Treatment for influenza in adults

Review of antiviral drugs in cases of influenza and influenza

Any disease, especially ARVI and the Flu is easier, cheaper and safer not to treat, but not to prevent, to prevent its occurrence. Recently, especially worried about the "point" - it's safer. Should I take antiviral pills at all? In today's complex world, how to understand the issues:

• Will the effect of using an expensive antiviral drug?
• Which drug is better for adults to take flu, children?
• Do not it cause harm to health?
• Is there the best cure for flu?
• Effective antiviral drugs - is it advertising, business, dummy or not?

Antiviral drugs for Orvy on the Russian pharmaceutical market are as follows:

Virtually all antiviral drugs for orvi and flu have no evidence base for their antiviral efficacy. Studies are very expensive, conducted by the manufacturers themselves and those interested in the positive conclusion of the parties. Today, most clinical trials of new drugs are regularly falsified in order to bring "miraculous" drugs to the market with a new price tag. Given the fabulous commercial benefits of selling expensive antiviral drugs during the epidemic, honesty and objectivity of research is not believed. As you know, pharmacological publications, even in medical journals today, are about 90 percent - these are custom-made articles of an advertising nature.

Today in the pharmacy chains an abundance of various medicines, some of which in fact "Medicines" are not, because there are a lot of fakes, frank dummies and inefficient means. Advocates of patients' rights in Ukraine, for example, argue that in 4 drugs registered as antiviral - the active substance was not found. However, a wide advertising company allows producers to earn millions of hryvnias on them per year.

Antiviral drugs for Orvi are conventionally divided into:

• Vaccines - stimulation of the production of antibodies before infection with the virus
• Immunostimulants - drugs that temporarily enhance nonspecific immunity, which promote the production of interferons
• Antiviral drugs are agents that affect neuraminidase (a viral enzyme) by suppressing the multiplication of the virus (Oseltamivir, Zanamivir) and blockers of M2-channels Amantadine, Remantadin - these drugs have proven clinical effectiveness, but as any means have a number of side effects effects.

Most antiviral drugs for orvi and influenza are developed and applied no more than 10-40 years. The drug should have a greater "trial period" in order to draw a conclusion about its effectiveness and side effects. As for immunostimulants, these funds can have delayed consequences (development risks autoimmune diseases, oncological diseases of the blood, etc.) and should be prescribed according to strict indications.

Immunity modulators and antiviral agents

The immunostimulants produced today show the activation of immune reactions at the biochemical level (what is called "In vitro"), but their real benefits and long-term consequences of use are rather complex, poorly understood region. Since information on many mechanisms of immunity has become known relatively recently, scientists are getting more and more information about its functioning every year. Therefore, there is no confidence in the safety and correctness of general stimulation of the "under-researched" immune system (see Fig. what is immunity and whether drugs are needed to improve it). Especially prudent should be the preventive use of immunostimulants and the treatment with antiviral medicines for children.

"Pharmacy immunostimulants can not only help the body, but also harm" - says Ph.D. Tatyana Tikhomirova, immunologist-allergist. Such a state as hyperactivation of the immune system, as well as immunodeficiency is extremely dangerous, the human body functions normally only with the balance of the immune system. And if a person each time stimulates ("to increase self-immunity"), then, in the presence of predisposing factors, this may result in pathological inflammation, launching of immune aggression on healthy tissues, hyperactivation of the immune system and theoretically (in extreme cases) to the development of autoimmune or oncological disease.

If the next of kin has any autoimmune disease (rheumatoid arthritis, insulin-dependent sugar diabetes, Sjogren's syndrome, multiple sclerosis, etc.), then under no circumstances should a person use any immunostimulants. Even if a person is healthy, there is already a violation of the immune system, and one can live with them all his life, but if he is rude and persistently try to stimulate their immune system, it can end with the debut of an autoimmune disease.

Fortunately, for most healthy people, without the presence of any predisposing factors, it is difficult to "achieve" your immunity so as to seriously damage your health. Since most of the known immunostimulants either do not work at all, or almost do not work. One part of the drugs - an ordinary deception, another - ineffective means. But it should be remembered that any drug has side effects.

Drug Groups	Act	Names of drugs
Interferon preparations	Blockade of viral mRNA translation, presentation of viral antigens	Recombinant alpha / gamma interferons
Etiotropic means	Neuraminidase inhibitors	Relenza Tamiflu Peramivir
Ion channel blockers	Rimantadine (Remantadin, Orvirem)
Antiviral drugs with varying degrees of evidence of action	Enabling synthesis endogenous interferons	Kagocel Cycloferon Lavomax (Amiksin, Tyloron) Cytovir 3
Specific HA chaperone	Arbidol
NP-Protein Inhibitors	Ingavirin

Alexander Khadzhidis, Chief Clinical Pharmacologist, St. Petersburg states the following: "Some doctors for some reason first appoint patients antipyretic drugs, and then immunomodulators, supposedly for the production of interferon - which is illogical and generally is absurd. That is, first, knocking down the temperature - "forbid" the body to fight the virus (at high temperature, antibodies are produced against the virus and infection), and then artificially "forced" do.

In developed countries, interferonogens (drugs that stimulate the production of interferon) are not at all. Interferons can work only with parenteral (intravenous) administration, and even then, their effectiveness is questionable. In Russia, these drugs are extremely popular, despite the fact that they are useless.

With regard to antipyretics with the virus - to knock down the temperature better with paracetamol and once with a rise in temperature, rather than 4 p / day - "just in case." Taking Aspirin (acetylsalicylic acid) in ARVI, especially in children under 12 years old, is contraindicated, it can become the cause of severe damage to the central nervous system and the liver, it is not recommended to apply it to those who suffered from peptic ulcer disease Gastrointestinal tract. "

Well-known in Russia doctor Alexander Myasnikov says that all immunomodulators widely advertised in our country are a waste of money. In the United States and Western Europe, it is already unequivocally recognized and proven that these remedies are ineffective, but most Russian doctors continue to believe in the power of immunomodulators in treating Orvi.

