PROTEKTIN (Protectinum)
Pharmachologic effect. Immunostimulating (increasing immunity - the body's defenses) remedy.
Indications for use. Decrease in immunological resistance (resistance) of the body.
Method of administration and dosage. Inside, 1-2 (up to 4-6) capsules per day for 2 months.
Contraindications
Release form. Capsules containing: borage oil - 0.1 g, cod liver oil - 0.1 g, tocopherol (vit. E) - 0.0525 g, ascorbic acid (vit. C) - 0.165 g, beta-carotene 30% - 0.25 g, yeast with selenium 1000 μg / g -0.05 g, soybean oil -0.0425 g, beeswax -0.015 g.
Storage conditions. Store in a cool dry place.
RIBOMUNIL (Ribomiuiilum)
The drug is based on fragments of microorganisms: pneumonic rods and diplococci, pyogenic (pyogenic) group A streptococci and hemophilic influenza.
Pharmachologic effect. Immunostimulating (increasing immunity - the body's defenses) means that increases specific and nonspecific immunity.
Indications for use. Recurrent (recurring) respiratory tract infections, bronchitis, ENT infections (prevention).
Method of administration and dosage. Inside, 3 tablets in the morning on an empty stomach 4 days a week for 3 weeks in the first month of treatment, in the next 5 months - 4 days a month.
Contraindications Hypersensitivity to the drug.
Release form. Tablets. One tablet contains ribosomes 0.00025 g and proteoglycans of the membrane part 0.000375 g.
Storage conditions. Store in a cool dry place.
SOLKOTRIKHOVAK (Solcotrichovacum)
Pharmachologic effect. Suspension (suspension) of inactivated bacteria of Lactabacteriumacidofilum strains. It has an immunostimulating (increasing immunity / body defenses /) effect.
Indications for use. Female trichomoniasis ( infectious disease caused by genitourinary Trichomonas), nonspecific bacterial vaginitis (inflammation of the vagina caused by bacteria).
Method of administration and dosage. Intramuscularly at a dose of 0.5 ml. Course - 3 injections with an interval of 2 weeks; a year later, another 0.5 ml is administered as a re-inoculation.
Side effect. Redness and swelling at the injection site, fever.
Contraindications
Release form. Solution for injection in ampoules of 0.5 ml in a package of 3 pieces. A 0.5 ml dose contains 7x109 killed bacteria and 0.25% phenol.
Storage conditions. In the refrigerator at a temperature of + 4- + S "C.
SOLKOUROVAK (Solcourovacum)
Pharmachologic effect. Multivalent vaccine based on 6 different strains of E. coli, Proteusmirabilis, Proteusmorganii, Klebsiellapneumoniae, Streptococcus faecalis. It has an immunostimulating (increasing immunity - the body's defenses) action.
Indications for use. Severe and acute recurrent (recurring) urinary tract infections: cystitis (inflammation of the bladder), urethritis (inflammation urethra), pyelonephritis (inflammation of the tissue of the kidney and renal pelvis), bacterial prostatitis(inflammation of the prostate gland caused by bacteria), etc.
Method of administration and dosage. Intramuscularly 0.5 ml 3 times with an interval of 1-2 weeks; revaccination (0.5 ml) after 1 year.
Side effect. Redness, feeling of tension, pain at the injection site, fever.
Contraindications Acute infectious diseases, diseases of the hematopoietic system, liver damage, heart failure.
Release form. Lyophilized (dried by freezing in a vacuum) powder for the preparation of injection solution in ampoules complete with a solvent.
Storage conditions. In a dark place at a temperature not exceeding +8 ° С.
TACTIVIN (Tactivinum)
Synonyms: T-activin.
A drug of a polypeptide nature, obtained from thymus(thymus) large cattle.
Pharmachologic effect. Immunomodulating (affecting the body's defenses) remedy. In immunodeficiency states (a decrease or absence of the body's defenses), the drug normalizes the quantitative and functional indicators of the T-system of immunity (the system of cellular protective functions of the body), stimulates the production of lymphokines (total
the name of biological active substances formed by cells participating in the implementation of the body's cellular defenses), including alpha- and gamma-interferon, restores the activity of T-killers (T-lymphocytes - blood cells involved in the formation of cellular mechanisms responsible for maintaining protective forces of the body), the functional activity of hematopoietic stem cells (cells from which blood cells are formed in the bone marrow) and normalizes a number of other indicators characterizing the tension T-cell immunity(systems of cellular protective functions of the body).
Indications for use. It is used in adults with immunodeficiency conditions with a predominant lesion of the T-system of immunity arising from infectious, purulent and septic processes (diseases associated with the presence of microbes in the blood), lymphoproliferative diseases (diseases associated with an increase in the formation of lymphoid cells): lymphogranulomatosis ( malignant disease lymphoid tissue), lymphocytic leukemia (cancer of the lymphoid tissue); multiple sclerosis (a systemic disease of the membranes of the nerve cells of the brain and spinal cord), tuberculosis, recurrent ophthalmic herpes (recurrent appearance of signs viral disease eye tissues), psoriasis, etc.
Method of administration and dosage. Apply subcutaneously. Usually, 1 ml of the drug (which is 40 μg / m2 or 1-2 μg / kg) is administered before bedtime 1 time per day every day for 5-14 days. If necessary, repeat the course of treatment.
In case of persistent disorders of immunity, taktivin is prescribed with a replacement purpose for 5-6 days, followed by the administration of the drug once every 7-10 days.
In multiple sclerosis, the drug is used daily for 5 days, then once every 5-14 days. The course of treatment is from 1 to 3 years. In severe cases of multiple sclerosis, taktivin is prescribed in combination therapy with corticosteroids.
For the treatment of surgical patients, taktivin is administered before surgery for 2 days and after it for 3 days.
In malignant neoplasms and autoimmune diseases, taktivin is prescribed in 5-6-day courses during the breaks of specific therapy.
For the treatment of patients with recurrent ophthalmic herpes, 0.1 ml of the drug (which is 10 μg / m2 or 0.1-0.2 μg / kg) is administered per day with an interval of 1 day for 14 days. The course of treatment is repeated after 4-6 months.
Contraindications Atopic form of bronchial asthma (nonspecific allergic bronchial asthma), pregnancy.
Release form. In vials 0.01% solution of 1 ml (100 μg).
Storage conditions. In a dry, dark place at a temperature of +2 to +7 "C.
THYMALINE (Thymalinum) Synonyms: Timarin.
A drug of polypeptide nature, obtained by extraction (extraction) from the thymus gland (thymus) of cattle.
Pharmachologic effect. Restores immunological reactivity (the body's response to pathogenic stimuli, usually accompanied by the formation of the body's protective properties) - regulates the number and ratio of T- and B-lymphocytes (blood cells responsible for the formation of cellular and tissue defenses of the body) and their subpopulations, stimulates reactions of cellular immunity (cellular defenses of the body), enhances phagocytosis (the process of active capture and destruction by phagocytes / blood cells / pathogens), stimulates the processes of regeneration (recovery) and hematopoiesis in case of their suppression, and also improves the processes of cellular metabolism (metabolism) ...
Indications for use. Used in adults and children as an immunomodulator (a substance that affects the body's defenses) and a biostimulator (a substance that increases metabolism, stimulates the body's defenses) in conditions and diseases accompanied by a decrease in immunity, including acute and chronic purulent inflammatory diseases of the bones and soft tissues; acute and chronic viral and bacterial infections; violation of regenerative (restorative) processes (bone fractures, burn disease and frostbite, trophic ulcers/ slow healing skin defects /, radiation tissue necrosis / tissue necrosis due to radiation /, peptic ulcer stomach and duodenum); bronchial asthma; multiple sclerosis (a systemic disease of the membranes of nerve cells in the brain and spinal cord); obliterating endarteritis (inflammation of the inner lining of the arteries of the extremities with a decrease in their lumen); rheumatoid arthritis (an infectious-allergic disease from the group of collagen diseases, characterized by chronic progressive inflammation of the joints); conditions associated with hypofunction (weakening of activity) of the thymus gland, with suppression of immunity and hematopoiesis after radiation therapy or chemotherapy in cancer patients and in other conditions.
They are also used for the prevention of infectious and other complications, in the post-traumatic and postoperative periods, in the course of radiation or chemotherapy, with the appointment of large doses of antibiotics.
Method of administration and dosage. Before injection, the contents of the vial are dissolved in 1-2 ml of isotonic sodium chloride solution. The drug is administered intramuscularly daily in the following doses: adults - 5-20 mg (30-100 mg per course of treatment), children under 1 year old - 1 mg; 1-3 years old - 1-2 mg; 4-6 years old - 2-3 mg; 7-14 years old - 3-5 mg for 3-10 days, depending on the severity of immunity disorders. If necessary, a second course of treatment is carried out (after 1-6 months).
WITH preventive purpose the drug is used intramuscularly daily for adults at 5-10 mg, for children - 1-5 mg for 3-5 days.
Release form. Sterile lyophilized (dried by freezing in a vacuum) powder in vials of 10 mg.
Storage conditions. In a dry, dark place.
THYMOGEN (Thymogenum)
Pharmachologic effect. Thymogen is a synthetically obtained dipeptide consisting of amino acid residues - glutamine and tryptophan. According to reports, the drug has an immunostimulating effect (activates the body's defenses) and enhances nonspecific resistance(stability) of the organism.
Indications for use. According to indications for use, it is mainly similar to other immunostimulants and is used in the complex therapy of adults and children for acute and chronic infectious diseases, accompanied by a decrease in cellular immunity, with the suppression of reparative (restorative) processes after severe injuries (bone fracture), necrotic processes ( necrosis
tissue), as well as in other conditions of immunodeficiency (decrease or absence of the body's defenses).
For prophylactic purposes, it is used to prevent complications in infectious diseases, operations.
Method of administration and dosage. The drug is administered intramuscularly for 3-10 days for adults 50-100 mcg (300-1000 mcg per course), children under 1 year old - 10 mcg, 1-3 years old - 10-20 mcg, 4-6 years old - 20-30 mcg, 7-14 years old - 50 mcg. If necessary, repeat the course in 1-6 months.
