Method of external treatment of psoriatic onychodystrophy

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to dermatology and can be applied for external treatment of psoriatic onychodystrophy. For this purpose mixture of gel tisol and ointment daivonex is applied on nidus of affection in ratio 1:2 with following keeping under adhesive plaster during 8-10 h two times per day. Course of treatment constitutes not less than 14 days.

EFFECT: method ensures reduction of treatment terms and duration of remission and obtaining high therapeutic effect.

1 tbl, 2 ex

 

The invention relates to the field of medicine - dermatology, in particular to a method for the treatment of dystrophic lesions of the nail plate with psoriasis (onychodystrophy).

Changes in the nail plate negribkovoy and fungal etiologies are one of the most frequent reasons for referral of patients to a dermatologist. On a number of issues of pathogenesis, differential diagnosis and treatment of onychodystrophy there is no consensus of specialists in different fields. Differential diagnosis is quite difficult and, first of all, it is necessary to exclude mycological nature of the disease. The absence of treatment, and improper tactics pharmacotherapy if onychodystrophy often leads to progression of the process, significantly reduces the quality of life of patients.

In the treatment of onychodystrophy used massage, water procedures, application of oil solution of retinol acetate 3,44%, intradermal injection of triamcinolone in nail ridges, local PUVA therapy, long-term use of retinoids, drugs (Fitzpatrick T. and et al. "Dermatology, Atlas-Handbook", McGraw-Hill Practice, 1999, s.89). The need to use these funds systemic therapy of psoriasis is determined by the severity of the process and leads to the development of a number of side effects and complications (high blood pressure, disorders of function the kidneys, increasing the concentration of potassium and uric acid in the body and others) and is characterized by a high cost of therapy (Dobrica V.P. et al. "Modern immunomodulators for clinical application", 2001, p.236-238, Kubanova AA "Dermatovenereology. Clinical guidelines", 2006, 2007, p.48).

Also known is a method of treatment of one of the variants of psoriatic onychodystrophy - onycholysis applique corticosteroid ointments after the massage the affected fingers (Voskopoulos. Reference "Skin and venereal disease" Ed. by Olivanova. M.: Medicine, 1997, s). However, not proven clinical effectiveness of this method not only when onycholysis, but also other variants of psoriatic onychodystrophy.

The objective of the invention is to improve the treatment of different variants of psoriatic onychodystrophy.

The technical result consists in the reduction of treatment time and duration of remission in achieving a high therapeutic effect.

This technical result is achieved by the method of external treatment of psoriatic onychodystrophy by applying ointment money pathogenetic antiaritmicheskogo effect on the lesions and exposure under the plaster, as ointment money pathogenetic antiaritmicheskogo actions use a mixture of gel is isolation and ointment daivonex in the ratio of 1:2, the shutter speed under the plaster spend at least 8 to 10 hours twice a day for a course of treatment for at least 14 days.

The invention consists in the optimal combination ratio used medicines pathogenic action with temporal parameters.

Drug Tizol-gel for external use and gel structure provides its conductive properties. The drug has anti-inflammatory, accelerating the repair processes and antipruritic action.

Ointment daivonex is a means for the external treatment of psoriasis, contains the active ingredient calcipotriol (50 mcg, a synthetic analogue of the active metabolite of vitamin D). The essence of the pathogenic action of this external tool in the treatment of psoriasis because of its ability to ensure the reduction of the inflammatory process in the skin, inhibit the proliferation of keratinocytes by inhibiting DNA synthesis, stimulate the differentiation of epidermolytic. Proven immunomodulatory effects of calcipotriol by reducing the synthesis of interleukin - 1, 2, 6, 8, profile activated in psoriasis, the T-lymphocytes. Calcipotriol reduces inflammatory response in psoriasis plaques, resulting in a substantial decrease in dermal okolososudistoe infiltrate. Drugs of calcipotriol (daivonex solution, cream, ointment), t is time, have low calcimine potential due to low ability be absorbed through the skin and rapid elimination from the body.

The use of external therapy of psoriatic onychodystrophy mixture of title-daivonex in the ratio of 1:2 under the plaster for 8-10 hours twice a day rate not less than 14 days is optimal to reduce the course of treatment while maintaining a high therapeutic effect.

From the analysis of scientific-technical and patent literature inventive combination of features that provide significant reduction in treatment time and increase the duration of remission us not identified, which allows to make a conclusion on the conformity of the proposed solutions to the criteria of "novelty" and "inventive step".

The invention is carried out as follows.

