Medical leech (Hiruda medicinalis)

Composition Pharmacodynamics Indications Carefully Contraindications Dosing and Administration Side effects Form release / dosage
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Dosage form: & nbspmedical leeches
Description:

View Hirudo medicinalis refers to the type Annelides - annel worms, subspecies leech pharmacist (Hirudo medicinalis officinalis), medicinal leech (Hirudo medicinalis medicinalis) and leech eastern (Hirudo medicinalis orientalis). The leech body, flattened in the dorsal-ventral direction, terminates at both ends with suckers. The posterior sucker is developed more strongly, it is always visible, has no holes, serves for attachment and movement. The front sucker appears at the moment of sucking to any object, the patient's body or the animal. In the depth of the sucker is the oral cavity. A medical leech (Hirudo medicinalis), unlike other species that live in water reservoirs in Russia and do not have medicinal properties, there are orange patterned strips on the back, located closer to the sides. They are clearly visible even in dark-colored specimens.

Features:

Hirudo medicinalis officinalis. Along the back there are longitudinal orange bands with regularly repeated extensions. The ventral side is olive-green in color with black longitudinal stripes on the sides.

Hirudo medicinalis medicinalis. Along the back stretch four narrow, pairwise arranged orange bands in the form of a chain with uniformly repeated expansions filled with black spots of a drop-shaped shape.The abdomen is olive-green, with black spots of various shapes.

Hirudo medicinalis orientalis. Along the back there are narrow longitudinal orange bands, covered at regular intervals by black quadrangular spots. Abdominal side - black with green spots, pairwise located at the same intervals.

Leech should be healthy, do not have physical injuries on the body and suckers.

Pharmacotherapeutic group:Anticoagulant means of direct action
ATX: & nbsp
  • Heparin and its derivatives
    • Pharmacodynamics:

    The therapeutic effect of leeches is determined by the properties of the secretion of the salivary glands, which enters the human body after biting the leech of the skin, and continues to flow throughout the blood-sucking period.

    The secret of the salivary glands is an inhibitor of the thrombocyte-vascular unit of hemostasis. It blocks the general adhesion and primary attachment of platelets to the surface of the collagen, which is exposed when the vascular wall is damaged. The secret of the salivary glands blocks the aggregation of platelets. The secret of salivary glands of leeches inhibits the initial stages of the activation cascade of proteins of the blood coagulation system by blocking kallikrein of blood plasma and Hageman factor.These properties of the secretion of the salivary glands determine the protective antithrombotic effect of hirudotherapy.

    The destabilase and pyogenic "prostanoids" secreted in a secret cause a thrombolytic effect when using medical leeches. Destabilase hydrolyses isopeptide bonds. The effect of destabilase determines previously unknown mechanisms of fibrinolysis - isopeptidolysis. The prostanoid-like compounds found in secretion, like stable prostacyclin analogs, inhibit platelet aggregation and stimulate the secretion of tissue plasminogen activator from the vascular wall.

    Systematically conducted hirudotherapy reduces the severity of atherosclerosis. The secretion property of the salivary glands of medical leeches has been shown to reduce the proliferative capacity of smooth muscle cells of intima of large human vessels affected by atherosclerosis and cause hydrolysis of glycerol-triolate and cholesterol-oleate.

    The anti-inflammatory effect of the leech secret is due to its ability to block the amidolytic and kininogenase activity of human plasma kallikrein. This blocks the formation of kinins, which are mediators of inflammation.In addition, kininases found in secret, reduce the activity of bradykinin, stimulating pain, thus providing an analgesic effect. The enzyme apyrase, which cleaves the phosphoric acid residue from ATP, has an anti-inflammatory effect when developing inflammations stimulated by ATP. An essential anti-inflammatory effect is possessed by euglins, elastase inhibitors and cathepsin G of human granulocytes.

    The secret of the salivary glands of medical leeches has a pronounced bactericidal and bacteriostatic effect, which is determined by a symbiotic bacterium that lives in the intestinal canal of a leech.

    The secret of leeches hyaluronidase changes the permeability of tissues, the degree of their hydration, accelerates the transport of water and ions, facilitates the penetration of biologically active secret substances into the body during hirudotherapy. Increase in permeability of tissues and walls of capillaries is achieved by depolymerization and cleavage of hyaluronic acid, one of the components of the basic substance of connective tissue.

    Biologically active leech secret compounds ensure the successful use of hirudotherapy to normalize microcirculation and "engraftment"autotransplant in reconstructive surgery. Contained in secret collagenase provides resorption of scar tissue.

    The secret of medical leeches has a general nonspecific effect on the human body, as evidenced by the increase in phagocytic activity of blood neutrophils due to the effect of secret on the complement system.

    Indications:

    - Otolaryngological diseases: acute neuritis of the auditory nerves, acute external otitis, acute unperforated otitis and adhesive otitis media, diseases of the paranasal sinuses.

    - Ophthalmic diseases: glaucoma.

    - Cardiac diseases: ischemic heart disease (in the acute stage as an adjuvant); open coronary syndrome (after the end of heparin therapy).