Cytovir 3

Pharmacological action: Integratedimmunostimulating, an antiviral drug,

has an interferonogenic effect. As part of the drug - Timogen sodium, ascorbic acid, bendazole. Timogen synthetically obtained dipeptide, it enhances the nonspecific resistance of the organism. Ascorbic acid normalizes the permeability of capillaries, reducing the activity of the inflammatory process. Bendazol stimulates the production of endogenous interferon in the body.

Side effects: in people suffering from vegetative-vascular dystonia, causes a decrease in blood pressure.

Contraindications: in pregnancy, children under 1 year, thrombophlebitis, severe hypotension, diabetes mellitus, stomach ulcer, urolithiasis.

Issued: since 2001 in capsules, for children since 2006 in syrup, in powder for the preparation of solution
Research: There is no reliable information about clinical trials confirming its efficacy and safety. Often, doctors and pharmacists recommend this tool for children, but use it to treat children should be used with caution or not used at all.

References: Quite a lot of reviews in patients who use Citovir, about the effectiveness and absence of side effects. Improvement of well-being is observed on the second-third day, in single cases the drug did not help.
Price: Cytovir 3 - average240-580rub.

Kagocel

Pharmacological action: inducer of interferon synthesis, antiviral,immunomodulatingeffect. Composition: the sodium salt of the copolymer, which causes the formation of late interferon, which has high antiviral activity. The greatest effect occurs if you start treatment within the first 24 hours of the disease, but not later than the 4th day after the onset of an acute infection. With a view to prevention, it is possible to take it at any time, preferably immediately after contact with a sick Orvy or a flu.

Side effects: the emergence of allergic reactions.
It is issued: It is registered in 2003, since 2005 it is made in tablets, since 2011 it is resolved to use for children over 3 years old for the treatment of influenza, as an prevention for children can be used for children older than 6 years.

Research efficiency and safety: There is conflicting information. The active ingredient is the sodium salt of the gossypol copolymer with carboxymethyl cellulose.

And Gossipol itself is a natural polyphenol, it has been banned in the world since 1998 due to its toxicity. Gossypol for a long time and actively studied by some countries as a contraceptive, with its continued intake completely stops spermatogenesis. Chinese and Brazilian scientists say that host gossypol boys and men may suffer infertility in the future. However, Kagocel is not pure gossypol, it is the sodium salt of the copolymer, which has other properties that differ from the properties of the chemical itself.

The manufacturer actively advertises the drug and claims that the salt in Kagocel is negligible, 4 times lower than the concentration from the international standards allowed. Multiple stages of purification of the product ensure the absence of free Gossypol in the final drug, which is checked by monitoring the quality of each series of Kagocel tablets. The method used to check the availability of free gossypol is very accurate, it can reveal its content higher, 036%. In early 2013, data were published on tests performed on rats - no changes in reproductive function were detected in animals.

That is, research on primates was not done? It is known that gossypol for different animal species has its maximum dose of toxicity, according to the EFSA (European Food Safety Authority) for rats the limiting toxic dose is 2200-3300 mg / kg.,for pigs 550, for guinea pigs up to 300 mg / kg. The research carried out by the manufacturer consisted in the administration of therapeutic doses to male rats, and doses 25 times higher than therapeutic doses250 mg / kg). Can you trust the rest of the statements and "studies"?

Neither in Western Europe nor in the United States Kagocel is not used, there are no WHO medicines on the list. The effectiveness of the drug is not proven according to the representatives of the Formulary Committee of the RAMS and SDMX. There were no statistical studies on the development of side effects as of autumn 2013.

The drug is actively recommended for use by adults and children, but evidence of the safety of this medicines for children 3-6 years old no, clinical studies for this age group are not was produced.

Reviews: Many help, some children and adults are allergic reactions in the form of rashes, swelling, itching.
Price: Kagocel - average180-280rub. In 2012, the volume of sales amounted to - 2.64 billion. rubles

Tyloron (Amiksin, Lavomax)

Pharmacological action: active ingredient Tiloron, possesses antiviral andimmunomodulatingaction, it is a synthetic inducer of interferon that stimulates the formation of interferons alpha, beta, gamma.

Side effects: short-term chills, allergic reactions, contraindicated in breastfeeding and pregnancy.

Issued: almost 40 years ago, children under 7 years of age are strictly prohibited.

Research: The benefits of the drug are unquestionable for both treatment and prevention of viral diseases, but this can overlap with potential harm to the body. In the 80's in the US, after tests on mice, the drug was banned, as it had a highly toxic effect,in experimental animals, retinal bundle, liver lipidosis and other side effects were observed. It does not apply in the US and the European Union. In our country, continue to produce antiviral Amiksin and doctors appoint it to patients.
A small study involved 14 patients who received tilorone in a dose of 152 and 189 g, in 2 the drug caused keratopathy and retinopathy (while the visual acuity did not decrease), these effects were reversible. The authors of the study concluded about the potential danger of the drug for health.
Reviews: The occurrence of allergic reactions, the high cost of medicine.
Price: Amiksin - on average500-560rub. Sales volume in 2012 amounted to 7 billion. rub.

Additionally! Medicines, the so-called immunomodulators - Lycopid, Polyoxidonium, Cycloferon, Proteflazide, Timogen, Panavir, Isoprinosine, Neovir, Groprinosin and others. - should not be used to treat children (for various diseases) without immunograms and serious indications as they do not have the proper clinical trials of efficacy and safety in the treatment children.

Antiviral drugs

Below are just some of the antiviral medications from Orvi, reviews about them, a brief description, comments on known studies of their effectiveness, the average price in pharmacies.

Ingavirin

Pharmacological action: active substance imidazolylethanamide pentandioic acid. It is active against adenovirus infection, influenza A, B, respiratory syncytial infection, parainfluenza. It is an immunomodulator that affects the functional activity of the interferon system.

Side effects: allergic reactions

Contraindicated: children under 18 years.

Produced: as a drug for the treatment of influenza and orgi from 2008, before that, according to prof. Vlasova Vasilia Vitaglutam (imidazolylethanamide pentane diacid) was used in Russia before 2008 as a stimulant for hematopoiesis in cancer patients receiving an anticancer therapy.

