Papaverine - a drug that has been used for many years. Previously, it was obtained from the opium poppy, but today all of papaverine prepared synthetically. Open papaverine was in the middle of the 19th century, but, despite the fact that in recent years there have been more effective drugs of this series, papaverine and today is widely used for the treatment of various diseases.

The mechanism of action of papaverine

Papaverine belongs to the group myotropic antispasmodics, ie drugs, relieves spasms of smooth muscles of internal organs and blood vessel walls by acting directly on muscle cells. Papaverine produced tablets to 0, 04 g, in rectal suppositories to 0, and 02 g of a 2% injectable solution of 2 ml ampoule.

The pharmacological action of papaverine is associated with the suppression of the enzyme phosphodiesterase (PDE), which causes the accumulation of cyclic mononucleotides in the cell (cAMP). CAMP accumulation compound inhibits myosin protein with another protein actin, whereby shall be obtained actomyosin - a substance with which twitch muscle fibers.

Thus, papaverine inhibit smooth muscle cramps internal organs and blood vessel walls. The most active it acts on the smooth muscles of the gastrointestinal tract, bile ducts, pancreatic ducts, urinary tract, reproductive system and bronchi. To a lesser extent papaverine relieves spasms of the artery walls, thereby increasing blood flow, including the heart and the brain (cerebral vasospasm slightly removed). Also reduced blood pressure.

The use of high doses of papaverine may lead to disruption of cardiac impulses within the myocardium, which can lead to the development of heart block.

Papaverine is rapidly absorbed into the bloodstream when taken orally or rectally administered, rapidly distributed to tissues and is valid for three to four hours. Papaverine is decomposed in the liver and then excreted in the urine.

Indications and contraindications for use - instructions

Papaverine used to relieve spasms of smooth muscles, which develop in the following diseases and conditions:

• gastrointestinal disease - chronic gastritis, gastrodurdenitah, gastric ulcer and duodenal ulcer, chronic colitis, intestinal dysbiosis Intestinal dysbiosis - how dangerous it is?   and so on;
• respiratory diseases - asthma, bronchitis, accompanied by bouts of bronchospasm;
• diseases of the circulatory system - angina (in this disease there are strong short-term pain in the heart Pain in the heart - always consult a doctor Associated with coronary vasospasm), stroke, peripheral vascular spasm (for example, occlusive disease);
• in preparation for the operation under general anesthesia (sedation), along with painkillers and sedatives.

Intravenous papaverine administered very slowly, spreading its previously in saline. During the course of treatment papaverine Papaverine - for pain caused by spasms of smooth muscles   to exclude the use of alcoholic beverages (perhaps the collapse - a sharp decline in blood pressure).

Do not use this papaverine with heart block (disorders of the heart pulses of the atrium to the ventricles of the heart), glaucoma, severe liver disease with impaired function of the body, in old age, and the age of six months, as well as hypersensitive to the components of the drug by the body of the patient.

Be wary appoint papaverine after traumatic brain injury, with severe kidney disease in violation of their function, adrenal dysfunction, reduced thyroid function The thyroid gland - is responsible for your hormones , Increase (hyperplasia) of the prostate gland, shock conditions (the threat of a sharp decline in blood pressure).

Side effects of papaverine

Papaverine is generally well tolerated at therapeutic doses. However, if it is applied may cause nausea and constipation (due to the suppression of motor activity of the muscles of the gastrointestinal tract), transient liver dysfunction (increased liver enzymes), somnolence, sweating, reducing blood pressure (particularly when administered intravenously) . When administered intravenously (if the solution is injected rapidly) may develop atrioventricular blockade and cardiac arrhythmias.

In case of overdose of papaverine marked strengthening of its side effects, especially on the part of the cardiovascular system.

Papaverine - a drug that is used for a long time and widely. But completely safe to call it impossible.

Galina Romanenko

Reactive hepatitis develops quite often and has a benign course. Primarily the liver responds to severe, long-occurring gastrointestinal disease. Chronic diseases of other organs and systems can also be complicated by reactive hepatitis.

