Multi-component infusion hepatoprotectors for liver damage
https://doi.org/10.21518/2079-701X-2019-3-84-88
Abstract
Drug-induced liver injuries (DILI) remain today one of the most pressing problems not only in gastroenterology, but also in all therapy. Up to 10% of the changes in laboratory parameters can be attributed to the use of drugs. The importance of DILI has increased significantly in recent years, due to the increase in the number of over-the-counter medicines on the pharmaceutical market, as well as non-compliance with the methods and modes of administration. There are common links in the pathogenesis of DILI, including hypoxia, de-energization (deficit of ATP production), damage to hepatocyte membranes and suppression of antioxidant protection. Therefore, pathogenetic pharmacotherapy and prevention of liver damage are based on drugs with an action mechanism aimed at eliminating one or more links in the pathogenesis. One of these drugs is Remaxol, which includes antihypoxantantioxidants of metabolic type: natural metabolites, substrates and cofactors involved in energy metabolism. Remaxol was administered to 30 patients with duodenal ulcer (DU) in the acute phase in addition to the main eradication therapy in the case of cytolytic syndrome by the end of the first week of therapy intravenously dripping at a rate of 40-60 drops/min in a daily dose of 400 ml for 10 days a day. Against the background of Remaxol application, the patients with DILI had stabilization of the main biochemical parameters: the level of AST, ALT, direct bilirubin, GGT and alkaline phosphatase. These changes were accompanied by a positive dynamics of the general state of health. The use of Remaxol in patients with DILI will allow to achieve clinical and biochemical remission, preventing the development of severe liver damage, and contributes to the preservation of the recommended duration of treatment of the underlying disease.
About the Authors
E. I. Sas
Federal State Budgetary Military Educational Institution of Higher Education «Military Medical Academy named after S.M. Kirov» of the Ministry of Defense of the Russian Federation;
Federal State Budgetary Educational Institution of Higher Education «St. Petersburg State Pediatric Medical University» of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Dr. of Sci. (Med), Professor ,of the 2nd Department (Therapy of Advanced Medical Education), 194044, Saint-Petersburg, 6, Akademika Lebedev Street;
194100, Saint-Petersburg, 2, Litovskaya St.
V. B. Grinevich
Federal State Budgetary Educational Institution of Higher Education «St. Petersburg State Pediatric Medical University» of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Dr. of Sci. (Med), Professor, Head of the 2nd Department (Therapy of Advanced Medical Education), VicePresident of the Scientific Society of Gastroenterologists of Russia (SSGR) - President of the Pancreatic Club,
194100, Saint-Petersburg, 2, Litovskaya St.
References
1. Abboud G., Kaplowitz N. Drug-induced liver injury. Drug Saf. 2007;30(4):277–294.
2. Andrade R.J., Robles M., Fernández-Castañer A., López-Ortega S., López-Vega M.C., Lucena M.I. Assessment of drug-induced hepatotoxicity in clinical practice: a challenge for gastroenterologists. World J Gastroenterol. 2007;13(3):329– 340.
3. Mindikoglu A.L., Magder L.S., Regev A. Outcome of liver transplantation for drug-induced acute liver failure in the United States: analysis of the united network for organ sharing database. Liver Transpl. 2009;15:719–29.
4. Polunina T.E. Medicinal hepatitis. Ther. archive. [Ter. arhiv.]. 1999;71(12):46–49. (In Russ).
5. Polunina T.E., Maev I.V. Medicinal hepatitis. Consilium medicum. Appendix to the journal Consilium medicum. Gastroenterology [Consilium medicum. Prilozhenie k zhurnalu Consilium medicum. Gastrojenterologija]. 2008;1:3–10. (In Russ).
6. Kovtun A.V., Yakovenko A.N., Yakovenko E.P. et al. Drug-induced liver injury. Diagnostics and treatment. Doctor in charge [Lechashhij vrach]. 2009;2:8-14. (In Russ).
7. Gunawan B., Kaplowitz N. Chapter 119 Druginduced liver disease. Advanced therapy in gastroenterology and liver disease. 2005:689– 693.] (In Russ).
8. Suhanov D.S., Artyushkova E.B., Dudka V.T.,Okovityj S.V. Efficacy of remaxol and ademetionine in experimental druginduced liver injury with combination of backup anti-tuberculosis drugs and alcohol. Tuberculosis and lung diseases. [Tuberkulez i bolezni legkih.] 2014;92(4):59–62. (In Russ.)
9. Bode C. Dangerous Liaisons. The Scientist. 2010;5:320–343.
10. Sherlock S., Dooley J. Liver and biliary tract disease: Practical hands: Per. from English. Under editorship of Z.G. Aprosina, N.A. Mukhin. M.: Gaotar Medicine, 1999; 864 p. (In Russ).
11. Clark J.M., Brancati F.L., Diehl A.M. The prevalence and etiology of elevated aminotransferase levels in the United States. Am J Gastroenterol. 2003;98: 960–7.
12. Jalan R., Hayes P.C. Review article: quantitative tests of liver function. Aliment Pharmacol Ther. 1995;9:263.
13. Lee W.M. Drug-induced hepatotoxicity. N. Engl. J. Med. 2003;349:474–485.
14. Poordad F.F. Laboratory evaluation and liver biopsy assessment in liver disease Chapter105. Advanced therapy in gastroenterology and liver disease. 2005:604–611.
15. Pavelkina V.F., Ampleeva N.P. Comparative efficiency of hepatotropic activity of Remaxol and Essentiale N in chronic viral hepatitis. Exper. and clin. pharmacol. [Jeksper. i klin. farmakol.]. 2014;12:17-21. (In Russ).
16. Sologub T.V., Goryacheva L.G., Sukhanov D.S., et al. Hepatoprotective activity of Remaxol in chronic liver damage (materials of multicenter randomized placebo-controlled study). Clin. med. [Klin. Med.]. 2010;1:62-66. (In Russ).
17. Sukhanov D.S., Romantsov M.G. Effects of hepatoprotector in liver damage in patients with respiratory tract tuberculosis. Successes of modern science [Uspehi sovremennogo estestvoznanija]. 2008;10:40-50. (In Russ).
Review
For citations:
Sas EI, Grinevich VB. Multi-component infusion hepatoprotectors for liver damage. Meditsinskiy sovet = Medical Council. 2019;(3):84-88. (In Russ.) https://doi.org/10.21518/2079-701X-2019-3-84-88
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