A method of treating and preventing diseases, which is based on the use of drugs of natural or artificial origin, is called drug therapy. In other words, this is a general concept that implies treatment with medications.
Drug therapy is divided into several types. Doctors use symptomatic therapy based on eliminating specific symptom diseases. An example is the prescription of antitussive drugs for bronchitis.
Etiotropic therapy destroys the causative agent of the disease with the help of medications, that is, it eliminates the causes of the disease. For example, the use of chemotherapeutic agents in the treatment of infectious lesions.
Elimination of the main mechanism of development pathological process provides pathogenetic therapy. An example of medicinal effects in this type of therapy is the use of painkillers for various injuries. First of all, the medications used resist the development pain syndrome.
Replacement therapy is also included in a number of types of drug treatment. It includes the process of restoring the deficiency of substances that form in the human body. These substances include vitamins, enzymes, and hormones that regulate basic physiological functions. Replacement therapy is not intended to eliminate the causes of the disease, but it can ensure normal human life for a long time. An example of the use of replacement therapy is the administration of insulin to a patient suffering from. With regular use of insulin, normal carbohydrate metabolism in the body is ensured.
Finally, another form of drug therapy is preventive therapy aimed at preventing the occurrence of diseases. For example, using disinfectants or antiviral drugs during influenza epidemics. Similarly, the use of anti-tuberculosis drugs helps to counter the occurrence of exceeding the epidemiological threshold. An illustrative example of preventive therapy is routine vaccination of the population.
When considering the above types of drug therapy in more detail, it should be noted that in practice the noted directions in pure form are implemented quite rarely. The course of pathological processes can be influenced by different therapeutic methods and types medications. For example, replacement therapy may well be used for preventive purposes. Physiological and biological processes are highly interconnected in the human body. Therefore, the influence of drugs on systems, organs, and tissues is multiple.
When prescribing medications to a patient, the doctor must constantly take into account many different individual factors and choose the most appropriate type of therapy from the many available treatment options. Therefore, the doctor's decision-making is based on strategic principles. The main thing is that in each specific case it is necessary to ensure a reasonable balance between the safety, tolerability and therapeutic effectiveness of the drug used.
An important role in the process drug therapy plays a role in the timeliness and correctness of diagnosis. The doctor must adequately assess and take into account the patient’s condition, the capabilities of his body’s defenses, age, gender, the presence of concomitant diseases, and sensitivity to a certain type of medication. The specialist must take into account possible reaction the patient's body when several drugs are prescribed simultaneously. Of course, the behavior of the patient himself, how accurately he follows all the instructions and recommendations of the attending physician, is of significant importance in any type of therapy.
Each drug has a number of specific pharmacological characteristics, therefore, to obtain the desired effect from treatment, medications are introduced into the body in various ways. Enteral administration involves taking the medication through the mouth. In this case, the medication is absorbed through the intestines into the blood. The use of the medicine sublingually, under the tongue, makes it possible to receive remedy into the mucous bloodstream, bypassing the intestines. Direct administration of the medication into the rectum is called rectal. Medicines are also delivered to the body through injections, inhalations, and electrophoresis. All methods of administering medications are an integral part of any type of therapy.
A properly selected drug allows you to solve the main task of the doctor - to cure the patient.
Students, graduate students, young scientists who use the knowledge base in their studies and work will be very grateful to you.
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1. Concept and principlesdrug therapy
Pharmacotherapy - (from ancient Greek tsmbkpn - medicine and therapy), treatment with drugs, or otherwise, pharmacological agents. Pharmacotherapy is classified as conservative (non-invasive) methods of treatment. Drug therapy is often combined with other treatment methods: physiotherapy, nutritional therapy and others. For pharmacotherapy, a large number of drugs and substances are used, often prescribed in various combinations. The choice of drug is determined by the nature of the disease, the characteristics of its course, tolerability of the drug and other conditions and should ensure the greatest effectiveness of treatment and the least side effects.
Treatment of animals for internal non-contagious diseases, as for other diseases, will only be effective when it is purposeful and scientifically based.
The main goal of treatment is to achieve complete recovery of the animal, restore its productivity and obtain full-fledged products.
Basic principles of modern therapy:
Prophylactic
Physiological
Complex
Active
Economic feasibility
The preventive principle of therapy is the main one in the conditions of industrial technology, concentration and specialization of animal husbandry. Unlike medical work on small farms and in the individual sector, here, along with individual treatment, everything higher value acquires group therapy.