Sometimes it is used intranasally (in the nose), 2-3-5 drops of a 0.01% solution in each half of the nose 2-3 times a day.
Side effect. Not found.
Contraindications Not identified.
Release form. Lyophilized (dehydrated by freezing in a vacuum) powder or porous mass of 0.0001 g (0.1 mg = 100 μg) in glass hermetically sealed vials in a package of 5 or 10 pieces and 0.01% solution in 5 ml vials. It is also produced in the form of a 0.01% solution for injection in 1 ml ampoules in a package of 5 pieces.
Storage conditions. List B. In the dark place at a temperature not higher than +20 ° C, ampoules - at a temperature not higher than +4 "C.
Timoptin (Thymoptinum)
Like thymalin and taktivin, thymoptin contains a complex of polypeptides from the mammalian thymus gland.
Pharmachologic effect. Immunostimulating (activating the body's defenses) agent.
Indications for use. In action and indications for use, it is similar to taktivin.
Method of administration and dosage. Injected under the skin. Before the introduction, dissolve the contents of 1 bottle (100 μg) in 0.5-1.0 ml of isotonic sodium chloride solution. Assign to adults at the rate of 70 mcg per 1 m2 of body surface (about 100 mcg). The course of treatment consists of 4-5 injections at 4-day intervals. If necessary, repeat courses are carried out, setting the intervals depending on the clinical and immunological parameters.
Contraindications Individual intolerance to the drug. Pregnancy. In the presence of rhesus conflict (mismatch between the Rh factor of the pregnant woman and the fetus).
Release form. Lyophilized (dried by freezing in a vacuum) powder, 100 μg (0.0001 g) in hermetically sealed glass vials.
Storage conditions. List B. In a dry, dark place at a temperature not exceeding +20 ° C.
Tonsilgon (Tonsilgonum)
Pharmachologic effect. It has an immunostimulating (increasing immunity - the body's defenses) and antimicrobial action.
Indications for use. Viral and bacterial infections, including for the prevention of complications arising after them; supportive treatment with antibiotic therapy; recurrent (recurring) and chronic respiratory tract infections; susceptibility to infectious diseases and a decrease in immunity (body defenses) in childhood.
Method of administration and dosage. Inside, 2 tablets or 25 drops (adolescents - 1 tablet or 15 drops; children younger age- 10 drops; infancy- 5 drops) 3-6 times a day.
Side effect. Not found.
Contraindications Not identified.
Release form. Dragee in a package of 50, 100 and 200 pieces; drops in bottles of 50 and 100 ml. One dragee contains: dry powder from marshmallow root - 0.008 g, chamomile flowers - 0.006 g, CynosbatisineSemine fruit - 0.004 g, horsetail herb - 0.01 g, walnut leaf - 0.012 g, yarrow herb - 0.004 g, oak bark - 0.004 g and dandelion herbs -0.004 g. 100 g drops contain 29 g of alcohol extract from 0.4 g of marshmallow root, 0.3 g of chamomile flowers, 0.4 g of CynosbatisineSemine fruit, 0.5 g of horsetail herb, 0.4 g of walnut leaf , 0.4 g of yarrow herb, 0.2 g of oak bark and 0.4 g of dandelion herb.
Storage conditions. In a cool, dark place.
ESTIFAN (Estifanum)
Pharmachologic effect. Immunostimulating (increasing immunity - the body's defenses) remedy. Increases phagocytic activity (the level of activity of blood cells that actively capture and destroy pathogens) neutrophils (blood cells) and macrophages (blood cells capable of capturing and destroying pathogenic microbes), potentiates (enhances) the production of interleukin-1 by macrophages, induces (causes ) transformation of beta-lymphocytes (blood cells that take part in the formation of the body's defenses) into plasma cells (cells that produce immunoglobulin - a specific protein involved in the formation of the body's defenses) and T-killer activity (the activity of T-lymphocytes - the formed elements of blood taking part in the formation of cellular mechanisms responsible for maintaining the body's defenses).
Indications for use. Immunodeficiency states (decreased immunity) in chronic recurrent (recurring) inflammatory diseases (chronic bronchitis, pneumonia, diseases of the ENT organs / ear, throat, nose / and others).
Method of administration and dosage. Inside, 1-2 tablets 3 times a day after meals. The course is 10-20 days with a repeat in 2-3 weeks.
Contraindications Hypersensitivity to the drug.
Release form. Tablets of 0.2 g in a pack of 10 and 30 pieces.
Storage conditions. In a dry, dark place.
See also amigluracil, arbidol, retinol acetate, ascorbic acid, riboflavin, pyridoxine hydrochloride, cyanocobalamin, methyluracil, pentoxil, splenin, encad, ceruloplasmin, interferoi, reaferon.
Vilosenum
Lyophilized (dehydrated by freezing in a vacuum) dialysate extract (purified extract) of the thymus gland of cattle.
Contains compounds of nucleotide and nucleoside nature, amino acids, oligopeptides, amines, inorganic salts.
Pharmachologic effect. It has immunomodulatory activity (affects the protective properties of the body), stimulates the proliferation and differentiation of T-lymphocytes (an increase in the number and specialization of blood cells responsible for the cellular defense reaction of the body), suppresses the development of hypersensitivity (a type of allergic reaction of the body) of an immediate type.
Unlike thymalin, taktivin and timoptin, vilozen is used topically as nasal instillation or intranasal inhalation (inhalation through the nose medicinal substances in gaseous or aerosol form).
Indications for use. Allergic diseases of the upper respiratory tract: pollinosis (allergic disease caused by pollen), allergic rhinosinusitis (combined inflammation of the mucous membrane of the nasal cavity and paranasal sinuses).
Method of administration and dosage. It is prescribed for adults and older children. Immediately before use, add 2 ml of boiled water or isotonic sodium chloride solution to an ampoule with vilosen. 5-7 drops are instilled into each nostril 5 times a day or intranasal inhalation is done. The course of treatment is 14-20 days. If necessary, courses of treatment are repeated. Treatment should be started at the first signs of the disease or prophylactically (before the onset of clinical symptoms).
There is evidence of the use of vilosen in patients with bronchial asthma. Enter into the nasal passages at 0.02 g (20 mg) per day for 14-20 days.
Side effect. When using vilosen, it is possible that in the first days of a passing headache, an increase in nasal congestion is possible.
In case of individual intolerance, the drug is canceled.
Contraindications In bronchial asthma, contraindications are the presence of a bacterial infection and a pronounced broncho-obstructive syndrome (inflammation of the bronchi, combined with a violation of air permeability through them).
Release form. 0.02 g of substance in ampoules in a package of 10 ampoules.
Storage conditions. List B. In the dark place at a temperature not exceeding +20 "C.
GALIUM-HEL (Galium-heel)
Pharmachologic effect. Homeopathic medicine... Has an activating effect on the detoxification (neutralizing) functions of cellular enzyme systems, as well as detoxification and drainage processes connective tissue... Stimulates immunity (body defenses)
Indications for use. For stimulation of nonspecific immunity and as a detoxification agent for severe forms of infectious diseases, pain syndrome and chronic diseases internal organs(cachexia / extreme degree of physical exhaustion /, neuropsychiatric exhaustion, septic / associated with the presence of microorganisms in the blood / complications), especially in chronic diseases accompanied by impaired enzyme metabolism (bronchial asthma, bronchiectasis / expansion of limited areas of the bronchi /, hypertension / persistent rise blood pressure/, liver disease, colitis / inflammation of the colon /, achilia / lack of secretion in the stomach of hydrochloric acid and enzymes /, Parkinson's disease, multiple sclerosis / systemic disease of the membranes of nerve cells of the spinal cord and brain /, amyotrophic lateral sclerosis / disease of the central nervous system, characterized by impaired movement of the muscles of the face and neck /, causalgia / pain syndrome that developed after a lesion of a peripheral nerve, characterized by intense burning pain and vascular disorders along its course /, neuralgia / pain spreading along the nerve / etc.). Precarcinosis (precancerous conditions). In geriatric practice to stimulate immunity in the elderly.
Method of administration and dosage. Usually prescribed 10 drops 3 times a day. In the acute period, 10 drops are prescribed every 15-30 minutes for 1-2 days. In case of neoplasms, the drug is prescribed 3-4 times a day, 5-50 drops. The maximum daily dose of the drug is 150-200 drops.
In case of precarcinosis (precancerous conditions) and cancer, it is advisable to use it in combination with other homeopathic medicines.
Release form. Drops for oral administration, 30 and 100 ml in a dropper bottle
Composition (per 100 ml): galium aparine D3, galium album D3 - 4 ml each; sedum acre D3, sempervivum tectorium D4 clematis D4, thuja D3, caltha palustris D3, ononis spinosa D4, juniperus communis D4, hedera helix D4, betula alba D2, saponaria D4, echinacea angustifolia D5, calcium fluoratum D8, phosphorus D8, aunim DIG, argentum D8, apis melifica acidum nitricum D12, pyrogenium D6 - no 5 ml; urtica D3 - 2 ml.
Side effect. When used according to indications and at the recommended dosage, it has not been identified.
Contraindications Hypersensitivity to the components of the drug.
Storage conditions. In a cool place.
IMMUNAL
Pharmachologic effect. Stimulant of nonspecific immunity. The juice of Echinacea purpurea, which is part of the immunal, contains active substances of a polysaccharide nature, which stimulate bone marrow hematopoiesis, as a result of which the number of granulocytes (one of the types of leukocytes - blood cells) increases by 34-89%, and also increases the activity of phagocytes (the common name of blood cells capable of capturing and destroying pathogenic microbes) and cells of the reticuloendothelial system of the liver. Immunal has antiviral action against influenza and herpes viruses.
Indications for use. Prophylaxis colds and flu; weakening of the functional state of the immune system caused by various factors(impact ionizing radiation, ultraviolet rays, chemotherapy drugs; long-term therapy antibiotics; exposure to various toxic compounds in the air, water, food - heavy metals, pesticides, insecticides, fungicides); chronic inflammatory diseases: rheumatism, polyarthritis (inflammation of several joints), prostatitis (inflammation of the prostate gland), gynecological diseases.
