Meningeal Syndrome: Diagnostic Algorithm, Treatment Tactics

Abstract

Вісник проблем біології і медицини -2023 -Вип. 3 (170) / Bulletin of problems in biology and medicine -2023 -Issue 3 (170) 39 ОГЛЯДИ ЛІТЕРАТУРИ / LITERATURE REVIEWSIn particular, modern criteria for choosing a therapeutic strategy, the main problems that accompany therapy, and factors that affect patient compliance are analyzed by the authors.According to current guidelines, the first line therapy usually includes the administration of 5-aminosalicylic acid orally or rectally, followed by evaluation of clinical efficacy. In a case of insufficient effectiveness, almost all schemes involve corticosteroid's administration (topically or systemically depending on the severity of the disease). The main problem remains the high risk of glucocorticoids side effects. In case of ineffectiveness or insufficient effectiveness of steroid therapy or colectomy, second-line therapy may be recommended -calcineurin inhibitors (CsA, tacrolimus) and infliximab. It should be noted that, unfortunately, only about a quarter of patients respond to therapy with these medicines. The cytostatic methotrexate is also considered as a medication for therapy maintening in certain cases, especially in patients with intolerance to other immunosuppressants.In conclusion, nowadays, ulcerative colitis has a high prevalence in the population, which requires constant improvement of the medical correction ways. The latter is due to the fact that, despite the rather wide arsenal of medicines used for the ulcerative colitis therapy, they cannot provide effective and safe treatment of the disease in a number of cases. This dictates the urgent need to find and research new methods of pharmacotherapy.