Possibilities of the drug Actovegin in the prevention and treatment of dementia

Many women, while expecting a baby, are very worried about his health, the progress of pregnancy, fearing possible complications.

Fear especially increases if the doctor reports detected dysfunctions of the placenta, which threatens worsening blood circulation and the development of fetal hypoxia.

In this case, most women are ready to take various medications just to eliminate the problems that have arisen and successfully carry and give birth to a child.

Often, when the above diagnoses are made, Actovegin is prescribed during pregnancy. But is it safe for everyone? And maybe there are more useful ways to improve the condition for the expectant mother and baby?

In what cases do doctors prescribe Actovegin?

This drug contains deproteinized hemodialysate, a substance found in the blood of young calves. It is used to improve metabolic processes in blood vessels, that is, there is a more active filling of cells with oxygen and absorption of glucose.

Indications for the use of Actovegin during pregnancy are:

Actovegin is designed to help cope with the above problems, in particular, eliminate dysfunction of the placenta, improve blood circulation and prevent oxygen starvation of the fetus.

As you can see, everything in the instructions looks wonderful and I want to believe in the magic of one pill that will eliminate all problems during pregnancy.

BUT! It is important for you to know that the effectiveness of this drug has not been confirmed, since it has not been subjected to clinical studies.

Know! In a number of countries, Actovegin is prohibited for use during pregnancy, since its active substance is not approved as a medicine.

But in Russia the situation is different: the drug is in great demand by doctors and is quite often prescribed to pregnant women. I would also add that it is prescribed to absolutely all pregnant women, along with vitamins and folic acid (read the article on the topic: Vitamins in early pregnancy>>>).

Can everyone use Actovegin during pregnancy?

Contraindications to the use of the drug are:

• heart failure;
• kidney diseases;
• pulmonary edema;
• hypernatremia;
• fluid retention;
• individual intolerance to the components of the drug.

Important! Never prescribe the drug yourself. Do not drink it for the prevention or treatment of unproven diagnoses.

The danger of the drug lies in the possible occurrence of side effects. Among them are:

1. allergic reactions (usually skin rashes);
2. increased sweating;
3. flushes of blood to the face;
4. pressure changes;
5. increased heart rate;
6. the appearance of shortness of breath;
7. increased body temperature;
8. a sore throat;
9. headaches, dizziness;
10. digestive system disorders (stomach pain, diarrhea);
11. pain in muscles, back, joints.

If these symptoms appear, you should stop taking the drug and consult your doctor.

Drug safety

Drugs produced from various animal substances have always attracted increased attention. Animals are often carriers of numerous infections and parasites.

Therefore, the raw materials for Actovegin are tissues from Australian calves, in accordance with international standards that determine the suitability of certain substances for the production of medicines.

The general safe background of animal husbandry in Australia is complemented by special conditions for growing and testing raw materials before launching into production.

Contraindications and side effects

There are no strict contraindications to treatment with this drug. But it is not recommended for low blood pressure and the following health conditions:

• lack of urination for more than 12 hours;
• pregnancy and breastfeeding;
• swelling of various nature;
• diabetic crisis;
• child under 3 years old.

You should not “play hospital” and independently prescribe medications that affect the activity of the cardiovascular system.

If, after using the drug, prolonged discomfort or pain occurs, you should stop treatment and contact a medical facility.

Cases of overdose in the practice of official medicine have not been recorded to date.

All negative reactions to Actovegin associated with blood pressure or other manifestations are common, as a rule, among patients with personal intolerance to the components of the drug.

With intravenous injections or uncontrolled taking of pills, they may experience:

• loss of consciousness due to anaphylactic shock;
• redness and itching of the skin;
• increased heart rate and breathing;
• increased sweating and shortness of breath;
• migraines and dizziness;
• pain in the heart area;
• muscle spasms.

In the standard treatment regimen, Actovegin lowers blood pressure under medical supervision, does not affect the speed of reactions and has no restrictions on access to driving a car or working with moving machinery.

Actovegin - what kind of drug is this?

Actovegin has established itself as an effective medication for pregnant women based on natural ingredients of animal origin. The blood of young calves is purified from high-molecular protein fractions and used as the basis for the drug.

Actovegin includes:

• amino acids;
• low molecular weight peptides;
• nucleosides;
• antioxidants;
• electrolytes;
• metabolic products of fats and carbohydrates;
• microelements.

Release form and effect on the body

Actovegin is available in various forms and dosages. Most often, doctors prescribe the drug in tablets to pregnant women in the early stages for the prevention or treatment of minor deviations, and in especially severe cases, when there is a threat of miscarriage, they use intramuscular injections and intravenous drips based on Actovegin solution.

In addition, in pharmacies you can find the drug in the form of a gel or cream, which is used topically for various skin lesions. There are also eye drops with the same name used to treat diseases of the visual organs (see also: what eye drops can be used during pregnancy?).

Many women do not understand why Actovegin is prescribed to pregnant women and how the drug affects the body. Thanks to its unique composition, Actovegin is successfully used to eliminate factors that threaten the life of the fetus at any stage of pregnancy. Taking Actovegin helps:

• improving blood supply in all tissues and organs (including the placenta);
• regeneration of damaged tissues;
• the formation of oxygen inside cells;
• activation of all metabolic processes;
• increased blood microcirculation;
• activation of cell restoration and nutrition processes;
• increasing cellular glucose reserves;
• restoration of membrane functions (in case of detachment of the ovum);
• development of tissue resistance to hypoxia.