Method of administration and dosage. Adults are prescribed in an average dose of 20 drops 3 times a day. The drug is taken with a small amount of liquid. In the acute stage of the disease, the initial dose is 40 drops, then the first 2 days are taken 20 drops every 1-2 hours, after which the treatment is continued with medium doses.
Children from 1 to 6 years old are prescribed 5-10 drops 3 times a day; children from 6 to 12 years old - 10-15 drops 3 times a day.
The minimum duration of the course of treatment is 1 week; maximum - 8 weeks.
In the case of long-term storage of the drug, it may become cloudy, and a precipitate consisting of active polysaccharides may appear. In this case, shake the bottle several times before use.
Side effect. In rare cases, hypersensitivity reactions are possible.
Contraindications Tuberculosis; leukemia (a malignant tumor arising from hematopoietic cells and affecting the bone marrow / blood cancer /); collagenoses (common name for connective tissue diseases / rheumatism, rheumatoid arthritis, systemic lupus erythematosus, systemic scleroderma, nodular periarthritis); multiple sclerosis (a systemic disease of the membranes of nerve cells in the brain and spinal cord); allergic reactions.
Release form. Drops for oral administration in bottles of 50 ml. 1 ml contains 0.8 ml of Echinacea purpurea juice.
Storage conditions. In a cool, dark place.
IMMUNOGLOBULIN (Immunoglobulinum)
Synonym: Immunoglobin, Imogam-RAZH, Intraglobin, Pentaglobin, Sandoglobin, Cytopect, Human normal immunoglobulin, Human antistaphylococcal immunoglobulin, Immunoglobulin against human tick-borne encephalitis, liquid, Human tetanus immunoglobulin.
Pharmachologic effect. A human immunoglobulin molecule contains two light and two identical heavy chains. Heavy polypeptide chains have 5 structurally and functionally different classes of immunoglobulins: IgG, IgA, IgM, IgD, IgE. When treated with Ig-proteinases (enzymes that decompose proteins), in particular, papain, 3 large fragments are obtained. Two of them are identical and are designated as Fab (Fragmentantigenbinding). The third fragment is designated as Fc (Fragmentcrystalline). The Fc fragment determines various effective functions of antibodies (blood proteins formed in response to the ingress of foreign proteins and toxins into the body), which have nothing to do with their specificity, binding of compliment components, interaction with the Fc receptor of macrophages (blood cells capable of capturing and destroying pathogenic microbes) and dr.
IgG includes a variety of antibodies against bacteria, their toxins and viruses. IgG is contained not only in the vascular bed, but easily penetrates into the extravascular (extravascular) spaces. It is the only class of immunoglobulins that crosses the placenta and provides immune protection newborn.
IgM is a pentamer. those. contains 5 four-chain structures. Each IgM molecule has 10 Fab fragments capable of specific interaction with the antigen and having a high antigen-binding activity, which is manifested only in the case of an intact molecule. Antibodies related to IgM appear in the vascular bed at early stages immune response, performing a protective function in the initial phase of the development of infectious inflammation.
IgA is contained both in blood serum (about 50% of the total IgA content in the body) and in various secretions, which protects the mucous membranes from pathogenic (pathogenic) microorganisms. Unlike IgG and IgM, IgA antibodies do not activate the compliment and do not induce the release of inflammatory mediators.
The pharmacological action of Igу preparations of patients in whom there is a deficiency of antibodies is determined by the presence in the preparations of immunoglobulins of antibodies directed against certain bacteria and viruses. A number of immunoglobulin preparations have a wide range of antibodies, which depends on the size of the plasma pool used to isolate Ig. Usually a pool of 1000 or more healthy donors is used. Thus, Ig isolated from the pool of plasma of healthy donors contains antibodies that are normally found in the donor contingent. Some immunoglobulin preparations contain antibodies of the same specificity. The pharmacological action of Ig drugs in autoimmune diseases (diseases based on allergic reactions to the body's own tissues or waste products) is under study. Several mechanisms have been proposed, among them blockade of the Fc receptor function of phagocytic cells, inhibition of production or neutralization of autoantibodies with anti-idiopathic antibodies, influence on the function of T cells (blood cells responsible for the cellular defense reaction of the body), production and activity of cytokines.
Indications for use. Substitution therapy (introduction into the body of a substance / immunoglobulin /, natural education which is reduced or discontinued) in order to prevent infections in primary immunodeficiency syndromes; agammaglobulinemia (absence of gammaglobulins / specific proteins involved in the formation of the body's defenses / in the blood); common variable immunodeficiencies associated with agammaglobulinemia; with deficiencies of UgG subclasses. Substitution therapy for the prevention of infections in secondary immunodeficiency syndrome caused by the following conditions: chronic lymphocytic leukemia (cancer of the lymphoid tissue), AIDS in children, transplant bone marrow... Idiopathic (of immune origin) thrombocytopenic purpura (multiple hemorrhages in the skin and mucous membranes associated with a low platelet count in the blood). Kawasaki syndrome (usually as an adjunct to standard medication acetylsalicylic acid). Severe bacterial infections, including sepsis (infection of the blood with microbes from the focus of purulent inflammation), in combination with antibiotics, and viral infections. Prevention of infections in premature infants with low birth weight (less than 1500 g). Guillain-Barré syndrome and chronic inflammatory demyelinating polyneupropathy. Neutropenia (decreased content of neutrophilic granulocytes in the blood) of autoimmune origin and autoimmune hemolytic anemia(a decrease in the content of hemoglobin in the blood due to the increased breakdown of red blood cells in the blood). True erythrocyte aplasia mediated through antibodies. Thrombocytopenia (low platelet count in the blood) of immune origin, such as post-infusion purpura or isoimmune thrombocytopenia in newborns. Hemophilia (decreased blood clotting) caused by the formation of antibodies to factor P. Treatment of myasteniagravis (diseases of the nervous and muscular systems, manifested by weakness and pathological fatigue of various muscle groups). Prevention and treatment of infections during therapy with cytostatics (agents that prevent cell division) and immunosuppressants (agents that suppress the immune system / the body's defenses /). Prevention of recurrent miscarriage.
Method of administration and dosage. The drug is administered intravenously. Doses are set individually, taking into account the indications, the severity of the disease, the state of the patient's immune system and individual tolerance.
In primary immunodeficiency syndromes, usually single dose is 0.2-0.8 g / kg of body weight (average 0.4 g / kg). The drug is administered at intervals of 3-4 weeks in order to achieve and maintain minimum levels of IgG in blood plasma of at least 5 g / l. In secondary immunodeficiency syndromes, a single dose is usually 0.2-0.8 g / kg. The drug is administered at intervals of 3-4 weeks. For the prevention of infections in patients who undergo bone marrow allotransplantation (bone marrow transplant obtained from a donor / other person /), the recommended dose is 0.5 g / kg. It can be administered once 7 days before transplantation (transplant) and then repeated once a week for the first 3 months after transplantation and once a month for the next 9 months.
In idiopathic thrombocytopenic purpura, an initial single dose of 0.4 g / kg is administered for 5 consecutive days. Perhaps the appointment of a total dose of 0.4-1.0 g / kg once or for two consecutive days. If necessary, in the future, you can enter at 0.4 g / kg at intervals of 1-4 weeks to maintain a sufficient level of platelets.
With Kawasaki syndrome: 0.6-2 g / kg in several doses for 2-4 days.
In severe bacterial infections (including sepsis) and viral infections 0.4-1 g / kg daily for 1-4 days.
For the prevention of infections in premature infants with low birth weight, 0.5-1 g / kg is prescribed with an interval of 1 to 2 weeks.
In Guillain-Barré syndrome, chronic inflammatory demyelinated polyneuropathy, it is usually prescribed at 0.4 g / kg for 5 consecutive days. If necessary, 5-day courses of treatment are repeated at 4-week intervals.
Depending on the specific situation lyophilized (dried by freezing under vacuum) preparation can be dissolved in 0.9% sodium chloride solution, in water for injection or in 5% glucose solution. The concentration of immunoglobulin in any of these solutions is from 3 to 12%, depending on the volume used.
Patients who receive the drug for the first time should be administered it in the form of a 3% solution, and the initial infusion rate should be from 0.5 to 1 ml / min (approximately 10 to 20 drops per minute). In the absence of side effects during the first 15 minutes, the infusion rate can be gradually increased to 2.5 ml / min (approximately 50 drops per minute).
Patients who regularly receive and tolerate immunoglobulin can be administered the drug in higher concentrations (in the flesh up to 12%).
A separate dropper should always be used to administer the drug solution. Shaking the vial should be avoided as this would result in pricing. For administration, only a clear, particle-free solution can be used. After preparation of the solution, the infusion should be made immediately. The remaining unused solution should be discarded.
Side effect. Side effects of immunoglobulin administration are more likely with the first infusion. They occur shortly after the start of the infusion or within the first 30-60 minutes. Possible headache, nausea, less often - dizziness; in rare cases - vomiting, abdominal pain, diarrhea (diarrhea). Hypotension or hypertension (decrease or increase in blood pressure) tachycardia (increased heart rate, feeling of tightness or pain in the chest, cyanosis (blue skin and mucous membranes), shortness of breath. increased sweating feeling tired, feeling unwell; rarely, back pain, myalgia (muscle pain), numbness, hot flashes, or a feeling of coldness. In extremely rare cases, severe hypotension, collapse ( a sharp decline blood pressure) and loss of consciousness.
Most of the side effects are associated with a relatively high rate of infusion and can be stopped (removed) when it decreases or the infusion is temporarily stopped. In case of severe side effects (severe hypotension, collapse), the infusion should be discontinued; intravenous administration of adrenaline, glucocorticoids, antihistamines and plasma-interfering solutions may be indicated.
Contraindications Hypersensitivity to human immunoglobulins, especially in patients with IgA deficiency due to the presence of antibodies to IgA.
Release form. Lyophilized dry matter for infusion in vials (= 1 dose) containing 0.5 g, 1 g, 3 g, 6 g, 10 g or 12 g of human immunoglobulin.
Storage conditions. List B. In the dark place at a temperature not higher than +25 C. The drug should not be frozen.
Immunomodulators are drugs that help the body fight bacteria and viruses by strengthening the body's defenses. Adults and children are allowed to take such medications only as directed by a doctor. Immunologic drugs have a lot of adverse reactions in case of non-compliance with the dosage and the wrong selection of the drug.
