What to take after a stroke. Drug therapy for stroke: recovery period and prevention of relapse

25.5.2006 - Elena

Question: Hello. My dad (65 years old) had an ischemic stroke in January of this year. Speech, right leg and right arm were affected. Now the functions of the arm and leg are almost completely restored. A person independently walks, dresses, etc. But there were problems with speech, he repeats words and phrases well, but he himself can hardly say anything. What would you advise to do in our case? What is the average length of stay in a sanatorium for your program? What timeframe would you recommend to us? Thank you in advance!

1. Classes with a speech therapist;

2. Drug therapy (neurometabolites, vascular drugs) as prescribed by a neuropathologist.

The average length of stay in the sanatorium is 21 days.

23.5.2006 - Tatyana Fedorovna

Question: Hello. My mother had an ischemic stroke (or microstroke). After treatment, all functions seemed to be restored. She is hypertensive. There are sudden pressure drops. Tell me, what drugs should I take or do something to “smooth out” such jumps?

1. Observation by a neuropathologist and a cardiologist at the place of residence;

2. Diet with limited intake of animal fats, salt;

3. Taking antihypertensive drugs under the control of blood pressure (BP). Medicines are prescribed by a doctor.

4. Regular control of blood pressure;

5. Mode of work and rest.

May 5, 2006 - Inna

Question: My father (79 years old) has been completely paralyzed since 2003 after a severe stroke. He does not speak, does not move, serious problems in urology (a cystostomy was performed). Crying all the time, trying to complain. Don't know how to help him? Do you accept such severe patients? And how much will it be?

Answer: Patients are admitted to the rehabilitation department from the moment they begin to sit on their own. Patients, upon admission, should not have bedsores, urinary catheters, cystostomy, mental disorders.

2/19/2006 - Vera

Question: In April 2004, you reported on the website that you would allocate an extra bed to an accompanying person in a single room for 480 rubles per day (food and accommodation). What are the conditions for the maintainer now?

Answer: From January 01, 2006, the cost of a place for an accompanying person is 610 rubles per day.

14.9.2005 - Katya

Question: Please tell me what medicines should be taken and how often to prevent a second stroke?

Answer: To prevent a recurrent stroke, it is recommended (in agreement with the attending physician):

1. Daily monitoring of blood pressure;

2. Thromb-Ass or Aspirin - 1/4 tablet at night (permanent intake);

3. Mexidol 1 tab. x 3 times a day (2 months);

4. Tanakan 1 tab. x 3 times a day (2 months).

6/6/2005 - Maria

Question: My husband suffered a heart attack half a year ago, the motor function of his right hand is not recovering well, tell me what to do and where to go, massage does not help.

Answer: Patients with movement disorders after a stroke are shown daily exercise therapy and gymnastics; classes on special simulators; massage of the affected limbs. If necessary, physiotherapy and drug therapy are carried out, which are prescribed by a doctor.

26.4.2005 - Leysan

Question: Hello, please tell me if you have a program to restore speech after a stroke. There is speech, but weakly expressed and bellowing. Thank you.

Answer: Patients with speech disorders are prescribed drug therapy under the supervision of a neurologist, speech therapy classes are also held with a speech therapist instructor, exercise therapy and physiotherapy if necessary.

12.2.2005 - Ivan Ivanovich

Question: My father had a hemorrhagic stroke in December 2002. The left side is completely paralyzed. Through the efforts of doctors, "primitive" movements were restored. Now he is bed sick. He speaks well. But recently worsened, one might say lost, memory, thinking. How and by what means can such patients be supported? Doctors have already “waved”, they only said to wait. I disagree. After all, it is probably possible to somehow maintain at least the current state, to prevent further rapid deterioration. I don't want a full recovery. Thank you in advance, I hope for good advice.

Answer: Your father needs to take courses of drug therapy with the following drugs: Mexidol, Gliatilin, Actovegin, Cortexin. The dosage of drugs and the duration of treatment should be agreed with the attending physician.

Neurologist Bogatyrev A.A.

13.1.2005 — Alexey Utkin

Answer: If a stroke occurs against the background of hypertension, then the consumption of animal fats and salt should be limited.

10/18/2004 - Galina

Question: Hello! My grandmother is 86 years old. At this age, the hospital is not hospitalized. She had a stroke (or a microstroke?), “led” the right side of her upper lip a little up. The nasolabial fold on the right became deeper. I started treatment on my own: B vitamins, cerebrolysate, diuretics, vinpocetine, etc. Why is this disease dangerous, what complications does it give, how soon does recovery come? Thank you.

Answer: First of all, a stroke is dangerous with a relapse, i.e. recurrence of the disease with more severe clinical manifestations in the form of impaired motor functions and consciousness. Therefore, it is desirable to consult a neurologist to receive recommendations on stroke prevention and the need to continue drug treatment at the moment. The early recovery period after a stroke lasts for 6 months, and the late recovery period is up to 1-2 years.

14.5.2004 - Natalia

Question: 1. Do you accept patients from other regions or do you provide services only to residents of Moscow and the Moscow region? 2. Is it difficult to get a seat from you? 3. Are you in the center of Moscow?

Answer: 1. We accept everyone, regardless of place of residence. 2. It is better to book a place in advance (2-3 weeks in advance) 3. The office is located in the very center of Moscow (you can see the exact address and directions in the "Contacts" section)

12.5.2004 - Elena

Question: Hello, Please tell me if there are discounts for pensioners and disabled people? If so, which ones? Thank you.

Answer: We have seasonal discounts: in May, the discount on tours is 10% of the total price. There are also "burning" tours. You can find out about their availability by contacting us.

27.4.2004 - Leonid Arkadievich

Question: How long should it take after a stroke to restore the motor functions of the limbs?

Answer: It is most effective to carry out a complex of rehabilitation treatment in the first 3-6 months, since the recovery process (volume, strength) occurs mainly in the first six months after a stroke. Recovery of complex motor skills (self-care, etc.) can take one to two years. In the future, supportive rehabilitation should be carried out so that the skills that a person has acquired as a result of intensive rehabilitation treatment are not lost.

5.4.2004 - Olga

Question: Can you accommodate a patient (stroke 2002) who cannot serve himself? under what conditions and how much does it cost?

Answer: In this case, the patient can come along with his relative or nurse. We allocate an extra bed in a single room. The cost of such a service will be 480 rubles per day (food and accommodation).

Oral, intramuscular and intravenous administration of drugs for stroke

Recall that the general or, as they say, the basic treatment of ischemic and hemorrhagic types of stroke is basically the same, and the specific treatment of different forms of this disease differs dramatically.

Inspection of specialists

At the same time, there are no unambiguous answers to the questions: what vitamins, what injections or what droppers are usually given to the patient after the development of a brain stroke.

After all, the treatment, in each case, varies significantly and depends on the severity of the pathology, the type and form of the disease, the age of the victim and many other factors.

For example, in the ischemic type of stroke, specific therapy is aimed at restoring and enhancing blood flow, at dissolving blood clots, at some blood thinning. The specific treatment of patients after a hemorrhagic cerebral stroke, in which cerebral hemorrhage occurs, categorically does not allow such thrombolytic tactics.

Specific treatment of cerebral hemorrhages, often surgical - this may be the removal of a hematoma, the specific application of a clip directly to the neck of the formed aneurysm, etc.

And, here, about the basic or general therapy carried out after the development of a brain stroke, when the patient experiences very specific ailments, dizziness, muscle weakness and other symptoms characteristic of apoplexy, we would like to talk in more detail.

