Pharmacological substance - a medicinal product in the form of one or more active substances with pharmacological activity, regardless of the nature of the origin, which is intended for the production, manufacture of medicinal products.

Medications- medicines in the form dosage forms used for prevention, treatment, rehabilitation, etc., that have passed clinical trials and are approved for use by authorized bodies.

What is the difference between these funds?

When comparing various medicines, should be considered:

• bioavailability parameters. Differences in the degree of absorption and the rate of reaching the maximum concentration of a drug can affect its quality characteristics.
• the quality of the medicinal product. The quality is influenced by the presence of excipients.
• excipients are able to form compounds that contribute to high degree dissolution and bioavailability and may affect therapeutic efficacy.

The developer of the medicinal product purposefully selects the concentration of active substances and auxiliary components to achieve the maximum effect on the pathogen and the minimum negative effect on the body.

Before the start of production, a medicinal product goes through several full cycles of clinical trials with an assessment of its effectiveness, during which not only the number of sick and recovered animals is taken into account, but also the duration of treatment, the dose of the drug, the absence of negative reactions, the results of laboratory studies, compatibility with other drugs and treatments are assessed ... The effectiveness and harmlessness of the drug, along with other indicators, are necessarily confirmed by preclinical and clinical studies at the control institute during the state registration procedure.

In order to reduce costs, veterinary medicine doctors and veterinary drug buyers seek to find inexpensive substances. Often their quality is low. This may be due to a change in the methods of synthesis (toxic impurities, etc.), since many substances are produced in countries with different conditions and control methods. It is also worth noting that the communication of suppliers with customers is often carried out through many intermediaries who deal with several manufacturers of substances. In addition, the composition of the substance does not include excipients, and this can significantly affect its quality, bioavailability, and lead to toxic and allergic reactions. In addition, the substances contain in their composition a number of unidentified substances, including residues of organic solvents, which increase the toxicity of the feed.

Please note that in the instructions for use, the substance is indicated as a concentrate that is used in the production of finished dosage forms. antibacterial drugs for therapeutic use in animals.

It is the user's choice to use a substance or preparation that has passed preclinical and clinical trials for safety and efficacy. In the case of using substances, the responsibility for possible negative or ineffective results cannot be shared with the manufacturer or seller of the substance, due to their inappropriate use.

Colleagues, the choice is yours!

Everyone has come across such a situation when a doctor prescribes an expensive imported drug, and in a pharmacy a pharmacist offers its analogue for more affordable price... How to deal with this situation? Is it worth saving? To find answers to these questions, let's try to figure out what generics are and define their "pros" and "cons".

Generic is an analogue of the original drug, but its cost is much lower. Several analogs of expensive imported medicines can be presented on the pharmaceutical market. But not all can be of the same quality as the originals.

The cost of drugs with the same composition: why is the price difference so significant?

The search for a chemical formula, the manufacturing process, laboratory research require not only an investment of money, but also a certain amount of time. Researchers and developers receive a patent for an invention.

Further pharmaceutical company buys out the patent and releases the drug for free sale. The cost of a new drug is quite high, this is explained by the need to recoup the money spent. After a certain period of the patent (about 20 years), the release of such a drug will be allowed by any pharmaceutical corporation.

In the future, the manufacturing company is developing an improvement on the previous version, the production of drugs of the 2nd and 3rd generation is being carried out.

The novelty drug, which has no analogues on the pharmaceutical market, is initially marketed at a high price, but after a few years its cost is significantly reduced.

What is the difference between analogue drugs and generics?

1. Generics differ in the level of purification of their constituent chemicals, as well as the side effects available. A number of analog drugs may have the same therapeutic effect, but side reaction may be different.
2. Original medicinal products contain more medicinal components than generics.
3. Expensive imported drugs are easy to use. The shelf life is longer than generics. Originals may contain a higher concentration of active substances in a tablet, capsule or syrup than those available in analogue preparations.

Benefits of generics

• Low cost
• Fakes are rare
• Have the same effect on the body healing effect as analogous drugs
• The concentration of active ingredients in a certain dosage may be lower; cheap excipients are used.

Let's consider a number of original drugs and their analogues. Let's try to figure it out on the example of some categories of medicines, when you can save money, and when you shouldn't give up cheap medicines.