When is Actovegin prescribed?

The mechanism of action of the drug is aimed at correcting the condition of blood vessels. This leads to the diagnoses for which it is indicated:

• hypertension;
• thrombophlebitis;
• diseases of the cardiovascular system;
• diseases of the organs of vision and hearing associated with capillary disorders;
• destructive changes in organs due to insufficient oxygen and nutrition.

By improving metabolism and the flow of oxygen to cells, Actovegin helps to enrich the vital resource, thanks to which the patient feels elated and less tired at work.

Based on the severity of the disease, various forms of the drug are used:

Intravenous infusion is preferable in cases of:

• stroke;
• thrombophlebitis;
• varicose veins;
• cerebral insufficiency;
• TBI and other pathological manifestations in the functioning of the brain associated with its anatomical changes;
• lesions of peripheral vessels, including on the retina of the fundus of the eye and in the organs of hearing;
• extensive bedsores and many other diseases in an advanced stage.

Ointments treat:

• wound surfaces;
• bedsores;
• inflammatory skin phenomena;
• osteochondrosis of the joints and spine.

Eye gel is used for chemical or mechanical injury to the eyeballs.

The tableted drug is used for all of the listed diseases, for a mild, prolonged therapeutic effect.

Indications for use during pregnancy

There are a number of factors, taking into account which the doctor prescribes Actovegin during pregnancy in tablets or in the form of injections. Most often these are somatic diseases in a woman, insufficient development of the fetus or the risk of placental insufficiency. The main indications for use of the drug during pregnancy are:

• Maternal diseases (diabetes mellitus, heart defects, arterial hypertension, rheumatism);
• Threat of miscarriage (when frequent contractions of the uterine muscles occur, resulting in disruption of the blood flow of the placenta);
• Feto-placental insufficiency (slower fetal development, decreased blood supply to the blood vessels of the placenta and umbilical cord);
• pathologies of the placenta (detachment of the ovum in the first trimester, hypoplasia, swelling of the placenta due to rhesus conflict);
• hereditary thrombophilia (formation of blood clots in blood vessels) (for more details, see the article: hereditary thrombophilia during pregnancy);
• features of the woman’s medical history (if there was a previous miscarriage or frozen pregnancy, low or polyhydramnios, multiple pregnancy).

Symptoms of adenomyosis

Adenomyosis can be asymptomatic or cause quite noticeable discomfort, which leaves its mark on a woman’s quality of life. These symptoms may include:

• Dark brown, chocolate-colored discharge on the eve of menstruation, as well as after it.
• Quite pronounced premenstrual syndrome, and during menstruation quite noticeable nagging, aching pain in the lower abdomen.
• Dyspareunia - painful sexual intercourse can also be a symptom of adenomyosis.
• Due to hormonal disorders with adenomyosis, there may also be disturbances in the ovarian-menstrual cycle.
• Infertility is the most common reason why women turn to obstetricians and gynecologists for help with adenomyosis.
• An increase in the size of the uterus, which may be accompanied by frequent urination or difficult bowel movements.
• Pathologies of pregnancy in the form of a threat of miscarriage, threat of premature birth may also indicate the formation of adenomyosis.

The benefits and harms of Actovegin for pregnant women

Currently, experts have different opinions about the drug and its effect on the pregnant woman’s body. Supporters of the product highlight a number of positive properties of Actovegin:

• operational effect after IVs (a couple of days after administration, positive dynamics are observed in case of threat of miscarriage: the child begins to actively move and develop);
• taking the drug allows those women who have a history of frozen pregnancy or spontaneous abortion to bear and give birth to a healthy baby;
• the drug helps to activate all metabolic processes in the body, improves blood circulation, increases the supply of nutrients and oxygen in cells, and adapts tissues to hypoxia.

READ ALSO: Why is the drug “Dipyridamole” prescribed in the 3rd trimester of pregnancy?

Some experts believe that Actovegin does not bring benefit, but harm to the body of the mother and child. Along with this, there are a number of negative factors of the drug:

• the effect of the medication has not been fully studied, so undesirable effects are possible;
• there is a possibility of becoming infected with Creutzfeldt-Jakob disease (mad cow disease) and other dangerous viruses contained in the blood of cattle (for this reason, Actovegin and other similar drugs based on animal components are prohibited in many countries);
• The product should be used strictly as prescribed by the doctor, taking into account the recommended dosage and frequency of administration;
• If a pregnant woman has kidney problems, Actovegin is not prescribed.

How does the drug affect the fetus?

The use of Actovegin during pregnancy is justified only when the benefits for the condition of the expectant mother and fetus are higher than the potential risks for them. The medicine is only conditionally permitted during pregnancy.

The dosage of the drug for a particular pregnant woman is determined only by the doctor - he takes into account the results of the studies completed.

Important! Actovegin should not be taken without a prescription from a specialist, even if the woman has previously been treated with this drug.

An action such as uncontrolled use of a medicine can harm the health of the expectant mother and child.

Side effects and contraindications

Before prescribing Actovegin, the doctor must study the patient’s medical history and make sure that there are no contraindications to taking the drug. These include:

• pulmonary edema;
• kidney dysfunction;
• heart failure;
• allergy;
• intolerance to components.

In some cases, side effects are observed. This mainly manifests itself in the form of an allergic reaction to the constituent components of Actovegin, as a rule, to low molecular weight peptides. The reaction may be accompanied by itching and burning of the skin, rashes, and life-threatening anaphylactic shock or angioedema.