Group therapy - it is carried out more often in relation to a certain technological group of animals, in a specific workshop, when hidden forms of the disease are identified, for example, therapy in cattle for ketosis, osteodystrophy, protein and carbohydrate deficiency, for gastrointestinal acute disorders in calves, massive respiratory diseases (for example, aerosol therapy); therapy of pigs - for hypovitaminosis, gastric ulcer; therapy of sheep for ketosis, bezoar disease. For group preventive therapy, as a rule, products and preparations produced by industry or locally are used: dietary feed, premixes, supplements of vitamins and microelements, chalk, bone meal, vitamin preparations, etc.
For this purpose, physiotherapeutic methods are also used:
Ultraviolet irradiation,
Animal heating,
Bathing,
Dosed movements.
Group therapy, in addition to normalizing functions and restoring health, also aims to prevent the occurrence of concomitant or new diseases. For example, in cows with ketosis - liver pathology, in pigs during the growing period - hypovitaminosis, peptic ulcer stomach.
The physiological principle of therapy involves developing a plan and carrying out treatment based on a deep knowledge of physiological processes in the body. Unlike non-traditional types therapy (homeopathy, traditional medicine), in which the choice of medicines is based only on superficial data (mainly accumulated facts, empiricism), modern therapy is based on the use of knowledge of physiological mechanisms. Treatment in each specific case is carried out taking into account the physiology of each system or organ: when treating patients with inflammation of the stomach or intestines, diet and medications are prescribed based on the functions of the mucous membranes (secretion of gastric, pancreatic, intestinal juice), bile secretion, peristalsis, digestibility, absorption capabilities. Treatment of patients with inflammation in the organs of the respiratory system is carried out purposefully, achieving restoration of bronchial patency, freeing the alveoli of the lungs from exudate, and normalizing gas exchange. The principle is that all prescribed drugs and methods used stimulate the body’s defense mechanisms, help neutralize toxic substances, increase resistance to infection (phagocytosis, cellular and humoral immunity, strengthening and normalization of secretory, enzymatic, respiratory, hormonal functions.
The complex principle of therapy is based on the recognition of the materialistic doctrine of the inextricable connection of the body with the external environment and the unity of all systems and organs. The external environment refers to feeding, use, and features of animal husbandry technology.
It has been established that the occurrence of non-communicable diseases in 70% of cases is caused by these factors external environment, genetic factors account for about 10% of the causes and about the same amount for unskilled veterinary care. In addition, due to the functional dependence of all systems, as a rule, when one system is damaged, the functions of other organs are disrupted. For example, when the heart is damaged, the function of the lungs and often the kidneys is always impaired; with pathology of the gastrointestinal tract, the function of the liver and hematopoietic system is always impaired. The complex principle of therapy does not involve the use of any one remedy, but their use in combination in order to eliminate external and internal reasons diseases, creating optimal conditions for keeping and feeding animals and using special therapeutic and prophylactic drugs.
Science and practice have proven that in the vast majority of cases with widespread and widespread diseases (gastrointestinal, respiratory, metabolic pathologies, etc.) high economic efficiency is achieved only simultaneously with the normalization of zoohygienic parameters of the microclimate, the introduction of dietary agents and premixes, and the use of a complex of drugs with etiotropic, pathogenetic, neurotrophic, substitutive and symptomatic effects.
In complex therapy, the modern teaching on neuroendocrine regulation in the body under normal conditions and pathology is taken into account.
Active therapy is the most important principle of modern veterinary medicine. Unlike passive, expectant therapy, active therapy provides for the earliest possible medical care, When clinical symptoms diseases have not yet manifested themselves or have just begun to manifest themselves.
Active therapy is combined with preventive therapy, especially in group treatment. In the pathogenesis of non-communicable diseases, a period of functional deviations from normal condition, although clinical signs cannot yet be detected at this time. This period is conventionally called the preclinical or premorbid state (in infectious pathology, a similar state is called incubation period). Active therapy is carried out for many metabolic diseases. In this case, before the onset of clinical signs, the level of vitamins in the blood is determined. minerals or their ratio, enzymes, hormones, reserve alkalinity, content ketone bodies, urea, cholesterol.
