Etiotropic therapy - what is it?

The treatment of any disease requires an integrated approach. The simultaneous use of drugs acting on various parts of the pathogenesis of the disease, contributes to the rapid recovery of the patient and prevent the development of complications. Etiotropic treatment is part of the therapeutic measures used. In general, etiotropic therapy - what is it? Next, we consider the concept of the term, the basic principles and types of treatment, criteria for evaluating its effectiveness.

General concepts

Etiotropic therapy is a set of measures aimed at weakening the action or eliminating the cause that caused the development of the disease. A similar term is also called casual therapy. Medications used in each specific form of this treatment are also called etiotropic.

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

• the use of antibacterial agents;
• hormone therapy;
• vitamin therapy;
• probiotic treatment;
• chemotherapy;
• the use of antidotes.

Principles of etiotropic therapy

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

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

The measures used to achieve the first goal are implemented with the help of medications (hormones, cytokines, enzyme preparations, chemotherapy). To fulfill the second principle, physical factors are used: the use of protective clothing, ultraviolet radiation, repeated exposure to a pathological agent to increase the patient's resistance to it.

Basics of the treatment of diseases of infectious genesis

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

• treatment should be comprehensive and take into account all possible acting factors;
• the purpose of the effect of the applied means should be the destruction of the pathogen;
• conducting immune correction;
• parallel restoration of hemostasis in the patient's body;
• continuity of therapy, since most diseases require long-term follow-up and recovery of the patient after discharge from the hospital;
• the choice of treatment regimen should be based on the form and period of the disease, the severity of the clinical manifestations, the assessment of the patient’s condition and the presence of concomitant pathologies.

Etiotropic therapy of infectious patients includes the use of drugs of specific and non-specific action. Means of specific treatment:

• serum;
• immunoglobulins;
• bacteriophages;
• vaccines;
• antitoxins.

Chemotherapy drugs and the use of interferons are classified as non-specific substances.

Serotherapy

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

Antitoxic serum includes antibodies against toxins secreted by pathogens. All antibodies are specific and act against a specific etiological factor using a neutralization reaction. Examples of this kind of serum:

• tetanus;
• diphtheria;
• anti-gangrenous;
• anti-anthrax;
• anti-botulinum.

The composition of antibacterial sera includes agglutinins, opsonins and bacteriolysins, which are antibodies against bacterial pathogens.

The effectiveness of serotherapy depends on the time and dose of its administration. Immediately after ingestion, antitoxins circulate in the blood, binding to the toxins of the pathogen. The sooner the drug is administered, the sooner the patient will recover.

Immunoglobulin is an etiotropic therapy used in the treatment of certain infectious diseases. Globulins penetrate tissues more easily and have a large number of antibodies in their composition. They are used in case of the following diseases:

• tick-borne encephalitis;
• measles;
• flu;
• smallpox
• staphylococcal infection;
• whooping cough;
• leptospirosis;
• herpetic infection;
• anthrax and others.

The use of bacteriophages

Virus-based drugs capable of devouring foreign bacterial cells are used as an alternative to antibiotic therapy. Available in the form of powders, tablet forms, suppositories, solutions in bottles and ampoules.

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

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

Chemotherapy

Such etiotropic therapy is aimed at the use of toxic substances and poisons that are detrimental to the cause of the disease. Depending on the direction of exposure, the following uses of chemotherapeutic drugs are distinguished:

• antibacterial chemotherapy;
• antifungal;
• antitumor;
• antiviral;
• anthelmintic;
• antiparasitic.

The use of chemotherapeutic drugs requires a thorough review of all other medications used by the patient. In some cases, the combination of therapeutic agents may cause a negative reaction from the patient.

The use of antibiotics in casual therapy

Antibacterial etiotropic therapy is a method of destroying the causative agent of the disease using antibiotics. Unfortunately, at the moment, most microorganisms have gained resistance to antibacterial agents.

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

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

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

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

• penicillins - Amoxicillin, Flemoxin, Ampioks;
• cephalosporins - "Ceftriaxone", "Cefazolin", "Cefotaxime";
• macrolides - Clarithromycin, Erythromycin;
• tetracyclines - "Metacyclin", "Doxycycline";
• aminoglycosides - "Gentamicin", "Neomycin", "Amikacin";
• Chloramphenicol;
• Fusidine
• "Novobiocin";
• nitrofurans - "Furazolidone", "Furadonin", "Furacilin";
• antifungal antibiotics - Levorin, Nystatin;
• sulfonamides - Biseptol, Sulfalen, Sulfadimethoxin.

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

Hormones

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

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

A stimulating form of the use of hormonal agents is prescribed when the endocrine gland needs to be stimulated to work. For this, hormonal drugs of the pituitary and hypothalamus are used.

The inhibitory type of treatment provokes a decrease in the production of hormones by the gland during its hyperfunction. An antagonist of the hormone that is in excess is introduced. Often used in oncology, gynecology, urology, andrology.

Vitamin therapy

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

1. The natural form of treatment is characterized by the intake of essential vitamins with food. A correction of the diet is carried out, in which emphasis is placed on foods that are richest in essential active substances.
2. The replacement form of treatment is accompanied by the introduction of vitamins in the form of medications for the treatment of vitamin deficiency or hypovitaminosis. There are both mono-and multivitamin agents.
3. Pathogenetic vitamin therapy is characterized by the use of drugs for the treatment of diseases caused by vitamin deficiency (hypotension, migraine, nervous breakdowns).
4. The pharmacodynamic form of treatment uses vitamins to affect factors that are not related to vitamin deficiency. For example, the introduction of funds can narrow or dilate blood vessels.

The use of vitamin preparations is considered by many to be a safe solution, however, this should only be done after consultation with a specialist.

Probiotics

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

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

• complex treatment of endocrine pathologies;
• enzymatic age-related disorders;
• toxic damage to the nervous system;
• occupational diseases ;
• pathology of the kidneys, heart and blood vessels;
• hypovitaminosis;
• immunodeficiency state;
• atherosclerosis;
• conditions associated with severe physical exertion and the influence of stress.

Antidototherapy

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

An antidote is a substance that, reacting with toxic agents or other medications, carries out a neutralization reaction and eliminates the negative effects of poisoning. Substances can be of a narrow and wide spectrum of action. Consider examples of specific agents used in antidototherapy.

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