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INHALATION

A method of medical administration based on the inhalation of gas, vapor or smoke. Inhalation can be natural and artificial, with the use of special nebulizer devices – inhalers.

In this way, gaseous and volatile substances, liquid aerosols and powders of a certain particle size are introduced into the body. Inhalation reduces the absorption time, provides a selective effect of the administered substance on the respiratory system, and allows obtaining both local and resorptive effects.

Most often, the inhalation route of administration is used for two purposes, the first is to have a local therapeutic effect on the respiratory tract in their diseases (bronchitis, tracheitis, bronchial asthma), the second is to have a systemic effect on the entire body (the most common option is inhalation anesthesia).

One of the main characteristics of the mixture used for inhalation is the dispersion, which is determined by the size of the particles of the active substance (dispersed phase) introduced into the carrier medium (disperse medium). Dispersity determines the depth of penetration of the active substance into the respiratory system: as smaller the particle size, as deeper their dissusion.

USE OF INHALATION DEVICES

In pulmonology, it is widely used as a way to deliver medicine to the smallest bronchioles and alveoli. It is of particular importance in the removal of an attack of bronchial asthma.

In anesthesiology, it is the main method of administering medicines using general anesthesia, simultaneously with mechanical ventilation.

In aromatherapy, as a method of administration of concentrated volatile aromatic substances.

MEANS OF CARRYING OUT ARTIFICIAL INHALATION:

• Smoking incense;

• Spray can;

• Vapor-moisture inhaler (including electronic ones);

• Nebulizer;

• Ventilator;

• Chamber of hyperbaric oxygenation.

VITAMIN B2 (RIBOFLAVIN)

Riboflavin (vitamin B2) is a water-soluble biologically active substance that is a coenzyme of many vital redox enzymes and is involved in the metabolism of proteins, fats and carbohydrates. There are approximately 15 flavoproteins, which include riboflavin in the form of flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD). Flavin enzymes oxidize various acids, inactivate highly toxic aldehydes and foreign isomers of amino acids, take part in the synthesis of coenzymatic forms of vitamin B6 and folacin, maintain glutathione and hemoglobin in a reduced state, metabolize tryptophan to niacin and retinol to retinoic acid. Vitamin B2 also functions as a cofactor for glutathione reductase, increasing its activity. It is necessary for the formation and preservation of the integrity of red blood cells, the synthesis of antibodies, growth processes, and tissue respiration. Together with vitamin A, B2 ensures the integrity of the mucous membranes. In addition, it promotes the absorption of iron and vitamin B6 from food, relieves eye fatigue, and prevents cataracts. Riboflavin preparations are used in the treatment of skin diseases, slow healing wounds, eye diseases, diabetes, anemia, liver cirrhosis, and intestinal pathologies.

Vitamin B2 enters the human body through food. It is found in milk, greens, cereals, liver, kidneys, vegetables, yeast, mushrooms, almonds. Also used as food coloring E101. Riboflavin does not accumulate in the body, so there is a daily need for its intake.

The level of riboflavin in the blood can increase with parenteral administration of the drug, its high content in foods or nutritional supplements, but its excess is quickly excreted through the kidneys. A high concentration of vitamin B2 in the urine turns it bright yellow. Riboflavin has no toxic properties even in high doses.

The daily requirement of an adult for riboflavin is 1.1-1.3 mg (pregnant women 1.6 mg). The need for riboflavin increases with intense physical activity and the use of oral contraceptives.

Vitamin B2 deficiency (ariboflavinosis) has some clinical similarities to pellagra (niacin deficiency). Its manifestations can be seborrheic dermatitis and rough scaly skin (especially on the face), cheilosis (red, swollen, cracked lips), angular stomatitis (cracks in the corners of the mouth) and similar lesions of the anal and vaginal areas, mucosal and skin junctions, glossitis (swollen, painful, red ‘magenta’ tongue), congested vessels of the conjunctiva and conjunctivitis, lacrimation, photophobia, keratitis, and in some cases cataracts. In addition, normochromic normocytic anemia, nervous disorders, muscle weakness, and burning pains in the legs may develop.

