Cytoflavin interaction with alcohol. Cytoflavin and alcohol – you can combine them, but is it necessary? Succinic acid as an independent medicine

The compatibility of Cytoflavin and alcohol can cause serious disturbances in the form of memory impairment, degradation, disorders gastrointestinal tract, problems with the nervous system and heart.

Moreover, the drug is effectively used in the treatment of chronic alcohol addiction.

Find the answer

Compatibility of Cytoflavin and alcohol

The active substances of the medicine stimulate metabolic processes in the brain. This occurs due to the saturation of cellular structures with energy glucose. Cytoflavin is prescribed for impaired blood circulation in the gray matter and oxygen starvation, which in itself is dangerous for humans.

If you take the pills with an alcoholic drink, which negatively affects the condition of the nerve cells, the situation will worsen many times over.

At best, the product will lose its effectiveness, since ethanol completely neutralizes the effect of the components of the medication. In addition, the likelihood of adverse reactions increases significantly - from nausea with vomiting to epileptic seizures and stroke. Therefore, you should not drink alcohol during the course.

Brief description

Cytoflavin is used for brain pathologies associated with impaired blood circulation. The drug consists of succinic acid and vitamins, which is why it has metabolic, antioxidant and antihypoxic effects. The tablets also increase the body’s adaptive properties to stress during ischemia and oxygen starvation.

After consumption, the cellular structures are better saturated with nutrients, the functioning of the central nervous system, blood vessels of the heart and brain improves.

All this helps to normalize general well-being after fainting, stroke, or mechanical damage to the head.

Cytoflavin is produced in the form of tablets and solution for injection.

The first type of remedy is used to treat the following diseases:

• astheno-neurotic syndrome – lethargy, decreased level of intelligence, fatigue;
• complications after a stroke or acute deterioration of cerebral circulation;
• cerebrovascular pathologies associated with cerebral vascular diseases.

Liquid medicine for intravenous administration is used for ischemic stroke, various disorders of blood circulation in the gray matter, endotoxemia, oxygen starvation after surgery, as well as to improve the condition after anesthesia.

Use for addiction

Cytoflavin is often used to treat chronic alcoholism. The drug improves the general condition of the patient, metabolism in the brain, and eliminates signs of intoxication. With the help of these tablets you can get rid of your addiction to alcoholic drinks.

The therapy eliminates hand tremors, restores blood pressure, and migraines. At the initial stage, treatment is aimed at normalizing the water balance, since ethyl alcohol has a dehydrating effect. After this, medications are used to eliminate symptoms and restore metabolism.

Cytoflavin has a beneficial effect on brain activity in patients with alcoholism. However, therapeutic procedures must be carried out only under the supervision of the attending physician.

Use during withdrawal

A hangover is a state of acute intoxication of the body with the breakdown products of alcohol. The process occurs in people with chronic addiction when ethanol actively participates in metabolic processes. If such metabolism is prevented, a craving for drinking the drink appears.

Often, hangover syndrome is relieved with small doses of ethanol, which restore blood pressure, relieve tremors, headaches and other manifestations of intoxication. However, it is impossible long time expose the body to chronic poisoning.

With free syndrome, a large amount of fluid helps (therapeutic mineral water) or brine, while in severe cases medical attention is required.

In the hospital, droppers with special medicinal substances are used that improve well-being and restore electrolyte balance. To normalize metabolic processes in cellular structures Cytoflavin is prescribed.

Complications from combination

First of all, the entire therapeutic effect of the tablets is neutralized if they are combined with alcohol.

The following consequences are still developing:

1. Mental degradation.
2. Memory impairment.
3. Disorders of the digestive system in the form of nausea with vomiting, pain in the upper abdominal cavity.
4. Negative changes in the central nervous system– headaches, increased excitability, irritability, panic attacks, depression.
5. Problems with myocardial activity - tachycardia, pain in the chest, enlargement blood pressure.
6. Redness or paleness of the skin.
7. Hypoglycemia, gout.
8. Acute renal failure, pathologies of the urinary system.
9. Rashes, hyperemia, itching, swelling, anaphylactic shock.

In severe cases, the patient is affected by a stroke, which often leads to death.

When can you take the substance?

The combined use of Cytoflavin with ethanol is extremely dangerous for humans, so you need to wait a certain period after drinking the drinks before taking the tablets.

For men, this period is 24 hours, while women will have to wait at least 32 hours. This will completely clear the blood of acetaldehyde and prevent the development of dangerous complications.

When can you drink?

It is best to completely avoid alcohol during the course. Banning ethanol will improve the effectiveness of therapy and protect against negative impact toxic substances.

14 (men) and 20 (women) hours before taking the medicine, you are allowed to consume no more than 50 g of high-quality alcohol. After completing the course, a two-week break is needed, otherwise the result of the treatment will be insignificant.