For example, the preclinical stage of rickets in young animals can be detected by X-ray photometry of bones or based on an increase in blood activity alkaline phosphatase. With a sharp increase in the amount of glucose in the blood, it can be determined in carnivores initial forms diabetes Preclinical stages of myocardial lesions are diagnosed by electrocardiography.
The principle of economic feasibility is based on the fact that ultimately the treatment of sick farm animals must be economically justified. Unlike medical therapy and in some cases, in the treatment of dogs, cats and ornamental birds, when the humane principle is fundamental, economic calculations always prevail in the treatment of farm animals.
The veterinary specialist decides on the basis of economic calculation in accordance with developed and approved guidelines and recommendations to determine in each specific case the feasibility of therapy, that is, to treat the animal or cull it immediately after diagnosis. Practice shows that treating patients with internal non-communicable diseases V initial stage, at acute course almost always economically justified. In a number of cases, for example, with progressive purulent-necrotic pneumonia, traumatic pericarditis, liver cirrhosis, pulmonary emphysema and other diseases with pronounced irreversible changes In the authorities, the commission decides on the issue of culling: they are sent for slaughter after a diagnosis has been established or after a course of treatment.
medicinal pharmacotherapy treatment
2. Types of drug therapy
1) Symptomatic therapy is aimed at eliminating a specific symptom of the disease, for example, prescribing antitussives for bronchitis. Symptomatic therapy is the treatment of manifestations of a disease (symptoms) without a targeted impact on the underlying cause and mechanisms of its development (in the latter cases they speak of etiotropic or pathogenetic treatment, respectively). The goal of symptomatic therapy is to alleviate the suffering of the patient, for example, to eliminate pain due to neuralgia, injuries, debilitating cough due to damage to the pleura, vomiting due to myocardial infarction, etc. Symptomatic therapy is often used in cases emergency treatment- until an accurate diagnosis is made
How independent method does not apply, since the elimination of any symptom is not yet an indicator of recovery or favorable course disease, on the contrary, can cause undesirable consequences after stopping treatment.
Examples of symptomatic therapy include: the use of antipyretic drugs for very high promotion body temperature, when fever can be life-threatening; the use of cough suppressants when it is continuous and can cause oxygen starvation; the use of astringents for profuse diarrhea when it develops life-threatening dehydration of the body; giving irritating respiratory center and cardiac drugs during a sharp decrease breathing movements and heartbeats.
Many researchers consider symptomatic therapy as a type of pathogenetic therapy; in some cases, it can become one of the decisive factors in the recovery of animals against the background of complex treatment.
Although the use of therapeutic agents and pharmacological drugs Taking into account their prevailing action in certain directions, it justifies itself in clinical veterinary practice when developing a reasonable treatment plan.
2) Etiotropic therapy - elimination of the cause of the disease, when medicinal substances destroy the causative agent of the disease. For example, treatment of infectious diseases with chemotherapeutic agents.
A numerous group of drugs with etiotropic action is used to treat patients with inflammatory processes in the body:
Respiratory diseases (rhinitis, bronchitis, pneumonia, pleurisy, etc.),
Gastrointestinal (stomatitis, pharyngitis, gastroenteritis, etc.),
Cardiovascular (myocarditis, pericarditis),
Diseases urinary system(cystitis, nephritis, etc.),
Nervous system (meningitis, encephalitis, myelitis, etc.).
As with other diseases (gynecological, surgical, infectious), antimicrobial agents are widely used:
Antibiotics,
Sulfonamides,
Nitrofurans, etc.
Etiotropic drugs are used exclusively to suppress the primary or opportunistic microflora, which speeds up recovery.
Etiotropic conditionally includes:
Specific immune serums,
Anatoxins,
Bacteriophages,
Anthelmintics,
Remedies against fluff eaters,
Removal methods surgically foreign bodies from the mesh or pharynx.
3) Pathogenetic therapy is aimed at eliminating the mechanism of disease development. For example, the use of painkillers in case of injury, when the pain syndrome leads to the development of life-threatening shock. Pathogenetic therapy is aimed at mobilizing and stimulating the body’s defenses to eliminate the pathological process, that is, at the mechanism of disease development.
Eliminating or weakening pathogenetic mechanisms, pathogenetic therapy thereby contributes to the normalization of the process opposite to pathogenesis - sanogenesis (restoration of impaired self-regulation of the body), which promotes recovery.
