Method of assessment the individual effectiveness of antiarrhythmic drug
(57) Abstract:The invention relates to medicine, cardiology. Essence: ectopic activity of the myocardium provoke the introduction of dobutamine before and at the peak of the antiarrhythmic effect of the drug. Effective consider the drug, against which the arrhythmia by dobutamine infusion at the same dose is not called. The invention relates to medicine, particularly cardiology, and can be used for individual assessment of the effectiveness of antiarrhythmic drug.There is a method of assessing the individual effectiveness of antiarrhythmic drug, which uses a discrete introduction of izoprenalin to the controlled playback of ventricular tachyarrhythmias in a patient before and at the peak of action antiarrhythmic drug. An effective consider the drug on the expected maximum which the arrhythmia is not played. (Beavers Century A. Mitchenko, I. Frolov A. I. Simonot Century. N. Method of assessment the individual effectiveness of antiarrhythmic drug. Auth.St. USSR N 1586674, A 61/B 5/00, 1990).However, the application of isoprenaline has the following disadvantages. With the introduction of isoprenaline significant writei. Izoprenalin, increasing the need of oxygen without increasing coronary blood flow in patients with coronary heart disease can lead to exacerbation of the disease, including the cause angina, or myocardial infarction, the effect of izoprenalin stops after 30 to 40 min after injection, which can spend to long provoked ventricular arrhythmias and hemodynamic instability of the patient. Izoprenalin is a stimulator of both beta-1 and beta-2-adrenergic receptors, the stimulation of which there is a pronounced vasodilatation and lower blood pressure, even without the occurrence of ectopic activity of the myocardium, which leads to disruption of the hemodynamics of the patient. Izoprenalin can improve glucose and lactic acid in the blood, which limits its use in patients with diabetes mellitus.The proposed method is free of the above disadvantages, since the introduction of dobutamine titration method can achieve activation of ectopic lesion in the myocardium without frequent sinus rhythm. Dobutamine does not violate the balance in the process "requirement of a myocardium in oxygen delivery oxygen and is used as angina, cumin is a selective beta-1-adrainostimulatoram and only affects the receptors, located in the myocardium of the ventricles. Dobutamine does not increase the glucose content in the blood, it can be used in patients with diabetes mellitus.The aim of the invention is to increase security and informative way, as well as the expansion of contingent examined patients.This goal is achieved by the fact that ectopic activity of the myocardium of the ventricles is called twice intravenous dobutamine in the same doses up to and at the maximum effect of anti-arrhythmic drug, and the drug is considered effective to the maximum of the action which the arrhythmia does not occur.The method is as follows: the patient under the supervision of the ECG and HELL is injected intravenously, the method of the pit dobutamine 250 mg in 250 ml 5-Noah glucose to the occurrence of ectopic activity of the myocardium at a rate not higher than 10 µg/kg/min In case of inducing ventricular fibrillation introduction of dobutamine stop and intravenous antiarrhythmic drug: metoprolol 0.2 mg/kg of body weight, amiodarone 5 mg/kg, ritilin 2 mg/kg of body weight, obzidan 1 mg, etmozin 150 mg Then the expected maximum effect of anti-arrhythmic drug is re-administered dobutamine in the same dose. Antiaritmicheskogo fails, it is considered effective. In the absence of the efficiency test is repeated with another antiarrhythmic drug over time due to 3 5 elimination half-life previously introduced anti-arrhythmic drug.Given that dobutamine does not cause increased demand of oxygen, increases coronary blood flow does not cause pressure reduction does not exceed the content of glucose and lactic acid in the blood, it gives the possibility to enlarge the pool of examined patients.The method has clear advantages in comparison with the prototype, since the introduction of dobutamine titration method can achieve activation of ectopic lesion in the myocardium without frequent sinus rhythm. Dobutamine does not violate the balance in the consumption of the myocardium of oxygen and is a selective beta-1-adrainostimulatoram that affect only the receptors of the myocardium of the ventricles. The action of dobutamine is terminated after 3 min after injection. Dobutamine does not increase the glucose content in the blood, it can be used in patients with diabetes mellitus. Dobutamine can be used as angina and acute myocardial infarction.Way follow illustrate the points parasystole, ventricular premature beats. Periods of accelerated idioventricular rhythm NGOs.In the selection of antiarrhythmic therapy, while samples with dosed physical load and isoprenaline test was observed sinus tachycardia (140 to 150 in 1 min),which was suppressed by the proposed method: in a horizontal position under ECG and AP control titration method intravenously introduced dobutamine before the occurrence of ectopic activity of the myocardium of the ventricles (frequent ventricular premature beats, accelerated idioventricular rhythm). After the introduction of ratmalana 150 mg intravenously, by injection of dobutamine in the same dose to cause ectopic activity of the myocardium failed. The patient was discharged in satisfactory condition after a 10-day course of treatment with ratmalana. Arrhythmia was not observed.Example 2. Patient D. 50 years old, diagnosis: myocarditis infarction, ventricular premature beats NCodiabetes mellitus is of moderate severity. Sick implemented the proposed method: in a horizontal position under the control of the ECG and HELL intravenous drip titration method introduced dobutamine before the occurrence of ectopic activity of the myocardium caused by ventricular extras is chopicalqui activity failed. After taking a course etmozina within 2 weeks the patient was discharged in satisfactory condition, ventricular arrhythmia was not observed. Method of assessment the individual effectiveness of antiarrhythmic drugs in patients with ventricular rhythm disorders without concomitant hypertension by inducing ectopic activity of ventricular myocardium under the control of the ECG, characterized in that it is held twice intravenous administration of the same doses of dobutamine at a rate not exceeding 10 µg/kg/min before and at the peak of action antiarrhythmic drug, with an antiarrhythmic drug, on the maximum of which ectopic activity is not provoked, it is considered effective.