Antipyretic drugs

The most common drug that is used to lower body temperature is paracetamol (price - 24 rubles). The minimum number of tablets in a plate is 10 pieces. But Panadol, similar in composition and action, will cost almost twice as much (54 rubles).

Paracetamol is also available in other forms that are more convenient for children (syrup, suppositories). In order to choose the most suitable drug in terms of action, you should carefully study the composition of each of them and choose the most affordable one.

Medicines with mucolytic action

The main component of almost all syrups and cough tablets is ambroxol, which dilutes phlegm and allows it to be cleared out of the bronchi more quickly. The most affordable option is Ambroxol (syrup -50 rubles) with various dosages active substance(for children and adults). In the pharmacy chain, you can also find imported drugs with the same composition - Lazolvan (200 rubles), Ambrobene (120 rubles), Haliksol (110 rubles), Linkas (200 rubles). But it should be borne in mind that cheap syrups can cause allergic reaction so you should prefer the more expensive ones medications.

Antihistamines

All familiar antiallergic drugs. Ketotifen (65 rubles), Diazolin (40 rubles), Loratadin (30 rubles), in addition to the main action (blockade of histamine receptors), cause by-effect- drowsiness.

Modern drugs from this category have no similar side effects–Erius (400 rubles), Telfast (460 rubles). Not worth giving of great importance side effects of domestically produced antihistamines, because the price imported analogues unreasonably high.

Sedative drugs

Drugs that have a sedative effect on nervous system enough. Pay attention not to the brand, but to the active ingredients. Sedavit (90 rubles), Sedasen (125 rubles), as well as Sedafiton (75 rubles) and Valerian (50 rubles) have a sedative effect. Therefore, it makes no sense to acquire more expensive analogues Persen (300 rubles), Novo-passit (250 rubles).

There are much more cheap analogs than those listed above. Be careful, check with the pharmacist for the availability of a generic of this or that drug, you will be able to save on the necessary medicine. Do not forget to compare the dosage of the active ingredient in the original preparation and its analogue!

And many others. One of the most popular is Perineva.

But the necessary medicine is not always available in the pharmacy. In this case, substitutes are bought.

What are Perinev's tablets, analogues of the drug and their price - the article will tell you about all this.

Description of the medicinal product

The drug belongs to the group. The medicine has antihypertensive effect prolonged action.

The composition includes the substance perindopril erbumine, as well as auxiliary components:

• lactose monohydrate... Helps to optimize calcium metabolism. It is a sugar substitute.
• calcium chloride hexahydrate... It is a harmless food supplement;
• magnesium stearate. It is also considered food additive animal origin. Ensures the connection and uniformity of all ingredients that make up the tablets;
• microcrystalline cellulose. Gives homogeneity, strength and smoothness to the product;
• crospovidone. Ensures the stability of the composition during long-term storage, and also improves the release of active substances;
• colloidal silicon dioxide. It is an enterosorbent.

The substance perindopril in medical practice has established itself as an effective and reliable agent. With its help, it is possible to restore health to more than 80% of patients diagnosed with congestive heart failure. In almost 50% of cases, complications such as stroke and heart attack can be avoided.

The indications for taking the medicine are:

• arterial hypertension;
• suffered a stroke;
• ischemic cerebral circulation disorder;
• prevention of recurrent stroke;
• chronic heart failure;
• cardiac ischemia;
• condition after suffering a heart attack.

The drug reduces the likelihood of cardiovascular complications in patients with ischemic heart disease. Numerous clinical researches the drug has proven its safety and effectiveness. Take pills once a day. The dosage is selected individually for each patient, taking into account the severity of the course of hypertension, the presence of complications and contraindications.

For some patients, taking perindopril alone is not sufficient to relieve symptoms of hypertension. In this case, a combination therapy is needed, which involves the use of an antihypertensive drug and a diuretic. To make the work of doctors easier and to make it easier for patients to take pills, pharmacists have created combination drugs that combine substances from the group ACE inhibitors, and diuretic components. Ko Perineva belongs to such medicines.

Co Perinev tablets

Many are interested, Ko Perineva and Perineva, what is the difference, which is better. The difference lies in the composition: in addition to the substance perindopril, Perineva Co. also contains indapamide, which is a thiazide diuretic. Perindopril in combination with indapamide can more effectively reduce high rates tonometer.