Cytoflavin and beer

The drug stimulates metabolic processes in the brain. At correct execution clinical recommendations, the required treatment effect is achieved. Effective in the treatment of pathologies with impaired blood supply to the brain.

Beer and other alcoholic beverages are prohibited during the entire course of therapy.

The following complications are observed:

• personal degradation;
• memory loss;
• headaches;
• nausea;
• vomit;
• change in skin tone;
• depression;
• panic attacks;
• tachycardia;
• pain in the heart area;
• allergic reactions;
• acute renal failure.

Organs affected by the toxin

The combined use of pharmacological agents and alcohol has toxic effect on the internal organs and environments of the body. Alcohol, entering chemical reaction with medicine, leads to poisoning, disrupts physiological processes, enhances or weakens the medicinal properties of drugs.

The liver suffers more than other organs. She gets hit twice. Many medications have a side effect - hepatotoxicity, destroy cells, and disrupt the physiology of the organ. In the liver, alcohol breaks down to ethanal, a substance 20-30 times more toxic than ethanol, which causes the death of hepatocytes.

Dangerous groups of drugs for the organ in combination with alcohol:

• anti-inflammatory;
• hormonal;
• antibacterial;
• antifungal;
• glucose control agents for diabetes mellitus;
• anti-tuberculosis;
• cytostatics (chemotherapy drugs);
• tranquilizers (anti-epileptic, psychotropic).

In second place among internal organs those exposed to the harmful effects of alcohol together with medications ─ heart and vascular system. Strong drinks during drug therapy constrict blood vessels and increase blood pressure. Simultaneous intake of alcohol and chemicals leads to failure of the myocardium, increases the risk of developing an attack of angina pectoris, heart attack.

A mixture of ethanol and pharmaceuticals disrupts the quality of the blood and reduces clotting. This is dangerous due to the occurrence internal bleeding, strokes.

State of the nervous system under the influence of alcohol and drugs

No less negative influence The autonomic nervous system, which is responsible for the coordinated functionality of all internal organs, is affected. Under the influence of toxic substances, a chain reaction occurs, which is manifested by a disorder of the gastrointestinal tract (stomach, pancreas, small intestine), kidneys, and endocrine glands.

Rules for taking medications and alcohol

The intake of alcoholic beverages during treatment is minimized clinical effect from therapy and creates a risk of developing complications of the disease.

If this cannot be avoided, follow the rules of behavior that will reduce the occurrence of negative consequences:

1. Do not drink strong drinks (vodka, cognac, whiskey), choose dry wine (100-150 ml), beer (no more than 300 ml). Don't drink alcohol on an empty stomach.
2. The interval between taking the medicine and alcohol should be at least 2 hours.
3. To reduce the toxic effect, take medications that protect the liver (hepatoprotectors), pancreas (pancreatin), and stomach (antacids ─ Rennie, Almagel).

If a person accepts antivirals for colds, anti-inflammatory, alcohol in moderation does not pose a threat to the body.

Alcoholic drinks during treatment are strictly contraindicated in cases of liver cirrhosis, severe infectious diseases, and during a course of chemotherapy.

Medicines, alcohol and chronic diseases

If a person has chronic diseases, the simultaneous use of alcohol and medications is potentially dangerous for the functioning of vital organs. Since patients systematically take prescribed medications, the influence of alcohol can lead to negative consequences.

People with chronic heart disease (angina pectoris, heart defects) develop arrhythmias to varying degrees gravity. Heart attacks with severe pain syndrome develop, which is not relieved by Nitroglycerin, and the risk of developing myocardial infarction increases significantly.

In case of chronic liver diseases (viral hepatitis, hepatosis), alcohol during treatment can become a trigger in the development of cirrhosis and hepatocellular carcinoma (cancer).

Drinking alcohol during cirrhosis leads to the following consequences:

• bleeding into the abdominal cavity;
• liver decomposition, infection, peritonitis;
• hepatic coma;
• lethal outcome.

If a person is on long-term treatment with sedatives, psychotropic drugs, tranquilizers, he is contraindicated in drinking alcohol. This leads to severe depression and the appearance of obsessive states (hallucinations, phobias). Suicidal feelings develop. Such a patient needs constant monitoring and assistance from a psychiatrist.

The most dangerous combinations and consequences

The combination of alcohol and drugs chemical basis can lead to serious disorders in the body, and in some cases to fatal consequences.

List of medications and their side effects in combination with alcohol:

Some patients ask whether it is possible to combine alcohol intake with a course of treatment with cytoflavin. At the same time, everyone is well aware that alcohol kills brain cells, while cytoflavin is a neuroprotector - a drug that protects brain cells from any toxic effects.

Is it worth combining Cytoflavin with alcohol?