As a rule, before using the drug, the doctor gives a test injection to the pregnant woman in order to exclude an allergic reaction. Side effects also include:

• disorders of the gastrointestinal tract: diarrhea, abdominal pain, vomiting;
• weakness and malaise: dizziness, increased sweating, hypertension, high body temperature, shortness of breath;
• deterioration of health: sore throat, choking, migraine;
• discomfort in joints and muscle fibers;
• the appearance of swelling and bumps at the injection site.

The appearance of any of the above symptoms is a reason to stop taking Actovegin. The reaction should be reported to your doctor.

Actovegin - contraindications for use

No less important information for patients than what Actovegin is prescribed for is the list of restrictions on the use of this drug. All forms of the drug cannot be used if there is an individual intolerance or allergic reactions to the components. This is the only case when external forms of medication are contraindicated. As for the drug in tablet form, it is recommended to use it for treatment with extreme caution in the following cases:

• diabetes;
• hyperglycemia;
• impaired urine output;
• pulmonary edema;
• heart failure;
• pregnancy and lactation period.

Parenteral forms of the drug Actovegin have the following contraindications:

• pulmonary edema;
• impaired urine output;
• decompensated heart failure;
• swelling.

In addition, medication solutions should be prescribed with caution for the following diagnoses:

• diabetes;
• hyperchloremia;
• hypernatremia.

Is there an analogue?

If the patient has contraindications or side effects occur after taking Actovegin, you can select an effective analogue that is similar in therapeutic effect. The most identical remedy is Solcoseryl, an analogue of Actovegin. The composition of the medications is similar. The main component of the analogue is also the purified blood of a young cow.

The list of Actovegin analog drugs is presented in the table:

Possibilities of the drug Actovegin in the prevention and treatment of dementia

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Dementia is understood as a diffuse impairment of mental functions as a result of organic brain damage, manifested by primary disorders of thinking and memory and secondary emotional and behavioral disorders. Dementia is an extreme degree of decline in higher mental functions. It is customary to talk about dementia in cases where impairments in memory and other cognitive functions are so pronounced that they interfere with the implementation of professional and social activities in the same volume and quality. If a person has impairments in memory, thinking or other higher mental functions, but they do not interfere with professional activities and/or do not cause maladaptation of the patient in everyday life, they speak of cognitive impairment (cognitive decline).

There are several types of dementia:

Alzheimer's disease, vascular dementia ("subcortical" dementia, subcortical arteriosclerotic encephalopathy), mixed dementia, alcoholic dementia, etc. Dementia is especially common in the elderly. According to population studies, it is detected in 5–20% of people over 60 years of age. According to a number of authors, the presence of dementia increases the mortality rate of elderly patients by almost 3 times. It is believed that this is due to mnestic-intellectual decline, so patients with dementia cannot adequately assess the severity of their disease and the need for treatment. In addition, due to memory loss (the main diagnostic criterion for dementia), such patients forget to take medications.

Alzheimer's disease and vascular dementia are the most common types of dementia

. In Russia, vascular dementia ranks first in frequency (5.4%), its share is from 10 to 39% of all cases of dementia. According to the ICD-10 definition, vascular dementia is the result of cerebral infarctions due to cerebral vascular disease, including cerebrovascular disease due to arterial hypertension (AH). Heart attacks are usually small, but their cumulative effect is manifested.

The development of vascular dementia is promoted mainly by ischemic brain lesions, both focal and diffuse, and clinically this can be characterized by a progressive deterioration of cognitive functions (memory, thinking, attention, orientation, etc.) and social skills. “Subcortical” dementia is characterized primarily by an increase in the time that the patient spends on performing mnestic-intellectual tasks. There is a decrease in concentration, rapid exhaustion, memory impairment, especially for current events, emotional and behavioral disorders. Memory loss is a characteristic symptom of “subcortical” dementias. However, mnestic disorders, as a rule, are more mildly expressed in comparison with the dementia that develops in Alzheimer's disease. There is no clinically clear amnesia for current or distant events. Memory impairments manifest themselves mainly during learning: it is difficult to memorize words, visual information, and acquire new motor skills. Basically, active reproduction of material suffers, while simpler recognition is relatively intact. External stimulation in the form of assistance with memorization, the establishment of semantic connections during information processing, and repeated presentation of material increase the productivity of memorization. The mnestic defect in subcortical dementias is localized at the stage of “working memory”: a decrease in the volume of information assimilation after the first presentations is noted.

The main pathogenetic role in the formation of mnestic disorders in subcortical dementias is played by dysfunction of the frontal lobes of the brain, which leads to decreased activity, lack of planning, and disruption of the sequence and selectivity of mnestic operations. Patients with vascular dementia are characterized by a slowdown in all mental processes and a narrowing of their range of interests. In later stages, impairments in abstract thinking and judgment may develop. As a rule, focal disorders of higher cortical functions (aphasia, agraphia, alexia, apraxia, acalculia) do not develop, which is typical for cognitive disorders of the subcortical type. The appearance of such severe symptoms accompanies severe dementia.

More than half of patients with vascular dementia experience so-called emotional incontinence (weakness of spirit, violent crying). Vascular dementia is characterized by long periods of stabilization and even a certain reverse development of mnestic-intellectual disorders, and therefore the degree of its severity often fluctuates quite significantly in one direction or another. In such cases, fluctuations in the state of regional cerebral blood flow are important.

