[CLINICAL CASE OF ACUTE SEVERE COMBINED POISONING WITH NARCOTIC SUBSTANCES OF DEPENDENT AND PSYCHOSTIMULATING EFFECTS].

A case of acute severe concomitant poisoning with narcotic substances of depreciating and psychostimulating action (1,4 - butanediol, 1-phenyl-2- (1-pyrrolidinyl) -1-pentanone, methadone) complicated by the development of severe hypoxic-ischemic changes in the supratentorial white matter of the large brain is presented. edema and swelling of the brain, nosocomial focal left-sided lower lobe pneumonia in a 25-year-old patient. Psychoactive substances were used for hedonic purposes. Acute poisoning occurred after taking 100 ml of 1,4-butanediol together with phenyl-2- (1-pyrrolidinyl) -1-pentanone and 2 g of methadone, clinically manifested in the form of convulsive syndrome, depression of consciousness to the level of coma 3, edema and swelling brain, acute respiratory failure, mixed decompensated respiratory and metabolic lactic acidosis (pH 7.193; partial pressure of carbon dioxide 62.3 mm Hg, lactate 7.4 mmol / l) and complications in the form of nosocomial focal left-sided lower lobe pneumonia. Intensive therapy was of a complex nature, including infusion-detoxification therapy, correction of acid-base state disorders, hypoxic disorders, by using the substrate antihypoxant "Cytoflavin" in a daily dosage of 60 ml, for 15 days, against the background of basic infusion therapy and vasopressor support ... The clinical picture of acute poisoning, the features of its course, the data of radiological diagnostics and the effectiveness of pathogenetic approaches to intensive therapy are presented.

[[Features of Pharmacological Correction of Alcoholic Fatty Liver Disease in Patients with Acute Ethanol Intoxication].]

The aim of the study was to increase the efficiency of the treatment of acute ethanol intoxication in patients with alcoholic fatty liver disease. The article presents the results which received during the investigation and treatment of 166 patients with acute ethanol in- toxication on the background of alcoholic fatty liver disease Patients were assessed by the severity scale APACHE-Il. Were studied the dynamics of clinical, laboratory, biochemical parameters, the state of the antioxidant system activity and lipid peroxidation. The study found the effect of the combination hepatoprotective drug remaxol on the many links of metabolism, which was confirmed by the dynamics of biochemical parameters. There was a quick correction of hyperlactatemia, an effective reduction of ALT activity, the absence of reduction of albumin and urea concentration in the somatic period of ethanol poisoning. Period of using remaxol there was improvement in the clinical course of the disease, which manifested by the reduce the incidence of delirium tremens and shorten the duration of treatment of patients.

[The use of reamberin in combined intensive care of acute poisoning].

This review is focused on the substrate antihypoxant reamberin used in intensive therapy of acute poisoning with special reference to the mechanisms of its action consisting in the reduction of the severity of metabolic disorders manifested as a decrease of tissue hypoxia, recovery of antioxidant defense and suppression of the activity of lipid peroxidation and endotoxicosis. The antihyhypoxant activity of reamberin is apparent as the reduction of the hypoxic brain lesions in patients with acute poisoning which leads to a significant improvement in the clinical course of acute poisoning and decreases the number of adverse outcomes.

[Metabolic disturbances and ways of their pharmacological correction in acute poisoning with ethanol in patients with chronic alcoholism]. / Metabolicheskie narusheniia u bol'nykh s ostrymi otravleniiami étanolom na fone khronicheskogo alkogolizma i puti ikh farmakologicheskoi korrektsii.

AIM: To study an influence of chronic alcoholism on the clinical course and severity of metabolic disturbances in patients with acute poisoning with ethanol and to improve the treatment. MATERIAL AND METHODS: Authors examined 93 patients stratified into three groups (acute poisoning with ethanol in patients with chronic alcoholism, without chronic alcoholism and those treated with reamberin). RESULTS AND CONCLUSION: The presence of chronic alcoholism significantly augmented metabolic disturbances and influenced the disturbance of oxygen-transport function and free-radical processes in patients with acute intoxication with ethanol. Using of reamberin in the complex intensive therapy led to the decrease in metabolic disorders, which improved the clinical course of acute poisoning with ethanol in patients with chronic alcoholism.

[A case of favourable outcome of severe acute intoxication with an animal poison after a bite by the monocled cobra].

This paper reports a case of severe acute intoxication with an animal poison after a bite by the monocled cobra. Combined treatment including artificial lung ventilation, infusion-detoxication and desensitizing (hormonal) therapy, hemosorption, correction of metabolic disorders with cytoflavin, antibacterial therapy had positive effect on the patient's condition and ensured the favourable outcome ofpotentially lethal poisoning without the use ofa specific anti-snake venom serum.

[Features of clinical way and treatment of old and senile patients with severe poisoning with carbon monoxide and the products of combustion].

