ACUTE RESPIRATORY VIRAL INFECTIONS: MODERN APPROACHES TO TREATMENT AND PREVENTION
S. V. Valyukh, candidate of medical sciences, associate professor, S. Yu. Shtrygol, doctor of medical sciences, prof., V. F. Ostashko, candidate of medical sciences, associate professor. National University of Pharmacy
Etiopathogenesis
There are about 300 causative agents of respiratory infections, more than 200 of them are viruses. The most important diseases of the ARVI group are influenza, parainfluenza, adenovirus, respiratory syncytial and rhinovirus infection.
Viruses are transmitted by airborne droplets, less often through environmental objects (adenoviruses). The “entrance gate” is mainly the nasopharyngeal mucosa, where they multiply rapidly. Each type of virus is traced to a specific department respiratory tract, in which there is edema, inflammation, increased blood flow to the mucous membrane.
Clinic
Since ARVI primarily affects the nasopharynx, the main symptoms are a runny nose or nasal congestion, sneezing or coughing. Their intensity can vary depending on the type of pathogen and the state of the immune system. The virus multiplies rapidly, "breaks through" the protection (pharyngeal lymphatic ring) and, entering the bloodstream, causes viremia, which is accompanied by fever, sore throat, sore throat, weakness and loss of appetite. Influenza is characterized by intoxication, vascular disorders with a relative scarcity of catarrhal phenomena. With parainfluenza and rhino viral infection intoxication is poorly expressed, since viruses enter the bloodstream for a short time. Parainfluenza is mainly manifested by laryngitis, rhinitis, pharyngitis; adenovirus infection - tonsillitis, adenoiditis, conjunctivitis; rhinovirus infection - runny nose. Diagnosis is based on symptoms and clinical manifestations disease, and is confirmed by the detection of antibodies in the blood.
Features of ARVI in children
Characterized by increased susceptibility to all viral infections, ease of transmission of the pathogen, high contagiousness and insufficient immune response, protracted course of the disease. Viral-viral and viral-bacterial infections are often combined, which leads to a severe course and unfavorable outcomes. Respiratory pathology in newborns and children of the first year of life is more often caused by respiratory syncytial virus and adenoviruses. A child can become infected from a sick mother in utero or during childbirth, then the pathogens can be both viruses and pneumotropic bacteria, chlamydia, mycoplasma, legionella, pneumocystis, fungi. When infected with influenza and SARS during pregnancy, there is a threat of miscarriage, gestosis, anemia, anomalies of placenta attachment, and abnormalities in labor are possible. Up to 12 weeks, embryotoxic and even teratogenic effects of viruses are possible, more late dates - intrauterine growth retardation, encephalitis, hepatitis, nephritis, pneumonia in the fetus.
Treatment
Treatment consists of etiotropic (antiviral), syndromic and symptomatic therapy. All patients, regardless of age and severity of the disease, are assigned to bed rest until the body temperature returns to normal, and a milk-vegetable diet enriched with vitamins. It is necessary to drink enough liquid. This prevents drying out of the nasopharyngeal mucosa, liquefies phlegm, reduces the level of toxins, and stimulates perspiration. With severe intoxication, enterosorbents are shown - enterosgel, atoxil, activated carbon.
Ion channel blockers Amantadine and Remantadine have an antiviral effect, but the spectrum of their action is narrow (only the influenza A virus, rapidly developing resistance), are possible side effects from the central nervous system. Remantadine has been used since the age of seven, while Amantadine is mainly used in adults. Oseltamivir is registered among the neuraminidase inhibitors in Ukraine. Its disadvantages are high cost, side effects (nausea, vomiting), age restrictions (from 12 years old). Amizon also acts on the virus, has an interferonogenic and immunomodulatory effect, has antipyretic, anti-inflammatory and analgesic effects, has been used since the age of six. Arbidol has been used since two years, has a direct antiviral effect on pathogens of influenza A, B and other acute respiratory viral infections, herpetic and acute intestinal infections of rotavirus etiology; has interferon-inducing, immunomodulatory and antioxidant effects. Amiksin is a broad-spectrum antiviral drug that stimulates the production of all types of interferon (α, β, γ), activates cellular and humoral immunity, is allowed for young children.
Arbidol, amizon and amiksin have proven to be effective and relatively safe drugs for the treatment of influenza and ARVI.