In addition to cognitive impairment, patients with vascular dementia also have neurological manifestations: subcortical, pseudobulbar, cerebellar syndromes, impaired control of pelvic functions, mainly urinary incontinence, paresis of the muscles of the limbs, often mild and usually not affecting the functional activity of the patient. The combination of cognitive and marked neurological disorders distinguishes vascular dementia from degenerative diseases, in particular Alzheimer's disease, in which cognitive disorders and symptoms of impairment of higher cortical functions (aphasia, apraxia) dominate.

The leading role in the formation of dementia with vascular lesions of the brain is played by damage to the white matter of the brain and the basal ganglia, which leads to disruption of the connection between the frontal lobes of the brain and subcortical structures (the phenomenon of cortical-subcortical disconnection). The main pathogenetic factor in the development of this phenomenon is hypertension, which leads to changes in the vascular wall (lipohyalinosis), mainly in the vessels of the microvasculature. As a result, arteriolosclerosis develops, which causes a change in the physiological reactivity of blood vessels. Under such conditions, a decrease in blood pressure (BP), including due to inadequate antihypertensive therapy, leads to a decrease in perfusion and the development of ischemia of the white matter of the brain.

On T2-weighted images of magnetic resonance imaging of the brain, a marker of the presence of chronic ischemia is a rarefaction of the periventricular or subcortical white matter - leukoaraiosis (“glow of the white matter”), which is visualized. Morphologically, these zones represent a zone of demyelination, gliosis and expansion of perivascular spaces.

Based on the above, prevention and treatment

vascular dementia and cognitive impairment should primarily include adequate correction of high blood pressure. Achieving target blood pressure is mandatory, but the pace of its achievement should be as gentle as possible. They depend on the initial values ​​of blood pressure in a given patient, the duration and severity of both hypertension and concomitant diseases. But in general, the rule is true - a sharp decrease in blood pressure for an elderly patient with hypertension is no less, but rather more dangerous than its sharp increase. Treatment of hypertension, coronary heart disease, heart failure, prescription of antiplatelet agents, surgical correction of atherosclerotic narrowing of the great arteries help prevent the increase in cognitive impairment and, according to some data, reduce existing ones. Control of hyperglycemia and hyperlipidemia is also necessary. However, in a number of cases, pathogenetic therapy for dementia still seems impossible, since its cause remains either unknown (senile dementia of the Alzheimer's type) or cannot be affected (multi-infarct dementia).

Current approaches to the treatment of dementia are also based on improving the delivery and use of oxygen and glucose. Glucose and oxygen are necessary for brain cells to carry out aerobic glycolysis, during which 38 ATP molecules are produced, which, in turn, provide the cells with an adequate level of functioning. The importance of oxygen and glucose for maintaining the normal functioning of brain cells is evidenced by the fact that for the functioning of the brain (the weight of which is 2% of body weight), 50% oxygen and 10% glucose are extracted from the flowing blood at a normal volume of total blood flow. Indeed, in conditions of deficiency of these substances, the processes of not aerobic, but anaerobic glycolysis occur, as a result of which only 2 ATP molecules are formed. Under such conditions, not only is the normal functioning of brain cells impossible, but they also die.

Therefore, there are other areas for the prevention and treatment of dementia. Thus, for quite a long time in clinical practice, the drug Actovegin, a modern antihypoxant, has been used for this purpose. This is a highly purified hemodialysate obtained by ultrafiltration from the blood of calves. The drug contains organic low-molecular compounds: amino acids, oligopeptides, nucleosides; intermediate products of carbohydrate and fat metabolism; oligosaccharides and glycolipids, as well as electrolytes (sodium, calcium, phosphorus, magnesium) (Fig. 1). The technology for obtaining hemodialysate excludes the presence of protein and other components with antigenic and pyrogenic properties.

Rice.
1. Composition of the drug Actovegin The basis of the pharmacological action of Actovegin is its effect on the processes of intracellular metabolism
. Under the influence of this drug, the transport of glucose into cells and the absorption of oxygen in tissues improves. The entry of a large amount of oxygen into the cell leads to the activation of aerobic oxidation processes, which increases the energy potential of the cell (Fig. 2). Under the influence of Actovegin, glucose transporters are activated, and an increase in glucose transport is noted up to 50% of the maximum effect of insulin. But this action of Actovegin is insulin-independent: due to the presence of glycolipids in its composition, Actovegin directly causes the activation of glucose transporters.

Rice. 2. Pharmacological effect of Actovegin on the processes of intracellular metabolism

There are a large number of studies, both domestic and foreign, that indicate an improvement in cognitive processes during treatment with Actovegin. However, of particular interest, of course, are the results of double-blind, placebo-controlled studies (Fig. 3). The results of these studies indicate that patients with various brain diseases during treatment with Actovegin showed a significant improvement in cognitive functions compared to placebo.

Rice. 3. Results of double-blind, placebo-controlled studies of the drug Actovegin

Thus, B. Saletu et al., using IV Actovegin, found a significant improvement in memory, attention and some parameters of thinking in patients with age-related memory decline compared to placebo. This study included patients aged 50 to 80 years (mean age 64 years) with age-related memory decline, and none of the patients met diagnostic criteria for dementia. The authors noted this effect of Actovegin after 14 days of treatment.

Another group of researchers (WM Herrmann et al.) also used the IV route of administration of Actovegin. However, they examined patients with Alzheimer's disease and multi-infarct dementia (Fig. 5). Therefore, the period of treatment with Actovegin was already 4 weeks. In the Actovegin group, the authors found a significant improvement in cognitive processes for collecting and processing information, severity of dementia symptoms, patients’ general well-being and care needs compared to placebo. Moreover, improvement was noted after the second week of therapy and was even more pronounced after four weeks. Despite the fact that the chosen treatment period was relatively short (at least three months are needed), the required and significant effect was still revealed. This may be due to intravenous use of the drug, which could cause a faster onset of effect.

