The problem of choice: original drug or generic? Emphasis on rosuvastatin

An increase in the life expectancy of the population and the number of polymorbid patients with a combination of two or more diseases in different age categories, including among young people, has led to a significant increase in the cost of medical care in the field of public health. The transition from original drugs to generic ones has become a common measure to contain these costs. While this is an important goal for healthcare systems around the world, the impact of this practice on patient outcomes needs to be carefully considered. In some cases, generics may represent a suitable alternative to branded products, but this is not always the case. In particular, studies have shown that changing the drug can negatively affect not only patients' adherence to treatment, but also clinical outcomes, and a subsequent increase in the total cost of treatment, therefore, the use of generics in clinical practice still causes caution and concerns on the part of both the doctor and the patient. Due to the high prevalence of dyslipidemia and hypercholesterolemia both worldwide and in Russia, in this review the problem of choosing an original drug or generic is described by the example of such a hypolipidemic agent as rosuvastatin. According to numerous studies, rosuvastatin is one of the most potent and widely prescribed statins. Considering that most of the clinically significant effects of this drug are demonstrated in relation to its original form, the review emphasizes the importance of prescribing the original drug rosuvastatin in routine clinical practice

Drug-induced intracerebral hemorrhage

Intracerebral hemorrhage (ICH), which is a form of hemorrhagic stroke, is an extremely serious disease. This pathology is characterized by very high levels of disability and mortality. Despite the improvement in the treatment of those diseases that can lead to ICH, its frequency is currently increasing, which is largely due to the use of drugs, in which case the term «drug-induced intracerebral hemorrhage» (DI ICH) is used. One of the main reasons for drug-induced ICH is an increase in the frequency of prescribing anticoagulant therapy for the prevention of ischemic stroke in atrial fibrillation, as well as dual antithrombotic therapy. In addition to anticoagulants, thrombolytic drugs can lead to the development of this pathology. According to the literature, an increase in the risk of developing ICH is also associated with therapy with antidepressants from the group of selective serotonin reuptake inhibitors, as well as high doses of statins. Risk factors for this adverse reaction are age, smoking, hypertension, and thrombocytopenia. Treatment of DI ICH is an extremely difficult task and includes the withdrawal of the culprit medication, antihypertensive therapy, correction of intracranial hypertension, and, in some cases, the administration of antidotes. The main method of prevention is the use of antiplatelet drugs and other drugs, the use of which is associated with an increased risk of developing DI ICH, in strict accordance with modern protocols and recommendations

Heart failure as a risk factor of adverse drug reactions. Part 2: potential changes in pharmacokinetics of some drugs

Drug administration, can be potentially associated with adverse drug reactions (ARDs), including serious ones, contributing to an increase in the risk of death or the development of conditions that potentially increase mortality and / or morbidity and / or become the cause of clinical manifestations, requiring the patient to seek medical attention or hospitalization - so called drug-induced diseases (DID). Some pathological conditions, like chronic heart failure (CHF), are potential risk factors for DID due to changes in the pharmacokinetics and pharmacodynamics of drugs. For example, after oral administration of fosinopril, the average T1/2 value in patients with CHF II - III NYHA functional class was 14.2 (±7.3) hours, and in healthy individuals of the control group - 11.0 (±5.2) hours. Values of AUC per os and Cmax were also slightly higher in patients with heart failure (HF) than in healthy individuals, and Cl per os, on the contrary, were lower. After intravenous administration of fosinopril, similar results were observed. Another example is the altered absorption of furosemide in patients with decompensated heart failure. Thus, in patients with heart failure, as the edema syndrome is corrected, the time to the onset of the maximum drug concentration in the blood serum (Tmax ) decreases by 27 % and Cmax increases by 29 %, which may indicate a decrease in the slowdown in the absorption rate (by 57 %). Since furosemide is mainly excreted in the urine unchanged, the observed changes in Cmax and Tmax could be associated with delayed gastric emptying, decreased intestinal motility, or edema of the intestinal wall. Individual selection of the dose and dosing regimen, taking into account the characteristics of the pharmacokinetics of drugs in patients with CHF, will help improve the quality of life and prevent potential ADR