Cytoflavin is a combination drug that contains succinic acid, riboxin and two vitamins - nicotinamide (vitamin PP) and riboflavin (vitamin B2). Cytoflavin is an excellent neuroprotector and protects nerve cells(neurons) from exposure to toxic substances (for example, free radicals), as well as from a lack of oxygen, without which neurons die. Chronic lack of oxygen can lead to slow death (degradation) of cells, and acute sudden lack of oxygen can lead to their necrosis. If there are a lot of such cells, then they talk about a focus of necrosis or an ischemic stroke.

The substances that make up cytoflavin improve metabolism in brain cells, they begin to actively receive energy from , build intracellular proteins, as a result of which the cell “comes to life” and begins to function at full capacity, without spending a lot of oxygen for its needs.

Alcohol is a poison for brain cells; under its influence, neurons gradually degrade and die. What can be seen in patients with chronic alcoholism: they gradually lose their memory, learning ability, professional skills and moral qualities.

If you drink alcohol while being treated with cytoflavin, then there will be no benefit from such treatment, because “all the forces” of cytoflavin will be spent on neutralizing the toxic effect of alcohol on brain cells (by the way, the effect of intoxication will be reduced). But the main problem, for which Cytoflavin was prescribed, will remain unresolved.

Cytoflavin is usually prescribed after traumatic brain injuries, strokes and other serious problems. So maybe, given the negative effects of alcohol on the brain, it is worth refraining from taking it not only during the course of treatment, but also later, when it ends?

Cytoflavin in the treatment of patients with chronic alcoholism

In chronic alcoholism, cytoflavin is prescribed both to bring patients out of a state of withdrawal and in a state of remission, to improve metabolism in brain cells.

Withdrawal or hangover - this condition occurs only in a patient with chronic alcoholism, that is, in the case when a dependence on alcohol has already formed. In this case, alcohol “becomes a full-fledged participant in metabolism” and when separated from it, the body “expresses protest” and demands that alcohol be supplied immediately.

Everyone knows that as soon as the patient drinks a little alcohol, his blood pressure is restored and goes away. headache, hand trembling and others unpleasant symptoms. Even the beginning of delirium tremens can be relieved with alcohol. But the body cannot withstand chronic poisoning for long, and sooner or later the patients themselves understand that they need to stop drinking alcohol. If withdrawal syndrome (AS) is mild, then patients come out of binge drinking on their own (for example, with the help of brine and drinking plenty of fluids). But with severe AS, the patient requires emergency medical care.

First of all, such a patient is given intravenous drips of liquid, since alcohol is a diuretic and dehydrates the body. In addition, various medicines to relieve certain symptoms of AS, as well as drugs that restore metabolism .

Since metabolism suffers most in neurons, special drugs are used that have a positive effect on these cells. Such drugs include cytoflavin. It has antihypoxic (reduces the oxygen demand of neurons) and antioxidant effects (reduces the formation of free radicals and activates enzymes that decompose free radicals), having a positive effect on the processes of energy production in the cell and intracellular protein synthesis.

When treating AS, cytoflavin is usually administered intravenously and it helps to quickly remove the patient from the state of withdrawal.

Cytoflavin is also used in the treatment of patients with chronic alcoholism in remission. Most patients with chronic alcoholism have a concomitant disease such as alcoholic encephalopathy, in which all basic functions of the brain are disrupted. To treat and prevent these disorders, patients are prescribed courses of treatment with cytoflavin. In this case, the drug is often prescribed in tablet form.

If you combine cytoflavin and alcohol, then nothing terrible will happen, of course, but the treatment will also go down the drain.

Galina Romanenko

Among drugs for improving cerebral circulation, Cytoflavin stands out as highly effective. It is also recommended for spinal pathologies - the list of indications is very long.

Cytoflavin - description, action

The drug Cytoflavin- a metabolic agent, a popular medicine among neurologists' prescriptions. Cytoflavin is available in the form of a solution in ampoules for intravenous use, as well as in the form of tablets for oral administration. Packaging cost 50 tablets - 500 rubles, price for 5 ampoules of 10 ml - 650 rubles.

The main composition of the medicine is as follows:

1. Succinic acid. Antihypoxic agent, increases the concentration of gamma-aminobutyric acid in the brain.
2. Nicotinamide. Protects brain tissue (neuroprotector), antihypoxant.
3. . Precursor to ATP.
4. . Regulator of protein and fat metabolism.

Additional ingredients of the solution are sodium hydroxide, water, meglumine; in tablets, the composition is supplemented by polymers, ethyl acrylate, povidone, calcium stearate and a number of other substances.

The drug is used to treat various diseases of the nervous system and blood vessels, since it penetrates natural protective barriers better than many drugs and begins to act very quickly.

Cytoflavin has the following effects on the patient's body when administered intravenously:

When used as a course of treatment, the medicine helps reduce the severity of asthenia, muscle pain, pain in the spine, dizziness, reduces anxiety, depression, improves memory, and other cognitive functions.

