PHARMACODYNAMICS AND PHARMACOKINETICS OF DRUGS USED IN PNEUMONIA

Аннотация

The prevalence of infectious diseases of the respiratory system and, first of all, pneumonia among the population, the presence of various etiological factors and conditions for the appearance of diseases, doctors of various specialties - therapists, surgeons, neuropathologists - predetermine the occurrence of this disease. Faced with this pathology. Few or atypical clinical signs characteristic of the modern course of pneumonia complicate the diagnosis and complicate the treatment of the patient. The presence of diseases accompanied by decompensation against the background of an infectious lung lesion worsens the prognosis and increases the risk of death. It is especially important to correctly diagnose infectious lung disease in time and to prescribe adequate antibacterial therapy. Pneumonia is a group of acute infectious diseases of different etiology and pathogenesis, characterized by focal damage of the respiratory parts of the lungs and the presence of alveolar exudation (see picture). Modern classification defines the following types of pneumonia: 1) community-acquired - CP (ambulatory) - acquired outside a medical institution; 2) nosocomial (hospital, in-hospital) - acquired in a medical institution; 3) aspiration; 4) pneumonia in people with severe immune deficiencies - pneumonia caused by congenital immunodeficiency, HIV infection, iatrogenic immunosuppression. This division is based on the difference in the conditions in which the disease occurs and the approaches to the selection of antimicrobial therapy. Among registered pneumonias, the most common is CAP (ambulatory). Key words: Pneumonia, origin, diagnosis, prevention, prevention, pharmacodynamics of drugs affecting the disease. They firmly occupy a leading position in the composition of acute infectious diseases of urban residents. Etiological factors of SAP Due to significant limitations, none of the microbiological methods can detect all potential triggers of bronchopulmonary infection, so the etiology of the infectious process cannot be determined in 30-50% of patients. More than 100 microorganisms that can cause SAP have been described, almost all of which have been isolated at least once during lung tissue biopsy. 132 NEW RENAISSANCE 2024 NOVEMBER INTERNATIONAL SCIENTIFIC AND PRACTICAL CONFERENCE VOLUME 1 | ISSUE 9 However, in routine practice, they rely on microbiological studies of blood, sputum or pleural fluid and the results of serological studies to make an etiological diagnosis. Information on the etiology of SAP obtained in various studies depends on the following factors: the investigated patient population (age, the presence and severity of concomitant diseases - chronic obstructive pulmonary disease - COPD, immunodeficiency conditions; places of development of pneumonia - nursing homes, isolated groups); endemic characteristics and epidemiological situation of the region during the study; set of used diagnostic methods, their sensitivity and specificity, criteria for evaluating the obtained results. The etiology of CAP is directly related to the microflora, usually colonizing the upper respiratory tract. The most common causative agent of CAP is Streptococcus pneumoniae, which, according to various authors, causes the disease in 30-50% of cases in people of all ages. Haemophilus influenzae is less common (10-20%). Up to 10% of CAP is caused by an association of two or more microorganisms, most commonly S. pneumoniae and H. influenzae. However, in each case, it is not clear whether both microorganisms are equivalent etiological agents or whether one of them serves only as a predisposing factor for infection caused by another pathogen. Staphylococcus aureus, Moraxella, gram-negative bacteria (Klebsiella pneumoniae, Escherichia coli, Enterobacter spp., Pseudomonas spp., etc.), viruses (respiratory syncytial, influenza A and B viruses, parainfluenza) play a lesser role. Although atypical microorganisms - Chlamydophila (Chlamydia) pneumonia, Mycoplasma pneumoniae and Legionella pneumophila - cause 8 to 30% of SAP cases, it is difficult to accurately assess the role of these pathogenic microorganisms in the etiological structure of SAP. adequate diagnostic methods. The role of oral microflora anaerobes (Peptostreptococcus spp., Bacteroides spp., Veilonella spp., etc.) in the genesis of CAP is small, but significantly increases with aspiration pneumonia, which occurs in 6-10%. conditions against the background of mental retardation, encephalopathy, trauma, cerebrovascular diseases. Post-influenza pneumonia is most often caused by hemolytic streptococcus serogroup A (Streptococcus pyogenes), S. aureus, H. influenzae, or S. pneumoniae. The most common causative agent of CAP in smokers is nontypeable strains of H. influenzae. In patients with immunodeficiency, including neutropenia, in addition to pneumococci, staphylococci and gram-negative bacteria, pneumocystis carinii (Pneumocystis carinii), atypical mycobacteria, fungi and cytomeg