FIELD: medicine, anesthesiology, resuscitation.
SUBSTANCE: one should perform puncturing of epidural space at Th12-L1 level. Through the lumen of puncture needle one should introduce catheter to move it cranially at the depth of 3 cm. After that one should inject 10 ml 05%-marcaine solution to perform repeated injections per 5.0 ml every 4 h during 1-8 d. The effect is achieved due to unloading minor cycle of circulation.
EFFECT: higher efficiency of therapy.
FIELD: medicine, pharmacy.
SUBSTANCE: invention proposes new tablets with size less 3 mm with sustained-releasing the opioid analgesic drug for 30 min in the amount above 75%. Invention provides opioid for oral intake with taking into account individual necessity of patient due to selection of required amount of mictotablets by dispenser.
EFFECT: valuable properties of tablet, expanded assortment of medicinal formulations of opioid analgesics.
19 cl, 4 tbl, 4 ex
FIELD: medicine, endocrinology.
SUBSTANCE: the present innovation deals with preventing diabetes mellitus and its aftereffects. It is suggested to apply sibutramin and its analogs to decrease non-susceptibility to insulin in diabetes-free patients, prevent decreased tolerance to glucose and decrease the quantity of introduced insulin in diabetes-suffering patients and normalize body weight, as well.
EFFECT: higher efficiency of application.
28 cl, 3 dwg, 1 tbl
FIELD: organic chemistry, medicine, pharmacy.
SUBSTANCE: invention relates to new derivatives of benzene of the formula (I): wherein A represents a group taking among the following groups: -C≡C-, -CH=CH-, -CH2-CH2; n = 1 or 2; X represents hydrogen, chlorine or fluorine atom or methyl or methoxy-group; Y represents hydrogen, chlorine or fluorine atom; R1 represents cyclohexyl group monosubstituted, disubstituted, trisubstituted or tetrasubstituted with methyl group, phenyl group monosubstituted or disubstituted with fluorine or chlorine atom or methoxy-group, cycloheptyl, tert.-butyl, dicyclopropylmethyl, 4-tetrahydropyranyl or 1- or 2-adamantyl, or adamantine-2-ol group; or R1 represents phenyl group and in this case X and Y both represents chlorine atom; R2 represents hydrogen atom or (C1-C4)-alkyl group; R3 represents (C5-C7)-cycloalkyl, and salts of these compounds formed by addition of pharmaceutically acceptable acids, and their solvates and hydrates also. Also, invention relates to methods for preparing compounds of the formula (I) and to pharmaceutical composition able to interact with receptors sigma-2 based on these compounds. Invention provides preparing new compounds and medicinal agents based on thereof for treatment of autoimmune states, disturbance on heart contraction frequency and control against proliferation of tumor cells.
EFFECT: improved preparing methods, valuable medicinal properties of compositions.
18 cl, 14 tbl, 78 ex
SUBSTANCE: method involves administering typical tricyclic antidepressants combined with selective reverse serotonin capture inhibitors. Anxious version of subpsychotic level depressive syndrome of endogenous genesis being treated, intravenous drop-by-drop infusion of 2.-4.0 ml of 1% amitriptiline solution per 200 ml of physiologic saline is applied in 12-14 procedures combined with selective reverse serotonin capture inhibitor given per os, Zoloft is per os administered as the inhibitor at a dose of 50-100 mg. Then, supporting Zoloft therapy is applied at a dose of 100 mg during 3 months. Atypic version of depressive syndrome of subpsychotic level and endogenous genesis is treated with intravenous drop-by-drop infusion of 1.25% Melipramine solution at a dose of 2.0-4.0 ml per 200 ml of power supply source in 12-14 infusions combined with a reverse serotonin capture inhibitor. Paxyl is taken at a peroral dose of 40-60 mg as the inhibitor. Then, supporting Paxyl therapy is applied at a dose of 40-60 mg during 3 months.
