Microcalorimetric investigation of amylopectin branching and the content of amylose in potato starches

Hydroxyethylated starches are of particular interest for applications in infusion therapy because of their high volemic effect. The duration of this effect depends on the circulation time of the drug in the blood, i.e., the volume of circulating blood increases with an increase in the concentration, molecular weight and degree of polymer substitution. It is known that hydroxyethylated starches have a wide range of molecular weight and degree of substitution. This allows their solutions to circulate for a long time (up to 10 hours) in the bloodstream without leakage of the active substance into the interstitium of vital organs. The dependence of the melting point of the crystalline starch lamella on the number of glucose residues can be described using the modified Fox - Loshaek ratio, which takes into account the degree of branching of amylopectin molecules and the content of amylose in starch. We proposed an analytical expression for the evaluation of the degree of branching of amylopectin from potato starch based on microcalorimetric data. The proposed methodology allows the genotypes of potatoes with the highest degree of amylopectin branching and a minimum quantity of amylose in starch to be selected. Starches of such potato varieties can be used in the blood plasma substitutes production - hydroxyethylated starches that have good pharmacodynamic properties. Within the developed approach, it is possible to determine the effect of the degree of substitution on the thermodynamic properties of the studied starches through a change in the melting temperature of the lamella, Tm, hence estimating the main pharmacodynamic parameters of substituted starches.

Infusion therapy in the internal diseases’ propaedeutics

Background. Infusion therapy (IT) is one of the main methods of drug therapy optimization. The essence of IT is to correct homeostasis disorders in order to detoxify, to restore the disrupted microcirculation and tissue perfusion, to eliminate the disorders of rheological and coagulation blood properties, to eliminate metabolic disorders, to improve drug delivery to the pathological focus, to restore circulating blood volume, to normalize fluid and electrolyte and acid-base balance. Objective. To describe modern IT. Materials and methods. Analysis of the literature sources on this topic. Results and discussion. Requirements for modern plasma substitutes include safety, sufficient and long-lasting volemic effect, rapid renal excretion, lack of accumulation and effect on the coagulation system, maximum similarity to blood plasma, and availability. There are several classes of plasma substitutes, and each of them has its own indications. For example, crystalloids are prescribed for dehydration, and colloids – for hypovolemia. The infusion volume is calculated based on the physiological needs of the organism, taking into account pathological fluid loss (fever, shortness of breath, postoperative wound drainage, vomiting, polyuria). Endogenous intoxication (EI) – a pathological condition that occurs as a result of exposure to toxic substances of exogenous or endogenous nature, which cause dysfunction and the development of extreme conditions – is an important field of IT application. EI can accompany chronic heart failure, peripheral vessels atherosclerosis, autoimmune and allergic diseases. Toxins have a direct (direct destruction of proteins and lipids, blocking of synthetic and oxidative processes in the cell) and indirect (microcirculation system and vascular tone disorders, changes of blood rheological properties) adverse effects. Clinical manifestations of EI include fever, malaise, and the dysfunction of various internal organs. As EI depletes the natural mechanisms of detoxification, worsens the clinical course of the disease, reduces drug sensitivity, suppresses immunity, it is an indication to detoxification via infusion. The tasks of the latter are to improve tissue perfusion, to provide hemodilution with a decrease in the toxins’ concentration, to stimulate diuresis, to eliminate acidosis, and to maintain the functional state of hepatocytes. For this purpose, solutions of polyatomic alcohols (Reosorbilact, Xylate, “Yuria-Pharm”) can be used. Reosorbilact increases the circulating blood volume, improves microcirculation and rheological blood properties, increases tissue perfusion, promotes “wash-out” of toxins, corrects acidosis and fluid and electrolyte balance, normalizes hepatocyte function, improving the own detoxification mechanisms. In case of microcirculation disturbances, it is reasonable to use the combined IT with the inclusion of Reosorbilact, Latren and Tivortin (“Yuria-Pharm”). Latren increases the elasticity of erythrocytes, reduces the aggregation of erythrocytes and platelets, normalizes the electrolyte composition of blood plasma, and Tivortin acts as a substrate for the formation of nitric oxide – the main signaling molecule of the endothelium. In addition to EI, IT usage is often prescribed for diabetic ketoacidosis. In such cases, it is advisable to use Xylate (“Yuria-Pharm”), which has antiketogenic properties, improves hemodynamics, corrects acidosis, and does not increase blood glucose levels. Xylate is recommended to be used only after preliminary rehydration with the help of isotonic saline solutions. Conclusions. 1. IT is an important method of treating a number of diseases. 2. EI accompanies not only diseases that involve intoxication syndrome, but also almost all internal diseases. 3. Reosorbilact and Xylate are the optimal solutions for detoxification. 4. It is reasonable to use combined IT, for example, the combination of Reosorbilact with Latren and Tivortin.

