Introduction . The most common extragenital pathology during pregnancy includes upper and lower respiratory tract infections (URTI and LRTI), which, if left untreated, leading to obstetric and perinatal pathology. It is relevant to conduct pharmacoepidemiological studies assessing the preferences of specialists regarding the treatment of pregnant women and attitudes towards vaccination in real clinical practice. Aim . To analyze approaches to pharmacotherapy of URTI and LRTI in pregnant women, evaluate the compliance of prescribed drugs with current clinical recommendations and treatment standards. Materials and methods . The study was conducted from 2018 to 2022 using an anonymous questionnaire method in seven regions of Russia. Results and discussion . A total of 227 physicians from seven regions of Russia were surveyed, with 66.8% being internal medicine doctors and 33.2% obstetrician-gynecologists. This study revealed that physicians’ knowledge regarding the rational use of antimicrobial drugs (AMD) in pregnant women is insufficient. Respondents showed better results in the use of AMD in the treatment of pneumonia, with 78.7% of surveys indicating correct tactics. The worst results were observed in answering the question about the appropriateness of prescribing AMD for URTI, tracheitis, and bronchitis (40.3% to 67.7% of respondents made incorrect choices). Overall, 57.7% of respondents understand the importance of vaccination among pregnant women. Conclusion . The results of the conducted study indicate that the choice of drugs for the therapy of URTI and LRTI, especially AMD, for outpatient treatment of pregnant women in some situations does not fully correspond to the current clinical recommendations in our country. Moreover, it is particularly concerning that some physicians prescribe drugs that are unsafe for pregnant women or lack the necessary evidence base or indications for use.

This paper presents an assessment of health professionals' knowledge of antimicrobial stewardship within the first phases of the multicenter KANT project.

The aim of the study was to assess the tolerability and impact on the quality of life of pharmacotherapy for gastric ulcer, erosive gastritis using regimens including rebamipide. The quality of life of patients was assessed using the SF-36 questionnaire. Pharmacotherapy of gastric ulcer with the inclusion of rebamipide as part of the conventional treatment regimen provides data comparable to the healthy group on the scales of physical functioning, role functioning due to physical condition, pain intensity, general health, and vital activity. The results of our own research and data from literary sources indicate that rebamipide is a drug with a confident evidence base, good tolerance and safety of use.

Community-acquired pneumonia (CAP) is one of the most relevant problems of modern medicine. Today, CAP takes 4 th place in the structure of mortality (after cardio­vascular, cerebrovascular diseases and malignant neoplasms) and 1 st place among all deaths from infectious diseases. The aim of the study is to assess the level of general physician’ and senior medical students’ basic knowledge in CAP treatment. The article represents the results of anonymous prospective surveys within the framework of the second stage of KNOCAP multi-centered research project (full name of the project «The assessment of physician’ and students’ knowledge of community-acquired pneumonia basics») aimed at accessing the knowledge and preferences of doctors and students on the fundamental issues in diagnosis and treatment of community-acquired pneumonia. The survey conducted in 2017-2019 involved 588 physicians and 394 students from seventeen Russian, Kyrgyzstan and Ukrainian centers. The method of anonymous questioning was used in this study, for which an original questionnaire was developed on the basis of current clinical recommendations. The following fundamental questions caused the greatest difficulties in the respondents: terms for a repeated X-ray examination in positive dynamics of CAP treatment, the choice of main diagnostic criteria of CAP, the choice of the typical mistakes of CAP treatment, the choice of the initial antimicrobial therapy. In general, the respondents’ knowledge in CAP patients’ management deviates significantly from the current clinical guidelines, as of 2010, and from the new clinical guidelines draft, 2018-2019. Currently, there is a need to increase the level of knowledge and improve the professional activities of therapists and senior medical students, as a multicenter section of the knowledge and preferences of specialists in many issues revealed their insufficient level for the correct management of patients with CAP.

The article analyzes properties of potassium and magnesium, which may exert vasodilatory, anti-inflammatory, anti-ischemic, antiaggregant, and antiarrhythmic effects. These are extremely important microelements and potentially beneficial therapeutic agents for treatment of cardiovascular diseases.

The article discusses the problem of using ACE inhibitors and diuretics in arterial hypertension. Analysis of the position of doctors when prescribing ACE inhibitors and diuretics showed its compliance with current national guidelines for the treatment of hypertension. Physicians use more adequate criteria for antihypertensive drugs usage. There were no non-rational use of diuretics in combination, regardless of indications and contraindications. If there are indications for the use of a diuretic and a preparation of ACE inhibitors, you have to make greater use of fixed combinations of drugs. The article discusses the results of clinical efficacy studies of perindopril and indapamide in clinical practice. Noliprel® forte is an effective antihypertensive medication, not only reducing BP, but also organoprotective aim and good tolerability in wide range of patients with arterial hypertension.