In order not to harm the body, you need to competently approach the choice of immunomodulators.
Description and classification of immunomodulators
What are immunomodulatory drugs in general terms is clear, now it is worthwhile to figure out what they are. Immunomodulatory agents have certain properties that affect human immunity.
There are the following types:
- Immunostimulants- These are a kind of immunostimulating drugs that help the body to develop or strengthen the already existing immunity to a particular infection.
- Immunosuppressants- suppress the activity of immunity in the event that the body begins to fight with itself.
All immunomodulators perform different functions to some extent (sometimes even several), therefore they also distinguish:
- immune-strengthening agents;
- immunosupportive agents;
- antiviral immunostimulating drugs;
- antineoplastic immunostimulating agents.
It makes no sense to choose which drug is the best of all the groups, since they stand at the same level and help with various pathologies. They are incomparable.
Their action in the human body will be aimed at immunity, but what they will do depends entirely on the class of the selected drug, and the difference in the choice is very large.
An immunomodulator can be by nature:
- natural (homeopathic medicines);
- synthetic.
Also, an immunomodulatory drug can be different in the type of synthesis of substances:
- endogenous - substances are synthesized already in the human body;
- exogenous - substances enter the body from the outside, but have natural sources of plant origin (herbs and other plants);
- synthetic - all substances are grown artificially.
The effect of taking a drug from any group is quite strong, so it is also worth mentioning how dangerous these drugs are. If immunomodulators are used uncontrollably for a long time, then when they are canceled, the real immunity of a person will be zero and there will be no way to fight infections without these drugs.
If drugs are prescribed for children, but the dosage is not correct for some reason, this may contribute to the fact that the body of a growing child cannot strengthen its defenses on its own and subsequently the baby will often get sick (you need to choose special children's medicines). In adults, such a reaction can also be noted due to the initial weakness of the immune system.
Video: advice from Dr. Komarovsky
What are they prescribed for?
Immune drugs are prescribed to those people whose immune status is significantly lower than normal, and therefore their body is unable to fight various infections... The appointment of immunomodulators is appropriate in the case when the disease is so strong that even a healthy person with good immunity will not be able to overcome it. Most of these drugs have antiviral effects, and therefore are prescribed in combination with other drugs to treat many diseases.
Modern immunomodulators are used in such cases:
- with allergies to restore the body's strength;
- with herpes of any type to eliminate the virus and restore immunity;
- with flu and acute respiratory viral infections to eliminate the symptoms of the disease, get rid of the causative agent of the disease and maintain the body in rehabilitation period so that other infections do not have time to develop in the body;
- with a cold for a speedy recovery, so as not to use antibiotics, but to help the body recover on its own;
- in gynecology, for the treatment of certain viral diseases, an immunostimulating drug is used to help the body cope with it;
- HIV is also treated with immunomodulators of various groups in combination with other drugs (various stimulants, drugs with antiviral effects, and many others).
For a specific disease, even several types of immunomodulators can be used, but all of them must be prescribed by a doctor, since the self-administration of such strong drugs can only worsen a person's health.
Features in the appointment
Immunomodulators should be prescribed by a doctor so that he can select an individual dosage of the drug according to the age of the patient and his illness. These medicines are different in their form of release, and the patient can be prescribed one of the most convenient forms for taking:
- tablets;
- capsules;
- injections;
- candles;
- injections in ampoules.
Which is better for the patient to choose, but after coordinating his decision with the doctor. Another plus is that inexpensive but effective immunomodulators are being sold, and therefore the problem with the price will not arise in the way of eliminating the disease.
Many immunomodulators have natural plant components in their composition, others, on the contrary, contain only synthetic components, and therefore it will not be difficult to choose a group of drugs that is better suited in one case or another.
It should be borne in mind that taking such drugs should be prescribed with caution to people from certain groups, namely:
- for those preparing for pregnancy;
- for pregnant and breastfeeding women;
- for children under one year old, it is better not to prescribe such drugs at all unless absolutely necessary;
- children from 2 years of age are prescribed strictly under the supervision of a doctor;
- To old people;
- people with endocrine diseases;
- with severe chronic diseases.
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The most common immunomodulators
Many effective immunomodulators are sold in pharmacies. They will differ in their quality and price, but with the correct selection of the drug, they will well help the human body in the fight against viruses and infections. Consider the most common list of drugs in this group, the list of which is shown in the table.
Photos of drugs:
Interferon
Likopid
Decaris
Kagocel
Arbidol
Viferon
Amiksin
Classification of immunoactive agents:
A: Immunostimulating agents:
I IC of bacterial origin
1. Vaccines (BCG, CP)
2. Microbial lipopolysaccharides of Gr-negative bacteria
ry (prodigiosan, pyrogenal, etc.)
3. Low molecular weight immunocorrectors
II Preparations of animal origin
1. Preparations of thymus, bone marrow and their analogs (ty
raspberry, taktivin, thymogen, vilosen, myelopid, etc.)
2. Interferons (alpha, beta, gamma)
3. Interleukins (IL-2)
III Herbal preparations
1. Yeast polysaccharides (zymosan, dextrans, glucans)
IV Synthetic immuno active funds
1. Derivatives of pyrimidines (methyluracil, pentoxil,
orotic acid, diucifon)
2. Derivatives of imidazole (levamisole, dibazole)
3. Microelements (Compounds of Zn, Cu, etc.)
V Regulatory peptides (tuftsin, dolargin)
VI Other immunoactive agents (vitamins, adaptogens)
B: Immunosuppressants
I Glucocorticoids
II Cytostatics
1. Antimetabolites
a) purine antagonists;
b) pyrimidine antagonists;
c) amino acid antagonists;
d) antagonists of folic acid.
2. Alkylating agents
3. Antibiotics
4. Alkaloids
5. Enzymes and enzyme inhibitors
Along with the above means, physical and biological methods of influencing the immune system are distinguished:
1. Ionizing radiation
2. Plasmapheresis
3. Drainage of the thoracic lymphatic duct
4. Anti-lymphocyte serum
5: Monoclonal antibodies
Pathology of immune processes is very common. According to far from complete data, the participation, to one degree or another, of the immune system in the pathogenesis of diseases of internal organs has been proven for 25% of patients in the country's therapeutic clinics.
The rapid development of experimental and clinical immunology, the deepening of knowledge about the pathogenesis of immune disorders in various diseases, determined the need for the development of a method of immunocorrection, the development of experimental and clinical immunopharmacology. Thus, a special science was formed - immunopharmacology, a new medical discipline, the main task of which is the development of pharmacological regulation of the impaired functions of the immune system using immunoactive (immunotropic) agents. The action of these funds is aimed at normalizing the functions of cells involved in the immune response. Here, the modulation of two conditions encountered in the clinic is possible, namely, immunosuppression or immunostimulation, which significantly depends on the characteristics of the patient's immune response. This raises the problem of conducting optimal immunotherapy, modulating immunity in a clinically necessary direction. Thus, the main goal of immunotherapy is to target the ability of the patient's body to an immune response.
Based on this, and also considering that in clinical practice the doctor may need to carry out both immunosuppression and immunostimulation - all immunoactive agents are divided into immunosuppressants and immunostimulants.
Immunostimulants are, as a rule, drugs that integrally increase the humoral and cellular immune response in general.
Due to the complexity of the choice specific means, the scheme and duration of therapy should dwell in more detail on the characteristics and clinical application of the most promising immunostimulating drugs that have been tested in the clinic.
The need to stimulate the immune system arises with the development of secondary immunodeficiencies, that is, with a decrease in the function of effector cells of the immune system caused by a tumor process, infectious, rheumatic, bronchopulmonary diseases, pyelonephritis. which ultimately leads to the chronicity of the disease, the development of an opportunistic infection, and resistance to antibacterial treatment.
The main feature of immunostimulants is that their action is directed not at the pathological focus or the causative agent of the disease, but at the nonspecific stimulation of populations of monocytes (macrophages, T- and B-lymphocytes and their subpopulations).
By the type of exposure, there are two ways to enhance the immune response:
1. Active
2. Passive
The active method, like the passive one, is specific and nonspecific.
An active specific method for enhancing the immune response includes the use of methods for optimizing the antigen administration schedule and antigenic modification.
An active nonspecific way to enhance the immune response includes, in turn, the use of adjuvants (Freund, BCG, etc.), as well as chemicals and other drugs.
A passive specific method for enhancing the immune response involves the use of specific antibodies, including monoclonal antibodies.
A passive nonspecific method includes the introduction of donor plasma gamma globulin, bone marrow transplantation, the use of allogeneic drugs (thymic factors, lymphokines).
Since there are certain limitations in the clinical setting, nonspecific therapy is the main approach to immunocorrection.
Currently, the number of immunostimulating agents used in the clinic is quite large. All existing immunoactive agents are used as drugs pathogenetic therapy, capable of influencing various links of the immune response, and therefore these agents can be considered as homeostatic agents.
In terms of chemical structure, method of production, mechanism of action, these agents represent a heterogeneous group, therefore there is no single classification. The most convenient is the classification of immunostimulants by origin:
1. ICs of bacterial origin
2. IP of animal origin
3. IP of plant origin
4. Synthetic ICs of various chemical structures
5. Regulatory peptides
6. Other immunoactive agents
Immunostimulants of bacterial origin include vaccines, lipopolysachyrides of Gr-negative bacteria, low-molecular-weight immunocorrectors.
In addition to the induction of a specific immune response, all vaccines induce immunostimulating effects to varying degrees. Most studied BCG vaccines(containing the non-pathogenic bacillus Calmette-Guerin) and CP (Corynobacterium parvum) are pseudodifteroid bacteria. With their introduction, the number of macrophages in the tissues increases, their chemotaxis and phagocytosis increase, monoclone is observed
nal activation of B-lymphocytes, the activity of natural killer cells increases.
In clinical practice, vatskins are used mainly in oncology, where the main indications for their use are the prevention of relapses and metastases after combined treatment of the tumor carrier. Typically, the initiation of such therapy should be one week ahead of other treatments. For the introduction of BCG, for example, you can use the following scheme: 7 days before the operation, 14 days after it and then 2 times a month for two years.
