Products that envelop and protect the gastric mucosa. Drugs that protect the gastric mucosa. Things to Remember

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Enveloping agents are substances that can protect tissues from the action of irritants.

As a rule, these drugs have a high absorption capacity and make it difficult to absorb harmful substances in the gastrointestinal tract. They also have antiemetic and antidiarrheal effects.

Enveloping substances are used to reduce inflammatory processes, and also, in combination with other medications, are prescribed to reduce irritation and reduce the absorption of toxic products and drugs.
They are used for poisoning with salts of heavy metals and alkaloids, and are used as bases for the preparation of certain dosage forms.

Enveloping folk remedies

To enveloping agents plant origin include the following drugs:

1. Potato starch.
Used as an enveloping anti-inflammatory agent in the form of a paste (brewed hot water).
Take 1-2 tbsp. l.

Infusions

4. Fireweed infusion.
2 tbsp. l. crushed leaves of fireweed angustifolia (fireweed tea), brew 200 ml of boiling water, leave for 2 hours, strain.
Take 1 tbsp. l. 3-4 times a day before meals.

Remember, in large doses the plant is poisonous! Follow the dosage!

Decoctions

9. Quince decoction.
10 g of crushed quince seeds pour into 200 ml hot water, bring to a boil and boil in a water bath for 20 minutes, leave for 10 minutes and strain.
Drink the resulting mucous decoction 70-100 ml 3 times a day before meals.

Attention! An overdose can cause vomiting, diarrhea and an itchy rash!

With increased stomach acidity and other irritating factors, the most rapid analgesic effect is provided by enveloping agents. However, their functions do not end there.

Enveloping drugs and their scope of application

Enveloping agents contain components that, when interacting with water, form colloidal compositions and suspensions. These can be either natural or chemical substances, but they are all designed to reduce sensitivity nerve endings and thereby protect them from aggressive influences. The following diseases are indicated:

• heartburn;
• gastritis;
• enteritis;
• colitis;
• ulcers;
• chemical burns of the mucous membrane and others.

External coating agents are used to protect skin covering and other tissues for burns, frostbite, wounds. Sometimes enveloping components are also added to medications to reduce their aggressiveness.

Coating agents for the stomach and intestines

Enveloping agents and drugs to protect the digestive tract are practically not absorbed and therefore do not enter the blood. This feature allows the use of both natural medicines and synthetic analogues. Almost everything folk remedies contain starch or starchy substances. Here is a short list of herbal components that have an enveloping effect:

• flax seeds;
• liquorice root;
• potato starch;
• corn starch;
• comfrey;
• oats and oatmeal.

All these enveloping agents are good for gastritis and even ulcers - they almost instantly relieve pain and inflammation. Having oatmeal with water for breakfast is useful not only for those who are watching their weight, but also for those who care about their stomach health.

Since the medicine enters the intestines later than the stomach, it makes sense to resort to pharmaceutical drugs. Today there is no shortage of enveloping agents. Here is a short list of the most popular medications:

In addition to their direct protective and analgesic effect, enveloping drugs have an antiemetic and antidiarrheal effect. This occurs due to the fact that such drugs reduce the reflex function of the nerve endings of the mucous membrane.

As a rule, if there is pathological process V digestive system the patient must take several types of medications, some of which eliminate symptoms, others have a therapeutic effect. For example, in case of inflammation of the stomach tissue, it is necessary to take medications that will protect the organ from the aggressive effects of hydrochloric acid, agents that normalize the digestive process, as well as medications that will eliminate the cause of inflammation.

Thus, the list of pills that need to be taken daily is impressive. Many of the drugs irritate the mucous membrane, so they contain complex therapy or for prevention, coating agents for the stomach and intestines are prescribed. Pathologies gastrointestinal tract(Gastrointestinal tract) are manifested by abdominal and dyspeptic syndrome.

For elimination severe pain Non-narcotic analgesics are used, and after the condition improves, they switch to antispasmodics. Enzyme preparations, antacids, enveloping agents, and antifoam agents help relieve dyspepsia. Medicines to restore gastrointestinal functions should be prescribed by a doctor, since only a specialist will be able to develop the correct treatment regimen, select the best remedy, determine the dosage of the drug and, if necessary, adjust it.

What medications can relieve abdominal pain?

To dock pain syndrome, analgesics or antispasmodics are most often used. Depending on the nature of the pathological process, the use of enzyme preparations, agents that reduce the amount of hydrochloric acid in the stomach, defoamers, sorbents or choleretic drugs. Of the analgesics, the most popular drugs are Analgin, Paracetamol and products based on them.

Analgin (metamizole sodium) has an analgesic, antipyretic and slightly anti-inflammatory effect. Active substance inhibits cyclooxygenases, reduces the production of endoperoxides, prostaglandins, bradykinins, free radicals, interferes with the conduction of impulses and reduces the sensitivity of areas of the brain that perceive a painful stimulus.

The drug begins to act 20–40 minutes after administration, the maximum effect appears after 2 hours.

Analgin is used for acute pain after injury or surgery, with colic, with high temperatures. The drug is prescribed depending on the severity of the pain syndrome and individual sensitivity to it. For children 10–14 years old, a single dose of 8–14 mg/kg is recommended; adults can take up to 1000 mg (2 Analgin tablets) at a time. The maximum simultaneous dose can be taken no more than 4 times a day.

Metamizole sodium is the active ingredient in the following drugs: Analgin-Ultra, Spazdolzin for children, Baralgin M, Spazmalgon, Bral, Bralangin, Spazgan, Plenalgin. Paracetamol is available in syrup, tablets, suppositories, and solution for infusion. It is prescribed to eliminate moderate pain and febrile syndrome in acute infectious and infectious-inflammatory diseases.

Paracetamol tablets are contraindicated in children under 6 years of age.

To take the analgesic, adults, elderly people and adolescents over 12 years of age are prescribed 1-2 tablets if the dosage of the tablet is 500 mg, or 2.5-5 tablets if the dose is 200 mg, with an interval of 4 hours. The maximum daily dose is 4000 mg. Children 6–12 years old are given 1 tablet (200 mg) or half a tablet with a dosage of 500 mg. For children, the daily dose should not exceed 2000 mg.

Paracetamol syrup can be prescribed to children over 2 years of age. Give 5-10 ml of syrup to children aged 2-6 years, children 6-12 years old 10-20 ml of medicine, and adults and adolescents - 20-40 ml. You can take the product once every four hours. If paracetamol is used as an antipyretic, then the maximum duration of therapy is 3 days, and if as an analgesic, then no more than 5 days.

Paracetamol is contained in the following drugs: No-shpalgin, Brustan, Ibuklin, Citramol P, Panoxen, Pentalgin, Rinza, Coldrex, Fervex.