Semantic adaptation of French scientific and technical terminological borrowings in Russian language

In the light of foreign language vocabulary use increase in Russian language at the end of XX-th - the beginning of XXI-st century due to the intensification of business, scientific and cultural ties between the countries the study of foreign language terminology borrowing becomes increasingly important. Usually, a borrowed term retains the meaning of a term prototype in an accepting language or is exposed to terminologization, transterminologization or terminological derivation. These mechanisms are closely related to the general processes of borrowing semantic transformation, such as narrowing or widening of a prototype word semantic scope. This article demonstrates the analysis of the semantic transformations concerning the borrowed scientific and technical terms of French origin, included in Russian language during the XIX-XX-th centuries. The study is carried out within the basic methods of linguistic analysis such as descriptive methods, comparative method and component analysis. During the analysis of the test body concerning the borrowed scientific and technical terms of French origin (228 units) it was found that in the course of borrowing term semantics formation in the system of an accepting language the preservation of a prototype term meaning (30% of terms) takes place as a rule, often exposing its meaning to specification or terminologization (20% of terms). The rest of borrowed terms are subjected to the semantic scope expansion on the basis of secondary borrowing mechanisms or the development of new meanings on the basis of Russian language. This allows to use them in other fields of terminology and leads to the appearance of cross-field homonyms. Thus, the transformation of a borrowed term semantics includes it in term formation processes and in Russian language system in general. The analysis of the semantic adaptation stage concerning scientific and technical terms is of particular importance in terms of their lexicographical description and it also allows to identify national and international element in Russian language within the light of scientific terminology increasing internationalization

Food-drug interaction as a risk factor of drug-induced diseases: epidemiology, risk factors, potential mechanisms of interaction

Any drug is potentially associated with the risk of adverse drug reactions (ADRs), the incidence of which in developed and developing countries is estimated at 6.3 (3.3—11.0) and 5.5 % (1.1—16.9), respectively. Many ADRs increase mortality and / or morbidity and / or cause clinical manifestations that require a patient to seek medical help or hospitalization; a special term has been introduced — drug-induced diseases. Food can interact with drugs and increase the risk of ADRs, including serious ones. The simultaneous intake of food and drugs can affect the bioavailability, pharmacokinetics, pharmacodynamics and therapeutic efficacy of drugs due to changes in drug absorption and metabolism. A striking example of the effect of food on the pharmacokinetic profile of drugs is the change in the bioavailability of the tyrosine kinase inhibitor lapatinib: compared with taking on an empty stomach, the bioavailability of lapatinib in a single dose of 1 500 mg after taking it together with high-calorie standard food increases by an average of 325 % — 4.25 times. In other words, the concentration of the drug in the blood serum after taking one tablet at the same time with food is comparable to taking 4 tablets on an empty stomach. Currently, there are no recommendations for choosing a dosage regimen for drugs depending on the qualitative and quantitative composition of food, as well as taking into account potential interactions with food components, although these recommendations are extremely necessary for patients and healthcare professionals. In this regard, this article summarizes the data available at the time of writing in open sources concerning the effect of food on the absorption and metabolism of drugs, and also describes the possible mechanisms of interaction

The didactic aspect of foreign language creative teaching

© Journal of Language and Literature. This article considers the problem of foreign language creative teaching; its actualization and necessity of its introduction reflect the dynamic nature of modern society development, which requires the formation of the creative personality and the search of real mechanisms for providing creative education. In the process of experimental work the legitimate use of new creative educational technologies, innovative forms and methods of teaching, that contribute to the formation of creative language personality, possessing the high level communicative competence, has been proved

Heart failure as a risk factor of adverse drug reactions. Part 1: potential changes in pharmacokinetics

