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Еволюція лікарських засобів у XXI столітті ознаменувалася істотним підвищенням вимог до їх ефективності та безпеки. При цьому досить жорстким критеріям безпеки відповідає вельми обмежений спектр препаратів, зокрема представники популяції ноотропів, що мають унікальні клініко-фармакологічні можливості. У статті запропоновані варіанти оптимізації ноотропної терапії препаратом Олатропіл, що представляє собою поєднання в одній лікарській формі двох «істинних» ноотропів — аміналону (125 мг) і пірацетаму (250 мг). Подібна комбінація дає можливість одномоментної реалізації комплексу багатосторонніх і різноманітних ефектів щодо центральної нервової системи, що властиві як пірацетаму, так і аміналону, однак досягаються за рахунок принципово різних механізмів дії даних засобів. Таке поєднання дозволяє зменшити в 2 рази терапевтичні дозування кожної з діючих речовин, що, в свою чергу, призводить до зниження частоти виникнення і вираженості можливих побічних ефектів. Фармакологічний потенціал Олатропілу більш вагомий, ніж у звичайних ноотропів, завдяки наявності полівалентної фармакодинаміки, а саме власне ноотропного, антиастенічного, анксіолітичного, вегето- і судиностабілізуючого ефектів. З урахуванням механізмів впливу Олатропіл покликаний одночасно впливати як на когнітивні, так і на вегетативно-емоційні розлади. Препарат є ефективним інструментом терапії різних форм цереброваскулярної патології, покращує когнітивні функції, психічну активність, психоемоційний статус, вегетативні функції, сприятливо впливаючи на якість життя пацієнтів.

Based on the analytical study of domestic and foreign literature, the authors of the article describe the main pharmacological properties of the drug Alflutop (manufactured by S.C. Biotehnos SA, Romania) and its effectiveness in the pharmacotherapy of degenerative-dystrophic diseases of the musculoskeletal system. The pharmacological effects of Alflutop are described and proven mechanisms of their development are revealed. The authors showed that Alflutop is an effective and safe mean of pharmacotherapy for degenerative-dystrophic diseases of the musculoskeletal system.

Vaginal infections are highly spread among the female population and they impact the woman’s organism, fetal development and child health. They remain an important medical and social problem, so the optimizing the treatment is very important. The article is a review of the modern domestic and foreign publications about the etiological factors, pathogenesis, and local pharmacotherapy of nonspecific and candidiasis vaginitis and bacterial vaginosis, including their manifestation during pregnancy. The issues of vaginal infections in non-pregnant and pregnant women, the main risk factors for their development, the range of pathogens of infectious lesions of the vagina, which are the most common - bacterial vaginosis (G. vaginalis and A. vaginae), nonspecific vaginitis (Streptococcus spp., S. aureus, coagulase-negative staphylococci, E. coli, etc.), candidiasis vaginitis (C. albicans and C. non-albicans), and the importance of changes in the composition of the vaginal microbiome in the development of these diseases are demonstrated. Based on the data from scientific publications, the article presents the analysis of the sensitivity of pathogenic flora to anti-infective methods. The attention is drawn to the risks of nonspecific and candidiasis vaginitis and bacterial vaginosis during pregnancy (miscarriage and premature birth, placental insufficiency, etc.), the advantages and disadvantages of systemic and local therapy for these diseases, the comparative characteristics of individual drugs for topical therapy are given, taking into account the composition and pharmacodynamics of their components. The clinical and pharmaceutical benefits of a complex preparation that includes ternidazole, neomycin sulfate, nystatin and prednisolone sodium metasulfobenzoate and has the bactericidal (including antianaerobic), fungicidal, antiprotozoal, and anti-inflammatory effects have been analyzed. Data on the microbiological and clinical efficacy of the drug, its storage effect on the vaginal microbiome, and features of innovative technology for the manufacture of its dosage form are presented.