Among antispasmodics, drugs based on drotoverine and papaverine are most often recommended. They have a similar mechanism of action: they relax smooth muscles and dilate blood vessels, which normalizes pressure in the internal organs and clears away stagnant secretions or feces. Antispasmodics are recommended for organ spasms abdominal cavity, urinary tract, with spasms of peripheral vessels.

Papaverine is not prescribed to babies under 6 months of age. The product is available in the form of a solution, suppositories and tablets of 40 and 10 mg. Adults are advised to drink 40–60 mg 3 or 4 times a day, children from 6 months to 2 years are given half a tablet (5 mg), children 3–4 years old are recommended to take Papaverine 5–10 mg, and children 5–6 years old A small 10 mg tablet is prescribed.

Contraindication to the use of Drotaverine is childhood up to a year. Adults are prescribed 1–2 tablets (dosage 40–80 mg) three times a day, children 1–6 years old, a quarter or half a tablet, children 6–12 years old, half a tablet (20 mg) 2 or 3 times a day.

Myotropic antispasmodics (Papaverine, No-shpa) are used for increased gastric motility and “stomach colic”

List of antispasmodics: No-shpa, Avisan, Spasmocystenal, Bendazole, Duspatalin, Plantex, Spazoverin, Platyfillin. Among the homeopathic remedies, Spascuprel, Nux vomica gomaccord, and Gastrikumel have an antispasmodic effect.

How to normalize the acidity of gastric juice

Hydrochloric acid promotes digestion, has a bacterial effect, triggers the synthesis of hormones that stimulate the secretion of bile, intestinal and pancreatic juice. If too much hydrochloric acid is produced, the walls of the stomach become inflamed, heartburn, sour belching, and digestive disorders appear.

It is also necessary to reduce the acidity of gastric juice to ensure functional rest of the pancreas or gall bladder. To neutralize hydrochloric acid, you need to take antacids. Drugs from this group are divided into absorbable and non-absorbable.

The former penetrate the bloodstream and begin to act within 3-5 minutes, the latter are not absorbed into the gastrointestinal tract and reduce the acid level after half an hour. Both of them last no more than 4 hours. A representative of absorbable antacids is Rennie. It contains calcium and magnesium carbonate, which contribute to the rapid neutralization of hydrochloric acid and thereby have a protective effect.

Indications for use are heartburn, belching, periodic stomach pain, a feeling of fullness and heaviness in the abdomen, flatulence, and dyspepsia. The medication is prescribed for adults and adolescents over 12 years of age, 1–2 tablets (they need to be chewed). You can take a maximum of 16 tablets per day.

Absorbable antacids also include Vikalin and Vikair. Non-absorbable antacids are considered safer because they do not enter the bloodstream and do not affect internal organs.

Names of drugs from this group: Maalox, Almagel, Gastal, Phosphalugel, Gastratsid, Relzer. Some antacids contain additional components that are designed to protect the gastric mucosa, relieve pain, or remove air bubbles.

For example, Almagel Neo contains aluminum hydroskid, magnesium hydroxide, simethicone. The drug is prescribed for diseases that occur with increased or normal acidity of gastric juice and with excessive gas formation in the intestines.

Depending on the type of pathology, 1 or 2 sachets of the drug are prescribed four times a day, an hour after meals. The daily dosage is up to 6 sachets, in this quantity you can take the product for no more than a month. In the complex therapy of acid-related diseases, longer-acting agents are used than antacids. These are H2 inhibitors - histamine receptors and proton pump inhibitors.

After taking Almagel Neo, it is not advisable to drink or eat for half an hour

Histamine H2 receptor blockers are divided into 3 generations. The first includes Cimetidine (Histodil, Tagamet), which needs to be taken 3-4 times a day, but it has antiandrogenic activity (suppresses the level of male sex hormones).

Ranitidine (Gistac, Zantac, Zantin, Ranisan) belongs to the second generation; it should be taken 1-2 times a day. It has fewer contraindications and side effects. The most advanced drugs from this group are based on famotidine (Kvamatel, Famocid, Famo, Ulfamid).

Famotidine is available in tablets of 20 and 40 mg. It suppresses the basal production of hydrochloric acid and does not allow histamine, gastrin and acetylcholine to stimulate the production of a new portion of acid. The drug increases the stability of the gastric mucosa, as it increases the formation of protective mucus, the secretion of bicarbonates, and indirectly the drug accelerates tissue regeneration.

After using the medication, the effect is noticeable within an hour and reaches a maximum after three hours. Depending on the severity of the pathology, 1–2 tablets are prescribed 1 or 2 times a day. Proton pump inhibitors suppress the production of hydrochloric acid for a long time. To this group medicines include capsules Omeprazole (Omez, Zerotsid, Losek, Omegast), Lansoprazole (Lansocap, Lancerol), Rabeprazole (Pariet). They need to be taken once a day.

How to protect the gastrointestinal mucosa

Enveloping drugs, interacting with water, form colloidal solutions that protect the mucous tissues of the esophagus, stomach and intestines from the aggressive effects of hydrochloric acid and enzymes. These funds participate in the normalization of the gastrointestinal tract, as they allow the mucous membrane to recover. For the symptomatic treatment of heartburn and pain due to pathologies of the gastrointestinal tract, the following medications may be prescribed.

Phosphalugel

Reduces the level of hydrochloric acid, has enveloping and adsorbing properties, reduces the aggressiveness of pepsin, binds bile acids. The active substance captures only excess acid, which is due to its buffering properties, while maintaining conditions for normal digestion.

Hydrochloric acid levels change within 30 minutes after taking the product. By stimulating the synthesis of prostaglandins, they increase the secretion of mucus and bicarbonates, which protect the stomach tissue. The medicine is not prescribed to children under 12 years of age. It is recommended to use 1-2 sachets of Phosphalugel 2 or 3 times a day after meals or when heartburn or pain occurs.

Almagel

Contains aluminum hydroxide, magnesium hydroxide. It has an antacid, enveloping, adsorbing effect. Protects stomach tissues, protects them from inflammatory and erosive lesions. The effect after administration appears within 3–5 minutes. The action lasts for three hours (until the stomach is empty).

The drug is prescribed as part of complex therapy for acid-dependent diseases, as well as to reduce stomach irritation during drug treatment. For prevention inflammatory process Prescribe 5-15 ml of suspension 15 minutes before taking medications.

For therapeutic purposes, adults and adolescents over 15 years of age take the medicine 5–10 ml of liquid 3 or 4 times a day 60 minutes before meals or at night; children 10–15 years old are prescribed 5 ml. After achieving the desired effect, the dosage is reduced, but use continues for 15–20 days.