The article presents the materials obtained in the course of treatment of 64 patients with severe poisoning with carbon monoxide and the products of combustion. It is established that acute carbon monoxide poisoning and combustion products in elderly and senile age is accompanied by more pronounced metabolic disorders, higher frequency of complications and lethality. Intensive therapy of severe poisoning with carbon monoxide has its own peculiarities. The use of Cytoflavin with antihypoxic purpose can lead to the development of metabolic desynchronization. To correct the hypoxic disorders in elderly and senile patients is more appropriate to use Reamberine, not having a negative effect on the indices of central hemodynamics and effectively reducing the depth of metabolic disorders.

[Pharmacologic correction of hypoxia in patients with acute cerebral failure due to acute poisoning with carbon monoxide and combustion products].

The article deals with the materials, which have been received in the process of the examination and treatment of 48 patients with acute severe carbon monoxide and burning products poisonings on fires. It has been registered that the including of citoflavin into the complex program of the intensive therapy of acute severe carbon monoxide and burning products poisonings on fires leads to a decrease of hypoxia and manifestations of acute toxicohypoxic cerebral deficiency, which significantly improves the clinics of acute severe poisonings.

[Pharmacological correction of hypoxia in patients with severe carbon monoxide poisoning].

The article deals with the materials, which have been received in the process of the examination and treatment of 44 patients with acute severe methadone poisonings. It has been revealed, that gravity of these patients' condition depends on the intensity of hypoxia due to breath deficiency because of methadone. The development of hypoxia, in its turn, causes violations of antiradical protection system and intensification of processes of peroxide lipid oxidation. It has been registered that the including of reamberin into the complex program of the intensive therapy of acute severe methadone poisonings leads to a more rapid restoration of antiradical protection system and to a decrease of activity of processes of peroxide lipid oxidation. The correction of hypoxia and free-radical violations led to the improvement of the acute poisonings clinics, what was characterized by a decrease of coma-period duration, duration of treatment with artificial lung ventilation, a decrease of secondary lung complications and a decrease of lethality.

[Comparative evaluation of clinical efficacy of drugs remaxol and ademetionine in patients with acute ethanol poisoning complicated by the toxic damage of the liver].

As a result of survey in process of treatment of 100 patients with severe acute poisoning of ethanol on the background of the toxic damage of the liver set that the severity of poisoning depends on the duration abuse of alcohol (Binge drinking). Inclusion in the intensive care infusion hepatoprotector remaxol compared with ademetionine leads to a faster dynamics of improvement of the patients condition, evaluated by the scale assessing the severity APACHE II. Also found, Use of remaxol can reduce development of complications such is alcoholic delirium on the background of long-term abuse of alcohol in percentage from 31.9% to 16%, as well as reduces the time of stay of patients in the departments of the resuscitation and intensive care unit from 7,3±0,6 to 5,6±0,3 days and duration of treatment of patients in the hospital from 11,8±1,1 to 9,0±0,4 days.

[Pharmacological correction of toxic liver damage in patients with heavy forms of acute ethanol intoxication].

The efficiency of using remaxol and ademethionine in the therapy of patients with heavy acute alcohol intoxication on the background of toxic liver damage has been studied. The administration of remaxol led to improvement of the clinical treatment of alcohol intoxication, which is manifested by a decrease in the rate and duration of delirium tremens (from 33.9 to 10.8%), frequency of secondary lung disorders (from 18.5 to 3.1%), duration of stay in hospital (from 7.3 +/- 0.6 to 5.6 +/- 0.3 days), and total therapy duration (from 11.8 +/- 1.05 to 5.6 +/- 0.3 days). The results of biochemical investigations confirmed that remaxol and ademethionine provide effective treatment of the toxic liver damage. Remaxol decreases the degree of metabolic disorders to a greater extent than does ademethionine.

[Characteristics of the pharmacological treatment of toxic liver damage in patients with an alcohol abused syndrome and an acute severe ethanol poison].

The examination of 130 patients with an alcohol abused syndrome and a severe ethanol poison have revealed that ethanol action are accompanied by significant metabolic disturbances. The comparative evaluation of the inclusion of heptral and remaxol in the treatment has shown that remaxol improves the clinical course of mentioned disorders decreasing the frequency and duration of alcohol delirium. Patients treated with this drug spent less time in acute care and their treatment duration was shorter. Remaxol reduces more effectively the severity of metabolic disorders.

[Using of reamberin for correction of free radicals disturbances in patients with acute severe methadone poisonings].

The article deals with the materials, which have been received in the process of the examination and treatment of 44 patients with acute severe methadone poisonings. It has been revealed, that gravity of these patient's condition depends on intensity of hypoxia due to breath deficiency because of the methadone. The development of hypoxia, in its turn, cause violations of antiradical protection system and intensification of processes of peroxide lipid oxidation. It has been registered that the including of reamberin into the complex program of the intensive therapy of acute severe methadone poisonings lead to a more rapid restoration of antiradical protection system and to a decrease of activity of processes of peroxide lipid oxidation. The correction of hypoxia and free-radical violations led to improvement of the acute poisonings clinic, what had been characterized by a decrease of coma-period duration, duration of treatment with artificial lung ventilation, a decrease of secondary lung complications and a decrease of lethality.