The drug has a pronounced antihypertensive, vasodilating and diuretic effect. This reduces the likelihood of complications. arterial hypertension... Therefore, if increasing the dosage of Perinev does not give the desired result, it makes sense to try Ko Perineva.

The necessary medicine is not always available in pharmacies. Therefore, it is useful to know what substitutes are, and which analogue of Ko Perinev (4 mg, 8 mg) and Perinev is better to buy.

Ko Perinev's analogs

An analogue is a means that is identical in composition, action and result. The only difference lies in the list of active ingredients and contraindications. Any drug has its own substitute. Co Perinev tablets have analogues in terms of effect and active ingredient.

If the pharmacy does not have Ko Perinev, then you can replace these tablets with the following medicines:

• Ampliton;
• Caposide;
• Ko-Renitek;
• Akkuzid;
• Amprilan;
• Lisinopril;
• Berlipril plus;
• Ko-Diroton;
• Vasolong;
• Fozide 10;
• Renipril GT;
• Listril Plus;
• Skopril plus;
• Hartil-D;
• Moeks plus;
• Fozinotek N;
• Enapharm-N;
• Tritace plus;
• Enalapril-Acri N;
• Enzix;
• Noliprel A;
• Euroramipril;
• Prilamidm
• Ko Prenessa.

Prilamide tablets

All analogs differ in price, but in principle are affordable. Ko Perineva costs on average about 650 rubles. Noliprel has a cost of about 800 rubles. Perindide is sold for 300 rubles.

And pharmacies offer Prilamid for 200-400 rubles. Ko Prenessa costs about 400 rubles. The price of Euroramipril is 200 rubles. It should be noted that the analogs do not differ in high quality.

The low price is often associated with the fact that the properties of the original drug are not preserved. For analogs, the effect is similar, but it can also differ significantly. Therefore, doctors do not recommend changing the drug if it works well.

Perinev's analogs

Perinev has analogs of tablets: at the moment, pharmacists produce about 19 medicines based on perindopril. Therefore, it is not difficult to find a replacement.

Most often, doctors prescribe the following substitutes:

Prestarium tablets

Also, substitutes include Stopstress, Pyristar, Hypernik, Perindopril-Teva, Arentopres, Perindopril-C3, Prenessa, Ko-Dalneva and Pyristar. But these pills are less popular and are rarely prescribed by general practitioners for the treatment of hypertension.

Perineva costs from 240 rubles. So it is worth noting that almost all analogs are more expensive. Since the cost of Perindopril-Richter is at the same level, many hypertensive patients have a question: Perineva or Perindopril, which better and faster helps with high blood pressure. The composition of these medicines is identical. Therefore, it can be argued that the effect of these drugs will be similar.

Choosing from all possible options tablets based on the active ingredient perindopril, it should be noted that the bioequivalence of the drug was proved only by the company KRKKA, which produces Perineva. Therefore, it is better not to use an analog if there is an original product on sale.

Patients with various pathologies of the heart and blood vessels in complex therapy prescribe drugs containing magnesium and potassium. Often the question arises as to which is better - Asparkam or Panangin. It is impossible to unequivocally answer this question, because each drug has its own characteristics. To understand how both drugs work on the body, and to try to figure out which one is better, a comparative analysis should be carried out.

What are the similarities of drugs

Panangin and Asparkam are medications used among patients with heart disease. Medicines can improve cardiac activity, maintain the level of trace elements in the body. Both tools have both similarities and differences.

Common drugs:

• both the one and the other medication includes potassium, magnesium. This is what makes it possible to use both means to replenish the level of trace elements in the body;
• both are available over the counter without a prescription;
• analogues have a similar regimen. Usually, patients are prescribed 1 - 2 tablets three times a day;
• Both drugs help prevent the involuntary contraction of a person's muscles that occurs with the constant use of diuretics to lower blood pressure;
• the products have similar indications for use. These include ischemic disease heart failure, heart failure, hypertension, potassium or magnesium deficiency in the body.

The drugs are similar in composition and action. Both funds are necessary for the heart in its severe pathologies. With regard to the therapeutic effect.

Important! Cannot be distinguished best medicine, both of them have approximately the same effect on the body.