Vikair

This is a combined drug that has an antacid, antispasmodic, enveloping effect. The bismuth nitrate included in its composition forms a protective film on the gastric mucosa, thereby providing anti-inflammatory, bactericidal and reparative effects.

The medicine also contains calamus (relaxes the muscles) and buckthorn (provides a laxative effect), therefore the passage of feces through the intestines improves. The drug is taken 1–1.5 hours after a meal, 1–2 tablets, frequency of administration – 3 times a day, duration – 30–60 days.

Contains sucralfate, which has an antiulcer effect. By interacting with the proteins of the affected tissue at the site of erosion or ulcer, the product forms a protective layer that for a long time protects the necrotic area from the aggressive effects of acid and enzymes. The medicine inhibits the activity of pepsin. For the prevention of peptic ulcers, 1 tablet is prescribed twice a day; in case of exacerbation of an ulcer, 1 tablet is prescribed four times a day, half an hour to an hour before meals.

Duration of treatment with Venter – 4–6 weeks

Aluminum hydroxide

It is an antacid and has adsorbing and enveloping properties. Neutralizes free hydrochloric acid without causing its secondary hypersecretion. Raises the pH of gastric juice to 3.5–4.5 and maintains it at this level for several hours.

For prophylactic purposes, take 5–10 ml of the suspension before taking aggressive drugs (medicines, alcohol). The drug is prescribed 0.6–1.2 g (in the form of chewable tablets) or 5–10 ml of suspension 1–2 hours after meals. Duration of therapy – from 6 weeks.

De-Nol

The active ingredient is bismuth. After taking the drug, a film forms on the walls of the stomach, which protects the tissues from aggressive substances. In addition, the medicine increases the synthesis of prostaglandin and stimulates the production of mucus and bicarbonates. De-Nol also has a bactericidal effect against Helicobacter.

It is recommended to take 1 tablet 4 times a day half an hour before meals or at night for 4-8 weeks. Folk remedies can also be used to restore the mucosa. Decoctions and infusions are made from medicinal plants(oats, comfrey, licorice root, flaxseeds), white clay, starch.

Medicines for the stomach and intestines have a number of contraindications and, with long-term use, can cause unwanted side effects. Therefore, before treating the digestive tract with medications, you need to consult a specialist and find out the cause of the pathological process.

For quotation: Vasiliev Yu.V. Enveloping (antacid) medications in the treatment of certain diseases of the upper digestive tract // RMZh. 2004. No. 5. P. 244

Central Research Institute of Gastroenterology, Moscow

ABOUT tarnish agents (drugs) - medicinal substances, forming colloidal solutions with water that protect the primary endings of the mucous membranes and skin from the action of irritating substances and complicate their absorption. Currently, these drugs also include medicinal substances that dissolve in certain solutions of heterogeneous composition (for example, in gastric juice). It is still unknown exactly which medicinal (drug) preparations have an enveloping effect, and when they first began to be used in the treatment of patients (apparently, first as external agents, and later as per os for the treatment of diseases affecting the mucous membrane of the esophagus, stomach and intestines).

Currently, in the practice of treating patients suffering from various diseases upper parts of the digestive tract, non-absorbable antacid drugs, sucralfate and bismuth potassium dicitrate, are most often used, which, along with an enveloping “healing” effect, also have other positive “healing” effects (see below).

General information about antacids

The effectiveness of the onset of a rapid therapeutic effect, primarily in the elimination (decrease in intensity) of heartburn (burning) and pain in the chest and/or in the epigastric region, after patients take antacid drugs per os, has long attracted the attention of various researchers. It is believed that antacid drugs have been known for more than 100 years. Due to undesirable side effects and insufficient buffering action, some of the first antacid drugs have now lost their practical significance. However, in Lately, in connection with the emergence of new effective antacid drugs that can not only neutralize the acid secreted by the parietal cells of the gastric mucosa, but also have other positive “therapeutic” effects, as well as minimal side effects, the appearance of which is possible only with long-term use of modern antacid drugs, there is an overestimation of their role in the treatment of many diseases of the upper digestive tract.

This primarily refers to the group of so-called “non-absorbable” antacid drugs (aluminum hydroxide, aluminum phosphate, magnesium hydroxide, magnesium trisilicate and some others), the primary effect of which is an enveloping and adsorbing effect on the mucous membrane of the upper gastrointestinal tract with subsequent neutralization of hydrochloric acid . Unlike absorbed antacids non-absorbable antacids have a longer lasting effect , do not disrupt the acid-base balance and do not lead to an increase in the pH of the gastric contents above the neutral value, without causing the so-called “acid rebound” syndrome.

When assessing the effectiveness of antacid drugs, their acid-neutralizing activity and duration of action are usually taken into account. It is known that antacid coating drugs cause a persistent acid-neutralizing effect due to their ability to be adsorbed on the gastric mucosa, allowing them to exhibit buffering properties at a level of 2.4 pH. The acid-neutralizing activity (ability) of antacid drugs is usually understood as the number of hydrogen ions that can be neutralized by a certain amount of the drug, or the amount of a specific antacid drug in grams or mmol/l required to achieve a pH level of 50 ml of 0.1N hydrochloric acid solution to 3. 5.

Among non-absorbable antacid drugs, they are most often used in the treatment of patients in Russia. Almagel Neo , ritotsid, taltsid and some others. Most modern antacid drugs are combination drugs containing aluminum (along with other ingredients) that have enveloping and adsorbing properties when exposed to the mucous membrane of the upper gastrointestinal tract, including the esophagus, neutralize hydrochloric acid, and increase the protective properties of the mucous membrane (due to their cytoprotective effect associated with stimulation of prostaglandin synthesis), they also have the ability to bind bile acids, influencing the epithelial growth factor and fixing it in the area of ​​ulcers, locally stimulating reparative and regenerative processes, cell proliferation and angiogenesis, reducing the risk of damage to the capillary epithelium from the damaging effects of so-called “ulcerogenic” factors. Aluminum-containing preparations worsen living conditions Helicobacter pylori (NR) in the gastric mucosa, reducing its urease activity

One of the antacid drugs that has recently increasingly attracted the attention of doctors and researchers is Almagel Neo . This is a non-absorbable, water-soluble, balanced antacid drug containing in its composition the optimal amount of aluminum and magnesium hydroxide, which ensures the optimal acid-neutralizing ability of the drug. The presence of simethicone in Almagel Neo (a surfactant that reduces the external tension of gas bubbles) promotes the natural release of intestinal gases and their absorption, which to a certain extent prevents the occurrence of stool retention (constipation) and flatulence, reduces the likelihood of belching, and allows for effective use in the treatment of patients with the aim of eliminating pain in the chest and epigastric region, discomfort, including heartburn and flatulence, in a fairly short time. The presence of sorbitol in Almagel Neo allows the use of this drug in the treatment of patients who have and diabetes. The usual dosages for administering this drug to patients are: orally for adults, one sachet or two dosage spoons 4 times a day, an hour after meals and at night; For children over 10 years of age, the dosage of the drug is determined by the attending physician (taking into account the body weight and condition of the child).

