Combined administration of mexidol with known medicines
Author:
T.A. VORONINA, E.A. IVANOVA
Research Zakusov Institute of Pharmacology, Moscow, Russia
Summary:
This review summarizes the available data on the combined administration of mexidol with medicines of different pharmacotherapeutic groups. Mexidol has a multifaceted mechanism of action and exhibits a wide range of pharmacological effects. It enhances therapeutic effects of a variety of drugs in research and clinical settings, boosts the effectiveness of therapy prescribed in accordance with the applicable federal standards and contributes to reducing the severity of complications. Effectiveness data and pathogenetic considerations underpinning combination therapy with mexidol and other drugs suggest that this is a viable approach for treating cerebrovascular and cardiovascular diseases, diseases of the nervous system, open-angle glaucoma and alcohol intoxication as well as a number of other diseases.
Keywords: mexidol, combination therapy, free radicals, lipid peroxidation, ischemic stroke, myocardial infarction, ischemic heart disease, epilepsy, alcohol intoxication.
Effect of mexidol on the efficiency of intravenous thrombolytic therapy for ischemic stroke during the therapeutic window
Author:
Knni K.S., Dyomin T.V., Adeeva L.B.
Interregional Clinical and Diagnostic Center, Kazan, Russia 12A, Karbyshev St., Kazan, Republic of Tatarstan 420101
Summary:
Objective: to evaluate the effect of intravenous mexidol on the efficiency of intravenous thrombolytic therapy (TLT) during the therapeutic window. Patients and methods. The retrospective study enrolled 123 patients with ischemic stroke (IS) who had undergone intravenous TLT in the vascular centers of the Republic of Tatarstan. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the time course of changes in their neurological status. According to the baseline severity of a neurological deficit, all the patients were divided into three subgroups: 1) mild IS (<8 NIHSS scores at admission); 2) moderate IS (>8 scores); and 3) severe IS (<16 scores). All the patients underwent X-ray computed tomography at admission, at 24 hours after TLT, and in case of worsening of their health status. Results. The prehospital use of mexidol followed by TLT in patients with IS had a positive effect on the regression of neurological deficit regardless of the severity of the disease. There were significant differences in the degree of regression of neurological deficit according to NIHSS at 24 hours and 10 days after hospital admission in patients with severe IS, who received intravenous mexidol at the prehospital stage and who did not take this drug before TLT. The pre-TLT use of mexidol contributed to higher regression of neurological deficit. There was a lower frequency of hemorrhagic transformations in the patients who used mexidol at the prehospital stage versus those who did not. Conclusion. The findings demonstrate the positive effect of mexidol on the efficiency and safety of TLT in patients with IS.
Keywords: ethylmethylhydroxypyridine succinate; intravenous thrombolytic therapy; ischemic stroke; neuroprotective therapy.
Experience with mexidol in neurological practice
Author:
O.A. GROMOVA, I.YU. TORSHIN, L.V. STAKHOVSKAYA, E.G. PEPELYAEV, V.A. SEMENOV, A.G. NAZARENKO
Federal Research Center «Informatics and Management», Institute of Pharmacoinformatics, RAS, Moscow, Russia; Research Institute of
Central Research Hospital of the Russian National Research Medical University. N.I. Pirogova, Moscow, Russia; FGBOU VO «Kemerovo
State Medical University» MH RF, Kemerovo, Russia; Federal State Autonomous Institution «National Medical Research Center for
Neurosurgery named after Academician N.N. Burdenko» of the Ministry of Health of the Russian Federation, Moscow, Russia
Summary:
Antihypoxic, antioxidant and nootropic effects of mexidol contribute to the improvement of patients with cerebrovascular pathology. The results of clinical studies show that the sequential scheme of using mexidol (first i.v. or i.m., then per os) is effective in the complex therapy of ischemic diseases of the brain, vascular surgery, therapy and rehabilitation of patients with degenerativedystrophic changes of the spine, treatment of neurodegenerative pathology (including multiple sclerosis, Parkinson’s disease and diabetic polyneuropathy), infectious neuropathies (ARVI, herpes, tick-borne encephalitis), neuropsychological and autonomic disorders.
