Physiology and pharmacology of the hiking first-aid set

Written by Добрушина О.Р. Well-known, that the majority of tourists does not understand at all medicines. Hundreds difficult to pronounce names, pages of indications, contra-indications, dosages - unless all is real it to learn(teach)? Not so really, but it also is not so necessary. In fact in any decent first-aid set there is a list where all it is written. And what is necessary? It is necessary to know even in general, than one groups of preparations differ from others, on as as they operate(work) with what should be tactics of their application. And missing concrete information always can be found in the summary to a medicine, in the literature, on the Internet.

In this lecture we shall try to be torn through thorns of pharmacology to understanding of principles of application of medicines. In a way! Anesthetizing means: what to choose?

Yet there was no never a philosopher who could maintain a toothache patiently
U.Shakespeare

  Analginum, baralgin, aspirin, paracetamol, efferalgan, nurofen, ketanov, voltaren, kaffetin... - at the physician facing to a counter in a drugstore, the head from uncountable set of familiar and unfamiliar names is turned. What the general(common) at these medicines and than they differ from each other? For the beginning we shall notice, that it is necessary to distinguish the name of operating(working) medicinal substance and the name of a preparation. Each firm-manufacturer aspires to give the, new trading name to a preparation containing for a long time known medicinal substance. It is impossible to remember all trading names. But frequently the medicine with a terrible label appears old friend, it is necessary to read through operating(working) substance on packing. Above we have intentionally mixed trading names and names of substances in a uniform porridge to show arising mess. It is More we so we shall not do(make), and basically we shall use names of operating(working) substances, resulting(bringing) trading names in brackets.

The majority of the listed preparations concerns to group under the name " not steroid anti-inflammatory means " (NPVS). All NPVS have the uniform mechanism of action - they oppress synthesis prostaglandinov. prostaglandiny are substances which are developed(produced) in different parts of an organism and carry out very many functions. First, they play the important role in the center of an inflammation. Adjusting(regulating) its(his) such displays, as a pain, temperature, reddening. The center of an inflammation is the "chilled" joint, "nojushchy" a tooth - prostaglandiny deliver a great deal of trouble, and NPVS allow to repulse them. At cold the inflammation also takes place, and NPVS effectively reduce temperature. However it is necessary to understand, that these remarkable means, eliminating(erasing;removing) symptoms, do not render any influence on the reason of disease. Other functions prostaglandinov - protection of a mucous membrane of a stomach against an acid available in its(his) gleam, regulation of curtailing of blood, a tone of bronchial tubes. Undesirable effects NPVS are connected with it(this) collateral, i.e.: development of a stomach ulcer, increase in time of bleedings, possible(probable) provocation of an asthmatic attack. The legend that NPVS damage(injure) mucous a stomach only that get on it(her) at intake is widespread. Exist even kishechnorastvorimye forms of these medicines which ostensibly do not cause a ulcer. But, what way would not get NPVS in an organism, it all is equal through blood will reach up to mucous a stomach and will reduce synthesis in it(her) useful prostaglandinov - the result is clear. Also prostaglandiny strengthen reductions of a uterus, therefore NPVS can detain rody (that, I hope, it is not actual in a hike) and effectively to reduce a pain at menstruatsii (that, alas, happens actually).

And now we shall understand distinctions between preparations. Despite of as a whole the general(common) mechanism of action, there are nuances. Different NPVS differently influence synthesis prostaglandinov in different parts of an organism.

Atsetilsalitsilovaja an acid (aspirin) - one of the most popular NPVS. However at all the best. Possessing rather weak anesthetizing and anti-inflammatory effect, aspirin has the expressed influence on mucous a stomach, can cause " aspirinovuju an asthma ". This substance has a unique feature - among all NPVS it(he) to the greatest degree oppresses curtailing blood. We shall not press in the mechanism of this phenomenon, only we shall tell, that is paradoxical, but most of all influence curtailing small (125мг/1 once a day) dozes of aspirin. That has practical value, including and in a hike. For example, if we wish to prevent corking by blood clots (blood clots) vessels of the freezed finiteness, it is necessary to use aspirin and in smaller, than for anesthesia, dozes.

Analginum (operating(working) substance - метамизол-sodium) is even more popular and, that is remarkable, is even more harmful some aspirin. Possessing similar anesthetizing effect, it(he), besides other, can cause seryoznye infringements in system of blood (in its(her) cellular component). Therefore this means is better for throwing out from the first-aid set.

And on what it(him) to replace? For example, on ibuprofen (nurofen) or on ketoprofen (ketonal). These means are similar to analginum and aspirin by efficiency, but cause less by-effects. Ketoprofen it is possible to prick, if there is no opportunity to accept inside (for example, at a migraine, accompanied vomiting) or if it would be desirable that it(he) has worked more quickly.

Whether and is not present ideal NPVS which would not possess by-effects? Trying to create such means, pharmacologists have developed so-called selective ingibitory циклооксигеназы-2 (tselekoksib, rofekoksib (vioks), etc.) which have quickly won popularity. However in 2005 it was revealed, that rofekoksib increases risk of cardiovascular diseases, such, as a heart attack of a myocardium. Therefore to these preparations concern with care [7].

From NPVS are more feasibly most widespread diklofenak and ketorolak. At diklofenaka (voltarena) the anti-inflammatory effect is expressed in a greater degree, than anesthetizing. Therefore it(he) well approaches(suits) for the inflamed joints which have been stretched(which have been dragged out) svjazok, sinews - unduly "cleared up" the inflammation leads to damage of these structures. Diklofenak it is rather expressed influences a mucous membrane of a stomach, therefore it(he) is better for applying mestno in the form of gel or ointment. At ketorolaka the anesthetizing effect, on the contrary, is more expressed. Ketorolak (ketanov) - one of the strongest not narcotic anesthetizing. In the form of a solution it(he) is very useful to injections in the hiking first-aid set. Unfortunately, at this means strongly pronounced not only anesthetizing effect, but also damaging(injuring) influence on mucous a stomach. Therefore do not recommend to prick ketorolak longer, than 5 days on end.

From the most popular means we still did not name paracetamol, or atsetaminofen (efferalgan, panadol), and it is not casual. Paracetamol is not NPVS: it(he) oppresses synthesis prostaglandinov only in a brain and has no anti-inflammatory effect. On anesthetizing and febrifugal effect paracetamol is similar to analginum and aspirin. On by-effects it is more safe than them and consequently it is quite comprehensible to application. However it is necessary to remember, that the daily doze of paracetamol (4 grams) should not be exceeded at all, differently probably heavy defeat of a liver. The matter is that this medicine in an organism is processed in a toxic product; if it is a little of it(him), toxin is quickly neutralized and does not render damaging(injuring) action. But, it is necessary to exceed a doze, and, not having had time to be neutralized, poison will damage(injure) a liver.