Rice. 5. Data from a survey of patients with Alzheimer’s disease and multi-infarct dementia after a course of Actovegin (iv)

The literature contains data from double-blind, placebo-controlled studies on the effectiveness of the oral dosage form of Actovegin. Thus, WD Oswald et al. showed that Actovegin increased the speed of cognitive processes in patients with mild to moderate organic brain damage syndrome to a significantly greater extent compared to placebo (Fig. 4). In this study, patients over 60 years of age with mild to moderate psychoorganic syndrome received 400 mg x 3 times or placebo for 8 weeks.

Rice. 4. Data from double-blind, placebo-controlled studies of the oral dosage form of Actovegin

W. Jansen and GW Brueckner studied the therapeutic effects of Actovegin forte tablets (200 mg of active substance) and the dependence of the results of therapy on the dose of the drug in elderly (60–72 years) patients with cerebrovascular insufficiency. Patients were randomized into 3 groups: Actovegin forte 3 tablets 3 times a day (40 people), Actovegin Forte 2 tablets 3 times a day (40 people), placebo (20 patients 3 tablets 3 times a day, 20 patients 2 tablets 3 times a day). The duration of therapy was longer than in the study by WD Oswald et al. and amounted to 12 weeks.

To assess intelligence, a jigsaw test was chosen (it is necessary to sort 16 decks in 7 patterns within a certain time), which requires synthetic and analytical abilities and is considered especially difficult for patients with reduced intelligence and the elderly (Fig. 6). This test also characterizes the degree of age-related decline in intellectual abilities. The authors found that both Actovegin dosage regimens improved thinking and attention in elderly patients to a significantly greater extent than placebo.

Rice. 6. Results of a mosaic test to assess intelligence in the elderly when taking Actovegin according to the regimen

HV Semlitsch et al. In a double-blind, placebo-controlled study, the effect of Actovegin on the so-called P300 component of evoked brain potentials in patients with age-related memory disorders was studied. The late positive component (P300) of potentials (syn.: cognitive evoked potentials) is used in studies of cognitive processes and nootropic drugs, since a close connection has been established between P300 and cognitive functions. This means that a potential nootropic drug should shorten P300 latency and/or increase P300 amplitude, and/or increase the activity of P300 sources.

Each patient in this study received therapy for 2 weeks with either 250 ml of a 20% Actovegin solution or 250 ml of placebo. After using Actovegin, the amplitude of parietal P300 increased in comparison with placebo. This may reflect improved cognitive processes in the parietal cortex, a region that plays a fundamental role in attention but is functionally damaged in dementia.

The results of EEG brain mapping showed that Actovegin, in contrast to placebo, has a significant positive effect on human brain function (decrease in delta and theta activity and increase in slow beta activity adjacent to alpha, decrease in fast beta activity). Topographically, the encephalotropic effects of treatment with Actovegin were more pronounced in the parietal, fronto-central and temporo-occipital areas. At the same time, topographically, the greatest differences between Actovegin and placebo were also observed in the parietal and temporal regions. These data are of interest because in recent studies with EEG brain mapping in Alzheimer's type dementia, it was the parietal and temporal regions that differed from those in the control group of healthy individuals. Indeed, most of the changes are described by neuropathologists, neurobiochemists and neuroradiologists in these areas of the brain. Significant decreases in cortical mass in the parietal and temporal regions have been described, consistent with decreased cerebral blood flow in the central and parieto-occipital regions and decreased glucose metabolism in these regions measured by positron emission tomography (PET) in the disease. Alzheimer's. RP Friedland et al. noticed that glucose metabolism suffers most in the temporo-parietal cortex. The author emphasizes that histopathological changes are most pronounced in this same area.

Thus, the results of double-blind, placebo-controlled studies indicate the effectiveness of the drug Actovegin for the prevention and treatment of dementia.

To prevent dementia in patients with impaired cognitive functions, Actovegin forte 200 mg x 3 times a day is usually used for 1.5–2 months. In patients with vascular dementia, they usually start with intravenous Actovegin 400-800 mg (10-20 ml) intravenously for 10-14 days, and then switch to oral Actovegin forte 200 mg 3 times a day.

An integrated approach to the treatment of elderly patients, including adequate treatment of cardiovascular diseases and the use of drugs with proven effectiveness, will improve the quality of life of elderly people, which is of great medical and social importance.
Literature:
1. Vereshchagin N.V., Gulevskaya T.S., Yu.K.Milovidov. Neurological aspects of the problem of vascular dementia. Journal of Neurology and Psychiatry - 1993 - No. 3 - P.91–95.

2. Yakhno N.N., Zakharov V.V. Cognitive and emotional-affective disorders in dyscirculatory encephalopathy. // Russian Medical Journal – 2002 – Volume 10 – No. 12–13 – P. 539–542.

3. Preobrazhensky D.V., Sidorenko B.A. Treatment of arterial hypertension. Part 1. – Moscow, 1999. – P.4–23.

4. Kalashnikova L.A., Kadykov A.S., Gulevskaya T.S. et al. Cognitive impairment and dementia in subcortical arteriosclerotic encephalopathy in the elderly and senile. // Clinical gerontology – 1996 – No. 1 – P.22–26.

