Осмотическая Активность И Безопасность Инъекционных Форм Нестероидных Противовоспалительных Препаратов

Urakov, Aleksandr; Уракова, Наталия Александровна; Ловцова, Л. В.; Sorokina, Yulia; Занозина, О. В.

doi:10.30906/0869-2092-2018-81-10-15-19

Cited by 4 publications

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“…Помимо этого показано, что неспецифическая фармакологическая активность лекарств в лекарственной форме «раствор для инъекций» может иметь очень большое значение для проявления их местных раздражающих свойств [14][15][16][17][18][19]. Установлено, что наиболее существенно увеличивают физикохимическую агрессивность лекарств при инъекциях высокая концентрация ингредиентов, растворенных в растворе лекарственного средства, чрезмерно высокая кислотная (основная) и осмотическая активность [23][24][25]. При этом значения концентраций растворенных ингредиентов и показатели кислотной (основная) активности растворов для инъекций включены в перечень контролируемых показателей качества лекарств, а значения осмотической активности не включены в современный стандарт качества лекарств ни в одной стране мира [26].…”

Section: Introductionunclassified

“…Установлено, что именно отсутствие изотонической активности у современных растворов для инъекций, а также неизвестность их истинной осмотической активности лежит в основе непредсказуемости местного раздражающего и прижигающего действия лекарств. Отсутствие понимания природы возникновения осложнений до сих пугает медицинских работников и пациентов вероятностью развития постинъекционных воспалений, некрозов и абсцессов [19,24,25].…”

Section: Introductionunclassified

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Medicines in pharmaceutical form “solution for injection” and the injection of drugs: advantages and limitations

Urakov

Ливиевич²

2019

Rev Clin Pharm Drug Ther

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The literature review shows that today any substance, and hence any drug, can be in such physical states as solid, liquid, gas and plasma. The classification of pharmaceutical forms of drugs, from which it follows that presently the drugs are produced in solid, liquid, soft and gaseous “dosage forms”. It is shown that the modern quality standards of drugs do not guarantee the presence of a single aggregate physical properties of all drugs produced in the same dosage forms. It is established that modern quality standards of drugs allow the production of drugs in the same pharmaceutical forms, but with different concentrations of all ingredients and with different physical and chemical properties. The ranges of concentration values of the dissolved ingredients and indicators of acid (alkaline) and osmotic activity of high-quality drugs from different pharmacological groups produced by different pharmaceutical companies in the form of “Solutions for injection” are given. From the above examples, it follows that at present qualitative “Solutions for injections” have an acidity value in the range of pH 2-12 and an osmotic activity value in the range of 0-3900 mOsmol/l of water. In addition to this, it is shown that modern drugs prepared in the pharmaceutical form “Solutions for injection” and considered to be of high quality, have a concentration of dissolved ingredients in the range of 0.01-100 %. Therefore, almost all modern medicines produced in the dosage form “Solutions for injection” have different mechanical, physical, chemical and/or physico-chemical properties that can change their pharmacological activity. Examples are given of how different concentrations of ingredients and osmotic activity of certain drugs in the dosage form “Solutions for injections” affect the severity of their local action on tissues in the range from short-term inflammation of tissues to their necrosis. It is proved that modern “solutions for injections” do not guarantee the safety of local interaction with viable tissues of the human body. The technologies of improving the safety of injection of modern “Solutions for injection” and technology to prevent tissue necrosis with “wrong” injections of drugs (by accident, ignorance, ignorance, mistake) are listed.