Side effects include many local and systemic complications:
Ulceration at the injection site;
Long-term persistence of mycobacteria at the injection site;
Regional lymphadenopathy;
Heartache;
Collapse;
Leukothrombocytopenia;
DIC syndrome;
Hepatitis;
With repeated injections of the vaccine into the tumor, anaphylactic reactions can develop.
The most serious danger in the use of vaccines for the treatment of patients with neoplasms is the phenomenon of immunological enhancement of tumor growth.
Due to these complications, their high frequency, vaccines as immunostimulants find less and less use.
Bacterial (microbial) lipopolysaccharides
The frequency of use of bacterial lipopolysaccharides in the clinic is growing rapidly. The LPSs of gram-negative bacteria are used especially intensively. LPSs are the structural components of the bacterial wall. The most commonly used is prodigiosan obtained from Bac. prodigiosum and pyrogenal derived from Pseudomonas auroginosa. Both drugs increase resistance to infection, which is achieved primarily by stimulating nonspecific defense factors. The drugs also increase the number of leukocytes and macrophages, enhance their phagocytic activity, the activity of lysosomal enzymes, and the production of interleukin-1. This is probably why LPS are polyclonal stimulators of B-lymphocytes and inducers of interferons, and in the absence of the latter they can be used as their inducers.
Prodigiosan (Sol. Prodigiosanum; 1 ml of 0, 005% solution) is administered intramuscularly. Usually a single dose for adults is 0.5-0.6 ml, for children 0.2-0.4 ml. Enter at intervals of 4-7 days. The course of treatment is 3-6 injections.
Pyrogenal (Pyrogenalum in amp. 1 ml (100; 250; 500; 1000 MPD minimum pyrogenic doses)) The dose of the drug is selected individually for each patient. Injected intramuscularly once a day (every other day). The initial dose is 25-50 MTD, while the body temperature rises to 37, 5-38 degrees. Or they are injected at 50 MTD, daily increasing the dose by 50 MTD, bringing it to 400-500 MTD, then gradually decreasing it by 50 MTD. The course of treatment is up to 10-30 injections, only 2-3 courses with a break of at least 2-3 months.
Indications for use:
With protracted pneumonia,
Some variants of pulmonary tuberculosis,
Chronic ostiomyelitis
To reduce the severity of allergic reactions
(with atopic bronchial asthma),
To reduce the incidence of anemia in patients with chronic
kim tonsillitis (with prophylactic endonasal administration
Pyrogenal is also shown:
To stimulate recovery processes after
damage and diseases of the central nervous system,
For resorption of scars, adhesions, after burns, injuries, spa
erythematosus,
With psoriasis, epidymitis, prostatitis,
For some persistent dermatitis (urticaria),
For chronic inflammatory diseases of women's polo
out organs (prolonged sluggish current inflammation of the appendages),
As an additional tool in the complex therapy of syphilis.
Side effects include:
Leukopenia
Aggravation chronic diseases intestines, diarrhea.
Prodigiosan is contraindicated in myocardial infarction, central violations: chills, headache, fever, joint and lower back pain.
Low molecular weight immunocorrectors
This is a fundamentally new class of immunostimulating drugs of bacterial origin. These are peptides with a small molecular weight... Many drugs are known: bestatin, amastatin, ferfenecin, muramyldipeptide, biostim, etc. Many of them are at the stage of clinical trials.
Bestatin has been the most studied, which has shown itself especially well in the treatment of patients with rheumatoid arthritis.
In 1975, a low molecular weight peptide, muramyldipeptide (MDP), was obtained in France, which is a minimal structural component of the cell wall of mycobacteria (a combination of a peptide and a polysaccharide).
The clinic is now widely used biostim - very active
ny glycoprotein isolated from Klebsiellae pneumoniae. It is a polyclonal B-lymphocyte activator that induces the production of interleukin-1 by macrophages and activates the production nucleic acids, increases macrophage cytotoxicity, increases the activity of cellular factors of nonspecific protection.
Indicated for patients with broncho-pulmonary pathology. The immunostimulating effect of biostim is achieved by administering a dose of 1-2 mg / day. The action is stable, the duration is 3 months after the termination of the drug administration.
There are practically no side effects.
Speaking about immunostimulants of bacterial, but not corpuscular origin in general, three main stages should be distinguished, and in fact three generations of immunostimulating agents of bacterial origin:
Creation of purified bacterial lysates, they have specific properties of vaccines and are nonspecific immunostimulants. The best representative of this generation is the drug Bronchomunal (Bronchomunalum; capsules at 0, 007; 0, 0035) lysate of the eight most pathogenic bacteria... Has a stimulating effect on humoral and cellular immunity, increases the number of macrophages in the peritoneal fluid, as well as the number of lymphocytes and antibodies. The drug is used as adjuvant in the treatment of patients with infectious diseases of the respiratory tract. When taking bronchomunal, side effects are possible in the form of dyspepsia and allergic reactions. The main disadvantage of this generation of immunostimulating agents of bacterial origin is weak and unstable activity.
Creation of fractions of bacterial cell walls, which have a pronounced immunostimulating effect, but do not possess the properties of vaccines, that is, do not cause the formation of specific antibodies.
The combination of bacterial ribosomes and cell wall fractions represents a new generation of drugs. Typical representative it is Ribomunal (Ribomunalum; in tab. 0, 00025 and 10 ml aerosol) - a preparation containing ribosomes of 4 main causative agents of upper respiratory tract infections (Klebsiella pneumoniae, Streptococcus pneumoniae, Streptococcus pyogenes A, Haemophillus influenzae) and membrane proteoglycans Klebs. It is used as a vaccine for the prevention of recurrent infections of the respiratory tract and ENT organs. The effect is achieved by increasing the activity of natural killer cells, B-lymphocytes, increasing the level of IL-1, IL-6, alpha-interferon, secretory immunoglobulin A, as well as by increasing the activity of B-lymphocytes and the formation of specific serum antibodies to 4 ribosomal antigens. There is a specific regimen for taking the drug: 3 tablets in the morning for 4 days a week for 3 weeks, and then for
4 days a month for 5 months; subcutaneously: injected once a week for 5 weeks, and then once a month for 5 months.
The drug reduces the number of exacerbations, the duration of episodes of infections, the frequency of prescribing antibiotics (by 70%) and causes an increase in the humoral response.
The drug is most effective when administered parenterally.
With subcutaneous administration, local reactions are possible, and with inhalation - transient rhinitis.
Immunoactive drugs of animal origin
This group is the most widely and frequently used. Of greatest interest in it are:
1. Preparations of thymus, bone marrow and their analogues;
2. A new group of B-lymphocyte stimulants:
Interferons;
Interleukins.
Thymus preparations
Every year, the number of compounds obtained from the thymus and differing in chemical composition, biological properties. Their action is such that, as a result, the induction of maturation of precursors (precursors) of T-lymphocytes occurs, the differentiation and proliferation of mature T-cells, the expression of receptors on them, also an increase in antitumor resistance and stimulation of repair processes occur.
The following preparations of the thymus gland are most often used in the clinic:
Timalin;
Timogen;
Taktivin;
Vilozen;
Timoptin.
Timalin is a complex of polypeptide fractions isolated from the thymus of cattle. Available in vials as a lyophilized powder.
It is used as an immunostimulant for:
Diseases accompanied by a decrease in cellular immunity
In acute and chonic purulent processes and inflammatory
diseases;
With burn disease;
With trophic ulcers;
With suppression of immunity and hematopoietic function after lu
chemotherapy or chemotherapy in cancer patients.
The preparation is injected intramuscularly at 10-30 mg daily for
5-20 days. If necessary, repeat the course in 2-3 months.
A similar drug is thymoptin (unlike thymalin, it does not act on B cells).
Taktivin also has a heterogeneous composition, that is, it consists of several thermostable fractions. It is more active than thymalin. Has the following action:
Restores the number of T-lymphocytes in patients with their low
Increases the activity of natural killer cells as well as the killer
new activity of lymphocytes;
In low doses, it stimulates the synthesis of interferons.
Thymogen (in the form of a solution for injections and a solution for instillation into the nose) - even more purified and more active drug... It is possible to obtain it synthetically. Significantly superior in activity to taktivin.
A good effect when taking the listed drugs is achieved when:
Therapy for patients with rheumatoid arthritis;
With juvenile rheumatoid arthritis;
With recurrent hepatic lesion;
In children with lymphoproliferative diseases;
In patients with primary immunodeficiency;
With mucocutaneous candidiasis.
An essential condition for the successful use of thymus preparations is initially altered indicators of T-lymphocyte function.
Vilosen - a non-protein low molecular weight extract of thymus of cattle - stimulates the proliferation and differentiation of T-lymphocytes in humans, inhibits the formation of reagins and the development of HRT. The best effect is achieved when treating patients allergic rhinitis, rhinosinusitis, hay fever.
Thymus preparations, in fact, being the factors of the central organ of cellular immunity, correct precisely the T-link and macrophages of the body.
V last years new, more active agents are widely used, the action of which is directed to B-lymphocytes and plasma cells. These substances are produced by bone marrow cells. Based on low molecular weight peptides isolated from supernatants of animal and human bone marrow cells. One of the drugs in this group is B-activin or myelopid, which has a selective effect on the B-immune system.
Myelopid activates cells that produce antibodies, selectively induces the synthesis of antibodies at the time of the maximum development of the immune response, enhances the activity of killer T-effectors, and also has an analgesic effect.
It has been proven that myelopid acts on inactive in a given mo
time point of the population of B-lymphocytes and plasma cells, increasing the number of antibody-producers without increasing their production of antibodies. Myelopid also enhances antiviral immunity and is shown primarily when:
Hematological diseases (chronic lymphocytic leukemia,
macroglobulinemia, myeloma);
Protein loss diseases;
Management of surgical patients, as well as after chemotherapy and
chevoy therapy;
Bronchopulmonary diseases.
The drug is non-toxic and does not cause allergic reactions, does not give teratogenic and mutagenic effects.
Prescribe myelopid subcutaneously at a dose of 6 mg, for a course - 3 injections every other day, repeated 2 courses in 10 days.
Interferons (IF) - low molecular weight glycopeptides - a large group of immunostimulants.