A targeted effect on pathogenesis is accompanied by a weakening or elimination of the effect etiological factor. Consequently, pathogenetic therapy is closely related to etiotropic therapy, and practically it is used for pathology in all systems of the body.
Pathogenetic therapy includes:
Natural and artificial radiation (solar or ultraviolet irradiation),
Water procedures,
Warming compresses,
Irritants (rubbing skin turpentine, mustard plasters, cupping, massage, electropuncture, electrotherapy),
Medicines that stimulate the function of organs and tissues (expectorants, laxatives, enhance peristalsis, diuretics, increase the secretion of gastric and intestinal glands, cardiac, choleretic).
Pathogenetic therapy also includes some healing techniques complex action (lavage of the proventriculus and stomach, enemas, puncture of the scar and book, catheterization bladder, bloodletting).
The veterinarian uses the listed funds based on his own clinical experience, as well as guided by textbooks and reference books on pharmacology, formulation, instructions and recommendations.
4) Replacement therapy - restoration in the body of the deficiency of natural substances formed in it (hormones, enzymes, vitamins) and taking part in the regulation physiological functions. For example, the introduction of a hormonal drug in case of loss of function of the corresponding gland. Replacement therapy, without eliminating the cause of the disease, can ensure livelihoods for many years. Thus, insulin preparations do not affect the production of this hormone in the pancreas, but when constantly administered to a patient with diabetes mellitus, they ensure normal carbohydrate metabolism in his body.
Vitamin and mineral products and preparations are widely used as replacement therapy, especially for group prevention and therapy in specialized and industrial complexes.
Treatment with vitamins (vitamin therapy) is carried out when there is a deficiency of them in the body, for which purpose dietary feeds containing large quantities of vitamins in their natural form are used, and when there is a lack of vitamins in feeds, vitamin preparations are used. From an economic point of view, it is most expedient to use vitamins in the form of premixes or additives to mixed feed; In this case, vitamin stabilizing agents are needed (for example, diludin - a vitamin A stabilizer). Vitamin preparations- both monovitamins and multivitamins are used taking into account the condition of the animals, including for individual treatment. Most widely with for preventive purposes vitamins are used in poultry farming and in raising young farm animals.
Mineral components are used as group preventive therapy, taking into account the provision of macro- and microelements to animals. Of particular importance in this regard are biogeochemical provinces with insufficiency of macro- and microelements in the soil, feed, and drinking water. Premixes or feed additives in the form of mineral salts: chalk, sodium chloride, calcium phosphoride compounds, iron, iodine, cobalt, copper, zinc, manganese, etc.
For individual treatment of replacement therapy, homogeneous blood transfusion and parenteral administration of isotonic fluids are recommended ( saline solution, Ringer's solution, etc.), giving inside hydrochloric acid or natural gastric juice for hypoacid gastritis, hormone therapy(for example, insulin for diabetes, thyroid hormones for goiter, prednisolone or cortisone for adrenal insufficiency, pituitary hormones for ketosis).
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It is customary to distinguish the following types drug therapy.
1. Symptomatic therapy - i.e. aimed at eliminating a certain
symptom of the disease, for example, prescribing antitussives for
bronchitis.
2. Etiotropic therapy - eliminating the cause of the disease when drugs
substances destroy the pathogen. For example, treatment of infectious
diseases with chemotherapeutic agents.
3. Pathogenetic therapy - aimed at eliminating the development mechanism
diseases. For example, the use of painkillers for an injury when
pain syndrome leads to the development of life-threatening shock.
4. Replacement therapy - restoration of natural deficiencies in the body
substances formed in it (hormones, enzymes, vitamins) and taking
participation in the regulation of physiological functions. For example, the introduction of hormonal
drug in case of loss of function of the corresponding gland. Substitute
therapy, without eliminating the cause of the disease, can ensure life activity in
for many years. So, insulin drugs do not affect the production of this
hormone in the pancreas, but with constant administration to the patient
diabetes mellitus ensures normal carbohydrate metabolism in the body.
The body's reaction to drugs. Body cells respond to
exposure to various medicinal substances very monotonous. In principle
changes in cell functions under the influence of drugs are reduced to either an increase
(excitation) or to a decrease (inhibition) of their activity. For example, with
With the help of medications you can easily increase or decrease gastric secretion
glands and thus affect digestion. The effect of some drugs
even if their concentration remains constant, it increases over time.
