motion management.

Under the leadership of K.A. Seminovova in the Department of Recovery Treatment of Children with Palsy Razbeat dynamic proproceptive correction method, carried out with the help of therapeutic overalls of Adeli-92 and "Gravistat". This load device, imitating the gravitational field of the Earth, is used in astronauts with prolonged flights in weightlessness. The system of elastic thrust increases the load on the body and the limb of the patient, which leads to an increase in propriceceptive impulsation from muscles, ligaments and joints and normalizes the functional state of the nervous system. Due to the forced change in the patient's posture, both alone and motor activity, a motor system is restructuring, which contributes to the formation of a new motor stereotype. After the course of dynamic proprioceptive correction, the patients decreases muscular tone, the implementation of active movements is facilitated and the pathological posture is corrected, there is also a tendency to reduce the hyperkinetic activity and the severity of tonic friendly reactions.

Favorable, versatile impact of massage on the patient's entire body in terms of the time consideration of the procedure itself, served as a reason for the development pneumatic pulse massage costume "Pilot"designed with the participation of NTC PNIC employees. A mechanical impact on certain areas corresponding to the metairological structure of the patient's body using special pneumomagers equipped with an arraying element - elastic rubber "ribbons".

The work of the costume is a two-feed: in the first phase, the cuff is spaced under the influence of compressed air, the distance between the massaging "rollers" of the adjacent cameras is reduced. In the next phase, the pressure in the chambers falls - rollers diverge. Thus, the pneumatic pulse massage suit carries out a local compressive, rubbing and kneading effect, ensuring the possibility of simultaneous impact on a significant amount of muscle groups. Against the background of treatment using a pneumatic pulse massage suit in patients with spastic forms of centers, an improvement in overall well-being is observed, an increase in the volume of active movements, strengthening the ability to actively reduce antagonist muscle, improving body verticalization, facilitates the development of sticographical skills of crawling, seats, walking, The posture is improved when walking. In addition, the procedure itself is accompanied by pleasant sensations, soothing the action, which is especially important when using suit in children.

A comprehensive approach to the stimulation of functions is applied to the NTCs: stimulation of motor development by scleromeric and miper massage, medical gymnastics, stepper electrostimulator, apparatuses for improving the function of the visual analyzer ("Speed \u200b\u200bperception" function), hearing (synthesizer with an individual selection of sound and musical stimuli . For the restoration of shallow Motoric brushes, the Hand-based hardware complex is used, working on the principle of feed biological communication and consisting of a special control manipulator, which allows the child in the mode of special computer gaming programs to visually control the result of manipulation on the monitor screen. This device allows you to reduce the spastic installations of the brush not only to achieve its greater mobility and flexibility, but also greater meaningfulness and focusing of its movements.

Currently, the basis of many modern instrumental methods of motor education is the principle of biological feedback. Methods of functional biocopulation Aims to develop and improve the mechanisms of self-regulation of physiological functions under various pathological conditions.

During the procedures, the patient with the help of external feedback (sound signals, video recordings), information about the correctness of the motor acts performed by it is supplied, which allows the patient to learn to independently control their behavior and movement. The sound signals supplied by the electromyograph in the recording of muscle biotokov, help the patient to control the muscle contraction force, the amplitude of the corner of the angle in the limb joints when performing movement. Special methods provide a patient's ability to observe the trajectory of its movements on the monitor screen, moving the center of mass of its body (computer stability), which contributes to the normalization of coordination of movements.

The development of self-control contributes to the formation and consolidation of a normal motor and behavioral stereotype. The influence of biological feedback on children with violation of the development of psychomotor functions is expressed in increasing the volume of active movements, a decrease in muscle tone, a decrease in the severity of pathological installations of limbs, improving the coordination of movements. Under the influence of functional biocopulation, the bioelectric activity of the brain is normalized.

Regular conducting correctional classes requires parents and patients of large emotional and physical efforts. To facilitate this process can form a positive motivation in a child, desire for classes. The search for the emotional involvement of patients in the rehabilitation process led to the creation of "game" modifications of bio-control. In this case, the fulfillment by the child of special exercises allows him to take part in a computer game. The development of self-control normalizes the bioelectric activity of the brain, contributes to the formation and consolidation of a normal motor and behavioral stereotype.

A comprehensive approach to the correction of motor functions allows you to achieve noticeable positive results with the restoration of the vertical position of the body, walk, the movement of the hands.

Physiotherapy. For the treatment of violations of the development of psychoneurological functions in children, including children's cerebral paralysis, various methods of physiotherapeutic impact on the nervous system have been developed. Physiotherapy methods that reduce muscle spasticity are widely used. They can be used before studying therapeutic physical education to increase their effectiveness.

Thermal procedures It causes warming the tissues, the extension of the vessels, enhance blood and lymph formation, improve the trophic, regenerative processes, reduce muscle tone, increase the elasticity of muscles and ligaments, contribute to the decrease in the severity of contractures. For thermal conductivity use hot bobble with mud, peat, ozokerite, paraffin, sand. Ozokerite contains biologically active substances that penetrate the body through the heated skin and enhance the therapeutic effect.

Local cooling method It is the imposition of ice (ice applications) on the spashed muscles of the limbs, which slows down the pathological impulses from them into the brain structures and significantly reduces the muscle tone for 20-30 minutes, which makes it possible to use this time to build a correct movement during kinesiotherapy. To relax the calf muscle and Achilles, the tendon is used alternation of ice applications with hot wraps, which increases the degree of muscle relaxation.

Swimming It has a versatile influence on the child's body: it helps to reduce the muscle tone, increases the volume of active movements, allows the child to acquire new motor skills, feel power over its body and space around itself, to realize the movement of its own body. At the same time, swimming serves as a tempting procedure, creates conditions for the development of the initiative, delivers the child joy and serves as wonderful entertainment.

Underwater Massage Combines the hydroelectric and massaging effect. The stay of a patient in a bath with warm water leads to the relaxation of the muscles of the body and reduce pain, which creates conditions for holding a deep massage of tissues. The procedure ensures that blood circulation in muscles increases their contractile ability and the volume of movements in the affected limbs increases the psycho-emotional tone of the child. Useful combination of underwater soul massage with medical gymnastics in water.

Widely used as well reflexotherapy methods. Reflexotherapy (the classical method is the needleflexotherapy) stimulates adaptive and compensatory mechanisms, normalizes the function of the internal organs, has an anesthetic effect. Additionally, drug, vegetable, plant, minerals, electroplating, thermal, cooling, mechanical, physical, electron-ion, light, sound and other effects.

Medicinal electrophoresis It is introduced by administering with a galvanic current of medicinal substances, which provides both local and overall effect, makes it possible to improve the carrying out nerve impulse, reduce intracranial pressure, improve blood and lymph circulation in the central nervous system, to have a sedative effect.

In the treatment of violations of the development of psychoneurological functions applies sinusoidally modulated currents (with atonic forms of cerebral paralysis for the purpose of muscle stimulation, improvement of peripheral blood circulation), methods of microolarization brain structures transcranial electrotherapywhich increase the tolerance of the child to the loads of specific rehabilitation therapy, stabilize the functioning of vegetative, cardiovascular systems.

Impact electromagnetic radiation extremely high frequency Effective with cerebral palsy. The resonant nature of the interaction of radiation with bio-object was discovered, a new possibility of controlling biological processes at the level of intercellular interactions was shown. Magnetotherapystrengthens brain brain processes, which manifests itself with a soothing and analgesic effect, improves anabolic processes in brain cells and other tissues, improves microcirculation, reduces the need of cells and tissues in oxygen, reduces the severity of edema, has an anti-inflammatory effect. Methodik microwave resonance therapybased on the effects of electromagnetic waves on biologically active skin points make it possible to influence the favorable course of rehabilitation therapy.

Phototherapy - a generally recognized method of physiotherapeutic impact on the body with a prophylactic and therapeutic goal. In infrared radiation, an analgeling effect occurs, vascular reactions occur, the excitation of thermistors, transmitted to the thermoregulation centers of the nervous system, the local blood supply to tissues increases, the metabolism and phagocytosis reactions are improved, immunobiological processes are intensified. Laser radiation stimulates the processes of immunity, blood formation, regeneration (in particular, when damaged by nerve fibers, during bone fractures), accelerates healing of skin wounds, burning surfaces, has an anesthetic, anti-inflammatory, vasodilatory action. Laser radiation at reflexotherapy points is used in sluggish and spastic paralymps.

Developed medical and diagnostic the method of transcortic and transverter magnetic stimulation (TKMS and TVS). Diagnostics using TKMS drew the attention of doctors to the rehabilitation properties of the method. Therapeutic conduct of TCCs in motion disorders (caused by the pillars, the consequences of encephalitis, the cranial and brain injuries, the lesions of the nerves, plexuses) contributes to the restoration of muscle strength, an increase in the volume of active movements in the affected limbs, as well as the formation of new neuronal bonds in the central nervous system and, thus compensation Motive Defect. The scientific and therapeutic center for the prevention and treatment of psychoneurological disability is successfully used by TKMS also in the treatment of congenital hearing loss, violations of the development of visual perception, speech and intellectual-communicative functions, and TVS - in the treatment of myelodysplazium, enuresis, encopter and other spinal disorders and dysfunctions .

Surgery. One of the frequent complications of the cerebral paralysis is the formation of secondary deformations of the limbs, a pelvis, chest. The change in the muscular tone leads to forced fixation of the extremities of the sick child in a pathological position, limiting the volume of active movements in the joints. Hydodine and a violation of the trophic influence of the nervous system lead to shortening of spastic muscles, the loss of the elasticity of tendons, while the antagonists of spastic muscles are atroculated from inaction; At the same time, the ability of muscles and bones to normal growth is disturbed, which is the main reason for the development of contractures.

Prevention of secondary deformations and contractures is the most important task in carrying out rehabilitation activities. In solving this task, an important role is assigned orthopedic events - overlay gypsum dressings, the use of modern light orthopedic devices (orthaisms) - for fixing in the correct position of the ankle, knee, elbow and ray-taking joints, to increase the volume of movements in the joints and stretching the spashed muscles. The correct selection of orthetz is very important: the pressure must be evenly distributed to the maximum possible area, it should not be close (so as not to break the blood flow) nor too free (so as not to rub the skin). Ortez is put on a few hours a day and does not cause muscle atrophy.

Surgical operations To reduce spasticity are possible on four levels: on the brain, spinal cord, peripheral nerves and muscles. Surgical operations on the brain include various methods: the destruction of some structures of the brain involved in an increase in muscle tone or in the occurrence of violent movements (hypercines); Implantation (lusion) of the stimulator on the cerebellum surface and in other brain departments. In cases of rapidly progressive hydrocephalus with an increase in intracranial pressure, surgical drainage (shunting) of the brain ventricles is widely used.

In the spasticity of the lower limbs, the operation of the longitudinal dissection of the spinal cord (longitudinal myelotomy) is carried out in order to break the connection between the front (motor) and the rear (sensitive) spinal horns. The operation is technically complex and is associated with the high risk of complications, therefore it is rarely used. The selective rear risotomy is used more often, which is the release and intersection of nerve fibers going in the roots from the front horns of the spinal cord and carrying pathological impulse to the spastic muscle. With selective rear risotomy, it is possible to reduce the tone of individual muscles, increase the volume of movements in the joints and as a result of which the child's motorcycles are improved. The peripheral nerve dissection can also eliminate spasticity, however, this operation may be complicated by the development of peripheral paresses, pain, sensitivity disorders and often requires additional orthopedic correction, so it is rarely used.

Surgical operations in patients with an increase in muscle tone are also held on the muscles or their tendons: the lengthening of the muscle tendon or moving the place of attachment of the muscle reduces the activity of muscle receptors that react to the stretching of the fibers, reduces spasticity and prohibits the position of the limb.

In children with spastic forms of children's cerebral paralysis and muscle contractures, in some cases, a good effect is observed in conducting a phased fibrotomy (Ulzibat VB et al., 1995), which is to eliminate local muscle contractures and painful syndrome, which is achieved, according to Authors, dissection of connective grooves, a specially designed scalpel, allowing not to produce a large cut of the skin. At the same time, the most likely mechanism for reducing the tone on this method is dissection of fibrous threads that fix neuromuscular spindles in the tendons, which leads to a decrease in tensile reflex and, as a result, a decrease in muscle tone. The advantage of the method of phased fibroid is a small trauma. The elimination of articular deformations and muscle contractures provides a child to the child to gain self-walking skill.

A common problem in violations of motor development is a violation of the formation of hip joints. The process of forming joints occurs under the influence of muscle tone and with a certain hip set. In the infant, the articular surface (the godded depression) is normal, and only when the child begins to load the joint, the articular surface takes the shape of the bowl. As the child develops, the shape of the pelvis is changing and, accordingly, the location in it is the head of the hip bone. The increase in the tone of the muscles of the hips, butorous and other pelvits violates the ratio of the heads of the femur bones and the godpadin pelvis. As a result, the head of the femoral bone is not only not included in the articular depression, but also pulls up from the joint. In these cases, operations are carried out on the formation of articular depressions on the pelvic bone and correction of the position of the head of the thigh in the joint. The negative torque of orthopedically surgical treatment methods is the possibility of developing reverse deformations in the operated joints and various types of relapses.

Pedagogical and psychological correction. The child will know the world around the accumulation of experience. A huge role in the acquisition of knowledge about the world of the world is given to its motor activity, the ability to receive information when the senses (vision, hearing, tanging, etc.), with speech communication. Children with violation of the development of psychoneurological functions can not as easily as healthy, master the world around. A healthy child, learning to take a toy in his hands, feeling her, tries to taste, looking at her, knocking her on the surface, while he learns her properties. A child with a cerebral palsy is devoid of such an opportunity, his movement and the perception of the surrounding world are limited. Therefore, he needs to create a special situation that facilitates the acquisition of knowledge about the properties of the surrounding items, new skills, supporting interest in knowledge. The most important goal of psychological and pedagogical correction methods is the formation of a patient with a child motivation for learning.

Method conductive pedagogy, designed in the middle of the last century at the Peto Institute (Budapest) and is aimed at the formation of the independence and independence of the child. A specially trained educator-conductor seeks to lead the patient's biological and social needs of the patient, its adaptation to the external environment. Training of the patient is carried out in the process everyday lifeIn the same room in which he lives. As a result, learning actually turns out to be part of the child's life. In the course of classes in the atmosphere of warm communication, various activities are mastered: rowing, dressing, washing, food, drawing, letter, account. Actions are supported by a word, musical accompaniment, which contributes to the attachment of skills. Conductive pedagogy is combined with other methods of medical, surgical and orthopedic treatment.

Honored recognition uses development Rehabilitation Concept T.khelbruggga, on the basis of which a comprehensive interdisciplinary program of upbringing and learning for children with congenital or early acquired violations of movement, vision, hearing, speech, social adaptation has been developed. Only in early childhood there is a unique chance to restore or reducing the severity of disturbed functions, since in this period the plasticity of the brain and its compensatory capabilities are especially large. The rehabilitation center should be moved to the parent house. Parents teach a special rehabilitation program, taking into account the child's disease, the level of its development and opportunities. Monthly testing allows you to evaluate the dynamics of the development of psychoneurological functions against the background of conducting correctional classes and, depending on the results, plan further medical and pedagogical activities.

Method M. Montessori It is based on the creation of favorable conditions for maintaining and developing congenital motivation to research and knowledge, as well as their needs for learning others. Atolateral groups where children are concentrated with equal opportunities (equally strong or equally weak) exclude social actions of mutual assistance, and relationships are built on the basis of competition. These problems are naturally solved in the family, where the reconciliation, various degree of development of skills and skills stimulates social development due to the permanent opportunity to assist, teach something younger. The method provides for the combination of children in groups with different physical and intellectual possibilities on the principle of family groups. The conductor in every way stimulates the attempts of children to train less skillful. The older child with disabilities appears a chance to teach something younger healthy child, it increases the self-esteem of the sick child, helps him establish themselves in the team, supports interest in learning.