The term "interferon" originated from the observation of patients who have had a viral infection. It turned out that in the stage of convalescence they were protected, to one degree or another, from the effects of other viral agents. In 1957, the factor responsible for this viral interference phenomenon was discovered. Now the term "interferon" refers to a number of mediators. Although interferon is found in different tissues, it comes from different types of cells:
there are three types of interferons:
JFN-alpha - from B-lymphocytes;
JFN-beta - from epithelial cells and fibroblasts;
JFN-gamma - from T- and B-lymphocytes with the assistance of macrophages.
Currently, all three types can be obtained using genetic engineering and recombinant technology.
IFs also have an immunostimulating effect by activating the proliferation and differentiation of B-lymphocytes. As a result, the production of immunoglobulins may be enhanced.
Interferons, despite the diversity of the genetic material in viruses, IFs "intercept" their reproduction at the stage obligatory for all viruses - blocking the start of translation, that is, the beginning of the synthesis of virus-specific proteins, and also recognize and discriminate against viral RNAs among cellular ones. Thus, IFs are substances of a universally broad spectrum of antiviral action.
Medical preparations of IF are divided into alpha, beta and gamma by composition, and by the time of creation and application into natural (I generation) and recombinant (II generation).
I Natural interferons:
Alpha-ferons - human leukocyte IF (Russia),
egiferon (Hungary), velferon (England);
Beta-ferons - toraiferon (Japan).
II Recombinant interferons:
Alpha-2A - Reaferon (Russia), Roferon (Switzerland);
Alpha-2B - intron-A (USA), inrek (Cuba);
Alpha-2C - Berofer (Austria);
Beta - Betaseron (USA), Front (Germany);
Gamma - gammaferon (Russia), immunoferon (USA).
Diseases in the treatment of which IF are most effective are divided into 2 groups:
1. Viral infections:
The most studied (thousands of observations) various herpetic
cue and cytomegalovirus lesions;
Less studied (hundreds of observations) acute and chronic vi
Russian hepatitis;
Influenza and other respiratory diseases are even less studied.
2. Oncological diseases:
Hairy cell leukemia;
Juvenile papilloma;
Kaposi's sarcoma (AIDS marker disease);
Melanoma;
Non-Hodgkin's lymphomas.
An important advantage of interferons is their low toxicity. Only when using megadoses (in oncology) are side effects noted: anorexia, nausea, vomiting, diarrhea, pyrogenic reactions, leuko-thrombocytopenia, proteinuria, arrhythmias, hepatitis. The severity of the complications prompts an indication of the clarity of the indications.
A new direction in immunostimulating therapy is associated with the use of mediators of inter-lymphocyte relationships - interleukins (IL). It is a known fact that IF, inducing the synthesis of IL, create a cytokine network with them.
In clinical practice, 8 interleukins (IL1-8) are tested with certain effects:
IL 1-3 - stimulation of T-lymphocytes;
IL 4-6 - growth and differentiation of B cells, etc.
Clinical data are available only for IL-2:
Significantly stimulates the function of T-helpers, as well as B-lim
photocytes and synthesis of interferons.
Since 1983, IL-2 has been produced in recombinant form. This IL has been tested for immunodeficiencies caused by infection, tumors, bone marrow transplantation, rheumatic diseases, SLE, AIDS. The data are contradictory, there are many complications: fever, vomiting, diarrhea, weight gain, dropsy, rash, eosinophilia, hyperbilirubinemia, - treatment regimens are being developed, and doses are being selected.
Growth factors are a very important group of immunostimulating agents. The most prominent representative of this group is leukomax (GM-CSF) or molgramostim (manufacturer - Sandoz). It is a recombinant human granulocyte-macrophage colony-stimulating factor (highly purified water-soluble protein of 127 amino acids), thus it is an endogenous factor involved in the regulation of hematopoiesis and functional activity of leukocytes.
Main effects:
Stimulates the proliferation and differentiation of progenitors
hematopoietic organs, as well as the growth of granulocytes, monocytes
tov, increasing the content of mature cells in the blood;
Quickly restores the body's defenses after chemotherapy
therapy (5-10 mcg / kg once a day);
Accelerates recovery after autologous bone transplant
leg brain;
Possesses immunotropic activity;
Stimulates the growth of T-lymphocytes;
Specifically stimulates leukopoiesis (antileukopenic
means).
Herbal preparations
This group includes yeast polysaccharides, the effect of which on the immune system is less pronounced than the effect of bacterial polysaccharides. However, they are less toxic, do not possess pyrogenicity or antigenicity. As well as bacterial polysaccharides, they activate the functions of macrophages and neutrophilic leukocytes. The drugs of this group have a pronounced effect on lymphoid cells, and this effect on T-lymphocytes is more pronounced than on B-cells.
Yeast polysaccharides - primarily zymosan (biopolymer of the yeast membrane Saccharomyces cerevisi; amp. 1-2 ml), glucans, dextrans are effective in infectious, hematological complications arising from radio and chemotherapy of cancer patients. Zymosan is administered according to the scheme: i / m, 1-2 ml every other day, for a course of treatment 5-10 injections.
Also used is yeast RNA - sodium nucleinate (sodium salt of nucleic acid obtained by hydrolysis of yeast and with the help of further purification). The drug has a wide range of effects, biological activity: regeneration processes are accelerated, bone marrow activity is activated, leukopoiesis is stimulated, phagocytic activity increases, as well as the activity of macrophages, T- and B-lymphocytes, and nonspecific defense factors.
The advantage of the drug is that its structure is precisely known. The main advantage of the drug is the complete absence of complications when taking it.
Sodium nucleinate is effective in many diseases, but especially
benno indicated for leukopenia, agranulocytosis, with acute and protracted pneumonia, obstructive bronchitis, also used in recovery period in patients with blood pathology and in cancer patients.
The drug is used according to the scheme: inside 3-4 times a day, daily dose 0.8 g - course dose - up to 60 g.
Synthetic immunoactive agents of different groups
1. Derivatives of pyrimidine:
Methyluracil, orotic acid, pentoxil, diucifon, oxymetacil.
The drugs of this group are similar in the nature of the stimulating effect to the preparations of yeast RNA, since they stimulate the formation of endogenous nucleic acids. In addition, drugs in this group stimulate the activity of macrophages and B-lymphocytes, increase leukopoiesis and the activity of the components of the compliment system.
These funds are used as stimulants of leukopoiesis and erythropoiesis (methyluracil), anti-infectious resistance, as well as to stimulate the processes of repair and regeneration.
Among the side effects, allergic reactions and the phenomenon of the opposite effect are distinguished in severe leukopenia and erythropenia.
2. Derivatives of imidazole:
Levamisole, dibazole.
Levamisole (Levomisolum; tablets of 0, 05; 0, 15) or decaris - a heterocyclic compound was originally developed as anthelmintic drug, it has also been proven to enhance anti-infectious immunity. Levamisole normalizes many functions of macrophages, neutrophils, natural killer cells and T-lymphocytes (suppressors). The drug has no direct effect on B cells. A distinctive feature of levamisole is its ability to restore impaired immune function.
The most effective use of this drug in the following conditions:
Recurrent ulcerative stomatitis;
Rheumatoid arthritis;
Sjogren's disease, SLE, scleroderma (DZST);
Autoimmune diseases (chronic progressive diseases)
Crohn's disease;
Lymphogranulomatosis, sarcoidosis;
Defects of the T-link (Wiskott-Aldridge syndrome, mucocutaneous
thy candidiasis);
Chronic infectious diseases (toxoplasmosis, leprosy,
viral hepatitis, herpes);
Tumor processes.
Previously, levamisole was prescribed at a dose of 100-150 mg / day. New data have shown that the desired effect can be achieved at 1-3 times
With the free administration of 150 mg / week, the undesirable effects are reduced.
Among the side effects (frequency 60-75%), the following are noted:
Hyperesthesia, insomnia, headache - up to 10%;
Individual intolerance (nausea, decreased appetite
that, vomiting) - up to 15%;
Allergic reactions - up to 20% of cases.
Dibazol is an imidazole derivative, mainly used as an antispasmodic and antihypertensive agent, but has an immunostimulating effect by increasing the synthesis of nucleic acids and proteins. Thus, the drug stimulates the production of antibodies, enhances the phagocytic activity of leukocytes, macrophages, improves the synthesis of interferon, but acts slowly, therefore it is used to prevent infectious diseases (influenza, ARVI). For this purpose, dibazol is taken once a day every day for 3-4 weeks.
There are a number of contraindications for use, such are severe liver and kidney diseases, as well as pregnancy.
Regulatory peptides
Practical use regulatory peptides makes it possible to influence the body in the most physiological and targeted way, including the immune system.
The most comprehensively studied Tuftsin is a tetrapeptide from the heavy chain region of immunoglobulin-G. It stimulates the production of antibodies, increases the activity of macrophages, cytotoxic T-lymphocytes, and natural cells. In the clinic, tuftsin is used to stimulate antitumor activity.
From the group of oligopeptides, Dolargin is of interest (Dolarginum; powder in amp. Or in a bottle. 1 mg - diluted in 1 ml of saline; 1 mg 1-2 times a day, 15-20 days) - a synthetic analogue of enkephalins (biologically active substances of the class of endogenous opioid peptides, isolated in 1975).
Dolargin is used as an anti-ulcer drug, but studies have shown that it has a positive effect on the immune system, moreover, it is more powerful than cimetidine.
Dolargin normalizes the proliferative response of lymphocytes in patients with rheumatic diseases, stimulates the activity of nucleic acids; generally stimulates wound healing, reduces the exocrine function of the pancreas.
The group of regulatory peptides has great prospects in the market for immunoactive drugs.
The choice of selective immunoactive therapy requires a comprehensive quantitative and functional assessment of macrophages, T- and B-lymphocytes, their subpopulations, followed by the formulation of an immunological diagnosis and the choice of immunoactive agents.
lective action.
The results of studying the chemical structure, pharmacodynamics and pharmacokinetics, practical application immunostimulants do not give an unambiguous answer to many questions regarding the indications for immunostimulation, the choice of a particular drug, regimens and duration of treatment.