Research: According to the manufacturers, the idea of ​​producing Ingavirin arose in the 1980s, but Only after many years of research into its safety and efficacy was the drug submitted for registration by 2008 year. When Vitaglutam was used in patients with oncological diseases, there was no convincing evidence of its effectiveness. And when in 2008 Ingavirin appeared on the pharmaceutical market without full-fledged studies, the "epidemic of swine flu" began in the country, therefore Ingavirin was actively sold. The drug was recommended by the Ministry of Health and Social Development, even despite the absence of placebo-controlled studies, reasonable evidence of its effectiveness.

One study conducted at 105!!! of patients with confirmed influenza showed the following results:

• Receiving ingavirin reduced the duration of fever to 3 hours (if used in the first 1 days after the onset of the disease)
• In the placebo group, this is 72 hours
• In the group taking Arbidol - 48 hours

Analyzing the duration and intensity of flu symptoms - weakness, headache, dizziness in patients with ingavirin was confirmed to reduce the severity of the disease, side effects are not revealed.

In May 2009, Alexander Chuchalin, chief therapist of the Russian Federation, (he led a team of drug developers) gave an interview to the magazine Ogonek: "The new antiviral agent Ingavirin efficiency is much higher than that of the AmericanTamiflu. The Russian drug is quickly and easily integrated into the genome of the A / H1N1 virus, immediately destroying it. It is also effective with other dangerous viruses. "

Reviews: Most drug does not help, isolated cases confirm the reduction in the timing of the disease.

Price:380-460rub. From January to June 2010, the sales volume of Ingavirin was 220 million. rubles, 467 thousand packages were sold.

Arbidol

Pharmacological action: Antiviral, has the ability to suppress viruses of influenza A and B, SARS - severe acute respiratory syndrome, associated coronavirus. Arbidol is also used in the complex therapy of acute rotavirus intestinal infections.
Active substance: Methylphenylthiomethyl-dimethylaminomethyl-hydroxybromoindole carboxylic acid ethyl ester.

Side effects: use of children under 3 years is prohibited, individual

allergic reactions.
Produced: invented in 1974, in 1992, it began its industrial production.

Research: Until 2013 there was no convincing evidence in its effectiveness and safety. Studies conducted in the USSR have not been published. In Russia in 2008, a study of 300 people showed that Viferon was more effective than Arbidol. In 2004, in China, tests for 230 patients with symptoms of Orvi showed it was not effective, in contrast to Tamiflu and Ingaverin. In 2009, in the journal of the UK "Antiviral Research the authors of the research stated that strains resistant to Arbidol are formed less frequently than those of Remantadine and Amantadine.

The Office of Quality Control of US Medicines denied registration of Arbidol in the United States, and WHO has never considered this drug as an effective antiviral drug.

Update on the drug: At the end of 2013, the World Health Organization Arbidol (umifenovir) as an antiviral drug with a direct effect, assigning it an individual code J05AX13. Thus, Pharmstandard received a nominal permission for widespread use of the drug on the territory of the Russian Federation, where Arbidol is included in the standards of treatment and prevention of influenza and ARVI in children and adults.

Nevertheless, the multicenter test of the effectiveness of Arbidol, which was planned to be completed in 2013, has not been completed to this day, and its terms have been postponed to 2015. The results of this test, which has serious sponsors and does not suffer from a shortage of patients, could put a dot over I in the arbidol epic, but for unknown reasons this is not occurs. I.eevidence of effectiveness is not present until now, it remains to wait ...

Reviews: The same number of positive reviews and opinions about the ineffectiveness of its use. There are isolated cases of allergic reactions in the form of dermatitis, angioedema, pain in the epigastric region.
Price: Arbidol - on average130-710rub. In 2012, the volume of sales - more than 5 billion. rub.

At the pharmaceutical market in Belarus, an analog of Arbidol, producer of JV "Lekpharm" appeared. It is a generic drug, in the Belarusian import-substituting packaging - Arpetol. The instructions to him indicate that the active substance is: arbidol hydrochloride? Once again, the commercialization of today's pharma market and the lack of proper control is proved!

Tamiflu

Pharmacological action: an antiviral drug, which includes oseltamivir carboxylate (active metabolite), suppresses influenza A and B viruses. When Orvi is not effective.

Side effects: Nausea, insomnia, diarrhea, dizziness, lethargy, cough, headaches, with caution to pregnant women and lactation. Contraindicated for children under 1 year.

Produced: since 1996, the pharmaceutical company "F. Hoffmann-La Roche "registered the right to develop

preparations containing oseltamivir.

Research: Tamiflu has a disadvantage - it complicates the diagnosis, because side effects are similar to the symptoms of influenza. It is dangerous in the epidemic period with long-term admission. Optimum effective only short-term use - a few days at the beginning of the flu. Independent researchers demanded a standard report from the Swiss manufacturer of 4-5 research modules. To which the pharmaceutical company provided only the first modules, repeated requests for full information were never satisfied.

Since 2004, cases of neuropsychic disorders began to be registered, more often in children and adolescents, who took Tamiflu during influenza - hallucinations, nightmares, confusion, convulsions, anxiety, etc.

Japanese postmarketing studies of this drug in 2006 have indicated a risk of developing impaired consciousness in humans - psychosis, depression, suicidal tendencies, especially in children. And there were also 54 deaths after Tamiflu, 16 of which were in adolescents 10-19 years (15 killed suicide, 1 died, hitting a car), the rest died of kidney failure (it is possible that due to severe flu).

The latest information about this drug:Back in April 2014, the Cochrane Society (an independent health research network) represented by Tom Jefferson and the British Medical the journal published data from the Cochrane review of studies that did not confirm the efficacy of Tamiflu and Relenza in the treatment and prevention influenza. Also, the efficacy of reducing influenza complications with these drugs has also been questioned. The firm attempts of Roche firm to fight back with a firm promise to provide undeniable evidence in the form of results of randomized trials have so far not been successful. Evidence is expected to present.

April 10, 2014, the Cochrane Collaboration website published the results of these 26 clinical trials Relenza and 20 clinical trials of Tamiflu, in which 2, 00 people participated.