VITAMIN B3 (NIACIN)

Niacin (vitamin B3) is a water-soluble vitamin that is converted into nicotinamide in the human body. It is part of the coenzymes of some dehydrogenases: nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP). In these molecular structures, nicotinamide acts as an electron donor and acceptor and participates in vital redox reactions catalyzed by dozens of different enzymes. As an enzyme cofactor, nicotinamide is involved in the metabolism of proteins, fats and carbohydrates, purine metabolism, tissue respiration, and glycogen breakdown.

Niacin has a lipid-lowering effect, dilates small blood vessels and improves microcirculation. It reduces the concentration of total cholesterol, apolipoprotein A, triglycerides, low-density lipids and increases the level of high-density lipids, which have anti-atherogenic properties (prevent the formation of atherosclerotic plaques in the vessels). It also increases the fibrinolytic activity of the blood and prevents thrombosis by reducing platelet aggregation.

Niacin is predominantly ingested through food. It is found in rye bread, buckwheat, beans, nuts, unpeeled grains, yeast, egg yolk, milk, meat, liver, kidneys, mushrooms, pineapple. In the food industry, it is used as a food additive E375. Satisfaction of the body’s need for niacin is also ensured by its synthesis from the essential amino acid tryptophan in the presence of vitamin B6, riboflavin and iron by the intestinal bacterial flora.

With insufficient intake of niacin, the skin, digestive organs and nervous system are affected. Deficiency of this vitamin leads to pellagra, a disease that is manifested by diarrhea, dermatitis, dementia and without treatment is life threatening. The skin lesion in pellagra is a sunburn-like erythema, especially pronounced on sun-exposed parts of the body; pigmentation gradually increases and the skin thickens. There is nausea, constipation or diarrhea, the tongue becomes bright red, there is apathy, fatigue, depression, headache, disorientation, sometimes the patient even loses memory. The development of dementia with delusions is preceded by increased irritability, depression and anorexia.

VITAMIN B6 (PYRIDOXAL-5-PHOSPHATE)

Vitamin B6 is the common name for three substances that enter the human body with food: pyridoxine, pyridoxal and pyridoxamine. Each of them in the process of metabolism passes into an active form – pyridoxal phosphate, which, being the most important coenzyme, takes part in the formation of red blood cells, activation of immune reactions, the processes of glucose uptake by nerve cells and the synthesis of neurotransmitters, in protein metabolism (required for transamination of amino acids), as well as in the metabolism of fats, providing a lipotropic and hypocholesterolemic effect.

The norm of B6 consumption for an adult is about 1.3 mg per day, during pregnancy and lactation, the need for it increases to 1.8-2.0 mg per day. Cereal sprouts, walnuts and hazelnuts, spinach, potatoes, carrots, cauliflower and white cabbage, tomatoes, strawberries, cherries, liver, meat, and fish are especially rich in this vitamin. In addition, it is synthesized by the intestinal microflora.

With a balanced diet, B6 deficiency is extremely rare. However, a number of factors increase the risk of hypovitaminosis:

• reduced kidney function;

• autoimmune diseases (rheumatoid arthritis, celiac disease, Crohn’s disease, ulcerative colitis, etc.);

• homocysteinuria;

• long-term use of certain drugs (cycloserine, carbamazepine, valproic acid, phenytoin, theophylline-containing drugs, etc.);

• alcohol addiction.

VITAMIN B12 (CYANOCOBALAMIN)

Vitamin B12 is found exclusively in animal products such as meat (especially liver and kidney), fish, eggs, and dairy products. In recent years, cereals, breads, breakfast cereals, and other grain products fortified with vitamin B12 have become an important source of vitamin B12, especially for vegetarians.