Principles of basic therapy

It turns out that modern doctors use certain pills, injections or droppers to treat patients after a stroke, in strict accordance with the generally accepted (at the legislative level) basic post-stroke therapy plans.

Basic therapy after stroke

So, in the medical institutions of our country, the entire medical staff understands that the basic treatment of any form of brain stroke should be:

• As early as possible.
• Often versatile, depending on the specific symptoms observed in a particular case.
• Necessarily complex, including resuscitation, general recovery and specific measures.

There are also a number of other principles that are important to adhere to in the treatment of patients after a stroke, which we briefly describe in the table below:

International Neurological Journal 2(12) 2007

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Medical rehabilitation of patients after a stroke

Authors: A.A. Skopomets, V.V. KOVALCHUK St. Petersburg State Medical University. acad. I.P. Pavlova, city hospital No. 38 named after ON THE. Semashko, St. Petersburg, Russia

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Abstract

The study is devoted to assessing the effect of various drugs on the degree of recovery of functions in patients who have had a stroke. The effectiveness of drugs with nootropic, metabolic and antioxidant properties, as well as pathogenetic and symptomatic agents, differentially used in ischemic and hemorrhagic stroke, was studied. The results of treatment of 1920 patients who had a stroke as a result of acute cerebrovascular accident were analyzed. Of these, 1520 had a cerebral infarction, 400 had an intracerebral hemorrhage. The degree of recovery of various functions one year after the onset of the disease was determined, depending on the drugs used, using the Barthel, Lindmark and Scandinavian stroke scales. In addition, according to the formula developed by the authors, the effectiveness coefficients of the drugs were calculated. Based on the results obtained, it was concluded that the appointment of some traditionally used means is not always justified. The most effective drugs, the choice of which is justified in the rehabilitation of patients after ischemic stroke, were actovegin, instenon, berlition, reopoliglyukin and gliatilin. Only actovegin has a beneficial effect on the degree of recovery of functions in those who have had a hemorrhagic stroke.

Keywords / Key words

stroke, rehabilitation, actovegin, instenon, berlition, reopoliglyukin, gliatilin, efficiency ratio.

The problem of rehabilitation of stroke patients is one of the most urgent in medicine, since the lack of timely and adequate rehabilitation treatment, leading to the occurrence of irreversible anatomical and functional changes, causes a person's disability. In Russia, the level of disability one year after a stroke ranges from 76 to 85%, which exceeds the corresponding figures in Western European countries, where they are 25-30%. It can be added to the above that in our country, among stroke patients, no more than 10-12% return to work, and 25-30% remain severely disabled until the end of their lives.

These data indicate the need for an active search for ways to improve the rehabilitation process of post-stroke patients. It is known that the degree of recovery of certain functions of patients is greatly influenced by restorative measures using methods of physical rehabilitation, the organization of proper patient care in order to prevent possible complications, as well as the implementation of a multidisciplinary principle in the construction of all rehabilitation therapy. In this complex, according to many authors, timely and adequate drug treatment is of particular importance.

The aim of this study was to evaluate the effectiveness of drugs with nootropic, metabolic and antioxidant properties, as well as pathogenetic and symptomatic agents, differentially used in ischemic and hemorrhagic strokes during the period of rehabilitation of patients after a stroke.

Material and methods

The analysis of the results of treatment of 1920 patients who had a stroke as a result of acute cerebrovascular accident was carried out. Of these, 1520 had a cerebral infarction, i.e. ischemic stroke (IS), 400 - intracerebral hemorrhage - hemorrhagic stroke (HI). The mean age of patients with IS (846 women and 674 men) was 62.3 years (from 36 to 80 years), patients with GI (168 women and 232 men) — 58.8 years (from 33 to 76 years).

The patients were hospitalized in the Department of Neurological Rehabilitation of the City Hospital No. ON THE. Semashko from 2001 to 2005 inclusive. All of them were hospitalized in the department three times: during the 1st, 6th and 11th months of the disease.

During the rehabilitation period, patients received two groups of drugs. The first included drugs of general action aimed at metabolic protection of the brain, the second - drugs of pathogenetic action, differentially prescribed to patients with IS and HI.

General drugs included nootropics, antioxidants, drugs that increase resistance to hypoxia and normalize metabolism in the brain tissue, as well as vitamins: pyridoxylate, tanakan, encephabol, aevit, tocopherol acetate, actovegin, berlition, gliatilin, glycine, kronassial, cerebrolysin (total 11 funds).

The group of pathogenetically substantiated therapy for IS included 8 drugs: vazobral, instenon, cavinton, sermion, trental, stugeron, eufillin, rheopolyglucin (hemodilution drug); in the group of drugs used in patients with GI - 5 drugs: hemophobin, caproic acid, dicynone, Gordox and contrical. Thus, patients with IS received only 19 drugs, those with GI — 16.

Since we were interested in the effect of each of the listed drugs, they were prescribed to individual patients as monotherapy. This required the division of patients into therapeutic groups.

Patients with IS were divided into 19 groups of 80 people who received in the acute stage of the disease, along with one of the studied drugs, drugs that support vital functions, and subsequently one of the three antiplatelet agents (thrombo ass. cardiomagnyl or Plavix). Patients with GI comprised 16 groups of 25 people, each of which received one of the study drugs together with life-saving drugs. All experimental groups were comparable in terms of age, gender, severity of the condition, and the degree of impairment of various functions (matched-control).

In IS, all of the 19 drugs listed above were prescribed during the 1st, 6th, and 11th months of the disease. In case of HI, drugs of general action were used at the same time, and differentiated therapy of HI was used during the first week of the disease.

A year after the onset of the disease, the degree of recovery of various functions in all patients was determined using the Barthel, Lindmark and Scandinavian stroke scales. According to the Barthel scale, motor functions and everyday adaptation were assessed in points, according to the Lindmark scale - the functions of movement and sensitivity, according to the Scandinavian - motor and speech functions, as well as orientation in time, space and one's own personality. According to the results obtained, the recovery of functions was assessed: no recovery — the arithmetic mean of all three scales was less than 25% of their maximum score, the minimum score was from 25% to 49%, the satisfactory score was from 50% to 75%, and the sufficient score was from 75% to 90% , complete - more than 90%.

The criterion for inclusion of patients in the study was the degree of impairment of various functions 2-3 weeks after the stroke at the time of admission to the department: the average score should not exceed 24% of the maximum.

In addition, according to the formula developed by us, the coefficients of effectiveness (EC) of drugs were calculated.

KE = ((X. Y) + (Z. W)). 2,

where KE is the efficiency factor; X — percentage of patients with M/O B without P; Y — percentage of patients with M/O V with P; Z — percentage of patients with D/P V with P; W — percentage of patients with D/P B without P; B - restoration of functions; M / O - minimal and no; D / P - sufficient and complete; P is a drug.

The ECs calculated using this formula made it possible to conditionally divide all drugs into five groups in accordance with the severity of their effect on the restoration of certain functions: very effective (EC = 2.0 and higher), highly effective (EC = 1.4-1.99) , quite effective (EC = 1.2-1.39), conditionally effective (EC = 1.1-1.19), ineffective (EC = less than 1.1).

The results obtained are presented in the form of tables demonstrating the recovery of functions in the post-stroke period, depending on the drugs used. It should be noted that they present in percentage terms only cases with sufficient and complete recovery of functions and, accordingly, cases of lack of recovery and its satisfactory and minimal severity are not given.

