Nasal decongestant drugs. Rational consumption of nasal decongestants in case of hostile respiratory infections in children

For a quote: Zaplatnikov, E.M. Ovsyannikova Rational storage of nasal decongestants for hospitality respirators in Russian infections for children // RMZ. 2004. No. 1. P. 36

About Striae of respiratory viral infections (GRVI) are the most common infections in children. Significant level of ill health on the GRV early vik, Until the tributes to infections, to the great businessmen of ethological agents, as well as to the occasional drip of transmissions.

Exterior gates for GRVI schools and upper ones dikhalnyh nobles (Ніс, pharynx, larynx). Respiratory viruses, penetrating into the cells of the upper respiratory tract, start to actively replicate. Reproduction of viruses is superficially cytopathic; In the mucus of the respiratory tract, at the same time, fumes develop, which supervises the vasodilatation of the increased penetration of the vertebral column and the hardened exudation. Clinical manifestations of cich processes є catarrhal symptoms (undead, cough, hyperemia of mucous infantile migdalin, Pharynx i n.).

Likuvannia of children from the GRVI will be in the wilderness of the individual features of the child and the classic picture of the afflicted. So, in children with an unfriendly premorbid background, I will be right away, and also in patients with important options for infection, it is shown that they are not only symptomatic, but anti-tartar drugs(Interferon, inductors of endogenous interferon and in.). In milder forms of GDVI lіkuvannya children, as a rule, there are signs of symptomatic problems. Slid it means that in the rest of the rock they are actively negotiating algorithms for the selection of the particularity of the symptoms of children with symptomatic likars (feverish, protic, vidharkuvalny, mucolytic). At the same hour, the nutrition of the rational veterinarian in the pediatric practice of nasal vaso-sound preparations in the illumination of the lack, which served as the reason for the publicity.

Undead is the most common symptom of GDVI, which shows the inflammation of the mucous membrane of the nose. ... At the same time, the hypersecretion and swelling of the mucous membrane develop. As a result, the enlightenment of the nasal passages changes, which makes the wicked feel a bit "stuck" and complicates the nasal movement. The nasal mucosa must also be built up until the drainage of the paranasal sinuses is damaged, so that the squeeze is pushed in them. Create mind for the activation of intellectually pathogenic flora. As a result, the development of such an accelerated development, such as bacterial sinusitis, is risky. Bends of the mucous nasopharynx nasopharynx to produce obstruction of the hearing of the tube with the possible later diagnoses of Eustachitis, as well as otitis media. Slid means that undead, especially in children of the early age, can be the reason for the broken sleep and appetite. At the same time, in newborns and children of the breast, the nasal complication can be reduced to the appearance of the breast.

I’ll look around at the vyschevikladena, zoosulylo, how the sucking of the lykarsky zasobіv, stopping the undead during GDVI, will not only reduce the self-esteem of the child, ale and the development of happy... I’m going to be victorious preparations for vasoconstriction of mucous nasal vasoconstriction ... The name of the nasal decongestant is used for the sounding of the nasal decongestants (the literal translation is “how to learn the hypothesis and congestion in the nose”, in English. congestion- blockage, congestion, hyperemia). It is based on the method of storing the systemic and mice decongestants.

Pediatric practitioners have a great deal of importance mіscevі decongestants ... At the same time, in the end of the rock with GDVI, it is practical not to stagnate drugs, but to replace adrenaline and ephedrine, but to change it into imidazolines. Before imidazolines, such drugs as oxymetazoline (Nazivin) , Xylometazoline, Tetrizoline, Indanazoline and Naphazoline (Table 1). Іmіdazolіnіv є a -adrenomіmetіcheskіmі lykarskyy. When їkh vikorystanny is activated a-adrenergic receptors of the mucous nasal sudin, which leads to nasal vasoconstriction. The factories change the hyperemia and thickening of the mucous membrane, the level of the nasal secretion decreases, the latter changes to the mucus from the paranasal sinuses, so that they bring a vice to normalization in them. When all the undead are bought, there is a nasal reaction and a sense of the "pawns". In addition, there is a change in the thickness of the mucous in the area of ​​the pharyngeal ring of the auditory tube and an adequate airway of the middle air. However, unimportant to the specific mechanism of the process, the analysis of the preparation may be of suttuvі vіdminnostі, as well as viz. Most of the trivial anti-congestive effects are seen in preparations of a short, middle and trivial stage (Table 1).

The consumption of naphazoline, tetrizoline, indanazoline is characterized by nontrivial savings in the sounding effect (no more than 4-6 years), but more frequent victories are up to 4 times per dose. It has been established that in the middle of all nasal decongestants and preparations there may be the greatest toxic effect on the cells of the nasal mucus nasal epithelium. On the other hand, in the ranks of the countries of origin, naphazoline is not recommended for use in pediatric practice. In Russia, the consumption of naphazoline is allowed in children older than 2 years. With a lot of addiction, for children from 2 years to 6 years it is necessary to pick up 0.025% of naphazoline products. However, in practice, it is problematic to declare these recommendations, because the official products of naphazoline and their analogs are 0.05% and 0.1% concentration. Try the independent, especially from the side of the father, brought the drug to the required concentration to melt in its own potential overdose threat. I’ll look at the price, naphazoline vikorystannya і th older children of the early wіk thаt аrе underestimated. In general, in the last few years, the short-acting preparations of the short-range are still growing in children.

Before nasal decongestants of the middle triviality (up to 8-10 years), lost xylometazoline ... These preparations are not recommended for storing in new-born women, and for children of the first 2 years of life. For children from 2 to 12 years old, there can be 0.05% of xylometazoline solutions, and for children over 12 years old - 0.1% of solutions. I will look at the triviality of these preparations, the multiplicity of their storage is not guilty of changing 3 times for doba.

Possible oxymetazoline (Nazivin) It is necessary to apply to topical vasoculosis drugs, the triviality of such preparations should last for 10-12 years. The breeders of the whole classy effect can be reached with a large introduction - make sure you get enough of them not often, at least 2-3 times and do it with a stretch. It means that the preparation of oxymetazoline (Nazivin), when consumed in the recommended doses, does not induce mucociliary blood clots.

It has been established that the therapeutic efficacy of oxymetazoline is attainable in greater low concentrations, lower in the case of the other vessels. The oxymetazoline in a low concentration of 0.01%, which is effective in newborns and infants. The results of high clinical studies of the clinical effectiveness and safety of oxymetazoline (Nazivin 0.01%), carried out in 638 infants, showed that in 97% of the cases of nasal administration of the drug, the drug had three With a great deal more low in 70% of cases, normalization of normal sleep was indicated.