B12 is important for the synthesis of nucleic acids, the formation of red blood cells, cell and tissue metabolism, and it is also involved in maintaining the normal functioning of the nervous system. Vitamin B12 deficiency can lead to the development of macrocytic (megaloblastic) anemia. Its main manifestation is a decrease in the number of erythrocytes in the blood, but an increase in their size – the formation of macrocytes. Macrocytes tend to have a shorter lifespan than normal red blood cells and are more prone to hemolysis, leading to fatigue, weakness, and other symptoms of anemia. A lack of vitamin B12 threatens to damage the nervous system (funicular myelosis), which manifests itself in the form of tingling in the legs and arms of the patient (distal paresthesia), sensitivity disorder, increased tendon reflexes.

The main causes of vitamin B12 deficiency in the body:

• Insufficient intake of B12 accumulates mainly in the liver and spleen. Since the reserves of this vitamin in the body are quite large, and excretion is slow, it takes about 5 years of insufficient intake of it in the body to create a significant deficiency. Accordingly, the risk groups are starving people and vegetarians;

• Malabsorption. B12 deficiency sometimes occurs with various diseases of the small intestine that impair the absorption of this vitamin (celiac disease, Crohn’s disease, a decrease in the acidity of gastric juice (achlorhydria), as well as a decrease in the reabsorbent surface after resection of the jejunum. However, most

• Violation of disposal. Various diseases of the liver and kidneys, as well as alcohol abuse, lead to a decrease in accumulation and an increase in the release of vitamin B12;

• Increasing the body’s need for a vitamin. For various diseases that require large amounts of vitamin B12, such as hemolytic anemia, hyperthyroidism and alpha thalassemia.

VITAMIN C (ASCORBIC ACID)

Vitamin C (ascorbic acid) is a water-soluble vitamin essential for many biological processes in the body. It is not synthesized in the human body and accumulates in tissues in minimal amounts, so its reserves must be constantly replenished with food. The main sources of ascorbic acid are plant foods: rose hips, black currants, citrus fruits, green vegetables (especially broccoli), tomatoes, potatoes, peppers.

Vitamin C has a powerful antioxidant function and neutralizes free radicals in cells, protects against oxidative stress. It is a coenzyme for many metabolic processes. He takes part in the formation of collagen, the biosynthesis of carnitine, the absorption of iron, the conversion of dopamine to norepinephrine. In addition, ascorbic acid is necessary for wound healing and tissue growth, for the implementation of the function of the adrenal glands, the secretion of hormones and interferons, the metabolism of folic acid, tyrosine, phenylalanine. It increases the absorption of iron, reduces the concentration of cholesterol in the blood and helps to reduce high blood pressure. Ascorbic acid helps to strengthen the protective properties of the body, enhances the immune response in infectious diseases.

Smoking, hemodialysis, and stress increase the body’s need for vitamin C.

When used in a single dose of more than 2 g of vitamin C, abdominal pain, diarrhea, nausea may occur, 3 g – an increase in liver enzymes. Excess vitamin C is excreted in urine and feces. At the same time, the level of oxalates in the urine increases, which, in case of kidney pathology, contribute to the formation of urinary tract stones.

With a deficiency of ascorbic acid, the formation of connective tissue is disturbed, intradermal, intraarticular and intracavitary hemorrhages occur, inflammation and bleeding of the gums, joint pain, hair loss, dry skin, severe weakness and fatigue, emotional instability appear. With insufficient intake of vitamin C in children, bone growth is impaired.

In economically developed countries, cases of scurvy (vitamin C deficiency) are rare, and people who are poor or who abuse alcohol suffer from it. Cases of vitamin C deficiency have been reported with strict adherence to a macrobiotic diet.

With malabsorption syndrome (impaired absorption of nutrients from the digestive tract), metabolic disorders occur, which are manifested by signs of multivitamin deficiency.