Stimulation of antiviral defensecarried out by immunomodulators. Their main action is to increase the level of interferon and lysozyme, which have antiviral activity, stimulate the production of local immunoglobulins and the activity of macrophages. For this purpose, apply interferon, laferonin the form of nasal drops several times a day. For the treatment of influenza and other acute respiratory viral infections on the 1st or 2nd day, they are used as nasal drops native leukocyte interferon(1000 units / ml) 4-6 times a day. Can recommend recombinant α2-interferon (reaferon,10000 U / ml) intranasally for 5 days, 2 drops 3-4 times a day. As rectal suppositorieschildren of infancy and preschool age are prescribed interferon alpha 2b(viferon-1, 150,000 IU in one suppository) in combination with vitamins E and C. For schoolchildren - viferon-2 (500,000 IU), 1 suppository daily at 12-hour intervals for 5-10 days. Viferon-3, 4 is used in adults.
Due to the functional immaturity of the mucous membranes in children, reduced local immunity, agents that increase its protection are used. These drugs include Lisobakt, which includes lysozyme. It is used in children from 6 months, for a course of 8-10 days.
Increased body temperature- not only a signal about the disease, but also a sign of the body's struggle with the pathogen. In most cases, only the febrile temperature should be reduced. But if the child even subfebrile temperature - below 38.0 ○ С - causes convulsions (at least in history), it should be reduced. The same applies to patients of any age with severe heart or respiratory failure, since they cannot compensate for the increase in tissue oxygen demand during fever. With acute respiratory viral infections, the temperature usually does not exceed 39.0 ○ –40.0 ○ C and lasts for 1-3 days, while serious disorders from various organs and systems do not occur. When this level is reached, the vessels of the skin dilate (the skin turns red), giving off excess heat.
You should not wrap yourself up so as not to catch a cold. But if the febrile temperature lasts more than 3-4 days, this may indicate the addition of a bacterial infection and the occurrence of complications (otitis media, sinusitis, pneumonia, etc.) requiring treatment with antibiotics or (in adults) fluoroquinolones. All of them must be applied only by doctor's prescription.
A combination of antipyretics and antibacterial drugs in most cases it is undesirable, since the clinical assessment of the effectiveness of the latter is difficult.
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It is necessary to remember about the dangers of high body temperature: the risk of seizures or cerebral edema, dehydration, subjectively poor health. When elevated temperature dangerous?First of all, when it is accompanied by vasospasm of the skin vessels and impaired heat transfer - malignant hyperthermia. In this case, you need to call an ambulance medical assistance and be sure to give an antipyretic (the child is better in a solution that acts faster), use physical cooling, for example, rubbing with a weak solution of acetic acid, so that the body can effectively transfer heat. It should be remembered that a number of over-the-counter antipyretic drugs have serious side effects and are therefore not used in children. An example is acetylsalicylic acid,which can cause Reye's syndrome - a severe damage to the liver and brain. Analgin (metamizole)is able to inhibit hematopoiesis up to the development of fatal agranulocytosis, sometimes reduces the temperature to subnormal numbers. In emergency cases (malignant hyperthermia), you can use a 50% solution of analgin in injection (0.1 ml / year of life) once as directed by a doctor. Candles Tsefekon M and Tsefekon are intended only for adults, used in children Tsefekon D. Nimesulide- COX-2 inhibitor - is a part of drugs such as Nise, Nimulid, Nimesil.
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Acute rhinitis is most commonly caused by rhinoviruses. The main goal of rhinitis treatment is to improve nasal breathing. Vasoconstrictor drugs (decongestants), activating (β-adrenergic receptors, reduce the cavernous tissue of the turbinates. Decongestants are used in the form of nasal drops, sprays or orally. The first group includes Phenylephrine, Oxymethasone, Xylometazoline, Naphazoline, Indanazolamine, Tetrizolineetc. For oral administration are intended pseudoephedrine, phenylpropanolamineand phenylephrine. These drugs quickly eliminate swelling of the nasal mucosa, restore nasal breathing. With prolonged use, nasal decongestants can aggravate the common cold, so they are used for 3-5 days. If you need a longer use, you can recommend preparations containing essential oils: P inosol, Kameton, Evkazolinetc. Convenient (after 6 years) nasal sprays (for example , Knoxprey, Eucalyptus Spray Dr. Taisa), allowing evenly distribute the drug at a lower dose. Oral decongestants inhibit the ciliated epithelium less, so the risk of drug-induced rhinitis is reduced. But insomnia, tachycardia, and increased blood pressure are possible.
Moisturizers and hygiene products such as Aqua Maris, Salin, Humerprepared from seawater, sterilizing and bringing the salt content to isotonic concentration. The microelements contained in seawater (Ca, Fe, K, Mg, C, etc.) increase the motor activity of the cilia, normalize the functions of the mucous membrane, which improves nasal breathing. Phytopreparations are also used, for example Sinupret, which has a pronounced secretolytic and anti-inflammatory effect, antiviral and immunomodulatory properties.