Keywords: neurotransmission, GABA, acetylcholine, antihypoxants, nootropics, data mining, mexidol.
The efficacy of mexidol for transient ischemic attacks in the vertebrobasilar system in elderly patients with chronic cerebral ischemia
Author:
YU.V. ABRAMENKO
Tver State Medical University, Tver, Russia
Summary:
Objective. To evaluate the clinical efficacy, metabolic and membrane protective effects of mexidol for transient ischemic attacks (TIA) in the vertebrobasilar system in elderly patients with chronic cerebral ischemia (CCI). Material and methods. Fifty-three patients, aged from 60 to 74 years, with the first episode of TIA in the vertebrobasilar system and CCI were examined. Patients of the main group (n=33) received mexidol in the dose of 500 mg for 10 days along with standard therapy, patients of the comparison group (n=20) received only standard therapy. The clinical implications of TIA, laboratory indices of the state of oxidant and antioxidant systems and percentage absorption of lipid-phospholipid complexes in the infrared spectrum of blood serum were studied. The control group consisted of 20 healthy people. Results and сonclusion. The use of mexidol was associated with more rapid regression of the focal neurological deficit. Mexidol significantly reduced the intensity of lipid peroxidation and had a positive impact on the level of neuronal membrane phospholipids. Metabolic and membrane protective effects of mexidol and it’s positive impact on the regression of focal neurological deficit justify its inclusion into complex therapy of TIA in the vertebrobasilar system developed in patients with CCI, especially in elderly patients.
Keywords: transient ischemic attack, vertebrobasilar system, chronic cerebral ischemia, mexidol, lipid peroxidation, phospholipids.
Characteristics of anxiety in patients of older age groups with different types of mild cognitive disorder
Author:
A.P. SIDENKOVA
Urals State Medical University, Ekaterinburg, Russia
Summary:
Objective. To study the structure of anxiety symptom complex in patients of older age groups with amnestic, disregulatory and polymodal types of mild cognitive impairment (MCI) and determine the clinical efficacy of 2-ethyl-6-methyl-3-hydroxypyridine succinate (mexidol). Material and methods. Thirty-two patients over 55 years of age with MCI (ICD-10 item F 06.7) seeking medical help due to anxiety were included in the study. Inclusion criteria were the compensation of concomitant diseases, absence of relevant stressful events during the last year, absence of depression. Clinical-psychopathological method and psychometric scales (HAM-A, GDS, MMSE, CGI-S, CGI-I) and a stressful life events list were used. Reduction of the total score on the HАМ-А was the main criterion of the efficacy of 4-week treatment with mexidol (375 mg daily). Results and conclusion. At baseline, mean scores on the HAM-A and MMSE were 39,9+3.18 and 25.7+0.6 respectively. The study of the anxiety structure in patients with amnestic, disregulatory and polymodal types of MCI revealed the different phenomenology of anxiety symptom complex. Repeated assessment of anxiety on the HAM-A was performed on 1, 2 and 4 week of treatment with mexidol. The improvement of mental state was noted in all types of MCI but the better results were obtained in disregulatory and polymodal types. The rate of anti-anxiety effect was higher in the disregulatory type of MCI. In all patients, mexidol improved attention stability and autonomic function.
Keywords: anxiety in the elderly, mild cognitive disorder, neuropsychological types MCI, comorbidity MCI and anxiety, mexidol.
Neuroprotection of cerebral accidents in ambulance phase
Author:
V. L. RADUSHKEVICH, A. I. OKUNEVSKY
Voronezh State Medical University n. a. N. N. Burdenko, Voronezh, Russia
Summary:
Relevance. Neuroprotection is a required component of intensive therapy of cerebral catastrophes on pre-hospital and hospital phases of care. The purpose of the study. Identification features and the effect of neuroprotection of different cerebral accidents. Materials and methods. For determination the level of knowledge and practical skills of neuroprotection of different cerebral accidents were conduct an anonymous voluntary questioning doctors Voronezh city ambulance station. The effectiveness of the use of neuroprotection of cerebral accidents was study by special protocols in practice on Voronezh ambulance station. The results. More good theoretical training believe 75 % doctors. Using mexidolum in complex intensive therapy on the prehospital neuroprotection of cerebral accidents has expressed a positive clinical effect.
