And pharmacotherapy. types of drug therapy

29.07.2020

The method of treatment and prevention of diseases, which is based on the use of drugs of natural or artificial origin, is called drug therapy. In other words, it is a generalized concept that implies drug treatment.

Drug therapy is divided into several types. Doctors use symptomatic therapy based on the elimination of a specific symptom of the disease. An example is the appointment of antitussives for bronchitis.

Etiotropic therapy destroys the causative agent of the disease with the help of drugs, that is, 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 of the pathological process is provided by pathogenetic therapy. An example of a drug effect in this type of therapy is the use of pain relievers for various injuries. First of all, the medicines used resist the development of pain syndrome.

Substitution therapy is also included in a number of types of drug treatment. It includes the process of restoring the deficiency of substances that are formed in the human body. Such substances include vitamins, enzymes, hormones that regulate basic physiological functions. Substitution therapy is not intended to eliminate the causes of the disease, but it is able to ensure the normal functioning of a person for a long time. An example of the use of replacement therapy can be the administration of insulin to a patient suffering from. With regular use of insulin, normal carbohydrate metabolism is ensured in his body.

Finally, another form of drug exposure is considered to be preventive therapy aimed at preventing the occurrence of diseases. For example, the use of disinfectants or antiviral drugs during flu epidemics. Similarly, the use of anti-tuberculosis drugs helps to resist the occurrence of exceeding the epidemiological threshold. An illustrative example of preventive therapy is routine vaccination of the population.

With a more detailed examination of the above types of drug therapy, it should be noted that in practice, the indicated areas in their pure form are rarely implemented. The course of pathological processes can be influenced by various therapeutic methods and types of medications. For example, substitution 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, tissues is multiple.

When prescribing drugs to a patient, the doctor must constantly take into account many of the most diverse individual factors, choose the most appropriate type of therapy from the many available treatment options. Therefore, the decision-making by the doctor is based on strategic principles. The main thing is that in each specific case it is necessary to ensure a reasonable balance of safety, tolerability and therapeutic efficacy of the drug used.

An important role in the process of drug therapy is played by the timeliness and correctness of the diagnosis. The doctor must adequately assess and take into account the patient's condition, the capabilities of the defenses of his body, age, gender, the presence of concomitant diseases, sensitivity to a certain type of drugs. The specialist must take into account the possible reaction of the patient's body while prescribing several drugs. Of course, the behavior of the patient himself is essential in any type of therapy, how accurately he fulfills all the instructions and recommendations of the attending physician.

Each drug has a number of specific pharmacological features, therefore, to obtain the desired effect from treatment, medications are introduced into the body in various ways. Enteral administration involves the administration of the drug through the mouth. In this case, the drug is absorbed through the intestines into the blood. The use of the drug sublingually, under the tongue, makes it possible for the therapeutic agent to enter the mucous bloodstream, bypassing the intestines. Direct administration of the medication into the rectum is called rectal. Also, drugs are delivered to the body through injections, inhalation, electrophoresis. All methods of administering medications are an integral part of any type of therapy.

A well-chosen drug allows you to solve the main task of the doctor - to cure the patient.

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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 a conservative (non-invasive) 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 a drug is determined by the nature of the disease, the characteristics of its course, the tolerability of the drug and other conditions and should ensure the greatest effectiveness of treatment and the least side effects.

Treatment of animals with non-communicable internal diseases, as well as with other diseases, will only be effective when it is purposefully and scientifically grounded.

The main goal of the treatment is to achieve complete recovery of the animal, restore its productivity and obtain full-value products.

Basic principles of modern therapy:

Prophylactic

Physiological

Complex

Active

Economic feasibility

The preventive principle of therapy is the main one in terms of industrial technology, concentration and specialization of animal husbandry. In contrast to treatment work on small farms and in the individual sector, group therapy is becoming increasingly important in addition to individual treatment.