High efficiency and good tolerance of low concentrations of oxymetazoline (Nazivin 0.01%) were allowed to recommend a new one for new children ... Slide means that Nazivin 0.01% per hour is a single topical decongestant, which is allowed by the Ministry of Health of the Russian Federation until breastfeeding in newborns and children. With a whole new neonatal disease, Nazivin 0.01% should be given 1 dots in the skin 2-3 times a day, and for the last month - 1-2 dots in the skin 2-3 times a day. For children older than 1 rock and for preschool children (up to 6 years) it is recommended to vikoristovuvati Nazivin 0.025% At the same concentration of the drug in 2 times lower, lower in the other mussel decongestants, recommended until the end of the period from 2 to 6 years. The children of the school vikorist Nazivin 0.05% .

for practical sucking hand-held topical decongestants, which are used for nasal sprays. Vikoristannya nasal sprays are more effective in applying an equal dose of the drug to the nasopharyngeal mucosa. However, until recently, їkh victoriousness in pediatric practice was surrounded by the visibility of lykarsky forms, which were allowed to be stuck in children. Tilki in the rest of the rocky in Russia, the bullets have been registered nasal sprays xylometazoline and oxymetazoline (Nazivin 0.05%). At the same time, there are a large number of them, they may be interrupted, so it is recommended for children over 6 years old or 12 years old.

With a strict adherence to the recommended dosage regimen, the methods of sucking (intra-nasal administration of the drug in vigorous drops or a spray) and triviality of viciousness (no more than 3-5 days) are not likely to occur in case of severe vascular disease. Among them there are descriptions: individual intolerance, medication rhinitis, as well as external manifestations ( head bill, Nudota, pidvishchena zhudlivist, sertsebitty and іn.), Which often develop in patients with an increased sensitivity to adrenergic drugs. When the dosage regimen is broken, musculoskeletal drugs may develop medication rhinitis. At the same time, in the main reason for this, I will discuss the determination of the refractoriness of the mucous nasal mucosa to adrenoceptors, which should lead to the development of secondary nasal vasodilation. Clinically, medication rhinitis is characterized by the repeated appearance of hyperaemia and nasal mucous nasal congestion and nasal damage and “nasal congestion”, without interfering with the therapy. The most frequent development of this accelerated development is to be developed with victorian preparations in a short period. With trivial and uncontrolled vikorystanny muscle decongestants, the development of the atrophy of the mucous nose. It is innocent for 3-5 days to use these drugs.

Slid means, for children, especially early age, are unaffected by the muscular way of storing, victorious decongestants can be supervised by the development of systemic, irrelevant effects. It’s tied together, since children have a resorptive surface of the mucous nose due to the large size of their common area (usually masi tila). Adequate appropriate muscular decongestants into the systemic bloodstream are also susceptible to traumatization of mucous membranes, which are not often diagnosed through defects in the toilet of the nasal passages (inconveniently, if the ear is inserted into the bag).

Violation of the recommended dosage regimen (an increase in single doses or the frequency of viciousness) can lead to an overdose with the development of serious pathological stanes right up to the reduction of the central nervous system, hypothermia and Komi. analogue cleverly show it is indicated in case of severe oral administration of these drugs. To that miscellaneous decongestants, as and all of them, it is necessary to keep them out of the reach of children, and those who are victorious are guilty of being strictly regulated. In the presence of a whole drug, which is a child of the drug, he is guilty about the inadmissibility of replacing the recommended doses.

There is also a memory about the inadmissibility of microwelling of musculoskeletal sounds at once with the intake of tricyclic antidepressants (amitriptyline, clomipromin and іn.) with a high rizik the development of non-commercial appearances.

The characteristics of musculoskeletal vascular drugs, which mean, in general optimal topical decongestant for children with GDVI є oxymetazoline (Nazivin) .

In the rest of the rock on the vichiznya pharmaceutical market, there is a wide range of combinations of drugs for symptomatic treatment of hospitals and diseases of the upper dysfunctional paths. As a rule, an antipyretic and systemic decongestant should be included in the warehouse of these drugs, before the combination of additional antihypertensives, ascorbic acid and vidharkuvalny. At the same time, phenylephrine is a vicarious substance in systemic decongestants. Previously, they entered the warehouse of combined non-prescription drugs in phenylpropanolamine and pseudoephedrine on the current day before the group of potent drugs, which was included in the list of non-prescription drugs.

Therapeutic effect of systemic decongestants of accumulation and stimulation of a-adrenergic receptors in the sudin of the mucous membrane of the nasopharynx. As a result, nasal vasoconstriction, a change in tissue hyperaemia and exudation. The price of supervising changes in the "nasal congestion" of the nose, liquidation of the undead and the improvement of the nasal dysfunction as a whole. drainage renewal sinuses nose and vstakhієvoi trumpets and a low grip in the paranasal emptying і in the middle. However, the prevalence of selectivity for systemic decongestants and potential risk development in a wide variety of side effects, Vimagayut seryoznachennoy up to їх sign in children. In connection with the cymbals, you need to spend a little bit of time on the most important meals of practical storage of systemic decongestants in pediatric practice.

Fenilephrine - adrenomimetic, stimulating and a-adrenergic receptor. Fenilephrine of inclusions in a number of combinated lykarsky diseases, which can be used in case of influenza and other state of the art respiratory infections. If I want the drug in very specific therapeutic doses, it does not affect the stimulation of the central nervous system, when it is stagnant, it can develop side effects, which can manifest itself in deranged, uncomfortable, deranged. Vikoristannya phenylephrine can also be supressed by arterial hypertension, pain in the area of ​​the heart and arrhythmias, problems with headache. One hour vicorystannya from phenothiazine to children, furosemides and іnshih sechogіnnnyh change therapeutic effect.

Particularly a follow-up to education, in pediatric practice of systemic decongestants (fenilephrin and іn.)

When combined drugs are recognized, to replace the systemic decongestants, the drug is responsible for the treatment of the patient and his father for those who may include anti-inflammatory drugs (paracetamines) .), cough (dextrametorphan), ascorbic acid, coffee and in. This can lead to overdose and development of non-fatal effects.

In such a rank, when nasal decongestants are vicious, when children are treated with GDVI, then the offensive principles are followed. Vibir to the drug to lay down in the form of children and their individual features (table. 2). In case of neonatal infants and children, breastfeeding with Vibor є Nazivin 0.01%. In children from 1 rock to 2 rock, in the capacity of starting anti-congestion therapy, Vikoristovuvatis Nazivin is guilty of 0.025%.

In children from 2 to 6 years with vikorstanny drugs in viglyadі intranasally, the droplet of the drug is to blame for the name of the drug Nazivin 0.025%, as a drug that is to avenge the active speech in the lower concentration and in the case of a triple class of patients. In quiet children, if in children from 2 to 6 years of age the decongestants are decongestants in the nasal spray, only Ximelin 0.05% (xylometazoline) is indicated.

