Etiotropic therapy is what?

Treatment of any disease requires an integrated approach. Simultaneous use of drugs acting on various links of the pathogenesis of the disease, contributes to the rapid recovery of the patient and the prevention of complications. Etiotropic treatment is part of the treatment measures used. In general, etiotropic therapy is what? Next, consider the concept of the term, the basic principles and types of treatment, the criteria for assessing its effectiveness.

General concepts

Etiotropic therapy is a complex of measures aimed at weakening or eliminating the cause that caused the development of the disease. This term is also called casual therapy. The medications used in each particular form of this treatment are also called etiotropic.

Casual therapy includes the following types of treatment, the application of which directly depends on the etiological factor of the disease:

• Use of antibacterial agents;
• Hormone therapy;
• Vitamin therapy;
• Treatment with probiotics;
• chemotherapy;
• Application of antidotes.

Principles of etiotropic therapy

Prevention and treatment of pathological processes and diseases are based on two goals, the implementation of which contributes to the speedy recovery of the patient. The first etiotropic principle of disease prevention and therapy is to determine the cause of the disease and use methods of struggle to stop the pathological effects on the body. The result of achieving the goal are the indices of the lack of progression of the clinical picture.

The second etiotropic principle of disease prevention and therapy is based on elucidation of additional factors that act in parallel with the primary, enhancing or weakening its pathogenic effect. Their precise definition and correction creates favorable conditions for the rapid rehabilitation of the patient's body.

The measures used to achieve the first goal are realized with the help of medications (hormones, cytokines, enzymatic preparations, chemotherapy). For the fulfillment of the second principle, physical factors are used: the use of protective clothing, ultraviolet irradiation, the repeated exposure of a pathological agent to increase the resistance of the patient's body to it.

Basics of treatment of diseases of infectious genesis

Etiotropic therapy of infectious patients implies the implementation of the following principles:

• Treatment should be comprehensive and take into account all possible factors that may be acting;
• The purpose of the applied means should be the destruction of the pathogen;
• Carrying out of immune correction;
• Parallel restoration of hemostasis in the patient's body;
• Continuity of therapy, since most diseases require prolonged follow-up and recovery of the patient after discharge from the hospital;
• The choice of the treatment regimen should be based on taking into account the form and period of the disease, the severity of clinical manifestations, the assessment of the patient's body condition and the presence of concomitant pathologies.

Etiotropic therapy of infectious patients includes the use of drugs of specific and nonspecific effects. Means of specific treatment:

• Serum;
• Immunoglobulins;
• Bacteriophages;
• Vaccines;
• Antitoxins.

To substances of nonspecific action include chemotherapeutic drugs and the use of interferons.

Serotherapy

Since etiotropic therapy is a complex treatment, one of the components of treatment is serotherapy. This section uses the use of antibacterial and antitoxic sera.

Antitoxic serum includes antibodies against toxins released by pathogens. All antibodies are specific and act against a specific etiological factor, using a neutralization reaction. Examples of such sera:

• Antitetanus;
• Antidiphtheria;
• Antigangrenous;
• Antisiberian;
• Anti-butulinic.

Antibacterial sera consist of agglutinins, opsonins and bacteriolysins, which are antibodies against bacterial pathogens.

The effectiveness of the use of serotherapy depends on the time and dose of its administration. Immediately after entering the body, the antitoxins circulate in the blood, binding to the toxins of the pathogen. The sooner a remedy is introduced, the sooner the patient recovers.

Immunoglobulin - a means of etiotropic therapy, used in the treatment of certain infectious diseases. Globulins are easier to penetrate into tissues and have a large number of antibodies in their composition. Applied in the case of the following diseases:

• Tick-borne encephalitis;
• measles;
• flu;
• Smallpox;
• Staphylococcal infection;
• whooping cough;
• leptospirosis;
• Herpetic infection;
• Anthrax and others.

Application of bacteriophages

Drugs based on viruses that can devour foreign bacterial cells are used as an alternative to antibiotic therapy. Produced in the form of powders, tablets, suppositories, solutions in vials and ampoules.

Solutions of bacteriophages can be administered orally, in the form of injections and enemas, used to wash the cavities formed, irrigation, wetting, application of affected areas.

Etiotropic therapy, whose preparations are represented by bacteriophages, has no contraindications and is quite common in pediatrics. Used as an independent method of treatment, and in conjunction with the use of antibiotics.

Chemotherapy

Such etiotropic therapy is directed to the use of toxic substances and poisons, which are detrimental to the cause of the disease. Depending on the direction of the effect, the following uses of chemotherapeutic drugs are distinguished:

• Antibiotic chemotherapy;
• Antifungal;
• Antineoplastic;
• Antiviral;
• Anthelmintic;
• Antiparasitic.

The use of chemotherapeutic agents requires a thorough review of all other medications used by the patient. In some cases, combinations of medications may have a negative reaction from the patient's body.

The use of antibiotics in casual therapy

Antibacterial etiotropic therapy is a method of destroying the causative agent of the disease with the help of antibiotics. Unfortunately, at the moment most microorganisms have become resistant to antibacterial agents.