Indications for use

The drug helps reduce ischemia and stop the spread of the necrosis zone. Therefore, the main indications for the use of Cytoflavin relate to various types of cerebrovascular accidents:

The medicine restores a person’s normal neurological status and helps reduce the level of disability in the early period after a stroke. The medicine Cytoflavin is also prescribed to participate in the complex therapy of neuroinfections - meningitis, tick-borne encephalitis. In toxic encephalopathy, the drug reduces the incidence of cerebral edema.

The drug can be used after anesthesia - it has a quick awakening effect and stops the state of depression of consciousness.

What else does the drug help with? Simultaneously with others vascular means Cytoflavin is prescribed to patients admitted to the hospital with multiple organ failure, in critical condition due to infections, after surgery. In adults, the medicine is used for diseases of the spine (for example, for osteochondrosis of the cervical spine).

Instructions for use

If the doctor has prescribed treatment with the tablet form of Cytoflavin, take 2 tablets half an hour before meals twice a day. The minimum interval between doses is 8 hours; in the evening you need to take the drug no later than 18 hours. The tablets cannot be chewed; they must be washed down with half a glass of water.

Usually in this dosage form the drug is recommended for chronic circulatory disorders, the course of therapy is 25 days. A month after the first course, Cytoflavin therapy can be repeated.

Treatment of certain pathologies using the drug solution is described below:

In case of a concussion, 10 ml of the drug is administered twice a day with 200 ml of glucose solution. Course - 7 days or individual.

Side effects and contraindications

During pregnancy, the medicine should not be prescribed without strict indications. It has proven itself well in cases of hypoxia in the fetus and in cases of disturbances of placental blood flow. The drug is prohibited for use during breastfeeding.

Other contraindications are:

Therapy should be used with caution in patients who are on mechanical ventilation. Side effects may include burning, sore throat, and redness of the skin, but such reactions are not grounds for discontinuing therapy. With a long course, stomach pain, shortness of breath, headache, dizziness, pale skin, and allergies are possible.

Analogs and other information

Among the analogues we can name a number of drugs that have a similar effect on the body.

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Cytoflavin in the detoxification of patients dependent on alcohol

Authors: A.I. Minko, I.V. Linsky, V.N. Kuzminov, E.S. Samoilova, V.V. Goloshchapov, K.A. Artemchuk. Institute of Neurology, Psychiatry and Narcology of the Academy of Medical Sciences of Ukraine, Kharkov

Resume

According to the World Health Organization, more than 90% of the world's inhabitants drink alcoholic beverages, and at least 40% drink alcohol monthly, which is associated with a high risk of health problems. About 10% of men and 3–5% of women drink alcohol daily. In addition to characteristic changes in the brain, excessive alcohol consumption causes numerous disruptions in the functioning of almost all body systems and leads to the occurrence of multiple organ pathologies. Therefore, it is not surprising that in most countries of the world, diseases associated with alcohol consumption are in 3rd–4th place among the causes of death. Current problem alcohol addiction and for Ukraine. As of January 1, 2007, 628,379 people, or 1,344.1 patients per 100 thousand population, were registered with the drug treatment dispensary in our country alone.

Alcohol dependence syndrome is a psychopathological manifestation of a state of chronic intoxication. It is no coincidence that the treatment of such patients begins with the elimination of the metabolic consequences of prolonged exposure to ethanol on the patient’s body. In this regard, the drug Cytoflavin attracts attention, the spectrum of action of which, it seems, is fully consistent with the tasks of the initial stage of treatment of patients dependent on alcohol, the tasks of detoxification. Cytoflavin, produced by the scientific and technological pharmaceutical company Polisan ( Russian Federation), is a transparent yellowish solution, each milliliter of which contains 100 mg of succinic acid, 10 mg of nicotinamide, 20 mg of riboxin (inosine), 2 mg of riboflavin mononucleotide (riboflavin), as well as excipients: N-methylglucamine (meglumine), sodium hydroxide and water for injection. Available in the form of a solution for intravenous administration.

The pharmacological effects of the drug are due to the complex influence of the substances that make up its composition. The drug stimulates respiration and energy production in cells, improves the processes of oxygen utilization by tissues, and restores the activity of antioxidant enzymes. The drug activates intracellular protein synthesis, promotes the utilization of glucose, fatty acids and the resynthesis of γ-aminobutyric acid (GABA) in neurons through the Roberts shunt. Cytoflavin improves coronary and cerebral blood flow, activates metabolic processes in the central nervous system, restores consciousness, reflex disorders, sensitivity disorders and intellectual-mnestic functions of the brain. It has an awakening effect when prescribed to patients with a depressed consciousness due to anesthesia.