Music therapy - The method of joint music practices using musical instruments and sounding items aimed at helping children with various developmental impairment. Each sound, a melody that makes a child becomes significant, find a response in an executed teacher music, so there is a kind of musical dialogue between the baby and adults. In classes with an experienced musician, the child gets the opportunity to voice his feelings, which has a positive impact on its emotional, communicative development, expands the ability to understand the reversed speech, helps to organize movements. Currently created a variety of musical simulators. The impact on them can be done when pressed on the key, pressing on the square of the floor, when illuminating a certain zone of light beam. The resulting result forms a positive motivation to classes and serves as a powerful impetus for learning a child with new skills.

An important role in the complex of therapeutic measures in violations of the development of psychoneurological functions in children is given medical and psychological rehabilitation.

The NTC stumps of psychological correction precedes the diagnosis, which is conducted in three directions:

1. psychological and neurological examination in order to determine the real "development profile" of the highest mental functions of the child. The indicators of motor, perceptual, intellectual, speech and communicative development of a child from birth to seven years are taken into account, which make it possible to objectively assess the initial level of development of psycho-neurological functions, to determine the dynamics of their improvement against the background of rehabilitation therapy;
2. neuropsychological research using a set of specific tests makes it possible to determine the location of preferential functional failure in the cerebral cortex. The results of neuropsychological research reveal the causes of defects that violate the development of the child determine the level of development of the main highest mental functions, thinking, memory, attention, speech, accounts, letters;
3. psychological research of parental-children's relationship makes timely identifying problems and conduct their psychological and medical correction. The harmonious relationship between the mother and the child contributes to the successful adaptation of the family in the social environment and improve the course of the rehabilitation process.

Based on the levels of levels and the possibilities of further development of higher mental functions, a correctional work is built in each particular patient. The complex of exercises for the development of motor functions, visual and auditory perception, intellect, communication ability (communication), the development of speech is individually selected. These neuropsychological research allows you to train the development of Praxis (the ability to perform targeted movements according to plan), Gnosis (ability to recognize, differentiate external stimuli) and other higher mental functions.

The correctional work plan is implemented in four stages:

1. Simple manipulations, including massage, stimulation of visual and auditory perception, passive gymnastics, aimed at correction of large and small motility, imitation of the normative position of the body in space, crawling, walking. Such classes can be conducted by trained parents in any room, after completing the course of treatment, they must be continued at home.
2. A more complex form of correctional classes - classes with a child in the office of a psychologist. For the development of visual-spatial orientation, constructive activities, attention, memory, thinking use special benefits of varying degrees of complexity. Start classes with elementary joint action with adults, gradually the participation of an adult decreases, while the child learns to solve the task itself.
3. An important component of the correction work is the game. It is a leading way to know the surrounding world for children of preschool age. The game becomes possible "playing" of various life situations. A specially organized game allows you to develop higher mental functions in a child - attention, memory, logical and abstract thinking. In the process of the game, the assimilation of the rules of behavior and social relations, adaptation of the child to the environment.
4. Instrumental correction of the development of higher mental functions with specially designed adaptations and apparatus: stimulation of visual and auditory perception, development of the movements of a child's brush, etc.

Significant assistance to a psychologist in addressing the task of the development of higher mental functions in children with a violation of psychoneurological development is provided by computer games that differ in varying degrees of complexity.

For the smallest and children with pronounced intellectual communicative disorders, the developing game "Visiting Rabbit", which can help speech development, accounts, teaches the basics of communication with the computer, improves the eye meter and reaction. For the development of visual perception, developing interactive games "Kid 1-5", "Crossword", "Lotto", "Airplane" are offered. For the correction of spatial disorders, which in the future may make it difficult to form a letter skill, training movement movement to the target, the simplest coordination of movements in space and time and control in the process of performing movements, uses computer programs "Eye", "Caterpillar", "steam locomotive " During classes in children, there is not only the formation of spatial perception, thinking, but also the development of small motility.

For the development of children with preserved intelligence from 3 to 7 years old, the game "Alik, soon to school", "Merry Mathematics", "Merry ABC", "Planet numbers", "Sesame Street", "Rabbit School" - they not only expand Knowledge of a child in the field of mathematics, letters, but also teach it to compare sizes, height, distance, solve simple logical tasks (classified in color and form), improve memory, attention, consistency. To work out the skills of shallow motility and visual-spatial orientation, the game "Learn, drawing", which expands the interest of children to paint the pictures, teaches to consider, write, recognize the voices of animals and birds, the sounds of various tools, logically thinking. For children of junior and middle school age (from 5 to 13 years old), more complex programs are used, for example, "Piglet in the Lost World", Mia Mia, "Royal Secret", Mulan, which require great intelligence, solutions to mathematical tasks , puzzles, issues on machinery, physics, chemistry.

All of the above methods, in addition to stimulating the production of certain motor and sensitive skills, contribute to the development of higher mental functions. The study of the psychoneurological "development profile" and the neuropsychological cartography of the highest mental functions as reducing therapy and improvement in the state of the child makes it possible to objectively determine specific positive shifts in the development of not only motor and sensitive, but also mental, speech and communicative functions.

An integral part of working with children suffering from a violation of the development of psychoneurological functions is the speech therapy correction. Children's violations in children can be associated with a decrease in the volume of lip movements, language, violation of the tone of the spectavatic muscles, the presence of hypercines, the discharge of speech respiration, hypersivia, a decrease in the volume of impressive and expressive speech, violation of sound; . An important direction in the work of a speech therapist with children, patients with cerebral palsy, is the normalization of muscle tone and motility of the articulation apparatus, which is achieved with various types of speech therapy massage.

Articulating gymnastics includes passive exercises (lip picking into the tube, stretching into a smile, raising up the upper lip, lowering the lower lip, movement of the language, jaw movement), which are carried out exaggerated with a large trajectory of movement, rhythmically, at a slow pace. The child is trained in such arbitrary movements, like a kiss, cough, eye closing, showing language, click language, closing, opening your mouth. Respiratory gymnastics allows you to increase the volume of inhaled and exhaled air with subsequent vocalization of exhalation.

Voice reaction stimulation is carried out during respiratory gymnastics. The speech therapist draws attention to the formation of the baby's ability to distinguish between voice intonations. The child is trained to the pronunciation of the sounds to imitation, stimulate the hugging of music by listening. A database is created to record vocalization and speech activities of a child, followed by analyzing the dynamics of expressive speech development.

Children with autism recorded egocentric speech expression. On the repeated courses they are listening to her parents, and the child himself. When stimulating the shelves, syllables are pronounced at the time of the child's exhalation, it is necessary to give him the opportunity to hear his own sounds, to repeat the sound to them. Teaching words are produced in game situations. The objects and actions meaningful to the child are voiced. To give the voice of greater intonation expressiveness, singing, reading poems. With the advent of simple phrases and proposals in the child's speech, much attention is paid to the clearly uttering of the expirational words.

Medico-social adaptation. When raising and treating a sick child, it is important to focus on the basics of social adaptation, teach the kid to the skills of self-service. It is desirable that he mastered the skills of herbs, learned on its own, dress, walk, talk, communicate. All listed skills are acquired gradually and gradually, each of them is divided into many simple actions requiring separate training.

For example, in order for the child to learn independently to dress, you need to teach it to control the position of my body; be able to maintain balance; follow the movements of your hands; be able to perform accurate moves with your fingers; Understand how parts of clothing among themselves relate (for example, buttons with holes for them) and with its own body; distinguish between the concepts of "top-bottom", "before-ass", "right-left"; be able to focus on the activities performed; Patiently bring the work started before completion. It is important that the target chosen to achieve was real, took into account the severity of motor, intellectual and emotional violations in the child at each stage of its development.

Experts (neurologist, psychologist, defectologist, instructor on therapeutic physical education, orthopedist) help parents in an adequate assessment of the gravity of the state of the kid. Formed the individual program of its rehabilitation, the most rational methods of drug, surgical correction, kinesiotherapy are selected, teach it properly choose and rationally use special devices designed to develop children with motor disorders vertical pose of body and independent movement.

The main role in the implementation of the Social Adaptation Program of the Patient Child belongs to the family. Only a family with her love and understanding, patience and mutual assistance can provide conditions necessary for an effective neuromotor, emotional, communicative and speech education of a child with a violation of the development of psycho-neurological functions. Doctors must be performed in this case the role of conductors who help close to the patient of the baby to learn how to make the use of rehabilitation tools and ways to care.

Parents must remember that the restoration of disturbed psychoneurological functions is a long-term process, it is associated with the functional and morphological restructuring of the nervous system, which continues for many months and years. It is impossible to achieve good and persistent results in the restoration of disturbed functions, interrupting classes with a child between treatment courses, and even more so experiencing various methods of restorative therapy on the child. Parents must steadily adhere to the selected rehabilitation program. Only a multiple, persistent repetition of the same correctional procedure makes it possible to achieve a positive result, and only therefore, in stages, you can master new skills. This contributes to the creation of a favorable climate in the family, faith of a child and close to improvement, the overall joy that every step passed by the baby on the way to recovery.

The most important direction of the work of a rehabilitologist and a psychologist is the correction of parent-child relationship. The functional relationship of the mother and the child is preserved for many years after its birth and contributes to the normal development of the baby and the woman itself. The mother of a seriously ill child is experiencing chronic stress that disrupts its psycho-emotional state, which negatively affects the course of the child's disease and the success of reducing treatment. Timely identification of problems in parent-child relations, their psychological and medical correction, the formation of a plant for success largely contribute to the restoration of disturbed psychoneurological functions in a child and the formation of harmonious relationships in the family.

Treatment of a child requires a constant effort from a mother. Prolonged emotional voltage varies adaptation mechanisms, leads to personal disorientation of parents. Individual psychocorrection conversations with careful analysis of personal positions of parents, the promotion of the development of adequate self-assessment, self-impact help to achieve a balanced state of the psycho-emotional sphere. Many mothers need consultation not only a psychologist, but also in medical care. It is necessary to convince the mother to take care of his health, as guarantees the well-being of a child and the success of his treatment. The harmonization of parent-child relationship has a positive effect on the course of rehabilitation therapy and is the key to family preservation.

Equally important for the success of social adaptation to teach a child to communicate. Education in the child is friendliness, interest in others, ease in communication will help him have people to himself, which will decorate his future life and will give the opportunity if necessary to contact people for help. At the same time, the social adaptation of the sick child depends not only on successful rehabilitation therapy and a delicate attitude towards him of other family members. A huge role belongs to the whole society, the state, legislative and moral basis of attitudes towards people with disabilities in general and especially to children with disabilities, the maximum involvement of such children to society - starting with kindergarten, elementary school.

The restoration of the nerve function after its damage passes several stages.

The beginning of the restoration of the nerve function is characterized by the appearance of non-differentiated nerve injuries, non-silized, prone to widespread and a long-lasting feature of sensations with a high threshold of irritation perceived as with a particularly unpleasant shade. Such sensations (hyperpathy) arise in irritation of a different nature.

Sometimes paresthesias are spontaneously appear on the place of injury and in the distal limbs in the form of crawling goosebumps, ripples, jolts, tides, heat. The study of the state of regenerating nerve fibers During the occurrence of these first signs of restoration of functions, it shows that the conductors of such sensitivity are cumulative or meal nerve fibers that are in the initial stage of myelinization, and the end of the nerves, not fully restored. It is very possible that during this period in the RubE and in the peripheral end there is a spread of centrifugal and centripetal pulses in the transverse direction, i.e. there is a "phenomenon of generalization of impulses", described by P. K. Anokhinov and proven by electrophysiological studies of his students.

In the further restoration of the nerve function, as they grow and ripening the regenerating nerve fibers on the periphery, there are movements of these sensations in the distal direction with a gradual change in their character. More differentiated sensations appear, the diffusion of their distribution and high irritation threshold; The sensations acquire a local character, disappears an unpleasant shade under local irritation. All this corresponds to the appearance of mature pulp fibers in the peripheral end and the formation of full-fledged finite structures.

The beginning of the contraction of the muscles is preceded by the termination of their atrophy, the appearance of tone and fibrillar twitching. The first movements are short and fast attenuating, long non-coordinated. Restoration of deep reflexes often delayed for a long time. The appearance of full-fledged movements occurs after the exercises necessary to restore conditional reflex ties between the various departments of the motor analyzer. The normal electrical conductivity of the regenerating nerve and muscles can recover after the appearance of movements. The complete restoration of the sensitive function of the nerve is less common. Apparently, it depends on the complexity and diversity of peripheral receptor structures and links in the field of sensitive analyzer.

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Section 2.

Drugs acting mainly on the peripheral nervous system

It is known that the control signals of the central nervous system (brain) governing the activities of internal organs and tissues of the body are transmitted by it with the help of a peripheral, so-called vegetative nervous system. Many pharmacological agents have a healing effect, specifically affecting the transmission of signals from the central nervous system by affecting the nerve end of the vegetative nervous system. The vegetative nervous system consists of two departments: sympathetic (adrenergic) and parasympathetic (cholinergic).

Signals from nerves to the organs are transmitted in special formations located innervous endings - synapses - by selecting medal seats (transmitters). In the sympathetic department of the vegetative nervous system, such a transmitter (mediator) is norepinephrine, and in parasympathetic -acetylcholine.

Internal organs perceive control signals transmitted to them with a mediator (transmitter) with special perceiving structures - receptors.

Receptors that perceive signals from the endings of sympathetic nerves are called adrenoreceptors (adrenoreceptors depending on its physiological role are divided into a number of subtypes: alpha1; alpha3; beta1; beta2), and receptors that perceive signals from the endings of parasympathetic nerves are called cholinoreceptors (cholinoreceptors depending on their physiological role is divided into a number of subtypes: mi; MR,MH and noline tractors).

Medicinal substances that act like mediators are called mimetics and from here and the name of the respective groups of drugs - cholinomimetics, i.e. substances acting like acetylcholine, and adrenomimetics - medicinal substances acting like noraderenlin.

Drugs that prevent the interaction of the mediator with the receptor and / or disturbing the development of the mediator by the nervous end are called politicians or blockers. From here, drugs blocking cholinoreceptors are called cholinolics or cholinoblockers, and blocking adrenoreceptors are called adrenolics or adrenoblays.

Based on this, a classification of medicines given in the second chapter was built. In addition, it should be emphasized that, in addition to acetylcholine and norepinephrine, other substances, such as dopamine, histamine, and serotonin can be performed by other substances, such as dopamine, histamine and serotonin, should be emphasized. Hence the name of the respective groups of drugs - dofaminergic, histaminergic and serotonergic.

Drugs acting in the field of "brake" nerve endings

(Drugs acting mainly on cholinergic processes)

Acetylcholine and cholineimetic drugs

Aceclidine(ACeclidinum)

Synonyms: Glauksostat, Glaudin, Glaungs.

Pharmachologic effect.Active cholinomimetic agent predominantly affecting M-cholinoreceptors. Feature of the drug is a strong mystical (narrowing pupil) action.

Indications for use.To eliminate postoperative atony (tone loss) of the gastrointestinal tract and bladder; In ophthalmology, for narrowing the pupil and lowering intraocular pressure during glaucoma (increased intraocular pressure).

Method of use and dose.Subcutaneously 1-2 ml of 0.2% solution. The highest one-time dose is -0.004 g, the daily -0.012 in ophthalmology is used by 3% and 5% eye ointment.

Side effect.Possible saline, sweating, diarrhea.

Contraindications.Stenzardia, atherosclerosis, bronchial asthma, epilepsy, hypercines (involuntary reductions of muscles of limbs), pregnancy, gastric bleeding.

Release form.Ampoules 1 ml of 0.2% solution per pack of 10 pieces; Ointment 3% and 5% to 20 g.

Storage conditions.List A. in a cool place.

Acetylcholine hydrochloride(Acetylcholini Chlondum)

Synonyms: acetylcholine, acetylcholine chloride, acecoline, Mikhol, Cytocholine, etc.