Main indications for the use of Almagel Neo: 1) gastric ulcer and duodenum; 2) acute gastritis, chronic gastritis with increased and normal secretory function of the stomach; 3) gastroesophageal reflux disease (GERD) in endoscopically “negative” and “positive” stages; 4) non-ulcer (functional) dyspepsia with ulcer-like and reflux-like variants; according to some data, irritable bowel syndrome in the treatment of patients in whom pain and flatulence predominate; 5) non-steroidal gastropathy, including in the presence of erosive and ulcerative lesions of the gastrointestinal tract; 6) elimination of symptoms, usually combined into a single term “discomfort”, that occur in some people after errors in diet, overuse alcohol, smoking, etc.

Antacids in the treatment of acid-dependent diseases

Typically, a large group of diseases is included in the group of acid-related diseases, regardless of whether the factor of acid aggression is central or only an additional significant factor in the occurrence and progression of these diseases. Currently, among patients suffering from acid-related diseases, the most common patients in a doctor’s practice are those suffering from peptic ulcer disease, gastroesophageal reflux disease (GERD), non-ulcer (functional) dyspepsia (NFD), pancreatitis, and less commonly, Zollinger-Ellison syndrome. Among the possible factors of aggression in these diseases, a significant place is given to hydrochloric acid, bile acids and pancreatic enzymes.

Despite the introduction into practice of treating patients with H2-blockers of histamine receptors and proton pump inhibitors, antacid preparations have not lost their importance in the treatment of patients . Our own experience of many years of using antacid drugs (including non-absorbable antacid drugs) in the treatment of patients suffering from acid-dependent diseases has shown the following: 1) antacid drugs can be used as monotherapy (in standard dosages) with a positive effect in the early (initial) stages of these diseases higher than acid-related diseases; 2) as a “course” of additional therapy in combination with H 2 -blockers of histamine receptors and/or prokinetics; 3) as a symptomatic means to eliminate (reduce intensity) heartburn and pain in the chest and/or epigastric region, both during the treatment of patients, combining their use with other drugs, and during the period of remission (as “on-demand” therapy) ; 4) during the screening phase (before the start of the intended treatment) when selecting patients to conduct randomized studies to study the effectiveness and safety of any medications (for the treatment of so-called “gastroenterological” patients) or regimens for their use, including prokinetics, N 2 - histamine receptor blockers and proton pump inhibitors (as a rule, taking antacid drugs, if necessary, is allowed during the screening phase before the start of treatment of patients, according to the Protocols of these studies), as well as directly during such studies as emergency therapy; 5) as monotherapy for any stages of acid-dependent diseases when patients are resistant to proton pump inhibitors and H2 histamine receptor blockers, which is possible in 10% and 20% of cases, respectively; 6) as means used in carrying out differential diagnosis between cardiac and non-cardiac pain that occurs behind the sternum, between pain in the epigastric region associated with peptic ulcer disease and with the so-called “biliary” pain.

On my own positive effect antacid drugs in the treatment of patients in the elimination (reduction of intensity) of heartburn (burning) and/or pain in the chest and in the epigastric region also has a certain diagnostic value: it indicates the possible presence of one of the acid-related diseases in patients.

The effectiveness of antacid drugs has been known for a long time. Even at the symposium “Antacid Therapy Today” (Antacid Therapy Today), held in Stockholm (Sweden) on June 18, 1982, reports were presented on the possibility of successful prevention and treatment of patients with gastrointestinal bleeding, reflux gastritis, duodenal ulcer, peptic ulcer with localization of ulcers in the prepyloric part of the stomach. In particular, it was shown that the combination of high doses of antacid drugs in combination with anticholinergic drugs in the treatment of patients with prepyloric gastric ulcers is more effective than treatment of patients with H 2 -histamine receptor blockers or placebo, respectively, 92%, 82% and 17% of cases; the results of 4 and 6 weeks of treatment with antacid drugs in patients with duodenal ulcers were almost the same compared with treatment of patients with H 2 -histamine receptor blockers (63% and 65% of cases, respectively; 72% and 84% of cases); there were no differences in the rate of ulcer recurrence in both groups of patients.

The feasibility of using antacid drugs in the treatment of peptic ulcer disease has increased recently due to the fact that it has become quite clear that the possibility of having a peptic ulcer not only associated with HP, but also peptic ulcer not associated with HP, which occurs in 8-30% cases (more often observed in children and adolescents). When treating such patients, there is no need for anti-Helicobacter therapy. However, in the treatment of peptic ulcer associated with HP, after discontinuation of antibiotics (carrying out anti-helicobacter therapy itself for 7-14 days) antacid drugs can be successfully used in the treatment of patients and as monotherapy to “consolidate” treatment results .

Experience in treating patients with GERD, as our observations have shown, has shown that some patients who require long-term treatment with proton pump inhibitors develop resistance even to modern proton pump inhibitors. Patients notice that even high doses of these drugs “have become less helpful in eliminating pain and/or heartburn (burning)” in the chest and epigastric region. A significant proportion of patients develop more or less pronounced flatulence, which significantly worsens their quality of life. H 2 -blockers of histamine receptors in the treatment of just such patients (before treating these patients with proton pump inhibitors or after them) turned out to be less effective, which forced a significant increase in the dosage of H 2 -blockers of histamine receptors, exceeding the standard one. We also drew attention to another fact: according to esophagogastroduodenoscopy (EGD), such patients during this period did not have erosions, peptic ulcers or signs of Barrett’s esophagus, including materials histological examination targeted esophagobiopsies. Only in the terminal part of the esophagus could one note slight swelling and slight (often only focal) hyperemia of the mucous membrane and/or a more or less pronounced thin whitish coating (in the anamnesis, according to endoscopy, before treatment with proton pump inhibitors, the patients had a typical erosive reflux esophagitis with typical clinical manifestations GERD). Treatment of these patients with non-absorbable antacid drugs in standard dosages improved the subjective condition of these patients. Treatment with Almagel Neo turned out to be especially useful patients who, along with the main clinical symptoms of GERD flatulence was noted. Already after 2 weeks of treatment, an improvement in the subjective condition of the patients was observed.

The feasibility of using H2-blockers of histamine receptors or proton pump inhibitors in the treatment of exacerbations chronic pancreatitis quite well known. Another fact is known - these drugs act more effectively in the treatment of patients with increased and normal acid-forming function of the stomach. However, most patients with GERD have normal or even reduced levels of acid production in the stomach. Another fact is known - from 10% to 20% of patients with GERD remain partially or completely resistant to therapy. The question inevitably arises - what kind of therapy?

