Varix dilatation of lower extremities › upload › files › lectiol › ... · Varix dilatation...

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Pharmaceutical care

Varix dilatation of lower extremities

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pregnancyobesity protracted stay in position uprightinnate weakness of connecting tissuetraumasunmoved lifestyletumour processes of pelvisreception of hormonal contraceptivesage more than 40 yearscarrying of stockings with tight elastics

factors, cooperant an origin

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ФАРМАЦІЯ Stages of varix dilatation of lower

extremities

I stage — there are not complaints, only cosmetic violationsII stage — there are sense of weight, holdings apart, cramps at nights, paresthesiasIII stage — there are edemamata, sense of holding apart, induration of skin and hypoderm, pigmentation IV stage — formation of ulcers

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1. With a defeat only of superficial veins- without the phenomena of Chronic Venous Insufficiency (CVI)

2. With the defeat of both superficial and perforants veins- with the phenomena of CVI (stage of compensation)

3. With a defeat as superficial, perforants and deep veins- with the phenomena of CVI (stage of decompensation)

- with trophic disturbances of skin- without trophic disturbances of skin

classification


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acute thrombophlebitisbreak of varicose knot with bleedingchronic venous insufficiency with development of trophic ulcerssepsis

complications


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Use of physical methods(carrying of stockings, elastic bandages, massage etc.)

Medicinal treatmentSclerotherapy(reticular forms of varices)

Surgical treatment(operations of Babcock-Narat, Madelung, sewing of communicant veins etc.)

basic directions therapy

complications!


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Chart of operations of Troyanov-Trendelenburg, Babcock, Narat


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preparations, making better microcirculation (venoruton, anavenol, aescusan, escin)liquidation of the inflammatory phenomenapreparations, step-up capillariresistance (vitamin C, rutinum)disaggregants (preparations of salicylic acid)diuretics

main ways of medicinal therapy


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Orientation of action of Venoruton®

133 women with CVI of II degrees

Indication:

for treatment of the early stage of CVI

for the combined therapy at more expressed stages of CVI

active for warning of CHI at predispositioned persons

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In home terms it is necessary to do daily cool foot-baths, massage of feet (hand or with the use of massagers).To avoid the visit of bath-house, sauna, protracted (more than 1 hour) stay in the sunshine or in apartments with the warmed up floors.A shoe must not be close, it is necessary to give up carrying of shoe on high heels, close underclothes, corsets, clothes from stretch material.

useful advices


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At the use of soft medicinal forms for VDtreatment of preparation (1–5 sm) by easy motions, slightly rubbing, inflict a skim on the staggered area. Tailings of ointment base in 30–40 min delete a paper serviette. At inflammation of veins preparations for outward application, rubbing is impossible. The inflicted layer of preparation is covered an occlusal or elastic bandage.

useful advices


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Application of venotonic facilities (rutozides) is contra-indicated in the I trimester of pregnancy, and also at individual unbearableness.

At usage of heparin-content drugs may observe the lengthening of protrombine time, that requireby obligatory laboratory control.

For the prophylaxis of thrombophlebitis course application of microdoses of acetophene is rotined as desaggregants.

useful advices


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At presence of the intensive or protracted pain feelings in feet alternation of phlebotonic facilities is expedient for outward application (ointments, gels) with the soft medicinal forms of NSAD on a chart (4 times per days): FS — NSAD is FS —NSAD.

useful advices


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Gels and ointments with high maintenance of heparin (1000 ME in 1 g) it is possible to use for chronic venous insufficiency at trophic disorders. In this case it is necessary to inflict them on the perimeter of the staggered skin as a ring breadthways 4 smIt is not necessary to inflict topical form of FS on the opened wounds, mucous membranes, infected diapyetic areas, areas are skins, exposed to radial therapy.Dermatological reactions at outward application of medicinal preparations for treatment of VRV are marked rarely, local allergic reactions are possible (skin pouring out).

useful advices


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At the choice of soft medicinal form FS it is necessary to take into account the features of ointment basis of preparation: ointments, made on fatty basis, can dint on clothes, bed, however more acceptable to application people with a dry skin; gels quickly get to the skin, not dinting, due to maintenance of alcohol and other volatilizable matters (for example, essential oils) render a cooling action, but can overdry by skin.

Heparincontent drugs at topic application, usable in VD therapy, don’t prescribe at present of hemorrhages and at predisposition tobleeding.

useful advices


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Acute thrombophlebitis with appearance of sickly tension bars on extremity and increase of t ° higher 38°СAppearance of proof edemata of extremityNecrosis of skin in area of varicose knotsSudden appearance of the expressed shortness of breath

Threatenings symptoms


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Pharmaceutical care

Hemorrhoid

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ФАРМАЦІЯ Hemorrhoid

bradyhemarrhea in the veins of rectum and small pelvis at the protracted overwhelming with their bloodincrease of pressure on a venous wall (constipations, assidenous way of life, prelum of veins a pregnant uterus, by a megascopic prostate, frequent carrying from place to place of weights et cetera) hepatocirrhosis with portal hypertensionobesity

factors, cooperant an origin

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feeling of awkwardness in area of anus, rarer are pains. sense of itch, pricking, is in an anal areaThe unpleasant feelings increase after getting up of weights, violation of diet, reception of alcohol Frequent constipations, sometimes with a fervescence In area of anus dense sickly haemorrhoidal knots are determined, at a restriction accepting the blue colouring.

main symptoms

Hemorrhoid

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External

Interstitial (under transition crease)

Internal

classification

Hemorrhoid

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Innate or inheritedPurchased

(primary or second)

• Acute• Chronic

Hemorrhoidclassification

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ФАРМАЦІЯ Degrees of hemorroid

I degree - outward haemorrhoidal knots of small size, tight-elastic consistencies, disposed below than toothed line, tendernessat palpation. Perianal skin slightly hyperemic. Characteristic complaints are sense burning and itch, increasing during defecation

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II degree - more expressed edema of greater part of perianal area, hyperemia. Palpation of this area and digit research of rectum is acute tenderness. Complaints about great pains in area of anus, especially at walking and in sitting position

Degrees of hemorroid

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III degree - all circumference of anus is busy at an inflammatory tumour. Palpation of it acute painful, digit research on this account is impossible. In area of anus blue-purple internal haemorrhoidal knots, falling out of road clearance of anal orifice are visible. Necrosis of knots can come in default of timely treatment, to develop perirectitis.


