Role of zoledronic acid in treatment of osteoporosis and prevention of fractures

Introduction. One of the causes of primary disability and high mortality, among patients with osteoporosis, are fractures that occur with minimal trauma, as a rule, it is a fall from the height of one’s own height. The final link in the chain of preventive measures to reduce the frequency of osteoporosis and fractures on its background is the introduction of pharmacological correction of bone deficiency into the practical activity of an orthopedic traumatologist. Currently, there are several drugs that can change the disturbed metabolism. For example, the use of zoledronic acid significantly reduces the risk of fractures.Aim: to study the effect of zoledronic acid on bone mineral density in patients with osteoporosis complicated by a fracture of proximal end of the femur.Materials and methods. In a prospective cohort study, 14 patients received zoledronic acid for 2 years.Results. When comparing BMD L2-L4, it was revealed that a year after the start of treatment, its increase relative to the baseline value was 4.6%, but was statistically insignificant (0.86 ± 0.078 g/cm2 versus 0.90 ± 0.08 g/cm2, p > 0.05). After 2 years of treatment, the BMD of this segment increased, relative to the baseline values, by 12% and the differences became statistically significant (0.86 ± 0.078 g/cm2 compared to 0.97 ± 0.076 g/cm2, p < 0.05). The increase in BMD for the second year of treatment by 6% was statistically significantly different from the increase for the first year of treatment (0.90 ± 0.08 g/cm2 compared to 0.97 ± 0.076 g/cm2, p < 0.05).A comparative analysis of the basic units of the IPC hip after 1 and 2 years of treatment did not reveal significant differences: 0.7075 ± 0.046 g/cm2 compared to 0.7079 ± 0.034 g/cm2 and 0.70751 ± 0.046 g/cm2 compared to 0.6630 ± 0.97 g/cm2, p > 0.05. In any case, for 2 years not marked new vertebral body fractures. Only one patient had a fracture of the radius in the distal third. The quality of life, after 2 years, significantly improved on the scale of “habitual daily activities” (p = 0.007), decreased indicators on the scale of “anxiety” and “depression” (p > 0.05).Discussion. The study confirmed that even in the presence of pronounced bone loss, pharmacological correction of impaired remodeling reduces the risk of new fractures and improves the quality of life.Conclusion. Pharmacotherapy with zoledronic acid, in our study, confirmed its effectiveness in the treatment of osteoporosis.

Trazodone succinate — new opportunities for pharmacological correction of situational behavioral abnormalities in dogs and cats

Currently, the interest of veterinarians and owners in the pharmacological correction of situational behavioral disorders in companion animals has increased significantly. To quickly correct deviant behavior in dogs and cats, veterinarians use some of the psychotropic drugs used in humane medicine, in particular, trazodone, an antidepressant antagonist / serotonin reuptake inhibitor. Based on the analysis of literature sources, data on the history of creation and pharmacological properties, assessment of the safety and efficacy of drugs based on trazodone hydrochloride in behavioral medicine of small pets are provided. The data on the prerequisites for the development, pharmaco-toxicological and clinical evaluation of a new drug for the modification of abnormal behavior in dogs and cats, Express Uspokoin® tablets based on trazodone succinate, which, with a high efficiency of the target action, made it possible to achieve the absence of side effects and significantly increase the tolerance of the dosage form by animals, are analyzed. compared with preparations based on trazodone hydrochloride.

PERSONALIZED PHARMACOLOGICAL CORRECTION OF IMMUNE SYSTEMS, METABOLIC AND NEUROPSYCHIC PARAMETERS IN CHRONIC BRAIN ISCHEMIA OF STAGE I AND II ON THE BACKGROUND OF HYPERTENSION DISEASE

The study aimed to develop a personalized pharmacological correction of immune, metabolic and neuropsychiatric disorders in chronic cerebral ischemia (CCI) stages I and II. The study included 104 patients, of which 76 were female and 28 were male, with CCI on the background of grade II hypertension, of which 52 patients were with stage I and 52 with stage II at the age of 50±5 years. Clinical and laboratory parameters were studied in 22 healthy donors of the same age who formed a control group. Patients with CCI were randomized according to gender, age, treatment method, concomitant pathology, and duration of the disease. Evaluation of clinical and laboratory data was carried out at the beginning of treatment and 2 weeks after its end. The sorption capacity of erythrocytes and the sorption capacity of the glycocalyx (SEG), the activity of lipid peroxidation processes, the state of the antioxidant system were determined in blood plasma and erythrocytes, the level of stable metabolites of nitric oxide (SMNO), neopterin, C-reactive protein, cytokines (TNFα, IL-1β, IL-8, IFNγ, IL-18, G-CSF, IL-4, IL-10), immunoglobulins (IgM, IgG, IgA), complement system components (C3, C4, C5, C5A), phagocytic and oxygen-dependent activity of polymorphonuclear blood leukocytes. It has been established that for patients with CCI I with high concentrations of IL-8, IL-10, SMNO and a low SEG index, the intake of Cereton and Actovegin or Ceraxon and Mexicor will be insufficient for effective correction of immunometabolic disorders, which requires additional administration of an immunomodulator. Patients with CCI II, who have a higher plasma level of TNFα, IL-10 and low SEG values, need to prescribe Ceraxon, Mexicor and Glutoxim or Ceraxon, Mexicor and Polyoxidonium in order to obtain the maximum clinical and laboratory positive effect.