This may depend on their accumulation in the body (for example, strychnine) or on
summing up individual effects of action (for example, ethyl alcohol), When
Repeated administration of the drug may increase sensitivity to it
body - this phenomenon is called sensitization. Or vice versa
weaken - the body becomes accustomed to the repeated administration of certain
medications (eg, morphine, ephedrine).
Pal - differences in sensitivity to drugs in individuals of different
the floor is small. In some cases, it has been experimentally established that women
more sensitive than men to some poisons, such as nicotine, but more
resistant to alcohol. But we must keep in mind that in special conditions,
characteristic female body, its sensitivity to certain substances
may change: during menstruation, pregnancy, lactation.
Body weight - in some cases, for greater accuracy, dosage of medications
substances are calculated per 1 kg of body weight.
Individual sensitivity - sensitivity to drugs
varies significantly among people. For some it may be very high
strong degree. In this case, they talk about idiosyncrasy, which is based on
modern concepts lie congenital deficiency enzymes, manifested
allergic reaction(see below. Complications of drug treatment).
Age - children are susceptible to sensitivity to drugs
some fluctuations. For example, children are more sensitive to morphine, strychnine,
less to atropine, quinine, cardiac glycosides. Depending on age
The dosage of medications changes accordingly.
Special attention it is necessary to turn to poisonous and potent drugs,
the therapeutic dose of which is calculated for adults (25 years). IN
in adolescence and childhood it is reduced approximately as follows: at 18 years old - 3/4
doses for adults, at 14 years old - 1/2, at 7 years old - 1/3, at 6 years old - 1/4, at 4 years old
1/6, at 2 years - 1/8, at 1 year - 1/12, up to 1 year - 1/24 - 1/12 doses for
adult. Higher doses are reduced to 3/4 and 1/2 also for persons over 60 years of age.
The importance of nutrition - in many cases when using medicinal substances
a certain diet is necessary, for example, when treating diabetes mellitus
insulin, attracting certain poisonings, etc.
The interaction of drugs with food products. It is forbidden
take tetracycline with milk or dairy products due to their content
large quantity calcium, with whose ions it interacts. At the same time
time drugs such as acetylsalicylic acid, butadione, diphenine,
indomethacin, metronidazole, iron salts, steroids, furadonin recommended
drink with milk to reduce their irritating effect on the mucous membrane
food channel. Calcium chloride, calcium gluconate are easily formed with acetic acid,
oxalic, carbonic and fatty acids, sparingly soluble complexes,
excreted in feces. Therefore, it is recommended to take such drugs over 40 years of age.
minutes before meals, and one tablespoon of 10% calcium chloride solution is necessary
dissolve in 1/3 glass of water to reduce its irritating effect on
gastric mucosa. Bile forms sparingly soluble complexes with
such antibiotics as: polymyxin, neomycin, nystatin - take them
should be 30 minutes before meals. The same bile promotes absorption
fat-soluble drugs. These are vitamins, hormones - they are taken
vice versa after eating.
Drug interactions. Very often with a particular disease
take not one, but two, or even more different medications.
It is necessary to know the mechanism of their action. Medicinal substances may
act in one direction, and then the effect they have is, as it were,
is summed up. If the drugs you take act in opposite ways
directions, such cases are referred to as antagonism (“struggle” effects). IN
medical practice simultaneous administration of several drugs finds
increasingly used, since such a combined method leads to
strengthening therapeutic treatment or weakening and preventing side effects
phenomena and complications. Thus, in the treatment of hypertension, they simultaneously use
cardiac vasodilator glycosides and diuretics, thus
complexly influencing various parts of the unified circulatory system.
Drugs influence each other at any stage of passage through the body: when
absorption, transport phase, metabolism (intracellular metabolism),
excretion from the body.
It is not rational to use adsorbents (aluminum hydroxide, almagel, magnesium
sulfate) together with alkaloids, glycosides, enzyme preparations,
dyes, antibiotics. By physical and chemical properties not compatible in
one syringe of bepzylnenicillium with chloramphenicol, aminazine, genarin,
tetracycline, B vitamins.
Routes of administration of drugs into the body.