Group therapy - it is carried out more often in relation to a certain technological group of animals, in a specific workshop, when latent forms of the disease are detected, for example, therapy of cattle with ketosis, osteodystrophy, protein and carbohydrate deficiency, with gastrointestinal acute disorders in calves, mass respiratory diseases (for example, aerosol therapy); pig therapy - with hypovitaminosis, gastric ulcer; Sheep therapy for ketosis, bezoar disease. For group preventive therapy, as a rule, drugs 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,

Heating animals,

Bathing,

Dosed movements.

Group therapy, in addition to normalizing functions and restoring health, also pursues the goal of preventing the occurrence of concomitant or new diseases. For example, in cows with ketosis - liver pathology, in pigs during the rearing period - hypovitaminosis, stomach ulcer.

Physiological principle of therapy - provides for the development of a plan and treatment based on a deep knowledge of the physiological processes in the body. Unlike non-traditional therapies (homeopathy, traditional medicine), in which the choice of drugs 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 case is carried out taking into account the physiology of each system or organ: in the treatment of 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 ability. Treatment of patients with inflammation in the organs of the respiratory system is carried out purposefully, seeking to restore the patency of the bronchi, release the alveoli of the lungs from exudate, and normalize gas exchange. The principle is that all prescribed means and methods used stimulate the body's defense mechanisms, contribute to the neutralization of toxic substances, increase resistance to infection (phagocytosis, cellular and humoral immunity, enhance and normalize secretory, enzymatic, respiratory, hormonal functions.

The complex principle of therapy is based on the recognition of the materialistic doctrine of the inseparable connection of the organism with the external environment and the unity of all systems and organs. The external environment is understood as feeding, use, features of the technology of keeping animals.

It was found that the occurrence of non-communicable diseases in 70% of cases is caused by the specified environmental factors, genetic factors account for about 10% of the causes and about the same amount for unqualified 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 also 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. The complex principle of therapy does not provide for the use of any one remedy, but their use in combination with the aim of eliminating the external and internal causes of the disease, creating optimal conditions for keeping and feeding animals and using special therapeutic and prophylactic drugs.

Science and practice have proven that in the overwhelming majority of cases with massive and widespread diseases (gastrointestinal, respiratory, metabolic pathologies, etc.), high economic efficiency is achieved only simultaneously with the normalization of the zoohygienic parameters of the microclimate, the introduction of dietary products and premixes, the use of a complex of drugs etiotropic, pathogenetic, neurotrophic, replacement and symptomatic action.

The complex therapy takes into account the modern theory of neuroendocrine regulation in the body in health and disease.

Active therapy is the most important principle of modern veterinary medicine. In contrast to passive, expectant, active therapy provides for the possible early provision of medical assistance, when the clinical symptoms of the disease have not yet manifested or have just begun to appear.

Active therapy is combined with preventive therapy, especially in group treatment. In the pathogenesis of non-communicable diseases, a period of functional deviations from the normal state has been established to varying degrees and durations, although clinical signs at this time have not yet been detected. This period is conventionally called the preclinical or premorbid state (in infectious pathology, a similar state is called the incubation period). Active therapy is carried out for many metabolic diseases. At the same time, before the onset of clinical signs, the blood level of vitamins, minerals or their ratio, enzymes, hormones, reserve alkalinity, the content of ketone bodies, urea, cholesterol are determined.

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 the activity of alkaline phosphatase in the blood. With a sharp increase in the amount of glucose in the blood, the initial forms of diabetes can be established in carnivores. 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 when treating dogs, cats and ornamental birds, when the humane principle is fundamental, economic calculation always prevails when treating farm animals.