Effect of early and late pharmacological correction with GABA derivatives on cognitive disorders in offspring of rats with experimental preeclampsia

BACKGROUND: Preeclampsia is a serious complication of pregnancy which augments the risk of cognitive disorders in the offspring at different stages of life. Presently, there are no methods with proven effectiveness for correction of post-hypoxic disorders in children of mothers with preeclampsia. AIM: To assess the cognitive functions of the offspring of rats with experimental preeclampsia (EP) through early (40th to 70th day of life) and late (24th to 25th month of life) pharmacological correction with gamma aminobutyric acid (GABA) derivatives: Succicard, Salifen, Phenibut, and the drug of comparisonPantogam. MATERIALS AND METHODS: EP was modeled by replacing drinking water with 1.8% sodium chloride solution in rats from the first day of pregnancy to delivery. In the offspring, short-term and long-term memory was studied at the age of 34, 1819, and 2526 months in the Novel object recognition test and Barnes Maze test. The functioning of the GABAergic and dopaminergic systems (which play an essential role in the development of memory) was evaluated by cases of convulsions after administering corazol at a dose of 20 mg/kg intraperitoneally (model of corazol kindling) and by haloperidol-induced catalepsy (haloperidol at a dose of 0.3 mg/kg intraperitoneally), respectively. RESULTS: Early and late pharmacological correction with GABA derivativessuccicard, Salifen, Phenibut, and comparison drug, Pantogamneutralized the negative effect of EP on the function of GABAergic and dopaminergic systems in the offspring of the experimental groups. Therapy with Succicard in puberty and long-term periods of life contributed to the improvement of short-term and long-term memory in the offspring of rats with EP. Thus, it could be reasonable enough to develop a drug against cognitive disorders in children of mothers with preeclampsia. CONCLUSION: In the offspring of rats with EP, short-term and long-term disorders of memory in the functioning of the GABAergic and dopaminergic systems were noted in the early and late stages of the individual development. Pharmacological correction with GABA derivatives improves cognitive processes and the functioning of neurotransmitter systems in the offspring of rats with complicated pregnancy. The highest effectiveness was demonstrated by succicard, and was comparable with or superior to the Pantogam (standard drug).

Modern facilities of pharmacological correction of hyperuricemia in rheumatic diseases: management of difficult clinical cases

The article presents clinical cases of management of patients with low compliance with treatment, suffering from rheumatic diseases and disorders of purine metabolism.Cases report 1. The first patient with advanced gout, after taking 100 mg of allopurinol, developed undesirable effects: sore throat, change in voice, cough, and therefore treatment was discontinued. After six months without therapy, the condition worsened and, in self-medication, the patient resumed taking allopurinol at a dose of 300 mg per day, which, as expected, resulted in a resumption of the allergic reaction and a serious exacerbation of gouty arthritis. In order to stop continuous relapses of arthritis, it became necessary to prescribe glucocorticoids. After stabilization of the state, constant administration of febucostat with positive clinical and laboratory dynamics was recommended.Cases report 2. The second patient with rheumatoid arthritis (RA) developed analgesic nephropathy, secondary hyperuricemia, and typical gouty attacks in the background of high activity of the underlying disease, existing kidney pathology and inappropriate use of non-steroidal anti-inflammatory drugs (NSAIDs). Frequent exacerbations of arthritis prompted the patient to finally see a rheumatologist. The adjusted therapy made it possible to reduce RA activity, reach the recommended level of uric acid, and reduce the drug load on the kidneys with almost complete withdrawal of NSAIDs. Thus, in modern conditions, rheumatologists have in reserve all the necessary means for the pharmacological correction of hyperuricemia, even in difficult clinical cases. Febucostat is the drug of choice for correcting uric acid levels in case of intolerance to allopurinol, as well as in the development of secondary gout against the background of renal failure. In addition, it should be noted that the effectiveness of the treatment of rheumatic diseases largely depends on the patient’s compliance. To increase adherence to therapy, regular patient schools are recommended.