In this regard, the use of drugs must meet rational treatment criteria:

1. Therapy should begin as early as possible, using a wide spectrum of action until the agent is clarified.
2. Treatment should be carried out under conditions of constant laboratory and bacteriological control.
3. The dosage and interval of administration of the dose of the drug should ensure a constant circulation of the drug in the blood in the required amount.
4. Antibacterial therapy lasts 3-4 days longer than symptoms of intoxication, hyperthermia.
5. A few days of lack of effectiveness is an indication for changing the antibacterial agent for another, reviewing the treatment regimen.
6. Prolonged etiotropic antibacterial therapy provokes hypovitaminosis of group B and requires parallel administration of vitamin therapy.
7. Treatment should be accompanied by monitoring of the immune status, since it is possible to suppress the immune reaction under the action of antibiotics.

The effectiveness of antibiotic therapy is assessed by the general condition of the patient, normalization of body temperature, reduction of intoxication manifestations, and peripheral blood parameters.

As an example, consider the treatment with antibacterial agents of one of the diseases of the respiratory system. Etiotropic therapy of pneumonia includes the use of the following groups of drugs:

• Penicillins - "Amoxicillin", "Flemoxin", "Ampioks";
• Cephalosporins - "Ceftriaxone", "Cefazolin", "Cefotaxime";
• Macrolides - "Clarithromycin", "Erythromycin";
• Tetracyclines - "Metacyclin", "Doxycycline";
• Aminoglycosides - "Gentamicin", "Neomycin", "Amikacin";
• "Levomycetin";
• Fuzidine;
• "Novobiocin";
• Nitrofurans - "Furazolidon", "Furadonin", "Furacilin";
• Antifungal antibiotics - "Levorin", "Nystatin";
• Sulfonamides - "Biseptol", "Sulfalen", "Sulfadimetoksin".

Children, pregnant women, as well as patients with impaired renal and liver function, are most sensitive to the toxic effects of antibacterial agents, so self-medication with these groups of drugs is unacceptable.

Application of hormones

Hormonal etiotropic therapy is a complex of measures aimed at eliminating the cause of the disease with the help of hormonal drugs. There are substitution, stimulating and inhibitory forms of treatment.

The substitutive use of hormones is used in endocrinology for partial or complete failure of the functioning of endocrine glands. The patient takes medications, the introduction of which provides a normal hormonal background in the body. Most often this type of treatment is used for life. An example is the consumption of insulin in diabetes mellitus.

Stimulating form of hormonal use is prescribed when the gland of internal secretion needs to be motivated to work. For this, hormonal preparations of the pituitary and hypothalamus are used.

The inhibitory type of treatment provokes a decrease in the production of hormones by the gland with its hyperfunction. Introduces an antagonist of the hormone, which is in excess. It is often used in oncology, gynecology, urology, andrology.

Vitaminotherapy

The use of vitamins for the treatment of diseases caused by their insufficiency or complete absence in the patient's body is called vitamin therapy. Active substances are regulators of all functions of human life, therefore their presence in the required quantity is considered compulsory.

1. The natural form of treatment is characterized by the intake of essential vitamins with food. Correction of the diet, under which emphasis is placed on products most rich in the necessary active substances, is performed.
2. The substitution form of treatment is accompanied by the introduction of vitamins in the form of medicinal preparations for the therapy of beriberi or hypovitaminosis. There are both mono- and multivitamin agents.
3. Pathogenetic vitamin therapy is characterized by the appointment of drugs for the treatment of diseases caused by vitamin deficiency (hypotension, migraine, nervous breakdowns).
4. The pharmacodynamic form of treatment uses vitamins to influence factors that do not have a connection with vitamin deficiency. For example, the administration of drugs can narrow or dilate blood vessels.

The use of vitamin preparations is considered by many to be a safe solution, however, it is necessary to do this only after consulting a specialist.

Probiotics

Etiotropic symptomatic therapy with probiotics is prescribed for the treatment of intestinal dysbiosis. Eliminating the cause of the disease, drugs can get rid of the clinical manifestations. The composition of probiotics includes bacteria and microorganisms, which are among the normal microflora of the intestinal tract. Their intake into the human body in adequate quantities allows us to normalize the work of the digestive tract, restore the microbiocenosis and accelerate the patient's recovery.

In addition to dysbiosis, the use of drugs is indicated in the following cases:

• Complex treatment of endocrine pathologies;
• Enzymatic age-related disorders;
• Toxic lesions of the nervous system;
• Occupational diseases ;
• Pathology of the kidneys, heart and blood vessels;
• Hypovitaminosis;
• The state of immunodeficiency;
• atherosclerosis;
• Conditions associated with severe physical stress and stress.

Antidototherapy

The flow of toxic and poisonous substances into the human body requires immediate removal of the latter. Some of these substances have antidotes that can neutralize the harmful effects of poisons.

Antidote is a substance that reacts with toxic agents or other medications, conducts a neutralization reaction, eliminates the negative effects of poisoning. Substances can be a narrow and broad spectrum of action. Consider examples of specific drugs used in antidototherapy.

Poison, toxic substance	Specific antidote
Amanita, organophosphorus substances	Atropine sulfate in combination with dipiroxime
snake poison	Heparin, adrenaline hydrochloride, antiserum serum
Acids	Sodium bicarbonate (soda solution)
Potassium permanganate	Ascorbic acid
Hydrocyanic acid	Unitiol, methylene blue
Carbon monoxide	Inhalation with oxygen
Opiates and derivatives of morphine	Naloxone
Phenol, heavy metal salts, arsenic, hydrocyanic acid	Sodium thiosulphate

Etiotropic therapy, the types and characteristics of which were considered in the article, is not based solely on the use of a specific group of medications. The effectiveness of its conduct depends on an integrated approach: correction of drugs in the dynamics, constant laboratory and bacteriological control of the patient's body, treatment of concomitant pathologies.