ANTISYPHILITIC MEANS — the chemotherapeutic means applied to specific therapy of syphilis.
Pages carry to specific P.: 1) drugs of penicillin — benzylpenicillin sodium salt, Benzylium of penicillin potassium salt, phenoxymethylpenicillin (see. Penicillin ), Bicillinum-1, Bicillinum-3, Bicillinum-5 (see. Bicillinum ); 2) erythromycin (see. Makrolida ); 3) organic drugs of arsenic — Novarsenolum (see), Myarsenolum (see), Osarsolum (see); 4) drugs of bismuth — biyokhinol (see), Bismoverolum (see), Pentabismolum (see); 5) drugs of iodine — potassium iodide, Natrii iodidum, solution of iodine spirit (see. Iodine ).
Antibiotics of group of penicillin pages are the most effective P. Under their influence pale treponemas disappear from syphilides on average in 10 — 11 hour. Drugs of penicillin are effective at all forms of syphilis. At the same time its active forms will easier respond to treatment drugs of penicillin, than the latent and late forms. Sodium and potassium salts of benzylpenicillin (drugs of short action) use for treatment of patients with syphilis in the conditions of a hospital and enter intramusculary every 3 hour (8 times a day). Drugs of penicillin of long action use (Bicillinums) for treatment of syphilis both in the conditions of a hospital, and in out-patient practice. These drugs are administered intramusculary in the double-stage way (Bicillinum-1 and Bicillinum-5 — 1 time in 5 days, Bicillinum-3 — 1 time in 4 days). Before administration of drugs of penicillin of long action for prevention of allergic reactions it is necessary to appoint antihistamines (see. Antihistaminic substances).
Fenoksimetilpenitsillin use for treatment of syphilis in cases when for any reasons injection administration of drugs of penicillin is impossible. It is appointed inside in doses twice big in comparison with drugs of penicillin of short action.
Erythromycin apply page of hl as P. obr. in cases of intolerance of drugs of penicillin.
Organic drugs of arsenic in modern practice to treatment of syphilis apply seldom, as a rule, at intolerance of penicillin and erythromycin, at resistant to penicillin forms of a disease, and also in the presence of contraindications to purpose of drugs of bismuth. Drugs of arsenic do not use for treatment of pregnant women and children, and also patients with visceral syphilis and neurosyphilis sick with syphilis. Drugs of this group are very toxic and can cause various complications (nitritoidny crisis, hemorrhagic encephalitis, fever of the ninth day, salvarsanny dermatitis, hepatitises, polyneurites, etc.).
Drugs of bismuth the USSR applies generally at treatment of infectious and late forms of syphilis. In comparison with drugs of arsenic they are better had by patients and have bigger antisyphilitic activity. At treatment of patients with syphilis use the combined treatment by drugs of penicillin (Bicillinum-1,-3,-5) and one of bismuthic drugs. At the same time the specified drugs are appointed consistently or at the same time. Contraindications to use of drugs of bismuth are damages of a mucous membrane of an oral cavity, a disease of kidneys, an alveolar pyorrhea, tuberculosis, acute and hron, diseases of a liver with defeat of its parenchyma.
Drugs of iodine apply at tertiary, nervous and visceral syphilis, and also at other forms of syphilis in breaks between courses of treatment since drugs of this group cause a rassasyvaniye of specific infiltrates and promote removal from an organism of arsenic and bismuth. Besides, drugs of iodine are effective at the night ostealgias arising at patients with nek-ry forms of syphilis. Most widely from drugs of this group as P. pages apply potassium iodide and Natrii iodidum. Contraindications to use of drugs of iodine — an allergy to drugs of iodine, nephrites and nefroza, an active pulmonary tuberculosis, disturbances of a hemopoiesis, a disease of cardiovascular system with the phenomena of a decompensation, pregnancy.
Specific treatment of syphilis using P. the page is appointed only after establishment of the diagnosis confirmed with data a lab. researches. An exception of this rule are cases when preventive use of P. of page or treatment of the pregnant women who had syphilis, and the children who were born from mothers sick with syphilis is necessary (uncured or received insufficient treatment). Besides, P. can be used by page for differential diagnosis.
If necessary along with specific P. the page can apply also various means of nonspecific therapy, e.g. the pyrogenic substances, vitamins, biogenic stimulators to treatment of syphilis a vitreous, extracts of an aloe, placenta), Coamidum, pentoxyl, etc.
Features of use both specific P. of page, and the drugs intended for nonspecific therapy in the USSR are defined according to the existing instruction of M3 of the USSR for treatment and prevention of syphilis.
See also Syphilis , treatment.
Bibliography: Astvatsaturov K. R. Syphilis, its diagnosis and treatment, M., 1971; Venereal diseases, under the editorship of O. K. Shaposhnikov» page 303, M., 1980; The Medicines used in dermato-venereologic practice under the editorship of V. A. Chernov, M., 1971; Mirakh-medov U. M., etc. The quick reference guide on syphilology, Tashkent, 1977; The Multivolume guide to a dermatovenereology, under the editorship of O. N. Podvysotskaya, t. 1, page 375, M., 1959.
T. V. Vasilyev.