Background. Endothelioprotectors (EP) are a group of drugs with different pathogenetic mechanisms of action that prevent disruption and/or restore the structural and functional properties of vascular endothelium. EP are mainly used in the treatment and prevention of cardiovascular and cerebrovascular diseases and their complications. Objective. To describe the role of EP in modern therapy of vascular diseases on the example of L-arginine (Tivortin, “Yuria-Pharm”). Materials and methods. Analysis of literature data on this topic. Results and discussion. The endothelium can be considered as a separate organ that regulates the work of blood vessels. Nitric oxide (NO) is the main signaling molecule of the endothelium. In humans, NO is produced from L-arginine. The latter is a conditionally essential amino acid, which means that it is synthesized in sufficient quantities only in perfectly healthy adults. Arginine is practically not synthesized in children under 5 years of age and in persons over 50 years of age. The main food sources of arginine are meat (pork, poultry), chocolate, soybeans, however, nutrition may not always provide the necessary need for L-arginine. The effects of NO include decreased intracellular calcium, smooth muscle cell relaxation, and vasodilation. As a result, the total peripheral vascular resistance and blood pressure decrease. One of the leading negative factors affecting the heart and blood vessels is hypercholesterolemia, which disrupts the production and release of NO. An improvement in endothelium-dependent vasodilation and a reduction in the size of atherosclerotic plaques with L-arginine have been demonstrated in a rabbit model with hypercholesterolemia. Endothelial dysfunction is an important concept in modern cardiology and medical science. Its main manifestation is a decrease in the NO bioavailability, so in order to eliminate endothelial dysfunction, EP are prescribed. The ideal EP should have such properties as a pronounced cardio- and cerebroprotective effect, rapid onset of action, no side effects, and low cost. L-arginine (Tivortin) is one of the best known EP. It can be used in the treatment of chronic heart failure to increase exercise tolerance. Tivortin supplies the depleted endothelium with a substrate for NO synthesis, facilitating cell function. Tivortin can be used not only in cardiological patients. The research of V.V. Bezugla et al. (2017) showed that Tivortin aspartate for oral administration improves the general and special performance of athletes in cyclic and strength sports, as well as reduces the severity of psychophysiological stress. In addition, the neuro-rehabilitation properties of Tivortin are demonstrated, which justifies its feasibility in the treatment and prevention of stroke. In the study of M.M. Sunychuk et al. (2014) the inclusion of Tivortin (100 ml infusion once a day from the 4th day after stroke for 10-14 days) in the complex therapy contributed to a more positive dynamics of assessments on the NIHSS, Bartel and Rankin scales than the use of standard therapy only. Improvement of the cerebral blood flow with the use of Tivortin is shown in other scientific papers (Mankovsky B.N. et al., 2014). The beneficial effect of L-arginine on the course of hypertension has also been proven (West S.G. et al., 2005). Studies conducted at the Department of Pharmacology and Clinical Pharmacology of the Dnipropetrovsk Medical Academy confirmed the cardiotropic and vasotropic properties of L-arginine. Conclusions. 1. NO – the main signaling molecule of the endothelium – is produced from L-arginine, the production of which almost stops after 50 y. o. 2. EP supply the endothelium with a substrate for NO synthesis, facilitating its function. 3. L-arginine (Tivortin, “Yuria-Pharm”) improves clinical, laboratory and functional parameters in patients with cardiovascular and cerebrovascular diseases.

One of the key and strategically important problems of modern gynecology both around the world and in Ukraine is infectious and inflammatory diseases (IVD) of the lower genital tract: according to various estimates, back in the 90s of the last century, this diagnosis was made in about 40 % of patients in gynecological hospitals. Over the first decade of the 21st century, the incidence rate of genital IVI increased 1.4 times in 18–24-year-old patients, and 1.8 times in 25–29-year-old patients. At the same time, the costs of diagnostics and treatment have increased, which reach 50-60% of all costs for the provision of gynecological care to the population. In the structure of gynecological morbidity, the indicator of the number of patients with infectious and inflammatory diseases of the genital area continues to occupy a leading position in terms of frequency in the population, amounting to 60.4-65.0%, however, information from different authors regarding their true prevalence is very contradictory. So, according to the materials of the 33rd European Congress of the International Union against for Sexually Transmitted Infections (IUSTI-Europe), bacterial vaginosis (BV) occurs in 12-80% of women, vulvovaginal candidiasis – VVC (at least one episode in life) - in 75%, aerobic vaginitis (AV) – in 15-25% [8]. According to other authors, the prevalence of BV is 24-30%, VVC – 9.7-11.7%, nonspecific (aerobic) vaginitis – 5.0-23.7%. Combined drugs Neo-Penotran® Forte and Gainomax have a high safety profile, which is due to the unique features of the pharmacokinetics and pharmacodynamics of their components. This determines the advantages in the speed of bactericidal action over other antibacterial and antimycotic agents. These drugs are highly effective in the local treatment of BV and vulvovaginal infections, reaching 98.5% in some nosologies. The effectiveness and safety of the use of Neo-Penotran® Forte and Gainomax in the treatment of infections of the female genital area served as the basis for their inclusion in standard treatment regimens according to indications, and their use is regulated by the normative documents of the Ministry of Health of Ukraine.