EFFECT: enhanced effectiveness of treatment; reduced risk of complications; accelerated depressive syndrome relief.
SUBSTANCE: the suggested transdermal therapeutic system (TTS) is indicated for percutaneous injection of tolterodin for several days. It is, also, described the method for its manufacturing. The suggested TTS is being a self-gluing lamellar matrix structure that contains methacrylate copolymer including ammonium groups, at least, one plastifier and up to 25 weight% tolterodin. TTS is of good tolerance by skin and is of good physical and chemical stability at prolonged storage and application, it, also, has got good adhesive properties and can provide the penetration of maximal quantity of active substance through skin.
EFFECT: higher efficiency of application.
8 cl, 2 dwg, 3 ex, 3 tbl
FIELD: medicine, pharmacy.
SUBSTANCE: invention relates to new acid-additive nitrate salts of compounds taken among salbutamol, cetirizine, loratidine, terfenadine, emedastine, ketotifen, nedocromil, ambroxol, dextrometorphan, dextrorphan, isoniazide, erythromycin and pyrazinamide. Indicated salts can be used for treatment of pathology of respiratory system and elicit an anti-allergic, anti-asthmatic effect and can be used in ophthalmology also. Indicated salts have less adverse effect on cardiovascular and/or gastroenteric systems as compared with their non-salt analogues. Also, invention proposes pharmaceutical compositions for preparing medicinal agents for treatment of pathology of respiratory system and comprising above indicated salts or nitrate salts of metronidazol or aciclovir.
EFFECT: improved and valuable properties of compounds.
6 cl, 5 tbl, 19 ex
SUBSTANCE: method involves applying fractal introduction of 0.2 mg/kg MT calypsol and 0.4 mcg/kg MT fentanyl every 10 min during operation. Additional local spinal cord root irrigation with 2% lidocaine solution at maximum traumatic operation moment.
EFFECT: enhanced effectiveness of treatment; preserved spontaneous patient respiration.
FIELD: organic chemistry, medicine.
SUBSTANCE: invention reports about preparing new substituted derivatives of 2-dialkylaminoalkylbiphenyl of the general formula (I):
wherein n = 1 or 2; R1 means cyano-group (CN), nitro-group (NO2), SO2CH3, SO2CF3, NR6aR7a, acetyl or acetamidyl; R2 means hydrogen atom (H), fluorine atom (F), chlorine atom (Cl), bromine atom (Br), cyano-group (CN), nitro-group (NO2), CHO, SO2CH3, SO2CF3, OR6, NR6R7, (C1-C6)-alkyl, acetyl or acetamidyl being alkyl can comprise one or more similar or different substitutes taken among halogen atom or hydroxy-group; or R1 and R mean in common group -OCH2O, -OCH2CH2O, CH=CHO, CH=C(CH3)O or CH=CHNH; R3 means H, F, Cl, Br, CN, NO2, CHO, SO2CH3, SO2CF3, OR6, NR6R7, (C1-C6)-alkyl, acetyl or acetamidyl being alkyl can comprise one or more similar or different substitutes taken among halogen atom or hydroxy-group; R4 and R5 have similar or different values and mean hydrogen atom (H) or unsubstituted (C1-C6)-alkyl; R6 and R7 have similar or different values and mean hydrogen atom (H) or unsubstituted (C1-C6)-alkyl; R6a means hydrogen atom (H) or unsubstituted (C1-C6)-alkyl; R7a means unsubstituted (C1-C6)-alkyl as their bases and/or salts of physiologically acceptable acids, with exception of compound representing 4-chloro-2'-dimethylaminomethylbiphenyl-2-carbonitrile and to a method for their preparing. Derivatives of 2-dialkylaminoalkylbiphenyl can be used in medicine for treatment or prophylaxis of pains, inflammatory and allergic responses, depressions, narcomania, alcoholism, gastritis, diarrhea, enuresis, cardiovascular diseases, respiratory ways diseases, cough, psychiatry disorders and/or epilepsy.
EFFECT: valuable medicinal properties of compounds.
13 cl, 2 tbl, 43 ex
FIELD: obstetrics and gynecology.
SUBSTANCE: over a 2-5 day period, 2.0 ml of Ginipral is administered once a day intravenously in a drop-by-drop manner followed by intravenously drop-by-drop administered 30-40 min later 2.0 ml of Instenone and, in the evening, 1 dragee Instenone orally. Afterwards, Instenone and Ginipral are administered orally: the former in dose of 1 dragee thrice a day with meal and the latter in dose of 1 pellet four times a day after meal until symptoms of the risk of prevention of pregnancy disappear.
EFFECT: prolonged pregnancy and prevented premature birth, which favors reduced irritation, normalized tonus, contractive activity of uterus, and improved psychic and emotional state of women.