CLINICAL PHARMACOLOGY OF HEPATOPROTECTORS

Аннотация

This article is about special place in the treatment of hepatobiliary pathology is occupied by drugs belonging to the group of hepatoprotectors. This is a group of drugs of different origin, the action of which aimed at restoring homeostasis in hepatocytes, which contributes to the resistance of the organ to the influence of pathogens. Increase the resistance of the organ to the influence of pathogenic factors, normalization of functional activity and stimulation of reparative and repair activity, stimulation of reparative and regenerative processes in the liver. Due to these effects, hepatoprotectors used in liver diseases, pathology of internal organs complicated with liver damage, as well as a method of medical cover for the use of drugs affecting the liver. The review presents the classification, mechanism. Of hepatoprotectors, peculiarities of clinical pharmacology of preparations of plant and animal origin, drugs containing essential phospholipids and other groups. The issues of drug safety in treatment with hepatoprotectors are also considered. Key words: hepatoprotectors, pharmacological properties, indications, undesirable drug reactions, drug interactions. Introduction. Preparations of plant origin most often contain in their composition- standardized extract of flavonoids milk thistle, the main component of which is silymarin. Silymarin consists of chemically related substances: silibinin, isosilibinin A and B, silicristin, silidianin, isosilicristin and taxifolin. Silibinin considered the main pharmacologically active substance. All isomers have a phenylchromanone structure (flavolignans).In hepatocytes, silymarin stimulates the synthesis of proteins and phospholipids, which leads to stabilization of cell membranes and reduce their permeability, reducing cytolytic syndrome. Comparison of silymarin isomers in their pharmaceutical equivalence led to the allocation of legalone as a reference silymarin-containing drug. Possibilities of diagnostics and specific prophylaxis. The most difficult and far issue of therapy of patients with acute and chronic viral hepatitis (VH) remains the most difficult and far from being solved. Hepatitis (VH), steatohepatitis of alcoholic and non-alcoholic etiology. In accordance with modern principles of treatment of liver diseases, the program of complex therapy of such pathology includes two main directions. The first represents etiotropic therapy aimed at suppressing the pathologic pathogen, its elimination and sanitation of the body. In clinical practice etiotropic therapy used only in viral hepatitis with parenteral mechanism of infection. Preparations of plant origin have a membrane-stabilizing effect; protect liver cells from the penetration of toxins. Liver cells from penetration of toxins into them, and due to their phenolic structure, they are able to bind free radicals and exhibit antioxidant properties phenolic structure, they are able to bind free radicals and exhibit antioxidant properties. Preparations of this group also stimulate the antioxidant defense system by increasing the 98 content of reduced glutathione in the liver, as well as protein synthesis, accelerate regeneration of damaged hepatocytes. Their antifibrotic effect has been experimentally established, which is believed to be due to an increase in the clearance of free radicals and direct inhibition of collagen synthesis .Indications. Predominantly in toxic lesions liver, prescribed in chronic alcoholic and drug- induced hepatitis and cirrhosis. The possibility of antiviral action in chronic viral hepatitis C manifested only with intravenous use of the drug. Use with caution in patients with cholestasis, as it is reported that under the influence of milk thistle preparations cholestasis may increase. Similar in properties is the drug hipbone, which is composed of milk thistle extracts, which consists of milk thistle extracts and drugstore melon. The latter has antispasmodic effect. The drug used in chronic hepatitis and cirrhosis. Liver fatty degeneration of the organ, toxic-metabolic lesions of the organ, including xenobiotics. Artichoke leaf extract (chofitol) due to the presence of phenolic acids and flavonoids in the drug A similar hepatoprotective effect observed when administering selenium containing compounds, thiobarbituric acid derivatives In their chemical structure, phospholipids are similar to triglycerides, but in their molecule, one of the fatty acids is replaced by a phosphoric acid residue. The main phospholipids are lecithin (phosphatidylcholine), phosphatidylethanolamine, phosphatide inositol, phosphacetylserine, phosphatide acid. Phospholipid preparations, being a constituent part of cytoplasmic membranes of the Cell’s membranes, contribute to the restoration of the structure, replace defects of the damaged lipid layer of biological membranes and restore its physicochemical properties. The most well-known and long-used hepatoprotector is essential, a complex preparation con