When treating with immunoactive agents, the individualization of therapy is determined by the following objective prerequisites:
The structural organization of the immune system, which is based on populations and subpopulations of lymphoid cells, monocytes and macrophages. Knowledge of the mechanisms of dysfunction of each of these cells, changes in the relationships between them, is the basis for the individualization of treatment;
Typological disorders of the immune system in various diseases.
Thus, in patients with the same disease with a similar clinical picture differences in changes in the functions of the immune system, pathogenetic heterogeneity of diseases are found.
In connection with the heterogeneity of pathogenetic disorders in the immune system, it is advisable to isolate clinical immunological variants of the disease for selective immunoactive therapy. Until now, there is no unified classification of immunostimulating agents.
Since the division of immunoactive agents by origin, production methods and chemical structure is not very convenient for clinicians, it seems more convenient to classify these agents by their selectivity of action on populations and subpopulations of monocytes, macrophages, T- and B-lymphocytes. However, an attempt at such a separation is complicated by the lack of selectivity of the action of existing immunoactive drugs.
The pharmacodynamic effects of the drugs are due to the simultaneous inhibition or stimulation of T- and B-lymphocytes, their subpopulations, monocytes and effector lymphocytes. Hence the unpredictability of the unpredictability of the final effect of the drug and the high risk of undesirable consequences.
In terms of the strength of their effect on cells, immunostimulants also differ from each other. Thus, the BCG and C. parvum vaccine more stimulates the function of macrophages and less affects B- and T-lymphocytes, Thymomimetics (thymus preparations, Zn, levamisole), on the contrary, have a greater effect on T-lymphocytes than on macrophages.
Pyrimidine derivatives have a greater effect on nonspecific defense factors, and myelopids - on B-lymphocytes.
In addition, there are differences in the activity of the effect of drugs on a certain population of cells. For example, the effect of levamisole on macrophage function is weaker than BCG vaccines. These properties of immunostimulating drugs can be used as the basis for their
classification according to their relative selectivity of the form-dynamic effect.
Relative selectivity of the pharmacodynamic effect
immunostimulants:
1. Drugs that mainly stimulate nonspecific
protection factors:
Purine and pyrimidine derivatives (isoprinosine, methyluracil, oxymetacil, pentoxyl, orotic acid);
Retinoids.
2. Drugs that mainly stimulate monocytes and poppy
Sodium nucleinate; - muramylpeptide and its analogs;
Vaccines (BCG, CP) - plant lipopolysaccharides;
Lipopolysaccharides of Gr-negative bacteria (pyrogenal, biostim, prodigiosan).
3. Drugs that mainly stimulate T-lymphocytes:
Imidazole compounds (levamisole, dibazol, immunithiol);
Thymus preparations (thymogen, taktivin, thymalin, vilosen);
Zn preparations; - lobenzarite Na;
Interleukin-2 - thiobutarite.
4. Drugs that mainly stimulate B-lymphocytes:
Myelopids (B-activin);
Oligopeptides (tuftsin, dalargin, rigin);
Low molecular weight immunocorrectors (bestatin, amastatin, forfenicin).
5. Preparations, mainly stimulating natural
killer cells:
Interferons;
Antiviral drugs (isoprinosine, tilorone).
Despite the certain conventionality of the proposed classification, this division is necessary, since it allows prescribing drugs on the basis of not a clinical, but an immunological diagnosis. The lack of selective drugs significantly complicates the development of methods of combined immunostimulation.
Thus, individualization of immunoactive therapy requires clinical and immunological criteria that predict the outcome of treatment.
Means that stimulate the processes of immunity (immunostimulants) are used in immunodeficiency states, chronic sluggish current infections, as well as in some oncological diseases.
Immunodeficiency- This is a violation of the structure and function of any part of the integral immune system, the loss of the body's ability to resist any infections and restore disorders of its organs. In addition, with immunodeficiency, the process of renewal of the body slows down or stops altogether. At the heart of a hereditary immunodeficiency state ( primary immunological deficiency) are genetically determined defects in the cells of the immune system. At the same time, acquired immunodeficiency ( secondary immunological deficiency) is the result of the influence of factors external environment on the cells of the immune system. The most fully studied factors of acquired immunodeficiency include radiation, pharmacological agents, and acquired immunodeficiency syndrome (AIDS) in humans caused by the human immunodeficiency virus (HIV).
Classification of immunostimulants.
1. Synthetic: LEVAMIZOL (decaris), DIBAZOL, POLYOXIDONIUM.
2. Endogenous and their synthetic analogues:
- Preparations of thymus, red bone marrow, spleen and their synthetic analogs: THIMALIN, TIMOGEN, TACTIVIN, IMUNOFAN, MYELOPID, Spleenin.
- Immunoglobulins: Human polyvalent immunoglobulin (INTRAGLOBIN).
- Interferons: human immune interferon-gamma, recombinant interferon gamma (GAMMAFERON, IMUKIN).
3. Preparations of microbial origin and their synthetic analogs: PRODIGIOZAN, RIBOMUNIL, IMUDON, LIKOPID.
4. Herbal preparations.
1. Synthetic drugs.
LEVAMIZOL is an imidazole derivative used as an antihelminthic and immunomodulatory agent. The drug regulates the differentiation of T-lymphocytes. Levamisole increases the response of T-lymphocytes to antigens.
POLYOXIDONIUM is a synthetic water-soluble polymer compound. The drug has an immunostimulating and detoxifying effect, increases the body's immune resistance against local and generalized infections. Polyoxidonium activates all factors of natural resistance: cells of the monocytic-macrophage system, neutrophils and natural killer cells, increasing their functional activity at the initially reduced rates.
DIBAZOL. Immunostimulatory activity is associated with the proliferation of mature T - and B-lymphocytes.
2.Polypeptides of endogenous origin and their analogs.
2.1. THIMALIN and TACTIVIN are a complex of polypeptide fractions from the thymus (thymus gland) of cattle. The drugs restore the number and function of T-lymphocytes, normalize the ratio of T- and B-lymphocytes and cellular immunity reactions, and enhance phagocytosis.
Indications for the use of drugs: complex therapy of diseases accompanied by a decrease in cellular immunity - acute and chronic purulent and inflammatory processes, burn disease (a combination of dysfunctions of various organs and systems resulting from extensive burns), trophic ulcers, suppression of hematopoiesis and immunity after radiation and chemotherapy ...
MYELOPID is obtained from the culture of mammalian (calf, pig) bone marrow cells. The mechanism of action of the drug is associated with the stimulation of proliferation and functional activity of B - and T cells. Myelopid is used in complex therapy infectious complications after surgery, trauma, osteomyelitis, with nonspecific pulmonary diseases, chronic pyoderma.
IMUNOFAN is a synthetic hexapeptide. The drug stimulates the formation of interleukin-2, has a regulatory effect on the production of immunity mediators (inflammation) and immunoglobulins. It is used in the treatment of immunodeficiency states.
2.2. Immunoglobulins.
Immunoglobulins are a completely unique class of immune molecules that neutralize most infectious pathogens and toxins in our body. The fundamental feature of immunoglobulins is their absolute specificity. This means that in order to neutralize each type of bacteria, viruses and toxins in the body, its own and unique in structure immunoglobulins are produced. Immunoglobulins (gamma globulins) are purified and concentrated preparations of serum protein fractions containing high titers of antibodies. An important condition effective use sera and gamma globulins for the treatment and prevention of infectious diseases is as early as possible their appointment from the moment of illness or infection.
2.3. Interferons.
These are species-specific proteins produced by the cells of vertebrates in response to the action of inducing agents. Interferon preparations are classified according to the type of active ingredient into alpha, beta and gamma, according to the method of preparation for:
a) natural: INTERFERON ALPHA, INTERFERON BETA;
b) recombinant: INTERFERON ALPHA-2a, INTERFERON ALPHA-2b, INTERFERON BETA-lb.
Interferons have antiviral, antitumor and immunomodulatory effects. How antiviral agents interferon preparations are most active in the treatment of herpetic eye diseases (locally in the form of drops, subconjunctivally), herpes simplex with localization on the skin, mucous membranes and genitals, shingles (topically in the form of an ointment), acute and chronic viral hepatitis B and C (parenterally, rectally in suppositories), in the treatment and prevention of influenza and acute respiratory viral infections (intranasally in the form of drops).
In HIV infection, preparations of recombinant interferon normalize immunological parameters, reduce the severity of the course of the disease in more than 50% of cases.
3 . Microbial preparations and their analogues.
Immunostimulants of microbial origin are:
Purified bacterial lysates (BRONCHOMUNAL, IMUDON);
Bacterial ribosomes and their combinations with membrane fractions (RIBOMUNIL);
Lipopolysaccharide complexes (PRODIGIOZAN);
Fractions of bacterial cell membranes (LIKOPID).
BRONCHOMUNAL and IMUDON are lyophilized lysates of the bacteria most commonly associated with respiratory tract infections. The drugs stimulate humoral and cellular immunity. Increases the number and activity of T-lymphocytes (T-helpers), natural killers, increases the concentration of IgA, IgG and IgM in the mucous membrane of the respiratory tract. Used for infectious diseases of the respiratory tract, resistant to antibiotic therapy.
RIBOMUNIL is a complex of the most common causative agents of ENT and respiratory tract infections (Klebsiella pneumoniae, Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenzae). Stimulates cellular and humoral immunity. The ribosomes included in the preparation contain antigens identical to the surface antigens of bacteria, and cause the formation of specific antibodies to these pathogens in the body. Ribomunil is used for recurrent respiratory tract infections ( Chronical bronchitis, tracheitis, pneumonia) and ENT organs (otitis media, rhinitis, sinusitis, pharyngitis, tonsillitis, etc.).
PRODIGIOZAN is a high-polymer lipopolysaccharide complex isolated from the microorganism you. prodigiosum. The drug enhances the nonspecific and specific resistance of the organism, mainly stimulates B-lymphocytes, increasing their proliferation and differentiation into plasma cells that produce antibodies. Activates phagocytosis and killer activity of macrophages. Enhances the production of humoral immunity factors - interferons, lysozyme, especially when administered locally in inhalation. It is used in the complex therapy of diseases accompanied by a decrease in immunological reactivity: in chronic inflammatory processes, in the postoperative period, in the treatment of chronic diseases with antibiotics, in sluggish healing wounds, radiation therapy.