In children, from 6 to 12 years old, there may be vicorization, both oxymetazoline and xylometazoline. With a whole oxymetazoline, the nasal drips of Nazivin 0.05% or Nazivin spray 0.05% are observed in viglyadі nasal drips. Xylometazoline can also be found in nasal specks or in a spray.

In children over 12 years of age, and in children, there may be a “grown-up” dose of xylometazoline in patients with 0.1% of the drug. At the same hour, oxymetazoline is more beautiful than vicoristovuvati, which is more effective in children, with an effective lower concentration (Nazivin 0.05%). It also means that systemic decongestants can be used in patients of the whole group of patients as an alternative to topical vascular drugs. The assignment of nasal decongestants to the systemic activity can be justified, as in a child with GDVI one hour є symptoms of intoxication (fever, headache and іn.) І there is no evidence for їх congestion.

Thus, in the Danish hour, in the arsenal of children-pediatricians, it is possible to accelerate the anti-congestiveness of the diseases, the rationalization of which is allowed to rapidly reduce the appearance of the mucus in the nasopharynx,

S.V. Morozova, Professor of the Department of Ailments of Wuh, Throat and Nose, GOU VPO “Moscow Medical Academy IM. I.M. Sechenov State Medical University "Roszdrav, dr honey... Sciences, professor

Vibrocil ®: for quick weakening of all symptoms in rhinitis

The problem of hospitality and chronic rhinitis becomes relevant, indifferent to those who are pediatricians, and ENT doctors wonderfully know about the breadth, the principles of diagnostics of the disease, as well as about the special features of the second Riznogo viku... Tse is not tied only with a high pile of ailments different forms rinit, and for the increase in the number of patients with important forms of incapacitation, with which the development of the development is accelerated. According to the data of the young authors, for the rest of the fate, the frequency of broadening of the nasal congestion and nasal sinuses in children becomes 35-37%, of which 50% go to chronic form... Usually, the number of such ailments will increase by 1.5-2% (Lopatin A.S., Ovchinnikov A.Yu., Svistushkin V.M. All of the following are new therapeutic methods that can help you get rid of the symptoms of rhinitis, take control of the symptoms of rhinitis, and take control of the symptoms of rhinitis.

I especially respect the safety and efficiency of the development of children - to come to the pediatric life, so as in the childish life (in the first place - in children before the rock) in order to conquer the protection of the most important thing, quite often I do it. severe otitis media.

The most widespread form of rhinitis

Most often pediatricians are susceptible to decilecoma forms of rhinitis: hospitable infectious (virulent, bacterial and fungal), allergic and non-allergic, non-infectious rhinitis (NANIPER - Non-Allergic, Non-Allergic). In dermal rhinitis with all the symptoms of dysfunction - nasal congestion, mucous vision of the nasal passages, decreased scent and appetite, mouth fatigue - and its own specialties.

So, for example, infectious rhinitis can be developed in any hour of fate, but in a larger scale, it is more characteristic for the period of the seasonal splash of the GRVI and GRZ. Most often, this is the reason for the increase in virus infection, as when there is adequate treatment, the bacterial growth is accelerated. In the case of a severe infectious rhinitis, there are three stages: dry stage of dehydration, stage of serous vision and stage of mucous-swelling (Table 1).

Table 1
Clinical Stages of Gostry Rinitu

More important is the development of a drug - to prevent the chronization of the ignition process, the transition of pathological changes in the empty nose to the nasal sinuses with the development of rhinosinusitis. Recognition of the development of chronic rhinosinusitis allows the patient to see and nasal congestion in a trivial way;

Pid non-allergic, non-infectious persistent rhinitis (NANIPER) may be considered a heterogeneous group of nasal diseases, including professional, medicinal, hormonal and pediatric pediatric vasomotor rhinitis (NANIPER). ) ". M., 2009). At the same time, the child is meant to be sensitive to some of the nonspecific differences: cold drink, Tyutyunovy dimu, Perfumery zasob, zabrudnenny food, etc. valign = top An acute problem is allergic rhinitis, which, for the rest of the hour, will take away all the wider expansion in the world, including in Russia, as in the middle of a mature population, and in the middle of children. In Russia, allergic rhinitis occurs in 5-20% of the child population (M. Geppe, N.A. ... The most important diagnostic criterion for allergic rhinitis is a seasonal character, and two groups of allergens are mated with two groups of allergens: a file of deyaky roslin and spores of blooming mushrooms, which are sluggish on the roslin. When the season is over, the main symptoms of rhinitis, as a rule, are known to change significantly. In the hospitality period, the child is sensitive to allergies, and also to those who are sick (saw, dim, sharp odors, etc.).

Peculiarities of overcoming the rhinitis among children of the early age

As already said, all vidi rinitu supravdzhuyutsya with a thick mucous membrane of the empty nose, which can lead to severe damage to the nasal dyhannya and very importantly carried by children. Moreover, the severity of the sick person will be rich in what to lie down from this age, which gave me an opportunity to see hospitality rinit in older children and hospitality rinit in children of breastfeeding. Such a reason for the critical importance of the pathology in children of the first fate of life, as, due to physiological peculiarities, it is much more important to endure the destruction of the nasal disturbance.

Budova oropharynx in children of the first months of life does not allow dichotomy in the mouth when there is a nasal obstruction. The destruction of the normal behavior accelerates the process of bathing: the child cannot be smacked, the temptations are often re-privatized, zakovtu povitrya. As a result of the whole old death of sleep, part of the dressing, flatulence and destruction of the child's sleeping camp ...

Before that, the problems with the dichanies through nis are not easy to wick reflexively throwing the head (gracious opistotonus), as the space between my mother and the back of my throat and the back of my throat lays down. At the same time, through the spilnosti of the paths to the flow of venous blood from the sinuses of the dura mater and the emptying of the nose, the internal cranial grip moves, which appears in the restless child, on the load of the great djerelets ready and the court.

In such a rank, having pronounced rinita at dumb(Yak, vіtіm, і in the older children) inimage of the unattached mucous membrane of the empty nose and renewal of normal behavior.

General principle of the decision of rinitiv

Happy Pidhid to Likuvannya gostrich forms rhinitis of transmission of symptomatic therapy: treatment of antiseptic drugs, antibiotic therapy, treatment of emptying of the nose with ultrasound problems, ingestion, persistence of acute fever therapy,

A special place in drug therapy All types of rhinitis have long been occupied with sudinozuzhuvalny preparations, scho learn nasal congestion. The efficiency and efficiency of the availability of decongestants in the same economic availability have led to the mass popularity of these households among patients. However, such demands and in the region have negative inheritances: Lyudin's sickness (or a sick child) is not sickly ill.