A cough with ARVI can be both productive and unproductive. At the onset of the disease, mucus is usually poorly evacuated, therefore it is recommended moisturizing, enveloping, expectorant, mucolytic and mucoregulatory agents.
Moisturizing mucous membranesreduces irritation and viscosity of the secretion. Use steam inhalation, irrigation saline, rinsing with sodium bicarbonate solution or herbal extracts.
Enveloping actionbased on the creation of a protective layer on the surface of the mucous membrane of the nasopharynx and oropharynx, which reduces the excitability of cough receptors. Phyto-teas are used in the form of decoctions, tea, syrups, drops, lozenges and lozenges. They contain extracts of eucalyptus, acacia, licorice, cherry, pine buds, thymeand other components. A feature of these drugs is their short duration and relatively low effectiveness of action. Therefore, they should be used frequently, every 3-4 hours.
Expectorant effect (facilitating the discharge of liquid sputum) is provided by phytopreparations ivy (Gedelix, Prospan), marshmallow (including M ukaltin), plantain (Eucabal, Dr. Tais's cough syrup, plantain syrup), elecampane, anise, oregano, wild rosemary, coltsfoot, licorice, violets, pine buds, thermopsis, thyme, terpinhydrate, guaifenesin, iodides ... Pertussincontains thyme extract and potassium bromide. The mechanism of their action is based on a decrease in the viscosity of mucus by increasing its volume and activating the motor function of the bronchioles and ciliated epithelium. The reflexively acting thermopsis herb infusion is rarely used due to its high toxicity and emetic effect. Mother-and-stepmother due to the presence of pyrrolizidine alkaloids is not used for a long time.
In recent years, drugs of the mucolytic group and mucoregulators.A feature of the mechanism of action of mucolytics is the ability to liquefy sputum, practically without increasing its volume, due to the destruction of disulfide bonds of acidic mucopolysaccharides. In addition, mucolytics and mucoregulators reduce airway inflammation.
Mucolytics include: acetylcysteine \u200b\u200b(ACC), bromhexine and ambroxol.The main indication for the appointment of ACC is the presence of a large amount of thick, viscous secretion. ACC reduces the hepatotoxicity of paracetamol. ACC should be used very carefully in bronchial asthma, since it may worsen. Bromhexine hydrochloridealso suppresses cough, reduces the viscosity of phlegm and stimulates the synthesis of surfactant, which ensures the stability of the pulmonary alveoli. Currently, bromhexine is being replaced by the drug of its active metabolite - ambroxol hydrochloride, which also increases the formation and blocks the breakdown of the surfactant. This justifies its priority use in neonatology.
Mucoregulators are represented by carbocisteine, which differs significantly from ACC and bromhexine. Carbocisteine \u200b\u200boptimizes the ratio of acidic and neutral sialomucins, promotes the formation of mucus with normal rheological properties, which contacts the cilia of the ciliated epithelium. The drug is especially indicated in cases of a significant increase in the secretion of liquid mucus. Ambroxol with carbocisteine \u200b\u200bis part of Milistan - cough tablets for adults and syrup for children.
Antitussive drugscentral action (codeine, glaucin, tusuprex) and peripheral (libexin, falimint) are used mainly in cases when the convalescent has long persistent upper respiratory tract irritation, dry cough. Glaucin, blocking (β-adrenergic receptors, can lower blood pressure. If there is sputum, they are not used.
For a sore throat indicating severe inflammatory process, it is recommended to rinse with antiseptic solutions, for example furacilin (1: 5000), infusions of anti-inflammatory plants (sage, etc.).
With ARVI, vitamin therapy is also advisable, especially vitamin Cand its synergist rutin. They stimulate the immune system, strengthen the vascular wall, and reduce intoxication.
Prevention
During the period of the rise in the incidence of ARVI, it is recommended to visit less crowded places. Nonspecific pharmacoprophylaxisprovides for the use of herbal immunotropic drugs (adaptogens) based on echinacea, tea tree oil, sea buckthorn leaves, ginseng,however, their use is limited due to allergic reactions. Echinacea should not be used for a long time, since after a two-month course, the perversion of the immunostimulating effect is possible. Immunomodulators can be recommended bacterial origin and their synthetic counterparts such as Bronchomunal, Ribomunil, IR S-19, Engystol, Likopid, Biostim, Dibazol.However, it must be remembered that they stimulate the body's non-specific defense, and do not contribute to the development of specific immunity.