Arterial hypertension and dyslipidemia is a very frequent comorbid condition. Arterial hypertension and dyslipidemia are combined in 40-70% of patients. The statins is the basic drug in primary and secondary prevention of cardiovascular disease and in the reduction of cardiovascular complications. We`ve attempted to summarize some data about the statins and interaction of antihypertensive drugs. Rosuvastatin is a medicine that provides an intensive reduction of low-density lipoproteins, does not require dose adjustment when applied in conjunction with antihypertensive drugs. The absence of inhibition and activation of rosuvastatin cytochrome P450 provides a low risk of negative interactions in the clinical situations of induced polypharmacy. Every clinician is to remember that it`s crucial to take into account some adverse reactions combining the statins with drugs of other pharmacological groups.

The purpose of the study is to determine the spectrum used drugsslows the heart rate in patients with arterial hypertension and chronic heart failure in clinical practice and compliance of prescribing with clinical guidelines.Materials and methods. Consistently formed a retrospective sample of medical records of patients with arterial hypertension and chronic heart failure. Used sources of primary medical documentation for 2012-2015 (320 patients). Estimated the amount and quality therapyslows the heart ratein patients with arterial hypertension and chronic heart failure.Results and discussion. b-blockers prescribed for 72.5% of patients. Calcium antagonists range recommended by 13.1%. On the background of optimal doses of b-blockers in patients with arterial hypertension and chronic heart failure with the exile faction of less than 40 and heart rate more than 70 BPM, ivabradine is not assigned in 81.3% of patients, although it is in these situations of particular urgency is the drug given its bright positive effect on hard end points, proved in international multicenter trials.

В статье обсуждаются проблемы применения антагонистов кальция (АК) в реальной клинической практике. Тактика врачей в назначении АК свидетельствует о соблюдении основных рекомендаций фармакотерапии пациентов с артериальной гипертензией. Подчеркивается целесообразность применения дигидропиридиновых АК как средств с оптимальным сочетанием эффективности и безопасности у пациентов с сочетанием артериальной гипертензии, стенокардии и хронической сердечной недостаточности. Обсуждаются результаты исследований клинической эффективности фелодипина в сочетанной кардиальной патологии с когнитивными нарушениями.

The article discusses the problem of using calcium antagonists in clinical practice. Physicians' judgments in prescribing calcium antagonists showed its compliance with current guidelines for the treatment of hypertension. Emphasizes the feasibility of dihydropyridine calcium antagonists as efficacy and safety tools in patients with combination of arterial hypertension, stable angina and chronic heart failure. The article discusses the results of clinical efficacy studies of felodipine in a combined cardiac pathology with cognitive impairment.

Aim of the study was to analyze the validity of pharmacoepidemiological purpose and structure of lipid-lowering therapy (LLT) in patients with hypertension and dyslipidemia in clinical practice. Demonstrated commitment to the basic principles of medical verification of cardiovascular events with an adequate definition of risk SCORE scale for patients with high and very high risk. However, the lack of definition of fractions of cholesterol is not allowed to make the right decision on the appointment of GLT for a number of patients with low and moderate risk. The advantage in the appointment of atorvastatin used (32.3%), simvastatin (27.8%) and rosuvastatin (20.9%), and from the antihypertensive subgroups - angiotensin converting enzyme inhibitors, -blockers, calcium antagonists, sartan. Revealed insufficient control of blood lipid in the dynamics on the background of LLT, low activity of doctors in the statin dose titration and use of combined LLT (6.9%) in order to achieve target levels of atherogenic key biochemical parameters. Taking into account the literature data on the most effective and priorities destination rosuvastatin and its high safety in clinical situations of forced polypharmacy we conducted pharmacoeconomic comparison of rosuvastatin several manufacturers of direct cost. Established a price advantage of rosuvastatin (tevastor) with respect to both the original drug, and to a number specified in the prescribing of generics. No fixed assignment LLT is testimony not revealed irrational combinations of drugs with contraindications recommendations, including the appointment of antihypertensive drugs. CONCLUSION Further work is needed to evaluate pharmacoeconomic indicators LLT, to raise awareness of physicians to enhance quality control of medical assistance and measures to reduce the risk of complications in patients with cardiovascular disease of atherosclerotic origin.

We conducted an anonymous survey among 382 physicians (58% internists, 42% cardiologists) in order to obtain information on their opinion on various aspects of antithrombotic therapy in atrial fibrillation. The survey revealed low level of awareness about algorithms of stratification of risks of stroke, systemic embolism, and bleeding. Reported rates of clinical use of recommended antithrombotic agents were: warfarin - 30, aspirin monotherapy - 19, dabigatran - 10, rivaroxaban - 8, and combination of aspirin and clopidogrel - 8%. Rate of use of drugs without sufficient evidence base in AF was 25%. When asked to designate antithrombotic drug of choice 85% of physicians indicated warfarin and 12% - novel anticoagulants (NOAC). The following factors were considered as limiting wide application of NOAC: high cost (59%), lack of data on these drugs (14%), and impossibility to control safety of their administration (9%).