For the current classification, all adrenergic agonists are taken to be systemic (not stagnant in pediatrics) and topical - short, middle and trivial. Zastosuvannya topіchnih dekongestantіv dozvolyaє vplivati ​​bezposeredno on mucous nasal Ilya Obolonkov, zvuzhuyuchi roztashovanі in nіy krovonosnі sudini i tim by usuvayuchi utvorennya mucus gіperemіyu i nabryak tkanin scho generally produces up zmenshennya virazhenostі simptomіv rinіtu i zakladenostі nose and takozh vіdnovlennya prohіdnostі nasal hodіv i єvstahієvoї pipe.

The change in the mucous membrane filling with the infusion of the vessel-sounding preparations will significantly lighten the sick person and will speed up the process of lining. Until recently, decongestants were widely used in children's otorhinolaryngology, and during the preliminaries and preliminaries of clinical administration, it was shown that the group of drugs was not relieved of serious deficiencies. So, for example, a large number of decongestants in the middle and trivial days in case of vicorianism for more than 5-7 days are accompanied by a decrease in the therapeutic effect, there may be a reaction to the "ricochet syndrome" and so the titles of medication rhinitis.

Therefore, for the treatment of rhinitis in children (especially at the first time of life), it is recommended to use drugs based on phenylephrine (alpha 1 adrenergic agonist). It is very strong in the case of a vessel-sounding effect and at the same time it is practically not infused into the beta-adrenergic receptors, which allows the reduction of blood flow in the mucous membrane of the emptying of the nose, to preserve the functional activity of the serum s інshih adrenomimetics), as well as a central stimulating effect.

In Russia, fenilephrine has been removed from the widest range of applications for the drug Vibrocil ®.

Vibrocil ®

Vibrocil ® - drug combinations The antihistamine component, dimetindene maleate, is included in the yogo warehouse for phenylephrine. This is a topical decongestant, the activity of which does not lie in the concentration in the blood plasma, can be consumed by: sufferers, antiallergic and protynabryakov.

Decongestant component Vibrocil ® - phenylephrine - vibrating stimulates alpha 1 adrenergic receptors of the blood vessels of the nasal passages and viciousness of the blood-bearing vessels of the nasal passages, as if it allows for a few years to buy an increase in the amount of mucus due to the appearance

The antihistaminic component of the drug - dimetindene maleate - blocking the H1-histamine receptor, for which the main symptoms of allergic rhinitis are absorbed.

Zastosuvannya Vibrocil ® allows you to quickly eliminate the main symptoms of rhinitis and meaningfully polish the patient's age. The drug can be repaired even after 5 quills and its activity takes 6-7 years (Ludwig, A. (1983), Nose drops. Farm. Tijdschr. Belg., 60 (1983) 357-373).

Combined warehouse Vibrocil ® will provide maximum efficiency of the drug. Already on the 30th day of the disease, nasal resistance decreases and nasal dichotomy increases 3 times, and before the end of the first year, maximum efficiency is reached (Sauer, PH (1982), Rhinomanometric a single test of nasal resistance after nasal resistance Welt, 34 (1982) 102-103).

Vibrocil ® is rightfully used as a Vibor preparation for the treatment of hospitals and chronic rhinitis, whether of any ethology. Until the number Yogo naybіlsh vazhlivih dostoїnstv mozhna vіdnesti: vіdsutnіst at skladі steroїdіv, physiology - rіven pH may porіvnyati of pH slizovoї, іzotonіchnіst (gel i rozchin Vibrocil ® іzotonіchni - 300 mOsm) i vіdsutnіst nebazhanogo mіstsevoї dії (not prignіchuє funktsії migotlivogo epіtelіyu i slizovoї Ilya Obolonkov , not a vicious reactive hyperemia, as well as not impairing blood circulation in the emptying of the nose). Behind the additional addition of additional components, the preparation Volodya has excellent organoleptic power: lavender oil gives you a light, receptive aroma, and sorbitol and hypromelose will give you a foul-smelling effect.

Respect for hospitality and merit Vibrocil ® is a Swiss drug that is similar to GMP and ISO. During this process, all European standards of the technological process are adopted, the quality of the production process and the finished materials is supervised. All the above-mentioned guarantee of good tolerance of Vibrocil ® in 85% of sick people (Gunter, S. (1982), Treatment of rhinitis: Not at the cost of mucosal injury, Arztl. Praxis, 34 (1982) 102-103), allowing minimization of rhinitis negative side effects, on the basis of traditional decongestants, the drug should be kept up to 14 days old (for older children and children over 12 years old).

Shown for storing Vibrocil ® є:

• gostry rinit (including undead with colds);
• allergic rhinitis (at that, with a sick woman);
• vasomotor rhinitis;
• chronic rhinitis;
• Gostry and chronic sinusitis;
• gostry otitis media(In the quality of the additional method of treatment);
• preparation for surgical intervention in the area of ​​the nose and the loss of the mucous membrane of the nose and the appendages of the sinuses for the surgical intervention in the whole area.

Until the infinite merits of Vibrocil ® are introduced and versatile in licars' forms, they allow for the maximum speed of delivery and storage of patients in any way.

Dots in nis (solutions for intranasal administration) are recognized:
we will grow up and children over 6 years old - 3-4 dots in the skin, 3-4 times for doba;
for children (from 1 rock to 6 rock) - 1-2 drops in the skin nizdryu 3-4 times for doba;
children up to 1 rock - 1 dots in the skin 3-4 times a day.

Before stagnation of Vibrocil® drops, it is necessary to clean the nasal passages and inject into the nas, throwing the sick head back. It is recommended that you take a squeeze of decalcified khviliin. Bury the Nemovlyam Vibrocil ® in the NIS before bathing.

Spray nasal allows as much as possible to sprinkle the entire mucus membrane of the empty nose. It is recognized for growing up and for children over 6 years old - 1-2 times in the skin nizdryu 3-4 times for doba.

When vikorystannі spray razpilyuvach trim vertically, burn down with a tip. Insert the tip at the nizdryu, once with a short, slender grip, squeeze the wider, and, having wiped out the tip from the nose, press it. It is recommended to inhale slightly through nis for an hour.

Nasal gel in the first place of indications to patients with a sensitive shell of the nasal emptying, slenderness to dryness and teasing, as well as when approved. For adults and children over 6 years of age, apply the gel to the skin of the yakomoga more than 3-4 times per dose. Zastosuvannya drug before bedtime allows you to get past the nasal congestion in the middle of the year, preventing the patient from sleeping.

It is also obvious that Vibrocyl ® is well tolerated by patients, in the region it is rarely possible to reestablish, as a rule, you do not need to take a drug: at the same time as the nasal dryness and dryness of sinusitis are seen.