As a result of the research it was found that:

• Oseltamivir as a preventive agent slightly reduces the risk of developing influenza in families, without reducing the ability of the influenza virus to be transmitted from person to person.
• The duration of symptoms is reduced by 16 hours (from 7 to, days), in children this effect is absent altogether.
• The drug has no effect on the risk of serious complications (sinusitis, otitis media, pneumonia, bronchitis), that is, does not reduce the likelihood of complications.
• The medicine is recognized as sufficiently toxic, increasing the risk of nausea, vomiting in both children and adults.
• When used for preventive purposes, the drug was dangerous to health, because it leads to mental disorders, impaired renal function, in some cases found that it helps to reduce the production of their own antibodies to the virus.

Based on these studies, health officials of the world's leading countries should decide to stop mass procurement of antiviral drugs with the current substance Oseltamivir due to the high risk of side effects and low effectiveness as a medicine for the therapy and prevention of influenza virus in the period epidemic.

reference: only on the basis of the claims of the manufacturer Tamiflu that the drug significantly reduces the risk of serious complications and hospitalization of patients during the epidemic, countries such as the United Kingdom and the United States in 2009 in connection with the epidemic of swine flu, these drugs were purchased at 40 million doses (The USA, bln. dollars, Great Britain 424 million. f.St.).

Based on recent data on the low efficacy and non-safety of this antiviral agent, an international group experts in evidence-based medicine called on the governments of the world's leading countries to stop mass purchases of Tamiflu and Relenza.

Reviews: There are enough reviews about side effects in the form of vomiting, dizziness, psychosis, headache. The effectiveness of influenza is confirmed by many.

Price: Tamiflu-on average1200-1300rub.

Remantadine (Rimantadine)

Pharmacological action: antiviral drug, an adamantane derivative, suppresses various strains of the influenza A virus (swine flu including).

Side effects: contraindicated in pregnant women, children under 1 year. Reduces concentration of attention, causes dizziness, nervousness, headache, increased fatigue, nausea, vomiting, dryness in

mouth.

Produced: information on the first uses of the drug are known since 1968.

Research: The tests were conducted from 1981 to 2006, mainly they showed a lower toxicity of Remantadine in comparison with Amantadine. One study showed the effectiveness of preventing Amantadine influenza infection by 61% in compared with the placebo group and in the event that a person fell ill, then for 1 day reduced febrile syndrome. In the same study, he was compared to Tamiflu, he gave an efficacy of 73% of the placebo group. Rimantadine (Remantadine) is currently considered a drug with proven clinical efficacy, but the possible resistance to it of some strains of the influenza virus.

Reviews: There are reviews that Remantadin causes side effects - dizziness, tachycardia, bitterness in the mouth. In general, the reviews are positive.
Price: Remantadine - average50-150rub.

It is during the flu (including swine) with the first symptoms of therapists and pediatricians recommend: adults - Remantadin, Tamiflu. Children over 1 year old are shown by Orvir (rimantadine syrup), Viferon. Children older than 8 years can - Remantadin (in the table), Tamiflu.

Interferon preparations

Interferons are informant proteins, which are excreted by cells infected with viruses. They seem to inform other cells about the infection and the required inactivation of the virus. Alpha interferons produce lymphocytes, beta - fibroblasts. In addition to Viferon, the alpha group includes Intron, Reaferon, Kipferon.

Viferon

The creation of the drug was scientifically justified in the period 1990-1995. group of scientists of the Research Institute of Epidemiology and Microbiology. N.F. Gamaleia under the guidance of prof. Malinovskaya V.V.
Since December 1996 on the basis of the same SRI, serial production of recombinant interferon alfa-2b in suppositories begins. Viferon - a candle with a different content of the active substance.

Application:

• Viferon-1 (150000 IU) is designed for babies from birth to 7 years. It is used in ARVI, herpetic infection, as an additional remedy for prolonged pneumonia or sepsis, including in preterm infants with intrauterine infections. The drug is given a course for 5 days. Children under 7 years are recommended 1 candle 2 times a day. Preterm, born on a period of more than 34 weeks - as children under 7 years. With a shorter gestation period - 1 candle three times a day. If necessary, after a five-day break, the course can be repeated for another 5 days.
• In children older than seven years, an adult drug in candles for 50, 00 IU is used twice a day for five days. Possible use of viferon in pregnant women.
• Candles with viferon content of , 0, 00 and , 0, 00 IU are used in the treatment of viral hepatitis and herpetic infections.
• The preparation in the form of ointment is intended for the therapy of herpes on the skin and mucous membranes in adults and children older than a year.

Side effects: the main side effect of drugs viferon may be an allergic reaction, which happens infrequently.

Research: As for the effectiveness of the drug, it is not included in list A of evidence-based pharmacology. I.e,wide randomized trials in humans consistent with international standards were not performed. However, a positive practical experience of treatment with viferon in pediatric practice is available. (By the way, nitroglycerin also does not have randomized studies that prove its effectiveness, which does not make it an ineffective first-line drug for stenocardia). Publications of these clinical trials of the drug are available only in Russian and were conducted only in domestic clinics. Value for money allows pediatricians to recommend a drug for ARVI treatment in children younger than seven years. For adults in the treatment of acute respiratory viral infections, the drug is of limited use because of rectal administration and the availability of alternative drugs.

The main arguments of the opponents of the drug:

• high molecular weight of protein molecules that can not be absorbed in the gut
• lack of clinical trials that meet international standards.

Kipferon

In candle light a little expensive for the treatment of common colds. Therefore, it is replaced by viferon. But, with severe forms of intestinal dysbiosis in children of the first two years of life, the drug shows good clinical results.

Studies: Randomized trials were not conducted, that is, the drugrefers to the list of drugs with unproven effects. The main claims:

• High molecular weight, which prevents normal absorption
• Adding to the drug components of the donor blood, which can cause fever and allergies.

Cycloferon

Cycloferon was originally registered as a veterinary drug in 1993 for the treatment of animals with viral infections, in 1995 it was already honey. a drug.