To achieve pharmacological effect medicinal substances are necessary
enter into the body or apply to its surface. Medicines are administered into
the body in different ways, and each way has its own
features. The following are of greatest practical importance.
1. Medications are administered orally through the mouth (enterally) in the form
solutions, powders, tablets, capsules, pills. Oral administration is
in the simplest and most convenient way, but not without its drawbacks, since
absorption of the drug through the intestines into the blood cannot be accurately determined
quantitative accounting, some drugs are destroyed in the intestines, as well as
in the liver, and thus lose their activity. Therefore it is necessary
or water, etc.).
2. Use of medications under the tongue (sublingual). Advantages of this method:
medicinal substances without decomposing gastric juice, quickly fall into
systemic blood flow, thereby ensuring the development of the desired effect.
Disadvantages: irritation of the oral mucosa.
3. Introduction into the rectum (rectal). Helps avoid annoying
effects on the stomach, as well as use medications in cases where it is difficult
or we cannot take them by mouth (nausea, vomiting, spasm or obstruction
esophagus). Suppositories and liquids are administered into the rectum using enemas.
4. Parenteral (outside the gastrointestinal tract) use of drugs:
various options injection, inhalation, electrophoresis and surface application
them on the skin and mucous membranes. a) Intravenous, intraarterial injections,
intramuscular, subcutaneous. Advantages: rapid onset of effect, accuracy
therapeutic dose, possibility administration of substances, which are not absorbed from
gastrointestinal tract. Precautions: Do not administer medications until
there is no belief that the needle is in the vein. Entry of the drug into
the perivenous space can cause severe irritation, up to
tissue necrosis. It can be dangerous to accidentally get a needle into other
blood vessels. Some drugs must be administered slowly over time
avoiding serious complications. Injection is not performed near nerve
trunks, damage to which can cause severe pain, sometimes muscle paresis.
b) Inhalations. Inhalation of medicinal substances in the form of aerosols, gases and
powders, are quickly absorbed and have a local and general effect. V)
Superficial (external) use - ointments, lotions, powders, compresses, etc.
used to obtain a local effect. d) Electrophoresis. The method is based on
the use of galvanic current for the transfer and introduction of medicinal
substances from the surface of the skin into deep tissues.
Medicinal substances and their breakdown products are excreted from the body in feces,
urine, less important is excretion with air, sweat, saliva and lacrimal
liquid.
Kidneys. Most drugs are excreted by the kidneys, regardless of
concentrations in the blood by filtration in the glomeruli.
Digestive tract. Many alkaloids and
heavy metals.
Leather. Skin glands are capable of secreting bromine, iodine, arsenic and some others
substances.
Respiratory tract. Through them, gaseous and volatile compounds are released.
Mammary glands. The ability to secrete medicinal substances from these glands
must be taken into account from two points of view. Firstly, this can
used to administer medications into child's body, but, on the other hand
hand, the noted fact poses a danger of possible poisoning
breastfed baby.
Drug therapy (Pharmacotherapy) is treatment with drugs, or otherwise, pharmacological agents. Chemotherapy refers to pharmacotherapy as applied to oncology. Pharmacotherapy is classified as conservative (non-invasive) methods of treatment. Pharmacotherapy is also the name of the branch of pharmacology that studies drug therapy.
Types of pharmacotherapy
The following types of pharmacotherapy are distinguished:
Etiotropic therapy — perfect view pharmacotherapy. This type of pharmacotherapy is aimed at eliminating the cause of the disease. Examples of etiotropic pharmacotherapy include treatment antimicrobial agents infectious patients (benzylpenicillin for streptococcal pneumonia), the use of antidotes in the treatment of patients with poisoning toxic substances.
Pathogenetic therapy — aimed at eliminating or suppressing the mechanisms of disease development. Most currently used drugs belong specifically to the group of pathogenetic pharmacotherapy drugs. Antihypertensive drugs, cardiac glycosides, antiarrhythmic, anti-inflammatory, psychotropic and many other drugs have a therapeutic effect by suppressing the corresponding mechanisms of disease development.
Symptomatic therapy - aimed at eliminating or limiting individual manifestations of the disease. Symptomatic medications include painkillers that do not affect the cause or mechanism of development of the disease. Antitussives are also a good example symptomatic remedies. Sometimes these drugs (elimination of pain during myocardial infarction) can have a significant impact on the course of the main pathological process and at the same time play the role of pathogenetic therapy.
