Abstract
Difficulty selecting drug therapy for patients with intercurrent diseases is demonstrated, selection of drugs exerting the narrowest spectrum of undesirable effects in cases of compulsory polypharmacy is substantiated. In the cohort of patients with chronic cystitis there are patients with overactive bladder (OAB) occurring under the guise of cystitis and female patients with comorbid OAB and cystitis. Obviously, standard therapy for cystitis does not ensure restoration of normal urination in such patients. Thus, restoration of normal urination in patients with OAB can be considered as the cystitis prevention and treatment method and vice versa. When treating multimorbid and elderly patients with OAB, trospium chloride is the drug of choice, since it has a number of unique chemical and pharmacokinetic properties: trospium chloride is a positively charged quaternary ammonium compound, which does not allow it to cross the BBB; trospium chloride is not metabolized by the cytochrome P450 system, which significantly reduces the possibility of drug interaction; trospium chloride is excreted unchanged in urine as an active parent compound, ensuring extra local activity to achieve rapid and prolonged effect. Chronic prostatitis is another common disease in outpatient urology practice. The term “chronic prostatitis” (CP), like the term “chronic pelvic pain syndrome” includes a number of various symptomatic models, and many aspects of CP still remain a mystery. The association of oxidative stress with inflammation and inflammatory responses is beyond doubt. It has been proven that inflammatory macrophages release the glutathionylated peroxiredoxin-2 that later acts as a “danger signal”, triggering production of tumor necrosis factor alpha. It is emphasized that damage to DNA resulting primarily from oxidative stress is the main cause of sperm dysfunction. However, oxidative stress is caused by modifiable factors, and the use of simple measures, such as taking the antioxidant complex supplement, can reduce its severity. The following substances have antioxidant properties: vitamins А, Е, and С; minerals zinc, copper and selenium; glutathione, carnitine, N-acetylcysteine, coenzyme Q10, carnosine, L-arginine, lycopene, resveratrol, myo-inositol, folic acid, α-lipoic acid, pentoxifylline, quercetin, etc. We recommend to pay attention to the Selzinc® Plus antioxidant vitamin mineral complex containing both non-enzymatic low molecular weight antioxidants (α-tocopherol (47 mg), β-carotene (4.8 mg), ascorbic acid (180 mg)) and minerals (zinc (7.2 mg) and selenium (50 µg)).
Keywords: cystitis, lower urinary tract infections, overactive bladder, chronic cystitis, m-anticholinergics, trospium chloride, spasmex, antioxidants, selzinc.
Keywords: cystitis, lower urinary tract infections, overactive bladder, chronic cystitis, m-anticholinergics, trospium chloride, spasmex, antioxidants, selzinc.
For citation:Kulchavenya E.V. How to treat not causing harm? Clinical review for general practice. 2024; 5 (10): 107–112 (In Russ.). DOI: 10.47407/kr2024.5.10.00503
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