Rational pharmacotherapy in modern gastroenterology

Abstract Introduction. Modern gastroenterology is characterized by the combined (comorbid) nature of the diseases. In treatment, this promotes polypharmacy and increases complications (drug lesions, allergic reactions, exacerbation of diseases of other organs and systems), and, importantly, increase...

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Main Author: O. N. Minushkin
Format: Article
Language:Russian
Published: Remedium Group LLC 2021-10-01
Series:Медицинский совет
Subjects:
Online Access:https://www.med-sovet.pro/jour/article/view/6411
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author O. N. Minushkin
author_facet O. N. Minushkin
author_sort O. N. Minushkin
collection DOAJ
description Abstract Introduction. Modern gastroenterology is characterized by the combined (comorbid) nature of the diseases. In treatment, this promotes polypharmacy and increases complications (drug lesions, allergic reactions, exacerbation of diseases of other organs and systems), and, importantly, increases the cost of pharmacotherapy.Aim. To compare two pharmacotherapy options for patients with gallstone disease at the stage of biliary sludge and patients with biliary sludge combined with irritable bowel syndrome.Materials and methods. In the work, based on the experience of treating 170 patients, two options for pharmacotherapy are considered, which may well turn out to be rational in all respects. Option 1 - monotherapy aimed at one of the components that form a complex pathogenetic symptom complex. The basis for offering this treatment option is the biological concept of the “regulatory cascade”. Option 2  – “stepwise” (stepwise) therapy with the  choice of  the “base” drug for  the  first step. Evaluation of the effectiveness and rational correction for the second step of treatment and subsequent ones – if necessary. Results. The biliary sludge was eliminated or reduced in patients who received the UDCA monotherapy against the background of recovery of gastrointestinal motility. The overall treatment effect (for each nosology) in patients with biliary sludge and irritable bowel syndrome using the complex therapy (UDCA and mebeverin) was 84 and 87.8% respectively.Conclusions. Both options are rational today: 1st requires further study; 2nd – active use. Both options exclude polypharmacy and other adverse effects.
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spelling doaj.art-88f4ab3d18e840e280d1c1aa8f09a7ff2023-04-23T06:56:35ZrusRemedium Group LLCМедицинский совет2079-701X2658-57902021-10-01015131810.21518/2079-701X-2021-15-13-185782Rational pharmacotherapy in modern gastroenterologyO. N. Minushkin0Central State Medical Academy of the Presidential Administration of the Russian FederationAbstract Introduction. Modern gastroenterology is characterized by the combined (comorbid) nature of the diseases. In treatment, this promotes polypharmacy and increases complications (drug lesions, allergic reactions, exacerbation of diseases of other organs and systems), and, importantly, increases the cost of pharmacotherapy.Aim. To compare two pharmacotherapy options for patients with gallstone disease at the stage of biliary sludge and patients with biliary sludge combined with irritable bowel syndrome.Materials and methods. In the work, based on the experience of treating 170 patients, two options for pharmacotherapy are considered, which may well turn out to be rational in all respects. Option 1 - monotherapy aimed at one of the components that form a complex pathogenetic symptom complex. The basis for offering this treatment option is the biological concept of the “regulatory cascade”. Option 2  – “stepwise” (stepwise) therapy with the  choice of  the “base” drug for  the  first step. Evaluation of the effectiveness and rational correction for the second step of treatment and subsequent ones – if necessary. Results. The biliary sludge was eliminated or reduced in patients who received the UDCA monotherapy against the background of recovery of gastrointestinal motility. The overall treatment effect (for each nosology) in patients with biliary sludge and irritable bowel syndrome using the complex therapy (UDCA and mebeverin) was 84 and 87.8% respectively.Conclusions. Both options are rational today: 1st requires further study; 2nd – active use. Both options exclude polypharmacy and other adverse effects.https://www.med-sovet.pro/jour/article/view/6411gastroenterologybiliary sludgeirritable bowel syndromecomorbid pathologyregulatory cascadetreatment
spellingShingle O. N. Minushkin
Rational pharmacotherapy in modern gastroenterology
Медицинский совет
gastroenterology
biliary sludge
irritable bowel syndrome
comorbid pathology
regulatory cascade
treatment
title Rational pharmacotherapy in modern gastroenterology
title_full Rational pharmacotherapy in modern gastroenterology
title_fullStr Rational pharmacotherapy in modern gastroenterology
title_full_unstemmed Rational pharmacotherapy in modern gastroenterology
title_short Rational pharmacotherapy in modern gastroenterology
title_sort rational pharmacotherapy in modern gastroenterology
topic gastroenterology
biliary sludge
irritable bowel syndrome
comorbid pathology
regulatory cascade
treatment
url https://www.med-sovet.pro/jour/article/view/6411
work_keys_str_mv AT onminushkin rationalpharmacotherapyinmoderngastroenterology