The aim of the study is pharmacoepidemiologicalanalysis of the structureandreasonability of diuretic therapy in patients with hypertensive disease (HD)in ‘real-life’ clinical practicesettings.Materialandmethods:we underwentthe retrospectivepharmacoepidemiologicalcomparative analysisof the structureofdiuretic therapyreviewingoutpatient cardsfrom 2011 to 2014.We extracted data from outpatientcardsin outpatient department of Krasnodar Territoryusingcontinuous sampling method(421 patients)with the subsequent assessmentin accordance withmodern guidance materials. Results. In comparison with the regional study historic resultsthe administrationoftorsemidehad significantly increasedin patients withHD andnoncomplicatedchronic cardiac failure(12%).The priority drugs for the administrationamong diuretics werehydrochlorothiazide (24%)and indapamide (20%),spironolactone (20%).The ACE inhibitoror sartanusing in fixed combination with diuretic was recommended in 20% of out- patient cards.Structure ofdiuretic distribution in group of patients with HD, associated withCHF(II-IVfunctional class)had showedthe efficiencyof spironolactonein26%,of hydrochlorothiazide - 15%,torsemide - 13%,indapamide - 7%;the combination of spironolactoneandtorsemidewas receivedby 14% of patients,the combination of spironolactoneandhydrochlorothiazide - 6%,spironolactoneand furosemide - 1%,in 4% of outpatient cardswe noticed the triple combination of monocomponentdiuretic.Conclusion. We did not find unreasonable administration of diuretic therapy combination out ofindication and in the presence of contradictions.The prescription of modern long-termdiuretics associated with lower risk of side-effects developing will improve efficiencyand safetyof pharmacotherapy.It is very important to use fixed drugs combinationin case of administration the diuretic and agentsofrenin angiotensin system inhibitors.The volume and prescription reasonability analysis ofdiuretic therapy in patients withHDin ‘real-life’ clinical practicesettingshas shown compliance with modernnational guidance materials for the HD and CHF treatment.

Reorganization of the drug supply is one of the most important parts of the Russian health care reform. Pharmacoepidemiology is one of the sections of clinical pharmacology, the study of the results of the application and effects of drugs in large groups. The aim of the study was the analysis of pharmacoepidemiological and validity purpose diuretic therapy in patients with hypertension and chronic heart failure in clinical practice. A comparative analysis of retrospective pharmacoepidemiological diuretic in the hospital according to the sources of primary medical records for 2010-2012. - Continuous sampling histories hospital regional center and district hospitals in Krasnodar Krai (435 patients). The results of our study showed an active and relevant guidance documents use of diuretics doctors practical medicine. There have been no use of diuretics is the testimony and in the presence of contraindications, revealed no excess doses and irrational combinations. Can be considered a positive increase in the activity of torasemide destination due to the impact of the drug on the prognosis of the disease, which can be realized through antialdosterone effect and influence on depozitsiyu collagen. Analysis of contemporary domestic and foreign recommendations GB and CHF, as well as evidence-based data suggests that the use of diuretics is a stable long-term trends in the pharmacotherapy of cardiac disease, so you need to continue to assess the quality of the clinical use of pharmacological agents, to raise awareness doctors about clinical situations with the need to connect with spironolactone and acetazolamide, as well as a new indication and especially the appointment of torasemide in patients with chronic heart failure, hypertension, as reflected in clinical guidelines and "standards of primary health care workers in essential hypertension (hypertension) "Health Ministry.

Subjects with an increased blood pressure have a decreased regulatory-adaptive potential. The degree of its decrease increases in individuals with higher blood pressure values. The achievement of the target blood pressure level with antihypertensive drugs normalizes the regulatory-adaptive potential. However, only those patients whose blood pressure values did not exceed 160/90 (systolic/diastolic) mmHg attained the level of adaptation of healthy individuals.

People with increased arterial pressure have more low regulatory-adaptive abilities than people with normal arterial pressure. The achievement of target blood pressure level with antihypertensive drugs is accompanied by normalization the regulatory-adaptive abilities. It is true only for people who had arterial hypertension less than 160/90 mm Hg until treatment.

Doksazozin has impairеd functional and adaptive abilities of patients with arterial hypertension, which was revealed in decrease of cardiorespiratory synchronisation range of cardiac and respiratory rhythms, and increase of the duration of synchronisation development at the minimum limit of synchronization range. The indicated changes were observed during acute pharmacological test, after four weeks and six months of treatment, despite of the achievement of normal arterial pressure.