It is obvious that not only acid, but also the frequency of its entry with reflux of gastric contents into the esophagus play a role in the occurrence and progression of reflux esophagitis in patients with GERD, as well as in patients with chronic pancreatitis, in whom GERD is also possible as in the stage of reflux esophagitis, and more often in the endoscopically “negative” stage (as a concomitant disease). Another question involuntarily arises. Why do proton pump inhibitors and H2-blockers of histamine receptors have a positive effect in the treatment of most patients suffering from GERD or chronic pancreatitis? Indeed, in most patients, the aggressive effect of hydrochloric acid leads to the appearance and progression of GERD, and treatment of the majority of patients only with proton pump inhibitors or H2-blockers of histamine receptors is quite successful.

However, in addition to acids, bile acids and pancreatic enzymes, especially trypsin, are known to play a role in the occurrence and progression of GERD. Obviously, this can explain the lack of a significant effect in improving the condition of some patients, even with long-term, seemingly adequate treatment of these patients with GERD.

Inhibition of hydrochloric acid secretion leads not only to a decrease in the intensity (inhibition) of the secretory function of the stomach, but also to inhibition of the exocrine function of the pancreas, which, in turn, reduces the impact of pancreatic secretions on the esophageal mucosa. However, the role of bile acids as a pathological factor in the occurrence and progression of esophageal damage in GERD still remains in many patients. Therefore, according to our observations, in such cases, the use of proton pump inhibitors or H 2 -blockers of histamine receptors in combination with the use of non-absorbable antacid drugs that allow the absorption of bile, more or less periodically flowing from the duodenum, first into the stomach, and then into the stomach, is quite justified. esophagus. This combination of the above drugs allows you to reduce the dosage of H 2 -blockers of histamine receptors or proton pump inhibitors to once a day and, accordingly, improve the condition of patients. It is only necessary to observe a 3-3.5 hour interval between patients taking drugs that inhibit acid formation in the stomach and antacid drugs.

Obviously, the combined use of proton pump inhibitors or H 2 -blockers of histamine receptors with non-absorbable antacid drugs is completely justified in the treatment of patients with preserved exocrine pancreatic function, including in the treatment of patients with chronic pancreatitis who have GERD. In the presence of flatulence from antacid drugs, it is most advisable to use Almagel Neo .

It is known that chronic gastritis, according to modern concepts, is considered primarily as a morphological diagnosis; NFD is possible both in patients with chronic gastritis and in its absence. When treating patients with NFD who are bothered by pain and/or heartburn, non-absorbable antacid drugs are especially advisable to use in the ulcer-like or reflux-like variants of this functional disease, in necessary cases combining them with H2-blockers of histamine receptors and/or with prokinetics (in the presence of symptoms of dyspepsia, usually associated with worsening gastric emptying), as well as with antacids (in the presence of symptoms associated with increased hypersensitivity of the stomach to distension).

STARCH (Amytum)

It is obtained from wheat grains - wheat starch (Amylum Tritici), corn (Amylum Maydis), rice (Amylum Oryzae), from potato tubers (Amylum Solani).

IN cold water insoluble, forms a colloidal solution when hot (Mucilago Amyli).

Indications for use. Prescribed as an enveloping agent to protect sensitive nerve endings from the effects of irritants and to slow down the absorption of drugs.

Method of administration and dose. Externally (in the form of powders and powders with zinc oxide, talc, etc.), internally and in enemas (in the form of starch paste or mucus).

Release form. Powder.

Storage conditions. In a dry place.

LIQUIRITON (Liquiritonum)

Contains a sum of flavonoids from licorice root.

Pharmachologic effect. It has antispasmodic (relieving spasms), anti-inflammatory and moderate antacid (the ability to reduce stomach acidity) properties.

Indications for use. For exacerbation and for the prevention of gastric and duodenal ulcers, chronic gastritis with preserved secretory function of the stomach, erosive gastritis (inflammation of the gastric mucosa with the formation of its defects).

Method of administration and dose. Orally 0.1-0.2 g 3-4 times a day 20-30 minutes before meals for 4-5 weeks; after a 10-12 day break, the course of treatment is repeated.

Release form. Tablets of 0.1 in a package of 25 pieces.

Storage conditions. In a dry, dark place.

FLAX SEEDS (Semena Lini)

Ripe and dried flax seeds (Linum usitatissinum L.), fam. flax (Linaceae). Contain fatty linseed oil(Oleum Lini) and mucus.

Indications for use. Used as an enveloping and softening agent.

Method of administration and dose. Externally for poultices and internally in the form of flaxseed mucus, which is prepared from 1 part whole flaxseed and 30 parts hot water extempore (before use).

Release form. In cardboard packs of 200 g.

Storage conditions. In a dry place.

MAGNESIUM CARBONATE BASIC (Magnesii subcarbonas)

Synonyms: Magnesia is white.

Indications for use. As an enveloping, antacid (reducing stomach acidity) and mild laxative.

Method of administration and dose. Orally, adults are prescribed 1-3 g, children under 1 year - 0.5 g, from 2 to 5 years - 1-1.5 g, from 6 to 12 years - 1-2 g per dose 2-3 once a day. Apply externally as a powder.

Release form. Powder and tablets containing basic magnesium carbonate and sodium bicarbonate, 0.5 g each.

Storage conditions. In a well-closed container.

TABLETS "VICAIR" (Tabulettae "Vicairum")

Synonyms: Rother.

Indications for use.

Method of administration and dose. Prescribed orally after meals (after 1-11/2 hours), 1-2 tablets 3 times a day. Take with a small amount (1/4 cup) of water.

Side effect. The stool turns dark when taking Vikair tablets.

Release form. Tablets containing: basic bismuth nitrate - 0.35 g, basic magnesium carbonate - 0.4 g, sodium bicarbonate - 0.2 g, calamus rhizome powder and buckthorn bark (finely ground) - 0.025 g each, in a package of 100 pieces .

Storage conditions.

TABLETS "VICALIN" (Tabulettae "Vicalinum")

Pharmachologic effect. The tablets have complex impact. Basic bismuth nitrate, sodium bicarbonate and magnesium carbonate provide an antacid (reducing stomach acidity) and astringent effect, buckthorn bark (albeit in a small dose) promotes a laxative effect. The presence of rutin allows one to count on some anti-inflammatory effect, and kellina - on an antispasmodic (relieving spasms) effect.

Indications for use. Used for peptic ulcers of the stomach and duodenum and hyperacid gastritis (inflammation of the stomach due to a persistent increase in acidity).