The veterinarian decides on the basis of an economic calculation in accordance with the developed and approved guidelines and recommendations to determine in each specific case the feasibility of therapy, that is, to treat the animal or discard immediately after the diagnosis is established. Practice shows that the treatment of patients with internal non-communicable diseases in the initial stage, with an acute course, is almost always economically justified. In a number of cases, for example, with progressive purulent-necrotic pneumonia, traumatic pericarditis, cirrhosis of the liver, emphysema of the lungs and other diseases with pronounced irreversible changes in the organs, the commission decides the question of culling: they are sent for slaughter after the diagnosis or after a course of treatment.

drug pharmacotherapy treatment

2. Types of drug therapy

1) Symptomatic therapy is aimed at eliminating a specific symptom of the disease, for example, the appointment of antitussives for bronchitis. Symptomatic therapy is the treatment of the manifestations of the disease (symptoms) without a targeted effect on the underlying cause and the mechanisms of its development (in the latter cases, they speak, respectively, of etiotropic or pathogenetic treatment). The goal of symptomatic therapy is to alleviate the suffering of the patient, for example, to eliminate pain with neuralgia, trauma, debilitating cough with lesions of the pleura, vomiting with myocardial infarction, etc. Often, symptomatic therapy is used in cases of emergency treatment - until an accurate diagnosis is established

It is not used as an independent method, since the elimination of any symptom is not yet an indicator of recovery or a favorable course of the disease, on the contrary, it can cause undesirable consequences after stopping treatment.

Examples of symptomatic therapy include: use of antipyretic drugs for very high fever 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 life-threatening dehydration develops; giving irritating respiratory center and heart drugs with a sharp decrease in respiratory movements and heartbeats.

Many researchers consider symptomatic therapy as a kind of pathogenetic, in some cases it can become one of the decisive factors in the recovery of animals against the background of complex treatment.

Despite the fact that the use of therapeutic agents and pharmacological preparations, taking into account their prevailing action in the directions, is conditional, it justifies itself in clinical veterinary practice when developing a plan for a reasonable treatment.

2) Etiotropic therapy - elimination of the cause of the disease, when medicinal substances destroy the causative agent of the disease. For example, the 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 of the 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 agents are used exclusively to suppress the primary or conditionally pathogenic microflora, thereby accelerating recovery.

The etiotropic conditionally includes:

Specific immune sera,

Toxoid,

Bacteriophages,

Anthelmintics,

Means against downy eaters,

Methods for surgical removal of foreign bodies from the mesh or pharynx.

3) Pathogenetic therapy is aimed at eliminating the mechanism of the development of the disease. For example, the use of pain relievers for trauma, 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 the development of the disease.

By eliminating or weakening pathogenetic mechanisms, pathogenetic therapy thereby contributes to the normalization of the opposite process to pathogenesis - sanogenesis (restoration of impaired self-regulation of the body), which contributes to recovery.

Purposeful action on pathogenesis is accompanied by weakening or elimination of the effect of the etiological factor. Therefore, pathogenetic therapy is closely related to etiotropic, and in practice it is used for pathology in all body systems.

Pathogenetic therapy includes:

Natural and artificial radiation (solar or ultraviolet radiation),

Water procedures,

Warming compresses,

Irritants (rubbing the skin with turpentine, mustard plasters, cupping, massage, electropuncture, electrotherapy),

Medicines that stimulate the function of organs and tissues (expectorants, laxatives, enhancing peristalsis, diuretics, increasing the secretion of the glands of the stomach and intestines, cardiac, choleretic).

Pathogenetic therapy also includes some therapeutic methods of complex action (washing of the proventriculus and stomach, enemas, puncture of the scar and book, catheterization of the bladder, bloodletting).

The veterinarian uses the listed means based on his own clinical experience, as well as guided by textbooks and reference books on pharmacology, recipes, instructions and recommendations.

4) Substitution therapy - restoration in the body of the deficiency of natural substances formed in it (hormones, enzymes, vitamins) and taking part in the regulation of physiological functions. For example, the introduction of a hormonal drug when the function of the corresponding gland is lost. Substitution therapy, without eliminating the causes of the disease, can provide vital activity for many years. So, insulin preparations do not affect the production of this hormone in the pancreas, but with constant administration of it to a patient with diabetes mellitus, they ensure the normal exchange of carbohydrates in his body.