Plasma replacement solutions in the intensive care unit of shock for acute spontaneous canine babesiosis

The article presents the results of studies on the study of secondary processes that develop during acute spontaneous babesiosis in dogs, as well as on the use of infusion therapy with plasma substitutes for the development of shock as a complication of the underlying disease. It is shown that acute blood parasitic disease is accompanied by the development of moderate subcompensated shock, which determines the state of unstable equilibrium and the tendency to avalanche-like disorders due to the transition of the process to the decompensated phase. The basis for the diagnosis of the shock state was the establishment of the following hemodynamic and hemorheological changes: hypovolemia with a decrease of all blood components (shaped elements and plasma components) in the circulation, a significant decrease in the specific volume of circulating blood, hematocrit value, a significant increase in spontaneous aggregation of shaped blood elements (platelets and red blood cells), hypotension, an increase in the Alghöver shock index by almost 2 times. There was a significant deficit in the volume of circulating blood (the degree of blood loss), which was about 30 %. It is shown that the presence of a state of shock in the subcompensation stage poses a threat to the life of the animal in the event of transition to the terminal stage. In order to stop the development of shock, infusion therapy was used with the most common plasma–substituting solutions – Rheopolyglucin and Rheosorbylact at a dose of 5 ml/kg of body weight intravenously drip per day for 3 days. A comparative assessment of the effect of drugs on the correction of major hemodynamic and hemorheological shifts was carried out. It was found that Rheopolyglucin as a colloidal plasma substitute has a better effect on the normalization of hemodynamic disorders – hypovolemia and hypotension, and Rheosorbylact as a crystalloid plasma substitute turned out to be the best disaggregant and reducing agent of hemorheological disorders. Both drugs provided a complete recovery of hemodynamic and hemorheological parameters in 72 hours. As a result, it is recommended to use a combination of drugs with the priority of Rheopolyglucin in the first hours of treatment and combine it with an infusion of Rheosorbylact in subsequent days.

Gas Transport Characteristics of Hemocorrectors and Perfusates Based on Perfluorocarbon Blood-Substituting Emulsions

This review summarizes the data regarding the gas transport characteristics of hemocorrection and perfusates on the basis of low concentrated drugs nano-sized perfluorocarbonic 20% Perftoran (a blood substitute, it is allowed for clinical use in Russia), 20% Ftoremulsion III (an improved blood substitute, registered in Russia), 10-20% Perfusol (a perfusion solution for perfusion of the isolated heart), 20% Ftorem (a cardioplegic emulsion for surgeries on the stopped heart) used in the biomedical field. The compensation of blood loss using traditional plasma substitutes without the gas transport function or with low gas transport characteristics leads to a decrease in the oxygen capacity of the resulting mixture and subsequently to deterioration in the oxygen transport characteristics of blood. The synthetic gas-transport blood substitutes can be used in the treatment of various forms of ischemia, such as carbon monoxide poisoning. Furthermore, recent results regarding the mechanism of COVID19 infection indicate a possible use of the synthetic gas-transport blood substitutes in the treatment and therapy of COVID19 infected patients.