Antiviral chemotherapy drugs can be used when influenza is on the rise (Arbidol, Amizon, Amiksin, Amantadin, Oseltamivir, Remantadin, Ribavirin).During pregnancy only in the third trimester, you can use arbidol, amiksin, amizon; in all trimesters - engystol, IRS-19, influenzaeel, aflubin.
Specific prevention- vaccination. In recent years, new vaccines have appeared: Vaxigripp (France), Begrivac (Germany), Fluarix (Belgium), Influvac (Holland), Grippol (Russia). These vaccines are effective in preventing influenza. Studies show that the incidence of ARVI of non-influenza etiology also decreases in those vaccinated against influenza. This is due to the stimulation of non-specific defense factors.
LITERATURE
1. Ershov F. Rational pharmacotherapy of influenza and acute respiratory viral infections / / Pharmaceutical Bulletin. - 2003. - No. 39. - P. 39–43.
2. Cellular biology of the lungs in health and disease. A guide for physicians edited by V.V. Erokhin, L.K. Romanova. - M .: Medicine, 2000; 496 s.
3. Korovina AA, Zaplatnikova AL Acute respiratory viral infections in the outpatient practice of a pediatrician: A guide for doctors. - M., 2004 .-- 237 p.
4. Kramarev SA Modern approaches to the treatment of influenza and acute respiratory viral infections in children / / Zdorov'ya Ukrainy. - 2004. - No. 21. - pp. 33–36.
5. Tkachenko S. K., Besh L. V. Garyachka at children. Suchasn_y vіbіr antipyreticheskikh zasobіv. - Lviv, 2001 .-- 36 p.
6. Khaitov RM, Nekrasov AV, Lytkina IN and others. Influence of vaccine prevention on the incidence of influenza and ARVI / / Vaccination. - 2001. - No. 5 (17). - S. 7.
ARVI - acute respiratory infections - cause viruses of various strains, which in most cases are introduced into the body by the respiratory route. Against the background of painful symptoms, bacterial infections quickly join viral diseases, the condition worsens, and complications appear.
The symptoms of these diseases are very similar:
With ARVI appear: rhinitis, tonsillitis, pharyngitis, rhinopharyngitis, laryngitis, laryngotracheitis and similar diseases.
Complications may occur: bronchitis, pneumonia, sinusitis ...
The severity of the course of a viral infection depends on the amount of pathogenic flora that has invaded the body, the strain, the immune status of the body, and chronic diseases history.
It is impossible to cure the disease in one day - it takes time. But even at home, without the use of specific drugs, you can speed up the healing process by correcting the daily regimen, nutrition and folk recipes.
ARVI - how to quickly cure
When the first unpleasant symptoms appear, you must immediately adjust the daily regimen. Changing the habitual way depends on your own feelings.
When there is no temperature, and the symptoms are limited to sore throat and nasal congestion, it is enough to reduce the load on the body, expand the drinking regimen and begin medical home procedures - inhalations, nasal rinsing, distracting warming and the like.
If the temperature has risen above subfebrile, then - regardless of other symptoms - bed rest is necessary. Quarantine conditions need to be created for the entire duration of the disease - this will not only help to cure it faster, but also protect others from infection.
The acute stage can last from a day - with strong immunity - up to 5 days. If the temperature does not drop during this time, then it is worth concluding that complications have appeared.
Healthy adults may well solve the problem of how to cure ARVI in 3 days:
A warm drink helps to quickly get rid of intoxication - to remove the waste products of pathogenic microorganisms from the body.
Children also need to drink more to stay hydrated. This condition is also dangerous for the child's body, as well as the activation of pathogenic flora. If the water-electrolyte balance is disturbed in children, the functioning of the central nervous system and cardiac activity is disrupted, which can cause respiratory failure and provoke death. For adults, dehydration is also dangerous, but to a lesser extent.
Rapid ARVI treatment
If the temperature is not high, you can do distracting warming up - steam your feet or hands in hot water with mustard, salt, soda, anti-inflammatory herbs and similar ingredients.
Absolute contraindications to the procedure:
- oncological processes;
- dermatitis, purulent-inflammatory process and damage to the skin on the feet;
- neoplasms of any nature of gynecological organs or prostate.
With symptoms of a respiratory nature - nasal congestion, dryness in the nasopharynx, pain and sore throat - rinse the nose and begin to gargle.
Nasal wash and nasopharyngeal rinse solutions can be purchased at the pharmacy or prepared at home.
"Pharmacy" facilities: "Aquamaris", "Aqualor", "Dolphin", solution of furacilin, potassium permanganate, "Chlorhexedin", "Miramistin", "Chlorfillipt"… The list of such funds is huge.