Method of administration and dose. Prescribed orally 1-2 tablets 3 times a day after meals with 1/2 cup warm water(it is advisable to crush the tablets). The course of treatment usually lasts 1-2-3 months; after a month's break the course is repeated. During treatment you must follow a diet.

Side effect. Tablets usually do not cause side effects, sometimes there is an increase in stool, which stops when the dose is reduced. The stool turns dark green or black when taking the pills.

Release form. Tablets containing: basic magnesium carbonate - 0.4 g, basic bismuth nitrate - 0.35 g, sodium bicarbonate - 0.2 g, calamus rhizome powder and buckthorn bark - 0.025 g each, rutin, etc. Kellin - 0.005 g each.

Storage conditions. In a dry place, protected from light.

MAGNESIUM OXIDE (Magnesii oxydum)

Synonyms: Burnt magnesia.

Pharmachologic effect. Magnesium oxide is one of the main representatives of antacids used to reduce high acidity of gastric juice.

When magnesium oxide is introduced into the stomach, it is not absorbed and neutralizes the hydrochloric acid of the gastric contents to form magnesium chloride. Carbon dioxide is not released, therefore the antacid (reducing stomach acidity) effect of magnesium oxide is not accompanied by secondary hypersecretion. There are no phenomena of alkalosis (Shelling) observed. Passing into the intestines, magnesium chloride has a laxative effect.

Indications for use. For hyperacid gastritis (inflammation of the stomach due to a persistent increase in acidity), peptic ulcer of the stomach and duodenum.

Method of administration and dose. Prescribed orally (0.25-0.5-1 g) for increased acidity of gastric juice, acid poisoning and as a mild laxative (3-5 g per dose).

Antacids are usually taken one hour before meals. However, it should be noted that when taken on an empty stomach

The antacid effect is short-lived (about 30 minutes), it increases significantly (up to 3-4 hours) when taking antacids after meals. For a long-term antacid effect, it is advisable to take them 1 hour and 3 hours after meals.

Before use, the tablets must be crushed thoroughly.

Release form. Powder and tablets of 0.5 g.

Storage conditions. In a well-closed container.

MISOPROSTOL (Misoprostol)

Synonyms: Cytotec, Cytotec.

Pharmachologic effect. Synthetic analogue prostaglandin E. Has antisecretory activity. When taken orally (in tablet form), it reduces the secretion (excretion) of hydrochloric acid, stimulates the secretion of bicarbonate and mucus, and has a cytoprotective (cell-protecting) effect. The action usually develops 30 minutes after administration and lasts about 3 hours.

Indications for use. They are used mainly to prevent the ulcerogenic (ulcer-causing) effects of non-steroidal anti-inflammatory drugs, including acetylsalicylic acid. Taken simultaneously with anti-inflammatory drugs for the entire duration of their administration.

Method of administration and dose. Prescribed to adults: 0.2 mg (200 mcg) 3-4 times a day with meals. The last dose is taken shortly before bedtime. In case of poor tolerance, reduce the single dose to 0.1 mg (100 mcg). The drug is not prescribed to children under 18 years of age.

Side effect. When using the drug, nausea, diarrhea (diarrhea), stomach pain are possible, rarely - skin rash, swelling, drowsiness, hypo- or hypertension (low or high blood pressure) and other side effects.

Contraindications. Pregnancy (causes contraction of the uterine muscles). For kidney disease, it is necessary to reduce the dose.

Release form. Tablets of 0.2 mg (200 mcg) in a package of 100 pieces.

Storage conditions. In a dry place.

SUCRAFAT

Synonyms: Alsukral, Andapsin, Sacras, Ulkon, Sucrafil, Keal, Sukrat, Algofel, Venter, Gelfos.

Pharmachologic effect. The drug has an antacid (reduces stomach acidity), adsorbent (absorbing) and enveloping effects.

Neutralizes gastric acid, inhibits the secretion of pepsin (an enzyme that breaks down peptides and proteins). When entering the stomach, it forms a polymeric protective film on the surface of the mucous membrane and has an itoprotective (cell-protecting) effect.

Indications for use. Prescribed to adults for peptic ulcers of the stomach and duodenum, hyperacid gastritis (inflammation of the stomach due to a persistent increase in acidity).

Method of administration and dose. Take 2-1 hour before meals daily dose 2-4 g (4-8 tablets): 0.5-1 g (1-2 tablets) before breakfast, lunch and dinner and 0.5-1 g (1-2 tablets) before bed. The tablets are swallowed whole, without chewing, with a small amount of water. The course of treatment is 4-6 weeks. and more. If necessary, the course is repeated.

Side effect. Constipation is possible when taking the drug. Sucralfate should not be prescribed together with tetracyclines (the absorption of tetracyclines is impaired).

Contraindications. Severe kidney damage and pregnancy.

Release form. Tablets of 0.5 g in a package of 100 pieces.

Storage conditions. In a dry place, protected from light.

PHOSFALUGEL (Fosfalugel)

Synonyms: Phosphalugel, Aluminum phosphate, Alfogel, Gasterin.

Colloidal gel containing aluminum phosphate (about 23%). The composition of the drug includes pectin and agaragar gel.

Pharmachologic effect. The drug has an enveloping effect and antacid (reduces stomach acidity) activity, helping to protect the gastric mucosa.

Indications for use. Used for peptic ulcers of the stomach and duodenum, gastritis (inflammation of the stomach), dyspepsia (indigestion), food intoxication (poisoning).

Method of administration and dose. Take orally undiluted, with a small amount of water or diluted in ]/2 glasses of water (possibly with added sugar).

Dose: 1-2 packets 2-3 times a day 30 minutes before meals.

Release form. Packaged in plastic bags of 16 g.

Storage conditions. In a dry place.

ANDREWS LIVER SALT

Pharmachologic effect. Combination drug, which has an antacid (reducing stomach acidity) effect. Sodium bicarbonate, which is part of it, reduces the acidity of gastric juice. In combination with citric acid, sodium bicarbonate forms a buffer solution, the pH (an indicator of the acid-base state) of which is higher than the pH of the stomach contents, as a result of which the drug increases the pH (reduces the acidity) of the stomach contents, having an antacid effect. Magnesium sulfate has a laxative effect.

Indications for use. Acute gastritis(inflammation of the stomach), chronic gastritis with normal secretory function of the stomach (secretion of gastric juice) in the acute phase, acute duodenitis (inflammation of the duodenum); peptic ulcer of the stomach and duodenum in the acute phase; pain, feeling of discomfort in the epigastrium (the area of ​​the abdomen located directly below the convergence of the costal arches and the sternum); heartburn after excessive consumption of alcohol, nicotine, coffee, sweets, errors in diet, taking medications; constipation.

Method of administration and dose. For adults with epigastric pain and heartburn, take 1 teaspoon of powder per 1 glass of water. If necessary, the drug can be used 4 times a day.