The drug Cycloferon is approved for use in adults and children older than four years. Produced in solution for injection, tablets, liniment. Refers to immunomodulating drugs, is an inducer of interferon, enhancing its production and exhibiting antiviral, anti-inflammatory and immunostimulating properties.

Application: on the territory of the Russian Federation is used in the treatment of acute respiratory viral infections, influenza, viral hepatitis, herpes infection, human papillomaviruses and other urological and gynecological pathologies (eg, candidiasis, chlamydia).
Contraindications: The drug is not recommended for pregnant and lactating. May cause an allergic reaction.
Research: Cycloferon is an immunostimulant that stimulates the immune system and the production of interferons. To date, allclinical trialsthis drug, published in the medical literature,were conducted only in the territory of the Russian Federation and do not meet international standards.

There are no serious clinical trials for cycloferon that would prove its effectiveness or refuted the absence of long-term adverse effects of this drug (development of autoimmune diseases). It is not superfluous to recall that all drugs that are on the pharma market for less than five years are still at the fifth level pharmacological tests and it is quite possible to identify previously unknown undesirable effects from drugs such series. In the presence of newly identified harmful effects, the drug will be withdrawn from the pharmacy networks and discontinued, and most of those who have been treated with this remedy and have earned some disruptions in health are unlikely to receive at least some compensation.

Conclusions:

Ineffectiveness of antiviral agents due to the stability of strains of the virus

The lack of a positive effect with the use of certain antiviral drugs for influenza is possible, and because there are drug-resistant viruses and a specific influenza strain may already be resistant to a particular drug (eg, Remantadin).

Other treatments and placebo effect

It is also possible that patients whose reviews indicate the efficacy of such remedies were quickly recovered by other methods of symptomatic treatment, and the placebo effect is not excluded (cf. amazing facts about placebo).

Strong immunity

In a healthy organism, after 2-3 days, the immune system produces enough protective antibodies against the virus, it does not need additional medicines. It is enough to comply with all the known rules - bed rest, plentiful hot drink, vitaminized foods and drinks, clean air in the patient's room, gargling, etc.

Rapid recovery with antiviral drugs

In various life situations, reducing the duration of the disease even for one day can be very important, for example - wedding day, urgent business trip, important business deal, exam, interview and etc. It is in such cases that the use of antiviral drugs, which reduce the duration of the illness by 2-3 days, may make sense.

There are no adequate studies

Absence of benign studies on the study of effectiveness and side effects (on a large group of people, different ages, during long time), most antiviral agents from Orvi and influenza suggest the caution of their use or even the rejection of them.

Do not spend money on pacifiers

Spending money, in some cases, considerable, on drugs with unproved efficacy, side effects, questionable safety, perhaps, is not advisable. Any medicine, even useless or empty, can damage the body.

Video transmission: How the placebo effect works

• sec: 4 min. - about what means are usually prescribed by doctors
• with 2: 0 - about the effect of placebo on the work of the immune system
• with 3: 7 - about the high effect of placebo in children
• with 3: 5 - about preparations-pustachki, appointed or nominated at ORVI
• with 3: 0 - about homeopathy and antiviral drugs in ARVI
• with 4: 7 - on how modern research is conducted

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Names of antibiotics for colds and flu

In the treatment of respiratory diseases, direct-acting drugs are used that affect the cause of the disease. They depress the pathogens. Such therapy is called etiologic. In the fight against the flu and cold the main thing is right - to choose the right medication. Some people, trying to get better sooner, begin to drink strong antibiotics from a cold at the first symptoms of ARVI. Is it correct?

When it is necessary to drink antibiotics for colds and flu

In most cases, respiratory diseases are caused by viruses to which antibacterial drugs do not work. Therefore, their reception from the first day of the disease is not justified. Therapy of respiratory diseases with antibiotics is justified, if on the 5th-6th day of the course of the flu or cold, the person's state of health is consistently poor. As a rule, these are symptoms of bacterial infection, which provokes the development of purulent sore throat, acute bronchitis, pneumonia.

Signs of complications of the flu and colds:

• after the onset of acute respiratory viral infection, the body temperature rises sharply after 5-6 days;
• general health worsens, fever, coughing, shortness of breath;
• pain in the throat, chest area, ears;
• enlarged lymph nodes.

When treating colds and flu with antibiotics, do not interrupt treatment while improving well-being. People who commit such a mistake then suffer twice as much. In this case, the improvement of a person's condition does not mean that the disease has passed. The batch of bacteria under the influence of antibiotics died, but another part of them adapts to the drug and begins to attack the weakened organism with new strength. This leads to a new round of disease with subsequent complications.

What antibiotics are better for taking cold?

For the treatment of respiratory diseases, bactericidal preparations are used to destroy pathogenic microorganisms. Antibiotics in the fight against colds and influenza are given the role of heavy artillery when there is a risk of acute complications. For treatment of respiratory diseases, three main groups of antibacterial drugs are used:

1. penicillinic - ampiox, augmentin, amoxaplav;
2. cephalosporins - cefotaxime, cefpyr, cefazolin;
3. macrolides - roxithromycin, azithromycin, clarithromycin.

List of effective antibiotics for adults

For colds of bacterial origin, doctors prescribe antibiotics in extreme cases. Prolonged cough, prolonged angina, severe fever, stably high body temperature - these are alarming signs of the development of an acute disease. In this case, traditional antiviral drugs, immunostimulants, vitamins and medicinal herbs are powerless. For effective therapy, you need to know which antibiotic is better for a cold to an adult:

• amoxicillin;
• arlet;
• fleumoclave;
• rovamycin;
• azithromycin;
• hemomycin;
• suprax;
• cefepime;
• erythromycin;
• levofloxacin.

Names of good drugs for children

To treat bacterial diseases at an early age, antibiotics are used in extreme cases. With pneumonia, acute otitis, purulent angina, resulting from a respiratory illness, it is justified to take such drugs. The form of antibiotics is prescribed depending on the age of the child. Breastfeeding - drugs in pricks, older children - in pills. Babies do not always make injections, it is allowed to open the ampoule and give the child a medicine in the proper dosage. Baby antibiotics for colds:

• ampicillin;
• flemoxin solute;
• moximac;
• avelox;
• augmentin;
• zinnat;
• Macropen;
• gt;
• esparoxy;
• alpha normix.