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I stage (knots come out from an anus during defecation and set independently)

II stage (necessity of setting of falling out knots)

III stage (knots fall out at the least physical loading)


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useful advice

Accept baths as possible more frequent.

A reception of bath is a very effective mean prophylaxis of piles. Reception of bath very much well normalizes of blood microcirculationin an anal area supports it an area is in a cleanness.

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Observe the hygiene of perianal areas and areas of crotch.

Not limited to only the use toilet paper. Necessarily undermined after every defecation. Try to utillize soft multi-laered toilet paper.

Prophylaxis of hemorroiduseful advice

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Try to avoid constipations.

Spoiling timely treatment, normalization of activity of digestive tract, regular and correct feed will help you to avoid a hemorroid. You remember! it is adjusting of consistency intestinal content and his transit to on it is a colon necessary by the condition of prophylaxis of hemorroid.


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Try to avoid diarrheas

Besides an irritation at diarrheas probability of penetration is high in anal crypts of infection, that can to serve reason of inflammatory process and formation of rectal fistula.


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Avoid supercooling

Supercooling can be reason violations of local bloodflow, that can to serve reason of formation of hemorroid or his intensifying and complications (thrombosis, great pains etc.).


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You do not conduct in assidenous position too much time

"Assidenous" work results in violation circulations of blood and to stagnation of venous blood, that is strongly instrumental in evelopment of hemorroid. If to you to duty-bound to be much more frequent do small there are dwells, and in assidenous position periodically strain buttock muscles. Regularly engaged in a gymnastics, swimming, anymore go for a walk on foot.


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You do not conduct much time at steering wheel.

Long seating position at steering wheel results to in to violation of circulation of blood, that promotes to development of hemorroid. If you professional driver, more frequent do interruptions and limbering-up. Regularly to go in for gymnastics, swimming, anymore go for a walk on foot.


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Not practise upon alcoholic, spice food

Alcoholic strengthens circulation of blood salt food in to the perianal area, that can result to in to strengthening of bleeding. Spice and salt food is promote in a strong irritation to the perianal area and aggravating of flow diseases.


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In time consult by a physician

For raising of correct diagnosis not engaged in self-diagnosis and not save on the health. In some cases, copying off the symptoms of rectal shrine on a hemorroid, patient too late hears about a veritable diagnosis.


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persons with the initial signs of hemorroid must substitute hard physical work by more easy types of works;to pregnant with the purpose of diminishing of venous stagnation in the organs of small pelvis recommend a daily gymnastics, walks on foot, rational diet with plenty of laxative products, prohibition on carrying of tight belts;persons, anchorwomen assidenous way of life, must be engaged in a gymnastics, swimming, anymore to go for a walk on foot.not practise upon purgative.

Prophylaxis of hemorroid

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In a feed adhere to the that diet, which will cause neither disorder of intestine nor constipation. It means that is needed am a little less mealyfood and milk (except for soul-milk), to add brans to food, there are more green-stuffs. Bifido-containin kefirs/yoghurts are daily obligatory etc. Drink of mineral waters strengthens motive activity of intestine. High- and middle-mineralized waters is recommended, and also waters, containing the ions of magnesium and sulfates, such as «Essentuki» №17 and №4, «Moscow» — for to a 1 glass of room temperature 3 times per day.

Prophylaxis of hemorroid

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necrosis of haemorrhoidal knotbleeding (sometimes massive) !thrombosis of haemorrhoidal knotsperirectitissepsis

complications

Hemorrhoid

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preparations, making better circulation of blood in an anal area (venoruton, detralex, suppositories and ointment with a heparin and proteolytic enzymes)antiinflammatory preparations (microclysters with sea-buckthorn butter, butter of wild rose) liquidation of sanguifluousness (suppositories with methyluracilum, ointment of ultraproctum) relief of pain syndrom, itch (ointment procto-glyvenol, suppositorieswith belladonna)


Hemorrhoid

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At the choice of local treatment of acute hemorroid it is necessary to take into account one predominating of symptoms: pain, thrombosis, prevalence of inflammatory process and presence of destructive component

Hemorrhoidmain ways of medicinal therapy

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Frequency of met of basic complaints

Hemorrhoid

Anal itchSense burning, become intensify after defecationPain during or after defecationBlood excretion after defecationDifficulties during defecationProlapsus of the knots

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DETRALEX ®

Diminishing of volume of dosages unnarcotic analgetics at treatment of intensifying of piles of diosminum

Hemorrhoid

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origin of attacks of acute pains, attended with the increase of temperatureappearance fresh blood in an excrement

Threatenings symptoms

Hemorrhoid

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ФАРМАЦІЯ Surgical treating of hemorroid

Ligating of knots latex rings

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Imposition of staples under control of flowmeter

Surgical treating of hemorroid

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The End

Varix dilatation of lower extremities › upload › files › lectiol › ... · Varix dilatation...

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