The intracellular interaction of nicotinamide, riboxin and riboflavin mononucleotide stimulates the formation of important endogenous redox enzymes - flavin adenine nucleotide (FAD) and nicotinamide adenine dinucleotide phosphate (NADP), which play an important role in cellular and tissue respiration. With intravenous infusion at a rate of about 2 ml/min (in terms of undiluted Cytoflavin), succinic acid and riboxin (inosine) are utilized almost instantly and are not detected in the blood plasma.

Riboxin (inosine) is metabolized in the liver to form glucuronic acid, followed by its oxidation. A small amount is excreted by the kidneys. Nicotinamide is quickly distributed throughout all tissues, penetrates the placenta and into breast milk, metabolized in the liver to form nicotinamide - methylnicotinamide, excreted by the kidneys. The plasma half-life is about 1.3 hours, the steady-state volume of distribution is about 60 liters, and the total clearance is about 0.6 l/min. Riboflavin is distributed unevenly: the largest amount is in the myocardium, liver, and kidneys. The plasma half-life is about 2 hours, the steady-state volume of distribution is about 40 liters, and the total clearance is about 0.3 l/min. Penetrates through the placenta and into mother's milk. Binds to plasma proteins - 60%. Excreted by the kidneys, partly in the form of a metabolite; in high doses, mainly unchanged.

Cytoflavin is used to treat acute cerebrovascular accident, discirculatory (vascular) encephalopathy stage 1-2 and the consequences of cerebral circulatory disorders (chronic cerebral ischemia); toxic and hypoxic encephalopathy in acute and chronic poisoning, endotoxemia, as well as after depression of consciousness due to anesthesia. In adults, Cytoflavin is used exclusively intravenously in a dilution of 100-200 ml of 5-10% glucose solution or 0.9% sodium chloride solution 1-2 times a day with an interval between administrations of 8-12 hours for 10 days. With rapid drip administration, the appearance of adverse reactions which do not require discontinuation of the drug: hyperemia of the skin of varying severity, sensations of heat, bitterness and dry mouth, sore throat. With prolonged use of high doses, transient hypoglycemia, hyperuricemia, and exacerbation of gout may occur. Very rarely, short-term pain and discomfort in the epigastric region and sternum, shortness of breath, nausea, headache, stupor, “tingling” in the nose, blanching of the skin of varying degrees of severity, and skin itching may occur.

Contraindications to the use of Cytoflavin include individual sensitivity to the components of the drug and the period of breastfeeding. For patients who are on mechanical ventilation, administration of the drug is not recommended when the partial pressure of oxygen in arterial blood decreases to less than 60 mmHg. Prescribe with caution

drug for nephrolithiasis, gout, hyperuricemia. In case of overdose, symptomatic treatment is necessary, because there is no specific antidote. In critical conditions, the use of the drug should be carried out after normalization of central hemodynamic parameters. There may be a decrease in blood glucose levels (which must be taken into account when prescribing); during treatment with the drug, urine may become light yellow in color.

Cytoflavin ingredients such as succinic acid, inosine and nicotinamide are quite compatible with other medicines. But riboflavin, also part of the drug, reduces the activity of a number of antibiotics: doxycycline, tetracycline, oxytetracycline, erythromycin and lincomycin. In addition, it is incompatible with streptomycin. Chlorpromazine, imizine, amitriptyline, by blocking flavin kinase, activate the inclusion of riboflavin in flavin adenine mononucleotide and flavin adenine dinucleotide and increase its excretion in the urine. Thyroid hormones accelerate the metabolism of riboflavin. The drug reduces and prevents the side effects of chloramphenicol (disturbance of hematopoiesis, optic neuritis). Cytoflavin is compatible with drugs that stimulate hematopoiesis, antihypoxants, and anabolic steroids. Thus, the pharmacological properties of Cytoflavin suggest that it may be useful when administered to alcohol-dependent patients during the detoxification phase.

In connection with the above, the purpose of this work was to evaluate the effectiveness and safety of the drug Cytoflavin in the complex therapy of patients with alcoholism at the stage of relieving alcohol withdrawal syndrome.

Design, contingent research methods

The work had the design of an open comparative clinical trial in parallel groups without placebo control. The total duration of the study in both comparison groups was 10 days. During this period, there were 7 meetings of each patient with his researcher (visits), with visit No. 1 devoted to screening (preliminary research with the appointment of a date of hospitalization), and daily visits No. 2-6 (days 1-5 of treatment, respectively ) and the final visit No. 7 covered the period of relief of alcohol withdrawal syndrome and acute post-intoxication disorders. It is necessary to emphasize once again that the term “visit”, characteristic of the vocabulary of clinical trials, is conditional in this text, because All patients who took part in the study were in the hospital throughout the entire observation period.