By chemical structure, LIKOPID is an analogue of a product of microbial origin - a semi-synthetic dipeptide - the main structural component of the bacterial cell wall. It has an immunomodulatory effect.
4. Herbal preparations.
IMMUNAL and other drugs ECHINACEE . Immunal is a stimulant of nonspecific immunity. The juice of Echinacea purpurea, which is part of Immunal, contains active substances of a polysaccharide nature, which stimulate bone marrow hematopoiesis, and also increase the activity of phagocytes. Indications: prevention of colds and flu; weakening of the functional state of the immune system caused by various factors (exposure to ultraviolet rays, chemotherapy drugs); long-term antibiotic therapy; chronic inflammatory diseases. Echinacea tinctures and extracts, juice and syrup are also used.
Side effects of immunostimulants:
Immunomodulators of synthetic origin - allergic reactions, soreness at the injection site (for injections)
Thymus preparations - allergic reactions; bone marrow preparations - pain at the injection site, dizziness, nausea, fever.
Immunoglobulins - allergic reactions, increased or decreased blood pressure, fever, nausea, etc. With slow infusion, many patients tolerate these drugs well.
Interferons have undesirable drug reactions of different severity and frequency, which may differ depending on the drug. In general, interferons (injectable forms) are not well tolerated by everyone and may be accompanied by flu-like syndrome, allergic reactions, etc.
Bacterial immunomodulators - allergic reactions, nausea, diarrhea.
Herbal immunomodulators - allergic reactions (Quincke's edema), skin rash, bronchospasm, lowering blood pressure.
Contraindications for immunostimulants
Autoimmune diseases such as rheumatoid arthritis
- blood diseases;
- allergies;
- bronchial asthma;
- pregnancy;
- age up to 12 years.
IV. Anchoring.
1. What is the main function of the human immune system?
2. What is allergy?
3. What are the types of allergic reactions?
4. How are anti-allergic drugs classified?
5. What is the preferred use of 1st generation drugs? Generation II? Generation III?
6. What drugs are classified as stabilizers of mast cell membranes?
7. What are mast cell membrane stabilizers used for?
8. What are the main side effects of antiallergic drugs?
9. What are the measures of assistance for anaphylactic shock?
10. What drugs are called immunotropic?
11. How are they classified?
12. What are the indications for the use of immunosuppressants?
13. How are immunostimulants classified?
14. What are the indications for the use of representatives of each subgroup?
15. Name the side effects of using immunostimulants and contraindications to their use.
V. Summing up.
The teacher makes a generalization of the topic, assesses the activities of students, draws conclusions whether the goals of the lesson have been achieved.
Vi. Home assignment.
- for adults and children, they are medicines that eliminate the imbalance of various parts of the immune system. Thus, the action of these drugs should be aimed at normalizing the parameters of immunity, i.e. to decrease the increased or increase the decreased indicators.
V Russian Federation some effective immunomodulators-registered as immunostimulants, including of plant origin. It is believed that the use of these drugs leads to an increase in immunity indicators, however, this is not entirely true, since the immunity indicators under the influence of such drugs do not exceed the level physiological norm... In connection with the above, it is more correct to use the term- immunomodulators.
In this section, we will dwell in detail on the description of various types - immunomodulators, which, depending on their origin, can be divided into three large groups: exogenous, endogenous and synthetic.
Exogenous immunomodulators (bacterial and plant origin)
Among the immunomodulators of exogenous origin, bacterial and herbal preparations are distinguished.
Bacterial immunomodulators
The most famous drugs in this group are: "imudon", "IRS 19", "broncho-munal", "ribomunil".
Main indications: chronic bronchitis, tonsillitis, pharyngitis, laryngitis, rhinitis, sinusitis, otitis media.
Contraindications: drug allergy, acute upper respiratory tract infection, autoimmune diseases, HIV infection.
Side effects: the drugs are very well tolerated; allergic reactions, nausea, and diarrhea are rare.
Herbal immunomodulators
The most famous drugs in this group are: "Imunal", "Echinacea Vilar", "Echinacea compositum CH", "Echinacea liquidum".
Main indications: prevention of ARVI.
Contraindications: drug allergy, tuberculosis, leukemia, autoimmune diseases, multiple sclerosis, allergic reactions to pollen.
Side effects: the drugs are very well tolerated, allergic reactions (Quincke's edema), skin rash, bronchospasm, and decreased blood pressure are rare.
Endogenous immunomodulators
Endogenous immunomodulators can be divided into the following groups: drugs isolated from the thymus and bone marrow, cytokines (interleukins, interferons and interferon inducers) and nucleic acid preparations.
drugs isolated from the thymus and bone marrow.
Medicines obtained from the tissue of the thymus (an organ of the immune system) are: "taktivin", "thymalin", "timoptin"; from the bone marrow - "myelopid".
Main indications:
- for preparations from the thymus - immunodeficiencies with a predominant lesion of the T-cell link of immunity, developing with purulent and tumor diseases, tuberculosis, psoriasis, ophthalmic herpes;
- for preparations from bone marrow - immunodeficiencies with a predominant lesion of the humoral immunity; purulent diseases, as part of the complex therapy of leukemia and chronic infectious diseases.
Contraindications: for drugs from the thymus - drug allergy, pregnancy.
for drugs from bone marrow - drug allergy, pregnancy with Rh conflict.
Side effects: for preparations from the thymus - allergic reactions.
for preparations from bone marrow - pain at the injection site, dizziness, nausea, fever.
cytokines - interleukins: natural ("superlimph") and recombinant ("betaleukin", "roncoleukin")
Main indications: for natural cytokines - treatment of wounds and trophic ulcers.
for recombinant cytokines: "roncoleukin" - pyoinflammatory diseases, some malignant tumors; "Betaleukin" - leukopenia (reduced number of blood leukocytes).
Contraindications: for natural cytokines - drug allergy, thrombocytopenia, renal and hepatic failure, epilepsy.
for recombinant cytokines: "roncoleukin" - drug allergy, pregnancy, autoimmune diseases, cardiovascular disease; "Betaleukin" - drug allergy, septic shock, high fever, pregnancy.
Side effects: for natural cytokines - exacerbation of inflammation (short-term)
for recombinant cytokines - chills, fever, allergic reactions.
cytokines - interferons: this class of immunomodulators is very extensive, it includes interferons of three types (alpha, beta, gamma); depending on the origin, interferons are divided into natural and recombinant. The most common form of administration is injection, but there are other forms of release: suppositories, gels, ointments.
Main indications: very different depending on the type of interferon. Interferons are used in the treatment of viral, tumor diseases and even multiple sclerosis. In some diseases, the effectiveness of interferons has been proven by many studies, in others, there is only moderate or even little experience successful application.
Contraindications: drug allergy, severe autoimmune, cardiovascular diseases, epilepsy, diseases of the central nervous system, severe liver disease, pregnancy, childhood.
Side effects: interferons have undesirable drug reactions of different severity and frequency, which may differ depending on the drug. In general, interferons (injectable forms) are not well tolerated by everyone and may be accompanied by flu-like syndrome, allergic reactions, and other unwanted drug effects.
cytokines - interferon inducers: this class of immunomodulators is represented by substances that stimulate the production of interferons in our body. There are forms of medicine for oral administration, in the form of external agents, injectable forms. Trade names of interferon inducers: "Cycloferon", "Alloferon", "Poludan", "Tiloron", "Neovir", "Megosin", "Ridostin".
Main indications: treatment of chronic viral infections as part of complex therapy.
Contraindications: allergy to medicine, pregnancy, breastfeeding, children (up to 4 years).
Side effects: allergic reactions.
nucleic acid preparations: "ridostin" and "derinat".
Main indications: secondary immunodeficiencies manifested by viral and bacterial infections.
Contraindications: drug allergy, pregnancy, breastfeeding, children (up to 7 years), myocardial disease, severe renal and hepatic failure.
Side effects: allergic reactions, increased body temperature.
Immunomodulators of synthetic origin
This group of immunomodulators is represented by drugs that are different in their chemical structure, and therefore each drug has its own characteristics of the mechanism of action, tolerance and undesirable effects. This group includes: "Isoprinazine", "Galavit", "Gepon", "Glutoxim", "Polyoxidonium", "Imunofan", "Thymogen", "Licopid".
Main indications: secondary immunodeficiencies associated with chronic viral and bacterial infections.
Contraindications: drug allergy, pregnancy, breastfeeding. "Isoprinazine" is also contraindicated in padagr, urolithiasis, chronic renal failure and arrhythmias.
Side effects: allergic reactions, soreness at the injection site (for injections), exacerbation of gout (isoprinazine), etc.
Immunoglobulins
Intravenous immunoglobulins - medications, which are protective blood proteins that protect us from bacteria, viruses, fungi and other foreign microorganisms.
There are immunoglobulins (antibodies) directed against a specific foreign particle (antigen), in this case, these antibodies are usually called monoclonal (i.e. all as one clone - the same), if the immunoglobulins (antibodies) are directed against many foreign particles they are called polyclonal, just such polyclonal antibodies are intravenous immunoglobulins. Monoclonal antibodies are drugs of the 21st century that can effectively fight certain tumors and autoimmune diseases. However, polyclonal antibodies are also very useful because they are successfully used at the most different diseases... Intravenous immunoglobulins, as a rule, consist predominantly of immunoglobulins G, however, there are intravenous immunoglobulins also enriched with immunoglobulins M ("pentaglobin").
The main intravenous immunoglobulins registered in the Russian Federation include: "intraglobin", "octagam", "humaglobin", "cytotect", "pentaglobin", "gamimn-N", etc.
Main indications: primary immunodeficiencies associated with a lack of synthesis of immunoglobulins, severe bacterial infections, autoimmune diseases (Kawasaki disease, Guillain-Barré syndrome, some systemic vasculitis, etc.), idiopathic thrombocytopenic purpura, etc.
Contraindications: allergic reactions to intravenous immunoglobulins.
Side effects: allergic reactions, increased or decreased blood pressure, increased body temperature, nausea, etc. With slow infusion, many patients tolerate these drugs well.
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