To compare qualitative features and percentages, the X 2 test and Fisher's exact test were used. In order to analyze quantitative data in the presence of a normal distribution, multivariate analysis of variance (ANOVA) was used, in the absence of a normal distribution, a nonparametric test was used. Correlation and regression analysis was used to identify the relationship between quantitative indicators.

Results and discussion

In table. 1 shows the most effective drugs for IS and GI. Actovegin and Berlition from the general group with IS turned out to be such (among the patients who received these drugs, sufficient and complete restoration of functions was noted in 78.3 and 65.3%, respectively), and among the pathogenetic agents, instenon (69.8%). On the contrary, in the groups of patients who did not take these drugs, the degree of recovery was observed only in 24.8; 27.8 and 26.9%, respectively. The next most effective group of drugs were gliatilin, encephabol and tanakan, which resulted in sufficient and complete recovery in 56.3; 51.2 and 49.6% of cases. Among patients who were not prescribed these drugs, sufficient and complete recovery was noted, respectively, in 27.7; 31.8 and 31.0%. Less effective (Table 1) were cerebrolysin, glycine, kronassial, aevit and tocopherol acetate. Pyridoxylate had no effect on functional recovery. There was practically no difference in the degree of recovery between the groups of patients who received and did not receive these drugs, which indicates their indifferent effect on the recovery of functions in patients after a stroke and the absence of any effect on increasing the number of patients with sufficient and complete recovery.

As for the effectiveness of these drugs in GI, in these cases, only in relation to Actovegin, we can talk about efficiency: the difference between the groups of patients who received this drug and did not receive it was significant: 82.5 and 47.8%, respectively. There were no positive effects of other drugs. These agents, in descending order of effectiveness (if any at all) were presented as follows: gliatilin, cerebrolysin, glycine, berlition, kronassial, encephabol, tanakan. The rest - pyridoxylate, aevit and tocopherol acetate - practically had no effect on the restoration of functions in patients with HS.

In table. Table 2 shows the results of treatment of patients with IS with vasoactive drugs and hemodilution agents. The best indicators were noted in patients who were prescribed instenon and reopoliglyukin. As you can see, there is a very, very significant difference in the severity of the restoration of various functions between groups of patients who received these drugs and did not receive them. For instenon, the figures were 69.8% and 29.6%, respectively, for rheopolyglucin, 62.5% and 22.7%. High efficiency was noted with the use of vazobral (49.0% versus 30.4%, respectively). To a lesser extent, but also quite effective was the use of drugs such as trental, cavinton and sermion. The rest of the study drugs - stugeron and eufillin - did not have a positive effect on the recovery of patients who underwent IS. Moreover, eufillin, on the contrary, caused deterioration in the results of rehabilitation and rehabilitation treatment.

The degree of recovery of functions in patients who underwent HI was also beneficially affected by some other drugs used for differentiated therapy, which, of course, were prescribed for a different purpose. First of all, this concerns Gordox (Table 3). Dicinone, ε-aminocaproic acid and hemophobin did not have any pronounced effect on the recovery of patients after HT.

As for CE, it was found that the group of very effective drugs for IS includes actovegin (3.86), instenon (3.10), berlition (2.81), gliatilin (2.00) and reopoliglyukin (2.61 ). The highly effective group consists of encephabol (1.70), tanakan (1.40) and vasobral (1.59), quite effective - trental (1.26), cavinton (1.24), kronassial (1.23), sermion ( 1.22), glycine and cerebrolysin (1.20 each). A group of drugs with conditional efficacy are aevit (1.14) and tocopherol acetate (1.10). And finally, the last group of so-called ineffective drugs includes stugeron (1.01), pyridoxylate (0.99) and eufillin (0.84). We emphasize once again that, speaking about the effectiveness or inefficiency of the listed drugs, we mean only their effect on the restoration of certain functions in stroke patients.

In accordance with the results of the assessment of the effects of GI, the use of only actovegin was justified (EC = 4.14). On the positive side, Gordox also showed itself, which could be attributed to the group of highly effective drugs (1.50). All other drugs were in the groups of sufficiently effective, conditionally effective and ineffective.

Based on the analysis, we came to the conclusion that the appointment of some traditionally used drugs is not always justified. The most effective drugs, the choice of which is justified in the rehabilitation of patients after IS, are actovegin, instenon, berlition, reopoliglyukin and gliatilin. Only actovegin has a beneficial effect on the degree of recovery of functions in patients who have undergone GI.

The results obtained are consistent with the data of other authors on the positive effect in terms of recovery of functions in patients after a stroke of actovegin, instenon and gliatilin. But there are still few studies on berlithion and other α-lipoic acid preparations, as well as rheopolyglucin. Their study in the light of our observations is very interesting.

References / References

1. Agafina A.S. Rumyantseva S.A. Skoromets A.A. Suslina Z.A. Cytoflavin in the correction of cognitive impairment in patients with ischemic stroke // Proceedings of the IX All-Russian Congress of Neurologists. - Yaroslavl, 2006. - S. 359.

2. Beloyartsev D.F. Surgical prevention of ischemic brain damage // Treatment of nervous diseases. - 2005. - 6, 2, 16. - S. 9-12.

3. Vilensky B.S. Stroke. - St. Petersburg. MIA, 1995.

4. Voznyuk I.A. Makarenko S.V. Kim K.V. Lipoic acid in the acute period of ischemic stroke // Proceedings of the IX All-Russian Congress of Neurologists. - Yaroslavl, 2006. - S. 384.

5. Volchenkova O.V. Ivanova G.E. Polyaev B.A. The use of an electromagnetic field generated by the Cascade device in patients with acute ischemic cerebrovascular accident // Proceedings of the scientific-practical conference "Actual issues of medical rehabilitation in modern conditions". - M. 1999. - S. 197-199.

6. Gusev E.I. Skvortsova V.I. cerebral ischemia. - M. Medicine, 2001.

7. Damulin I.V. The use of instenon and encephabol in neurological practice. - M. 2004.

8. Demidenko T.D. Ermakova N.G. Fundamentals of rehabilitation of neurological patients. - St. Petersburg. Folio, 2004.

9. Ivanova G.E. Shklovsky V.M. Petrova E.A. and other Principles of organization of early rehabilitation of patients with stroke // Quality of life (medicine). - 2006. - 2, 13. - S. 62-70.

10. Kamaeva O.V. Monroe P. Multidisciplinary approach in the management and early rehabilitation of neurological patients: Method. allowance / Ed. A.A. Skoromets. - St. Petersburg. 2003.

11. Kolesnichenko I.P. Zhdan I.L. Early rehabilitation of patients with acute cerebrovascular accident on the basis of the neurovascular rehabilitation department of the sanatorium "Northern Riviera" // Proceedings of the scientific-practical conference "The system of rehabilitation of neurological patients". - St. Petersburg. - Zelenogorsk, 2002. - S. 46-50.

12. Mishina E.A. Organization of the work of the ergotherapeutic link in the work of the multidisciplinary team of the rehabilitation department of the Medical Unit No. 18 // Proceedings of the scientific-practical conference "The system of rehabilitation of neurological patients". - St. Petersburg. - Zelenogorsk, 2002. - S. 56.

13. Odinak M.M. Voznyuk I.A. New in the treatment of acute and chronic brain pathology. - St. Petersburg. 1999.

14. Skvortsova V.I. Chazova I.E. Stakhovskaya L.V. Primary prevention of stroke // Quality of life (medicine). - 2006. - 2, 13. - S. 72-77.