Often parents mistakenly believe that antibiotic therapy is necessary for the successful treatment of influenza and colds in children. This is a misconception about the effect of antibiotics on the baby's body. In viral infections in children, the prescription of these drugs is unreasonable even at high temperatures, which persists for a long time.

Treatment with antibiotics of children leads to dysbiosis, weakening of the immune system, anemia. To conduct antibacterial therapy for babies is advisable exclusively in critical situations. For example, when there is aerobic streptococcal angina, acute otitis media, pneumonia, inflammation of the paranasal sinuses. The use of antibiotics to treat children with colds and flu without complications is justified when:

• expressed signs of reduced resistance to the body - a constant subfertile body temperature, frequent cold and viral diseases, HIV, oncology, congenital disorders of immunity;
• rachitis, malformations of general development, lack of weight;
• the presence in the history of the child of chronic recurrent otitis media.

Gentle medications for treating colds in pregnant women

When treating complications of respiratory disease in a woman in a position or nursing mother, take into account the effects of the antibiotic on the development of the fetus. For treatment select sparing antibacterial drugs. To find the right medicine, the doctor identifies the causative agent of the disease, its resistance to various drugs. If it is impossible to conduct such a study, prescribe sparing antibiotics for pregnant women:

• ampicillin;
• oxacillin;
• cefazolin;
• erythromycin;
• azithromycin;
• bioparox;
• minocycline;
• oxam;
• ericcicline;
• ristomycin.

To treat influenza and colds in pregnant and lactating mothers, in order to avoid the occurrence of dysbiosis, it is advisable to take drugs in the form of injections. To avoid allergic reactions, the use of antibiotic therapy is combined with antihistamines. From the diet of pregnant and lactating women, chocolate, citrus and coffee are excluded.

List of broad-spectrum antibiotics

In bacterial therapy for the treatment of complications of influenza and cold prescribe drugs aimed at inhibiting groups of pathogens. Such drugs are called broad-spectrum antibiotics. They help to cure the complications of influenza and acute respiratory disease. Cheap tablets are effective, as are expensive ones. These types of drugs are dispensed in pharmacies without a prescription. Before taking the drug, read the instructions and read reviews about antibiotics. A good drug has a small number of side effects. Antibiotics of a wide spectrum of action:

• amosin;
• beccampicillin;
• ospamox;
• eco-ball;
• zinforo;
• kefelim;
• flamixi;
• cefodox;
• klatsid;
• oleterin.

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Treatment and symptoms of intestinal (gastric) flu in children and adults

Gastrointestinal flu, intestinal flu is a simplified name for a disease, which in medicine is called gastroenteritis or rotavirus infection, since this disease is not actually a flu. The causative agent of gastroenteritis is various viruses, most often it is the virus of the order Rotavirus, and also astroviruses, caliciviruses, noroviruses and adenoviruses, which, when multiplied, lead to inflammation gastrointestinal tract.

In general, children with this disease are susceptible to this disease, the intestinal flu in children lasts longer and is more severe, as well as older people. Symptoms of gastric flu are pronounced, but at the same time, in adults with a strong immune system rotavirus infection can occur in a latent form, asymptomatic, while an apparently healthy person can be a carrier the pathogen. Usually within a week the acute period of the disease ends and after 5-7 days there is a complete recovery, during this period the patient is still contagious.

How can you get stomach flu?

The easiest way to avoid getting infected with gastric flu is to wash your hands thoroughly

The virus penetrates the human body through the mucous membrane of the gastrointestinal tract. The incubation period of this disease is from 16 hours to five days. The rate of development and severity of the course of the gastric flu depends on the concentration of the pathogen penetrated into the body and the state of the human immune system.

• One type of transmission is food. That is, the infection enters the body through unwashed fruits, vegetables, substandard dairy products. Gastrointestinal flu can rightfully be called a "dirty hand disease". Also, infection through not boiled tap water, even with banal bathing, is possible.
• The second way of infection is airborne. With loud talk, sneezing, coughing, germs from a sick person spread in the air.
• It is not excluded and contact-household way of transmission of the pathogen, especially in places of mass congestion: in offices, in kindergartens, schools, shops.

The causative agent of gastric flu is very viable, the usual detergents can not destroy it. It is sufficiently resistant to frost and high temperatures, withstands heating to 60 ° C. The intestinal virus is destroyed only by concentrated chlorine-containing disinfectants.

What happens in the body during infection?

With the penetration of rotavirus into the body, half an hour later, it is possible to detect the pathogen in the cells of the small intestine. Due to the attack of the virus, the structure of the intestinal mucosa is disturbed. This, in turn, leads to a disruption in the production of digestive enzymes responsible for the cleavage of complex sugars. Thus, non-split carbohydrates accumulate in the small intestine, this attracts an excessive amount of fluid, causing diarrhea or watery diarrhea.

Symptoms of gastrointestinal influenza

If the child is sick, then a pediatrician's call is needed to determine the possibility of treatment at home or hospitalization in a hospital. As a rule, if vomiting is observed no more than 5 times, and the stool is not more often than 10 times a day, then outpatient treatment is acceptable. About 5 days the incubation period of gastric flu lasts. Symptoms of it are quite acute and violent.

Literally a few hours before the appearance of dyspepsia (gastrointestinal disorder), first there appear a small cough, runny nose, sore throats, which quickly pass. From other infectious diseases, the gastrointestinal tract is distinguished by intestinal flu, the symptoms of which begin not with digestive disorders, but with rapidly passing catarrhal phenomena.
The main signs of gastric flu:

• Pain in the throat when swallowing, redness in the throat
• Catarrhal phenomena - a slight runny nose, coughing, sneezing, which quickly pass
• Liquid stool up to 5-10 times a day, stools abundant, gray-yellow, clayey, with a sharp odor, but without mucus and blood
• Pain in the abdomen, rumbling
• Nausea, vomiting
• High fever or subfebrile
• Growing Weakness
• With severe development of gastric flu, dehydration (symptoms) is possible.