Reactive hepatitis - what happens to the patient's liver

Reactive hepatitis is a secondary disease, it develops under the influence of internal toxins produced in the body in long flowing chronic or severe diseases simply. It may be such gastrointestinal disease as gastric ulcer and duodenal ulcer, chronic gastritis, gastroduodenitis, colitis, pancreatitis, cancers of the gastrointestinal tract, and so forth.

From diseases of other organs and systems of reactive hepatitis often develops in the presence of leukemia, Hodgkin's disease, hemolytic anemia, systemic lupus erythematosus, rheumatoid arthritis, rheumatism, diabetes, serious diseases of the thyroid gland The thyroid gland - is responsible for your hormones   and so on. By the development of reactive hepatitis can cause any long-occurring infectious-inflammatory processes of the internal organs.

Under the action of the toxins produced during the pathological process, changes the metabolism Improves metabolism and losing weight without dieting   throughout the body, including the liver cells (hepatocytes). Violation of the cellular metabolism in hepatocytes leads to the fact that the cells gradually developed exchange-degenerative processes, and they can not cope with its function of neutralizing toxic substances. Part of the cells can be destroyed, but necrosis captures small areas of cells, so often the process is reversible and depends on the underlying disease, which is caused reactive changes in the liver.

Symptoms of reactive hepatitis

Fulminant hepatitis in most cases starts and runs a mild and sometimes asymptomatic. The course usually corresponds to chronic persistent hepatitis (CPH), ie it is not a progressive course with a favorable prognosis, which often can not carry out special medical treatment of hepatitis Treatment of hepatitis - a difficult task   - Sufficient treatment of the underlying disease.

The main symptoms connected to the primary disease hepatitis B are weakness, fatigue, headache, malaise. Icteric staining of the skin and sclera are not always found, as well as dark urine with discolored feces.

A doctor at survey reveals a moderate enlargement of the liver and sometimes - the spleen. From the laboratory parameters observed increased blood levels of liver enzymes (AST, ALT), sometimes - bilirubin. Revealed as easy Dysproteinemia (violation of the ratio of individual protein fractions of blood).

Fulminant hepatitis in children

Children reactive hepatitis Hepatitis - the scourge of our time   in most cases a benign, type CPH. A feature of reactive hepatitis in children is that it often develops on the background of allergic diseases: atopic dermatitis and asthma. In adults, such complications are much less common. As often reactive hepatitis in children develop on the background of diseases of the digestive system, blood system, diabetes, and various chronic infectious-inflammatory processes.

The disease begins with the appearance of weakness quietly, fatigue, tearfulness, often turning into aggression. Constant headaches, loss of appetite, bitter taste in the mouth, and sometimes nausea, vomiting and disturbances of stool (constipation or diarrhea). The appearance of jaundice staining of the skin accompanied by itching, dark urine, and the release of discolored feces.

The flow of reactive hepatitis depends on the underlying disease: the harder it is, the more long-term flows hepatitis.

Diagnosis of reactive hepatitis

Diagnosis of reactive hepatitis can only excluding all other possible causes of the disease. For this blood checked for viral infection, instrumental investigations conducted, in some cases the biopsy is taken by a piece of tissue for analysis. Also, the patient carefully questioned about possible industrial hazards, medication with hepatotoxic, alcohol, drugs. Biochemical analysis of blood reveals the degree of liver dysfunction. Immunological blood tests carried out in order to exclude autoimmune ge6patita.

Treatment of reactive hepatitis

Treatment of the disease begins with the exception of heavy physical exertion, stress, receiving hepatotoxic drugs. Appointed special diet (table number 5) with the exception of fatty, fried, spicy dishes, strong meat, fish and mushroom broth.

Drug treatment - it is basically treatment of primary disease. If necessary, patients are administered an intravenous drip of different solutions to eliminate toxins from the body through the kidneys. To remove toxins from the intestines prescribed chelators.

Fulminant hepatitis - a disease for which depend on any other pathological processes in the body of the patient.

Galina Romanenko