Ефективність застосування у клінічній практиці лікаря загальної практики сімейної медицини препарату "Стеатель" у пацієнтів з дилатаційною кардіоміопатією

Abstract

Резюме. Проаналізовано результати рандомізованого контрольованого дослідження, що демонструє ефективність L-карнітину, який є основою препарату «Стеатель» в лікуванні дилатаційної кардіоміопатії. Вивчаючи як основні фармакологічні ефекти, так і їх ефективність в застосуванні при вищезгаданій патології, зроблено ряд висновків, щодо необхідності впровадження препарату «Стеатель» в основу допоміжної терапії при лікуванні дилатаційної кардіоміопатії. Розглянувши дані отриманих результатів, патогенетично обґрунтовано дію L-карнітину не лише при дилатаційній кардіоміопатії, а й при інших типах кардіоміопатій.; Резюме. Проанализированы результаты рандомизированного контролируемого исследования, демонстрирующие эффективность L-карнитина, который является основой препарата «Стеатель» в лечении дилатационной кардиомиопатии. Изучая как основные фармакологические эффекты, так и их эффективность в применении при вышеупомянутой патологии, сделан ряд выводов, о необходимости внедрения препарата «Стеатель» в основу вспомогательной терапии при лечении дилатационной кардиомиопатии. Рассмотрев данные полученных результатов, патогенетически обоснованно действие L-карнитина не только при дилатационной кардиомиопатии, но и при других типах кардиомиопатий .; Abstract. Introduction. Recently, on the the pharmaceutical market of Ukraine appeared the drug “Steatel”, based on a Levokarnityn. We successfully use the drug “Hepadyf” as its main component is L-carnitine. The difference between the two drugs is that “Hepadyf” – a multi-drug, which includes, in addition to L-carnitine, are antitoxic fraction of liver extract, adenosine, B vitamins, but “Steatel” contains only L-carnitine, and in much larger doses than “Hepadyf” – 100 mg per 1 ml of solution for oral administration. The initial daily dose for adults is 10 ml, means 1 g of carnitine. Gradually increase the dose to 3 g of carnitine per day. A solution for intravenous administration contains 200 mg of carnitine in 1 ml and the average daily dose is 1,000 mg carnitine. The purpose of the work. To examine the pharmacological effects of Levokarnityn and its effect in a treatment in patients with dilated cardiomyopathy: a generalization of the results and implementation of the drug in a clinical practice. Materials and methods of research. The main materials and research methods of this work is to examine the pharmacological properties of the drug “Steatel” and its influence on the treatment of patients with dilated cardiomyopathy. Since the main active ingredient of the drug “Steatel” is Levokarnityn, the main purpose was to analyze the pharmacological effects on the human body. The main pharmacological effects Levokarnityn are – anabolic, anti-hypoxic, antithyroid, stimulation of regenerative processes to stimulate fat metabolism, these effects have been studied and used in the work. The results and its discussion. Levokarnityn belongs to the group of vitamin B. It has an anabolic effect, reduces basal metabolic, promotes the penetration through the membrane of mitochondria and splitting long-chain fatty acids (palmitic, etc.)and form acetyl-CoA. It has a slight depression effect of the central nervous system, increases the secretion and enzymatic activity of digestive juices (gastric and intestinal), improves digestion. Reduces excess body weight and reduce fat in the muscles. Increases the threshold of resistance exercise leads to the elimination of acidosis after exercise and as a result, rehabilitation after a long exhausting physical activity. Increases glycogen in the liver and muscles, promotes its economically using. Provides a neurotrophic effect, inhibits the development of apoptosis, limiting damage area and restores the structure of nervous tissue. During the studying, a drug “Steatel” was used in the treatment of dilated cardiomyopathy in 17 patients of different age and sex from 36 to 56 years (2g 2 times a day for 3 months). In summary, after 3 months in 15 (89 %) patients showed improvement of the general condition of the basic disease, including reducing pain, weight loss, improved sleep. Conclusions. Having regard to the base properties and pharmacological effects of the drug “Steatel” and the basic principles and provisions for the development of dilated cardiomyopathy, it is appropriate to note that L-carnitine has a definitely positive effect on the course of the disease process. Purpose drug “Steatel” allows first, inhibit apoptosis and necrosis prevent myocardial cells, due to the food and stimulating action on the cells of the body; reduce development of the heart fibrosis, cause regression of myocardial hypertrophy, exhibit antioxidant activity in cells, removes sympathetic effects on the myocardium, Also, L-carnitine affects reduction of overweight and reduces adipose tissue in muscles, reduces the amount of total cholesterol and LDL and very low density, a positive effect on hemodynamics and reduces myocardial ischemia. In addition, carnitine is a universal drug,which helps to protect the body cells, take part in the synthesis of certain amino acids, improves efficiency, increases growth and tissue regeneration. The above effects Levokarnityn,as a drug, which used in the treatment of dilated cardiomyopathy certainly deserve attention, especially in the clinical practice of general practice of family doctors. It is particularly important, that the drug “Steatel” contains an adequate dose of L-carnitine, has a strong protective, antioxidant, metabolic activity.