So, we have finished with NPVS and similar means. Them unite under the name " not narcotic analgetiki ". Though we already know, that NPVS - is not simple analgetiki, but also anti-inflammatory, febrifugal and protivosvyortyvajushchie means. There and then I wish to consider(examine) spazmoliticheskie means because often them sell in the form of mixes with not narcotic analgetikami. Spazmolitiki weaken smooth muscles - the fibres reducing walls mochetochnikov, bilious kanaltsev, a uterus, vessels, etc. bodies. Therefore they are used at pochechnoj and hepatic kolikah, painful(unhealthy) menstruatsijah, put insignificant influence on arterial pressure (reduce it(him)). Apply papaverin (its(his) mix with analginum - baralgin) and drotaverin More often (But-Þ»á).

Besides spazmolitikov, not narcotic analgetiki frequently mix and with other medicines - caffeine, vitamin C, protivokashlevymi means, the substances reducing "zalozhennost" of a nose and so forth As a result on counters appear set of such mixes, as Koldreks, Ferveks, Kaffetin, Panadol ekstra... Last two preparations contain paracetamol and kodein - weak narcotic analgetik which strengthens effect of paracetamol and renders protivokashlevoe action. And nevertheless are on sale without the recipe: the parity(ratio) парацетамол:кодеин so is great, that at the potential addict a liver otomryot much earlier, than there will be an euphoria.

In heavy cases not narcotic analgetikov it appears insufficiently. For example, crisis of a hip to not anesthetize any more even ketorolakom. In spite of the fact that in case of seryoznoj traumas presence of narcotics can be critical for the forecast, in detail they will be not not considered(examined) by us since they are not accessible to us. The basic group narcotic analgetikov is opioidy. To them concern morfin, promedol, butorfanol (stadol), etc. Such known means as tramadol, concerns to opioidam, but possesses rather weak anesthetizing effect, sravnimym with those at ketorola. If at you in the first-aid set all is opioidy, keep in mind, that they oppress breath (to a lesser degree it concerns(touches) tramadola)! Therefore they are counter-indicative in case and so already there is an oppression of consciousness, for example, at a craniocereberal trauma. One more potentially dangerous effect opioidov - expansion of peripheral vessels which in a situation of a shock can lead to its(his) deepening.

But is better in case of seryoznyh to use traumas local anesthesia. Advantages are obvious: the pain is effectively stoped, and by-effects are minimal. Lacks too are obvious - it is necessary to be able to use local anesthetizing, the nobility, where and as them to prick. Are most widespread novokain and lidocaine, but to us approaches(suits) bupivakain - effective and long means on action more. Remember, that on local anesthetizing there is an allergy - it is necessary to learn(find out) from all participants up to a hike, whether there is no at them a undesirable reaction on novokain (if the participant treated a teeth at the stomatologist and no problems existing, it(her), most likely, is not present).

We have not without reason put a theme of anesthesia on the first place. Has put at all only that in any hike analgetiki is one of the most popular groups of medicines. Adequately to stop a pain is one of few ways really to help(assist) heavy enough victim.

 

 
Heart, vessels and our modest opportunities.

Some medicines it is more dangerous than illnesses
Seneka

The cardiovascular system is as it is easy to guess, heart and vessels. We shall briefly remind that, probably, not everyone remember from school. Blood in an organism of the person is universal system for transport of substances. For us it is the most important, that with blood from lungs oxygen very necessary to them is transferred(carried) to all other bodies. Vessels carry out function of "waterpipe" for blood, and heart - the "pump" setting it(her) in motion. From heart there are the vessels named by arteries, as approaching bodies they all more and is more vetvjatsja, passing in all more and fineer vessels and, at last, come to an end in bodies most thin "tubules" - with capillaries. Blood from capillaries gathers in the vessels going to heart - veins. And now will have to complicate a picture. The matter is that in cardiovascular system there are two circles, big and small. First heart sends blood in a small circle: On arteries it(she) goes to lungs where it is sated(saturated) with oxygen, on veins comes back in heart. Then this blood acts in the big circle: on arteries it(she) goes to bodies which take away oxygen, on veins - back to heart. And then blood again sends to a small circle. Actually, the beginning and here is not present the end.

How we can observe of work of cardiovascular system? From all set of parameters describing it(her) it is possible to measure in a hike at the best two: pulse and pressure. With pulse all is more not less clear: if to not go deep into nuances, it is possible to tell, that, feeling pulse, we feel, how heart is reduced. With pressure it is little bit more complex(difficult). On what it depends? At once we shall notice, that analogy between cardiovascular system and a waterpipe far not full: vessels are not easier "pipes", their walls can be reduced and extend. Arterial pressure as a result varies. Besides pressure depends on quantity(amount) of blood (by the way, in its(her) norm(rate) about 5 litres) and from that, heart is how much effectively reduced.

How it is possible to influence work of cardiovascular system? It is possible to reduce or increase volume of blood, to expand or narrow vessels, to stimulate reductions of heart. On it(this), certainly, opportunities are not settled(exhausted), but anything else in conditions of a hike, as a rule, is not used. Situations at which the volume of blood would be desirable to increase (this condition it refers to gipovolemija), first of all, bleedings. How it(him) to increase? The answer is simple - to pour in a liquid in a vascular channel. But, unfortunately, in practice it to make any more so it is simple. First, it is obvious, that it is impossible to pour into blood water from a pool or even from the mountain river, for this purpose solutions are necessary special. And these solutions will have to drag on the back! Secondly, that them to pour in, it is necessary to be able to enter preparations into a vein. And still it is necessary to think of inclusion krovezamenitelej in the hiking first-aid set since they happen are irreplaceable in sharp situations. On a parity(ratio) effect/weight are more favourable so-called kolloidy - solutions which are capable "to entice" a liquid from surrounding fabrics in vessels. Kolloidov there is a set, but the majority of them is on sale in glass that is very inconvenient. In remarkable easy(light) plastic packing it is possible to meet, for example, one of the most modern kolloidov Voljuven.

