From Big Medical Encyclopedia

ANTIMECOTIC MEANS — the chemotherapeutic means applied to treatment of a trichomoniasis.

There is no standard classification of P. of page. As P. villages use hl. obr. synthetic substances and some drugs of a plant origin. Synthetic P. belong to page to different classes of chemical connections. On this sign among P. the page is distinguished: derivatives of a nitroimidazole — metronidazole (see) and Tinidazolum; derivatives of nitrothiazol — Nitazolum; derivatives of nitrofuran — furasolidone (see); derivatives of aminoquinoline — Trichomonacidum (see); derivatives of aminoacridine — Aminoacrichinum (see); derivative N octyl alcohol — octyl; organic compounds of arsenic — aminarson, Osarsolum (see). From drugs of a plant origin in domestic medical practice as P. pages apply Lutenurinum (see).

The most effective P. of page are derivatives of a nitroimidazole (metronidazole, Tinidazolum), nitrothiazol (Nitazolum) and aminoquinoline (Trichomonacidum).

Mechanisms of action of P. of page are a little studied. It is known only that derivatives of a nitroimidazole, getting into activators, sensitive to them, turn into the active metabolites interacting with nucleinic to-tami. Items of page from among compounds of arsenic are inhibitors of thiol enzymes of microorganisms of various classes, including the activator of a trichomoniasis.

Depending on routes of administration of P. of page it is possible to divide into 3 groups: drugs for orally go uses — Tinidazolum; drugs for oral and intravaginalny administration — metronidazole, Nitazolum, furasolidone, Trichomonacidum, Aminoacrichinum; the drugs intended only for intravaginalny use — Lutenurinum, octyl. aminarson, Osarsolum and the combined drugs which part Osarsolum is (e.g., osarbon, osartsid).

Drugs of the choice for treatment of a trichomoniasis (see) are derivatives of a nitroimidazole — metronidazole and Tinidazolum.

Tinidazolum (a synonym fazizhin) in the chemical relation represents 1-[2 (ethylsulphonyl) - ethyl] - a 2-methyl-5-nitroimidazole. It is well soaked up from went. - kish. path. After intake in the maximum concentration collects in blood in 3 — 6 hours and it is slowly brought out of an organism (during 3 and more than a day).

Tinidazolum is applied to treatment of a trichomoniasis at men and women. Drug is appointed inside on one of the following schemes: 1) on 0,15 g 2 times a day within one week; 2) on 0,5 g 4 times a day within one day; 3) once 2 g; 4) on 0,5 g in 15 min. within 1 hour (in the general dose of 2 g). To children drug is appointed in doses from calculation for 50 — 60 mg/kg a day.

Women should not appoint Tinidazolum during pregnancy (especially in the first trimester) and during feeding a breast. Drug is contraindicated at hypersensitivity to it, and also at a serious illness of blood and c. N of page.

At treatment of a trichomoniasis at P. women of page, intended for oral and intravaginalny administration (metronidazole, Nitazolum, Trichomonacidum, etc.), at the same time appoint any of these drugs inside and intravaginalno courses of duration, various for separate drugs (e.g., for metronidazole — usually 6 — 10 days, for Nitazolum — 15 days etc.). If necessary the course of treatment is repeated.

The items of page intended only for intravaginalny use use for treatment of a trichomoniasis at women usually in addition to orally appointed drugs since local (intravaginalny) therapy of this disease is ineffective.

At men apply P. to treatment of a trichomoniasis of page, effective at oral administration (derivatives of a nitroimidazole, Nitazolum, Trichomonacidum, etc.). Sometimes treatment of mecotic uretrit at men is carried out it is combined, napr, by purpose of Trichomonacidum inside and syringings of an urethra by solutions of this drug.

Efficiency of treatment of P. of page is controlled parazitol. a research of vulval and cervical smears, and also separated urethras. It must be kept in mind that in order to avoid reinfection and for receiving permanent treatment of P. of page sexual partners need to appoint at the same time.

Side effect of P. of the page belonging to the different classes of chemical connections is shown unequally. So, derivatives of a nitroimidazole (metronidazole, Tinidazolum) can cause dispeptic frustration, a headache, a leukopenia, an itch, urticaria. Dizziness, a headache, abdominal pains, nausea, increase of an urination are characteristic of side effect of Nitazolum. Trichomonacidum has local irritative effect on mucous membranes and in this regard at intravaginalny use can cause in women plentiful allocations from a vagina. At administration of this drug to men in an urethra emergence of plentiful allocations from it is also possible. The expressed local irritative action also Aminoacrichinum possesses. At intravaginalny use this drug can cause in women sanious allocations from a vagina and hypostasis of external genitals. Less expressed local irritation of fabrics causes Lutenurinum, it is shown by a hyperemia and hypostasis of a mucous membrane of a vagina. The most toxic pages among P. are drugs of arsenic at which use emergence of dermatitis, neuritis, dispeptic frustration, signs of irritation of kidneys and damage of a liver is possible.

Bibliography: The medicines used at parasitic diseases under the editorship of A. I. Krotov, e. 71, M., 1979; Mashkovsky M. D. Pharmaceuticals, p. 2, page 293, M., 1977.

A. V. Konstantinov, V. K. Muratov.