5. Medvedev A.V. Vascular dementia // Modern psychiatry – 1998 – No. 4 – P.20–23.

6. Schaffler K., Wauschkuhn CH, Hauser B. Pilot–study to evaluate the encephalotropic potency of ActoHorm using electroretinography and visually evoked potentials unger hypoxyc conditions in 12 healthy volunteers. // Arzneimittel–Forschung – 1991 – Vol.41 – 398–403.

7. Saletu B., Grunberger J., Linzmayer L. et al. EEG Brain Mapping and Psychometry in age–associated memory impairment after acute and 2–week infusion with the impairment after acute and 2–week infusion with the hemoderivative Actovegin: double–blind, placebo–controlled trials. // Neuropsychobiology – 1990–91 – Vol.24 – P.135–148.

8. Herrmann WM, Bohn–Olszewsky WJ, Kuntz G. Infusion therapy mit Actovegin bei Patienten mit ptimar degenerativer Demenz vom Alzheimer Typ und Multiinfarction–Demenz. // Z.Geriatrie – 1992 – Vol.5 – P.46–55.

9. Oswald W.D., Steger W., Oswald B. et al. Increase of fluid cognitive components as an aspect in evaluation drug efficacy. A double–controlled study with Actovegin. // Zeitschrift fur Gerontopsychologie und Psichiatrie – 1991 – Vol.4 – No. 4 – P.209–220.

10. Jansen W., Brueckner GW Treatment of chronic cerebrovascular insufficiency using Actovegin forte tablets (double-blind, placebo-controlled study). // Russian Medical Journal – 2002 – Volume 10 – No. 12–13 – P.543–547.

11. Saletu B., Anderer P., Paulus E. et al. EEG brain mapping in SDAT and MID patients before and during placebo and xantinolnicotinate therapy: Reference considerations; in Samson–Dollfus D., Guieu JD, Gotman J, Etevenon P. (eds): Statistics and Topography in Quantitative EEG. Paris, Elsevier, 1988, pp. 251–275.

12. Najilerahim A, Bowen DM: Regional weight loss of the cerebral cortex and some subcortical nuclei in senile dementia of the Alzheimer type. // Acta neuropathol – 1988 – Vol.75 – P.509–512.

13. Duara R, Grady C, Haxby J et al. Positron emission tomography in Alzheimer's disease. // Neurology – 1986 – Vol.36 – P.879–887.

14. Friedland RP., Budinger TF., Ganz E. et al. Regional cerebral metabolic alternations in dementia of the Alzheimer type. Positron emission tomography with (F)fluorodeoxyglucose. // J Comput Assist Tomogr – 1983 – Vol.7 – P.590–598.

15. Semlitsch HV, Anderer P., Saletu B. Hochmayer I. Topographic mapping of cognitive event-related potentials in a double-blind, placebo-controlled study with the hemoderivative actovegin in age-associated memory impairment. // Neutopsychobiology – 1990–91 – Vol.24 – P.49–56.

Actovegin during lactation

For diseases that cause blood circulation, Actovegin is prescribed during pregnancy. If there is still a need to continue therapy with Actovegin, the drug is prescribed during lactation. Indications for prescribing Actovegin to women who are breastfeeding are the following diseases:

• Phlebeurysm;
• Acute cerebral circulatory failure;
• Traumatic brain injury;
• Diseases of the central and peripheral nervous system;
• Haemorrhoids.

Doctors at the Yusupov Hospital administer Actovegin therapy according to official instructions. The use of the drug does not harm the health of the baby and his mother. However, Actovegin is used during lactation only if the benefit outweighs the risk of complications. More detailed advice on the use of Actovegin during pregnancy and lactation can be obtained by making an appointment.

AuthorHead of the Department of Neurology, neurologist, Ph.D.

Actovegin - reviews

Most often, Actovegin is prescribed by doctors in the form of tablets and injections, and forms for external use (ointments, gels and creams) are usually used on an independent decision without a medical prescription. Accordingly, almost all reviews concern Actovegin in the form of tablets and injections.

Tablets and injections are most often prescribed to young children, pregnant women and adults for circulatory disorders in various tissues and organs, and associated symptoms.

Actovegin is actively prescribed to children by neurologists for cysts and cerebral circulatory disorders, as well as developmental delays. In most cases, the drug has a visible therapeutic effect, improving blood circulation in the brain, which is manifested by normalizing the child’s sleep, relieving moodiness, tearfulness, anxiety, excessive irritability, etc. In case of developmental delays, the drug has an ambiguous effect - some parents in the reviews indicate a noticeable improvement after the course of treatment, while others, on the contrary, indicate the absence of any effect. In the reviews, parents indicate that it is inconvenient to divide the tablets into halves and quarters, since they are biconvex and without risks. But children, as a rule, take a tablet dissolved in water, which has a salty taste, without problems, which is convenient for parents, since they do not need to make efforts to force the baby to drink the medicine. Also, a number of reviews about the use of Actovegin in children indicate that the drug caused diarrhea and severe, painful colic in the abdomen, as a result of which it was necessary to stop the course of therapy.

Actovegin is often prescribed to pregnant women, both in the form of injections and in the form of tablets. Typically, the reason for prescribing Actovegin is fetal hypoxia detected on ultrasound or during CTG, impaired blood flow in the placenta or fetoplacental insufficiency, as well as toxicosis, dizziness, headaches or cramps in the legs arising from circulatory disorders. In almost all cases, pregnant women leave positive reviews about Actovegin, since the drug improves their own well-being and the condition of the fetus, normalizing ultrasound, CTG and other studies.