Opposite effect possess diuretic. These preparations stimulate kidneys to deducing(removing) a liquid, as a result the quantity(amount) of blood decreases. Most often in the hiking first-aid set meets furosemid (laziks) - one of the strongest diuretic. What for these means are necessary? When heart does not consult with the work, happens it is useful to reduce this work. And the less than blood, the it is easier to pump over it(her). Therefore diuretic are widely applied in case of so-called intimate insufficiency. But in a hike such situations arise seldom enough. Other idea consists in applying diuretic at hypostases. The logic is simple: the hypostasis is many(a lot of;much) waters, means at a hypostasis it is necessary to deduce(remove) water. However, alas, the direct and clear logic not always leads to true conclusions. Because not all so is simple, hypostases happen different. If the hypostasis is caused by intimate insufficiency, diuretic will be effective. If is not present - not necessarily. Us high-altitude hypostases of lungs and a brain first of all interest. Unfortunately, in occasion of treatment of these conditions there are no demonstrative data. Therefore it is necessary to base(found;establish) all recommendations on analogies and on physiological reasons. It is necessary to understand, that diuretic, reducing quantity(amount) of blood, worsen delivery of oxygen to fabrics. And the reason of high-altitude hypostases - just lack of oxygen. Therefore intelligence of application furosemida at high-altitude hypostases is challenged. Now to do(make) it do not recommend [2]. There are also other ideas in occasion of application diuretic in a hike, in particular, offers to use them at CHMT for preventive maintenance of a hypostasis of a brain. But furosemid and means similar to it(him) artfully influence the maintenance(contents) of water in a brain, and, finally, their efficiency on reduction of its(her) quantity(amount) is at least insignificant [13]. We offer, being guided first of all a principle "do not do much harm", to not use strong preparations, not being assured(confident), that in it(this) there is a necessity. And, especially, not having an opportunity skorrektiroat their potential by-effects. To you to choose, take or to not take in the first-aid set furosemid, but if vozmyote, use with the big care. Reduction of volume of blood is "in most cases badly", and at a bleeding (which any trauma is accompanied practically) - is simply absolutely inadmissible!

To diuretic concerns also atsetazolamid (diakarb). But us its(his) diuretic effect which is insignificant enough interests not. This means, apparently, one of few really effective for preventive maintenance and treatment of sharp mountain illness. We in detail spoke about it(this) or we shall speak at lecture on high-altitude medicine, now we shall make only small deviation, concerning(touching) medicamentous aspect of adaptation to height. There is a set of means which suggest to use for simplification of process of acclimatization [14]. For each of them there is an explanation why this remarkable substance helps(assists) an organism to adapt for height. But only for 2-3 from them, it atsetazolamid, dexamethasone (about it(him) we still shall talk) and, according to some information, extract Ginkgo (such relic plant), there are competent researches in public, confirming their efficiency [5]; in one work efficiency of vitamins [1] is shown. That, however, does not mean, that all other means are not effective, can be simple up to them still do not send in addition(have reached) a hand. What to do(make) to the poor hiking physician? Here there are two approaches, creative and skeptical. The some people with enthusiasm fill the first-aid set adaptogenami (O.Janchevsky), the some people name all these means " medieval obscurantism " (A.Dolinin). Choose, what approach to you is more on a shower(soul).

So, we have talked how it is possible to influence volume of blood. The second way to interfere with work of cardiovascular system is a medicamentous change of a tone of vessels, i.e., speaking more human language, their expansion or narrowing. The means influencing a tone of vessels, it is a lot of and we do not have any opportunity (yes, however, and desires) regularly them to describe. Therefore we shall tell only about separate preparations. We shall begin with the means expanding vessels. In any first-aid set of first aid for certain there will be a nitroglycerine. This substance is capable to expand quickly and effectively vessels and consequently it is applied at a stenocardia. What is the stenocardia? At narrowing or corking of vessels feeding heart oxygen starts to not suffice it(him). While loading on it(him) is minimal (for example, the person sleeps), to heart it is a lot of oxygen and not necessary. But, as soon as the need(requirement) for oxygen increases (the person has run), the muscle of heart starts to feel its(his) shortage sharply. That is shown by a characteristic compressing pain behind a brest. Such episodes, naturally, are not peculiar to healthy heart and mainly meet at people of advanced age. Therefore in a hike the stenocardia is not so probable, though is possible(probable). Fortunately, more often the pain in the field of heart arises for other reasons. And still it is impossible to forget about a stenocardia. Because, if at this condition to not render the duly help, the heart attack of a myocardium can develop. The essence consists that cells(cages) cannot long live without oxygen and if its(his) inflow is not restored, die. How to restore supply of heart by oxygen?

You, probably, have already guessed, where conducts a string of reasonings: here just nitroglycerine which expands vessels also is necessary to us! When vessels in an organism are expanded, it is easier to heart to drive blood on such wide "pipes" besides expanding the vessels feeding heart, nitroglycerine provides the best delivery of oxygen. This medicine important correctly to apply: first, the tablet or a capsule should be put under language, secondly, to accept it(her) it is necessary sitting. Because nitroglycerine, expanding peripheral vessels, causes outflow of blood from a brain; in standing position when against blood supply of a brain the gravity most of all works, this effect is especially expressed. As a result, having accepted nitroglycerine costing(standing), it is possible to fall! In a prone position it(he) is less effective. Nitroglycerine is quickly soaked up and quickly operates(works). If in some minutes after reception of a tablet the effect has not come(stepped), means, it(he) and will not come(step) - in this case it is necessary to accept one more tablet. If, despite of repeated application of nitroglycerine, a pain does not pass(take place), here there are two variants: or it was not the stenocardia, and a pain of other nature, or, despite of all our efforts, shortage of oxygen to eliminate(erase;remove) it was not possible. The second condition refers to as a sharp coronary syndrome (a special case the heart attack of a myocardium is to specify the diagnosis in conditions of a hike it is impossible). In this case very strong and it(her) it is necessary to stop a pain. Unfortunately, not narcotic analgetiki here are poorly effective, the best means is morfin. Besides it is necessary to give aspirin (160-325мг), it is connected from it(him) protivosvyortyvajushchim by effect, its(his) application reduces death rate by 25 %! Reception of nitroglycerine it is necessary to continue (0,4 mg each 5 minutes). But, the main thing, it is necessary to lower the victim, and the more quickly, the better! First, the qualified medical aid is necessary oxygen, which at height, as is known, a little, secondly, is necessary.

  Some words about valocordin. Theoretically it(he), similarly to nitroglycerine (only by means of other mechanism), can expand vessels of heart. In practice this preparation possesses very weak, practically zero effect. Nevertheless, having the expressed pleasant taste, it(he) happens is useful in the first-aid set as psychotherapeutic means.