The study included 60 patients who, in accordance with the ICD-10 criteria, were diagnosed with alcohol withdrawal syndrome (F 10.3). All patients were routinely (after a screening visit the day before) hospitalized in the departments of the Kharkov City Clinical Narcological Hospital No. 9 (clinical base of the Institute of Neurology, Psychiatry and Narcology of the Academy of Medical Sciences of Ukraine (INPN AMNU, Kharkov)). Upon hospitalization, patients were randomly assigned to one of two study groups (30 patients - study group and 30 patients - control group). The average values ​​of age, body weight and some indicators of alcohol history in patients of the main and control groups at the start of the study are presented in Table. 1.

These data indicate that the selected comparison groups are quite comparable in terms of the main specified parameters and, therefore, suitable for a comparative analysis of the results of standard and study types of treatment.

The detoxification therapy scheme for patients dependent on alcohol was complex (Table 2).

During the study to evaluate current state patients and, accordingly, the effectiveness and tolerability of the treatment used, a complex of clinical, psychometric and laboratory research methods was used.

The clinical-psychopathological method was the main one in assessing the condition of patients throughout the study. Interpretation of data obtained using any other methods was carried out in the process of comparison with the results of a clinical-psychopathological study, which was carried out in accordance with the criteria of the International Classification of Diseases, Tenth Revision (ICD-10).

During treatment, patients in both groups underwent a daily test for the presence of alcohol vapor in their exhaled air (alco-test). To monitor alcohol withdrawal syndrome throughout treatment, daily monitoring of vital indicators (blood pressure, heart rate, body temperature, etc.) and four-fold (upon admission, as well as on the 3rd, 5th and 10th days of treatment) assessment of severity were carried out. withdrawal symptoms using the CIWA-Ar screening test. Twice, upon admission and on the 10th day of observation, the intensity and structure of pathological craving for alcohol was assessed using N.V.’s glossary. Cherednichenko - V.B. Altshuller. The obtained data were processed using mathematical statistics methods (dispersion, correlation, regression analysis) on a PC using SPSS 15.0 and Excel (from the Microsoft Office 2003 package).

Results and discussion

Changes in hemodynamic parameters - systolic blood pressure (BP), diastolic blood pressure, heart rate (HR), as well as body temperature (t °C) are the most important objective manifestations of that powerful homeostatic stress, which, in fact, is always the transition from systematic alcoholism to sobriety. That is why close attention was paid to these indicators (Fig. 1, 2).

It is easy to notice that changes in all mentioned physiological parameters are of the same type. First (from the 1st to the 3rd-5th visit) their increase is observed, then (from the 3rd to the 7th visit) - a decrease. Noteworthy is the fact that at the stage of relieving the withdrawal syndrome in patients receiving standard therapy along with Cytoflavin therapy (main group), normalization of hemodynamic parameters occurred significantly earlier (Fig. 1A, 1B and 2A) than in patients receiving only standard therapy (control group).

As a result, from the 3rd visit to the 7th (2-10th day from the start of the therapeutic program), hemodynamic parameters (systolic and diastolic blood pressure, heart rate) were significantly higher in the main group (p< 0,05) ниже, чем в контрольной группе (рис. 1А, 1Б и 2А). Что касается температуры тела, то по данному параметру достоверных различий между основной и контрольной группами на всем протяжении исследования не наблюдалось. Из приведенных данных следует, что Цито-флавин на этапе купирования синдрома отмены алкоголя существенно уменьшает силу гомеостатического стресса, связанного с переходом от систематической алкоголизации к трезвости, что проявляется ускоренной нормализацией показателей гемодинамики.

The dynamics of the average results of the screening test to assess the severity of alcohol withdrawal syndrome CIWA-Ar (The Clinical Institute Withdrawal Assessment for Alcohol-Revised) during the relief of alcohol withdrawal syndrome in patients of the main and control groups is presented in Table. 3. It is clearly visible that the various manifestations of alcohol withdrawal syndrome taken into account by the CIWA-Ar screening test (nausea and/or vomiting, tactile disturbances, visual disturbances, auditory disturbances, tremors, paroxysmal sweating, anxiety, headache and/or heaviness in the head , agitation, disorientation and confusion), reach their maximum severity at the time of visit No. 4 (3rd day of cessation of alcoholism), and then begin to decrease.

At the same time, in the main group of patients, the reduction of some symptoms of withdrawal syndrome occurred faster than in the control group, which was expressed (Table 3) in a significant (p< 0,05) меньших степенях выраженности тошноты или рвоты (визит № 4), тремора (визиты № 4-6), пароксизмального пота (визиты № 4-6), тяжести в голове или головной боли (визиты № 4-6) и, как следствие, тяжести синдрома отмены алкоголя в целом (визиты № 4-6). Поскольку, как уже было сказано, на этапе купирования синдрома отмены основная группа отличалась от контрольной только тем, что в ней помимо стандартной терапии применялся Цитофлавин, ускоренную редукцию упомянутых выше симптомов и синдрома отмены алкоголя в целом следует считать обусловленной действием именно этого препарата.