Pharmachologic effect.It causes the excitation of all cholinoreactive systems of the body, which is accompanied by a decrease in blood pressure, the expansion of blood vessels, slowing down heart Rhythm, increased reduction in the smooth muscles of internal organs, increase the secretion of sweat, tear and bronchial glands, narrowing of pupils.

Indications for use.Basically in laboratory practice, sometimes as a vasodilator in spasms (sharpness of the lumen) of peripheral vessels, endarteritis (inflammation of the inner shell of arteries), intermittent chromotype (symptom of circulatory disorders of the lower extremities), spasms of the retinal arteries, etc.; When conducting pharmacological and physiological studies.

Method of use and dose.Subcutaneously and intramuscularly at 0.05-0.1 g 1-3 times a day. The highest one-time dose is 0.1 g, daily - 0.3 g. When injections should be made that the needle is not in Vienna. Intravenous introduction is unacceptable due to the possibility of a sharp decrease in blood pressure.

Side effect.In case of overdose, a decrease in blood pressure with bradycardia (rare pulse) and heart rate disorders, profuse (abundant) sweat, miosis (narrowing of the pupil), a sharp increase in the peristaltic (wavy movements) of the intestine. In these cases, it should be immediately introduced into a vein or under the skin 1 ml of 0.1% of the atropine solution (repeated).

Contraindications.Angina, atherosclerosis, bronchial asthma, epilepsy.

Release form.0.2 g in ampoules with a capacity of 5 ml per pack of 10 pieces.

Storage conditions.List B. in a cool place.

Carbacholin.(Carbacholinum)

Synonyms: Carbachol, Carbaminylcholine, Carbamyotin, Karholin, Doril, Duraholin, Enterotonin, Glaucukil, Lentin, Moril, Jestril, Tonokolin, and others.

Pharmachologic effect.On the chemical structure and pharmacological properties are close to acetylcholine; More active and has a longer action.

The durability of the drug allows them to use it not only for parenteral (bypassing the gastrointestinal tract) of the introduction, but also for intake. When orally (through the mouth) and parenteral use, the drug is quickly absorbed.

Indications for use.Carbacholin is effective (stronger than acetylcholine) increases the tone of the muscles of the bladder and intestines. Under local application (in the form of eye drops) Reduces intraocular pressure under glaucoma (increased intraocular pressure).

Method of use and dose.Dose for adults when taking inside -0.0005-0.001 g (0.5-1 mg), subcutaneously and intramuscularly - at 0.0001-0.00025 g (0.1-0.25 mg) 2-3 times in day. With intravenous administration (0.00005 g \u003d 0.05 mg), greater caution should be observed: the drug is introduced very slowly. The specified doses due to the large activity of the drug should not exceed.

Higher doses for adults: permanent inside -0.001, under the skin - 0.0005 g; Daily inside - 0.003 g, under the skin - 0.001 g.

When glauer, carbacholin solutions (0.5-1%) are injected into the conjunctival bag (the cavity between the rear surface of the eyelids and the front surface of the eyeball) 2-6 times a day.

The concentration of carbacholin and the instillation frequency should be selected individually for each patient, since due to the strong narrowing of the pupil and the spasm of the ciliary muscles (muscles of the eye), headache and pain in the eyes are possible.

Side effect.When taking carbacholin, there is sometimes sensations of heat, salivation, nausea, bradycardia (rare pulse); These phenomena pass with a decrease in the dose.

Contraindications.Contraindications, possible complications and aid measures are the same as for Acetylho-Lina.

Release form.Powder.

Storage conditions.List A. In a well-appointed package that protects against the action of light, in a dry place.

Cabelope

Synonyms: isoptocarbachol.

Indications for use.Treatment of glaucoma (increased intraocular pressure).

Method of use and dose.When glaucoma, you are injected into the conjunctival bag (the cavity between the rear surface of the eyelids and the front surface of the eyeball) 2-6 times a day strictly by appointment of the doctor.

Release form.Eye drops (0.75%, 1.5%, 2.25% and 3% solution of carbacholin).

Storage conditions.List A. in a cool place.

Mostat intraocular

Mostat Intraocular)

Indications for use. The narrowing of the pupil during surgical eye operations.

Method of use and dose.0.5 ml injected into the front chamber of the eye.

Release form.0.01% carbacholin solution in 1 ml ampoules.

Storage conditions. List A. in a cool place.

Carbacholin is also part of the drug neoklimastilben.

Pilocarpine Hydrochloride (Pilocarpini Hydrochloridum)

Synonyms: Pilocarpine, Pilocar, Officonpylocarpine, Humacpine, Isop Cropin.

Pharmachologic effect.Stimulates peripheral M-cholinoreactive systems.

Indications for use.In ophthalmology as a mystical (narrowing pupil) means to reduce intraocular pressure, as well as for thrombosis (violation of passability) central veins of retina, acute obstruction of arteries, atrophy of the optic nerve.

Pilocarpines are also used to stop the mydritic (expanding pupil) of actions after applying atropine, homatropine, scopolamine or other cholinolitic substances to expand the pupil with ophthalmic studies.

Method of use and dose.Usually 1% or 2% aqueous solution of pylocarpine 2-3-4 times a day is used. In rare cases, more concentrated solutions are prescribed (5-6%).

Pilocarpine is often used in combination with other drugs that reduce intraocular pressure: betaadrenoblockers (see Timolol), adrenomimetics, etc.

Before bedtime, it is possible to lay 1 -2% pylocarpine ointment.

Eye films with pylocarpine are appropriate to assign in cases where the ocular of the eyeball is required to normalize the tone of the eyeball, more than 3-4 one-time buckling of pylocarpine solutions per day. The film is layered using an eye tweezers for the lower eyelid 1-2 times a day. Wetting the tear liquid, it swells and is held in the lower conjunctival arch (cavities between the rear surface of the eyelids and the front surface of the eyeball). Immediately after laying the film, the eye should be kept in a fixed state for 30-60 seconds, while wetting the film and switch it to a soft (elastic) state.

Treatment must be carried out with regular control of intraocular pressure.

Side effect.Rarely - headache, with long-term use - follicular conjunctivitis (inflammation of the outer shell of the eye).

Contraindications.Irit (inflammation of the iris eye), iridocyclitis (combined inflammation of the cornea and iris eye), other eye diseases in which myiosis (narrowing of the pupil) is undesirable.

Release form.Powder; 1% and 2% solutions in bottles of 5 and 10 ml; 1% solution in dropper tubes; 1% solution with methylcellulose in bottles of 5 and 10 ml; 1% and 2% eye ointment; Films Eye in Penals or bottles of 30 pieces with a content in each film of 2.7 mg of Pilocarpine hydrochloride (films painted with diamond green in green).

Storage conditions.

Pilar

Combined preparation containing pylocarpine hydrochloride and adrenaline hydrothatrate.

pharmachologic effectpilaren is due to the properties of components included in it.

Indications for use.To reduce intraocular pressure.

Method of use and dose.The film is layered using an eye tweezers for the lower eyelid 1-2 times a day. Wetting the tear liquid, it swells and is held in the lower conjunctival arch (cavities between the rear surface of the eyelids and the front surface of the eyeball). Immediately after laying the film, the eye should be kept in a fixed state for 30-60 seconds, while wetting the film and switch it to a soft (elastic) state.

Side effect.The same as in Pilocarpine hydrochloride.

Contraindications.Clothing glaucoma.

Release form.Eye films containing 2.5 mg of pylocarpine and 1 mg of adrenaline hydrotatherapy.

Storage conditions.List of A. in light-protected place.

Anticholinesterase drugs

Amiridine(Amiridmum)

Pharmachologic effect. It is a reversible cholinesterase inhibitor (reversibly suppresses the activity of cholinesterase - enzyme that destroys acetylcholine) and the pharmacological effects peculiar to the preparations of this group. It differs from conventional cholinesterase inhibitors, however, in that simultaneously stimulates the excitation of the excitation in nerve fibers and synaptic transmission in the nervous endings, which is associated with the blockade of potassium channels of excitable membranes.

Amiridine enhances the effect on smooth muscles (muscles of vessels and internal organs) not only acetylcholine, but also other media substances: adrenaline, serotonin, histamine, oxytocin.

Indications for use.Neuritis (inflammation of the nerve), polyneurite (multiple inflammation of peripheral nerves), myasthenia and miasthenic syndromes (muscle weakness), as well as bulbarial paralysis, paresis (reduction of force and / or amplitude of movements) with organic lesions of the central nervous system, accompanied by motor disorders. It can also be used in atony (loss of tone) intestines and with weakness of generic activity.

It is also proposed to apply amyridine to reduce memory disorders in Alzheimer's disease (senile dementia). The mechanism of action is associated with the stimulation of central cholinergic processes.

Method of use and dose.Apply in adults inside and parenterally (bypassing the gastrointestinal tract). Inside are prescribed by 0.01-0.02 g (10-20 mg) 3 times a day. Under the skin and intramuscularly - from 5 to 15 mg (1 ml of 0.5% -1 ml of 1.5% solution) 1-2 times a day. Course of treatment 1-2 months.

To relieve (removal) miasthenic crises (muscular weakness), parenterally briefly briefly briefly in 1-2 ml of 1.5% solution (15-30 mg).

Inside with severe disorders of the nervous conductivity (with miastenical crises), 1-2 tablets can be prescribed (0.02-0.04 g) to 5-6 times a day.

To stimulate the generic activity, they are prescribed inside 1 tablet once, and with an insufficient effect of 1 tablet 2 times with an hour break.

the same as when using other anticholinesterase preparations (see Fizostigmin, prozerne, etc.). In terms of overdose and individual elevated sensitivity, atropine or metacin is used.

Release form.0.5% and 1.5% solutions in ampoules 1 ml (respectively, 5 and 15 mg in ampoule); Tablets at 0.02 g (20 mg) per pack of 50 pieces.

Storage conditions.

Army(Arminum)

Pharmachologic effect. Active anticholinesterase drug, an irreversible cholinesterase inhibitor. Acts significantly longer and stronger than reversible cholinesterase inhibitors

Indications for use.Miotic (narrowing pupil) and anti-rigging agent.

Method of use and dose.In the form of eye drops (0.01% solution) 1-2 drops 2-3 times a day.

Side effect and contraindicationsthe same as for prozero.

Release form.In bottles of 10 ml of 0.01% solution.

Storage conditions.List of A. in light-protected place.

Galanamine Hydrobromid(Galantamini Hydrobromidum)

Synonyms: Nivalin, Galanamin, Galanamine Bromotrobyol.

Hydrobromide alkaloid galantamine, highlighted from Snowdrop of Voronova (Galantus Woronowi A. Los.).

Pharmachologic effect. Active anticholinesterase agent, reversible cholinesterase inhibitor.

Indications for use. Miastic (muscular weakness), myopathy (mouse disease); sensitive and motor disorders caused by neurites (inflammation of the nerve); Residual phenomena after polio: psychogenic and spinal impotence; If necessary, as antidot (antidote) of mineslaxants (means, relaxing muscles) with anesthesia, etc.

Method of use and dose. Subcutaneously 0.251 ml of 1% solution 12 times a day; Children depending on age - 0.10.7 ml of 0.25% solution; How antidot is introduced into Vienna (152025 mg).

Side effect. With overdose of saliva, dizziness, bradycardia (rare pulse).

Contraindications. Epilepsy, hypercines (involuntary contractions of the muscles of limbs), angina, bradycardia (rare pulse), bronchial asthma.

Release form. Ampoules 1 ml of 0.25%; 0.5% and 1% solution in a package of 10 pieces.

Deoxipian hydrochloride

DESOXYPEGANINI HYDROCHLORIDUM)

Pharmachologic effect. Reversible cholinesterase inhibitor. It helps to restore the nervous conductivity disturbed by antidehaloorous muscle relaxants (means relaxing by muscles). Increases the tone of smooth muscles (mice of vessels and internal organs) and enhances the sowing (salivation).

Indications for use. The lesions of the peripheral nervous system caused by various reasons, diseases with the damage to the front horns of the spinal cord, the consequences of the brainwater disorders (hemiplegia, hemipreps / motion disorders of one half of the body /), myasthenia and myopath-like syndromes (muscle weakness) of various origins.

Method of use and dose. Inside 0.05-0.1 g 3 times a day (adults). 1% aqueous solution is introduced under the skin. One-time dose for adults - 0.01-0.02 g (1-2 ml of 1% solution). Daily dose - 0.05-0.1 g. The duration of the course is 4-6 weeks. Depending on the effect.

Side effect. Bradycardia (rare pulse), saliva, moderate pain in the limbs, in the first minutes of administration - the feeling of heat and dizziness.

Contraindications. Bronchial asthma, ulcerative illness of the stomach and duodenum, angina, epilepsy, hypercines (involuntary reductions of the muscles of the limbs), high blood pressure.

Release form. 1% solution in 2 ml ampoules per pack of 10 pieces.

Storage conditions. List A. in a cool place.

Kalimin (Kalymin)

Synonyms: pyridostigmine Bromide, Caliminfort, Maltinon, Prydostigmine.

Pharmachologic effect.Anticholinesterate action preparation, reversible cholinesterase inhibitor.

Indications for use.Miastic (muscle weakness), motor disorders after injury, paralysis, encephalitis, recovery period after polio.

Method of use and dose.Inside of 0.06 g 1-3 times a day, intramuscularly in -0.4-1 ml of 0.5% solution.

Side effect.Under the overdose of hypersiviation (abundant salivation), MIOS (narrowing of the pupil), dyspeptic phenomena (digestion disorders), stripped urination, twitching muscles, followed by weakness.

Contraindications.Epilepsy, hypercines (involuntary reductions of the muscles of the limbs), bronchial asthma, angina, pronounced cardiosclerosis (excessive development of connective tissue in the heart muscle).

Release form.Dragee 0.06 g per pack of 100 pieces; 0.5% solution in 1 ml ampoules per pack of 10 pieces.

Storage conditions.List A. in a dry, cool place.

Oxazil(Oxazylum)

Synonyms: Ambenonium chloride, ambestigmin chloride, Mizuran chloride, Mithlase chloride, etc.

Pharmachologic effect.Anticholinesterase agent, reversible cholinesterase inhibitor.

Indications for use.Miastations (muscle weakness), paresa (reduction of force and / or amplitude of movements) and paralysis after injuries, meningitis and encephalitis; Recovery period after polio, lateral amyotrophic sclerosis, peripheral paralysis facial nerve.

Method of use and dose.Inside 0.001-0.01 g after eating 2-4 times a day. The highest one-time dose - 0.025 g; Daily - 0.05 g

Side effect and contraindicationsthe same as for prozerne.

Release form.Tablets at 0.001; 0.005 and 0.01 g per pack 50 pieces.

Storage conditions.List of A. in light-protected place.

Prezero(Proserinum)

Synonyms: Neostigmin, Eustigmine, Neostigmine methyl sulfate, proggarthmin methyl sulfate, synthethygmin, vagostigmine, metastigmine, mineiness, muastigmine, neozerin, stigmosis, etc.

Pharmachologic effect.It has pronounced anticholinesterase activity, a reversible cholinesterase inhibitor.

Indications for use.Miastations (muscle weakness), paresa (reduction of force and / or amplitude of movements) and paralysis; Recovery period after meningitis; Atrophy of the optic nerve, neuritis (inflammation of the nerve); glaucoma (increased intraocular pressure); for the prevention and treatment of atony (tone loss) of the stomach, intestines, bladder, to stimulate childbirth; As antidote (antidote) of minelaxants (funds, relaxing muscles).

Method of use and dose.Inward 0.015 g 2-3 times a day; subcutaneously - 1 ml of 0.05% solution 1-2 times a day; In ophthalmology - 1-2 drops of 0.5% solution 1-4 times a day. The highest one-time dose is 0.015 g, daily - 0.05 g, under the skin is one-time - 0.002 g, daily - 0.006 g.