Any body, not only heart can suffer from lack of blood supply. On a cold from lack of blood supply hands, legs(foots), a tip of a nose, mochki ears - the most remote from the center of an organism of a part of a body start to freeze. The mechanism of occurrence otmorozheny is those: the first reaction of an organism to hit in the cold environment (for example, at an output(exit) from tent) is an expansion of vessels in the most vulnerable for a frost places. As a result in the beginning hands without gloves, the person(face) redden: to them flows blood. As blood hot, it(she) warms these parts of a body and does not allow them to freeze. But after a while there can come(step) the second phase of reaction to a cold - narrowing before the expanded vessels. The matter is that finitenesses, mochki ears, tips of a nose, a cheek is not the most important bodies. And if so that them to warm, it is necessary to endow temperature of the blood acting to heart, a brain and other vital bodies, such compromise appears is unacceptable. Therefore in conditions of bad adaptation to a cold it is necessary to endow the least valuable and to narrow vessels in finitenesses - and arise otmorozhenija. It is not surprising, that for their preventive maintenance frequently suggest to use the vasodilating means, most popular of which are spirit ethyl and trental. Really, they expand among other vessels in finitenesses and can warn them otmorozhenie. But such approach is very dangerous, and you already for certain can guess, why. The classical example is a freezing the drunkard in a snowdrift. After reception of alcohol on a frost in the beginning it(he) feels pleasant heat in all body, but soon this sensation passes(takes place) and is replaced by drowsiness - the person starts to freeze: it was warm rastracheno all for nothing on warming of finitenesses, and as a result for maintenance of a life it(him) has not sufficed. In the same way in a hike use of vasodilating means on a frost can lead to the general(common) cooling. An another matter - in conditions of warm tent. For warming the victim delivered in a warm premise(room), it is possible to use trental. Spirit is worse than it(him) as possesses a lot(plenty) of known collateral actions.

The means expanding vessels and-or reducing pressure in another way, apply at an arterial hypertensia, i.e. in case of increase of arterial pressure. It is a lot of them and selection of such medicine - very much a challenge. Therefore we shall not stop at all on these means: if someone in group suffers such illness, before a hike it(he) should consult with the attending physician and by way of medicinal therapy to follow its(his) instructions(indications). Time speech has come about the means reducing pressure, we shall notice, that one of them, nifedipine, should be in the hiking first-aid set for the specific reason: it(he) is applied at a high-altitude hypostasis of lungs (expands vessels in lungs) [2].

  In many lists of hiking first-aid sets almost the first place is allocated(removed) to such preparations, as caffeine, niketamid (kordiamin), sulfokamfokain. These means refer to analeptikami and stimulate work of cardiovascular and respiratory system. Thus the basic mechanism of their action is an activation of the center of a brain responsible(crucial) for these vital functions. It is possible to meet recommendations on application of these means almost at all sharp conditions. Motivate it approximately so: if to an organism it is bad, something means in it(him) badly works, and, means, it(he) should be urged on". But, as a rule, the organism itself cares of urging on" that it is necessary, when it is necessary and as it is necessary, and our intervention here is absolutely excessive. Everything that we achieve purpose(assignment;destination) analeptikov, this increase in consumption of oxygen a brain, and in fact oxygen in sharp situations usually and so does not suffice! Perhaps, the unique case when from these means there can be an advantage(a benefit) is a warming the frozen person: from a cold work of the centers in a brain is oppressed and as a result vital signs-important are broken. Though hypodermic introduction, for example, kordiamina or from the mountain river will not give the person taken from an avalanche in general any effect. In fact under a leather(skin) in that case a blood-groove practically zero (fine vessels are narrowed from a cold) and the preparation hardly will leave strongly further a leather(skin). In general, it is possible to take, certainly, these means with itself in the first-aid set, but it is possible and to not take, and from it(this) a little that will change in the worst party(side).

So, for influence on work of cardiovascular system there is a set of means, and the open space for their use in a hike is great. However, solving(deciding), whether to give the patient the next medicine, it is necessary to be guided first of all by a principle " do not do much harm! ".

 
protivomikrobnye means: " a life against a life "

Perasperaadastra

Antibiotics - medicines special. Their action is directed not on systems of an organism of the person (macroorganism), and on mikrooorganizmov which can lodge in a macroorganism. Why we speak "antibiotics", and we write in the title " protivomikrobnye means "? Whether Mean these concepts the same? Whether Are antibiotics, for example, sulfanilamidy? Here there is a terminological subtlety. protivomikrobnymi substances which kill refer to all or slow down duplication of microorganisms (bacteria concern to microorganisms, the elementary, mushrooms and viruses). Happen protivomikrobnye means of not selective action - antiseptics, we shall not speak about them - and selective action. Antibiotics by tradition can be named only those protivomikrobnye means of selective action, which receive (or earlier received) natural by (for example, from a mould). Therefore, for example, streptocide which as a matter of fact nothing differs from antibiotics, does not refer to as an antibiotic, since is synthesized is artificial. Also formally is not an antibiotic popular pereparat tsiprofloksatsin (tsifran, tsiprolet). Certainly, bacteria of it(this) do not know, and it(him) all is perfect(absolute) equally as pharmacologists name substance killing them. But we speak all it that the listener understood, that those rules which concern to antibiotics concern to application of the same sulfanilamidov all.

And what it for especial rules?

   1. First, there is no such antibiotic which would kill all mikrooorganizmy. Any antibiotic has spectrum of action, i.e. set of kinds of bacteria, mushrooms, the elementary, viruses on which it(he) can have oppressing an effect. If, for example, at the frustration of digestion caused by an intestinal stick to appoint(nominate) a remarkable antibiotic which acts on a heap of any bacteria, but does not act on the intestinal stick, any to sense will not be. What to do(make)? How to understand, who has caused illness and than it(he) can be killed? Alas, in a hike we do not have opportunity to define(determine) etiologiju (reason) of an infectious disease, for it(this) is necessary microbiological laboratory. Not knowing etiologii an infectious disease, in conditions of a hike it is possible and it is necessary to use antibiotics with a wide spectrum of action.
   2. Secondly, there are features in dosages and duration of application of antibiotics. It is known, that any medicines, besides the cores, possess collateral actions. Therefore usually try to lower as much as possible whenever possible a dosage and duration of application of a preparation. With protivomikrobnymi means the situation is a little bit other. The matter is that microorganisms are able to adapt to antibiotics very well. If to give a bacterium a small doze of a preparation which not ubyot it(her), the bacterium will learn to cope with action of this substance, for it(her) it will be as "inoculation" against an antibiotic. And when we, having understood, that the small doze is inefficient, we shall increase it(her), the "learned" bacterium will not be lost already and from the big doze. The same concerns to duration of application. If to cancel an antibiotic as soon as there will be the slightest effect the "not finished" bacteria will develop(produce) to it(him;them) stability (resistency) and next time this antibiotic any more will not help(assist). And will not help(assist) not only "razdolbaju", "not drunk up" a preparation, but also to all those people with whom this "razdolbaj" will infect. Reception of antibiotics it is necessary to continue even some days after disappearance of symptoms of disease.
   3. From the aforesaid follows: than less often and the the antibiotic is more correctly applied, the it(he) is more effective. Therefore before to apply this or that antibiotic, always it is necessary to think, whether it is necessary to do(make) it. In world scales development(manufacture) rezistenstnosti at bacteria is characterized by the present(true) disaster: rate of the invention of new antibiotics is not in time behind rate of the invention microorganisms of ways of struggle against available means. We shall protect the biological kind, we shall carefully concerns to antibiotics!
   4. there is one more reason cautiously concerns to purpose(assignment;destination) of antibiotics. The matter is that microorganisms happen not only "harmful", but also "useful". Applying antibiotics, it is necessary to consider their influence on normal microflora. What is the normal microflora? It(She) is made with set of bacteria (and mushrooms), living on a leather(skin), in a gastroenteric path, in respiratory ways. We with them have adapted to each other: we give to them zhilyo, they too give us something in exchange. First, they do not start up the "strangers" harmful mikrorganizmov, on the territory. Secondly, microorganisms help(assist) with intestines to digestion. But ours with them the neighbourhood is far from idyll: costs(stands) to a macroorganism oslabnut, and the microorganism can desire to reconsider " the contract about an armistice ". So, for example, occurs(happens), when we overcool and as a result cold - the microorganisms living in respiratory ways begins, declare the rights. However we have a little distracted, from questions of good neighbourhood we shall return to antibiotics. These preparations, naturally, operate(work) not only on those bacteria on which we wish to work, but on all microorganisms entering into their spectrum of action. Therefore the normal microflora is frequently amazed. Knowing its(her) functions, it is easy to guess, that immunity as a result suffers - our stability to infections weakens, digestion is broken. Besides we break balance which exists in normal microflora. Kinds making it(her) are at enmity among themselves. If we, for example, apply doxycycline which kills bacteria the mushrooms which have remained in loneliness can be multiplied not moderately. Therefore together with doxycycline it is necessary to apply protivogribkovye means, for example, nystatin.