In such a rank, all the people who have been told are given the opportunity to develop visnovoks about those who have a therapeutic efficiency and a friendly profile of safety allow recommending Vibrocil ® for the treatment of rhinitis, whether it be a ethology of children or an age.

The list of literature is in the editorial office.

decongestant(Від "congestion" - blockage, congestion) - tse court-sounding zasobi, how to be vicious orally (systemically) or micevo (in nіs), which will change the congestion of the nose. In such a rank, according to the way of storing systematic and mice (topical) decongestants; moreover, mycelium (topical) decongestant, as if it were the only medicinal preparation, which stagnates muscularly, guilty of giving such main vimogs: (1) the presence of a significant symbolic lіkuvalnogo efectu(Ethiotropic, pathogenetic, symptomatic); (2) the visibility of a negative or undesirable activity, and the visibility of a skilful activity itself, as it is perceived as such and an extraordinary activity; (3) the duration of the resorptive activity.

Mechanism of dekongestants... Decongestant sympathomimetics, to drugs such as agonists 1- (fenilephrine), 2- (indanazolamine, xylometazoline, naphazoline, oxymetazoline, Tetrizolin) abo-adrenergic receptors (adrenalinehydrochloride) yogo utilization (cocaine hydrochloride). In such a rank of decongestants, sympathomimetics. Stimulation of adrenergic receptors to produce a ringing of the vessels of the entire body, reducing the blood pressure of the mucous membrane of the nose and reducing the amount of fat.

Classification nasal decongestants of the group a2-adrenoceptors: (1) short diy (lasting 4-6 years) - ephedrine, adrenaline (adrenaline), naphazoline, phenylephrine, tetrazoline; (2) middle stage (lasting 8-10 years) - xylometazoline; (3) trivalo diya (over 12 years old) - oxymetazoline.

trade name mice (top) decongestants: (1) indanazoline- Faria; (2) naphazoline- naftizin, sanorin, alergophthal, betadrin, okumetil, spersallerg, naphazol; (3) xylometazoline- galazolin, fornos, xylometazoline, ximelin, Olinto, otrivin, rinonorm, rinostop, Snoop, Grippostad rino, pharmacolin; (4) oxymetazoline: Rinazolin, Afrin, Lekonil, Nazivin, Nazol, 4-Vey, Noxprey, Oxymetazoline, Oxymetazoline Hydrochloride, Fazin, Fervex Spray from Undead; (5) Tetrizoline: Tizin, Octylia, Vizin.

Combined nasal decongestants(For example, vibrocyl, orinol plus), in addition to the vasoconstrictor speech, enter the components, which are anti-allergic, mucolytic, antibacterial or antibacterial. ( ! ) In the Danish hour to vvazhaєtsya, scho perevagu go to nasal decongestants in the viglyadi spray oskilki tsya likarska form is larger than in vikorystannі; zabezpechu іvnomіrne zroshennya mucous membrane of the nose; prescribing a more accurate dosage of the drug, which obviously reduces the risk of overdosing and the development of side effects. Until recently, sprays in pediatric practice were filled with bulo (recommended for children over 6 or 12 years). In the Danish hour, nasal decongestants have been registered at the viglyad sprays, the storage of those who grow up for help is allowed for children older than 2 years.

Shown before the storage of topical decongestants(Pathogenetically primed): (1) hospitals, bacterial infections and infections; (2) seasonal allergic rhinitis(Not more than 7 days, must be combined with topical or systemic antihistamines); (3) clinical allergic rhinitis (only symptomatic, in short courses not longer than 7 days, before the introduction of pathogenetic drugs, for example - topical glucocorticosteroids); (4) state of the art sinusitis (symptomatically, in combination with drugs of the other groups: antiapalny, antibacterial, secretolytic); (5) chronic sinusitis (only occasionally, with sharpening, in short courses not more than 7 days); (6) gosti otiti (for updating the ventilation function of the auditory tube); (7) how to get stuck when preparing a sick person before diagnostic procedures in the nasal passages; (8) how to become stagnant in case of operative management of ailments due to rhinological involvement.

contraindicated before the intake of a group of nasal decongestants є: atrophic rhinitis, medication rhinitis, arterial hypertension atherosclerosis, glaucoma and allergic intolerance. for okremich drugs contraindications є surgical involvement in the cerebral membranes in anamnesis; reduced oil mass. In case of stagnation, there are special features of the victorious period in the period of development. Decongestant can be stagnant in the period of vaginosity, only when cinnamon is cleaned out, it is a potent risik for the fetus.

side-by-side neobzanyefekti nasal decongestants. It is important to remember that a large number of vasoconstrictors (as it was already indicated earlier) are not recommended for taking trivial courses, more than 7 (seven) days sleep. Do not change the meanings in the summary of the dose, especially the drugs are used in the form of nasal drops, as it is important to doze out. In case of trivial admission, or overturned dose, there may be any onset of nasal decongestants or nasal decongestants: (1) minus the appearance of a liver, dryness in the empty nose and nasopharynx; (2) rebound syndrome; (3) impairment of vegetative regulation of the nasal cavity and nasal emptying due to the development of nasal hyperreactivity, drug-induced rhinitis, so that the nasal congestion and swelling of the mucous membrane of the nasal cavity reappear; (4) induction of secretory function and microcirculation, development of atrophic rhinitis; (5) systemically not sympathetic (zeal, headache, sleeplessness, nudity, heartbreak, ado arterial vise, Tremor, p_vischennya internal vise); (6) Allergic reactions develop even more rarely.

Factors, which are necessary for vrahovuvati in case of stagnation of muscular forms of decongestants: (1) before і after 5 mins when the drip / spray is taken away good hanging nіs; (2) positioning the head when instilling drops with decongestants: lift the head back into the seated position or lying down, then dip the drug into the skin half of the nose and then carefully nip the head from the side to the side; (3) the reduction of the nasal septum, polyp in the nose, reduce the efficiency of muscular decongestants; (4) it takes no longer than 3-5 days (in some cases, a maximum of 7-10 days, when a sign of medication rhinitis appears, it turns to a drug for the joy of drinking the drug); (5) in case of dryness in the empty nose and illumination of the blood is more beautiful than vicoristovuvati physiological breakdown And for the most important (for example, otrivin), as the order with the same speech (sympathomimetic), revenge the liquid components (for example, sorbitol, methylhydroxypropylcellulose).