For constipation, take 2 teaspoons per 1 glass of water in the morning on an empty stomach or before bed.

For children under 12 years of age, the drug is prescribed at a dose equal to half the dose for adults.

Side effect. Rarely - pain in the epigastric region.

Contraindications. Hypersensitivity to the components of the drug; diabetes.

Release form. Powder for the preparation of a solution for oral administration in bottles of 227 g and 113 g, in bags of 5 g. Composition: magnesium sulfate - 17.4%, sodium bicarbonate - 22.6%, citric acid- 19.5%, sucrose - 40.5%.

Storage conditions. In a dry place.

ALIGASTRIN

Synonyms: Alugastrin.

Pharmachologic effect. It has an astringent, antacid (reduces stomach acidity), enveloping effect. When taken orally, it forms a uniform protective film on the surface of the gastric mucosa.

Indications for use. Used for peptic ulcers of the stomach and duodenum and hyperacid gastritis (inflammation of the stomach due to a persistent increase in acidity).

Method of administration and dose. Take orally 2-1 hours before meals and before bedtime, 1-2 teaspoons of suspension (a suspension of solid particles in water) or the contents of 1-2 sachets (5 or 10 ml) with a small amount of warm boiled water or without water.

Side effect. The drug is usually well tolerated; Nausea and vomiting are possible.

Release form. In bottles of 250 ml and 5 or 10 ml in plastic bags.

Storage conditions. In tightly closed bottles (or bags) in a place protected from light.

BISMUTH NITRATE BASIC (Bismuth! subnitras)

Pharmachologic effect. Antacid (reduces stomach acidity), astringent, protects the lining of the stomach.

Indications for use. As an astringent, weak antiseptic (disinfectant), fixative for gastrointestinal diseases. It also has a local astringent and anti-inflammatory effect.

Method of administration and dose. Orally 0.25-1 g (children 0.1-0.3-0.5 g) per dose 4-6 times a day before meals 15-30 minutes. Topically 1-2 times a day for dermatitis (skin inflammation), erosions (surface defects) and small skin ulcers.

Side effect. With long-term use in large doses, methemoglobinemia (increased levels of methemoglobin in the blood).

Release form. Powder; 10% ointment.

Storage conditions. In a sealed container, protected from light.

Bismofalk

Pharmachologic effect. A combined preparation containing bismuth nitrate main and bismuth subgallate. An antiulcer agent with bactericidal (bacteria-destroying) activity against Helikobacter Pylori, a microorganism that is considered as one of the causes of the occurrence and recurrence (repeated manifestation) of chronic gastritis (inflammation of the gastric mucosa) and peptic ulcer.

In the acidic environment of the stomach and duodenum, bismuth subgallate and bismuth subnitrate form complexes with glycoproteins (proteins) released from the damaged mucosa. This resulting complex, containing bismuth, forms a protective layer on the surface of erosions (defects of the mucous membrane) and ulcers, which protects them from the effects of hydrochloric acid and pepsin (an enzyme that decomposes peptides and proteins). The drug enhances the processes of regeneration (restoration) of the mucous membrane, increases the production of mucus and improves its protective properties.

Indications for use. Peptic ulcer stomach and duodenum; chronic gastritis in the acute stage; a feeling of fullness in the epigastric region (the area of ​​the abdomen located directly below the convergence of the costal arches and the sternum).

Method of administration and dose. The drug is prescribed orally, 2 tablets 3 times a day, 1-2 hours before meals. The tablets are taken without chewing, with a small amount of liquid. The duration of treatment is determined clinical course disease and should be at least 4 weeks even with rapid improvement or disappearance of complaints. At the same time, as with all bismuth preparations, the duration of treatment should not exceed 8 weeks. If it is necessary to repeat the course, you should take a break of 8 weeks.

Since the drug acts most actively in the acidic contents of the stomach, antacids (drugs that reduce stomach acidity), as well as milk, should not be taken simultaneously with bismofalk. If necessary, these drugs are taken no earlier than 30 minutes before taking bismofalk or 30 minutes after taking it, so as not to weaken the effect of bismofalk.

Side effect. Possible dark coloration of stool due to the formation of bismuth sulfide. With long-term use in high doses possible development of encephalopathy (brain diseases associated with the accumulation of bismuth in the central nervous system, characterized by its dystrophic changes).

Contraindications. Hypersensitivity to the components of the drug; heavy renal failure; pregnancy; lactation. The drug is not prescribed to children under 14 years of age.

Release form. Tablets containing basic bismuth nitrate 0.1 g and bismuth subgallate 0.05 g, in a package of 100 pieces.

Storage conditions.

Basic bismuth nitrate is also included in the composition of the preparations: neoanuzole suppositories, Vikair tablets, Vikalin tablets.

Bismuth subsalicylate

Synonyms: Desmol.

Pharmachologic effect. Antiulcer and antidiarrheal (antidiarrheal) agent, which also has an enveloping and antimicrobial effect. Forms an insoluble protective coating at the site of the ulcer. Increases the resistance of the mucous membrane to the action of pepsin (an enzyme that decomposes peptides and proteins), hydrochloric acid and enzymes. Increases the production of mucus in the stomach and improves its protective properties. The drug has a nonspecific antidiarrheal effect; Usually diarrhea (diarrhea) is stopped (removed) within 24 hours.

Indications for use. Peptic ulcer of the stomach and duodenum in the acute stage; chronic gastritis (inflammation of the gastric mucosa) with normal or increased secretory function (formation of gastric juice) in the acute stage; diarrhea of ​​various origins.

Method of administration and dose. For the treatment of peptic ulcers, 2 tablespoons of the drug (or 2 tablets) are prescribed every 4 hours, but not more than 6 times a day.

For the treatment of diarrhea, adults are prescribed 2 tablespoons (or 2 tablets) of the drug every 0.5-1 hour (but not more than 8 times a day).

For the treatment of diarrhea, children are prescribed the drug every 0.5-1 hour (but not more than 8 times a day) in the following single doses: at the age of 3-6 years - 1 teaspoon (or Uz tablets), 6-9 years - 2 teaspoons (or 2/3 tablets), 9-12 years - 1 tablespoon (or 1 tablet). For children under 3 years of age, the drug is prescribed in doses based on the child’s body weight as prescribed by a doctor.

If diarrhea lasts more than 48 hours or is accompanied by fever (sharp rise in body temperature), consultation with a doctor is necessary.

Shake the gel before use.

Side effect. Darkening of the tongue and dark coloration of stool are possible.

Contraindications. Allergy information acetylsalicylic acid and other salicylates in the anamnesis (medical history).

The drug should be prescribed with caution to sick and breastfeeding women.