Now from the general(common) principles we shall pass to concrete preparations. The first antibiotics were benzilpenitsilliny, made revolution in medicine. However, being effective half a century back, now they on already clear you to the reasons have lost efficiency. Penitsillinymogut to cause an allergy, therefore, if will be going to apply them, necessarily ask the patient, whether was at it(him) allergic reactions to antibiotics. But as a whole these preparations are harmless enough, and their this advantage. And as to efficiency there are synthetic analogues benzilpenitsillinov, such, for example, as ampicillin and amoksitsillin, and they are more effective. Ampicillin is worse soaked up in intestines and can be applied at intestinal infections (about intestinal infections we still shall talk). Amoksitsillin it is especially effective in a combination to the substances, stirring(preventing) to bacteria it(him) to split. Such preparations - amoksiklav, augmentin, despite of the solid price, - quite worthy candidates in the hiking first-aid set.

Are similar on the mechanism of action to penicillins tsefalosporiny. These antibiotics are easy(light) for learning(for finding out) under the name: tsefazolin, tsefaklor, tseftriakson, tsefiksim. Now 4 generations tsefalosporinov are synthesized. Except for preparations I of generation (tsefazolin), tsefalosporiny possess a quite good spectrum of action. Unfortunately, the majority of them can be applied only in the form of injections (parenteralno). Exception make tsefaklor and tsefiksim. From parenteralnyh tsefalosporinov for us it is most convenient tseftriakson since it is applied once in day and it(he) can be pricked intramuscularly. Only have in I go, that it(he) is on sale in the form of a powder (since in the form of a solution quickly decays) - lay up 1 % a solution of lidocaine for cultivation (lidocaine is used, instead of it is simple fizrastvor since introduction is painful(unhealthy)). And still, consider, that penicillins and tsefalosporiny are similar not only on the mechanism of action, and if the patient has an allergy on penicillins with a high probability there can be a reaction and on tsefalosporiny.

Frequently in hiking first-aid sets it is possible to see ampoules of gentamycin. This antibiotic concerns to aminoglikozidam. Gentamycin is convenient that it is not necessary to plant it(him), it is possible to enter intramuscularly. And the price at it(him) very modest. Besides it is shown, that if to enter a daily doze aminoglikozidov not fractionally - some times into day in parts, and once a day all at once from it(this) efficiency only will increase, and by-effects will be less. Therefore gentamycin is rather convenient in application. However aminoglikozidy possess rather seryoznymi by-effects: they are toxic for kidneys, can cause irreversible damage of ears and balance. And the spectrum of their action approaches(suits) for application in hospitals (there the person flora) more likely. To take or to not take them in the first-aid set, to solve to you. But, if decide all to take, know, that gentamycin - at all the advanced variant, is aminoglikozidy more effectively, for example, amikatsin.

We already mentioned doxycycline. It(he) is cheap and effective, is applied peroralno (inside), however causes the expressed infringements of normal microflora (necessarily to combine with protivogribkovymi means), is toxic for a liver. Together with tetratsiklinom doxycycline concerns to tetratsiklinam. You for certain heard about tetratsiklinovoj eye ointment. Eye ointment with an antibiotic should be had in the first-aid set, especially if in group there are the people carrying contact lenses, and tetratsiklinovaja quite suits for this role.

Still toksichnee tetratsiklinov levomitsetin (hloramfenikol) .levomitsetin is an effective antibiotic, but its(his) application is limited, since it(he) can is very expressed to influence system of blood, causing, besides other, an anemia that is especially unpleasant at height. In the hiking first-aid set for it(him) there is only one place - ointment for local application!

Next representing for us interest the group of antibiotics is makrolidy, widely applied at infections of respiratory ways. The most known makrolid - erythromycin, but is most interesting to us not it(he), and azitromitsin (sumamed). Sumamed appoint(nominate) inside of 1 times day within three days in what its(his) convenience consists. But there is it(he) dearly(expensively) enough.

At last, finishing(stopping) with antibiotics before passing to synthetic antibacterial means, it would be desirable to tell about " best of the best " - karbapenemah. This group of antibiotics operates(works) practically on all microorganisms with rare exception. But for their this reason try to apply as it is possible less often: them protect for those cases when anything any more does not help(assist). Are most widespread imipenem (tienam) and meropenem (meronem). Last is more effective, but it(he) can be entered only intravenously. Tienam it is possible to enter and intramuscularly. Likely, it would be quite good to have karbapenemy in a reserve on extreme - and only on extreme! - a case (for example, poured a peritonitis at impossibility of fast evacuation). But it is unequivocal, that small weight and volume here you will not manage, and by too. Therefore it more likely a variant for the first-aid set of gathering, which one on some groups also lays in base camp.