15. Skoromets A.A. Kovalchuk V.V. Analysis of the effectiveness of various drugs in the treatment of strokes // Actovegin in neurology. - M. 2002. - S. 152-164.

16. Stolyarova L.G. Kadykov A.S. Varakin Yu.A. The use of encephabol in the rehabilitation therapy of patients with stroke // Encephabol. Aspects of clinical application. - M. 2002. - S. 19-22.

17. Fedin A.I. Rumyantseva S.A. Antioxidant therapy of cerebrovascular disorders // Actovegin in neurology. - M. 2002. - S. 74-84.

18. Karla L. The influence of stroke unit rehabilitation on functional recovery from stroke // Stroke. - 1994. - 25. - R. 821-825.

19. Warlow C.P. Dennis M.S. van Gijn J. et al. Stroke. A practical guide to management. — London, 1997.

In today's world, even young people are familiar with a common source of death - cardiovascular disease. Among these pathologies, the most dangerous is stroke. Each person should have certain information about the disease.

Knowing the cure for a stroke, you can prevent the disease in time. In case of its occurrence, you should immediately seek help from specialists.

How to prevent illness?

Despite popular belief, a stroke has nothing to do with fate or fate. Even in the case when the disease is due to heredity. The main factor provoking the disease is an unhealthy lifestyle. By changing it, you can avoid a stroke.

The most common cause of the disease is arterial hypertension. It is not at all difficult to correct it with adequate therapy. It should be remembered that the normal indicators of blood pressure are: 140 mm. rt. Art. (upper) and no more than 90 mm. rt. st lower. Pressure exceeding the above figures puts the patient at risk for the occurrence of such an ailment as a stroke.

All patients who are diagnosed are required to undergo an examination at the clinic by a neurologist every six months. It is he who will select special drugs for the prevention of stroke.

In addition to prescribing adequate drug therapy, the doctor will give the necessary recommendations. They relate to the constant control of blood pressure.

Sudden ill health requires special attention. In this case, it is recommended to call an ambulance. Arriving doctors will inject Cerebrolysin intramuscularly. This prophylactic drug is the best cure for stroke. Timely assistance for a stroke is the key to a successful recovery.

Medical therapy

Modern pharmacology has provided patients with many tools to prevent and treat stroke. Consider the main drugs that successfully help with this disease.

A group of angiotensin-converting enzyme inhibitors

These medicines contribute to the expansion of veins and arteries. This reduces the workload on the heart. The body activates special mechanisms that improve the blood supply to the brain.

This group of drugs includes the drugs Captopril (Capoten), Perindopril, Enalapril, Monopril, and some others.

It has been proven that these drugs are able to effectively protect the patient from the development of a stroke. For example, a patient taking the drug "Ramipril" as a cure for stroke, reduces the risk of disease progression by 32%.

Class of angiotensin II receptor blockers

Pretty effective drugs. This group is distinguished by excellent tolerance. The drugs completely eliminate the side effect (which differs from group 1 drugs) - an unpleasant dry cough.

Drugs are contraindicated for bilateral. Also, they are not recommended for use in case of liver damage. Malfunctions of the kidneys are another contraindication to taking drugs of this class.

Diuretics

Prescribe drugs for arterial hypertension, combined with heart failure. This class of drugs is not recommended for diabetes mellitus. Avoid taking such drugs if the level of lipids in the blood is elevated, as well as with a decrease in potassium. It is not recommended to appoint people of advanced age.

Classifies drugs as follows:

1. thiazide diuretics. They can act as monotherapy or combined with other antihypertensive drugs. These include the drugs "Hydrochlorothiazide", "Chlorthalidone", "Indapamide" ("Arifon"), "Clopamide" ("Brinaldix").
2. loop diuretics. Assign in severe forms of hypertension. The main drugs: Furosemide, Arelix and Uregit.
3. Potassium-sparing diuretics. They are combined with the appointment of funds that lead to the loss of potassium by the body. The representatives of this group include the drugs "Aldakton", "Amiloride" and "Triamteren".

Beta blockers

Quite effective in the diagnosis of treatment. Drugs are also prescribed for hypertension associated with heart disease. These are ischemia, rhythm disturbance, myocardial infarction. They are also effective in case of hyperthyroidism. Often, these drugs are used in a crisis of hypertension.

This group includes the following drugs: Atenolol, Propranolol, Metoprolol (Betaloc), Pindolol, Nadolol, Bisoprolol and some others.

The above drugs have contraindications. These are bronchial asthma and chronic obstructive pulmonary disease. Often they can cause a decrease in blood sugar. Therefore, diabetes medications should be taken very carefully.

calcium antagonists

These funds are prescribed for combination of hypertension with atherosclerotic damage to peripheral arteries, angina pectoris, dyslipidemia, obstructive pulmonary diseases.

They are divided as follows:

Short acting antagonists. These include the drugs Diltiazem, Nifedipine (Corinfar), Verapamil, Nimodipine, Isradipin.

Long acting antagonists. These are drugs "Nifedipin R", "Adalat-retard", "Isradipin SRO", "Isoptin-retard", "Amlodipine".

Contraindications for admission are acute some types of arrhythmia, reduced contractility of the myocardium of the left ventricle.

Adrenergic receptor blockers

This medicine is effective for stroke in hypertension, combined with diabetes, bronchial asthma, atherosclerosis of the lower extremities, impaired renal function.

You should not take such drugs with diuretics, as well as with centrally acting agents.

The main representatives of the group are the drugs Prazosin and Doxazosin.

Group of drugs of central action

1. "Clondin" ("Clondin"). It is used, as a rule, for the relief of a hypertensive crisis. The drug is completely incompatible with alcohol. Its action is aimed at reducing cardiac output. Contraindications are dyscirculatory encephalopathy and some types of arrhythmias.
2. "Labetalol". Stops pressure peaks in the morning, which in most cases lead to a stroke.

Medical rehabilitation

Mannitol is recognized as an excellent drug that can quickly restore the body. Its reception leads to a decrease in swelling of the brain, stimulation of normal blood circulation. As a result, memory returns to the patient much faster, musculoskeletal functions are restored.

They are quite effective in treating stroke. Their action is aimed at brain metabolism. They reduce the impact of damaging factors by stimulating blood circulation.

Consider the most popular drugs in neurological practice after a stroke:

• "Piracetam" ("Nootropil"). Improves memory, facilitates learning. The medicine does not have a side effect characteristic of psychostimulants. It is prescribed for patients who have had a stroke, especially in the elderly.
• "Encephabol". Used in the early recovery period.
• Pantogam, Phenibut. It relieves the patient of neurosis-like conditions, sleep disorders, hyperkinesis, pain and convulsive syndromes.
• "Cortexin". It is used for pathologies that are accompanied by cerebral edema.
• "Actovegin", "Solcoseryl". They have a neuromodulatory trophic mechanism of action.
• "Glycine". The drug has an anticonvulsant effect, reduces the increased tone in the muscles. It is used as an additional therapy for hypoxia, cerebral ischemia.

New drugs

The development of funds intended for the treatment of patients is being carried out quite effectively. A new stroke drug has been created at West Toronto Hospital. The clinic staff reported on the trial of this drug, the result was excellent. However, only if the drug was ingested within 3 hours after the impact.

Today, the hospital is trying to improve the medicine. A tool is being developed that can affect the body after 2 hours or more after a stroke.