The difference between drugs

What is the difference between medications? The main difference between Asparkam and Panangin is the country of manufacture of drugs. Asparkam is a domestic product, Panangin is produced by a Hungarian company. The cost of drugs also differs. Panangin is more expensive, its approximate cost is 140 rubles, the price of Asparkam is from 10 rubles. Domestic medicine is produced in the form of tablets, Hungarian - in the form of capsules. The main advantage of Panangin is a more convenient form of administration. In addition, the capsules are covered with a special protective shell, that is, they do not harm the tooth enamel.

Panangin is produced in the form of film-coated capsules

The individual preferences of the patient play an important role in the choice. For some people, it is more convenient to take products in the form of tablets, crushing them into powder, diluting them with water. For such patients, Asparkam is more suitable. Accordingly, patients who find it easier to swallow the capsule should be given preference to Panangin.

For people suffering from gastrointestinal diseases, such as ulcers, gastritis, colitis, the drug is recommended in the form of capsules, since its effect on the walls of the stomach and intestines is more gentle.

Indications for use

Both drugs are indicated for complex treatment cardiovascular pathologies, but there are some differences in indications for use.

Indications for use of Asparkam:

• a decrease in the level of magnesium in the body, which develops under the influence of various disorders;
• dysfunction of the heart;
• potassium deficiency;
• arrhythmia treatment.

Often, Asparkam is prescribed for people who do not tolerate therapy with cardiotonic and antiarrhythmic drugs.

Indications for use of Panangin:

• glitches heart rate triggered by a lack of potassium in the blood;
• dysfunction of the heart muscle due to toxic poisoning, including against the background of taking medications;
• extrasystole of the ventricles;
• transfer of myocardial infarction;
• coronary insufficiency;
• decreased oxygen supply to tissues as a result of cardiac dysfunction;
• potassium deficiency during treatment with diuretics.

It is safe to say that Panangin differs from Asparkam more a wide range actions.

Potassium and magnesium are essential for the normal functioning of the human body

Instructions

The instructions for use of both drugs indicate the same treatment regimen. Both remedies should be taken 1 tablet once a day, it is recommended to do this during a meal or immediately after a meal. The duration of the course is 1 month. After that, you should take a break of 30 days, then repeat the course.

Contraindications

Panangin and its analogue Asparkam are prohibited for the treatment of patients with cardiac pathologies in the following situations:

• development of urinary retention;
• excess potassium, magnesium in human blood;
• severe kidney pathology;
• dehydration;
• increased blood acidity;
• muscular myasthenia gravis.

Despite the fact that both products are sold in pharmacies without a prescription and have natural composition, before using this or that drug, it is recommended to always consult a doctor.

Comparative analysis of the composition

Potassium and magnesium are essential for the normal functioning of all human organs and systems. The pharmacological properties of Panangin and Asparkam are provided precisely due to these microelements. The table shows the composition of both drugs.

The table shows that the amount of the main active components of both drugs is absolutely identical. The only difference is in the excipients. Additional components do not affect the action of the drug, so it can be concluded that by pharmacological effect the medicines are the same.

Reviews of doctors

What are the doctors' reviews about analog drugs?

Anton Sergeevich, cardiologist, Moscow
“It is impossible to unequivocally answer the question of which is better - Panangin or Asparkam. The drugs have exactly the same composition, so their effect on the body does not differ. Asparkam is a more budgetary option, but it is not inferior to foreign funds. Among the downsides of Asparkam is its tendency to cause hyperglycemia. "

Valery Stanislavovich, cardiologist, Ufa
“I don’t see any fundamental difference between these two remedies, so it’s hard to choose one best medicine. Panangin is available in capsules, I think this is its advantage. In addition, the use of the product is allowed in pediatric practice... The advantages of Asparkam would be the low cost and availability. Both drugs have a number of contraindications, so I do not recommend using them on my own. "

Which is better

Which remedy is still better? Most experts believe that Panangin deserves more confidence, but this opinion has not been confirmed by clinical trials, that is, the best effectiveness of Panangin has not been proven in practice. Both the one and the other drug are good in their action, both funds have an identical composition.

The advantages of a foreign medicine include a sparing effect on gastrointestinal tract... This was achieved thanks to the special coating of the capsules. That is why doctors prescribe Panangin for patients with ulcerative colitis, gastritis, and other diseases of the stomach and intestines.

