Long courses

CLASSIFICATION OF STAGES OF ARTERIAL DISEASE OF LOWER LIMB

Ability to walk is the basis of classification of chronic arterial insufficiency of lower extremities in the severity of the disease - the classification of Fontaine, which is somewhat modified by us as shown below.

Stage 1

leg pain occur only after a rather long walk (about 1 km)
Stage 2a
patient passes (average pitch) over 200 m
Stage 2b
the patient is less than 200 m
Stage 3a
characterized by the appearance of "rest pain, pain that is occurring in a horizontal position, forcing the patient to periodically lower the leg down (up to 3-4 times per night)
Stage 3b
(Critical ischemia) - appears ischemic edema of the leg and foot. The patient is forced to drop the leg more than 3-4 times per night
Stage 4a
(Critical ischemia) - developed necrotic changes in the toes, when there is the prospect of saving in a subsequent reference limb function
Stage 4b

gangrene of the foot or lower leg, requiring amputation of a high

MAIN most frequently used to treat patients HOZANK, DRUGS

Acetylsalicylic acid: used in small doses (rheologically active), 100 - 150 mg daily or every other day. The drug used practically for life, except when the patient is receiving other drugs in the same manner affecting the flow properties of blood. There are forms of acetylsalicylic brand viagra acid with enteric-coated, which provides security for the gastric mucosa and creates conditions for prolonged use.
Pentoxifylline. Its modern therapeutic dose of 1200 mg / day. There are forms - tablets with slow, sustained release 400 mg of active substance (1 tablet 3 times a day). If you are using pentoxifylline in tablets of 100 mg, it should take a dose of at least 2 tablets. 3-4 times per day. Duration of treatment 3-6 months. During intravenous infusion of pentoxifylline at the same time the patient should receive him and in tablets to maintain a constant blood concentrations and the therapeutic effect within days. But we should remember that the total dose was given intravenous and oral administration should not exceed 1200 mg / day.
Ticlopidine - one of the most view of normal men potent platelet Antiaggregant. Particularly effective in severe stages of the disease and diabetic angiopathy. It is used long-course dose of 1 tablet (250 mg) 2 times a day. When applied to take aspirin is not needed.
Dipyridamole. Dose should be 75 mg 3 times a day. Course of treatment 2-3 months. It is advisable to combine with low-dose aspirin.
DRUGS nicotinic acid (nicotinate ksantinola). Dose: 2 tablets (300 mg) 3 times a day for 2-3 months. It is advisable to combine with low-dose aspirin.
Drugs for disorders of lipid metabolism. Used long courses under the supervision of investigations of lipid metabolism. Their purpose must be preceded by an attempt to diet.
GEMOPREPARATY. Actovegin is used inside of 1-2 tablets 3 times daily before meals or intravenously at a dose of 10 to 50 ml of the drug in the 200-300 mg saline solution or in the form of a specially prepared solution (10 or 20%) in bottles of 250 ml. Treatment course - 10-20 injections.
Calcium antagonists. Currently applied nifedipine and verapamil (finoptin). It is advisable to use retardirovannye form.
SYSTEMIC ENZYME - A new method of treatment based on pill containing a complex of enzymes (flogenzim, Wobenzym). Optimizes the natural physiological processes in the body, improves blood circulation. Course of treatment 3-6 months. Very important regimen of these drugs: for 30-40 minutes before eating, drinking plenty of water.
EXTRACT Ginkgo Biloba. The main active principle Tanakan - a standardized extract of Ginkgo biloba (EGb 761). Dose: 2 tablets 2 times a day. The course of treatment for 2-3 months. The drug is a beneficial effect on brain metabolism, eliminates the headache, dizziness, and improves memory. The drug improves blood rheology, microcirculation, has a positive effect on the vasomotor response of large blood vessels. Normalizes metabolic processes, have antihypoxia action on the fabric. Indications: encephalopathy, arteriopathy of the lower extremities. Effective with the combined pathology.
Alprostadil - the most effective in the treatment of critical ischemia. For clinical efficacy is important to introduce the recommended dose, ie 3 capsules, intravenously once a day for at least 2 weeks. Perhaps its application without other concomitant drugs used to treat HOZANK. Active ingredient of the drug is prostaglandin E1 (PGE1).

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