When applying prozero to relieve (removal), the actions of the muscle relaxants are introduced pre-atropine sulfate intravenously at a dose of 0.5-0.7 mg (0.5-0.7 ml of 0.1% solution), expecting pulse and after 1/2- 2 minutes are introduced intravenously 1.5 mg (3 ml of 0.05% solution) prozer. If the effect turned out to be insufficient, the administration of the same dose of prozerne is repeated (when the tears of bradycardia / regenerate pulse / make an additional injection of atropine). In total, it is possible to introduce 5-6 mg (10-12 ml of 0.05% solution) prozermina for 20-30 minutes.

Side effect.Hypercation (abundant salivation), abundant sweating, dyspeptic disorders (digestion disorders), frequent urination, violation, headache, dizziness, twitching muscles of the language and skeletal muscles, nausea, vomiting.

Contraindications.Epilepsy, bradycardia (rare pulse), hypercines (involuntary reductions of muscle limbs), bronchial asthma, angina, expressed atherosclerosis.

Release form.Powder; Tablets at 0.015 g per pack of 20 pieces; Ampoules 1 ml of 0.05% solution per pack of 10 pieces.

Storage conditions.List of A. in light-protected place.

Steflagabrina SulfatSTEPHAGLABRINI SULFAS)

Alkaloid highlighted from tubers with stefania roots smooth (Stephanie Glabra).

Pharmachologic effect. Possesses anticholinesterase activity; Inhibits (suppresses the activity of enzymes) True and false cholinesterase.

Indications for use. Diseases of the peripheral nervous system: myopathy (muscle disease) in adults, side amyotrophic sclerosis, fairy nerve paresis (reduction of force and / or amplitude of muscle movements innervated by face nerve), Sirinomyelia (nervous system disease with predominant spinal cord damage), etc.

Method of use and dose. Intramuscularly 12 ml of 0.25% solution 2 times a day. Course of treatment 2030 days.

Contraindications. Epilepsy, hypercines (involuntary reductions of muscle limbs), bronchial asthma, angina, bradycardia (rare pulse).

Release form. Ampoules 1 ml of 0.25% solution per pack of 10 pieces.

Storage conditions.

Fysostigminum (Physostigminum)

Synonyms: Ezerina Salicylate, Fisostigmine Salicylate, Fizostigmin Salicyloma).

Fisostigmine is the main alkaloid of the so-called Kalabar beans - the seeds of the West African Plant Physostigma Venenosum, this. Bean (Leguminosae).

Pharmachologic effect. Fisostigmine is one of the main representatives of the anticholinesterase substances of reversible action. In large doses, along with the influence on cholinesterase, it can (in the same way as other anticholinesterase drugs) direct action on cholinoreceptors.

Indications for use. Fisostigmine is used mainly in the eye practice for narrowing the pupil and lowering intraocular pressure during glaucoma (increased intraocular pressure).

Method of use and dose. Introduced into the conjunctival bag (the cavity between the rear surface of the eyelids and the front surface of the eyeball) of 1- 2 drops 0.25-1% solution 1-6 times a day. The narrowing of the pupil occurs usually in 5-15 minutes and keeps 2-3 hours or more. In keratitis (cornea inflammation), ointments with fizostigmine salicylate are used (0.2-0.25%).

With glaucoma, Fizostigmin causes a stronger decrease in intraocular pressure than pilocarpine, but it relatively often causes pain in the eye and the above-mentioned area due to a strong reduction in the iris. For this reason, the Fisostig mines are used in a sharp glaucoma and in the case when the pilocarpine is not effective enough. A good effect gives a combination of a physostigmine (0.25%) with a pilocarpine (1%) ..

Fisostigmine is sometimes used in the clinic of nerve diseases in nervous diseases, as well as in paresay (decrease in force and / or amplitude of movements) of the intestine (0.5-1 ml of 0.1% solution under the skin). Wider applications for these purposes have galantamine, oxazil, prozerne, and during the intestinal paresis and bladder - aceclidine.

Higher doses of fisostigmine for adults under the skin: one-time 0.0005 g, daily 0,001

Side effect.When using a physostigmine, as well as other anticholinesterase drugs, especially in high doses, there may be by-phenomena associated with hyperactivity of cholinergic processes: reinforcement of sowing (salivation), bronchospasm (narrowing of the lumen of bronchi), spasm of intestinal muscles and bladder, deceleration of heart Reduction and disorders of the rhythm of the heart, convulsive reactions.

Pharmacological antagonists (opposite effects) of the physostigmine are atropine, metacin and other cholinolitic drugs

Contraindications.Angina, organic heart disease, vessels, epilepsy, hypercines (involuntary reductions of the muscles of the limbs), bronchial asthma, mechanical blockage of the intestines and urinary tract, inflammatory processes in the abdominal cavity, late period of pregnancy.

Release form.0.25-1% solutions in orange glass flasks.

Storage conditions.List A. In well-baked orange glass banks, in a dark place protected from light.

Holinesterase reactivators

Alloxim.

Pharmachologic effect. It is a holinesterase reactivator.

Indications for use.It is used in acute poisoning with phosphorodic compounds (in combination with atropine and other cholinolitic preparations.

Method of application and dose. Enter intramuscularly once or re-depending on the severity of poisoning.

Before use, the contents of the ampoule (0.075 g of the drug) are dissolved in 1 ml of sterile water for injections.

With initial signs of poisoning (excitation, MIOS / narrowing of pupil /, sweating, salivation, initial phenomena of bronchio breeding / abundant selection of sputum mucosa /) are administered under the skin 2-3 ml of 0.1% solution of atropine sulfate and intramuscularly alloxyim in a dose of 0.075 g by 60 -70 kg body weight of the patient. If the symptoms of poisoning do not disappear, 2-3 hours are re-prepared in the same doses.

With more severe forms of poisoning, intravenously 3 ml of 0.1% solution of sulfate atropine, after 5-6 min, intravenous administration of atropine in the same dose repeated to the complete cessation of bronchospasm phenomena / narrowing of the bronchi lumen. At the same time, Alloxim is administered in a dose of 0.075 g intramuscularly with an interval between injections from 1 to 3 hours.

Indicators of treatment efficacy are distinct improvement in brain bioelectric activity.

(The emergence of a normal rhythm on the encephalogram), the cessation of myofibrillation (chaotic muscle twitching) and a persistent increase in the activity of blood cholinesterase.

Overland dose of Alloxima - 0.075 g, daily dose - 0.2-0.8 g. The total dose is 0.4-1.6 g.

Alloxy, in combination with atropine, is shown to use not only in the presence of symptoms of poisoning, but also in their absence, when it is known that the effect of poison on the body (prophylactic) has occurred.

Side effect and contraindicationsno detected.

Release form.Lyophilized porous weight or powder in ampoules of 0.075 g (75 mg) per pack of 10 ampoules fromappendix 1 ml of sterile water for injections).

Storage conditions.List B. in a light-protected place at a temperature not higher than +10 ° C.

Dipiroxim(Dipiroximum)

Synonyms: trimecedoxy bromide, trimecedoxy.

Pharmachologic effect.Holinesterase reactivator.

Indications for use.

Method of use and dose.Subcutaneously (if necessary intravenously) in a complex with cholinolithic agents (atropine sulphate, etc.), depending on the severity of the state once or several times 1-3 ml of a 15% solution, in particularly severe cases up to 7-10 ml.

Side effect and contraindicationsno detected.

Release form.Ampoules 1 ml of 15% solution per pack of 10 pieces.

Storage conditions.

Dietikism.

(Diaethyximum)

Pharmachologic effect. Reactivator of cholinesterase, the activity of which is suppressed by phosphorodorganic compounds (FOS). It is capable of penetrating through the hematorecephalic barrier (barrier between blood and brain fabric). Eliminates the block of nervous transmission, improves the bioelectric activity of the brain, reduces or completely eliminates the myofibrillation (chaotic twitching of the muscles), prevents bradycardia (pulse resistance), saliva, myiosis (narrowing of the pupil) and other symptoms of the excitation of M-cholinoreceptors.

Indications for use. Acute and chronic poisoning with phosphorodorganic pesticides (chlorophos, carbofos, metaphos, thiophos, dichlofos, etc.). Indications to the appointment are muscarinicinoscino-like symptoms of intoxication (poisoning) FOS: headache, dizziness, vomiting, nausea, difficulty breathing, abdominal pain, mios (narrowing of pupil), muscle twitching, sweating, savory (salivation), loss of consciousness, cramps, swelling Lungs, asthenic syndrome (weakness), psychomotor excitation, comatose (unconscious) state.

Method of use and dose. Intramuscularly as a 10% aqueous solution. Doses and inclusion frequency depend on the severity of the poisoning and activity of cholinesterase of blood. We are usually beginning with 3-5 ml. Dietikism is used in combination with atropine and other cholinolitic preparations, and also combined with vitamins (B1, B6, C), tranquilizers, sleeping equipment, glutamic acid and other drugs that normalize the state of the central and vegetative nervous system, as well as with drugs that improve functions. parenchymal organs (internal organs / liver, kidneys, spleen, etc. /).

Side effect and contraindicationsno detected.

Release form.In the form of a 10% aqueous solution in ampoules of 5 ml per pack of 10 pieces.

Storage conditions.List B. In the light-protected place at a temperature not higher than +8 "S.

Isonitrosis(Izonitrozinum)

Pharmachologic effect. It is a halinesterase reactivator, a specific antidote (antidote) in places of phosphorus compounds.

Indications for use.Poisoning with phosphorodorganic compounds.

Method of use and dose.Applied in combination with cholinolithic preparations (see Atropine). It is usually introduced intramuscularly in 3 ml of 40% solution. With severe poisoning, accompanied by a comatose (unconscious) state, intravenously (or intramuscularly) is administered to 3 ml of 40% solution, then repeated every 30-40 minutes before the cessation of muscle fibrillations (chaotic muscular twitching) and clarification of consciousness. Total dose of isonitrosine-up to 8-10 ml (3-4 g).

Side effect and contraindicationsno detected

Release form.40% solution in 3 ml ampoules per pack of 10 ampoules.

Storage conditions.List B. in the cool, protected from light place.

Cholinolytic (choline-blocking) drugs acting mainly in the field of peripheral M-cholinoreactive systems

See also Abaquel amizil, bellon, hyoscyamine, hyoscin, ipratropium bromide, dinesin, meklozin, norakin, oxytropy bromide, pyrenteypin, tropacin, cyclodol, epenal.

According to the modern classification, cholinolitic drugs are divided into alkaloids group Atropine(Atropine sulfate, whlen leaves, homatropine Hydrobromide, Durana Leaves, beauties Preparations, Skopolamine, Platifillan hydrotatch) and synthetic cholinolites(Aproofen, Arpenal, IPratropium Bromide, Metacin, Primility Bromide, Propantelin Bromide, Savazzzzolitin, Troverol).

Aproofen(Apropheniun)

Pharmachologic effect. It has a pronounced peripheral and central cholinolitic effect.

Indications for use.ENDARTERIT (inflammation of the inner shell of artery), angiosphazms (vessel spasms), weakness of generic activity, spastic dyskinesia (violation of mobility) of the gastrointestinal tract, ulcerative illness of the stomach and duodenum, spastic colitis (colon inflammation, characterized by sharp cuts), cholecystitis (inflammation of the gallbladder).

Method of use and dose.Inside after a meal of 0.025 g 2-4 times a day; Subcutaneously or intramuscularly - 0.5-1 ml of 1% solution. Higher doses for adults: ingestion - 0.03 g, daily - 0.1 g; under the skin and intramuscular: one-time - 0.02 g, daily - 0.06 g.

Side effect.Dry mouth, disorders of accommodation (violation of visual perception), dizziness, sense of intoxication, weakness, drowsiness.

Contraindications.

Release form.Tablets at 0.025 g in packing of 10 pieces; Ampoules 1 ml of 1% solution in a package of 10 pieces.

Storage conditions.List B. in light-protected place.

Arpelin(Arpenalum)

Pharmachologic effect. It has a blocking effect on N- and M-cholinoreactive structures.

Indications for use.Ulcery disease of the stomach and duodenal intestine, pylorospasm (spasm muscles of the gastrobus of the stomach), biliary disease, renal and hepatic colic, bronchial asthma, Parkinsonism, etc.

Method of use and dose.Inside 0.05-0.1 g 2-4 times a day. Course treatment - 3-4 weeks.

Side effect.Dizziness, headache, feeling of intoxication, dry mouth, violation of accommodation (violation of visual perception).

Contraindications.Glaucoma (increased intraocular pressure).

Release form.Tablets at 0.05 g per pack of 50 pieces.

Storage conditions.List B. in a dry, light-protected place.

Atropine Sulfat.(ATROPINI SULFAS)

Synonyms: Atropine sulk acid, Atomed.

Pharmachologic effect.The main pharmacological feature of atropine sulfate is its ability to block M-cholinoreceptors; It also acts (although significantly weaker) on n-cholinoreceptors. Thus, atropine sulfate refers to indiscriminate m-cholinoreceptor blockers.

The introduction of atropine into the body is accompanied by a decrease in the secretion of salivary, gastric, bronchial, sweat glands, pancreas, the increase in heart rate (due to the reduction of the braking action on the heart of the wandering nerve), a decrease in the tone of smooth muscle organs (bronchi, abdominal organs, etc.). The action of atropine is expressed stronger with an increased tone of a wandering nerve.

Under the influence of atropine, a strong expansion of pupils occurs. The mydriatic effect (expansion of pupils) depends on the relaxation of the fibers of the circular muscle of the iris, which is innervated by parasympathetic fibers. Simultaneously with the expansion of the pupil in connection with the violation of the outflow of fluid from the chambers, an increase in intraocular pressure is possible.

The relaxation of the cylinder eye ciliary muscle leads to the accommodation paralysis (violation of visual perception).

Indications for use.Atropine applies at ulcerative disease of the stomach and duodenum, pylorosphazma (spasme of the muscles of the gastric gatekeeper), bile sickness, in the intestinal spasms and urinary tract, bronchial asthma, to reduce the secretion of salivary, gastric and bronchial glands, in bradycardia (rare pulse) developed in As a result of increasing the tone of the wandering nerve.

With pains associated with smooth musculature spasms, atropine is often administered together with analgesic (analgesic) means (Analgine, Promedol, Morphine et al., 256, 255).

In the anesthetic practice, atropine is used to anesthesia and operation and during an operation to prevent bronchio and laryngospasz (sharp narrowing of the lumen of bronchi and larynx), restrictions on the secretion of salivary and bronchial glands and reducing other reflex reactions and side effects associated with the excitation of the vagus nerve.

Atropine is also used with a x-ray study of the gastrointestinal tract if necessary to reduce the tone and motor activity of the stomach and intestines.

Due to the ability to reduce the secretion of sweat glands, the atropine can sometimes use at elevated sweating.

Atropine is an effective antidote (antidote) in the poisoning of cholinomimetic and anticholinesterase substances, including FOS (phosphorus substances); It is used in sharp poisoning of FOS, as a rule, in combination with cholinesterase reactivators.

In the eye practice, atropine is used to expand the pupil with a diagnostic target (for the study of the eyeboard, the definition of true refraction, etc.), as well as for therapeutic purposes in acute diseases: with iris (inflammation of the iris), iridocyclite (combined inflammation of the cornea and iris The shells of the eye), Keratitis (cornea inflammation), etc., as well as injuries. An atropine relaxation of the eye muscles contributes to its functional peace and speeds up the elimination of the pathological process.

Method of use and dose.Apply atropine inside (before meals), parenterally (bye digestive tract) And locally (in the form of eye drops). Inside are prescribed by adults in powders, tablets and solutions (0.1%) of 0.00025 g (0.25 mg) -0.0005 g (0.5 mg) -0.001 g (1 mg) to receive 1-2 times in a day. Under the skin intramuscularly and intravenously injected at 0.00025-0.0005-0.001 g (0.25-0.5-1 ml of 0.1% solution).

Children are prescribed depending on the age of 0.00005 g (0.05 mg) -0.0005 g (0.5 mg) on \u200b\u200breception.