An amazing drug has also been patented in Russia. A new cure for stroke was invented by scientists from the Academy of Medical Sciences. The drug is aimed at saving the nerves from destruction. The new drug can become an effective drug for the treatment of Parkinson's and Alzheimer's diseases. No less effective it is able to fight depression.

Pine cones for stroke

Traditional medicine comes to the aid of the sick. Quite an effective remedy is a tincture of It is recommended to take it in 1 teaspoon immediately after meals. The substance tannin, which is rich in pine cones, minimizes the death of brain cells during a stroke. Thus, the tool has a rather positive effect on the recovery process.

To prepare the drug, you should stock up on green cones. They will need 7-10 pieces. Chop them up. For the manufacture of tinctures, it is recommended to use dark glassware. Put the crushed cones in it. Pour the mixture with quality vodka. You should choose alcohol without any impurities. Alcohol is allowed. First, it should be diluted with water in a ratio of 1: 2.

Close the container tightly and transfer to a dark place. The contents should be shaken daily. After a week, the tincture is recommended to be filtered. This drug is completely ready for use.

Conclusion

Unfortunately, such an ailment as a stroke has long ceased to be a disease of the elderly. Stress can affect a person of any age. Therefore, today you should take care of the right lifestyle. While it is still not too late to do so. If you have the first symptoms, you should immediately seek medical help. And know that taking drugs without a doctor's prescription is a very dangerous occupation.

A stroke is characterized by an acute violation of blood circulation in certain parts of the brain, leading to serious consequences. Most cases end in death, a considerable number of patients who have survived an attack become disabled. And only a small percentage of people return to a full life after going through rehabilitation procedures. Not the last role in a speedy recovery is played by timely assistance. For treatment, special drugs are used for stroke, which help to minimize the risks of subsequent complications.

Features of treatment

Depending on the mechanism of development of pathology, two types of stroke are distinguished - ischemic and hemorrhagic. The first is manifested as a result of blockage of blood vessels by a thrombus or narrowing of the lumen, the second - due to rupture of the arterial walls. Both conditions are extremely dangerous for human life.

Note! Effective means for stroke prevention are under development and are not available to the general public. Preventive measures include maintaining a healthy lifestyle and diet.

There is simply no magic pill that can cure a stroke at once. Standard treatment is aimed at eliminating the consequences of blockage of blood vessels or rupture of their walls and restoring normal blood circulation.

After a stroke, various complications develop - loss of working capacity, speech and movement disorders, mental disorders, the appearance of pneumonia and bedsores. Carrying out appropriate treatment and compliance with medical recommendations contributes to the restoration of lost functions in part or in full.

Treatment at the initial stage

Sudden blockage of blood vessels in women and men manifests itself as dizziness, severe headache, nausea accompanied by vomiting, immobilization of body parts (often the left side). For hemorrhagic stroke, the same symptoms are characteristic, but sudden loss of consciousness and coma are often added to them.

If any signs are found, especially in elderly patients, it is necessary to call an ambulance team. While she is driving, the patient should have their blood pressure measured. If the readings are significantly higher than normal, you can give an antihypertensive medication previously prescribed by a doctor. Otherwise, it is recommended to lay the victim on a bed with a raised headboard and carefully monitor his well-being.

As a first aid, intramuscular injections of neuroprotectors are given, which can reduce the spread of dying areas and normalize blood circulation in the brain. Their names are Encephabol, Cerebrolysin and Glycine.

Important! At an early stage of a stroke, it is forbidden to take vasodilators (No-shpa, Papaverine). On damaged tissues, they have the opposite effect, reducing blood circulation, which leads to an aggravation of the situation.

Treatment in a hospital

After the patient enters a medical institution and the implementation of measures to stabilize his condition, a series of tests are carried out aimed at making an accurate diagnosis. Depending on this, subsequent therapy is carried out.

Ischemic stroke

If an ischemic stroke is diagnosed, the patient is given droppers with thrombolytics (Anchord, Mannitol). Their action is aimed at resorption of the thrombus that clogged the vessel. With timely administration within the first three hours, cerebral circulation can be restored without significant complications. After the specified time, it is not advisable to drip such drugs, since the tissues begin to irreversibly break down.

Contraindications to the introduction of thrombolytics are pressure over 185 to 110, brain abscesses, hemorrhage in the intracranial cavity, recurrent stroke, epileptic seizure, mechanical head trauma, as well as performing any operations 2 weeks before the stroke.

Further medical treatment in the hospital is carried out with the help of drugs:

• to reduce and stabilize blood pressure;
• to prevent new manifestations of thrombosis;
• to restore blood circulation;
• to relieve spasms of blood vessels;
• to eliminate tissue swelling.

With rapidly developing hypoxia of the brain, special drugs are prescribed (Mexidol, Actovegin), inhalations and oxygen cocktails, hyperbaric oxygenation.

Important! A recent development of scientists - a drug based on the MASP-2 protein - is able to restore blood supply and stop inflammatory processes immediately after an attack of ischemic stroke. Injections are injected into the abdomen, into the region of the anterior abdominal wall.

Hemorrhagic stroke

A cerebral hemorrhage carries a great danger to human life - according to statistics, death occurs in the first hours after an attack. To stabilize the patient's condition, a list of drugs from different drug groups is used:

• hypotensive to reduce pressure;
• sedatives to relieve psychomotor agitation;
• antiemetics to eliminate nausea and vomiting.

If the hematoma formed after the hemorrhage does not resolve on its own, a surgical operation is prescribed. During the surgical intervention, the mechanical removal of the blood clot and the restoration of local blood circulation are carried out.

Further treatment is carried out in the neurosurgical department. The patient is prescribed a list of anti-stroke drugs to stabilize pressure and heart rate, improve the functions of the heart and brain, relieve swelling from tissues and prevent complications.

To stop severe bleeding and strengthen the walls of blood vessels, hot injections with magnesia are used. The injections got their name because of the sensation of pleasant warmth spreading over the body after the injection, which begins with a strong burning sensation in the mouth. This feature is due to the vasodilating property of the drug, which is injected intravenously.

How to treat at home

After carrying out medical procedures in the hospital and improving the patient's condition, the patient is discharged for further recovery. The first 6 months after discharge, the risk of a recurrent attack is high. During home treatment, aimed not only at rehabilitation, but also at preventing complications and relapse, the most effective drugs are used:

1. Antidepressants. A stroke patient is prone to frequent bouts of fear, anxiety, nervous excitement. To eliminate the negative symptoms associated with impaired brain activity, sleeping pills and antidepressants (Paxil, Mianserin, Mirtazapine) are prescribed.
2. Antiplatelet agents. To prevent the development of thrombus formation processes, patients after a stroke must constantly drink blood thinners (Aspirin, Curantil, Clopidogrel). They gently, unlike anticoagulants, prevent platelets from sticking together.
3. Painkillers. In the post-stroke period, pain occurs quite often. The best solution for their relief is taking painkillers (Aspirin, Analgin, Ketanov).
4. Anticonvulsants. Against muscle spasms that can develop against the background of impaired brain activity, various means are prescribed: they normalize the work of the central nervous system, reduce the activity of nerve cells and stop muscle contractions.
5. Nootropics. To eliminate cognitive impairment, as well as restore memory and attention, drugs are used that activate the work of nerve cell membranes through the formation of new phospholipids (Ceraxon, Piracetam).
6. Vitamins. Vitamin complexes are prescribed to improve brain and physical activity, as well as to prevent complications. They should include vitamins of groups B, C, A, E.
7. dietary supplements. Dietary supplements are indicated for the treatment of the consequences of a stroke after a course of conservative therapy. These include Papaya Attiva, SDA second faction, Tienshi. A contraindication to their use is the period of exacerbation of the condition.