An equally wide range of home remedies - extracts of chamomile, oak bark, calendula, sage, eucalyptus, saline solution, soda solution and the like ...
The concentration of the compositions for rinsing and rinsing in children and adults should be different - for adults, the concentration doubles.
Inhalations are recommended at low temperatures. For them, decoctions of medicinal herbs, steam of a decoction of potatoes with a few drops of iodine, and a soda solution are used. You can fill a nebulizer with liquid solutions - if you have one, or breathe in steam under a sheet. The temperature of the liquid should not be higher than 50 ° C - otherwise you may get burned. If children are being treated, you will have to crawl under the sheet together - for safety reasons.
Aromatherapy helps to quickly get rid of ARVI.
Essential oils - conifers, eucalyptus, tea tree, citrus fruits - are used to fill aroma lamps or make cold inhalations. A cold inhaler is easy to make - 2 tablespoons are poured into a resealable container sea \u200b\u200bsalt and 6 drops of essential oils are dripped there. Aroma procedures purify the air in the room and relieve nasal congestion.
Another condition for a quick recovery is a special diet - food must be easily digestible. It is especially important to observe this condition when treating children - ARVI is often accompanied by intestinal disorders. If there is no appetite, you do not need to feed by force - intoxication will end, the patient will eat himself.
Antiviral drugs for ARVI
If antiviral drugs are taken when the first symptoms appear, then the course of the disease is facilitated and recovery is much faster.
For the treatment of acute respiratory infections, such antiviral agents are most often used.
- Interferon-based drugs are especially often used to stabilize the condition in children. For the treatment of ARVI are used: "Viferon", "Cyclroferon" and "Kipferon"... For ease of use in pediatric practice "Viferon" is available in the form of suppositories.
- "Remantadin"... This drug has already proven its effectiveness - it has been used to treat ARVI for over 70 years. It suppresses almost all strains of influenza and ARVI, including pandemic ones. There are many contraindications: childhood, dysfunction of the thyroid gland, kidneys and liver. Bitter taste in the mouth is considered a slight side effect when it is taken - the treatment does not need to be interrupted. In the case of intestinal disorders, tinnitus, disturbances of consciousness, the reception is stopped.
- "Amiksin"... This is another long-liver in the fight against ARVI. The price is low, the side effects are insignificant and reversible, it is combined with antibiotics of all types. With pandemic strains, it is powerless.
- "Arbidol"... It is used to treat children and adults, has a low price, and successfully fights against many strains of influenza, torch and adenovirus infections.
- Modern antiviral drugs - "Kagocel" and "Ingavirin"... They stimulate the production of natural interferon, increase immunity, and are relatively safe. Ingavirin produced specifically for the treatment of children.
"Adults" antiviral drugs are limited in age - from 7 years, are not used in special conditions - during pregnancy and lactation. Before taking this or that remedy to quickly eliminate the symptoms of ARVI, you must read the instructions.
Folk remedies for ARVI
At home, the following methods can be used to treat viral infections.
- decoction of milk with onions or garlic;
- tea with ginger and honey;
- herbal teas from dandelion, sedge, currant and raspberry leaves, a mixture of chicory and motherwort, linden blossom.
Teas are brewed according to one algorithm - a tablespoon of plant materials per glass of boiling water. Drink the glass hot throughout the day.
Another way quick treatment - loading dose of vitamin C - 10 g 3 times a day. With a history of erosive diseases of the stomach and intestines - even if they have not been aggravated for a long time - it is not used. In this case, you should limit yourself to a couple of oranges, 2 tablespoons of lemon juice, or half a grapefruit.
Neither medical nor medical equipment will help to cure the disease in 1 day. folk remedies - this should be taken into account. You should not force events and start working before the symptoms of SARS disappear. If complications arise, it will be much more difficult to get rid of them than from the disease itself.
The most common and painful topic for every person and for every family in the autumn-winter period is ARVI. During epidemic periods, 8-9 people out of 10 can get sick. Respiratory viral infections mean diseases of the upper respiratory tract caused by a group of viruses. There are about 250 types of viruses that can lead to the development of ARVI.
The primary factor in the development of the disease is hypothermia of the body and, as a result, a decrease in general immunity. Hypothermia of the lower extremities is of great importance.
Symptoms
In people of any age, viruses cause approximately the same symptoms, which are divided into general intoxication and local, largely due to the presence of "weak" spots in humans. Among the common ones, the following symptoms prevail:
Temperature rise
Enlargement of the cervical and other lymph nodes
Muscle pain, aches in the back, joints
Decreased performance, weakness
Local symptoms and signs of acute respiratory viral infections in adults, which must be treated, are swelling of the nasal mucosa, the appearance of nasal discharge, cough, sore throat, sore throat, sputum separation. Depending on the individual characteristics and nature of the viral infection in adults, symptoms of laryngitis, pharyngitis, rhinitis, tracheitis appear. But sometimes acute respiratory infections can acquire an atypical course, which often leads to a late start of treatment and the development of complications - pneumonia, bronchitis and others.