Pathological craving for alcohol (PCA) is a core symptom of the syndrome of dependence on this psychoactive substance. It is PVA that becomes the main cause of alcoholic excesses during treatment and relapse of alcoholism in the post-therapeutic period. The dynamics of the average severity of PVA, its components and their components in the examined main and control groups during treatment are presented in Table. 4.

It is clearly noticeable that over the course of 10 days of observation, the intensity of PVA decreased markedly, which can easily be explained by the relief of the painful effects of alcohol withdrawal syndrome.

Along with general features Significant differences were found between the comparison groups in the nature of PVA reduction.

In a component-by-component comparative analysis, it was found that in the main group the severity of all components (appetite disorders, dreams, facial reactions) of the autonomic component of PVA on the 10th day of treatment was significantly less than in the control group.

Since the main group differed from the control group only in that it used Cytoflavin in addition to standard therapy, all of the above differences should be considered the result of the action of this drug.

Compliance with the sobriety regime by patients was assessed at each visit based on the results of an alcohol test, as well as through a retrospective anamnestic analysis of the period that had passed since each previous visit. The dynamics of the number of people who had alcoholic excesses during treatment, according to positive alcohol test results during visits, is presented in Fig. 3.

It can be seen that the first alcoholic excesses began at the stage of relieving the withdrawal syndrome, in hospital conditions (visit No. 6, or the 5th day from the start of treatment). At the same time, the frequency of alcoholic excesses in the control group was slightly higher than in the main group, which may be explained by the ability of Cytoflavin to suppress the vegetative component of PVA (as mentioned above). However, the above differences between the comparison groups in the frequency of alcoholic excesses were not statistically significant, so this assumption needs further verification.

Conclusions

1. Cytoflavin accelerates the reverse development of such manifestations of alcohol withdrawal syndrome as arterial hypertension, tachycardia, nausea, vomiting, tremor, sweating, heaviness in the head and headache.

Moreover, it is reliable (p< 0,05) снижается интегральный показатель тяжести алкогольной абстиненции по шкале CIWA-Ar (к 5-му дню лечения — на 31,35 % по сравнению с той же комплексной фармакотерапией, но без Цито-флавина).

2. Cytoflavin helps reduce pathological craving for alcohol due to reliable (p< 0,01) снижения интенсивности его вегетативного компонента, оцененного при помощи глоссария Н.В. Чередниченко — В.Б. Альтшулера (к 5-му дню лечения — на 45,64 % по сравнению с той же комплексной фармакотерапией, но без Цито-флавина).

3. The introduction of Cytoflavin into complex pharmacotherapy was not accompanied by adverse events, which allows us to consider Cytoflavin not only effective, but also a safe agent for complex detoxification of patients dependent on alcohol.

References

1. Kalinin A.V. Clinical perspectives of gastroenterology and hepatology. - M., 2001. - 4. - 8-14.

2. Shchukin M.A. Alcohol and alcoholism. Internal diseases: Transl. from English - M.: Medicine, 1997. - 433-46.

3. Indicators of health""I am the population and the vicinity of health care resources""I am in Ukraine for 2006: Collection of the Ministry of Health. - K., 2007.

4. Churkin A.A., Martyushov A.N. Quick Guide on the use of ICD-10 in psychiatry and narcology. - M.: Triada-X, 2002. - 232 p.

5. Friedman L.S., Fleming N.F., Roberts D.G., Hyman S.E. Narcology. - M.: Binom; St. Petersburg: Nevsky Dialect, 1998. - 320 p.

6. Minko A.I., Linsky I.V. Narcology: Scientific publication. - M.: Eksmo, 2004. - 736 p.

7. Cherednichenko N.V., Altshuler V.B. Quantitative assessment of the structure and dynamics of pathological craving for alcohol in patients with alcoholism // Questions of Narcology. - 1992. - No. 3-4. — P. 14-17.

8. Lapach S.N., Chubenko A.V., Babich P.N. Statistical methods in biomedical research with using Excel. - K.: Morion, 2000. - 320 p.

9. Gubler E.V. Computational methods for analysis and recognition of pathological processes. - M.: Medicine, 1978. - 294 p.

Vegetative-vascular dystonia– This is a very difficult disease to treat due to the variety and manifestation of symptoms. These are psychosomatic disorders that lead to malfunction of the heart, blood vessels, gastrointestinal tract, and brain. The patient’s mental state is disrupted, quality of life and performance are reduced.

If treatment is not started in time, the VSD disease will progress and can cause organic damage to the heart, brain and other organs. The volume of therapy is prescribed by the doctor after a thorough examination of the patient. Cytoflavin is often prescribed in combination for VSD to eliminate negative symptoms.