Vitamin and mineral agents 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 they are insufficient in the body, for which they use dietary feed containing large amounts of vitamins in their natural form, and when there is a lack of vitamins in feed, vitamin preparations are used. It is most expedient from the economic point of view to use vitamins in the form of premixes or additives to compound feed; at the same time, agents that stabilize vitamins are needed (for example, diludin - a stabilizer of vitamin A). Vitamin preparations - both monovitamins and multivitamins - are used taking into account the condition of animals, including for individual treatment. Vitamins are most widely used for prophylactic purposes in poultry farming and in raising young farm animals.

Mineral components are used as group preventive therapy taking into account the provision of animals with macro- and microelements. Of particular importance in this respect are biogeochemical provinces with a deficiency of macro- and microelements in soil, fodder, and drinking water. Premixes or feed additives in the form of mineral salts: chalk, sodium chloride, phosphoride-calcium compounds, iron, iodine, cobalt, copper, zinc, manganese, etc. are most often used as means of replacement therapy for mineral deficiency.

For individual treatment from substitution therapy, homogeneous blood transfusion, parenteral administration of isotonic fluids (saline, Ringer's solution, etc.), oral administration of hydrochloric acid or natural gastric juice for hypoacid gastritis, hormonal therapy (for example, insulin for diabetes mellitus, hormones thyroid gland for goiter, prednisone or cortisone for adrenal insufficiency, pituitary hormones for ketosis).

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Anti-relapse drug therapy in the Panacea center

The Panacea Medical Center recommends that you contact your doctor or a narrow specialist for the appointment of drug therapy. Self-treatment with any medication can be dangerous immediate complications and deterioration of health in the future. In our center, drug therapy is prescribed after a preliminary examination, taking into account:

results that help to assess the potential susceptibility of the body to active substances, the level of their tolerance, the likelihood of side effects, the expected benefit from the use of a particular drug;
anamnesis of the patient: history of his illness, data on the current state of health. This information is important for the correct, safe selection of medicines;
the proposed organization of anti-relapse treatment (may affect the release form, dosage, frequency of use of the selected drugs).

We follow certain principles when prescribing medicines:

medications are used only in cases where other options for anti-relapse therapy are ineffective, and the expected benefits justify their use;
compliance with the recommended dosages, taking into account the patient's age, state of health, susceptibility to drug components;
compatibility of drugs with each other (all drugs taken by the patient are evaluated). Separately, recommendations are formed on compatibility with alcohol, certain food products, correction of the diet, lifestyle, etc .;
the minimum amount of side effects. If they may appear, the doctor must inform the patient in advance;
safety, proven effectiveness. Our medical center prescribes only drugs that have passed certification in the Russian Federation, have proven efficacy, have successfully passed tests and trials. In some cases, if it is necessary taking into account the patient's state of health, experimental means can be used (the doctor must provide the patient with full information about them).

For drug therapy to be effective, the Panacea Medical Center recommends observing the dosages prescribed by the doctor and the regimen for taking medications (daily dosage, number of doses per day, time of taking medications, etc.), as well as other recommendations related to anti-relapse treatment and

The most common and simplest method of treatment for diseases is drug therapy. The doctor will prescribe medications using different routes of administration: it is important to strictly follow the recommendations of a specialist, without trying to change the therapy regimen on your own. Medicines can be part of a complex therapy used according to indications for different options for traditional treatment of diseases.

Tablets are a simple and effective method of treatment

Drug therapy - drug forms

The most common formulation for traditional therapy is tablets. The usual and frequently used drugs are always available in the home medicine cabinet. In addition to tablets, depending on the doctor's prescriptions, drug therapy involves the use of the following dosage forms:

capsules;
dragee;
syrup;
tincture;
powders (sachets);
candles (suppositories);
solution for injections (injections);
ointment, gel or cream;
a patch on the skin;
oral liquid;
solution for douching or introduction into the rectum (microclysters);
gaseous substance for inhalation (aerosol).