    - Phlebitis, acute and chronic thrombophlebitis: Acute thrombophlebitis of hemorrhoidal veins; acute and chronic thrombophlebitis of the veins of the lower extremities.

    - Phlebeurysm.

    - Stagnant phenomena in the liver due to heart failure.
    Contraindications:

    Individual intolerance, anemia,hemophilia, severe arterial hypotension, pregnancy, the period of breastfeeding, restriction of the drug by age (under 18 years).

    Dosing and Administration:

    Acute neuritis auditory nerves - Hirudotherapy should be started from the third and fourth days of treatment, after the detoxification therapy with leeches in the projection of both mastoid processes, receding 1 cm from the auricles, 2-3 leeches on each side, 5-9 sessions every other day. The duration of hemorrhage is not limited.

    Acute otitis externa - The location of leeches depends on the localization of the inflammatory process. If the inflammation is localized at the entrance to the auditory meatus, then the leeches are placed on the tragus and directly on the area of ​​inflammation. In the diffuse lesion of the entire ear canal, the leeches are located in the behind-the-ear area, retreating 1 cm from the place of attachment of the auricle and parallel to it. The number of leeches for 1 session is 1-3 pieces. The duration of the session is 5-7 minutes. Course - 2-4 sessions.

    Acute unperforated otitis media and adhesive otitis media - The leeches are placed on the tragus, as well as the BTE area. The number of leeches is 2-5 pieces. The duration of the session is 3-5 minutes.(At the right moment, leech with iodine or alcohol is brought to the front of the leech's body, and the leech disappears). The number of sessions with an unperforated otitis media is 2-4 sessions, with an adhesive median otitis - up to 7 sessions.

    Diseases of the paranasal sinuses - with purulent inflammation of the paranasal sinuses, leeches are applied to the outlet sites nsupraorbitalis and / or n.intraorbitalis depending on the localization of pain. The course of treatment includes 2-4 sessions lasting 3-5 minutes. Hirudotherapy is carried out together with general and local antibiotic therapy.

    Ophthalmic diseases - leeches are placed on the skin of the temple and mastoid process from the side of the diseased eye, usually in an amount of 2 pieces.

    In cardiology - places for setting leeches - mastoid processes and temporal region, at the sides of the cervical vertebrae, coccyx, heart region within the pain zones. The technique hirudotherapy - 4-8 leeches (an average of 5 pieces per session), 2-4 sessions in 2-3 days. Leech therapy with acute thrombophlebitis of the lower extremities: leeches are placed for 1 hour in the amount of 12-14 pieces along the course of the painful vein in a staggered order at a distance of not less than 1 cm from the vein. On the course appoint from 15 to 60 pieces.

    Acute thrombophlebitis of hemorrhoidal veins - The production of leeches is made in the amount of 1-2 pieces at the base of the thrombosed hemorrhoidal node. In an acute period, the first 2-3 procedures are performed daily, then 1-2 days in total to 8-10 procedures. When the pain process subsides, leeches can be placed in the area of ​​sacrococcygeal articulation, as well as in the projection of 3-4 sacral orifices on both sides of 2-4 leeches per procedure. Leeches are placed before independent departure.

    Stagnation in the liver due to heart failure - Leeches are produced in the V intercostal space on the right sredneklyuchichnoy and anterior axillary lines, as well as in the epigastric region and in the area of ​​the sacrococcygeal articulation for 2-4 leeches per session. Leeches are placed before independent departure. An aseptic dressing is applied. Course 2-4 sessions.

    Side effects:

    Allergic reactions in the form of redness and swelling of the skin at the site of suction of leeches, as well as skin itching, which pass by themselves.

    With individual intolerance, Quincke's edema is possible.

    In places bite of leeches sometimes hyperpigmentation of the skin is observed.

    Overdose:

    Cases of overdose have not been registered to date.

    Interaction:

    Hirudotherapy can not be carried out simultaneously with taking thrombolytic drugs.

    Do not use strongly smelling ointments, as the leech is very sensitive to foreign smells and may not stick.

    Effect on the ability to drive transp. cf. and fur:

    The drug does not affect the performance of potentially hazardous activities requiring special attention and quick reactions (driving and other vehicles, working with moving mechanisms, dispatcher and operator work).

    Form release / dosage:Leeches are medical.
    Packaging:

    For 10-200, 200-500 leeches are placed in a dense coarse bag full of packing soil (peat, clay, earth or a mixture of the listed soils) and tied up with twine.

    The bag is wrapped with wrapping paper, placed in a mail box made of cardboard. Free space in the mail box is filled with dry or moistened sawdust.

    The parcel box is packed with no more than 2000 leeches (4 bags of 500 leeches).

    Storage conditions:At a temperature of 4-18 ° C (in vessels filled with half dechlorinated water).
    Keep out of the reach of children.
    Shelf life:

    6 months.

    Terms of leave from pharmacies:Without recipe
    Registration number:LS-002693
    Date of registration:29.12.2011
    The owner of the registration certificate:Girudo-Mir, ZAOGirudo-Mir, ZAO Russia
    Manufacturer: & nbsp
    Information update date: & nbsp22.02.2016
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