P

This chapter presents information on neonatal drugs that begin with P, including use, pharmacology, adverse effects, fetal and infant implications of maternal treatment, treatment, and supply of Palivizumab, Pamidronate disodium, Pancreatin, Pancuronium, Paracetamol = Acetaminophen (USAN), Parenteral nutrition, Penicillin (Penicillin G; Benzylpenicillin), Pethidine = Meperidine (USAN), Phenobarbital = Phenobarbitone (former BAN), Phenytoin, Phosphate, Piperacillin with tazobactam (piperacillin-tazobactam), Plasma albumin (human albumin solution), Plasma substitutes, Platelets, Pneumococcal vaccines, Polio vaccines, Polystyrene sulfonate resins, Potassium chloride, Praziquantel, Prednisolone, Probiotics, Progesterone, Proguanil (with or without atovaquone), Propofol, Propranolol, Prostaglandins E1 (alprostadil) and E2 (dinoprostone), Pyrazinamide, Pyridoxine (vitamin B6) and pyridoxal phosphate, and Pyrimethamine

A COMPARATIVE ANALYSIS OF THE ASSORTMENT OF DIFFERENT MEDICATION GROUPS USED IN THE CENTRAL REGIONAL HOSPITAL OF THE MUNICIPAL REGION AND THE REGIONAL HOSPITAL OF THE FEDERAL STATE-OPERATED HEALTHCARE AGENCY “MEDICAL AND SANITARY CENTER-23” (FKUZ MSCH-23) OF THE FEDERAL PENITENTIARY SERVICE (FSIN) OF RUSSIA

Providing quality pharmaceutical care is a key task of healthcare; any medical organization must respond efficiently to a change in both external and internal factors that affect the medical support of patients. The aim of this study was to analyze the structure of medication consumption in comparable hospitals in the penitentiary and civilian healthcare systems. Materials and methods. The study was conducted on the basis of content analysis, documentary observation, ABC analysis, and comparison of performance indicators of medical organizations. Results and discussion. This study analyzed the assortment of commodity stocks of medications in the regional clinical hospital that is a part of the structure of FSIN and a typical central regional hospital (CRH). Using ABC analysis it was established that the Group A (the most costly) medications in the penitentiary medical organization consisted exclusively of anti-viraldrugs used for treating HIV-infected patients, which is 54.91% of the stock that are represented by 18 international non-proprietary medication names. In turn, Group A of the medication assortment of the State Budgetary Healthcare Organization of the Republic of Adygea (GBUZ RA) “Krasnogvardeiskaia CRH” consists of three pharmacological groups – plasma substitutes, cardiovascular medications, and antibiotics. On the basis of the obtained data, the study identified different groups of medications and studied their assortment based on international non-proprietary namesand medication forms that received preference either in the branch of Clinical Hospital-2 (KB-2) FKUZ MSCh-23 FSIN of Russia or GBUZ RA “Krasnogvardeiskaia CRH” (38 ATC groups in all). The first group consists of medications from the following 12 ATC groups (31.6%), the assortment of which can be found exclusively in the branch of “KB-2” FKUZ MSCh-23 of the Federal Penitentiary Service of Russia: antiretroviral, muscle relaxants, anticonvulsants, adaptogens, antidepressants) or significantly exceeds similar stocks in GBUZ RA “Krasnogvardeiskaia CRH”: anti-asthmatic agents (3 times), anti-fungal drugs (3 times), hormones except for insulin (2.2 times), respiratory regulators (2 times), non-steroidal anti-inflammatory drugs (1.7 times), medications regulating the gastrointestinal function (1.5 times), and antibacterial agents (1.4 times). The second group consists of medications of the following 9 ATC groups (23.7%) that are stocked only by GBUZ RA “Krasnogvardeiskaia CRH”: antifermental drugs, radiocontrast agents, chondroprotective and antiparasitic medications, and -- within a wider diapason of non-proprietary drugs and forms of manufacture – diuretics (5 times), antitubercular (3 times), antiviral with the exception of anti-HIV (2 times), spasmolytics (2 times), and hypertension drugs (1.5 times). It was determined that the main medical activity of medical organizations subordinate to FSIN of Russia, is aimed at treatment and prevention of complications of the most socially dangerous diseases – HIV/AIDS and tuberculosis – as well as therapy of the associated diseases. It was shown that pharmacists do not use methods of pharmacological-economic analysis in their work, and the medication needs of medical organizations are only 20% satisfied. Conclusion. The identified shortcomings attest to the need to develop and implement a more effective system for the formation of stockpiles in the pharmacies of the penitentiarymedical organization.