Why do most experts prefer Panangin? The point is the credibility of the Hungarian campaign and the quality checks used in the country. But according to many patients who tried Panangin treatment, they did not wait for the effect.

When choosing a remedy, you should be guided by personal preferences and doctor's recommendations

Complications of drug therapy are called differently: side effects of drugs, drug allergies, drug intolerance, drug pathology, etc.

Adverse reactions caused by certain drugs can be summarized as “side effects of the drug” or “complications of pharmacotherapy”.

Groups of side effects of drugs

In the clinical and pharmacological aspect, the side effects of drugs should be divided into several groups.

Allergic reactions negative and delayed types are most often caused by drugs:

• gold - 30-40%;
• penicillin -5-55%;
• anti-tuberculosis drugs - 8-45% and others.

They manifest clinically:

• dermatitis - in 45-50% of cases;
• eosinophilia - 40-45%;
• leukocytosis - 20-30%;
• leukopenia - 15-25%;
• urticaria - 10-20%, etc.

Such clinical phenomena are due to the allergization of the patient's body, as well as the quality of the drugs (manufacturing technology, duration and storage conditions). Thus, tetracyclines rarely cause allergic reactions; due to improper storage and administration of a drug with a prolonged shelf life, this agent can cause an active allergic reaction (O.P. Viktorov, 2008).

Pharmacotoxic reactions due to an absolute or relative overdose of the drug, manifested by symptoms due to the pharmacodynamic properties of substances (atropine - dry mouth; reserpine - neuroleptic effect in patients with hypertensive disease). Clinically, these are ulcerative lesions of the mucous membrane of the alimentary canal, changes in the number of blood cells, dysfunction of parenchymal organs, etc. Possible manifestations of nonspecific properties of the drug, in particular the effect on the fetus during pregnancy (embryotoxicity, teratogenic effect, fetotoxicity), as well as carcinogenic, mutagenic effects.

Changes in the immunobiological properties of the body(weakening of immune responses - immunosuppression, manifested by superinfection, frequent relapses infectious diseases, dysbiosis, candidiasis, staphylococcal lesions of the skin and other organs). Such complications cause:

• antibiotics,
• sulfonamides,
• immunosuppressants,
• antineoplastic agents.

Frequency of drug side effects

The question of collateral and toxic effect Many large monographs are devoted to drugs both in our country and abroad, many information letters have been written about the complications of drug therapy. These letters are based on reports from hospitals about different types side effects of drugs.

By 1968, the English literature reported the appearance of various negative reactions with drug treatment on average, 15% of people. But by 1972, American authors observed negative reactions with drug therapy in 55% of people.

There is a constant increase in deaths with the administration of penicillin. In France for last years the frequency of deaths with the introduction of penicillin increased 16 times. A natural question arises: were there any negative effects of drugs in the previous periods of the development of medicine?

Already in the days of Hippocrates, it was known that drugs under some circumstances provide the desired therapeutic effect, and under others they cause undesirable effects that worsen human health. In 1881 in Berlin, Levin published the book "Side Effects of Drugs". In the eighties and nineties of the XIX century, doctors began to produce contraindications for the prescription of medications. By the end of the 19th century, doctors had a conviction that it was necessary to select the appropriate drugs in the appropriate dose for a particular person.

Classification of side effects of drugs

To date, there is no exact classification of side effects / adverse reactions of drugs. In 1967, the classification of the undesirable effects of drugs was adopted.

• Overdose:
  • absolute,
  • relative.
• Intolerance.
• Side effects:
  • specific,
  • nonspecific.
• Secondary action.
• Idiosyncrasy.
• Allergic reactions.

Tareev A.N. (1968) proposed a scheme of etiological and pathogenetic factors of drug syndrome: toxic, nonspecific, teratogenic and mutagenic. Such a classification of the manifestations of side effects of drugs reveals the genesis of its individual syndromes and thereby determines the appropriate pathogenetic treatment.

According to the mechanisms of the incompatibility of the body with the drug, the following are distinguished:

• drug allergy,
• drug toxicity,
• medication idiosyncrasy.

Toxic effects are the result of high doses of drugs. Idiosyncrasy is a genetically determined reaction of the body. Drug allergy is determined by the immunological factors of the body and the drug.