Drugs
Systemic therapy
Specific antivirals can be used to suppress viruses. medicines, drugs containing the immune protein interferon or interferon inducers - drugs that activate the production of their own human interferon.
Specific antiviral agents (Remantadin, Zanamivir) are quick to act. Medicines in this group are distinguished by a narrow spectrum of action, respectively, they can be used to combat a limited number of types of pathogens. This significantly limits the possibilities of drugs in the treatment of ARVI.
Interferon preparations (Grippferon, Viferon) affect a larger number of pathogens. Like specific antiviral agents, they begin to act almost immediately after use. Available in the form of injections, suppositories, drops.
Means that activate the synthesis of their own interferon (Cycloferon, Amiksin) do not act so quickly - on average, 6 hours after application.
There are drugs for ARVI that have a complex effect: on the one hand, they stimulate the synthesis of interferon, on the other hand, they affect the virus, causing its death. Often used for the treatment of ARVI in adults, the drug Arbidol, which has such properties.
Antibiotics for ARVI in adults are not prescribed, since they affect bacteria, while viruses are the causative agents of ARVI.
However, with the addition of a bacterial infection to a viral disease and the development of complications, the use of antibiotics becomes reasonable and expedient.
Flu
Again, in the case of this disease, medications should support the body's natural immune responses, and not powerful means that only deal with the manifestations of infection - cough, runny nose, headaches - but at the same time carry side effects. Therefore, in the general case, drugs for ARVI should be herbal and have three features at once
- Medicines should act gently and carefully, that is, affecting only the virus, without touching systems and organs not affected by the infection.
- Syrups, drops, pills for ARVI and flu simply must be effective, that is, have a composition that helps to defeat the disease - this is obvious.
- Medicines should simultaneously relieve unpleasant symptoms - from sore throat, runny nose, cough.
Antivirals for ARVI: how effective are they?
It should be noted right away that such medicines will not be an instant panacea for all ills. The appointment of antivirals is the treatment and prevention of ARVI, and for the first it is necessary that the second be carried out. Simply put, you need to protect yourself from infections by increasing your immunity, and not just rely on the fact that in which case it will be enough to swallow one pill and forget about the disease.
But if all those conditions for treatment, which were repeatedly mentioned above, are provided, high-quality antiviral drugs for ARVI, that is, with an already developed disease, can be very effective and play the role of helpers for the body. Especially if these medicines will have immunomodulatory and / or interferonogenic effects.
Such drugs for ARVI are convenient in that they activate the body's defenses. So, for example, they stimulate humoral and cellular immunity, increase the production of alpha, beta and gamma interferon. Using antiviral drugs it is possible to accelerate and simplify the treatment of acute respiratory viral infections in adults and children. They can be taken even at high temperatures (more than 38 degrees), but, again, creating all the conditions for its reduction.
Antibiotics for ARVI: can they be used?
As a rule, these drugs are used only when the body is oppressed by a bacterial infection, not a virus. Therefore, usually antibiotics for ARVI are not drunk, this must be remembered. Although they can be prescribed by a doctor, but only in exceptional cases. Again, doctors usually prescribe antibiotics for ARVI when a viral infection is complicated by a bacterial and the disease has developed into pneumonia or, for example, otitis media. Well, of course, you cannot take such potent medications on your own - you can drink them only as directed by a doctor.
ARI
Since respiratory diseases are most often accompanied by inflammation of the nasopharynx (nasal congestion or discharge, redness and sore throat when swallowing, etc.), then from the moment they appear, rinse the throat and rinse the nose.
The rinse solution can be prepared from:
decoction of chamomile;
Furacilin tablets;
salt.One of the most common gargles for sore throat is soda-salt solution. To prepare it, you need to dilute half a teaspoon of salt and soda in half a glass of warm water. You can add a few drops of iodine or tea tree oil.
As vasoconstrictor, to eliminate nasal congestion, you can use:
Naphtizin;
Xilen;
Sanorin and others.It should be noted that these drugs have a drying effect on the mucous membranes of the nose, so they need to be used no more than 7-10 days.