Note! For post-stroke rehabilitation, physiotherapy procedures are prescribed using special devices. Their action is aimed at restoring brain and motor activity and preventing relapses.

During the recovery period, the patient must comply with a special regimen. The diet after ischemic stroke excludes from the menu fried, fatty and spiced dishes, a large number of sweets and baked goods made from premium flour. Instead, you need to eat a sufficient amount of seasonal vegetables and fruits, lean meats and poultry, drink plenty of clean water.

In order for the recovery of the body to be most fruitful, the patient must be surrounded by care and timely administration of drugs for stroke. In the absence of physical and psychological discomfort, he will be able to tune in to receive positive results.

A stroke is an acute violation of blood circulation in the brain, which leads to focal damage to the organ. With pathology, characteristic symptoms occur that cannot be ignored. When the first signs appear, it is important to start the right treatment in order to improve the patient's condition.

If nothing is done, then the human condition will worsen, which will cause negative consequences. There are many types of stroke medicine, and complex measures are best. It is necessary to use tablets not only for therapy, but also for the purpose of prevention.

As already mentioned, a stroke is a violation of blood flow in the brain, due to which damage is caused to nerve cells, which leads to their subsequent death. When this pathology appears, there are approximately 3-6 hours in order to prevent the occurrence of complications. If treatment is started on time, then it is possible to preserve the health of a person as much as possible.

Strokes can occur at any age, so neither young people nor the elderly are insured against it. On average, the disease rarely occurs before the age of 25, it mainly occurs at the age of 41 and at an older age. That is why every person should take care of the prevention of the disease, if he does not want to face significant disorders in the brain.

In total, there are two types of stroke:

• Ischemic. In this case, there is a blockage or narrowing of the blood vessels in the head.
• Hemorrhagic. There is a hemorrhage in the brain and in its membranes. The condition is considered extremely dangerous and requires immediate hospitalization.

The older a person gets, the more likely they are to have a stroke. That is why it is extremely important to start treatment in a timely manner, which is aimed at restoring neurons. Also it is important to eliminate the negative factors that led to a stroke.

This is necessary to prevent a second stroke, which will significantly aggravate the state of health or lead to death. It is extremely important to undergo rehabilitation and adapt to a new life after an illness.

Symptoms

It is extremely important to understand in time that a stroke has occurred. Often, health problems arise abruptly, but it also happens that there are precursors. They are transient ischemic attacks, which pass within a day and do not leave consequences.

If a person does not pay attention to them and does not visit the hospital, then the stroke itself may soon occur. For this reason, it is important to know the first symptoms of pathology in order to take timely action.

How does a stroke start?

• Numbness of certain parts of the body. Often they are the face, as well as the arms or legs. Sensitivity is significantly reduced, it becomes difficult for a person to move if the leg has been affected.
• Headache. With a stroke, it is intense and does not go away after using conventional medicines. A person does not help either rest or other ways to deal with pain in the head. Only special drugs for stroke can have an effect.
• Disorders of visual function. A person may experience double vision, flashes of light and flies.
• Violation of consciousness. A person may not understand what is happening around him.
• Nausea and vomiting. At the same time, even after the passage of food, a person does not feel better.
• Dizziness. It is an obligatory symptom that is present in a stroke. In this case, coordination often suffers significantly, a person can even lose balance completely.
• Hearing problems. For example, noise or ringing in the ears may occur. It does not last long, while it tends to appear from time to time.

This is how a serious pathology can begin, in which it is important to immediately use drugs for a brain stroke. Separately, it is worth noting that it is important to start the prevention of the disease in a timely manner.

It is especially important to take care of your health when harbingers appear. They occur a few months before the brain areas are affected, while repeating about once a week.

Alarm signals:

• Headache that does not have a specific location. It often occurs with overwork and with changes in weather conditions.
• Noise in ears. It can be either temporary or permanent.
• Memory losses. The person may notice that they do not remember the events that just happened.
• Dizziness that occurs even when at rest and is aggravated by movement.
• Performance issues. It becomes more difficult for a person to perform habitual tasks. Mental abilities suffer significantly, which generally affects the quality of life.

It is important to immediately consult a doctor when warning signs appear. If a person ignored unpleasant symptoms, then the likelihood of pathology is high.

Some people may not take any measures even with acute circulatory disorders in the brain. They do not fully understand the situation, which is why they do not seek to start medical treatment for stroke. In such a situation, others should take care of the patient and understand what exactly they have to deal with.

You need to pay attention to specific factors to identify a stroke. To begin with, you should look at the person’s face and think if it looks strange. Perhaps one eyelid is lowered, the corner of the mouth is distorted, or an eyebrow is raised. It is worth asking the patient to smile, and if he cannot do this, then a problem with cerebral circulation can be assumed.

You should listen to the speech, in a stroke condition it will sound strange. Perhaps a person will not be able to pronounce specific sounds, or will not be able to combine words to express thoughts. It is also worth asking to raise your hands up. One of them may spontaneously fall, or not rise at all.

If all of the above symptoms are present, then you should immediately call an ambulance. It will be necessary to take medicine for a stroke, as well as to undergo a diagnosis in general. Only a doctor can unambiguously say what exactly is happening to a particular person, as well as what exactly is needed to improve well-being.

Specific measures will depend on the stage of the disease. At the very beginning of the disease, it will be necessary to prevent factors that contribute to the development of the disease. It will be necessary to normalize the pressure, if it is increased. For this, antihypertensive drugs are used. Also, a person in a hospital is given droppers.

Nootropic drugs are recommended to protect nerve cells. Neuroprotectors are distinguished by the absence of a negative effect, while they maintain normal blood circulation in the brain. The duration of administration depends on how severe the brain damage is.. That is why for each person the course is assigned individually.

If necessary, you may need to drink vitamins, as well as use sedatives. They are especially needed in that situation, if a person suffers from stressful situations and complains of increased nervousness. Naturally, only a doctor can prescribe such a drug treatment for a stroke.

The acute period is observed in the first 2-3 hours after the attack, and it is this time that is considered the most dangerous for a person. It is extremely important to use medicines that will eliminate the causes of the onset of the disease.

It is worth noting that it will be necessary to resume normal blood circulation, so drugs are prescribed that reduce blood clotting. It is effective to use Actovegin, it prevents the appearance of paralysis, which is extremely important in case of a stroke.

Be sure to use drugs that improve cerebral circulation, because they relieve swelling and prevent the recurrence of an attack. Painkillers or special injections are used for those situations when a person suffers from pain. It is extremely important to improve the patient's well-being, in particular to relieve pain.

A stabilization period is observed after the acute phase has passed. The person will already be discharged from the hospital, and he will have to take medication at home after a stroke. In most cases, drug treatment is prescribed for life.

This is necessary in order to maintain a person in a normal state and prevent a recurrence of an attack. The doctor must prescribe specific drugs on an individual basis. If a person has an increased sense of anxiety, then sedatives or antidepressants should be used.

Common means:

• Ceraxon. The main component is citicoline. Its task is to improve metabolic processes in the nervous system. The drug eliminates cerebral edema, and also prevents cognitive impairment.
• Gliatilin. It is used both in the acute period and during rehabilitation. Use the remedy even for those who are in a coma. The drug prevents brain dysfunction and improves blood circulation.
• Mexidol. The tool increases the resistance of the nervous system to the appearance of hypoxia. If you use the drug together with Actovegin, then you can achieve a stable positive result.