After diagnosis of psoriasis - psoriatic onychodystrophy, clinical and laboratory examination the patient is systemic therapy in accordance with the Standard of care in patients with psoriasis (MOH and CP No. 433 dated 30.05.2006). External treatment is different depending on the stage of the disease (progressive, stationary), the nature of clinical manifestations and prevalence of individual symptoms, taking into account the peculiarities of the localization process.

the donkey holding soap-soda baths available machining changed the nails of the feet (hands) 2 times a day apply a thin layer of a therapeutic composition - gel Tizol and ointment daivonex in the ratio of 1:2 under the plaster for 8-10 hours daily. The duration of treatment 2 weeks, if necessary, may continue therapy up to 30 days.

Example No. 1.

Patient S., aged 35, arrived in the dermatology Department of Arnieboy with complaints extensive rash, peeling and mild itching during the day, diffuse degenerative lesion of the nail plate stop, the 1st and 5th of the nail plate of the hands in the form of a symptom of the "thimble", grooves of different directions, "oil stains", hypertrophy in the distal-lateral type, the fragility of the free edge. Okolonogtevogo rollers are not changed. History: suffering from psoriatic onychodystrophy with 22 years autumn and spring exacerbations. Traditional treatment with a small positive effect. The duration of this exacerbation of 4 months. The traditional clinical examination, PASI - 23,2, BSA - 45%, dermatology quality of life index (DICE) - 19, clinical assessment of itch - weak moderate violations, visually expressed in the vascular component of the rash. Mycological examination of the nail plate negative.

Treatment: traditional therapy. The area is orogennykh nail plates applied the proposed method therapy gel Tizol - ointment daivonex within 14 days. Began active growth of healthy nail plates.

The tolerability of the drugs was satisfactory, no adverse events were noted.

Example 2.

Patient K., 39 years old, was admitted to the hospital with complaints of widespread rash, dry skin, mild itching during the day and slight desquamation. History: got sick for the first time 11 years ago after suffering emotional stress, in subsequent annual exacerbations in fall and winter. Inpatient treatment was carried out annually, with subsequent remission for about 2 months. This exacerbation of 2-3 months, self-treatment for external funds with a small positive dynamics. The traditional laboratory examination, PASI - 22,1, BSA - 38%, DIKE - 20, level of anxiety average - 22 points, largely due to the presence of dystrophic pathology nails of the hands and feet. I, II-I of the nail plate both feet changed by hypertrophic type, the free edge brittle, cracks, various degenerative changes of the nail plate hands; okolonogtevogo rollers are not changed; mycological research negative.

Assigned to traditional therapy, topically for rashes assigned ointment daivobet 1 time per day. Treatment of nail plates was carried out the proposed method is m - gel Tizol - ointment daivonex for 18 days.

As a result of therapy hyperemia, marked hemorrhagic component, infiltration of elements decreased, a slight peeling was preserved only on the lower extremities, PASI - 5, 6, DICE - 2. Marked the beginning of active growth of a healthy nail plates on the 9th day of treatment.

Tolerability was satisfactory, no adverse events were noted.

This scheme was applied in the treatment of 30 patients vulgar psoriasis.

Recurrence of onychodystrophy in the observation within 12 months were not recorded.

A comparison group of 15 patients.

Comparative data of the invention and prototype are shown in table (clinical efficacy of the treatment of psoriatic onychodystrophy).

Table 1.
The proposed methodThe known method
1. The period of treatment, weeks3-4 weeks4-5 weeks
2. The effectiveness of treatment:
- clinical recovery88,7%/td> 48,4%
-significant improvement11,2%7,3%
3. The duration of the remission period11-12 months1-2 months
4. Side effectsnoSeveral cases of hyperemia, Postolachi, irritation okolonogtevogo ridges in the skin (data Arnieboy)

The proposed course of treatment to achieve a more pronounced clinical efficacy of treatment of psoriatic onychodystrophy, to shorten the patient's stay in hospital, to achieve a lengthening of the period of remission due to the impact on pathogenetically significant factor in psoriasis. In addition, the proposed method of treatment allows for the treatment of psoriasis patients in inpatient and outpatient settings, with obvious clinical effect, supported by clinical indicators, preventing complications, reducing length of stay of patients in hospital and increasing the length of remission compared with existing treatment methods.

The way external treatment of psoriatic onychodystrophy, including the application of ointment money pathogenetic antipsoriatics actions on the center of the lesion and the shutter speed under the plaster, characterized in that ointment money pathogenetic antipsoriatics actions use a mixture of gel title and ointment daivonex in the ratio 1:2, the shutter speed under the plaster spend at least 8 to 10 hours twice a day for a course of treatment for at least 14 days.



 

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12 cl, 8 ex

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41 cl, 2 dwg, 6 tbl, 76 ex

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.