For the treatment of cough in adults, with acute respiratory infections, drugs should be prescribed by the attending physician. As a rule, centrally acting drugs are used to reduce cough:
Tusprex;
Codeine;
Sinekod and others.To achieve an expectorant and anti-inflammatory effect, peripheral drugs are prescribed:
ACC;
Lazolvan;
Bromhexine.As antiviral agent for the treatment of acute respiratory infections in adults are prescribed:
Grippferon;
Remantadine;
Arbidol;
Tamiflu.These drugs act directly on the virus, preventing its development and reproduction.
Most often, ARI proceeds without an increase in temperature, and the use of antipyretics is not required in treatment. But in the case of its increase, such means are recommended as:
Paracetamol;
Antigrippin;
Teraflu, etc.
Folk remedies
Many of us traditionally go to the pharmacy when we have colds. However, is it always justified to take inorganic chemistry drugs? There is a smarter, safer and cheaper option - medicinal plants.
With a cold, the mother-and-stepmother has 3 effects at once: relieves inflammation, fights microbes, and also makes you sweat. 3 tablespoons of dried flowers and leaves of mother-and-stepmother pour 0.5 liters of boiling water in a thermos, leave for half an hour. Drink the infusion warm one third of a glass 3 times a day.
Pour 1 glass of milk into an enamel pan, add 1 tbsp. a spoonful of well-chopped sage leaves. Simmer, covered, for a few minutes, then strain. Remove the leaves and boil the milk again. Take at night before bed. This broth will be useful for coughs and bronchitis.
For colds, especially if there is heat, you need to take as much vitamin C as possible. Therefore, drink freshly squeezed orange juice.
Tincture of orange peels: pour one part of orange peel with one part of alcohol, close well and leave to infuse in a dark place. After seven days, strain, squeeze all the liquid from the crusts into a tincture, discard the cake. Strain again. Apply 15-20 drops diluted in water.
Pour 200 g of boiling water over the herb and flowers of the yarrow (1 tbsp. L.), Cook under a lid in a boiling water bath for 15-20 minutes. Remove from heat and leave to cool for 45 minutes, then strain. Drink a tablespoon every hour. This remedy can also be used as a rinse, along with ingestion.
For viral diseases, essential oils can be used. Microorganisms are unable to adapt to their action, which makes them vulnerable to natural drugs, especially essential oils. Recipe: take orally with 1 teaspoon of honey, 3 drops of one of the essential oils: lavender, lemon, pine, or mint, 3 times a day half an hour before meals for 7-10 days (after checking the body's allergic reaction to essential oils) ...
Garlic juice is a useful remedy for colds or flu. Every 2-3 hours, instill one drop in each nostril.
At the first symptoms of a cold or flu, take a hot shower, thoroughly warming up your face, neck, and chest. For those who have a healthy heart and blood vessels, a shower can be replaced by taking a hot fifteen-minute bath. Then you need to wipe yourself dry and go to bed, dressed warmly and covered with a blanket. Be sure to change your underwear after 2 hours. Take a shower (bath) every day of illness. In addition, the patient should be given hot tea with lemon or raspberries.
Grate a head of garlic and 2 cleanly washed lemons, after pouring boiling water over the lemons. Add 200 g softened butter (you can beat with a mixer). Stir. Spread this healthy mass on a slice of bread as often as possible. You can eat this sandwich with hot herbal tea.
Pour 3 chopped garlic cloves with one glass of hot milk and leave to infuse, covered with a towel. Strain after 10-15 minutes. Sip the drink slowly. It is advisable to drink 3-4 glasses during the day. This infusion is effective remedy with flu, colds, pneumonia.
At home
Cough
The most common cough with ARVI requires close attention, as it can be a sign of a more serious and dangerous illness, such as bronchitis and pneumonia.
In order to treat cough with ARVI, expectorant and antitussive drugs should be taken, however, in no case antibiotics. Unfortunately, by how intense the cough is, it is impossible to immediately determine the severity of the disease and correctly diagnose. Sometimes coughing, which scares all households and neighbors behind the wall, is just the body's reaction to the parainfluenza virus in the most common ARVI.
After making the correct diagnosis for the treatment of ARVI, you can use folk remedies taken in consultation with your doctor. It is necessary to consult with him, since although these methods are based on the use of natural drugs, it is necessary to prevent the onset of certain problems, such as allergies.
For the treatment of dry cough with ARVI, such well-known folk remedies as herbs are well suited: coltsfoot, licorice root, oregano, sage, thermopsis herb, chamomile.
In the event that a wet cough occurs, it should be borne in mind that, compared to a dry cough, it is more optimistic, since in this case the body is able to resist the disease on its own, which does not mean, however, that the disease should not be fought. True, when it comes to treatment wet cough the child must have it under the supervision of a pediatrician in order to avoid all kinds of problems.