Replacement therapy - used for deficiency of natural nutrients. Replacement therapy means include enzyme preparations(pancreatin, panzinorm, etc.), hormonal medications (insulin for diabetes, thyroidin for myxedema), vitamin preparations (vitamin D, for example, for rickets). Replacement therapy drugs, without eliminating the cause of the disease, can ensure the normal existence of the body for many years. It is no coincidence that such a severe pathology as diabetes mellitus- is considered a special lifestyle among Americans.
Preventive therapy - carried out to prevent diseases. Some preventive antivirals(for example, during a flu epidemic - rimantadine), disinfectants and a number of others. The use of anti-tuberculosis drugs such as isoniazid can also be considered preventive pharmacotherapy. A good example preventive therapy is the use of vaccines.
It should be distinguished from pharmacotherapy chemotherapy . If pharmacotherapy deals with two participants in the pathological process, namely the drug and the macroorganism, then with chemotherapy there are already 3 participants: the drug, the macroorganism (the patient) and the causative agent of the disease. The drug acts on the cause of the disease (treatment of infectious diseases with antibiotics; poisoning with specific antidotes, etc.).
One type of etiotropic therapy is replacement pharmacotherapy, in which drugs replace physiologically missing active substances(use of vitamins, hormonal drugs with insufficiency of glandular function internal secretion etc.)
Today, most tumors are treated with medications. This is the most universal and most common method of cancer treatment due to its features:
With the development of nanotechnology, molecular medicine and genetic engineering, many new antitumor drugs have appeared in the oncologist's portfolio; drugs have become more selective towards malignant cells and less toxic to healthy tissues and the body as a whole. Targeted drugs, the so-called targeted drugs, have appeared, the molecules of which act more selectively on cancer cells.
All anti-cancer drugsAccording to the mechanism of action they are divided into cytostatic And cytotoxic. The first ones cytostatic, inhibit the proliferation of malignant cells and cause their apoptosis, or self-destruction program, cellular decay. Second, cytotoxic, drugs cause cell death due to their intoxication, destruction of the cell membrane and nucleus, other structures, and ultimately tumor necrosis.
Given the different mechanisms of action, in most cases, oncologists select a combination of two or three drugs from different pharmacological groups.
To drug treatment oncological diseases include:
Drug treatment is usually carried out in courses. The course includes the time of drug administration (from 1 to 5 days for intravenous drugs, may be longer for tablet drugs) and a break time to allow the body to recover and reduce the risk of side effects of treatment. Before starting each new course, blood tests are usually monitored and an oncologist is consulted to decide whether it is necessary to adjust drug doses and/or increase the interval until the next drug administration.
For long-term drug treatment there is the concept of “lines” of treatment. The “line” of treatment is the sequential administration of identical courses of chemotherapy (or other types) of therapy. The “line” of treatment is carried out until the desired effect is achieved or until the disease causes loss of sensitivity. If the tumor continues to grow during one chemotherapy regimen, the medications are changed. Continuing treatment with a new chemotherapy regimen is called “Second (third, fourth, etc.) line” treatment.
Chemotherapy is the most common type of drug therapy. Chemotherapy is:
1. Curative – when chemotherapy is the main method of treating the disease. For example, for many patients with leukemia, lymphoma, and testicular germ cell tumors, chemotherapy can be the main treatment method, which often leads to recovery. For most patients with advanced forms of cancer, with metastases to various organs, chemotherapy is the main treatment method, providing the maximum opportunity to control the disease for a long time.
2. Neoadjuvant – when chemotherapy precedes the main method of treatment. Most often, such chemotherapy is prescribed before certain types of operations, in order to shrink the tumor and reduce the activity of its cells.
3. Adjuvant – it is also called “preventive”. It is prescribed after the main method of treatment, most often after surgery, in order to reduce the risk of the disease returning.
The most common antitumor drugs include the following groups:
1. Alkylating antineoplastic drugs.
The mechanism of their action is based on the introduction of the alkyl group of the drug to the DNA of the cancer cell: the DNA structure is disrupted and it cannot divide further, apoptosis is triggered. This group includes: bis-B-chlorethylamine derivatives - historically the first cytostatic antitumor agents; nitrosourea derivatives and platinum preparations containing divalent platinum.