In the case of an atropine application for the treatment of peptic ulcer of the stomach and duodenum, the drug is prescribed inside, selecting the dose individually (usually before the appearance of light dryness in the mouth). Depending on the sensitivity to the atropine, the dose may correspond to 6-8-10-12-15 drops 0.1% solution for reception 2-3 times a day. Assign 30-40 minutes before meals or an hour after eating. In cases of exacerbation of the disease, atropine in the form of subcutaneous injections first is introduced.

In ophthalmologic practice, 0.5-0.1% solutions (eye drops) are used. With therapeutic goal prescribed 1-2 drops 2-6 times a day. In severe cases, they are laying 1% atropine ointment in the evening. Apply eye drops with atropine.

For therapeutic purposes, it is advisable to apply atropine as a long-term mymatic (expanding pupil); For the diagnostic purposes, less than a long-term policy maker is more appropriate. Atropine causes the maximum expansion of the pupil 30-40 minutes after installation (instillation); The effect is saved to 7-10 days. Accommodation paralysis (violation of visual perception) occurs after 1-3 hours and lasts up to 8-12 days. At the same time, the homatropine causes maximum mydriasis after 40-60 minutes; The mydriatic effect and accommodation paralysis persists 1-2 days. The mydriatic effect when applying platifillin is preserved 5-6 hours.

In case of poisoning with cholinomimetics and anticholinesterase substances, a 0.1% solution of atropine into vein is introduced, preferably together with cholinesterase reactivators.

In bronchospasms (a sharp narrowing of the lumen of the bronchi), atropine can be used in the form of a fine aerosol (0.25 ml of 0.1% solution inhaled for 2-3 minutes).

Side effect.Dry mouth, expansion of pupils, accommodation violation (violation of visual perception), atony (loss of tone) intestines, dizziness, tachycardia (palpitations), difficulty urination.

Contraindications.Glaucoma (increased intraocular pressure), pronounced urination disorders during adenoma (benign tumor) of the prostate gland.

Release form.Powder; ampoules 1 ml of 0.1% solution in a package of 10 pieces; 1% solution (eye drops) in 5 ml bottles; Eye-eye films 0.0016 g per pack of 30 pieces.

Storage conditions.List of A. in light-protected place.

Atropine sulfate is also part of drugs neoesphrodal, perfillon, solutan, sPRASMOVERALGIN, zFAH.

Belen Leaves (Folia Hyoscyami)

Burnt and stem leaves of wild and cultivated two-year-old grasslage plants black (Hyoscyamus Niger) secil. Parenic (Solanaeae). Contain at least 0.05% alkaloids of the atropine group (hyoscyamine, scopolamine, etc.).

Pharmachologic effect.Remote painkillers and antispasmodic (removable spasms) action.

Indications for use.As an anticbandsmatic and painful agent (instead of hand-making extract).

Method of use and dose.Have limited use in the form of extract. In powders, pills and mixes (0.02-0.05 g at the reception).

Higher doses for adults: one-time - 0.4 g, daily - 1.2 g

Release form.Powder.

Storage conditions.List B. in a dry place.

White oil(Oleum Hyoscyami)

Indications for use. With neuralgia (pain spreading in the course of the nerve), myosites (muscle inflammation), rheumatoid arthritis (infectious-allergic disease from a group of colugenosis, trusted chronic progressive inflammation of the joints).

Method of use and dose.Apply externally for rubbing.

Release form.In bottles of 25 g.

Storage conditions.List B. in a cool place.

White oil is also included in the preparations capsin, salima.

Humatropini Hydrobromidum)

Synonyms: homatropine bromide hydropower.

Pharmachologic effect.The atropine is similar, but it is less active and the action of it is less long.

Indications for use.In ophthalmology to expand the pupil and as a means of causing paralysis of accommodation (in the study of the eye dna).

Method of use and dose.0.25-1% aqueous solution (eye drops) are used. The expansion of the pupil comes quickly and passes after 10-20 hours.

Side effects and contraindications.The same as when using atropine sulfate.

Release form.Powder; 0.25% solution in bottles of 5 ml.

Storage conditions.List of A. in light-protected place.

Duranalistia(Folia Datura Stramonii)

The leaves of the grassy wild and cultivated annual robust plant (Datura Stramonium L), this. Parenic (Solanaceae), containing alkaloids of the group atropine.

Pharmachologic effect.The coincides mainly with the properties of Atropine.

Indications for use.Bronchial asthma.

Method of use and dose.Self used extremely rarely. Inhale smoke formed when burning 1/2 teaspoon powder or smoke a cigarette containing dope leaf powder. Higher doses for adults: one-time - 0, 2 g, daily - 0.6g.

Side effects and contraindications.See Atropine.

Release form.In the package for 100 g

Storage conditions.List V. in a dry place.

Durmane oil

(Oleum Stramonii)

Indications for use. With neuralgia (pain spreading in the course of the nerve), rheumatism.

Method of use and dose.It is used externally for rubbing.

Release form.In bottles of 25 ml.

Storage conditions.List B. in a cool place.

The oil is also part of liniment of turpentine complex.

Beauty drugs

Shooting - Perennial Cultivated Herbatous Plant (Belladonna)(ATROPA BELLADONNAE L.) Sem. Parenic (Solanaeae).

The plant contains alkaloids of the group of atropine (historical, scopolamine, apoatropine, etc.). The content of alkaloids in the leaves (when recalculating the historical) should be according to the requirements of the state pharmacopoeia at least 0.3%; When the content of alkaloids is more than 0.3% for cooking dosage forms Leaves are taken in respectively less quantity.

Pharmacological propertiesbeauty coincide mainly with the properties of atropine ..

On the basis of plant raw materials, a range of drugs is manufactured:

Dragee "Bel'id"(Belloid)

Indications for use. Taken with increased irritability, insomnia, vegetative dystonia, Meniere syndrome, neurogenic disorders associated with violation menstrual cycle, hypertirees (thyroid disease).

Method of use and dose.1-2 tablets (dragee) 3 times a day.

Side effect.In some cases, dry mouth, nausea, vomiting, diarrhea.

Contraindications.The same as for Tablets "Bellataminal".

Release form.Dragee in packing 50 pieces. The composition of one dragee: 0.3 mg of ergotoxin, 0.1 mg of the sum of the alkaloids of beautification (belladonna) and 0.03 g of butyl ethylbarbit acid acid.

Storage conditions.List B. in light-protected place.

Beauty Leaves (Folia Atropae Belladonnae)

Collected in the phase of the beginning of the start of the bootonization to mass fruiting leaves of a long-term cultivated herbaceous plant of beautician (belladonna) - Atropa Belladonna L., Sez. Polenic -Solanaceae.

Pharmachologic effect. The pharmacological properties of the beauties coincide mainly with the properties of atropine.

Indications for use. Craswing preparations (extracts, tincture) are used as antispasmodic (removable spasms) and painful agents for ulcerative diseases of the stomach, bile sickness and other diseases, accompanied by spasms of smooth muscles of the abdominal organs, in bradycardy (rare pulse) due to the overexecision of the wandering nerve.

Method of use and dose. Inside in the form of tincture 5-10 drops.

Side effect. Dry mouth, dizziness, accommodation violation (violation of visual perception), tachycardia (heart rate).

Contraindications. Contraindicated in glaucoma (increased intraocular pressure).

Release form. In boxes.

Storage conditions. List B. in a dry, light-protected place.

Tinctura Belladonnae)

Prepare from the leaf of beauties (1:10) by 40% alcohol; Contains 0.027-0.033% alkaloids.

Indications for use.It is used as antispasmodic (removable spasms) and a painful agent for ulcerative diseases of the stomach, gall-eyed disease and other diseases accompanied by spasms of smooth muscles of the abdominal organs, in bradycardy (rare pulse) due to the overexcixation of the vagus nerve.

Method of use and dose.Adults 5-10 drops on the reception; Children 1-5 drops on reception depending on age.

Higher doses for adults: one-time - 0.5 ml (23 drops), daily - 1.5 ml (70 drops).

Release form.In bottles of 10 ml.

Storage conditions.List B. at room temperature, in a dark place.

Tablets "Bellataminal"(TABULETTAE "Bellataminalum")

Pharmachologic effect. Combined drug whose action is due to the properties of components included in it. Reduces the excitability of central and peripheral adrenergic and cholinergic systems of the organism, has a soothing effect on the central nervous system.

Indications for use.Used with increased irritability, insomnia, climacteric neurosis, neurodermatitis (skin diseases caused by a violation of the function of the central nervous system), vegetative dystonia.

Method of use and dose.Assign 1 tablet 2-3 times a day (after meals).

Side effect.Dry mouth, dizziness.

Contraindications.Due to the content of ergotamine, which can cause a reduction in the uterus and blood vessels, pills are contraindicated during pregnancy and during childbirth, in spasms (sharp narrowing of the lumen) of the blood vessels and peripheral vessels, in far-closed stages of atherosclerosis. Also are contraindicated in glaucoma (increased intraocular pressure).

Release form.The tablets coated with the shell containing: the sums of alkaloids of handsaw -0.0001 g (0.1 mg), phenobarbital - 0.02 g (20 mg), ergotamine tartrate - 0.0003 g (0.3 mg).

Storage conditions.List B. in light-protected place.

The beautification is also included in the preparations antastman, bellurg, valerians, Poland, beautiful tincture, valerians, wormwoods, beauties and mint pepper beds, drops of Zelenina, collect anti-masted, candles "Anusol", candles "Bethiol", Solutan, Tablets "Bekarbon", tablets "Bellalgin", tablets "Baptasal", tablets "Besalol", gastric tablets with handsome extract, teofedrine, theofedrine N., handscape extract thick, handscape extract Sukhoi.

Metacin (Methacinuni)

Synonyms: Metacin iodide.

Pharmachologic effect.Active M-cholinolitic agent, selectively acting peripheral cholinolitic.

Indications for use.Diseases accompanied by smooth muscle spasms (ulcerative ulcer of the stomach and duodenal intestine, chronic gastritis, renal and liver colic, etc.), in anesthesiology to reduce the secretion of salivary and bronchial glands, etc.

Method of use and dose.Inside at 0.002-0.004 g 2-3 times a day, parenterally (bypassing the digestive tract) - 0.5-2 ml of 0.1% solution.

The highest one-time dose for adults when taking inside - 0.005 g, daily - 0.015 g, parenterally single - 0.002 g, daily - 0.006 g.

Side effect.When overdose, dry mouth, constipation, difficulty urination.

Contraindications.Glaucoma (increased intraocular pressure), hypertrophy (increasing volume) of the prostate gland.

Release form.Tablets of 0.002 g per pack of 10 pieces; Ampoules 1 ml of 0.1% solution per pack of 10 pieces.

Storage conditions.List of A. in light-protected place.

Platiminal hydrotatch(Platyphyllini HydrotartRas)

Winnocamean alkaloid salt contained in a SNECOPHYLLUS (Senecio Platyphylus).

Pharmachologic effect. It has a predominantly m-cholinolitic, as well as a vasodilator and soothing effect.

Indications for use. Spasms of smooth muscles of the abdominal organs, ulcerative ulcer of the stomach and duodenum, bronchial asthma, hypertensive disease (resistant blood pressure), colic (intestinal, renal, liver), etc.; In ophthalmology to expand the pupil.

Method of use and dose. Inside of 0.0025-0.005 g 2-3 times a day, subcutaneously - 1-2 ml of 0.2% solution. In the eye practice, 1% solution for diagnosis, 2% solution for therapeutic purposes is used.

Higher doses for adults inside and under the skin: one-time - 0.01 g, daily -0.03

Side effect. Dryness in the mouth, violation of accommodation (violation of visual perception), heartbeat, difficulty urination.

Contraindications. Glaucoma (increased intraocular pressure). Organic liver and kidney disease.

Release form. Powder; Tablets at 0.005 g per pack of 10 pieces; Ampoules 1 ml of 0.2% solution per pack of 10 pieces.

Storage conditions. List of A. in light-protected place.

Tablet "Palefin" (Tablettae "Palunnum")

Pharmachologic effect. Combined drug, - antispasmodic (removable spasms) and cholinolitic agent.

Indications for use. The same as for platifillin.

Side effects and contraindications are the same as for platifillin.

Release form. Tablets of the composition: hydrotathe platoofillin - 0.005 g, phenobarbital and papaverine hydrochloride - 0.12

- Tablets "Tepaphillin"

(Tablettae "ThePaphyuinum")

Pharmachologic effect. Combined drug - antispasmodic (removable spasms), cholinolitic, vasodilator.

Indications for use. The same as for platifillin.

Method of use and dose. Assign 1 tablet 2-3 times a day.

Side effects and contraindications are the same as for platifillin.

Release form. Tablets of the composition: hydrotathe platoofillin - 0.003 g, papaverine hydrochloride and phenobarbital - 0.03 g, Theobromin - 0.25

Storage conditions. List A. in a dry place.

PRIFINE Bromide (Prifulinium Bromide).

Synonyms: Riabal for children.

Pharmachologic effect.Anticholinergic agent, acting mainly on M-cholinoreceptors of the digestive tract. Reduces the secretion (selection) of hydrochloric acid and reduces peptic (secretory) activity gastric juice. Reduces the exemplary activity (separation of digestive juices) of the pancreas. Reduces the tone of the smooth muscles of the gastrointestinal tract, contributes to the emptying of the stomach, has a corrective effect with an increased motor (motor) activity of the digestive tract.

Indications for use.Vomiting: Normal for babies and children; with acute gastroenteritis (inflammation of the mucous membranes of the stomach and the small intestine); with feverish states (sharp increase in body temperature); with intracranial hypertension (elevated intracranial pressure); with radiation therapy; With intolerance of drugs. Abdominal pain syndrome (abdominal pain): Functional diseases of the colon, accompanied or not accompanied by disorders of the passability and bloating; Spasms smooth musculature of the gastrointestinal tract of psychogenic nature; As an addition to the etiological (affecting the direct cause of the disease) the treatment of diseases of the gastrointestinal tract.

Method of use and dose.The preparation solution is intended only for intake. The average daily dose is 1 mg / kg of the body weight of the child. When determining the daily dose, it should be borne in mind that in one pipette filled to a red feature, a dose of 2 mg (0.4 ml) is contained. The multiplicity of prescription drug is 3 times a day.

Side effect.Dry mouth, expansion of pupils, violation of accommodation (violation of visual perception), drowsiness

Contraindications.Increased intraocular pressure, urinary tract function disorder, manifested in urination delay.

Release form.A solution for intakes in 50 ml bottles with a pipette of 0.4 ml. (In 50 ml of solution contains 0.25 g of bromide bond; in the filled pipette -0.002 g).

Storage conditions.List B. in the cool, protected from light place.

Propantelinbromid(Propantheline Bromide)

Synonyms: pro-Bantin, Aklobrom, Bropantyl, Ketaman, Lengastril, Mefaitheln, Neo Gastrosedal, Panthenn, Logger, Propantel, Spazzhel, Supratteil, etc.

Pharmachologic effect.Peripheral cholinolitic and antispasmodic (removable spasms) has an action.

Indications for use.Applied with functional gastrointestinal disorders, ulcerative ulcer of the stomach and duodenum, spasms of the ureter and bladder, etc.

Method of use and dose.Prescribed inside 1-2 tablets (15-30 mg) 2-3 times a day.

Side effect and contraindicationsthe same as for metacine.

Release form.Tablets at 0.015 g (15 mg) in glass tubes for 20 pieces.

Storage conditions.List of A. in light-protected place.

SkopolamineScopolaminum

Synonyms: Skopolamine bromide hydrobromic, hyoscin hydrobromide.

Pharmachologic effect.Close to atropine on the effect on peripheral cholinoreactive systems. Like atropyan causes the expansion of pupils, accommodation paralysis (violation of visual perception), the increase in heart rate, relaxation of smooth muscles, reducing the secretion of digestive and swelling glands.

There is also a central cholinolytic effect. Usually causes a sedative (soothing) effect: reduces motor activity, a hypnotic action can have. The characteristic property of the scopolamine is amnesia caused to them (memory loss).