Recommended doses of nasal decongestants for adults and children over 12 years old: naphazoline 0.05% 1 - 2 dots not more often than not through the skin 6 hours, naphazoline 0.025% 1 - 2 specks not more often than not through the skin 6 years; oxymetazoline 0.05% 2 - 3 drops 2 times a day with an interval of 12 years, oxymetazoline 0.025% 2 - 3 drops 2 times a day with an interval of 12 years, phenylephrine 0.5% 2 - 3 specks not often after skin 4 years, phenylephrine 0.25% 2 - 3 specks not often after skin 4 years, phenylephrine 0.125% 2 - 3 specks not often less through skin 4 years, Tetrizoline 0.1% 2 - 4 dots not often less after skin 3 years, Tetrizolin 0.05% 2 - 4 specks not often less after skin 3 years, xylometazoline 0.1% 2 - 3 skin dots 8 - 10 years, xylometazoline 0.05% 2 - 3 skin dots 8 - 10 years.

Principles of dosing decongestants in children... For children, from 6 to 12 years after the drug is taken in half doses, taken for older adults, from 2 to 6 years - in quarter doses, and for children under 2 years of age, the drug is administered only under control. However, in these recommendations, do not vrakhovuetsya masa tila child, that dose of changes in children, which are based on the mass of average vikovyh norms. For some reason, the indication and control of the drug, for children of the designated vik, it is not recommended to use such preparations in the given concentrations: naphazoline 0.05%: younger than 12 years, naphazoline 0.025%: younger than 6 years; oxymetazoline 0.05%: younger than 6 years; phenylephrine 0.5%: younger than 12 years, phenylephrine 0.25%: younger than 6 years; Tetrizolin 0.1%: younger than 6 years; xylometazoline 0.1%: younger than 12 years.

(! ) Nasal form fenilephrine, which vibrating stimulates the a1-adrenergic receptors of the cavernous venous tissue and the mucous membrane of the nose, which can be infused in this hour. Volodyuchi myakim vasoconstrictor effect (triviality - up to 6 years), price lykarskiy zasib not a significant decrease in blood flow in the mucous membrane of the nasal emptying and more provoking the development of the "ricochet syndrome". For patients under 2 years of age, preparations with a concentration of phenylephrine of 0.125% are recommended (up to 1 month - 1 drop through the skin for 6 hours). Children from 2 years of age and older, as well as growing older, can recognize a spray and drops, in which the concentration of phenylephrine is twice as high - 0.25%.

Decongestants - subozuzhuvalny for symptomatic therapy of nasal congestion in ailments of rhinitis, sinusitis and respiratory infections of the upper dyshally (cold).

lykarski formi, Designed for use in vseredin (phenylephrine, phenylpropanolamine, ephedrine, pseudoephedrine), is often dispensed into the pain syndrome and fever females with a cold.

Shown. Sudinosuzuvalny preparations vikoristoyut during the period of aggravation
nya AR and sinusitis, as well as in patients with severe nasopharyngeal infections
ki - host rinit(Chills), for the flu (div. Rozdil 32). decongestant so
zasosovyat for therapy of middle otitis media "
membranes of the nasopharynx) and during the preparation of a sick person to diagnostics
lyatsiyam in the nasal passages. ...

Prototype shown. Special indications for viciousness of de-congestants are hypersensitivity, arterial hypertension, tachycardia, atherosclerosis rotations, glaucoma, atrophic rhinitis, hyperthyroidism, vaginitis, period. To protect children and children.

NLR. Perevagu is rendered decongestant in the Mistsevoi Diy (spray or dots for dropping in nis). Naphazoline, oxy-metazoline, fenilephrine, etc. are introduced to such conditions. There is a small amount of ADR in the nasal emptying and Rhizik NLR, but tachyphylaxis develops in the presence of frequent vicoriasis. With frequent і / abo trivial stasis of nasal decongestants, medication rhinitis may develop: mutilation of the mucous membrane, burning, poking in the nose, chhannya, dryness of the mucous membrane of the nasal emptying, hypersecretion.

Decongestants do not suffer from medication rhinitis for taking in the middle of the disease, but when you take them in the middle of the rhinitis, it is significant. Withering, dullness and lack of sleep, and with high doses of high doses, hypertensive crisis, impaired cerebral blood flow, impaired heart rhythm, psychosis and suddenness. NLR most often develop in young people who have glaucoma, in patients with impaired heart rhythm, arterial hypertension.

vzaєmodiya s іnshi LZ. All decongestants produce an adrenal-multiplying effect, which, with one-hour appointment with MAO Ingibitors and three cyclic antidepressants, can increase the arterial grip. The decongestants did not go to waste at once with the Ingibitors of the MAO, but for a stretch of 10 days to get them back.

Decongestants trust in the wetting of micevo-anesthetic drugs, podovzhuyut їх dіyu. Spilnna signs of the other ship-sounding drugs in the development of side effects.

Filling the middle woh.

282 ■ #Klіnіchna sbaomzkologan і Fаomavdperapіn * Ptavz IS

Xlochetazolnn(Talosolіі)

Pharmacodynamics. Xilome gasoline - a-adrenostimulants, sounding blood-bearing vessels of the mucous membrane of the nose, assimilating the nasal mucosa. Diya pauses through a bit of hilin and a trive of years.

Pharmacoknneshka. With muscular absorption, it is practical not to be absorbed. to whom the price of Gran in the plasma of blood is on the edge of a miracle, who does not smell like this by any means.

Oxymetazoln(Nazol)

Pharmacodynamics. a-Atrenostimulating function for muscular consumption. When instilled into the conjunctival bear, it changes the swelling of the conjunctiva. The dialect manifests itself in 15 minutes after the time is spent and the time is 6-8 hours.

Without consultation with a doctor, it is possible to get sick for no more than 3 days. The drug is injected onto the zir, which can be substituted by reactions.

Tetrizoln

Pharmacodynamics. a-adrenostimulants of muscle and systemic development. Vayukons] rictorial: nrfect without secondary reactive hyperemia to develop v With a stretch of decilkokhilin and take 4-8 hours.

With a systemic zasosuvannі nadaє central edіtіvnoe dіyu. An intake of the drug before going to bed will give you a restful sleep throughout the whole night without additional intake.

Pharmacokinetnka. With a small amount of absorption, the systemic absorption is low.

Fenilefrnn(Mezashn) + carbnokeykam Combinations of deck l guest nt for reception in the middle.

Pharmacology. Combination of the drug, repair antihistamines, garlic anti-firing and vasoconstrictive action. A decrease in the turn of the muscular exudate manifestations, a decrease in the penetration of the capillaries of the mucous membrane, I call. Fenidhrrin wiklikє the ringing of the drill and the change in the mucous membrane of the nose. Usuvaє manifestations of rhinitis, sorrow in the eyes, feeling of heavyness in the head for 10-12 years.

11LR. Dryness in mouth, anorexia. dyspepsia, ruptured $ renіyu, zapamorochennya, head bіl, besonnіa. triviality, malice, heartache, cardialgia, arterial pressure, changes in the picture of peripheral blood, mental allergic reactions.