WHO identifies the following main groups of adverse reactions:

• Allergic, dose-independent drug - type B.
• Toxic, dose-dependent, type A.
• Local - at the injection sites.
• Interaction reactions of drugs - occur when several drugs are used and is a consequence of their mutual influence on the processes of pharmacokinetics and / or pharmacodynamics.
• Reactions versus drugs.
• Teratogenic effects are fetal abnormalities associated with the use of drugs.
• Carcinogenic effects - the formation of tumors associated with the use of drugs.

Causes of side effects of drugs

Side effects of the drug is any unwanted reaction caused by pharmacological properties the drug, which is observed exclusively when used in doses recommended for medical use. Adverse drug reaction is a combination or individual manifestations of the negative properties of a medicinal product that impede its effective and safe use in a patient or cause a negative impact on his quality of life. An adverse reaction is an unintentional and harmful reaction to the body that occurs when the drug is used in therapeutic doses for the purpose of prevention, treatment, diagnosis of a disease, and modification of physiological function. Taking a medicine is always associated with a certain risk.

The reasons for the inevitable risk, according to D. Lawrence, P. Benitt (1991), during pharmacotherapy are as follows:

• Insufficient selectivity of the drug.
• Some drug effects that are desired in one body system may cause unwanted effects in others.
• In the implementation of many physiological functions close analogous mechanisms are involved.
• Prolonged exposure to cellular mechanisms can lead to permanent changes in the structure and function of cells (including carcinogenesis).
• Limited information about pathological processes.
• Patients with genetic diseases can suffer to a very high degree, they can develop an unexpected immune response to the introduction of a drug.
• The selection of the required dose is inevitably inaccurate ( diabetes, depression).
• In cases of incompetent and accidental prescription of drugs.

Types of side effects of drugs

Distinguish between explicit or obvious side effects of drugs with a certain clinical characteristics(Hypertension with prolonged use of corticosteroids) and rare and unpredictable (not described in the literature and may not always be associated with the action of the drug).

By clinical course distinguish between:

• lungs- without discontinuing the drug, or special treatment (headache when using nitrates);
• moderate that require discontinuation of the drug and the appointment of treatment (urticaria);
• heavy- with a threat to the life or disability of the patient (anaphylactic shock);
• deadly.

Therefore, the side effects of drugs are divided into serious and non-serious.

Serious side effects of drugs- these are those that pose a threat to life (regardless of the dose), lead to the death of the patient, disability, require additional hospitalization, contribute to fetal developmental abnormalities or congenital anomalies resulting from drug overdose. Difference Between Serious and Severe side effects is that serious - provide for significant harm to the patient's health due to the development of the effects that are indicated above, and severe - this is a measure of the manifestation of side effects.

Minor side effects of drugs is defined as any of the adverse reactions that do not meet the criteria for "Serious Adverse Reactions".

The side effects of drugs are predictable and unpredictable.

Alleged Adverse Reactions are described in well-known reference books, manuals, textbooks, monographs, as well as leaflets (instructions for the use of medicines). The development of an expected adverse reaction cannot be a reason for a lawsuit against the doctor.

An unpredictable adverse reaction (in nature, severity or frequency of occurrence) is not expected, is not described in well-known reference books, manuals, textbooks, monographs, medical guidelines.

A side effect should also be distinguished - a reaction that is not related to a therapeutic goal, harmless or such that it is harmful, the action of the drug in therapeutic doses turns out to be next to the main specific effect (drowsiness when administered with histamine H1 receptor blockers of the first generation).

Side effects of the drug are caused by the tendency to prescribe drugs in high therapeutic concentrations, the appointment of treatment in doses without taking into account the individual characteristics of the patient, his heredity, long-term treatment, children and elderly age patients, as well as polypharmacy.

After establishing the relationship between the desired pharmacological and side effect, it becomes necessary to give a quantitative and qualitative assessment of the benefit / risk ratio, that is, the likelihood that the discovered side effect will worsen the course of the disease and the effectiveness of treatment.