Problems of the disease

Given the variety of symptoms, treatment of VSD should be complex and long-term. Once symptoms appear, they usually return again. For the treatment of vegetative-vascular dystonia (VSD) are used various types. This drug therapy, physiotherapy, psychocorrection, sanatorium-resort treatment. Such an integrated approach helps to rehabilitate patients, regain lost health, and improve the quality of life. The correct psychological attitude and belief in the possibility of healing are very important.

Metabolic processes and lack of energy resources play a major role in the development of symptoms. To replenish, drugs that improve cell metabolism are used. These are various vitamin preparations.

One of modern medicines for the treatment of vegetative-vascular dystonia (VSD) is Cytoflavin. This is a combination drug that contains succinic acid, inosine (riboxin), nicotinamide, riboflavin mononucleotide and excipients.

Pharmacological group - a drug that improves tissue nutrition. Available in tablets and injections

Effect of Cytoflavin in VSD

The effect of Cytoflavin in VSD is due to the following components:

1. Succinic acid is a metabolite of the Krebs cycle, the tricarboxylic acid cycle - this is a key stage in the respiration of all cells that use oxygen. This is not only energy, but also nutrition of body tissues. The formation of amino acids, carbohydrates and other compounds occurs.
2. Riboflavin is vitamin B2, a vitamin necessary for the body that affects metabolic processes. Flavonoids are necessary for the processes of oxidation and inactivation of harmful compounds. With its deficiency, hair, nails deteriorate, and skin suffers. It is necessary for the production of red blood cells and antibodies. If there is a deficiency, it affects the functioning of the thyroid gland and reproductive function.
3. Nicotinamide – vitamin PP – nicotinic acid amide. Participates in metabolic processes and cell nutrition. Side effects: allergies in the form of rash and itching, difficulty breathing. If the dose is exceeded, heart rhythm disturbances, diarrhea, dizziness, increased blood sugar occur. Also thirst, nausea, vomiting, pain in the stomach, itchy skin. Long-term use can cause fatty liver.
4. Inosine is an anabolic steroid that improves metabolism and microcirculation in the heart. Improves heart rhythm and blood supply, activates metabolism, nourishes cells.

The drug Cytoflavin is well absorbed and excreted.

Application of medicine

Cytoflavin is used for VSD, cerebrovascular diseases and neurasthenia. Can be used during increased physical or mental stress, or with heart disease.

Contraindications to taking Cytoflavin

Individual intolerance to the components of the drug Cytoflavin for VSD:

• Not allowed for children under 18 years old
• It is undesirable to use Cytoflavin for diseases of the gastrointestinal tract during exacerbation, low blood pressure, urolithiasis, gout, purine metabolism disorder.
• Pregnant and breastfeeding women should not take Cytoflavin during VSD.

Side effects

After taking Cytoflavin, VSD may cause headache, low blood pressure, epigastric pain, nausea, and diarrhea.

Allergies in the form of skin redness, itching, up to anaphylactic shock. It is necessary to administer Cytoflavin for VSD slowly intravenously.

Cytoflavin compatibility

Not compatible with streptomycin. The activity of antibiotics (tetracycline, macrolides) decreases. There have been no cases of Cytoflavin overdose in VSD. If you have diabetes, be sure to monitor your blood sugar. For hypertension – correction of drugs that lower blood pressure.

Alcohol compatibility

Cytoflavin for VSD cannot be combined with alcohol, because it is possible to develop a severe allergic reaction, lower blood pressure, and develop tachycardia.

In case of vegetative-vascular dystonia, consumption with alcohol, especially during treatment, is strictly prohibited. Quite a lot has been written about the dangers of alcohol. various sources. In case of vegetative-vascular dystonia, consumption is very dangerous because alcohol-containing substances affect the brain, cardiovascular system, causing tachycardia, increased blood pressure. Alcohol affects the psyche, causing addiction and withdrawal symptoms. This significantly aggravates the course of VSD.

When using Cytoflavin for VSD, the instructions do not indicate that you should not drink alcohol. But with any treatment, doctors always warn about the dangers of alcohol. This is an additional burden on all organs, in particular the liver. It is difficult to predict what the body’s reaction will be. No sane person will drink alcohol during the course of treatment.

Analogs

Analogues are vitamin preparations that improve metabolism. Vinpocetine or Cavinton are not analogues of cytoflavin because they belong to different pharmacological groups. Vinpocetine is a medicine that improves blood flow to the brain, thereby improving nutrition.

Cytoflavin is used as a complex drug for the treatment of vegetative-vascular dystonia in combination with other medications and has a positive effect.

In any case, self-administration of Cytoflavin medication for VSD is unacceptable; it must be prescribed by a doctor according to indications. It is important to observe the dose and interval between doses.

Take no more than 25 days.