It all depends on the diagnosis and method of treatment of the disease: the main goal of the therapeutic effect is the ingress of a drug into the bloodstream or a local effect on the human body. It is necessary to use the atraumatic form of administration of the dosage form to the maximum in order to minimize the risk of complications and side effects.

Routes of drug administration

For each patient, the doctor selects the optimal route of drug administration. The main ones are 3 types of therapy:

Local;
Enteral (through the intestines);
Parenteral (bypassing the gastrointestinal tract).

Each treatment option has indications and contraindications, advantages and disadvantages: the doctor knows all the nuances, pros and cons of medicinal effects, so it is necessary to follow the doctor's recommendations without trying to use alternative therapeutic methods.

Local therapy

The impact on the outer covers and nearby mucous membranes is a local treatment. In case of skin diseases, the doctor will prescribe creams, ointments, powders, pastes, and plasters. A variety of local therapy are special drugs:

vaginal suppositories;
eye drops;
nasal spray;
drops in the ears;
aerosols.

In each case, drug therapy is selected individually depending on the diagnosis and the complexity of the disease.

Enteral route

The introduction of drugs through the gastrointestinal tract involves the use of the following routes:

oral (by mouth);
rectal (suppositories in the rectum).

Oral tablets are the simplest, most affordable and effective method of therapeutic action, but one must take into account the risk of possible complications and side effects associated with the negative effect of the drug on the mucous membranes of the stomach and intestines.

Parenteral administration

The most effective option for introducing a drug into the human body is injection: during an injection, the drug quickly enters the bloodstream, bypassing the aggressive environment of the stomach. Injections can be done:

subcutaneously;
intramuscularly;
intravenously (jet or drip).

The main disadvantage of the technique is that invasive exposure requires certain conditions, experience and knowledge from the person who performs the injection, so it is advisable to give injections only in a hospital setting.

Injections must be done in a hospital setting

Drug treatment options

Treatment for each disease is selected individually. The following pharmacotherapy methods are distinguished:

antimicrobial (drugs to get rid of the infection);
anti-inflammatory (fight against the inflammatory process);
hormone therapy (correction of endocrine imbalance);
chemotherapy (suppression of metastatic foci);
(targeted impact on certain mechanisms and causes of the formation of the disease);
immunotherapy (correction of immunity);
enzyme therapy (the use of special enzyme preparations);
vitamin therapy (replenishment of the deficiency of vitamins and minerals important for life);
symptomatic (elimination of unpleasant and dangerous symptoms).

Almost always, drug therapy is combined - the doctor will prescribe various drugs to influence different factors of the disease.

Dosage of medicines

The medicine can become poison if the dosage is incorrect - exceeding the dose several times, you can harm your own body. If the amount of the drug is insufficient, the effect of treatment will be low (or there will be no effect). It is important to strictly follow the recommendations of a specialist, carefully taking the medicine in the right dosage.

Side effects of therapy

Each person is individual, so the reaction to a drug will not always be typically positive. There are 3 types of side effects:

Allergic;
Toxic;
Medicinal.

Allergies can occur to absolutely any drug form. Poisoning is more common with an overdose. Typical adverse reactions due to the pharmacological action of the drug include:

vascular reactions with a drop in blood pressure (headache, dizziness, weakness, fainting, vomiting, tachycardia);
dyspepsia (nausea, heartburn, belching, vomiting, diarrhea);
shortness of breath, cough.

Taking medication is a strong and pronounced effect on the body: you do not need to take drugs lightly, taking antibiotics or hormones orally with or without need. Drug therapy is a method that a doctor uses in the fight against a disease: pharmacotherapy can be started only after examination and finding out the cause of the disease, be sure to follow the specialist's prescriptions regarding the dosage and combination of drugs.