When taking the drug, undesirable "phenomena" may occur - withdrawal syndrome ("rebound"), tolerance to therapy, drug dependence, etc. Withdrawal syndrome occurs when the drug is suddenly stopped (withdrawal of clonidine and hypertensive crisis, antianginal drugs - an attack of angina pectoris). Tolerance it is difficult to distinguish therapy from the patient's reduced sensitivity to the drug, and only then can one think about it when the lack of effect from the use of the drug cannot be overcome by increasing the dose or the effect is manifested in a dose that causes undesirable, dangerous effects.

Prolonged repeated, not always regular, administration of drugs that change mental functions (psychostimulants or painkillers, suppressing the central nervous system), can lead to the development of drug dependence, which can be mental (with uncontrollable patient attraction and mental disorders) and physical (with severe dysfunctions internal organs and the development of abstinence).

The importance of placebo in determining the effectiveness and side effects of drugs

To test the therapeutic efficacy of drugs in clinical trials, dummy drugs — placebo — are used. Placebo- this term, legalized by medicine in 1894, denotes a drug that obviously does not possess any healing properties... Initially, these were "pills" from icing sugar or other pleasant to the taste substance. The Latin word is "placebo" and literally translates as "like". The placebo phenomenon is that it performs surprisingly (compared to its nil healing qualities) results.

Large-scale studies carried out in 1986 under the auspices of the Ministry social protection France, showed that after taking a placebo, headaches disappear in 62% of cases, ulcers and gastritis disappear without a trace in 58 out of a hundred patients, every second cures rheumatism ... For this, one thing is necessary - to deceive the patient by saying that he is being given real medicine. Experts believe that the secret of placebo lies in self-hypnosis. But this hypothesis does not explain many of the oddities of the placebo effect, such as its geographical selectivity. Experiments have shown that at different geographic latitudes, the percentage of successful action can differ quite dramatically. This does not fit into any of the explanations and indicates that the placebo phenomenon is still far from being fully understood by specialists.

The placebo is unable to act directly on the conditions for which the drug is prescribed to change. In addition, the term of the placebo effect is called the very phenomenon of non-drug action, not only of the drug, but, for example, radiation (sometimes different "flashing" devices, "laser therapy", etc. are used). Lactose is often used as a placebo. The degree of manifestation of the placebo effect depends on the suggestibility of the person and the external circumstances of the "treatment", for example, the size and bright color of the pill, the degree of trust in the doctor, and the credibility of the clinic.

Placebo is used as a control drug in clinical trials of new drugs, in a procedure for quantifying the effectiveness of drugs. One group of subjects is given a test drug that has been tested in animals, and the other is given a placebo. The effect of using the drug must significantly exceed the placebo effect in order for the drug to be considered effective. Placebo is also used to study the role of self-hypnosis in the action of drugs.

The typical level of positive placebo effect in placebo-controlled clinical trials averages 5-10%, and its severity depends on the type of disease. In most trials, a negative placebo effect (nocebo effect) is also manifested: 1-5% of patients experience some form of discomfort from taking a "pacifier" (allergies, stomach, cardiac manifestations). For some people, unpleasant expectations of a new drug can take the form of severe pharmacophobia or pharmacophilia.

Sometimes doctors deliberately prescribe placebos for patients who are prone to self-hypnosis painful sensations... In this case, it becomes possible to avoid unjustified neuroses typical for people in modern society and numerous drug complications. The beneficial effect of homeopathic remedies is also attributed to the placebo effect.

Many modern drugs act in an integral manner; their therapeutic effect also contains a "placebo component". Therefore, bright and large tablets generally work stronger than small and nondescript ones, and drugs from well-known companies (of the same composition and the same bioequivalence) have a greater effect than drugs from “outsiders of the market”.

This therapeutic suggestion does not require any special skills, since the criticality of consciousness (“I don’t believe”) is overcome by binding information, it is suggested to the actual object - a pill or injection without any real effect on the body. The patient is advised that this drug has a certain effect on the body, and, despite the ineffectiveness of the drug, the expected effect is manifested to one degree or another. Physiologically, this is due to the fact that, as a result of suggestion, the patient's brain begins to produce substances corresponding to this action, in particular endorphins, which, in fact, partially replace the action of the drug.

The second factor that ensures the effectiveness of placebo is an increase in the "defenses" of a person. The degree of manifestation of the placebo effect depends on the level of suggestibility of the person and the physiological possibility of the formation of the necessary chemical compounds.