Now we shall pass to synthetic means. First of all it is necessary to note sulfanilamidy. Such widely known preparations concern To them, as streptocide, сульфацил-sodium (albucid), ftalilsulfatiazol (ftalazol), sulfaguanidin (sulgin). And again it would be desirable to emphasize, that sulfanilamidy as a matter of fact do not differ from antibiotics, and is unacceptable to swallow of streptocide level with sugar candies for cough at cold, and ftalazol and sulgin - level with coal at a diarrhea. Sulfanilamidy, as well as benzilpenitsilliny, being are invented for a long time, now have lost former efficiency. But have not lost collateral actions - infringement of function of kidneys, a liver and system of blood, and also high allergenicity. Therefore in the hiking first-aid set the niche for them is rather narrow is a local application in the form of eye drops (albucid) and in the form of the means which are not soaked up in intestines (ftalazol and sulgin, to this question we still shall return).

Efficiency sulfanilamidov essentially raises(increases) if to combine them with other substances. The preparation to-тримоксазол, known under the name "biseptol" is those. Its(his) form of release - tablets, the wide spectrum of action and the price do(make) by its(his) possible(probable) candidate for the hiking first-aid set, but collateral actions do not do(make) its(his) attractive. It is necessary to understand besides, that though biseptol and not antibiotic, but before beginning its(his) reception, it is necessary to think not less than before drinking, for example, sumamed.

One more interesting protivomikrobnoe means - metronidazole. It(he) is interesting to that, unlike the set forth above means, operates(works) not only on a bacterium, but also on the elementary. So, if you in Asia vypyote water with ljamblijami, for correction of consequences of this miss metronidazole will be irreplaceable. Metronidazole can be accepted in the form of tablets. But consider: its(his) application cannot be combined with the use of alcohol! Metronidazole oppresses enzyme, inaktivirujushchy atsetaldegid - the substance causing a hang-over. Consequences - down to a lethal outcome!

And at last, we come nearer to one of the most popular hiking antibiotics - tsiprofloksatsinu (tsifranu, tsiproletu, etc.) . It(He) concerns to ftorhinolonam - rather safe and effective group of preparations. Unfortunately, tsiprofloksatsin it is used so widely, that has already noticeably lost efficiency. The matter is that in our country the set of poor-quality preparations in which "do not report" tsiprofloksatsin is used. And you already know consequences of use of low dozes of antibiotics. The guards love of tourists to this preparation more. In this case the principle " old, kind " is inapplicable. Besides at respiratory diseases (i.e. diseases of respiratory system), so often meeting in a hike, tsiprofloksatsin it is often poorly effective. This antibiotic has similar to it(him), but newer and effective, though also less known, and as the consequence(investigation), less "spoiled" "relatives", for example, levofloksatsin (tavanik), moksifloksatsin (aveloks). They, unlike tsiprofloksatsina, are effective at diseases of respiratory system, including at a pneumonia. But, as well as the majority of new preparations, roads. Advantage tsiprofloksatsina that it(he) is a preparation of a choice at intestinal infections (about them we we shall talk, when we shall discuss the medicines influencing digestive system). Ftorhinolony it is possible to apply and enteralno, and intravenously. In experiments on krysjatah it has been shown, that ftorhinolony break formation(education) hrjashchevoj fabrics. Therefore at their children apply only under vital indications i.e. when anything else does not help(assist), and to lose there is already nothing. Though in rare cases when ftorhinolony all were applied at children, influences on hrjashchevuju a fabric it was not observed.

Well, we have considered(examined) the cores for us groups of antibacterial antibiotics. Pair words about protivogribkovyh means. Most likely, they will not be necessary in a hike, and they should be taken only if someone from participants has fungoid diseases. Widely known nystatin is not soaked up in a gastroenteric path. As if to protivovirusnyh means in a hike it is used only atsiklovir (zoviraks) mestno at a herpes.

All. We have finished with protivomikrobnymi means., certainly, it is much more than them, than we have considered(examined), but if you will know even it, will be already remarkable. It is not necessary to despair because of the big volume of the information. Really at the hiking first-aid set usually there are 1-2 antibiotics which choice depends on personal preferences of the physician. It is very desirable to have antibiotics both in peroralnoj, and in parentealnoj to the form. And it is convenient to have the same means in the form of different forms then it is possible to pass in process of change of a situation with one to another. Also ointments with antibiotics for local application are irreplaceable.

And in summary. Despite of all to application of antibiotics and their undesirable effects, it is necessary to understand restrictions, that in a hike frequently the situation costs(stands) very sharply. And at the big height, in heart of mountains, evacuation whence is practically impossible, and banal cold can be the indication to purpose(assignment;destination) of antibiotics.

 
The means influencing digestive system

At serious troubles I refuse to myself in everything, except for meal and drink.
Oscar Uajld

  At once we shall make a reservation, that we shall not consider(examine) those medicines which are required for treatment of chronic diseases. With participants having them it is necessary to understand individually. And in the base first-aid set it is impossible to provide all, in fact quantity(amount) of diseases infinitely, and the volume of the first-aid set is limited. All is impossible, but something is possible and necessary. First, by all means it is necessary to count on a diarrhea various etiologii, especially if you go to Asia. Secondly, at height the food very badly is digested, and at descent(release) downwards, in a civilization, digested even worse since it(her) becomes in some times more.

Medicines, are applied at a diarrhea, for all are known: it adsorbenty (the activated coal, polifepan, smekta...), loperamid (imodium) - symptomatic means. We want will more in detail stop on a question antibiotikoterapii. First of all it would be desirable to emphasize, that antibiotics are means of treatment of an infection and if the diarrhea is caused not by a microorganism, from them there is no sense. How to distinguish an infection from a usual poisoning - read, for example, Dolinin. At treatment of an intestinal infection it is logical to use antibiotics, not vsasyvajushchieesja in digestive system is ftalilsulfatiazol (ftalazol), sulfaguanidin (sulgin). If remember, they concern to sulfanilamidam. But, as we already spoke, sulfanilamidy now are not so effective. And in modern conditions the preparation of a choice at food toksikoinfektsijah is tsiprofloksatsin. Also with this purpose ampicillin can be used. What to choose, solve to you, but consider, that the diarrhea is not too harmless: Provoked by her(it) obezvozhivanie in conditions of the big physical activity and acclimatization to height sharply weakens(easies) an organism.

One more important point in treatment of food infections concerns(touches) uses loperamida. It is necessary to understand, that this means - cleanly symptomatic, and it does not render any medical effect. Moreover, interfering with deducing(removing) of toxins, it can promote vsasyvaniju them in blood and, as consequence(investigation) to deterioration of a condition of an organism. Therefore to apply loperamid follows with the big care.