Most often, for the treatment of wet cough with ARVI, it is recommended to use infusions based on plantain and cabbage, as well as compresses made from cabbage with honey, cottage cheese and onions.
Antibiotics
When it is possible to use antibiotics for uncomplicated acute respiratory infections
With pronounced signs of reduced immunity - constant low-grade fever, more than 5 r / year for colds and viral diseases, chronic fungal and inflammatory diseases, HIV, any cancer or congenital immunity disorders
In a child under 6 months old - rickets in infants (symptoms, treatment), various malformations, with lack of weight
Against the background of certain blood diseases (agranulocytosis, aplastic anemia).
The indications for the appointment of antibiotics are
Bacterial sore throat (with the simultaneous exclusion of diphtheria by taking swabs from the throat and nose) requires treatment with penicillins or macrolides.
Purulent lymphadenitis requires broad-spectrum antibiotics, consultation with a surgeon, sometimes a hematologist.
Laryngotracheitis or acute bronchitis or exacerbation chronic bronchitis or bronchiectasis will require macrolides (Macropen), in some cases an X-ray chest to exclude pneumonia.
Acute otitis media - the choice between macrolides and cephalosporins is made by an ENT doctor after an otoscopy.
Pneumonia (see the first signs of pneumonia, treatment of pneumonia in a child) - treatment with semisynthetic penicillins after X-ray confirmation of the diagnosis with mandatory monitoring of the drug's effectiveness and X-ray control.
Inflammation of the paranasal sinuses (sinusitis, sinusitis, ethmoiditis) - the diagnosis is established using X-ray examination and characteristic clinical signs. Treatment is carried out by an otolaryngologist (see signs of sinusitis in adults).
Here is an example of a study carried out on the basis of data from one children's polyclinic, when analyzing data from the medical history and outpatient cards of 420 children 1-3 years old. In 89% of cases, ARVI and ARI were recorded in children, acute bronchitis in 16%, otitis media in 3%, and only 1% pneumonia and other infections.
And in 80% of cases, only with inflammation of the upper respiratory tract in acute respiratory disease and ARVI were prescribed antibiotics, for pneumonia and bronchitis in 100% of cases. Most doctors in theory know about the inadmissibility of using antibacterial agents for a cold or viral infection, but for a number of reasons:
administrative settings
early age children
preventive measures to reduce complications
unwillingness to go to assetsthey are nevertheless prescribed, sometimes in short 5-day courses and with a dose reduction, which is highly undesirable. Also, the spectrum of pathogens of acute respiratory infections in children was not considered. In 85-90% of cases, these are viruses, and among bacterial agents, it is pneumococcus in 40%, Haemophilus influenzae in 15%, fungi and staphylococcus in 10%, less often atypical pathogens - chlamydia and mycoplasma.
With the development of complications against the background of the virus, only according to the doctor's prescription, according to the severity of the disease, age, patient's history, the following antibiotics are prescribed:
Penicillin series - in the absence of allergic reactions to penicillins, it is possible to use semi-synthetic penicillins (Flemoxin solutab, Amoxicillin). In case of severe resistant infections among penicillin drugs, doctors prefer "protected penicillins" (amoxicillin + clavulanic acid), Amoxiclav, Ekoklav, Augmentin, Flemoklav Solutab. These are first-line drugs for sore throats.
Cephalosporin series - Cefixim (Suprax, Pantsef, Ixim Lupine), Cefuroxime axetil (Zinacef, Super, Aksetin, Zinnat), etc.
Macrolides - usually prescribed for chlamydial, mycoplasma pneumonia or infections of the ENT organs - Azithromycin (Sumamed, Zetamax, Zitrolide, Hemomycin, Zi-factor, Azitrox), Macropen is the drug of choice for bronchitis.
Fluoroquinolones - are prescribed in cases of intolerance to other antibiotics, as well as in case of bacterial resistance to penicillin drugs - Levofloxacin (Tavanik, Floracid, Haileflox, Glevo, Fleksid), Moxifloxacin (Avelox, Plevilox, Moximak). Fluoroquinolones are completely prohibited for use in children, since the skeleton has not yet been formed, and also because these are "reserve" drugs that can be useful to a person when he grows up in the treatment of drug-resistant infections.
In general, the problem of choosing an antibiotic for today is a task for a doctor, which he must solve in such a way as to help the patient as much as possible in the present and not harm in the future. The problem is compounded by the fact that pharmaceutical companies, in pursuit of today's profits, absolutely do not take into account the seriousness of the increasing resistance of pathogens to antibiotics and throw out those antibacterial novelties that could be in reserve for the time being into a wide network.