Одна из важных проблем в пульмонологии -инфекции нижних дыхательных путей, занимающие существенное место в структуре легочной патологии. Основные нозологические формы, при которых инфекция является ведущим или основным этиологическим фактором поражения нижних дыхательных путей, -внебольничная пневмония, обострения хронической обструктивной болезни легких, хронического бронхита. В арсенале антибактериальных средств, предназначенных для лечения инфекций нижних дыхательных путей, азитромицин неизменно сохраняет ведущие позиции. В зависимости от нозологической формы он используется как препарат первой линии, альтернативное средство или в комбинации с другими антибиотиками. Это обусловлено рядом исключительных особенностей азитромицина, выгодно выделяющих его среди других антибактериальных средств. MD Razumovsky Saratov State Medical University of the Ministry of Health of Russia AZITHROMYCIN: MODERN PLACE OF THE DRUG IN THERAPY OF LOWER RESPIRATORY TRACTS INFECTIONSOne of the important problems in pulmonology -lower respiratory tract infections that occupy a significant place in the structure of the pulmonary pathology. The major nosological entities at which this infection is the leading or the major ethiologic factor of the lower respiratory tract lesion is community-acquired pneumonia, exacerbations of the chronic obstructive lung disease, chronic bronchitis. The armamentarium of antibacterial drugs used for therapy of the lower respiratory tract infections azithromycin invariably retains leading positions. Depending on the nosological form it is used as the first line drug, an alternative drug or in a combination with other antibiotics. This is preconditioned by a number of exclusive peculiarities of azithromycin that makes it standing apart among other antibacterial drugs.
Pulmonary hypertension is characterized with persistent increase in pulmonary vascular resistance leading to progressive worsening of right ventricular failure and death. The basis for pulmonary arterial hypertension is structural changes in pulmonary arteries and arterioles caused by endothelial dysfunction. Endothelin-1 is the main pathogenic trigger of pulmonary hypertension and potential target for therapeutic exposure. The efficacy of endothelin receptor antagonists is proved in various preclinical and clinical studies. In patients with pulmonary arterial hypertension, the efficacy of dual and selective endothelin receptor antagonists is comparable despite the varied activity against various receptors. Bosentan is the most widely used pulmonary vasodilator which improves exercise tolerance and decelerates disease progression.
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