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14 cl, 73 ex, 8 tbl

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17 cl, 3 tbl, 9 ex

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11 cl, 38 ex, 3 tbl

FIELD: medicine, pharmaceutics.

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15 cl, 2 ex

FIELD: chemistry.

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6 cl, 5 tbl, 5 ex

FIELD: medicine, pharmaceutics.

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4 ex

FIELD: medicine, pharmaceutics.

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13 cl, 1 tbl, 3 ex

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4 cl, 4 dwg, 1 tbl, 29 ex

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7 cl, 15 dwg

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16 cl, 4 dwg, 7 tbl, 55 ex

FIELD: medicine, pharmaceutics.

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16 cl, 4 dwg, 7 tbl, 55 ex

FIELD: medicine, pharmaceutics.

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16 cl, 4 dwg, 7 tbl, 55 ex

FIELD: medicine, pharmaceutics.

SUBSTANCE: present invention refers to a solid dispersion wherein revaprazan particles are surface-modified by a water-soluble polymer, a water-soluble saccharide, a surfactant or their mixture wherein the water-soluble polymer is specified in a group consisting of polyvinylpyrrolidone, hydroxypropyl methyl cellulose, hydroxypropyl cellulose, polyethylene glycol, a water-soluble polyacrylic acid copolymer, polyvinyl alcohol or their mixture, and wherein the water-soluble saccharide is specified in a group consisting of lactose, white sugar, saccharose, mannitol, sorbitol, xylitol, trehalose, maltitol, dulcitol, inositol, dextrin, cyclodextrin and their mixture. The invention also refers to a method for preparing said solid dispersion. The present invention also presents a pharmaceutical composition containing the solid dispersion, and the method for producing the pharmaceutical composition.

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16 cl, 4 dwg, 7 tbl, 55 ex

FIELD: medicine, pharmaceutics.

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14 cl, 7 dwg, 17 ex

FIELD: medicine, pharmaceutics.

SUBSTANCE: dosage form contains oxycodone hydrochloride as a physiologically active substance (A), optionally one or more physiologically combined excipients (B), a synthetic or natural polymer (C) and optionally natural, semisynthetic or synthetic wax (D).

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14 cl, 7 dwg, 17 ex

FIELD: medicine, pharmaceutics.

SUBSTANCE: dosage form contains oxycodone hydrochloride as a physiologically active substance (A), optionally one or more physiologically combined excipients (B), a synthetic or natural polymer (C) and optionally natural, semisynthetic or synthetic wax (D).

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14 cl, 7 dwg, 17 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine. What is described is a donepezil-containing adhesive composition. At least one type of a stabiliser specified in a group consisting of ascorbic acid, metal salt or ester of such, isoascorbic acid or metal salt of such, ethylene-diamine-tetraacetic acid or metal salt of such, 2-mercaptobenzimidazole, 3(2)-tert-butyl-4-hydroxyanisol, 2,6-di-tert-butyl-4-methylphenol, tetrakis[3-(3',5'-di-tert-butyl-4'-hydroxyphenyl)]propionate pentaerythrite, (±)-α-tocopherol, (±)-α-tocopherol acetate, rutin, hypophosphoric acid, metabisulphite metal salt and metal salt of hydroxymethansulphinic acid; it is added to a layer of a pressure sensitive adhesive containing a pressure hardened adhesive and donepezil.

EFFECT: donepezil-containing adhesive composition inhibits time fading.

3 cl, 3 tbl

FIELD: medicine.

SUBSTANCE: invention refers to medicine. What is described is a method for staining inhibition of an adhesive composition having a substrate and a layer of a pressure sensitive adhesive containing a pressure hardened adhesive and donepezil in the layer of the pressure sensitive adhesive; the layer of the pressure sensitive adhesive contains ascorbic acid, metal salt or ester of such, and metabisulphite metal salt. The method involves: the stage of preparing a mixture containing the pressure hardened adhesive, donepezil, ascorbic acid, metal salt or ester of such, and metabisulphite metal salt, and the stage of formation of the film of the pressure sensitive adhesive by applying the mixture on the substrate surface. Staining inhibition of the donepezil-containing adhesive composition enables implementing a natural colour appearance.

EFFECT: what is presented is the method for staining inhibition of donepezil-containing adhesive composition and the method for reduction of donepezil-related compounds.

4 cl, 3 tbl

Anticancer agent // 2455011

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention refers to the use of potassium osmate salt K2[OsO2(OH)4] with isotope 187Os as a anticancer agent.

EFFECT: salt shows high anticancer activity in system in vivo with no undesired side effects.

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