The article considers clinical and pharmacological approaches to rational pharmacotherapy with direct oral anticoagulants (DOAC). The main issues of the mechanism of action, pharmacodynamics, and interaction of these medicines, as well as adverse reactions and, consequently, risks associated with taking DOAC, and the principles of selecting direct oral anticoagulants are discussed. The materials are presented on the basis of modern data from domestic and foreign literature.
A review article is based on current foreign sources. The level of cytokines in the peripheral blood can be increased in many diseases, but in some cases there may be an excess of their normal concentration in tens, hundreds or more times with the development of a peculiar clinical picture, which is based on a systemic inflammatory reaction. In the literature this condition has received the figurative name «cytokine storm», which highlights an extremely violent reaction of the immune system with an unknown (often unfavorable) outcome. Close attention of the scientific world and the public to the problem of extremely high levels of cytokines in the peripheral blood (hypercytokinemia) was drawn due to the high frequency of the cytokine storm in the novel coronavirus infection.
The article considers a clinical case of an adverse drug reaction with simultaneous use of amiodarone and warfarin, manifested by hemorrhagic syndrome. It also provides an overview of data available from domestic and foreign sources regarding the drug interaction of warfarin and amiodarone, as well as the features of pharmacotherapy in elderly patients, including the features of pharmacodynamics in this group of patients. The main result of the presented literature review is the conclusion that doctors in their practice should take into account the possibility of drug interaction and pay attention to this section in the instruction leaflets of medicinal products, especially in the treatment of an elderly patient.
A review article is based on current foreign sources. The level of cytokines in the peripheral blood can be increased in many diseases, but in some cases there may be an excess of their normal concentration in tens, hundreds or more times with the development of a peculiar clinical picture, which is based on a systemic inflammatory reaction. In the literature this condition has received the figurative name «cytokine storm», which highlights an extremely violent reaction of the immune system with an unknown (often unfavorable) outcome. Close attention of the scientific world and the public to the problem of extremely high levels of cytokines in the peripheral blood (hypercytokinemia) was drawn due to the high frequency of the cytokine storm in the novel coronavirus infection.
The widespread prevalence of gastroesophageal reflux disease in clinical practice makes urgent the issue of therapy. This article describes the clinical manifestations, considers the recommended methods of diagnosis and therapy, including in pediatrics.
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