In case of an overdose in children and limes of the old age, it is indicated that there is a problem.

Vzaєmodia with іnshim LZ. Insane with the MAO Ingibitors; sympa-tomimeticheskiy: the effect of adapting to the aphids of guanethidine and nzibarina. GALITAN zbilshu risik development of arrhythmia,

ephedrine

Pharmacodynamics. Sіchpagomіmetіk, i daє a- (1-adrenostnmulіruyushіy efekt. Dіyuchi pas aferentnі adrenergіcheekіe fibers. Spriyaє vidіlennyu noradrenalіnu in sinaptichnu schіlinu. Nadaє vazokonstrіk-tornі, bronchodilator pay ruyushee i psihostimulyuyuchu dіyu. Pіdvischuє zagalny peripheral character opіr sudin i systemically arterіalny vise. Zbіlshuє frequency i the strength of the heart is very fast, I will turn the atrioventricular

Al.-ktrgach * h-k№ "chabolevanya 4 283

Providence, adjusting tone skeletal cells, Stimulates the central nervous system, by psychostimulants, close to phenamines.

Effective when accepting everything in the middle, giving a trivial diyu. at re-introduced with a small interval (10-30 hv), the pressure of ephedrine is reduced rapidly - tachyphylaxis.

Pharmacokinetics. In small quantities, it is metabolized in the oven. T | y2 3-6 hours

Shown. Rhinitis, arterial hypotension, sinna fever, kropyv'yanka, syrovatkov ailment (at the warehouse of combined therapy), misfortune, narcolepsy, withdrawal of hypnotic drugs, enuresis, diagnostics in ophthalmology

Prototype shown. Hypersensitivity, sleeplessness, IXC, arterial hypertension. organic heart disease, hyperthyroidism.

NLR. Tremor, heartbeat (after 15-30 minutes when I get it in the middle), tachycardia, pity. In case of overdose, sleepiness, sleepiness, overshoot of slaughter, increase in arterial vise, appetite visibility, blues, food, visip.

Vzaєmodia with іnshim LZ. At once zastosuvanny with heart glucosides, chinidine, tricyclic antidepressants, the development of arrhythmias grows.

I will weaken the effectiveness of narcotic and sleepy drugs.

With a one-hour zasosuvannі with reserpіnom and іngіbіtor MAO, there is a decrease in arterial vise, with nonselective r-adrenergic blockers - a change in bronchodilator action.

It is not necessary to take ephedrine and take this drug at the end of the day and before bedtime. Ephedrine was underestimated.

At the zyvazyu zi stimulating infusion of ephedrine on the central nervous system can be ominous to him.

Pseudoephedrine + Ibuprofen

Pharmacodynamics. combinations for, I need a sudominal, febrile and analgesic action. Pseudoafedrin - sympa-tomimetik, changes in the swelling of the mucous membrane of the nose, nasopharynx, sinuses. Ear of corn in 30 minutes after receiving, triviality 4-5 years. Ibuprofen is an oil refinery, blocking cyclooxygenase, changing the metabolism of arachidonic acid, causing exudative and proliferative phases and inflammation. Reducing the penetration of capillaries, lowering the painful sensitivity of the fire in any ethology.

NLR. Dyspepsia, gastropathy as a result of dysfunction of ibuprofen, heart failure, tachycardia, embryo, arterial pressure, overload, headache, loss of heart, dullness, loss of sleep, dullness reactions: blood clotting, bronchospasm, sverbіzh, kvinke obesity, liver failure and nirok, agranulocytosis, leukopenia, anemia, thrombocytopenia, bleeding (shlunkovo-intestinal, ash, hemorrhage), uterine ulcer weakness.

284 ♦ Clinical pharmacology and pharmacotherapy ♦ Chapter 18

In case of overdosed nudota, bloating, sleep disturbance. zbujennya, tachycardia. Likuvannya: symptomatic.

Vzaєmodiya z іnshih LZ. Ibuprofen reduces the effectiveness of urinary-medicinal preparations, due to the use of anticoagulants, antiplatelet agents. fibrinolytics, lowering the effectiveness of hypotensive and severe diseases, hypoglycemic effect of the elderly court.

Angations and cholesterol reduce the absorption of ibuprofen.

Ibuprofen increased concentration in the blood of the drug in lithia, increasing the toxicity of methotrexate.

Peevdoephedrine for oral anticoagulants. will weaken the effect of diuretics, pidsilu diu silshagamimeticon.

Guanegidin, reserpin, methiddopa will ease the pseudoephedrine.

Three cyclical antipredictions can be done. so and weaken the efficiency of the pedagogy.

Peevdoefedrin will weaken the guanethilin, advancing aritm01ennyeffect of heart glucosides, chinilina. triplicle antidepressants.

To accommodate the hypertensive and risky development of tachycardia with a combination of three-dimensional anti-pressureangamies. with other sympathomimetics, anorexigenic drugs, amphetamines and new psychostimulants, I will relax :) the effect of hypotensive drugs.

During the period of life, it is necessary to take care of the care of the ailments, the number of which is tied up with a special problem (keruvannya by means of transport).

Peevdoephedrin + paracetamol + chlorfenamin

Farchakolnnamika. Combinations with, maє heat-resistant. analgesic. court-sounding, antihistamіnnu. educational. pro-cough і bronchodilating dіyu, assimilated with імгггоми simple-di. Ear of diy in 20-30 minutes. triviality 4-4.5 hours

NLR. Zabudlivist, zapamorochennya, disturbed sleep. nudota, rila, bіl in the energy, allergic reactions: shkіrny visip, sverbіzh, kvіnke quilting, dryness in roti. overlap of the section, paresis of akomodatsii, medrias. adduction of an internal vice, anemia, platelet one nya. pannitone-nya; 1molitic anemia, aplastic anemia, hepato- and nephrotoxicity (including papillary necrosis), bronchospasm.

Overdose, overdose with chlorfenamin: overdose, spoiled. ruined sleep. Likuvannya is symptomatic.

Vzaєmodiya. Pidsilyu Effectiveness Ingibitorіv MAO. edible preparations. ethanol. Ethanol will sedate chlorpheniramine. Antidepressant. antiparkinson, antipsychotic s \ CD nature, fsnotiazinovie of lost causes the risk of development of side effects (catching the slaughter, dryness in the mouth, constipation). Glucocorticostroid increase the risk of development of glaucoma. Paracetamol reduces the effectiveness of uricosuric drugs. Chlorfenamin at once with the ingibitors of MAO, furazolidone can lead to a hypertensive crisis, anxiety, hyperrexia. Tricky antidepressants to sympathize

Allergic illnesses ♦ 285

a mimetic, one-hour recognition of a halothane pidvischu rizik development of a lump arrhythmia. Reduces the hypotensive effect of guanetine-Dina, which, in its turn, podsiluє a-adrenostimulating activity of pseudoephedrine.