Indications for use.It is sometimes used in psychiatric practice as a soothing agent, in neurological - for the treatment of Parkinsonism, in surgical practice, together with the analgesics (morphine, Promedol, 256) -ond preparation for anesthesia, sometimes as a controversial and soothing agent - for sea and aerial disease, and Also, with iris (inflammation of the iris), iridocyclites (combined inflammation of the cornea and the iris, with a diagnostic purpose for expanding pupils instead of atropine.

Method of use and dose.Skptolamine is prescribed (usually in solutions) and under the skin in one-hour doses of 0.00025-0.0005 g (0.25-0.5 mg) or 0.5-1 ml of 0.05% solution. In the eye practice (to expand the pupil and paralysis of accommodation), 0.25% aqueous solution is used (1-2 drops in the eye 2 times a day) or 0.25% ointment.

Higher doses for adults inside and under the skin: one-time - 0.0005 g, daily -0.0015

In ophthalmological practice, along with a 0.25% aqueous solution, a prolonged (long-term action) is used - a solution of a zipolamine hydrobromide 0.25% with metchellulose.

Contraindications.Contraindications are the same as the appointment of atropine. It is necessary to take into account a very wide difference in individual sensitivity to scopolamine: relatively often conventional doses are not calmed, but excitement, hallucinations (nonsense, visions that acquire the nature of reality) and other side effects.

Release form.Powder; 0.05% solution in ampoules 1 ml; 0.25% solution with methylcellulose in bottles of 5 and 10 ml.

Storage conditions.List A. in a well-visited container and protected from light place.

Tablets "Aeron"

(Tablettae "Aeronum")

Pharmachologic effect. The combined drug, the action of which is associated with the peculiarities of the pharmacological properties of its components - scopolamine and hyosyiamine.

Indications for use.Tablets Aeron are used for the prevention and treatment of marine and airborne disease, as well as to prevent and relieve (removing attacks of the Meniere disease. Sometimes they are used to reduce mucus and salivation during plastic operations on the face and during operations on the upper respiratory tract.

Method of use and dose.With air and sea disease, the tablets are prescribed inside: preventive 30-60 minutes before departure take 1-2 tablets, and in the future, if necessary, after 6 hours, one tablet. If the aeon was prophylactically used, then at the first sensations of the disease (nausea, dizziness, headache) take 1-2 tablets, in the future they give one tablet 2 times a day.

Top doses for adults: one-time - 2 tablets, daily - 4 tablets.

In rare cases, with a stubborn vomit, instead of Aeron, candles containing so many sampling and horsesimamine can be assigned to the Aeron, how many of them are contained in the Aeron Tablet.

During the disease, Meniere is prescribed 1 tablet 2-3 times a day. In case of surgical interventions on the face of 20-30 minutes before the operation, 2 tablets are prescribed immediately and after the operation of 1 tablet 2 times a day in the first 2 days.

Side effect.When applying Aeron, thirst, dry mouth and throat are possible. To facilitate this state, drink and caffeine are prescribed.

Contraindications.It is impossible to prescribe pain in glaucoma (increased intraocular pressure).

Release form.Tablets at 0.0005 g per pack of 10 pieces. Ingredients: Skopolamine camphor - 0.0001 g and Hyoscyiamin camphor -0.0004

Storage conditions.List B. in light-protected place.

Spasmolitik (spasmolytinum)

Synonyms: Difazil, Adiphenin, Trazentin, Vagospazmil, Vegan.

Pharmachologic effect. Has peripheral M-cholinolitic activity; In addition, it has a blocking effect on n-cholinoreactive systems. It has spasmolytic activity: relaxes the smooth muscles of internal organs and blood vessels; It also causes local anesthesia (loss of sensitivity at the place of administration).

Indications for use. Used in pylorosphasis (muscle spasm of the gastric gatekeeper), spastic colic, gall-eyed disease, renal colic, ulcerative ulcer of the stomach and duodenal intestine, during angina, endarteritis (inflammation of the inner casing of arteries), as well as neuralgia (pain spreading along the nerve), Nearby (inflammation of the nerve), radiculitis. There are data on the effectiveness of the drug at italic dermatoses (skin diseases), as well as migraine.

Method of use and dose. Prescribed inside after a meal of 0.05-0.1 g 2-3-4 times a day. Course treatment - 3-4 weeks.

Side effect. When applying antispasmodics (like other cholinolithics), it is necessary to individually select a dose. In case of overdose, dizziness may appear, headache, a feeling of intoxication (due to the central action), dryness in the mouth (due to peripheral cholinolitic action), violation of accommodation (violation of visual perception).

Having an irritant effect on the gastric mucous membrane, the spasmolitic may cause dyspeptic phenomena (digestion disorders).

A sense of intoxication or dizziness can be prevented or weakened by the appointment of caffeine: 0.1-0.2 g of sodium cappinzoate inside or 1 ml of 20% solution under the skin.

Contraindications. Contraindicated in glaucoma (elevated intraocular pressure).

Antispasmodic and close to it preparations (arpenal, etc.) should not take before and during operation drivers of transport and other persons whose profession requires a quick mental and physical reaction.

Release form. Powder.

Storage conditions. List B. in a dry, light-protected place.

Trovlenol(Troventolum)

Synonyms: Drive.

Pharmachologic effect.It is an anticholinergic substance acting mainly on M-cholinoreceptors. Compared to atropine, the influence of the troventol on the cholinoreceptors of the muscles of the bronchi is stronger and long-term with a less pronounced effect on the cholinoreceptors of other organs (heart, intestines, salivary glands). The troventol does not penetrate the hematorecephalic barrier (barrier between blood and brain fabric). The selective effect of the Ttherol causes its advantages compared to atropine as an armored personnel and its best tolerability.

Indications for use.Trolnol as a very active bronchological (expanding bronchial lumen) The remedy is used in chronic obstructive bronchitis (inflammation of the bronchi, combined with a violation of air), bronchosphasis (sharp narrowing of bronchial lumen) in chronic pneumonia, with bronchospasm associated with colds (including number of elderly patients).

The troventol is most effective in bronchospasms caused by the hyperactivity of the cholinergic system, when adreminimetics (see Orciprenaline) and methylxantins (see theophylline) are not effective enough.

Method of use and dose.Tver in the form of inhalations from aerosol cylinders are used. Available cylinders S.two dosages: 12.5 and 25 mg in the cylinder. Each time you press the valve of a cylinder with 12.5 mg, a single dose of Ttherol 40 μg (0.04 mg) is distinguished, and when pressed to the cylinder valve with 25 mg - 80 μg (0.08 mg).

The preventive and therapeutic dose of the drug can fluctuate in different patients from 40 to 160 μg. The daily dose is 120 and 480 μg, respectively.

Start with the appointment of 40 μg, i.e. one breath when pressed on the cylinder valve with 12.5 mg. In case of insufficient effect, two inhales produce (two presss), i.e., increase the one-time dose to 80 μg. Depending on the clinical effect and tolerance of the drug, increase the one-time dose to 80-160 μg, while for convenience they use a cylinder with 25 mg of troventol (1-2 pressing). With a sufficient effect from a single dose of 40 μg, it continues to use a cylinder with 12.5 mg of troventol.

Inhalations are repeated every 4-6 hours.

Side effect.Inhalation of Ttherol is usually well tolerated, however, in connection with the cholinolitical action, dry mouth is possible, the sore throat, light disorders of the accommodation (violation of visual perception). If necessary, in these cases, the dose is reduced or the gaps between inhalations increase, and with highly pronounced side effects, inhalation is temporarily stopped.

Contraindications.Glaucoma (increased intraocular pressure); pregnancy.

Release form.Aerosol aluminum cylinders with a capacity of 21 g containing 12.5 or 25 mg troventol.

Storage conditions.List A. In protected from thermal influences and direct sunlight place at a temperature not higher than +30 ° C.

Tropicamide (Tropicamide)

Synonyms: Midrum.

Pharmachologic effect.Refers to mydritic (expanding pupil) tools. Blocks m-cholinoreceptors of the sphincter of the iris and the Rollarian muscle (structural formations of the eye), causing mydriasis (expansion of the pupil) and accommodation paralysis (disorder of the motor function of the eye muscle, accompanied by violation of visual perception). The effect of the drug occurs quickly, is relatively short. The trend towards an increase in intraocular pressure is less pronounced than when applying atropine. The expansion of pupils is observed in 5-10 minutes after the use of the drug; Maximum Midship and Cycliploplegia (accommodation paralysis) are marked after 20-45 minutes and are stored for 1-2 hours. The initial width of pupils is restored after 6 hours. The level of absorption (absorption) of the active substance coming through teat Channels The nose is relatively high, side effects caused by the systemic effect of the drug are possible.

Indications for use.For diagnostic purposes, if necessary, Midriasis and Cycliplegia, including when studying the Eye DNA and determining the refraction (refracting eye force). With increased sensitivity to other preparations, expanding the pupil (atropine, scopolamine, 95). As part of comprehensive therapy of inflammatory processes and sacking of adhesions - splicing of fabrics of the eye with his fabrics surrounding it).

Method of use and dose.0.5% or 1 is used for diagnostic purposes. % solutions in a single dose of 1 -2 drops according to the scheme depending on the type of research. When using a 0.5% solution of the drug, the optimal time for the study of the refraction of the eye is 25-40 minutes, 1% solution - 25-50 minutes. For treatment, 0.5% solution is used to 6 times a day.

Eye drops are buried into the lower conjunctival bag (the cavity between the rear surface of the lower eyelid and the front surface of the eyeball). To reduce the resorbative effect of the drug (the action of the drug, manifested after suction in its blood), it is recommended to be easily pressed into the area of \u200b\u200bthe tear bags for 2-3 minutes after the instillation. During the treatment period, you can not wear soft contact lenses. Cold compresses are recommended for eliminating hyperthermia (increasing temperature).

Side effect.With the use of high doses of the drug, an increase in intraocular pressure (glaucoma attack) is possible, disorders of accommodation (violation of visual perception), photophobia (light-free). Possible systemic effects (more often in children): Headache, psychopathic reactions, tachycardia (rapid palpitations), lowering blood pressure, collapse (sharp drop in blood pressure), hyperthermia (body temperature increase), transient sensation of burning, dry mouth, allergic reactions .

Contraindications.Glaucoma, especially a closed breeding form. Increased sensitivity to the components of the drug.

Release form.Eye drops (0.5%) in 10 ml bottle-dropper; Eye drops (0.5% and 1%) in 10 ml bottles.

Storage conditions.In a cool place.

Gangli-blocking drugs.

Arfonad(Arfonad)

Synonyms: Trimetafan Camsila.

Pharmachologic effect.The arponade reduces blood pressure by means of a ganglionic blockade with peripheral vasodilation (expanding the lumen of the vessels). It has a rapid, pronounced, but very short-term action.

Indications for use.Artificial hypotension (artificially adjustable decrease in blood pressure) in surgery, acute pulmonary edema in hypertensive patients with left-deuded deficiency, hypertensive crises (fast and sharp blood pressure).

Method of use and dose.Surgical interventions in a state of hypotension (on the background of reduced blood pressure): the arfonad is introduced by intravenous drip infusion. The infusion of the drug begins with 60 drops of 1% solution (approximately 3 mg) per minute after the introductory anesthesia and fixing the patient in the position required for operation (operating field at the top), 10 minutes before obtaining the desired pressure reduction. The infusion rate must be monitored to maintain a hypotension at the required level.

It usually happens 10-30 drops (0.5-1.5 mg) per minute. Arterial pressure should be monitored every 3-5 minutes. The young and strong patients require elevated doses, while the elderly and low arterial pressure - reduced.

In order to achieve a shorter action of the drug or improved control, you can use 0.5% or 2.5% of infusion solutions with an appropriate adjustment of the infusion rate.

Non-surgical indications (acute pulmonary edema or hypertensive crises): disposable intravenous doses of 0.1-0.2 mg / kg body weight.

Side effect.With strict compliance with the instructions for the use of the drug (careful blood pressure control and slow infusion), side effects are relatively rare and are mainly caused by an excessive pressure drop.

Sometimes nausea, vomiting and feeling of warmth occur. Tachycardia (palpitations), paralytic intestinal obstruction or atony (loss of tone) of the bladder is extremely rare and are a consequence of a parasympathetic blockade.

Contraindications.Anemia (reduction of blood hemoglobin), olighemia (decrease in total blood), shock, asphyxia (respiratory impairment / stroke /), pulmonary failure, progressive atherosclerosis, ischemic heart disease, and also acute diseases kidneys and liver. The impossibility of reimbursement of blood loss. Pregnancy (danger to the fetus) and childbirth.

Release form.Ampoules: 250 mg of dry matter and ampoules with solvent (5 ml of water for injection).

Storage conditions.List B. in a cool place. You can not freeze.

Benzohexonium(Benzohexonium)

Synonyms: hexenius b, hexametononia benzosulfonate.

Pharmachologic effect.Gangli-blocking agent.

Indications for use.Spasm (sharp narrowing of the lumen) peripheral vessels, hypertensive disease (resistant blood pressure), hypertonic crises (fast and sharp rise in blood pressure), bronchial asthma, ulcerative ulcer of the stomach and duodenum.

Method of use and dose.Inside 0.1-0.2 g 2-3 times a day; Subcutaneously and intramuscularly - 1-1.5 ml of 2.5% solution. The highest one-time dose is 0.3 g, daily - 0.9 g; subcutaneously one-time - 0.075 g, daily - 0.3 g.

Side effect.Total weakness, dizziness, heartbeat. Large doses can cause an orthostatic collapse (a sharp drop in blood pressure during the transition from horizontal to the vertical position), a pronounced MIDRIAZ (expansion of the pupil), dryness in the mouth, an atony (loss of tone) of the bladder.

Contraindications.Hypotension (reduced blood pressure), heavy parenchymal lesions of kidneys, liver, central nervous system, thrombophlebitis (inflammation of veins with its blockage).

Release form.Tablets at 0.1 g and 0.25 g per pack of 20 pieces; Ampoules 1 ml of 2.5% solution in a package of 6 pieces.

Storage conditions.List B. in a dry place.

Gigronium(Hygronium)

Synonyms: Triegery iodide,

Pharmachologic effect.Gangli-blocking short action.

Indications for use.In anesthesiology for controlled hypotension (artificially adjustable decrease in blood pressure).

Method of use and dose.Intravenously (drip) 0.1% solution in isotonic sodium chloride solution. Start from 70-100 drops per minute. Supporting dose 30-40 drops per minute.

Side effect.Sharp hypotension (reduction of blood pressure).

Contraindications.The same as for the Arfonada.

Release form.Powder 0.1 g in ampoules with a capacity of 10 ml per pack of 10 pieces.

Storage conditions.List B. in light-protected place.

DimeColinum

Synonyms: Domekolina iodide.

Pharmachologic effect.Gangliplocator. Besides in action to benzohexonia, but more active.

Indications for use.It is used for ulcerative diseases of the stomach and duodenum, spastic colitis, cholecystitis (gallbladder inflammation) and other diseases accompanied by spasms of smooth muscles, as well as in spasms of peripheral vessels and only sometimes with hypertension (resistant lifting of blood pressure).

Method of use and dose.For peptic ulcer of the stomach and duodenal and duodenal and spasms of peripheral vessels are prescribed inside (in the form of tablets) of 0.025-0.05 g 2-3 times a day (before meals). Course of treatment 3-4 weeks

With hypertensive disease (II-III stage), prescribed inside, starting from 0.025 g for reception 1-2 times a day, then increase the dose to 0.05 g 2 times a day. The course of treatment is 3-5 weeks.

Side effect and contraindications

Release form.Tablets of 0.025 g and 0.05 g (25 and 50 mg) covered with a shell.

Storage conditions.List B. in light-protected place.

Hashene(IMECHINUM)

Pharmachologic effect. It has a blocking effect on n-cholinoreactive systems and gives a pronounced, but short-term hypotensive (reduced blood pressure) effect.