For all other adults, Actovegin is usually prescribed for various circulatory disorders, such as, for example, headaches, vegetative-vascular dystonia, spasms in the limbs, stroke, etc. Reviews indicate that the drug effectively relieves headaches, dizziness and other symptoms caused by cerebrovascular disease, and also eliminates painful spasms in the limbs, and reduces the degree of freezing of the hands and feet. Reviews also indicate that Actovegin is very effective for vegetative-vascular dystonia, since it significantly improves overall well-being and reduces the severity and frequency of attacks. Somewhat less frequently, reviews indicate that Actovegin works great as a drug for rehabilitation after a stroke or traumatic brain injury.

When used for elderly people, Actovegin has a pronounced stimulating effect, against the background of which, after a course of injections, previously exhausted bedridden patients can get up and do simple housework (cook food, clean the room, wash things, etc.). Therefore, many reviews indicate that for older people Actovegin is an excellent maintenance drug that allows them to maintain activity and mobility.

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Reviews from women about treatment with Actovegin during pregnancy

Actovegin is a very good and effective medicine. It was prescribed to me for polyhydramnios. Polyhydramnios disappeared within a week. Prescribed to improve blood circulation. He has a lot of evidence. It definitely won't hurt the baby.

I came across the prescription of Actovegin (reasons: moderate oligohydramnios at 25 weeks, premature maturation of the placenta, suspension in the water). The decision was in favor of the drug. So, now I can objectively say that most likely it was possible to do without Actovegin. Moreover, it did more harm than good (very doubtful!). Firstly, when they dropped it on me, the baby began to be so active that it seemed like he was about to crawl out of his stomach (I don’t think he felt good)! Secondly, I developed a rash on my arm (an allergy), which the doctor told me about (no big deal!). As a result, after pregnancy I have an allergy to something unknown, including angioedema, and the child also has an allergic reaction.

I have been injected since 28 weeks, as the placenta has aged. At this stage there was 2–3 degree of maturity. Then she was kept in storage. Actovegin was given because the baby was not gaining weight well and was two weeks behind due date. Many girls were injected, it did no harm to anyone, it was only a benefit for everyone. If you have something connected with the placenta, then in the end the baby suffers, especially his brain suffers, then after birth there may be problems.

During pregnancy, I was injected with Actovegin, this drug was just for better oxygen supply, I had premature ripening of the placenta, a good drug, one course was injected intravenously, and the second - in tablets.

My ultrasound at 24 weeks showed a “not very good” placenta and the risk of oxygen starvation for the baby, but after Actovegin, by the next ultrasound at 27.5 weeks everything was back to normal. I read that Actovegin is a drug with unproven effectiveness, but for me personally its effectiveness has been proven both by my good health and by ultrasound results. The injections are a little painful, but no worse than other drugs that are offered to pregnant women and those who have given birth; they can be tolerated. The main thing is that there is an effect. I know that the drug is expensive in pharmacies, but they injected me in the hospital for free.

Features of treatment at different periods and instructions for use

In the first trimester, hypoxia is rare, since the fetus is still very small and its saturation with oxygen occurs unhindered. However, the use of any medications during this period is extremely undesirable.

In the first months of pregnancy, the formation of the child’s organs and systems occurs, so any external intervention can negatively affect the development of the fetus.

In the second trimester, the growing fetus does not receive enough oxygen and nutrients if the placenta is not able to fully perform its functions. At this stage, the lack of certain useful substances in the blood, for example, hemoglobin, affects blood flow and leads to placental insufficiency. The doctor may prescribe Actovegin to improve the child’s supply of micronutrients.

In the last trimester, a serious and common disease is premature aging of the placenta. It can provoke an acute lack of blood circulation, underweight of the fetus and early onset of labor. In such a situation, shortly before birth, intramuscular or intravenous injections of Actovegin may be prescribed.

The duration of treatment and dosage of all forms of the drug are determined by the doctor. Most often, treatment with Actovegin is limited to a period of 4–6 weeks.

Side effects for a pregnant woman

The use of Actovegin is not recommended in the following cases:

• hypersensitivity to the components of the drug;
• water retention in the body;
• a decrease in the amount or absence of urine produced by the kidneys;
• swelling of the lungs;
• high levels of chlorine and sodium in the blood.

For 15 years (1996–2010), comparative studies of Actovegin were conducted in countries where it was/was not used. It turned out that where the drug was prescribed, acquired dementia was diagnosed more often (approximately one third more patients than in countries that did not practice its use). After the publication of the results of this study, Actovegin was banned in Canada and the USA. At the moment, it is recommended only in the countries of the former USSR, North Korea and South Korea.

The drug may cause the following side effects:

• skin rash;
• pronounced redness of various areas of the skin;
• increased temperature and accumulation of excess heat in the body;
• anaphylactic shock is an acute and severe allergic reaction.

If such symptoms appear, you should stop taking Actovegin and consult a doctor.

Action and scope of Actovegin

The drug is produced from the blood of calves, removing proteins from it. The resulting deproteinized hemoderivative, containing components of cell mass and animal blood serum, is the active ingredient of Actovegin, which belongs to the group of antihypoxants.

Functions of Actovegin as an antihypoxant:

• helps transport and remove glucose from the blood;
• increases oxygen and nutrient consumption;
• reduces the time of tissue and skin regeneration, restores their sensitivity;
• normalizes metabolism in tissues;
• improves mental well-being.