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Section: Introductionunclassified

Medicines in pharmaceutical form “solution for injection” and the injection of drugs: advantages and limitations

Urakov

Ливиевич²

2019

Rev Clin Pharm Drug Ther

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Temperature, osmotic and acidic activity of infusion solutions as an integral part of their mechanism of action

Уракова

Александровна²

2021

Rev Clin Pharm Drug Ther

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A review of the literature shows that the physical-chemical properties of infusion solutions can be an integral part of the mechanism of their local action on the routes of administration. This new scientific and practical direction in clinical pharmacology was born at the end of the 20th century in Russia. Initially, it was found that isotonic solutions of glucose, mannitol, and sodium chloride with different temperatures have different local effects on the metabolism and viability of isolated biological objects such as mitochondria and blood plasma. At the same time, it was shown that increasing the temperature of solutions from +37 to +45C accelerates the metabolism of these biological objects, increases their reactivity and enhances their response to the action of many drugs-activators of metabolism and function. And vice versa, lowering the temperature of these solutions from +37 to +20C and below (up to 0C) slows down their metabolism, reduces their reactivity, weakens their response to the action of drugs-activators of metabolism and function, and also increases survival in conditions of ischemia and hypoxia. These results allowed us to recommend warm infusion solutions as universal means of activating aerobic metabolism in tissues and the response of tissues to drugs with local physical-chemical action, and cold infusion solutions as universal means of inhibiting aerobic metabolism in tissues and increasing the resistance of tissues to the action of drugs on them. Following this, it was shown that many infusion solutions do not have isoosmotic activity, since the osmotic activity of drugs is not controlled. Therefore, one part of the solutions has hypotonic activity, and the other part has hypertonic activity. Therefore, sometimes the infusion solution can increase the hypoosmotic or hyperosmotic activity of the blood plasma. Then it was shown that the absolute majority of infusion solutions do not have a pH of 7.4. At the same time, very many infusion solutions have acidic activity, so they have an acidifying effect on the blood. The chronology of the development of inventions based on the achievements of the physical-chemical pharmacology of infusion agents is shown.

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Embolization of the Renal Artery in Combined Treatment of Stage IV Kidney Cancer

Ганцев

IuN

Zhumagulova³

et al. 2020

Kreativnaâ hirurgiâ i onkologiâ

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Introduction. Kidney cancer remains an urgent problem in modern oncology. More than 200 thousand new cases of kidney cancer are diagnosed globally every year, with about 100 thousand patients dying. 15–17% of patients are diagnosed with stage IV kidney cancer. Arterial tumour embolization and nephrectomy are used as a palliative treatment.Aim. To evaluate the results of renal artery embolization in combined treatment of stage IV kidney cancer.Material and methods. The treatment results of 22 patients with stage IV kidney cancer are presented: 6 patients had metastases in the skeletal bones; 15 — metastases in the lungs; 1 — bilateral kidney damage. At the first stage, all patients underwent renal artery embolization. Subsequently, 6 patients received bisphosphonates and radiation therapy for metastases in the skeletal bones, 15 patients underwent operation followed by a targeted therapy with Sunitinib and Sorafenib), 1 patient with bilateral kidney damage underwent operation followed by a 2-year targeted therapy with Sorafenib.Results and discussion. Renal artery embolization was performed successfully without technical difficulties in all the patients. After embolization, hemostasis was achieved in all patients with hematuria (n = 14). Postembolization syndrome was noted in 13 patients with total renal artery embolization. 6 patients with metastases in the skeletal bones lived for 16.4 ± 2.1 months, the survival time of 15 patients who received renal artery embolization, nephrectomy and targeted therapy was 41.7 ± 15.3 months. Only one patient (bilateral kidney damage) has been under dynamic observation for the period of 10 years.Conclusion. Renal artery embolization is an effective and minimally invasive technical procedure that should be used in the combined treatment of patients with kidney cancer. The combined use of renal artery embolization and subsequent targeted therapy for kidney cancer provide new opportunities for stage IV combined treatment.

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Осмотическая Активность И Безопасность Инъекционных Форм Нестероидных Противовоспалительных Препаратов

Cited by 4 publications

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Medicines in pharmaceutical form “solution for injection” and the injection of drugs: advantages and limitations

Medicines in pharmaceutical form “solution for injection” and the injection of drugs: advantages and limitations

Temperature, osmotic and acidic activity of infusion solutions as an integral part of their mechanism of action

Embolization of the Renal Artery in Combined Treatment of Stage IV Kidney Cancer

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