During the period of testing, carry out monitoring of indicators in the peripheral blood and functional status of the liver. It is necessary to take care of the care of the victorious robots, in order to increase the concentration of respect and the quick reaction; ethanol implantation is not recommended.

ZHVORYUVANNYA LEGENIV

І BRONKHIV

With broncho-obstructive disease obmezheniye of dislocations in the bronchi. Rukh if ​​you dyhanna can accelerate bronchial spasm, bronchial enlargement, or buying sputum in the bronchial lumen. In the last drop, which is more typical for bronchial asthma (BA), bronchial obstruction is reversed and it may be more common to learn about it. When bronchial tubes are depressed, 1 or 3 remodeling of bronchial obstructions become non-vascular, which is typical for chronic obstructive ailments of the lungs (COPD).

Bronchial asthma

BA - chronic fired up dikhalnyh nobles, which take on the fate of rich cells and cells, especially ogryadny cells, eosinophils, T-lymphocytes, neutrophils and epithe-lyocytes. In schilous individuals, the incapacitation can lead to recurrent episodes of whispering, scuttling in breast cancer and cough, especially at night and early in the morning. The chain is sometimes uniquely tied with the obstruction of the spontaneous paths of a rapid turn, as it is often reversible spontaneously or during the course of the journey. Firing also a test of bronchial hyperreactivity on the basis of stimulation (assessed by the Group of Experts EPR-2, I997).

1 Depression of bronchi
lungs) lungs i / abo with growth in the lungs
noy tissue (pneumosclerosis).

2 Along with remodeling, the size is irreversible.
bronchi
bronchial collagen). The main reason for remodeling є
Trivially inflamed bronchial symptoms.

Captured legends and bronchon ♦ 287

Ethiology and pathogenesis. Prior to the development of BL, cover atopy :. іnshі slump bureaucrats, trivial contact with bogus and professional allergens.

In ailing people, repeated contact with the allergen wicklica has an allergic reaction of I gin. With a large number of cells and eczema, they see highly active speeches - mediators, the development of a spasm of the bronchial membrane membrane, and an increase in sensitivity to others. If the contact with the attenuate is pulled back, the processes are aware of the rapid development, it is altogether shorter that the allergen is uncomfortable (for example, atlergy to home saws, roselin saws), igniting the transition to the chronic phase.

Epidemiology. BA є one of the most common ailments dichotomous systems... V European countries BA stays up to 5% overgrown population і up to 7% children. Russia has 7 million ailments for bronchial asthma.

Z "Imptomocomplex BA may be more likely to be diagnosed in any case. The main symptoms are: if there is a problem with difficulty seeing, wheezing wheezing in the lungs (lingering with auscultation). Cough. cold mushrooms and food products. on a quintuple niligu - when traveling for a fool in the period of growing cold, with severe allergic symptoms of asthma; important attacks are often supervised by symptoms of mental deficiency - cyanosis. abuvayut siruvatiy vidtinok), orthopedic to a sick person, lighter than dikhati in the position of seated, damaged svidomosty (right up to the Komi) and zupinka dikhannya. An important symptom of asthma is a positive effect of bronchodilators in the respiratory tract stimulants or euphilin.

Excessiveness and severity of illness. In case of asthma attacked by breath, one is guided by periods (in some trivial) of general well-being in case of daily contact with an atlergen, or on the basis of adequate anti-inflammatory therapy. In case of a serious interruption, a sick person will be attacked, but the physical activity of the ailing person will often be intertwined.

Decline the decile of the BA severity levels:

burning intermittent- attack the kylka raziv on the rik, the liking is not necessary:

easier permіtіrukhee broach light attacks are spared permanently (ale not SHKDIY lin), to get rid of the ingestion of bronchodilators:

with a broach- attack the diagnosis of the day, the intake of only bronchodilators does not assimilate the symptoms;

Ayunia - the type of health of the Immune Department of the Ministry of Internal Affairs of the Republic of Belarus has been admitted (as a matter of fact) some of the specific Igt "in response to a contact with a.irk" nom.

288 * Clinical pharmacology and pharmacotherapy * Chapter 19

important interruption Practically, post-production complications,
physical design enclosed, uninvolved for an hour zasosuvannya
decilkoh LZ, do not expect to see symptoms.

Methods of thoroughness and diagnostics. The most informative methods for treating BA ailments:

Reception of a sick person, in the course of which to enter into symptoms of BA symptoms (Div. Vishche);

Auskulgania - in ailments due to acute asthma, dry wheezing is audible;

Spirometry, which allows the air flow and only to estimate oipa-low air flow. In case of bronchial enlightenment (for no reason), a decrease in the maximum (or peak) speed of the vidih ​​and the volume of the forced vidih ​​in 1 second is indicated. The results of the spirometry will be taken together with the proper values ​​for the given vik and statues. It is important to note that in the period when there are sharpened ones, if effective treatment indicators of spirometry in patients with BA show the norm;

Pіkflowmetrіya - vimіr pіkovoї shvidkostі vidikh, as in the simplified viglyadі you can see the ailment itself behind an additional downtime attachment - a peak flowmeter. Stagnation of the icflow meter allows us to be ill in control of our camp in the home minds;

Guest with bronchodilators ". Bronchial obstruction in asthma (on the basis of broncho-obstructive ailments) can be reversible if bronchodilators are used (most often for all (i.-adrenostimulants). Denmark test is great diagnostic value and allowing the diagnosis of BA from those with ailments with bronchial obstruction. It is diagnostically significant to improve the fixation of the fixed video in 1 second when the bronchodilator inhalation is higher by 15% in the case of out-of-pocket patients;

Broncho-provocation test, which allows the presence of hyperreactivity of the bronchial tubes, it can also be used for the diagnosis of asthma in patients with normal performance spirometry. As a result of the ingestion of nonspecific substitutes (for example, histamine), the patient is suffering from bronchial obstruction. you can talk about BA with good luck;

The level of Igli in the blood (the level of IgE is not only in people with bronchial asthma ailments. For detection of specific allergens, carry out additional allergic reactions in the blood or test screenings for different allergens.

BA diagnostics criteria:

key picture(Symptoms and skargi);

Evidence of bronchial obstruction during spirometry (or as a result of bronchoprovocation test);

Khvilepodіbny (zagostrennya - remіsіya) perebіg zhvoryuvannya.

Doslidzhennya obsyagu that soon dikhannya. - Broncholnators - LZ, which expands the bronchi in the route of the relaxation of the bronchial tubes.

Ingestion of legends and bronchiv F 289