Use caution when prescribing the drug to patients taking anticoagulants, antidiabetic agents, or antigout agents.

Release form. Tablets containing 0.262 g of bismuth subsalicylate, in a package of 30 pieces. Gel in bottles of 237 ml (1 ml - 0.0175 g of bismuth subsalicylate).

Storage conditions. In a carefully sealed package, protected from light.

BISMUTH SUBCITRATE (Bismuth! subnitras)

Synonyms: Bisnol, Ventrisol, Tribimol, De-Nol, Biscolvdtrat, De-Noltal, Duozol, Ulzeron, Bizmat, etc.

Pharmachologic effect. An antiulcer agent with bactericidal (bacteria-destroying) activity against Helicobacter pylori - microorganisms, which, in some cases, apparently contribute to the occurrence of chronic gastritis (inflammation of the gastric mucosa) and recurrent (recurrent) peptic ulcer.

In the acidic environment of the stomach and duodenum, it forms a protective film on the surface of ulcers and erosions (defects of the mucous membrane), which promotes their scarring, increases the resistance of the mucous membrane to the effects of pepsin (an enzyme that decomposes peptides and proteins), hydrochloric acid and enzymes. Increases the activity of cytoprotective (cell-protecting) mechanisms, increasing the synthesis of prostaglandin ei and the secretion (release) of bicarbonates.

Indications for use. Peptic ulcer of the stomach and duodenum. Exacerbation of gastroduodenitis (inflammation of the stomach and duodenum) in patients with peptic ulcer disease. Gastritis (inflammation of the stomach lining) caused by Helicobacter pylori.

Method of administration and dose. The drug is prescribed 1 tablet 3 times a day 30 minutes before breakfast, lunch and dinner and the 4th time before bedtime. Take the tablet with 1-2 sips of water (but not milk). Treatment is carried out for 4-6 weeks. If necessary, it can be extended to 8 weeks. After this, you should take a break for 8 weeks, during which you should not take other drugs containing bismuth.

When detected in a patient Helicobacter bacteria pylori, it is rational to combine treatment with the drug with oral administration of metronidazole 0.25 g 4 times a day for 10 days and/or amoxicillin 0.25 g 4 times a day for 10 days. In order to consolidate remission (temporary weakening or disappearance of disease manifestations) of diseases associated with Helicobacter pylori, as well as persistent sanitation (elimination and prevention of diseases) of the mucous membrane, it is advisable to conduct 3-4 two-week courses during the first year antibacterial therapy(bismuth

subcitrate + amoxicillin, or bismuth subcitrate + metronidazole, or bismuth subcitrate + furazolidone).

30 minutes before and after taking the drug, you should refrain from taking food, liquids and antacids (lowering stomach acidity).

The drug reduces the absorption of tetracycline.

At joint use with other drugs containing bismuth, the risk of increasing the concentration of bismuth in the blood plasma increases.

Side effect. Possible nausea, vomiting, more frequent bowel movements. While taking the drug, stool may become dark in color, as well as a slight darkening of the tongue. With long-term use of the drug in high doses, the development of encephalopathy (brain diseases associated with the accumulation of bismuth in the central nervous system, characterized by its degenerative changes) is possible.

Contraindications. Severe renal dysfunction, pregnancy, breastfeeding. The drug is not prescribed to children.

Release form. Tablets of 0.12 g bismuth subcitrate.

Storage conditions. In tightly sealed packages, protected from light.

GASTROPHARM (Gastropharm)

Pharmachologic effect. A combined preparation containing dried bacterial bodies of Lactobacillus Bulgaricus and their metabolic products, protein (25-30%), sucrose. Stimulates regeneration (restoration) processes in the mucous membrane of the stomach and duodenum, regulates the functions of the gastrointestinal tract.

Indications for use. Peptic ulcer of the stomach and duodenum in the acute phase; chronic gastritis (inflammation of the stomach) in the acute phase.

Method of administration and dose. Prescribe 1-2 tablets orally 3 times a day 30 minutes before meals. If necessary, the dose is increased to 8-12 tablets per day. The course of treatment is 30 days.

Side effect. Not found.

Contraindications. Hypersensitivity to the drug.

Release form. Tablets in a package of 6 pieces.

Storage conditions. In a dry place.

DALARGIN (Dalarginum)

Pharmachologic effect. From pharmacological properties dalargin deserves the greatest attention for its antisecretory (suppressing the secretion of digestive juices) activity, the ability to accelerate the healing of stomach and duodenal ulcers, as well as hypotensive (lowering arterial pressure) action.

Indications for use. The drug is recommended for use as remedy with exacerbations of gastric and duodenal ulcers.

Dalargin is also used in the complex therapy of obliterating diseases lower limbs(diseases associated with impaired blood flow through the arteries of the lower extremities) and alcoholism.

Method of administration and dose. For gastric and duodenal ulcers, dallargin is prescribed intravenously or intramuscularly. Single dose 0.001 g (1 mg). It is administered intramuscularly in 1 ml, and intravenously in 5-10 ml of isotonic sodium chloride solution. Intramuscular injections do 2 times, and intravenously 1 time per day. If necessary, one-time

the dose is increased to 0.002 g (2 mg), daily (intramuscular) - to 5 mg. The course of treatment lasts 3-4 weeks. The total dose of the drug per course of treatment is 30-50 mg.

In case of severe pain symptoms, simultaneous administration of antacids (reducing stomach acidity) is possible.

Also noted positive influence dalargin (intravenous slow administration of 1 mg in 10 ml of isotonic sodium chloride solution) on the mental functions of patients with alcoholism.

Injection solutions are prepared immediately before use.

Side effect. Dalargin injections are generally well tolerated; Possible reduction in blood pressure.

Contraindications. The drug should not be used during pregnancy and severe hypotension (low blood pressure).

Release form. Lyophilized (dehydrated by freezing in a vacuum) powder or porous mass in ampoules of 0.001 g (1 mg) in a package of 5 pieces.

Storage conditions. List B. In a dark place at a temperature not exceeding +20 °C.

FLACARBIN (Flacarbinum)

Pharmachologic effect. A combined drug that provides antispasmodic (relieves spasms), capillary-strengthening (strengthens the walls of the smallest blood vessels), anti-inflammatory effect.

Indications for use. Peptic ulcer of the stomach and duodenum.

Method of administration and dose. Inside, granules "/2 teaspoons 3 times a day before meals, washed down with "/2 glasses of warm water. Course - 3-4 weeks.

Side effects and contraindications. Not identified.

Release form. Granules in bottles of 100 g each. 100 g contain: lycurazide and quercetin - 2 g each, sodium carboxymethylcellulose and pectin - 10 g each, glucose - 76 g.

Storage conditions. In a dry place, protected from light.