Similar symptoms may be accompanied by other diseases, such as cholera, salmonella, food poisoning, therefore, to differentiate the diagnosis, you should immediately consult a physician (see p. also the causes of vomiting and diarrhea in a child without fever).

Treatment of gastrointestinal influenza

Specific treatment of rotavirus does not exist yet. The main treatment is aimed at reducing intoxication, normalization of water-salt metabolism, which is disturbed by diarrhea and vomiting. That is, the treatment is mostly symptomatic, aimed at reducing the negative impact of the virus on the body: to prevent dehydration, reduce toxicity, restore the work of urinary and cardiovascular systems, prevent the development of secondary bacterial infection.

• First of all, rehydration therapy is necessary, for which 1 bag of Regidron is dissolved in a liter of boiled water and drunk during the day every half hour. If desired, this solution for rehydration can be done by yourself - boiled water 700 ml (or a weak chamomile broth) + 300 ml of decoction of dried apricots (carrots or raisins) + 4-8 h. tablespoons sugar + 1 hour. spoon of common salt + 1/2 h. spoons of soda. It is indicated for repeated vomiting and diarrhea, to drink with small sips. Adults, regardless of the severity of the condition after vomiting or stool, drink 200 ml. solution, since fluid loss should be replenished in the first 6 hours. Children with frequent vomiting and diarrhea are shown hospitalization.
• When it will be possible to take food, it is necessary to strictly observe a sparing diet and to exclude from the diet all milk and dairy products, as they contribute to the rapid multiplication of pathogens in intestines.
• Also, the patient should take sorbents, such as Activated Carbon, Enterosgel, Smecta, Polysorb, STI Filter.
• With severe diarrhea with fever, doctors usually appoint Furazolidone (70 rubles) Enterofuril (300 caps. 500 suspension) or Enterol, their use helps to stop a prolonged course of diarrhea.
• And also should take medicines with digestive enzymes - Creon, Pancreatin, Mezim forte. In rare cases, phthalazole can be prescribed, but it can be used no more than 3 days.
• When the acute phase of the disease passes, it is necessary to restore the intestinal microflora. For this, there are many medicines, such as Linex, Bifiform, Rioflora-immuno, RioFlora-Balance, Bifidumbacterin Forte, Hilak Fort, etc. (cm. a complete list of all probiotics).

A few facts about intestinal flu

Does the flu vaccine help with intestinal flu?

Do not confuse two completely different diseases, two different pathogens. Of course, some signs of ordinary flu resemble symptoms of gastrointestinal flu - headache, manifestations of general intoxication, aches in joints, temperature. However, the usual flu does not cause a strong intestinal disorder and vaccination against it can not protect against infection with rotavirus infections.

Intestinal flu is very contagious

In the warm season, when there is a maximum spread of viral gastroenteritis, hygiene should be carefully observed. Gastric influenza enters the body by the fecal-oral route, that is, from a sick person through infected vomit or feces, when a healthy person is touched with a contaminated surface. Moreover, it is not uncommon for sewage, reservoirs, where the rest are bathed, contaminated food and dishes cooked by an infected person, contribute to the transmission of the causative agent of intestinal flu. Only careful washing of hands before any intake of food is able to protect against the development of gastroenteritis.

The gastrointestinal flu virus is quite hardy in the external environment

The causative agent of intestinal flu (norovirus) can remain alive for several hours on any surfaces in everyday life, even after cleaning, and, to infect a child, even a very small quantity. It is better to wash hands with soap under running water, this is more effective than using other hand products (napkins, spray).

Symptoms of the flu can not appear right away

Such intestinal symptoms as abdominal cramps, diarrhea and vomiting occur only after 1-2 days, after infection in the body, because the virus should reach the gastrointestinal tract and multiply in him. However, such pathogens as salmonellosis, etc., can cause signs of food poisoning after a few hours.

The most serious danger in children and adults is dehydration

Especially it is dangerous for children, as during vomiting and diarrhea there is a loss of fluid, it should be replenished. Moreover, with the liquid the body loses potassium, sodium and other minerals. Therefore, rehydration therapy (rehydron) is indicated. It is best to drink mineral water without gases, green tea, chamomile broth. It is not necessary to use milk, sour-milk products, bread and sweets in an acute period. During the recovery period, you should replenish the supplies of potassium, adding to the diet products such as bananas, rice porridge.

Intestinal flu not treated with antibiotics

Because this intestinal disorder is caused by a virus, antibiotics can not help here, contrary to the beliefs of many. Intestinal flu is treated symptomatically and antibacterial drugs are not indicated.

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List of inexpensive drugs against influenza and colds

Almost every person, at least once a year, suffers from a cold. No matter how strong the human body, it can not be fully insured against viruses and infections, especially if there is an off-season or winter. Producers for disease control offer inexpensive medicine for colds and flu. You need to know which ones are not just cheap, but also effective.

Antiviral drugs are inexpensive but effective

All funds for influenza and cold are divided into three broad categories:

1. Antiviral. These drugs fight the virus, make the body cells more resistant to its effects.
2. Immunomodulators. Preparations to correct the body's defense reactions to the natural level.
3. For symptomatic treatment. Drugs of this group do not suppress the infection, but simply remove the symptoms of a cold or flu.

Antiviral tablets

The most famous drugs of this category:

1. Tamiflu, Oseltamivir. Adults and adolescents drink 1 tablet twice a day for five days. The medicine is not recommended for those who have diseased kidneys.
2. «Amiksin». Adults drink on the first day of illness two tablets of 125 mg, and then - a piece every other day. The dosage of a child's drug is halved. The drug is not allowed for pregnant women.
3. "Ribavirin." The drug is a new generation, very effective. Adults take r, r four times a day. Course - 5 days.

Immunomodulators

Inexpensive good cures for cold and flu of this category:

1. "Cycloferon." The drug for adults and children, who are already four years old. The course is 20 days, take a pill every other day.
2. «Kagotsel». This medicine can be combined with antibiotics. Adults drink two tablets three times the first two days, and then one each. "Kagotsel" can not be taken for the first three months of pregnancy.
3. Anaferon. Homeopathic remedy. Adults drink one tablet 3-6 times a day.