In a gastroenteric path there are two basic ways of digestion of food. First, the stomach "kneads" it(her), secondly, on food enzymes, the fibers, capable to split a molecule on fineer pieces operate(work). Therefore the substances strengthening reductions of a gastroenteric path, or a mix of enzymes can be applied to improvement of digestion or so-called gastrokinetiki, i.e. To the first domperidon (motilium), the known medicine concerns to the second - festal and mezim.

One more problem from which for certain will have to collide(face) to the physician in a mountain hike is a heartburn. Its(her) reason - increase of acidity in a stomach. How to struggle with an acid? Correctly, by means of the bases! Of Alkali of type " toilet utyonka ", certainly, to swallow it is not necessary, and here poorly the basic substances will are rather useful. Are those antatsidnye means. Their most known representatives - "Almagel", "Maaloks", being liquid, weigh fairly. But antatsidy let out(release) and in the form of tablets - simply ask in a drugstore, something for certain will find. And that tablets have worked not worse gel, they need to be chewed simply well.

And one more group of medicines which to a plenty happen are irreplaceable are protivorvotnye means. For this purpose quite will approach(suit) popular metoklopramid (tserukal). By the way, guess, why it(he) is useful for having in the form of ampoules?
Glucocorticoids: panacea or poison?

Doctors are those who register medicines, about which know a little to treat illnesses about which they know even less, at people about whom they do not know in general anything
Volter

  Now we should consider(examine) very interesting and extremely inconsistent group of medicines - glucocorticoids. For tourists you can find in the popular literature, for example, such description of these medicines:

    " Possesses strong anti-inflammatory, antiallergic, antishock and antitoxic action, raises(increases) the HELL. Indications: stressful situations, a shock, poisonings, burns, traumas, asfiksija, etc. Apply at allergic diseases, a bronchial asthma, diseases of joints, infectious diseases, a hypotension, etc. "

Whether a lie, remarkable means? Especially involves coquettish ", etc.". It would Seem, in any heavy situation it is possible, not reflecting to apply glucocorticoids. Whether so it? Let's understand.

Let's begin, as always, with physiology. What is the glucocorticoids? Activity of our organism adjusts(regulates) set of the chemical substances named by hormones. Preparations of glucocorticoids are analogues of natural hormones of the glucocorticoids allocated by adrenal glands (small zhelezami, located as it is easy to guess, above kidneys). Glucocorticoids name " hormones of stress " since they are allocated in those situations when the condition of an organism leaves much to be desired. Their effects are numerous:

   1. First of all, glucocorticoids oppress the immune answer, render anti-inflammatory and antiallergic effect. We already spoke about one group of the medicines having anti-inflammatory action - about NPVS. The difference between glucocorticoids and NPVS consists that the first act higher levels of regulation and consequently their effect much more strongly and more globally. As consequence(investigation), glucocorticoids noticeably weaken(easy) resistibility of an organism to infections. It would Seem, action of glucocorticoids on immune system can be stated unequivocally a negative estimation. But not all so is simple, immunity is not always well. Frequently its(his) excessive activity leads to damage not only "another's", but also the cells(cages). Alas, diseases are rather widespread, at which such powerful weapon of protection as the immune system, "by mistake" goes against an organism of the person.
   2. What is necessary at stress for bodies? Oxygen and meal, i.e. blood and glucose are necessary to them. Therefore gljukortikoidy raise(increase) arterial pressure, strengthen reductions of heart and increase concentration of glucose in blood. Recommendations are based(founded;established) on it(this) to their application at a shock.
   3. Acting mucous a stomach, glucocorticoids, as well as NPVS, promote it(her) izjazvleniju. And, acting on bones, raise(increase) their fragility. But these effects are shown only at rather long application of preparations.
   4. there are also other effects of glucocorticoids, but for us they are less actual.

In medicine use not only the substances identical on chemical structure to natural glucocorticoids, but also their synthetic derivatives. Therefore preparations of this group much. Are most widespread prednizolon, metilprednizolon and dexamethasone. They differ from each other on activity, i.e. on a doze necessary for achievement of same effects. A choice of a concrete preparation - business more likely of taste. And the dosage always can be counted easily, using a following rule:

(A doze of dexamethasone) = (a doze prednizolona)/10 = (a doze metilprednizolona)/8

Thus, dexamethasone is ten times more active prednizolona and in eight - metilprednizolona.

Now we shall pass to the most interesting - to a question on when in a hike it is necessary to use glucocorticoids.

   1. Ability oppress immune reactions can to be used at extreme allergic displays - at anafilakticheskih reactions and an attack of a bronchial asthma. However in these cases glucocorticoids - not the best variant. The preparation of a choice at anafilakticheskom a shock is an adrenaline (and absolutely inaccessible for us infuzionnaja therapy). But it(him), first, not simply to buy(purchase), secondly, it is necessary to enter intravenously. Therefore most likely glucocorticoids will appear best of accessible variants. At a bronchial asthma is better to take advantage of inhalers of type "Ventolina", having left in a reserve intravenous introduction of glucocorticoids. But inhalers not always are in the first-aid set (in our opinion, it it is vain). But in any case, in such sharp situations glucocorticoids it is better, than ineffective antigistaminnye means (a Dimedrol, suprastin and so forth).
   2. At a shock any etiologii a question of application of glucocorticoids very thin. On the one hand, at deterioration of a condition of the victim and increase of a shock (and the shock who does not remember, is an insufficiency of blood circulation) it would be desirable to increase arterial pressure. It can be made not only by means of glucocorticoids, but other means are not accessible to us. On the other hand, in a hike the shock happens more often is caused by a trauma, and at a trauma the risk of infectious complications is great. In fact through the broken(disturbed) integuments of a bacterium easily get into an organism. A result - at a shock glucocorticoids to use it is possible and frequently it is necessary, but always it is necessary to think of, whether really it is necessary in the given concrete situation. Because, applying glucocorticoids at a traumatic shock in conditions of insanitary conditions, we " go on a knife blade ".
   3. Long time glucocorticoids were one of the favourite means applied at a craniocereberal trauma. However when began to check, how much(as far as) they improve survival rate, have received stunning(amazing) results: glucocorticoids have appeared are not simply useless, but also harmful! Per 2005 final results of huge research (CRASHtrial, 10 008 patients have been published! [4]), the application which have shown groundlessness of glucocorticoids at a craniocereberal trauma.
   4. More difficultly a situation with use of glucocorticoids at treatment of traumas of a spinal cord. Per 1990 large research (NASCISII) has shown, that earlier introduction of greater(big) dozes metilprednizolona (30¼ú/kg of weight of a body it is intravenously one-stage with the subsequent infusion of 5.4¼ú/kg hour within 23 hours) improves the subsequent restoration after a spinal trauma. In spite of the fact that other researches confirming this conclusion, it has not been lead, early application of greater(big) dozes of glucocorticoids became the private standard at treatment of traumas of a spinal cord. But till now heated arguments around of this question [6] proceed. To you to solve, whether to use glucocorticoids at a trauma of a spinal cord. But, if decide to use, it enter as much as possible (everything, that is as hardly in the first-aid set will be more, than it is necessary) and as soon as possible. As to a way of introduction theoretically intramuscularly too it is possible since Glucocorticoids are well soaked up, but to tell anything more proved on this occasion we cannot.
   5. One more indication to application of glucocorticoids are high-altitude diseases. It is shown, that dexamethasone is effective for preventive maintenance and treatment of sharp mountain illness [5]. But use such "muck" for such purpose can to be and it is not so justified. Besides dexamethasone recommend to apply at a high-altitude hypostasis of a brain. The indirect basis for such recommendations - efficiency of dexamethasone at sharp mountain illness (which, apparently, is softer stage of a hypostasis of a brain). Besides it is known, that glucocorticoids are effective at the hypostasis of a brain caused by changes in vessels what the high-altitude hypostasis of a brain is. Therefore, despite lacking researches in which efficiency of dexamethasone would be proved at a high-altitude hypostasis of a brain, it(him) widely use at this disease. A dosage - 8мг (2 ampoules) in the beginning, then on 4мг each 6 hours [2]. As in tablets contains on 0,5 mg of dexamethasone, them to use extremely inconveniently. If anybody in group is not able to do(make) intramuscular injections, it is possible to drink contents of an ampoule.