Indications for use.To obtain controlled arterial hypotension (artificially adjustable decrease in blood pressure) in surgical interventions, for preventing and relieving (removing) hypertensive crises (rapid and sharp lifting of blood pressure), treatment of pulmonary edema and brain swelling, with hypertension (armful pressure rack) on Soil of acute renal failure.

Method of use and dose.Intravenously. Drip at a speed of 90-120 drops per minute in dilution 1: 10 000 (1 ml of 1% solution is bred in 100 ml of isotonic sodium sodium solution or 5% glucose solution). After some time, the rate of introduction of the solution is recommended to reduce up to 30-50 drops per minute. With an insufficient hypotensive effect, the concentration of the solution is raised to 1: 5,000. Soon or fractionally at a dose of 5-7-10 mg (0.5-0.7-1 ml of 1% solution) are introduced slowly (2-3 mg with 3- 4-minute intervals). Combined: Initially, 5-10 mg is administered in the form of a solution of 1: 10,000 or 1: 5,000 at a speed of 30-50 drops per minute.

Side effect.Ortostatic collapse (sharp drop in blood pressure when moving from horizontal to vertical position), general weakness, dizziness, violation of accommodation (violation of visual perception), dry mouth.

Contraindications.Heavy heart disease, liver, thrombosis (vessel violation of the vessel), diseases of coronary (cardiac) vessels, closed-coronal glaucoma (increased intraocular pressure). It is not recommended to use the drug to obtain controlled hypotension in elderly people, as well as during the defeat of the kidneys with a violation of the function.

Release form.Ampoules 1 and 2 ml of 1% solution in a package of 10 pieces.

Storage conditions.List B. in light-protected place.

Camphonium(Camphonium)

Pharmachologic effect. Gangliplocator. Reduces arterial pressure, expanding peripheral blood vessels.

Indications for use.Obtained endarterite (inflammation of the inner shell of the arteries of limbs with a decrease in their lumen), the hypertensive disease of the I-II stage (resistant blood pressure), ulcerative illness of the stomach.

Method of use and dose.Take inside regardless of meals. Doses of the drug must be strictly individual, are mounted depending on the nature of the disease and are 0.01-0.1 g 1-2 times a day. Parenterally (bypassing the digestive tract) is administered, starting with 0.5-1 ml of 1% solution, with good tolerance, a one-time dose can be increased to 5 ml; Injections produce 1-3 times a day.

For a controlled hypotension (artificially adjustable decrease in blood pressure), a Vienna of 0.25-0.5-1 ml of 1% solution for 1-11 / 2 min is introduced into vein. With long operations, you can repeat the injection after 1-11 / 2 hours.

Side effect.Overall weakness is possible, the increase in the pulse, dry mouth, the expansion of pupils, constipation. In these cases, the drug should be discontinued and consult a doctor.

Contraindications.Hypotension (reduced blood pressure), pronounced atherosclerosis, organic myocardial lesions (heart muscle), thrombosis (vessel traffic violation), chronic coronary la refreshness (inconsistency of oxygen delivery with blood oxygen need), glaucoma (increased intraocular pressure), myocardial infarction , Hemorrhage in the brain.

Release form.Tablets of 0.01 g and 0.05 g per pack 50 pieces, 1% solution in 1 ml ampoules per pack of 10 pieces.

Storage conditions.List B. in light-protected place.

Quantheron(Quateronum)

Pharmachologic effect. The drug blocks the excitation in parasympathetic and to a lesser extent in the sympathetic ganglia. There is also some coronary-witting (expanding heart vessels) action.

Indications for use.It is used primarily at the ulcer of the stomach and duodenum, sometimes angina, and with hypertension (resistant increase in blood pressure).

Method of use and dose.Prescribed inside in the form of tablets or aqueous 0.6% solution.

For ulcerative stomach disease, 0.02-0.03 g (1-11 / 2 tablets or 5 ml of 0.6% solution) is taken 3-4 times a day. Course treatment - 3-4 weeks. and more.

When angina for the prevention of seizures are prescribed, starting with 0.01 g (10 mg) to receive, after 2-3 days, a one-time dose increases to 0.02 g. Take 3 times, and with frequent attacks 4 times a day. Course of treatment 3-4 weeks Treatment can be repeated after a 10-12-day break.

In hypertension, 0.02-0.03 g 3-5 times a day are prescribed; Course of treatment on average 3 weeks.

Higher doses for adults inside: one-time - 0.05 g, daily - 0.2 g.

Side effect.Dizziness, inclination to constipation, moderate tachycardia (palpitations). In patients with ulcerative stomach disease, sometimes in the first days there is an amplification of pain in the opposite region and dyspeptic phenomena (digestive disorders). In patients with angina, there are sometimes unpleasant sensations in the heart region, attacks are rapidly; In these cases, the drug is canceled for 2-6 days, then prescribed it in smaller doses; If the side effects do not stop, the drug is canceled. Caution should be observed when appointing quattern patients with arterial hypotension (reduced arterial pressure).

Contraindications.The same as for benzohexonium.

Release form.Powder and tablets of 0.02 g.

Storage conditions.List B. in a well-appointed container protecting from light.

Pahikardina Hydrorydid(Pachycarpini Hydroiodidum)

Singleine synonyms Hydrorydid, patchycrapine iodistogeneous.

Pharmachologic effect.Gangliplocator; Enhances the tone and enhances the reduction of the muscles of the uterus. One of the important features of Pahcicpine is its ability to increase the tone and strengthen the contraction of the muscles of the uterus. In this regard, Pakhicopine was relatively widely used to strengthen generic activities in the weakness of generic battles and with early existence of water, as well as with weakness. The drug, in contrast to pituitrine, does not cause an increase in blood pressure and can be appointed by feminine suffering from hypertension (resistant lifting of arterial pressure).

Indications for use.Spasms (sharp narrowing of the lumen) peripheral vessels, ganglyolites (inflammation of nerve knots), myopathy (muscle disease), to stimulate childbirth and in the postpartum period to reduce bleeding. Recently, rarely applied to stimulate childbirth.

Method of use and dose.Prescribed inside (before meals), subcutaneously and intramuscularly. With the endartheritis obliterathy (inflammation of the inner shell of the arteries of the limbs with a decrease in their lumen), they are given inward 0.05-0.1 g 2-3 times a day. Treatment is carried out within 3-6 weeks. After 2-3 months. The course of treatment with the exacerbation of the process can be repeated. When ganglyolites are prescribed inside at 0.05-0.1 g 2 times a day for 10-15 days. At myopathy, prescribed inside 0.1 g 2 times a day for 40-50 days. The course of treatment is repeated 2-3 times after 1-2-3 months.

To stimulate the generic activity subcutaneously or intramuscularly 2-4 ml of 3% solution.

Higher doses for adults: inside one-time - 0.2 g, daily - 0.6 g; under the skin is one-time - 0.15 g, daily - 0.45 g.

Side effect.The same as when using benzohexium. In case of overdose, it can cause toxic phenomena up to severe poisoning.

Contraindications.Hypotension (reduced blood pressure), pronounced atherosclerosis, angina, liver and kidney disease, pregnancy.

Release form.Tablets of 0.1 g per pack of 10 pieces; 3% solution in 2 ml ampoules.

Storage conditions.List B. in a dry, light-protected place.

Pentamine(Pentaminum)

Synonyms: Azametonium Bromide, Pendimid, Pentamethasen, etc.

Pharmachologic effect.Gangli-blocking agent. Removes spasm of vessels and smooth muscles.

Indications for use.Hypertensive disease I-II stage (resistant blood pressure) and hypertensive crises (fast and sharp blood pressure), spasms (sharp narrowing of the lumen) peripheral vessels, intestines and biliary tract, renal colic, attacks of bronchial asthma.

Method of use and dose.In spasms of vessels, intramuscularly 0.5-2 ml of a 5% solution is 2-3 times a day.

In hypertensive crises, the edema of the lungs, the edema of the brain is introduced into Vienna 0.2-0.5 ml or more than 5% of the solution divorced in 20 ml of isotonic sodium solution of chloride or 5% glucose solution. Enter slowly, under the control of blood pressure and general condition. You can enter intramuscularly 0.5-2 ml of 5% solution.

For a controlled hypotension (artificially adjustable decrease in blood pressure) inserted into vein before operation 0.8-1.2 ml of 5% solution (40-60 mg), if necessary, introduced additionally to a total dose of 120-180 mg (2.4-3 , 6 ml of 5% solution).

The highest one-time dose is 3 ml of 5% solution, daily - 9 ml of 5% solution.

Side effect and contraindicationsthe same as when using benzenexium.

Release form.5% solution in ampoules 1 and 2 ml per pack of 6 and 10 pieces.

Storage conditions.List B. in light-protected place.

Pyrine(Pirilenum)

Synonyms: pepidine Tosylate, Pampidin, Phelezen, Tonormal.

Pharmachologic effect.Gangliplocator.

Indications for use.Hypertensive disease (resistant blood pressure), hypertensive encephalopathy (pulsating pain in the head), spasms (sharp narrowing of the lumen) of peripheral vessels, ulcerative illness of the stomach and duodenum, toxicosis of pregnant women.

Method of use and dose.Inside 0.0025-0.005 g 3-4 times a day.

The highest one-time dose - 0.01 g, daily - 0.03 g.

Side effect.Constipation, blown of the intestine, etc.

Contraindications.Glaucoma (increased intraocular pressure), violation of the function of the liver and kidney, pronounced atherosclerosis, atony (loss of tone) of the stomach and intestines.

Release form.Tablets of 0.005 g per pack of 20 pieces.

Storage conditions.List B. in a dry place.

Tehechin(Temechinum)

Pharmachologic effect. Gangliplocator. By gangli-blocking properties are close to pyrinene, but more active.

Indications for usethe same as for pyrital, however, in some cases, techin is better transferred than pyrical, and gives a more pronounced therapeutic effect. In the treatment of patients with ulcerative disease, an analgesic (anesthetic) effect has an analgesic (anesthetic) effect, reduces the secretion and motor activity of the stomach.

Method of use and dose.Prescribed inside (in tablets, after meals).

For ulcerative ulcer of the stomach and duodenal and hypertensive disease (a permanent increase in blood pressure) is prescribed inside at 0.001-0.002 g 2-3-4 times a day. Course treatment -3-4-6 weeks. In hypertension, the Tehhener can be used in combination with reserparies and other hypotensive (blood pressure reduction) drugs.

In spasms (sharp narrowing of the lumen) of peripheral vessels, 0.001 g (1 mg) is prescribed 2-3-4 times a day for 3-4 weeks.

Side effect and contraindicationsthe same as when using benzenexium.

Release form.Tablets at 0.001 g (1 mg).

Storage conditions.List B. in light-protected place.

Drugs acting mainly in the field of endowment of motor nerves

Antide-polarizing (non-polarizing) muscle relaxants

Synonyms: Bromide, Pipecuroni Bromide.

Pharmachologic effect.Invalid Miorosant (means, relaxing muscles) average duration of action.

Indications for use.All sorts of general mercy, cardiac surgery, traumatological and others surgical interventionsin which it is necessary to achieve complete relaxation of muscles.

Method of use and dose.Arduan is introduced intravenously. The dose for intubation (introduction into the trachea tube for artificial respiration) is 0.04-0.08 mg / kg. At a dose of 0.08 mg / kg, the optimal conditions for intubation occur after 2-3 minutes. For muscle relaxation, drugose drugs are used in doses of 0.02 to 0.08 mg / kg (more often than 0.04-0.05 mg / kg). With these doses, complete relaxation occurs with a duration of about 50 minutes. If it is necessary to lengthen the effect, 1/4 part of the initial dose is used. With insufficient kidney function, more than 0.04 mg / kg should not be introduced. If necessary, to stop the action of Arduca introduces 1-3 mg of prozerne after the preliminary intravenous administration of 0.25-0.5 mg atropine.

Side effect.Moderate transit bradycardia (rare pulse).

Contraindications.Heavy miastic (muscular weakness), pregnancy.

Release form.Lyophilized (dried by freezing in vacuo) powder in ampoules of 0.004 g in a set with solvent (4 ml in ampoule).

Storage conditions.{!LANG-f20a7237911c570c41768aa5052106ef!}

{!LANG-2fff92f1afc83ae0ceeb5e0617b023de!}

Pharmachologic effect.{!LANG-7048e9993bdc06f0cf8e1ce628c0fffc!}

Indications for use.{!LANG-976f1007d9555485ecd3ea8d1303d779!}

Method of use and dose.{!LANG-21838d9767fc819885ed961b39e7ed7f!}

{!LANG-3ce515366fda2af5ada8768de5d36512!}

{!LANG-93c05afe60fbecaf9615cadcf1fa6397!}

Side effect.{!LANG-02247de851b472755c56d64dd8ab253f!}

Contraindications.

Release form.{!LANG-3f7342da42c0bc3228ca9a20252c1ced!}

Storage conditions.List of A. in light-protected place.

{!LANG-6045ec99540bec445b5f5e175808cc8e!}{!LANG-400e169d8725cd483acdff2a24f2ff67!}

{!LANG-6291cf35b423a03979cda92b30baa2fc!}

Pharmachologic effect.{!LANG-4c82f70fd5d31ed15e4d0f54e5240d39!}

Indications for use.{!LANG-d6d23ea7203c88ec0d719b26d62e27c8!}

Method of use and dose.{!LANG-5515c9a1454cd22934777641f28382b3!}

Side effect.{!LANG-f8da0a0623c12268ac48a06974ba649f!}

Contraindications.{!LANG-366c9021af56c6530cd87b730195c8d1!}

Release form.{!LANG-2f0c426f50af9f613ff821b0ccbe84a3!} 1% {!LANG-ec81a5918577294dab0729e434347587!}

Storage conditions.List of A. in light-protected place.

{!LANG-31619464ae7b6b43f116da12fc747078!}{!LANG-f7f2a277b0ed5f9b467d10fbd105e07e!}

{!LANG-24dba93c480ae2c5760f6a066b53201e!}

Indications for use.{!LANG-666c255dd02aedcc638f84be24ef9de5!}

Method of use and dose.{!LANG-e52e92cc7cf34ac12796dded8be6360a!}

{!LANG-b733688159cabce5f6b34ea181ba5085!}

Side effect.{!LANG-bc1d4ed187c4bd4eefee368a920a7d8d!}

Contraindications.{!LANG-3a97eeb45843d23313fc269e2e5bfa1a!}

Release form.{!LANG-ae9a2edb8b741a48f608929ba61f856e!}

Storage conditions.{!LANG-65f10ccb9a82994f9d31aabbe5c3a234!}

{!LANG-b58e642c0359dcf9f00f39204b57548c!}{!LANG-861a6fc9756ae329d42db33ee1cd7c48!}

{!LANG-547ed36c7af0dd763591fef4f209524d!}

Indications for use.{!LANG-3a52e19df9b4561d5029e1e06522ef1f!}

Method of use and dose.{!LANG-836e8abad35fa800e3730fc7dcb390db!}

{!LANG-05e65c342e11906de5bd44efc40c834b!}

Side effect.{!LANG-89a79b6bc733bc30b3e8fa694911de60!}

Contraindications.{!LANG-3bef92ff74d89bc7ed7f0a467438ebc3!}

Release form.{!LANG-3e13a409b928da7afa42977941c776e5!}

Storage conditions.List of A. in light-protected place.

{!LANG-84a8dead9a7023fc1049f717565ca4e4!}{!LANG-069fa8d6595d0619d41dbee8e37167a5!}

{!LANG-ef21c3be91a4cd4fe6d1b1befcf6736e!}

Pharmachologic effect.{!LANG-86d4377afc2f82818f9581c3b2552bc5!}

Indications for use.{!LANG-4732f7211960084b75ee2428b1f90bee!}

Method of use and dose.{!LANG-c5da7592f005b0dad88fc38931339511!}

{!LANG-05df5e1b495b3c2d0ba3148ca7b14560!}

Side effect.{!LANG-893403928236d0cebeed1417271bcff0!}

Contraindications.{!LANG-1135bc4f9bb3164e34f19a26f978a5e3!}

Release form.{!LANG-c649b6f4f38f133e9ef67dd6bc0838d1!}

Storage conditions.List of A. in light-protected place.