For those suffering from diabetes, after treatment with Actovegin, pain, tingling and burning in the extremities are reduced, and numbness in the legs is prevented.

Forms of release of Actovegin

Actovegin is available in several forms: tablets, ampoules, ointment, cream, gel. The use of the drug in a certain form depends on the condition of the woman and child, her diagnosis, and the duration of pregnancy.

Why are Actovegin tablets prescribed during pregnancy?

Most often, doctors prescribe the tablet form of the drug to expectant mothers for the purpose of prevention if the woman has previously had miscarriages or a frozen pregnancy. It is not clear how these phenomena are generally related to the use of Actovegin.

• An early miscarriage always has a reason: either physiological, when something in your body prevents you from carrying a pregnancy, or genetic, when the embryo already had developmental disorders and the body rejected it;
• Frozen pregnancy occurs for similar reasons.

In both cases, you should have undergone a full examination before pregnancy and understand the reasons for what happened.

Actovegin is not used to prevent miscarriage. These are not vitamins, not a safe medicine and not an indication for taking it.

Why are Actovegin droppers prescribed during pregnancy?

Droppers are administered intravenously; they are usually used when treating an expectant mother in a hospital. They are often used for emergency therapy, when urgent improvement in the condition of a woman and child is necessary.

Intramuscular administration of Actovegin (in ampoules) has a similar effect. The injections also give a quick effect if urgent intervention is needed.

In what cases are Actovegin gel, ointment and cream used?

The drug in the form of a gel, ointment and cream is applied to the affected areas of the body. Actovegin in these forms is used to treat wounds, cuts, abrasions, burns, radiation injuries to the skin and eyes, and is used in the complex treatment of hemorrhoids.

Adenomyosis and endometriosis: what is the difference?

Adenomyosis is a type of endometriosis that affects the female reproductive organ (uterus). Namely, adenomyosis is the proliferation of endometrioid cells in atypical places for their localization. That is, in the myometrium of the uterus, in the submucosal layer, as well as in the serous layer of the uterus.

Adenomyosis (endometriosis) of the uterus: causes of the formation of endometrioid heterotopias.

1. Surgical interventions on the uterus. This group of reasons includes cesarean section and conservative myomectomies.
2. Intrauterine manipulations in the form of curettage, abortions performed by acute curettage.
3. One of the most common causes of adenomyosis is the presence of infectious lesions of the urinary and reproductive system.
4. Hormonal imbalance plays an important role in the causes of endometrioid heterotopias.
5. Genetic predisposition to the occurrence of an atypical arrangement of endometrial cells plays a potentiating role in the development of this disease.
6. A stress factor does not exclude its influence on the development of a condition such as adenomyosis.

How is Actovegin taken during pregnancy?

To receive admission you must have very strong indications:

Fetal growth retardation, gestosis, placental abruption, poor ultrasound readings...

Something that could actually be an indication.

For a healthy woman, Actovegin is not needed.

Attention! If there are real and not fictitious indications, then only in this case can you decide to take the medicine.

As with any drug, be sure to read the instructions for using Actovegin during pregnancy. It indicates the general rules and dosages of the drug, depending on the form of release.

First of all, you should focus on the recommendations for taking the drug, which will be given by your attending physician, taking into account the individual characteristics of your body and the difficulties of pregnancy.

Dosage

1. Take 1-2 tablets, no more than three times a day, 30 minutes before meals;
2. They should be swallowed whole with a small amount of water, without chewing or dissolving;
3. The course of treatment is usually 4-6 weeks.

• Intravenous injections and injections are administered only under the strict supervision of a doctor and, most often, in a hospital;
• The dosage, in this case, is calculated individually, but, as a rule, ranges from 5 to 20 ml of injection solution, which is diluted in saline and administered via a dropper once a day or every other day;
• The solution for intravenous infusion is already available in diluted form and is ready for use.

1. Actovegin, in the form of an ointment, gel or cream, is applied in a thin layer to the affected areas several times a day;
2. Sometimes compresses are made using ointment. Depending on the severity of the affected area, treatment can last from 3 to 60 days.

Pages

Actovegin in gynecology. Endometrium. Infertility. ECO

What is the reason for the formation of endometritis?

There are many reasons, but the most common reasons are the following: :

intrauterine manipulation and, mainly, abortion; inflammatory diseases (including sexually transmitted diseases); hormonal disorders in the female body, etc.

As a result of these processes, diseases arise. And one of these diseases is chronic endometrium
,
which we write about in this article. Endometritis occurs among women who gave birth without birth complications (in the postpartum period, two to seven percent) and among women who gave birth with purulent-inflammatory postpartum complications (approximately forty percent of women). At the same time, a severe form of endometritis occurs in about 25% of women giving birth (in the postpartum period).

Today, hysteroscopy is used to diagnose the pathological process inside the uterus.

What are the signs of the inflammatory process in the endometrium?

In approximately a third of cases, this is uneven thickness of the endometrium, in another third of cases it is polyp-like growths, etc. There are no typical macroscopic signs of CE, so it is possible to determine endometritis using hysteroscopy in a maximum of a third of cases. This examination procedure is needed to determine the full picture of intrauterine pathology if CE is suspected. And to make a diagnosis, a morphological examination of the endometrium (diagnostic curettage of the uterine mucosa) is important.

Actovegin is available in the form of a solution for injection and infusion, and in the form of tablets. And this is very convenient. Therefore, those patients who cannot go to the hospital or go for injections take Actovegin at home orally before meals, with a small amount of water.

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