Non-classical alkylating agents, prodrugs, which, in order to exhibit their antitumor activity, must undergo a series of metabolic transformations in the body, as a result of which methylating agents are formed. The latter, penetrating into the DNA and RNA of the cancer cell, do not allow it to divide further.
Competitively interfere with the process of cell division, causing its apoptosis.
The mechanism of their action is based on cytotoxic action. They inhibit DNA synthesis, disrupt the permeability of cell membranes and other mechanisms of cell functioning.
Cytostatic drugs that selectively disrupt the DNA structure and division of cancer cells at different stages.
Chemotherapy drugs are in most cases administered intravenously or orally, then they have a systemic effect on the entire body. But they can also be used topically, for example, during surgery for processing the surgical field, or regionally, for example, into the ventricles of the brain.
Indicated only for hormone-sensitive types of cancer. Whether the tumor will respond to hormone treatment or not will be determined using special tests and laboratory studies of cellular material taken from the tumor.
Hormone-responsive tumors are often found in reproductive system and endocrine glands, for example, these are:
Hormone therapy can be prescribed before tumor removal in order to stabilize its growth or reduce its size, then it is called neoadjuvant. Or after - in order to prevent re-growth or metastasis, this therapy is called adjuvant.
At later times inoperable stages For tumors that are sensitive to this treatment, hormone therapy may be used as the primary treatment. As a palliative treatment for some types of cancer, it is quite effective and can prolong the patient’s life by 3-5 years.
The immune system plays an important role in preventing and fighting cancer. Normally, immune bodies recognize atypical cell and kill it, protecting the body from tumor development. But when immunity is impaired for various reasons, and there are many cancer cells, then the tumor begins to grow.
Immunotherapy for cancer helps the body cope with the disease by activating protective resources and preventing the development of recurrent tumors and metastases. In oncology, interferons, cancer vaccines, interleukins, colony-stimulating factors and other immune drugs are used.
Treatment is selected by an immunologist based on laboratory data on the state of the cancer patient’s immune system together with the attending oncologist and other specialists involved in the treatment of a particular patient.
Basic mechanisms of immunotherapy:
From English target - goal, target.They are considered promising methods of molecular medicine, the future in the treatment of oncological pathologies, as well as the development of vaccines against cancer.
Targeted drugs are very specific and are developed for a specific mutated gene of a cancer cell of a given type of tumor. Therefore, before targeted treatment, a genetic study of the material taken for biopsy is required.
For example, effective targeted drugs have been developed for the treatment of various genetic forms of breast cancer, multiple myeloma, lymphoma, prostate cancer, and melanoma.
Due to their specificity and targeted targeting of the target cancer cell, targeted drugs are more effective for treating tumors than, for example, classical antitumor drugs. And less harmful to normal cells, which do not have the characteristics of tumors. Many targeted methods are classified as immunotherapy, since in essence they form the desired immune response.
It is carried out by drugs, influencing the light flux of a certain wavelength on cancer cells and destroying them.
The most well-known and frightening complication for cancer patients after chemotherapy is hair loss. This happens because antitumor drugs are toxic to young, actively dividing cells, such as hair follicles and nail plates. In practice, not all types of chemotherapy cause hair loss. This complication is typical for a narrow range of drugs; many patients do not experience it. While the drug is in effect, the activity of the body's renewing cells may decrease, causing nails and hair to stop growing, hair loss to occur, and the hematopoietic system to be inhibited. After a course of chemotherapy it is necessary recovery period, during which the body returns to normal.
Severe complications are not observed in all patients, but their risk increases with increasing duration of treatment.
The following are common side effects after drug therapy:
Most complications can be corrected; with proper treatment, many of them can be prevented or stopped at the first manifestation. Severe complications may cause increased intervals between chemotherapy courses.
The earlier cancer is detected and the more accurately the type of tumor cells is diagnosed, the more successful treatment cancer and a better prognosis for recovery. Therefore, you should constantly monitor your health, undergo diagnostic tests according to your age, and not turn a blind eye to illness or periodic discomfort in the body. It is also better not to waste time trying to recover on your own or with the help of alternative medicine, which has no convincing evidence of effectiveness, ignoring modern methods medical treatment. This can only start the oncological process, aggravate the stage of the disease and complicate subsequent treatment. Do not waste precious time, get examined in specialized centers using modern equipment by highly qualified doctors.