Droppers for any type of stroke also give a positive effect. They are made with Actovegin, Piracetam and Vinpocetine. Which drug to use, the doctor will decide. Even saline will be useful for a person, because it eliminates cerebral edema and improves metabolism in the body.

If a person has had a stroke once, in the future he must take care to prevent a second attack. It is important to try to be less nervous, lead a healthy lifestyle and take medication in a timely manner. In this case, the likelihood of problems with cerebral circulation will be significantly less. Therefore, there will be a good chance to avoid another attack of stroke.

With any neuro-emotional excitation in the body, the release of active substances is activated. Catecholamines, for example, by attacking the cell and interacting with certain receptors, become a source of maintaining high blood pressure - one of the main factors in cerebral stroke. Can neutralize the "strike on the vessels" Glycine .

• In stressful situations and when the weather changes, when you know that you can react with a jump in blood pressure, try to put 10 tablets (1 gram) under the tongue. Of course, according to the scheme prescribed by the doctor, do not forget to take other antihypertensive drugs.
• For women during menopause, one of the manifestations of which is the development of vegetative-vascular diseases, we can recommend Glycine also according to a different scheme: 2 times a week, 10 tablets. A "shock dose" will help the body replenish this amino acid and protect blood vessels.
• For the prevention of stroke, it can be taken by those over 60, and all hypertensive patients as a basic drug to maintain blood pressure at working numbers. It is worth doing this regularly 3 times a day on a tablet (under the tongue) for a month.
• If a brain catastrophe has occurred - an acute stroke has nevertheless occurred, it is recommended to immediately give the victim 10 tablets glycine, ground into powder and (or) diluted in a small amount of water. This can greatly facilitate the further course of the disease. Regular intake of the drug in the future can prevent a recurrent stroke.

The second important risk factor for stroke is atherosclerosis. In adulthood, taking regularly Glycine. you can provide additional synthesis of lecithin - a substance that "prevents" cholesterol from settling on the walls of blood vessels, and prevents the appearance of atherosclerotic plaques.

Order of the Ministry of Health of the Russian Federation No. 25 dated January 25, 1999 "On measures to improve medical care for patients with cerebrovascular accidents" sublingual drug GLYCINE included in the equipment list of a specialized neurological ambulance team.

Stroke prevention. Nootropic drugs

Irina 04/09/2013 Stroke prevention. Nootropic drugs

Dear readers, today on the blog I continue to publish a series of articles from the doctor Evgeny Snegir. Anyone who visits my blog often already knows Eugene. This is a doctor with a lot of experience. I always say: “We wish we had more such doctors, when a doctor is both a professional in his field and just a sincere person.” It is no coincidence that the name of the site that Evgeny leads is Medicine for the Soul. I invite everyone to come visit Eugene. So much useful information can be found there.

So, for all the readers of my blog, Eugene has already given very detailed information about stroke prevention. Those were the articles Risk Factors for Stroke. Stroke prevention. article on blood viscosity reduction Antiaggregants and anticoagulants. How to lower your blood cholesterol levels. Today the conversation continues. Eugene will tell us about nootropic drugs that can be used to prevent stroke.

I give the floor to Evgeny.

Nootropic drugs

Nootropic drugs increase the resistance of the brain to damaging factors, so they can be used in the prevention of stroke. Let us explain the mechanism of action of these drugs and the purpose of their prescription by a doctor.

First of all, let's bring classification of nootropics .

1. Pyrrolidone derivatives: piracetam, phenotropil.
2. Derivatives of dimethylaminoethanol: deanol, deanol aceglumate, centrophenoxine.
3. Preparations of neuroamino acids: phenibut, picamilon, pantogam, glycine, glutamic acid.
4. Pyridoxine derivatives: pyritinol.
5. Cholinomimetics of central action: choline alphosphocerate (gliatilin).
6. Preparations of Gingko Biloba: bilobil, tanakan.

The basis of the action of nootropic drugs are the following effects:

1. Improving the energy state of nerve cells (utilization of glucose, increased synthesis of ATP, RNA and proteins).
2. Stabilization of nerve cell membranes.
3. Improving the transmission of nerve impulses along nerve fibers.

All these effects contribute to the protection of the brain in case of impaired blood supply and nutrition of the nerve cell.

We will give a clear description of the specific drugs that a doctor can prescribe for you.

I. Pyrrolidone derivatives.

1. Piracetam (nootropil).

In the mechanism of action, this drug has two directions: neuroprotective (directly protecting the nerve cell) and vascular (improving local cerebral blood flow).

When it is taken, mental activity is activated - memory, thinking, learning ability are improved, brain functions are restored and stabilized. Improves mood and attention.

Action features:

A. In the elderly and senile age, it enhances the effect of drugs prescribed for the treatment of angina pectoris (nitroglycerin) and reduces their need. Improves the functional state of the heart muscle.

B. Increases the effectiveness of antidepressants.

C. When prescribing drugs used in the treatment of thyroid pathology (thyroxine, triiodothyronine), anxiety, irritability, sleep disorders may develop.

Side effects: irritability, nervousness, irritability, insomnia, dizziness, nausea, vomiting, abdominal pain may develop.

The drug is contraindicated in end-stage renal failure, pregnancy and lactation.

2. Phenotropil is a nootropic drug from a new generation.

A modern drug that has recently appeared on the pharmaceutical market, but has already won the gratitude of patients and the respect of doctors.

Significantly improves memory, attention, improves performance, mood, learning ability. Increases the resistance of nervous tissue to hypoxia and toxic effects, improves regional blood flow in ischemic areas of the brain. Has anticonvulsant action.

Virtually no effect on the respiratory and cardiovascular system. With a course application, it reduces appetite, which can be successfully used in obese patients.

A good adaptogen: it increases the body's resistance to stress in conditions of excessive physical and mental overload, at low temperatures, it helps well in winter during the polar night.

With course use, drug dependence, tolerance (decrease in sensitivity to the drug), "withdrawal" syndrome do not develop. It is possible to apply to students during preparation for the session, to all persons engaged in mental work during the period of "life rush".

Features of the action: enhances the effect of drugs that stimulate the central nervous system and antidepressants.

Side effects: insomnia, so it is not recommended to take the medicine later than 18 hours. In the first days of taking, reddening of the skin, a feeling of warmth, a moderate increase in blood pressure are possible.

Contraindications: childhood, pregnancy, breastfeeding, severe liver and kidney disease, severe arterial hypertension, history of panic attacks.

II. Derivatives of neuroamino acids.

1. Aminalon (gamma-aminobutyric acid).

Restores metabolic processes in the brain, increases the resistance of neurons to hypoxia, helps to remove toxic metabolic products. Improves memory, thinking, has a moderate psychostimulating, anticonvulsant and hypotensive effect, reduces heart rate. In diabetic patients, it lowers blood sugar levels.

Application features: enhances the effect of hypnotics and anticonvulsants.

Side effects: possible nausea, vomiting, fever, feeling hot, shortness of breath.

2. Pantogam (hopantenic acid).

Increases the resistance of the brain to hypoxia and the effects of toxic substances, improves the absorption of glucose and oxygen by the brain. It has an anticonvulsant effect.

Features of the action: prolongs the action of hypnotics.

Side effects: allergic reactions are possible: rhinitis, conjunctivitis, skin rashes.