So, glucocorticoids are, certainly, not panacea, but also not poison. It is interesting and, at the same time, extremely inconsistent group of medicines, and its(her) place in medicine, apparently, still will be long specified.
 
The means influencing respiratory system

The doctor treats illnesses, but the nature cures
Gippokrat

  About medicines which are applied at heavy inflammatory diseases of respiratory system, such, as a pneumonia (an inflammation of lungs), we already spoke are antibiotics. And whether it is necessary to treat banal cold? More often it(she) is caused with viruses, and to kill them very uneasy, and harm from protivovirusnyh means, as a rule, it is more, than for the cold. With cold the organism consults itself. But some medicines everyone can be useful. What for they are necessary? First, they facilitate a condition of the patient, secondly, help(assist) to warn "descent(release)" of an inflammation in lungs.

What it for means?

   1. First of all it is antiseptics, i.e. substances which kill microorganisms. Unlike antibiotics, they in enough high concentration simply "mechanically" kill all successively. If the antibiotic can be compared to a rocket precisely reaching(achieving) the purpose antiseptics is such kosa which mows almost everything, that under it(her) gets. Will adapt to it(her) microorganisms cannot, as " against a breakage there is no reception ". Inside of antiseptics do not apply, it is senseless, at strong cultivation they cease to operate(work), and here mestno use. At cold them apply in the form of sprays in a nose and in a mouth, pastilok, sugar candies, rinsings... How much(As far as) they are effective in each concrete case, to tell difficultly, but harm from them is not present. By the way, the preferable way of application of antiseptic tanks is a rinsing since thus occurs(happens) still and mechanical clearing mucous.
   2. The structure of the same means often includes anesthetizing components, idea cleanly humanistic.
   3. At a cold in the form of drops apply vasoconstrictive means, such as nafazolin (naftizin), ksilometazolin (galazolin) and so forth In inflamed mucous a nose vessels extend, it(she) swells, as a result arises "zalozhennost" a nose. A symptom not only very unpleasant, but also fraught with complications: outflow of contents from additional bosoms of a nose is broken, their inflammation, for example, an antritis as a result can develop. Vasoconstrictive means eliminate(erase;remove) a hypostasis. But to apply them follows with care: consequences of long use of such means are unpleasant enough. The matter is that at long action of vasoconstrictive agents vessels lose natural ability to be reduced, as a result at a cancelling of such drops there is a constant "zalozhennost" a nose even if by then its(his) mucous already absolutely it is healthy. Therefore it is necessary to try to drip as small as possible galazolin or naftizin. And precisely it is impossible to apply these means of more week. Is better manages softer means, for example, drops and ointments with menthol if they help(assist).
   4. At cough can be used otharkivajushchie means. Function of cough - deducing(removing) mokroty from bronchial tubes. If mokrota too dense, it(she) leaves hardly, its(her) stagnation leads to increase of an inflammation. Otharkivajushchie means dilute mokrotu and stimulate its(her) best deducing(removing). To them concern atsetiltsistein (ATSTS), bromgeksin, ambroksol, etc. Ambroksol it is convenient that once a day can be applied - there is its(his) prolonged form - capsules retard on 75мг (these are such capsules from which the substance is allocated gradually).
   5. It would be desirable to warn against use protivokashlevyh means, such, as kodein. They eliminate(erase;remove) a symptom, but do not treat disease! That cough stops, mokroty does not become less. Such means are necessary only in case of when cough muchaet the patient, and mokrota all equally does not leave, despite of application protivokashlevyh means (cough is not always connected with presence mokroty, occasionally this reaction can be not physiological, but "false").

Thus, for cold it is a lot of means, and their correct application helps(assists) an organism will cope with disease. But all in many respects those who speaks are right, that " cold without treatment passes(takes place) for a week, and with treatment - for seven days ".
In summary

I know, that I know nothing
Sokrat

We have tried to inform up to you the most modern representations on pharmacology of the preparations entering into the hiking first-aid set. Naturally, very much much remains behind horizon, but all has been told much more, than it "is necessary" to know "nemedikam". Having loaded into memory the huge volume of the information on different medicines which can be necessary in a hike, is a high time to reflect: and whether this knowledge is necessary for me? Whether it is necessary to take and, especially, to use such heap of tablets, "kololok" and other food? Yes, sometimes (if fairly, seldom enough) their presence in the first-aid set can be critical for health of the participant. But, on the other hand, to a plenty (continuing to be frank, it is frequent enough) incorrectly used medicine can turn back poison. With the third, practice shows, that the people, wishing to go to mountain hikes of high categories in remote areas and simultaneously to remain alive, actively study(investigate) medicine and include fair quantity(amount) of strong means in structure of the first-aid sets. Anyway, understanding possible(probable) negative consequences of the work, we have decided all it to tell all to you. And what to do(make) or not do(make) with this knowledge is already your business.
 
The basic sources

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   4. CRASH trial collaborators. Final results of MRC CRASH, a randomised placebo-controlled trial of intravenous corticosteroid in adults with head injury-outcomes at 6 months. // Lancet, 2005, Vol.365, P.1957-1959.
   5. Dumont L., Mardirosoff C., Tramer M.R. Efficacy and harm of pharmacological prevention of acute mountain sickness: quantitative systematic review. // BMJ, 2000, Vol.321, P.267-272.
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