For symptomatic treatment

List of drugs that can remove signs of illness:

1. "Koldakt Flyu Plus." Capsules with paracetamol and excipients. Drink them one by one every 12 hours. During treatment it is necessary to refuse categorically from alcoholic beverages.
2. "Coldrex". Helps with a cold with a wet cough. It is necessary to take one tablet 3-4 times a day. This drug can not be drunk if you have diabetes, liver or kidney failure.
3. "Rince". Tablets take a piece 4 times a day. They can not be drunk with pregnant women, children under 15, people with heart disease, blood vessels. Course - 5 days.
4. Fervex. The drug is released in the form of sachets of powder, which must be dissolved in warm water. Do not use "Fervex" for more than three days. A day can not drink more than 4 packages.

Cold remedies

In addition to pills, there are many other drugs that fight disease effectively. If you do not want to take antiviral medications for cold and flu, drink complex means of symptomatic action, then you can try another treatment tactic. The decision must be made based on the severity of the disease. There are many inexpensive drugs for cold and flu that will ease your condition.

From a sore throat

To remove inflammation and irritation you will benefit from such medications:

1. "Grammidine." Quick-acting tablets for resorption with anesthetic. Take them two times four times a day, observing a weekly course.
2. Strepsils. Relieve pain and have an antiseptic effect. Tablets must be dissolved one at a time every three hours. Children over five years of age are allowed to be treated with the drug. Completely remove the pain in the throat for three or four days.
3. Faryngosept. A powerful medicine that is forbidden to children under six. Tablets are recommended to dissolve after eating and then for a while not to drink liquids. For a day - no more than five pieces. The course of treatment is three days.

Nasal drops

Runny nose will help you remove these drugs:

1. "Sanorin". Have vasoconstrictive effect. Do not treat nasal congestion, and temporarily eliminate it. These drops can not be used for more than five days in a row. The composition of the reduced concentration of vasoconstrictor substances and eucalyptus oil.
2. "Pinosol". Medicinal drops that have a curative effect. They struggle slowly with the causes of the common cold, but they do not eliminate the stuffiness.
3. Aqua Maris. Means for moisturizing the nasal mucosa. It does not dry the blood vessels, it speeds up the healing process. Moisturizing drops are recommended to apply for any type of common cold.
4. "Vibrocil". Antiviral drug. Drops remove not only the common cold, but also its cause. They have vasoconstrictive, antihistamine action, kill bacteria, and reduce swelling.

Antipyretic

Rapidly reduce the temperature of such medicines:

1. "Paracetamol". A time-tested and inexpensive remedy that removes heat, relieves pain and inflammation. There are practically no side effects. Paracetamol is the main active ingredient of many other medicines: Panadol, Fervexa, Flukolda, Coldrex.
2. Ibuprofen. This medicine is rather anti-inflammatory, but it also lowers the temperature well. Do not take those with an ulcer, kidney or liver disease. It is part of the "Nurofen "Ibuklina".
3. "Aspirin" (acetylsalicylic acid). Antipyretic and analgesic. Do not take pregnant women, children under 12, those who have low blood coagulability. It is the main component of a huge number of other antipyretic drugs.

From herpes

This unpleasant symptom of cold will help to overcome such ointments:

1. Acyclovir. The most inexpensive means. It struggles with the virus, does not allow it to multiply. If you are pregnant or are breastfeeding, do not use the drug. If herpes you often appears, it is better to alternate "Acyclovir" with another antiseptic ointment or cream, so as not to cause addiction.
2. Zovirax. The composition of the cream includes propylene glycol, thanks to which the active substance penetrates into the cells faster and more efficiently. It is well absorbed into the skin. "Zovirax" should be used clearly according to the instructions.
3. Fenistil Pencivir. Very powerful medicine that eliminates herpes immediately. Does not allow the wound to become scarring. The drug can not be used by pregnant, lactating mothers, children under the age of 12.

From cough

Table of preparations:

From a dry cough	From a wet cough
"Lazolvan Ambrohexal; "Herbion "Libexin "Stoptussin."	"ACTS "Broncholitin "Acestad" (analogue of ATSTS); "Pertussin Mukaltin; Doctor MOM.

Inexpensive drugs analogues

If even the cheapest antiviral drugs are too expensive for you, use Paracetamol, Aspirin, or Ibuprofen. For symptomatic treatment, use local remedies: nasal drops "Naphthyzine" or "Farmazolin tablets for the treatment of sore throat "Septifril medicine "From coughing". It will also be effective to rinse your throat with "Chlorophyllipt".

Drugs for the prevention of influenza and colds

To protect yourself from the disease, and not to cope with its manifestations, it is best to use drugs with immunomodulating action. The rules of preventive reception are described in the instructions of each of them. You can try capsules "Broncho-munal which is allowed to combine with almost all drugs. A good prophylactic action is possessed by such drugs as Ribomunil, Immunal, Rimantadine, Arbidol, Amizon.

Video: home Coldreks for colds

Reviews

Olya, 27 years old: At the first symptoms of the flu, I always take some symptomatic medicine, for example, "Rinzu" or "Coldrex". This does not allow the infection to "play out". Immunomodulators did not drink at all because of the high price. And I try to treat the child with folk remedies, but I knock down the temperature with Paracetamol. I trust more domestic products.

Lena, 35 years old: Now the pharmacy offers so many names of medicines for colds that it's hard not to get lost. I try to use antipyretic drugs, for example, "Aspirin" or "Paracetamol." If the runny nose begins, then I use "Pinosol". He helps well, though he does not break his nose. If you start a sore throat, I use "Chlorophyllipt".

Tanya, 24 years old: I always have ORVI with fever and cough. I drink Fervex in powders, and I also buy ACTS. Thanks to this treatment, my illness lasts for three or four days. Last winter, saw for the prevention of "Arbidol but still sick, so I do not recognize any medications for correcting the immunity. I'm cured when the cold has already begun.

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