3. Picamilon (nicotinoyl-gamma-aminobutyric acid).

Stimulates the metabolism in the nervous tissue, enhances energy processes. Improves attention, thinking, memory, speech, learning ability. Improves cerebral blood flow, microcirculation, reduces cerebral vascular resistance and platelet aggregation.

Application features: reduces the inhibitory effect on the central nervous system of drugs containing ethanol.

Side effects: possible nausea, headache, dizziness, irritability, agitation, anxiety, allergic reactions. Contraindicated in kidney disease.

4. Phenibut

Reduces tension, anxiety, improves sleep. Reduces the manifestation of asthenia, headache, irritability. Increases mental performance, attention, memory, has an anticonvulsant effect.

Application features: enhances the effect of antiparkinsonian drugs, neuroleptics, hypnotics, narcotic analgesics.

Side effects: drowsiness is possible at the first doses, allergic reactions. Contraindicated in liver failure. Use with caution in diseases of the gastrointestinal tract, possibly an irritating effect on the mucous membrane.

5. Glycine

Normalizes the processes of excitation and inhibition in the central nervous system, increases mental performance, helps with depression. Eliminates irritability, normalizes sleep. It is able to reduce the pathological craving for alcohol, prevents the development of alcoholic delirium and psychosis. It has antiepileptic, anti-stress and sedative (calming) effect. Normalizes metabolism.

Application features: reduces the toxicity of anticonvulsants, neuroleptics, antidepressants. Enhances the effect of inhibition of the central nervous system in combination with hypnotics, tranquilizers, antipsychotics.

6. Glutamic acid

Activates brain metabolism, promotes the removal of toxic substances.

Side effects: irritability, vomiting, diarrhea, anemia, leukopenia (decrease in the number of leukocytes) are possible. Contraindicated in diseases of the liver, kidneys, gastrointestinal tract, hematopoietic organs, increased excitability.

III. Pyritinol

Consists of two molecules of pyridoxine. Improves metabolic processes in the brain, increases resistance to hypoxia. Stabilizes the membranes of nerve cells, protects them from the toxic effects of free radicals formed as a result of biochemical reactions. Improves the rheological properties of blood, blood flow and oxygen delivery to the affected areas of the brain. Increases mental performance, memory, learning.

Application features: increases the likelihood of developing side effects of penicillamine, gold preparations, sulfasalosin.

Side effects: possible sleep disturbances, irritability, headache, dizziness. Contraindicated in epilepsy, liver and kidney failure, diffuse connective tissue diseases, pronounced changes in the blood picture, pregnancy and lactation.

IV. Gliatilin (choline alphosphocerate).

Improves cerebral blood flow, stimulates metabolism in the central nervous system. Improves mood, mental activity, concentration, memory, eliminates apathy.

Side effects: possible nausea, vomiting, allergic reactions. Contraindicated in pregnancy, lactation, in childhood.

V. Ginkgo Biloba Extract (bilobil, memoplant, tanakan)

It is a standard herbal preparation. Improves microcirculation and cerebral circulation, supply of the brain with glucose and oxygen. Reduces the permeability of the capillaries of the brain, has an anti-edematous effect. Reduces the amount of free radicals that can damage the membranes of nerve cells. Improves the metabolism of body cells.

Side effects: possible headache, indigestion, allergic reactions. Contraindicated in pregnancy, lactation, in childhood.

In the next conversation, we will talk about the importance of a healthy lifestyle in the prevention of stroke, and discuss the influence of environmental factors.

Good health!

I thank Evgeny for the detailed review of nootropics. On my own behalf, I want to add that my daughters and I drink glycine twice a year in courses, always a good result. Once in a sanatorium, I underwent a course of treatment with piracetam - they pricked intramuscularly, my head really “brightened” like that. And not so long ago, the doctor prescribed Phezam to me. I also liked the effect. Sometimes you need to support yourself, although I very rarely resort to pills.

A spiritual gift today will also be from Eugene. will sound composition by Yanni Chrysomallis. You must have heard of this wonderful musician. He works under the pseudonym Yanni. Interestingly, the musician has no professional education.

He is originally from Greece. A bachelor in philosophy, he is passionate about sports (at the age of 14 he already set a national record in freestyle swimming). Yanni's music is full of tenderness, very melodic, emotional. “I talk to the music, and the music talks to me” - the words of the musician himself about his compositions. So, Yanni's magical music.

I wish you all health and joy. We already feel like spring! I walked to work and back home on foot - such a blue sky, warm enough, but the snow has not yet completely melted. Fill your soul, Love you to your loved ones. Thank you for being with me.

Invented pills against Alzheimer's, Parkinson's and stroke

Scientists from the Academy of Medical Sciences have made and tested amino acids that save nerves from destruction.

At the Research Institute of Pharmacology named after V.V. Zakusov RAMS designed peptide compounds that can become a remedy for the most common and progressive in the world (according to WHO) diseases of the central nervous system - Parkinson's and Alzheimer's diseases. In addition, with the help of the same means it will be possible to treat strokes and save people from depression.

The compounds are two modified amino acid molecules that mimic the action of nerve growth factors BDNF and NGF. A positive effect of drugs on memory and on the survival of the organism was established in the simulation of various acute disorders of cerebral circulation. In addition, antidepressant properties are well manifested, - explains Sergey Seredenin, Academician of the Russian Academy of Sciences and the Russian Academy of Medical Sciences, Director of the Research Institute of Pharmacology of the Russian Academy of Medical Sciences.

Currently, newly synthesized compounds are undergoing preclinical trials. Pharmacological studies have already shown that the substances are effective when administered systemically to mammals. The authors of the preparations are academician Seredenin and the head of the department of chemistry of the same research institute, corresponding member of the Russian Academy of Medical Sciences Tatyana Gudasheva. The Institute has patented its invention in Russia, and the process of patenting is underway in the USA, Europe, India and China. At the same time, an article is being prepared for the American Journal of Medicinal Chemistry.

Parkinson's, Alzheimer's, ischemic and hemorrhagic strokes are associated with the activity of NGF and BDNF proteins, which essentially protect different types of brain neurons. Disturbances in cholinergic neurons contribute to the development of Alzheimer's disease, in dopaminergic neurons - Parkinson's. In addition, these same factors are directly related to the development of a stroke - for example, Veronika Skvortsova, Doctor of Medical Sciences, Minister of Health of the Russian Federation, in one of her scientific works proves that patients with a higher number of neurotrophins in the blood are more likely to recover from a stroke compared to patients who are deficient.

The whole difficulty in the treatment with these proteins lies in their size: NGF and BDNF cannot overcome the blood-brain barrier - the physiological border between the circulatory and central nervous systems, which means that they can only be delivered to neurons with the help of surgery. But this is not an option either: foreign proteins have side effects - they cause pain, they have oncogenic properties. That is why scientists took the path of synthesizing individual parts of proteins that mimic the desired effects of "large" proteins.

We have designed a small molecule based on a large protein molecule so that it enters the brain through the blood. The molecule passes the blood-brain barrier. But at the same time, it had to be designed so that it could mimic the effects of a large molecule. We succeeded. We prove that it interacts with receptors and produces the same biochemical effects as a large molecule. We look at what happens with systemic administration to animals. In animal models of Alzheimer's and Parkinson's diseases, the compounds show the desired effects, and they can even be administered orally. It is a great success that small molecules mimic the effects of very large proteins, - Tatyana Gudasheva explains the essence of her work.

However, while the tool has not passed all the tests, the authors of the invention are asked not to exaggerate its significance. The method can become a great achievement only after clinical trials.