The use of many drugs is associated with the risk of adverse drug reactions (ADRs), including those that increase mortality and / or morbidity and / or seek medical help or hospitalization, so called «drug-induced diseases» (DID). There is a number of factors that increase the risk of DID (risk factors) including comorbid diseases (for example, chronic kidney disease, hepatic impairment, obesity etc.). These pathologic conditions induce changes in pharmacokinetics (PK) and pharmacodynamics of drugs, thereby increasing the risk of ADRs. One of these diseases is heart failure (HF). Most studies of PK changes were conducted among patients with LVEF from 40 to 45 %, and excluded patients with concomitant diseases that could affect the PK of drugs (for example, serious liver and / or kidney diseases), therefore in polymorbid patients, trial findings may not be applicable. HF may be associated with a decrease in bioavailability, a decrease in volume of distribution, a change in the activity of cytochrome P450 isoenzymes, etc. Individual dose and dosage regimen adjustment can significantly reduce risks, improve the quality of medical care and improve the prognosis in patients with heart failure

Teaching French as a foreign language in the multilingual environment (the example of Tatarstan Republic)

© Medwell Journals, 2016.The study is devoted to defining methodological approaches to the formation of students' Foreign language communicative competence in multilingual environment. This research is of current interest due to the worldwide tendency towards integration in the economic, cultural and political spheres and due to the need to develop multilingual personality. The modernization of Russian society, including education, defines the overall learning concept and methodology and sets the scientists the task of developing the particular methodological issues of teaching certain disciplines in order to create the most effective strategies and methods of teaching. We consider this issue using the example of French teaching in Tatarstan Republic, one of the regions of the Russian Federation where the language situation is represented by two state languages, Russian and Tatar. In our opinion, an urgent need to develop new methodological teaching approaches and to write textbooks and teaching aids on their basis is due to the need to use a positive transference of language and speech skills of native tongues while learning other languages for effective students' communicative competence formation

Prospects for using a perindopril/amlodipine combination in patients with hypertension and/or coronary artery disease and COVID-19: focus on the endothelium

The outbreak of the coronavirus disease 2019 (COVID-19) pandemic is an ongoing public health emergency that has caused unprecedented morbidity and mortality. COVID-19 is a disease caused by severe acute respiratory syndromerelated coronavirus 2 (SARS-CoV-2), which affects not only the lungs but also the cardiovascular system. A strong theoretical justification for the multisystem effect of COVID-19 is the close relationship between it and endothelial dysfunction, which, according to expert consensus, is crucial for the pathogenesis and severity of the disease. Endothelial dysfunction is considered as the main pathophysiological process in the severe and/or prolonged course of COVID-19, and is probably the common denominator of many clinical aspects of severe COVID-19. This review presents scientific data on the effect of perindopril and amlodipine in patients with hypertension and/or coronary heart disease and COVID-19 on endothelial function

Drug-induced liver damage with cholestasis

The liver is the main organ responsible for the biotransformation and elimination of drugs, and therefore its function is often impaired by different medications. In this article, the authors inform practical health care professionals about the possible liver damage with cholestasis caused by drugs (DILI). Most often, DILI is caused some antibacterial drugs, steroids, barbiturates and some other drugs. DILI has no pathognomonic clinical manifestations. tte scientific literature describes both an asymptomatic increase of “liver” enzymes and the development of acute liver failure. Important diagnostic methods are the collection of anamnesis (especially the medicinal one), analysis of blood biochemical tests, and data from visual diagnostic methods. If the patient has DILI, it is necessary, whenever possible, to stop intake of a drug. ttere are no specific drugs recommended for pharmacotherapy of DILI but there is some the positive effect of ademetionine and ursodeoxycholic acid. ttere are no specific preventive measures for DILI. Healthcare practitioners are recommended not to use drugs off-label, optimize pharmacotherapy and fight with polypharmacy, monitore biochemical tests regularly etc