[Features of clinical course and the experience using of reamberin in complex intensive therapy in patients with acute severe azaleptin poisonings].

This article deals with materials, which have been received in the process of an examination and treatment of 69 patients with acute severe azaleptin (leponeks) poisonings. On the base of clinic data the special features of clinic of acute severe azaleptin (leponeks) poisonings has been shown. It has been registered that the using of substrate antihypoxant reamberin in the intensive therapy of severe forms of acute azaleptin (leponeks) poisonings led to significant improvement of clinic manifestations, such as a coma period duration, a duration of artificial lung ventilation, a period of holinolitic psychiatric violations and a decrease of lethal poisonings.

[Peculiarities of pharmacological correction of acute toxic hepatopathies in patients with severe forms of acute alcohol intoxication].

Results of examination and treatment of 130 patients with severe alcoholic intoxication and toxic hepatopathy in conjunction with metabolic disorders are presented Inclusion of remaxol in therapy of alcoholic intoxication improved its clinical course (reduction in the frequency of secondary pulmonary complications from 18.5 to 3. 1%, the frequency and duration of alcoholic delirium from 33.9 to 10.8%, the duration of stay in an intensive therapy ward from 7.3+/-0.6 to 5.6+/-0.3 days and the overall duration of therapy from11.8+/-1.05 to 5.6+/-0.3 days). Moreover, remaxol and ademetionine improved biochemical characteristics of the patients deteriorated as a result of hepatic toxicosis. This effect of remaxol was more pronounced than that of ademetionine.

[Use of cytoflavin into the complex intensive therapy of acute cerebral insufficiency caused by poisoning].

In the result of treatment of 147 patients with toxic acute brain insufficiency were revealed that the employment of citoflavin (20 ml with 400 ml 5% glucosae twice a day) in 7 days intensive therapy of acute brain insufficiency leaded to decrease of hypoxic brain damages and intensity of brain depression, what was revealed in improvement of brain bioelectric activity. Rehabilitation of central nervous system regulation function and life-support systems leaded to quick rehabilitation of respiratory part of oxygen transport. These changes in acute period leaded to quick reparation of cognitive-mnestic functions and social adaptation. The employment of citoflavin leaded to improvement of clinic of toxicohypoxic encephalopathy and to decrease of secondary lung complications (decrease of coma-period from 45,3 ± 8,2 to 27,7 ± 6,9 hours; decrease of secondary lung complications from 72,7% to 35,9%).

[Immune system disorders and their correction in critically ill patients with toxic and hypoxic encephalopathy].

In this article there are materials, which were received in the process of treatment of 69 patients with azaleptin (leponeks) acute severe poisonings. The immunologic research has shown that the first phase of acute poisonings in patients with toxicohypoxic encephalopathy is accompanied by severe immune alterations. The alterations of proinflammation and antiinflammation cytokines have been investigated and its increase has not been revealed. It was shown, that the employment of citoflavin in intensive therapy of acute poisonings leads to decrease of the level of immunosupression.

[Approaches to the improvement of treatment efficacy in patients with acute severe asaleptin intoxication complicated by acute respiratory insufficiency of mixed genesis].

We studied the development of metabolic disorders related to tissue hypoxia in 54 patients with acute severe asaleptin intoxication complicated by acute respiratory insfficiency of mixed genesis. We also estimated the role of a substrate antihypoxant cytoflavin in the correction of these disorders and clinical features of acute intoxication. Cyroflavin was shown to accelerate normalization of metabolic disorders which in turn improves clinical symptoms of severe forms of acute asaleptin intoxication.

[Correction of nonspecific damages in acute poisoning of substance from the group of opiate drug in patients in critical condition].

The obtained materials were received in the process of examination and treatment of 134 patients in the early phase of severe acute poisoning with the development of opiate toxicohypoxic encephalopathy using a corrector of tissue metabolism Cytoflavinum. Positive clinical results were achieved: reduction of length of stay of patients in a comatose state, reduction of incidence of pulmonary complications and mortality. The results of immunological studies have established immunomodulatory effects of cytoflavinum in patients with severe acute poisoning opiates. These biochemical studies have shown that the effects cytoflavinum realized largely due to its ability correct the effects of tissue hypoxia.

[The use of cytoflavin in combined neurometabolic therapy of acute cerebral insufficiency associated with acute poisoning with neurotropic poisons].

Examination and treatment of 262 patients with severe acute intoxication by neurotropic poisons and unaffected oxygen delivery system showed that inclusion of cytoflavin in combined neurometabolic therapy of acute cerebral insufficiency significantly reduced severity of metabolic disorders. Specifically, tissue hypoxy, endotoxicosis, lipid peroxidation activity, and immunosuppression decreased while antioxidative protection and clinical picture were improved. Duration of comatose state and artificial lung ventilation was reduced from 64.5 +/- 15.1 to 28.8 +/- 10.2 hours and that of critical condition from 117.2 +/- 17.2 to 63.7 +/- 9.2 hours. Overall lethality dropped from 16 to 9.9%.