In the conditions of experi mental chronic gastritis and duodenitis reproduction, carried out among Wistar line 24 rats, was investigated effect of the nitrogen oxide stable metabolites content in the gums homogenates on a lamina propria structure and function. Results of our research have been shown, that level of nitrogen oxide stable metabolites in the rats’ gums tissues homogenates with gastritis and duodenitis decreased in three times, compared with a same period at the intact animals, which indicated about depletion of a nitrogen oxide depot at the given disease. It was revealed a significant decrease typical for the protein and glycoprotein content in the animals gums tissues at the experimental group, which indicated about the catabolic processes predominance. Amount of hexosamines in the gums was significantly increased, which was correlated with a morphological picture (gums lamina propria impregnation with the blood plasma proteins), testified about a change in the vascular wall permeability and microcirculation disruption. In the animals from experimental group was reduced a height of gums papillae connective tissue to 27.18±1.86 x 10-6 m against 56.93±2.64 x 10-6 m in the rats from control group. In the gums lamina propria defines phenomenon of the papillary and reticular layer fibrosis. After medicamentous correction, carried out with an antioxidant and the nitrogen oxide donor was observed repairing structure of the gums lamina propria on a background of increasing microvasculature area. It was determined significantly increased protein and glycoprotein content in the gums tissues with increased levels of nitrogen oxide metabolites.

Data about pharmacodynamics, pharmacokinetics, clinical efficacy and safety of long-term therapy with acetylsalicylic acid (ASA) in patients with cardiovascular diseases are presented in the review paper. The main practical ways to reduce the possible gastrointestinal complications are discussed. Convincing positive results of clinical trials and so-called gastric toxicity of ASA together with the need of prolonged use of the preparation as an antiaggregant were the basis for the appearance of the various do­sage forms of ASA: soluble, with controlled release, enteric-coated, local, buffer, as well as combined agents containing ASA and substances with antacid effect. To date, the most convincing evidence for the efficacy and gastrointestinal safety has been obtained for enteric forms of ASA., В обзорной статье представлены сведения, касающиеся фармакодинамики, фармакокинетики, клинической эффективности и безопасности длительной терапии ацетилсалициловой кислотой (АСК) пациентов с сердечно-сосудистыми заболеваниями. Показаны основные практические способы уменьшения возможных осложнений со стороны желудочно-кишечного тракта. Убедительные положительные результаты клинических испытаний и так называемая желудочная токсичность АСК наряду с необходимостью длительного применения препарата в качестве антиагреганта стали основанием для появления различных лекарственных форм АСК: растворимых, с контролируемым высвобождением, покрытых кишечнорастворимой оболочкой, локальных, буферных, а также комбинированных средств, сочетающих в себе АСК и вещества с антацидным эффектом. К настоящему времени наиболее убедительные доказательства эффективности и гастроинтестинальной безопасности получены для кишечнорастворимых форм АСК., В оглядовій статті представлено відомості, що стосуються фармакодинаміки, фармакокінетики, клінічної ефективності та безпечності тривалої терапії ацетилсаліциловою кислотою (АСК) пацієнтів із серцево-судинними захворюваннями. Показані основні практичні способи зменшення можливих ускладнень із боку шлунково-кишкового тракту. Переконливі позитивні результати клінічних випробувань і так звана шлункова токсичність АСК поряд із необхідністю тривалого застосування препарату як антиагреганта стали підставою для появи різних лікарських форм АСК: розчинних, із контрольованим вивільненням, покритих кишковорозчинною оболонкою, локальних, буферних, а також комбінованих засобів, що поєднують у собі АСК і речовини з антацидним ефектом. На сьогодні найбільш переконливі докази ефективності та гастроінтестинальної безпечності отримані для кишковорозчинних форм АСК.

restriction increased expression of NR2A and NR2B proteins and decreased expression of p-CREB and BDNF proteins in the Hp were observed. The up-regulation of NR2A protein accompanied by a decreased expression of p-CREB and BDNF proteins was also found in the PFC, but only after prolonged (6 weeks) zinc deprivation. Conclusions: The current data show that the increased expression of hippocampal NR2A and NR2B proteins after dietary zinc deprivation is linked to the depressive-like behavior. The altered composition of NMDAR subunits has been observed in experimental models of depression based on stress exposure [2] and in post-mortem tissues of suicide victims who may have suffered from depression [3]. The present data further support the zinc deficiency paradigm as a model of depression. Moreover, it indicates that changes of NMDAR subunits at the protein level in a response to zinc deprivation are complex and vary across brain regions and the course of time.