{!LANG-5f5b23de64f99802c0bde6ee2b2058af!}{!LANG-0ebe289b305f551d335030383a50f920!}

{!LANG-f90f1ca3f6d929ffb13274ebcf97a326!}

{!LANG-430ae3f4b7ab7b3fb880d81492431338!}

Pharmachologic effect.{!LANG-0caff5a05f5e76ac594cdbd1eb8dd56d!}

Indications for use.{!LANG-d100df998bde7f1511b37199152deda7!}

Method of use and dose.{!LANG-bb5c95dd149f7d488e1b28ac0a4a77b2!}

{!LANG-bb96a02b30f40c4d6bb531204645edd5!}

{!LANG-c12e6c7ebd83338732dddb26c92f1794!} {!LANG-8bc5061b85dce739a933eaaecfb8ba0b!}{!LANG-910fd1edf81e56cc3c0b636367478924!}

{!LANG-0e64c95736c3eb9c02f921b724e19bf5!}

Side effect.{!LANG-24661a86dec4520d29dde25fc608bf8c!}

Contraindications.{!LANG-a6e572516eab39c80853029753ea64bb!}

Release form.{!LANG-39fa3e3c88f62b1ad2d2010c588a94e3!}

Storage conditions.{!LANG-81a7a0bf00a3163feced5f4db6a41562!}

{!LANG-c7fdefff2b4f1f19b01d645d717af187!}

{!LANG-eab4bfd3b3a4ada9429691b960da6cc3!}

{!LANG-5543697a9ec03cdd4e393a33a2cdcef6!}{!LANG-270de68d4d1e0159e814a74fce40d108!}

{!LANG-7f41f7690748fa31358e74599c6ee3ec!}

{!LANG-baa9685e210c724e2e28a6c16ad73ca8!}

Pharmachologic effect.{!LANG-0116b53b4a4baa5d22e36a6bf41e6f8f!}

Indications for use.{!LANG-6e04e91d62199fcb59ec51e201ef8f9a!}

{!LANG-acc526c577c165854fd5786fa6ed6808!}

Method of use and dose.{!LANG-f0a34f2db5fb89e1c8cc618a12ec599a!}

{!LANG-9932fa1953d456238de0fb99a90e1e93!}

Side effect.{!LANG-9daa72fb16298e8a3702a3e4c4445e97!}

Contraindications.{!LANG-fb542b8aaddccc91429d29d786ccb26b!}

Release form.{!LANG-4a575e56e763e51b4204c589744e4f41!}

Storage conditions.{!LANG-b51831d676cddaffd267d82fc874fb85!}

{!LANG-0f09e2d16c35c2faa26aeb9bbddc934e!}

{!LANG-04a0e79b626b7b822a8dee4529427188!}

Pharmachologic effect.{!LANG-adde18c6e9ea57c5266da35cc0b4682d!}

{!LANG-4e28d1cd57fb9212d8cef8ec7b9f3f2b!}

Indications for use.{!LANG-c851e952abfa54635eb76404e7af3717!}

Method of use and dose.{!LANG-0629bc9f5eb926b5ebcfd6882f47a73a!}

{!LANG-ccd2572b357d5086d3b40c5dacb822cf!}

{!LANG-e8dadcb027df17fce209051bb3c26430!}

{!LANG-8a2c88589e1ab25764ed04b161f8d6da!}

{!LANG-d254d3858fb6609d095aa17dd25c5504!}

Side effect.{!LANG-54776f9ee209e073c67122a63e8d7180!}

Contraindications.{!LANG-33f973db5091ab913a8c5e5ef9685b7e!}

{!LANG-b52f5383f8d7016eb348439d853c2df5!}

Release form.{!LANG-3b84fdb257c5e92cf91c696e65a8b9e7!}

Storage conditions.List B. in light-protected place.

{!LANG-aa152a0d90b037733cf94dfe8d093438!}{!LANG-3106d7442717939d7623d181c5e744a9!}

{!LANG-28d0e94e7fe530b728d9063bf3800b16!}

Pharmachologic effect.{!LANG-9b80d52048f5df0fa3bfbd9f35ee95f3!}

Indications for use.{!LANG-146333b708c276a880d91f9bbbf1ce4e!}

Method of use and dose.{!LANG-ee61058839229885cad0dcec435440fc!}

{!LANG-3ffd91f15a396bdd930f8b7b5dc3a523!}

Side effect.{!LANG-c028bc843a44985495d2c7b91a6c605a!}

{!LANG-aa3eb2a6b20c82ba4dee422002643b71!}

{!LANG-57d9a4fc695e84a5df10f29339d423e9!}

Contraindications.{!LANG-8c128bb9547ce1e2ed1f1ce5273cf1f7!}

Release form.{!LANG-744efbdab6f9b83b76efa03926174c37!}

Storage conditions.List B. in a dry, light-protected place.

{!LANG-284a5ac19cf21fe4028b3a2fdef33ccc!}

{!LANG-c93169ba275a13827c05cfc1a9b81df2!} {!LANG-2814a5957b4239fbf0d1227fe9b57a94!}, {!LANG-b0985d0485f89c066602e5b97f51f884!}, {!LANG-04668f4fd8c61e2aa6e25756419698e9!}, {!LANG-22bb4522426d10003a421dbd5b1ae7ae!},
{!LANG-72590d06de8b56e4e0eace3a89a91f56!}.

{!LANG-8f8dd78c374bfc070430f90e18da8d6d!}

{!LANG-f6c8c861af96c70ad5019189dd19cf95!}

Pharmachologic effect.{!LANG-5259b2a7272f9f9a84f0d996da794d65!}

Indications for use.{!LANG-7db95fb14653217fcf6c53395a6635e8!}

Method of use and dose.{!LANG-2196f88e3da747f0db44115acb1c42f7!}

Side effect.{!LANG-029492e06aead1a95e3a8fd46671acf9!}

Contraindications.{!LANG-aed1b629e0c6965fca3bcae47889d626!}

Release form.{!LANG-420489fae8081c830353e90e261c9ab4!}

Storage conditions.List B. in the cool, protected from light place.

{!LANG-35b5f06f04b6b8bc847d11e0a3827064!}{!LANG-3a4b1dbaa0c3b89213c66ae4b338d193!}

{!LANG-dd8a962bf97b013b0f8da0cc972d138e!}

{!LANG-af5a323f184c54a3c5ea6411601343f5!}{!LANG-c230720cf2156baf9ca7c5091f101283!}

Release form.{!LANG-4df2d52461a9a209fd98a8e5133298ea!}

Storage conditions.List B. in light-protected place.

{!LANG-76854db33a6ab22803b3787f3055d840!}{!LANG-a61617aeb88513dda720cb0d0b0e4225!}

{!LANG-3fcf51357c09ff48f8ff702de25c2300!}

Pharmachologic effect.{!LANG-00f87d4221dd0470cf2632de33d38e0c!}

Indications for use.{!LANG-15649c9400e4735c3f83e6e97ee77cad!}

Method of use and dose.{!LANG-00058c1a70dfd4bf35ab6d59d0b0ad39!}

Side effect.{!LANG-809e6473de074ec19536df768efdaef6!}

Contraindications.{!LANG-a75f8bd3ad327b765422322d049cd0a7!}

Release form.{!LANG-e1f18967b939ab1629da154827435210!}

Storage conditions.{!LANG-1557fc9ec765efde9af5a0aaeaef0f1c!}

{!LANG-2e94a9468ee0b407a067310f5f4379d1!} {!LANG-c045bd40b1f5182893c03a4b4961db84!}, {!LANG-7008148eff2c6232a5d662b43ab11cb3!}, {!LANG-f0765ed59ac5ed4e63ba428c720b8153!}, {!LANG-79fee2b0132916874c77529bef260464!}.

{!LANG-3d0e13501d177db48890c5e96784cefc!}

{!LANG-bfbfcf89e70b1dc185aa1e3d364716c9!}

pharmachologic effect{!LANG-ac45380ab9eb48ecd2a6da48b247f090!}

{!LANG-b3108619bc3328475cbad9da460015d2!}

Indications for use.{!LANG-a571fbe441082d528c9b6aa1f0e074e7!}

Method of use and dose.{!LANG-e8ba3a0d3d39bf56e15aeb1e57d6d17b!}

{!LANG-82db045ee7a4e22e9a9ba84709a5c2d7!}

{!LANG-5fd8b97025680950460b388f61272d24!}

Side effect.{!LANG-338a2ad5a43a9fbf507e7d0b6862911a!}

Contraindications.{!LANG-1a973e58fe930afbe07eb9dc9f1d4bd7!}

{!LANG-d18ee3ed323187ae90665d261dbb5e75!}

Release form.{!LANG-7543af0aac557013b5218fe5c96f9a5a!}

Storage conditions.List B. in light-protected place.

{!LANG-3585edd5704d6548a945025dbc5397b5!}{!LANG-84eeb1f520df6d15ca4590b4d29ea65a!}

{!LANG-4018c77948f1e4a640edd43bb4f6101d!}

Pharmachologic effect.{!LANG-ed22246355576f519b21864819bca5e7!}

{!LANG-73b640f9a7455c841e11eefc8d85a6fd!}

{!LANG-e231f0040d1e32aa1dd868cfab6501af!}

{!LANG-f66266f8a943243c61a4bc817eadfd98!}

Indications for use.{!LANG-37c241df117de2e279c25fda5999f0d6!}

Method of use and dose.{!LANG-6d07f79970250a0335ee3e42d60a977d!}

{!LANG-d7807dd138b5e998fa0702fc0ca9eaf2!}

Side effect.{!LANG-2df934886979d3a888d665b6dc3a36e3!}

Contraindications.{!LANG-53c30cd8bb0c57635d8fb59c0edb6fab!}

Release form.{!LANG-a6430f18f610b88e9144f538a505cdb2!}

Storage conditions.List B. in light-protected place.

{!LANG-e1559ba77a337b934f030ef7e27ba4bc!}{!LANG-e0f55ad35ae0e68b839119f168170e5a!}

{!LANG-cf2ef5cf21259753137cea06437ddacb!}

Pharmachologic effect.{!LANG-ec438ef54aa8186b10b59beb701b378d!}

{!LANG-d1f87d02e8ca73d644f69b1466c08d1d!}

{!LANG-30fa26d43a8d254efaf36d71bae22534!}

Indications for use.{!LANG-bd729d2c33739314d38600a8734423dc!}

{!LANG-a89ed661cd6f48b81f6789d205c93710!}

Method of use and dose.{!LANG-4d869b499699de9f4756cf83781140a4!}

{!LANG-662f5add3852c486c8aedfe1bf346fde!}

{!LANG-90ff9c50de9eb68381c77c63270522a3!}

{!LANG-a295a98d61b6f468d59558503bfc0e87!}

Side effect.{!LANG-3e828e0197fa200b5decdb1b4ee97c0f!}

Contraindications.{!LANG-39e059b935c6065219717897a831c1b3!}

{!LANG-3d11f09c55c6579163d7cad574bb22b3!}

Release form.{!LANG-058ee8e8e6644df7457c3ba356a3e48d!} \% {!LANG-a3514550a46dc40d6c7a208612662d5f!}

Storage conditions.List B. in the cool, protected from light place.

{!LANG-4f963d291847c267d2cd2522175a5d07!}{!LANG-6f965becab1e1dad94e4f83f9f720e38!}

{!LANG-1d4931364227b7b4aa4373284f4cf1c0!}

Pharmachologic effect.{!LANG-38449ad4b9b38ff1de23bc85a70ca1d9!}

{!LANG-c8e0727f0836877b34b87be0993f0557!}

{!LANG-b9a3ec24fbc85ef614226cea22de463f!}

{!LANG-3ac9acd65bbae29b055911c26f9ca94a!}

Indications for use.{!LANG-b94da0f669bec726267181cee52622e2!}

{!LANG-b5237694ac794553bbac49bf0eb4020a!}

{!LANG-9ee9e37c20f38aad9f61e59b22435153!}

Method of use and dose.{!LANG-35a15cf7b2a0085c88e8fcf54efba6e5!}

{!LANG-ca3815984188b75cb823042db900da00!}

{!LANG-c7a41274b96276ed5423b4ac59d0d28b!}

{!LANG-88a385267452a3533511159bd3915609!}

{!LANG-5d3e090e451479f9f8e412b4776a3809!}

{!LANG-0f2d00abf135d5ea01828c8560e95f21!}

{!LANG-34ee6b3627f296d1ece54252627a357d!}

{!LANG-fb9a5672457cde74889cc715e5a12039!}

{!LANG-d4cdafedb471d312ec8491172e289b5d!}

{!LANG-29bad02c45d5a6ee79039b4b4eaaabd3!}

{!LANG-fc5a83fbf015d0c551e34a7645399908!}

{!LANG-0f743fa162b2fd74a92c1e6f833bf45f!}

{!LANG-33e5f4be6371380175e3d071599ae694!}

Side effect.{!LANG-1e77ae0b213f6e7c54f9cae66c547ed0!}

Contraindications.{!LANG-fbf135fe7c671d9203f45835a25592ae!}

Release form.{!LANG-cca384aeba12e7ef847bc91c2619141e!}

Storage conditions.{!LANG-342428a3e3e2c1c212f5eb0aec43ed23!}

{!LANG-c170419e1c5d7eeef9dd81281803cc96!} {!LANG-1d3a3623676167531ec0a0f8f5bd162e!}, {!LANG-d1ab88dd345c5a2f630acfd91b1938ef!}, {!LANG-47dfe543ef7a9f17bdcc31fd7fc11adb!}, {!LANG-a283f027c94fd39624006a417ad5cdab!}, {!LANG-68049f4cef0a0cb23e62176f80780679!}, {!LANG-7123c6a3860f6632c8d2ae2541549dff!}, {!LANG-04ebd6a9246e16dc9d40ae5b1ede92b7!}, {!LANG-803254beee715dac33ffc0c1a2839e27!}, {!LANG-9c1cd9ae51f3579607dc3b6813388ec4!}, {!LANG-8467222ec212ef20435d1693220892e6!}, {!LANG-80945d05e0c7c5b99cfd151acbb4b420!}, solutan, sPRASMOVERALGIN, teofedrine, {!LANG-8e4e1072f46dd542286cf28905c20a98!}, {!LANG-6e171286a73cecf5d2d7213b46b37b31!}, {!LANG-65f5d9bcb98c325760680702eaedafa8!}.

{!LANG-2573c315edde785d1a10c2ea1dacbbfb!}

{!LANG-642bec4af0a3337cd87745ccb905eb88!}

{!LANG-affaa5ace6216a72493bcd3292d901ab!}

{!LANG-fcc965d653709e56a42942e22300aad2!}

Pharmachologic effect.{!LANG-f9fda6bb0269075c99f28770c4de9678!}

Indications for use.{!LANG-2e45e7934b33a271866457c91678c9e1!}

Method of use and dose.{!LANG-a8cb56ae36c18be93f7d770fa63d600e!}

{!LANG-c87da0d1f064c72be72f48894df77140!}

Side effect.{!LANG-2121d5598cbff023d8c3dbd6210599aa!}

Contraindications.

Release form.{!LANG-460c64937f8b3d8f236c965dd7f5d1ef!}

Storage conditions.List B. in light-protected place.

{!LANG-bd2d284108e5ce9f0f9176a893466a64!}

{!LANG-0835d623f4324c6ef43799020c20cf79!}

Pharmachologic effect.{!LANG-3cf8414c9fc82600d5bbb84c3f07bc7d!}

Indications for use.{!LANG-db790277150037e211dfa66427cf68af!}

Method of use and dose.{!LANG-38e2074df5f71cd23fa7ed2d8b052f35!}

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Storage conditions.List B. in light-protected place.

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