Keywords: cerebral accident, neuroprotection, ambulance.
Oxidative stress and its pharmacological correction mexidol in traumatic brain injury
Author:
N.V. GOVOROVA
State budget institution of higher professional education «Omsk State Medical Academy» of Ministry for health care of Russia, Omsk, Russia
Summary:
Abstract. Examined and treated 114 patients with isolated severe head injury at the age of 18 to 55 years. Group I included 61 patients who survived, in group II — 53 patients who died on the 3–15th day post-traumatic period. Patients I and II groups had complex intensive therapy according to existing protocols. 15 patients (subgroup I1) was prepared in the complex therapy meksidol 1200 mg per day for 7–10 days. Against the background of mexidol decreased intensity of lipid peroxidation, maintained at a sufficient level power antioxidant defense system cells, there was an earlier resolution of post-traumatic encephalopathy and recovery of consciousness. The treatment mexidol noted more favorable during the early post-traumatic period, a reduction of complications (χ2=55,4; p<0,0001) — syndrome of acute lung injury, disseminated intravascular coagulation, acute cardiovascular failure, and pneumonia.
Keywords: traumatic brain injury, oxidative stress, mexidol.
Contemporary aspects of diagnostics and treatment of post-traumatic stress disorder in patients with brain injury
Author:
M.L. CHUKHLOVINA
State Pediatric Medical Academy, St. Petersburg
Summary:
Abstract. Thirty four patients (14 females and 20 males, 18 to 44 years old) with a post-traumatic stress disorder (PTSD) after mild brain injury were under observation. To perform scoring of cognitive functions and severity of anxious state, appropriate specific scales - Mini-Mental State examination – MMSE and Covi anxiety scale were employed. Levels of patients’ recovery motivation for their own disease were assessed with a special questionnaire (Recovery Locus of Control). Cognitive functions were decreased, showing mild to moderate disorders in patients with PTSD after brain injury. The levels of motivation for recovery from own disorder proved to be significantly decreased, and an inverse correlation was found between this parameter, and a degree of anxious condition in these patients. Treatment of the patients with Mexidolum improved cognitive functions, motivation, decreased the degree of anxious condition in PTSD. The results of study argue for a necessity of early detection PTSD after mild brain injury and inclusion of modern antioxidant and antianxiety drugs into combined therapy of the disease.
Keywords: post-traumatic stress disorder, brain injury, cognitive functions, anxious condition, Mexidolum.
Rehabilitation in stroke patients
Author:
V.V. KOVALCHUK, A.O. GUSEV
Summary:
The present article is devoted to the problems of the organization and carrying out of rehabilitation in post stroke patients. The features of stroke patient’s management with the help of multidisciplinary team are discussed. Main principles and rules of physical, psychotherapeutic and medication rehabilitation are reviewed.
Keywords: rehabilitation, stroke, multidisciplinary team, physical therapy, mexidol.
Alexithymia in patients with left-hemispheric cerebral infarction in the late recovery period
Author:
N.A. ANTONOVA, E.B. KUZNETSOVA, I.I. SHOLOMOV
Razumovsky Saratov State Medical University, Saratov
Summary:
Objective. To study emotional status, including alexithymia, anxiety and depression, in patients with cerebral infarction in the area of the middle cerebral artery (on the left side) in the late recovery period and to develop a method for correction of the damage. Material and methods. The study included 30 patients with cerebral infarction in the area of the middle cerebral artery (on the left side). A comparison group consisted of 10 patients with chronic brain ischemia. Results and conclusion. The results have demonstrated the correlation between the level of alexithymia and the severity of neurological deficit, sex-related level of anxiety and depression. The cerebral infarction impacts on the level of alexithymia. Alexithymia in patients with cerebral infarction affects the adequate self-esteem of physical and mental condition that may complicate the rehabilitation of these patients and demands correction as a combination of pharmacotherapy and psychotherapeutic intervention.
Keywords: alexithymia, cerebral infarction, anxiety, depression.