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Dosage form: & nbspmedical leeches
Description:

Medical leech is a type of annelid worms Annelides. The body, flattened in the dorsal-ventral direction, terminates at both ends with suckers. The posterior sucker is always visible, has no holes. The anterior sucker manifests itself at the moment of sucking to any object, the body of the sick or animal. In the depth of the sucker is the oral cavity. Leech should be healthy, do not have physical injuries on the body and suckers.

External distinctive signs of leech medical:

- medical leech leech - Hirudo medicinalis officinalis - has on the back longitudinal yellow-orange stripes with correctly repeated expansions. The bug is olive-green with black longitudinal stripes on the sides;

- medical leech leech - Hirudo medicinalis medicinalis - has along the back narrow, pairwise located yellow-orange stripes with a patterned pattern. The abdomen is olive-green with black spots of various shapes.

The third subspecies is the medical east leech - Hirudo medicinalis orientalis - has on its back narrow, pairwise arranged yellow-orange stripes with a patterned pattern. Abdomen black with olive-green spots, arranged in pairs through regular intervals. This subspecies of leeches is not bred in artificially created conditions, therefore it can not be used for medicinal purposes as a medicinal preparation.

Pharmacotherapeutic group:anticoagulant
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 gets into the human body after biting the leech of the skin and continues to flow throughout the blood-sucking period.

    The secret is an inhibitor of platelet-vascular 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 blocks the aggregation of platelets. The secret of leeches inhibits the initial stages of the activation stage of the proteins of the blood coagulation system by blocking the kallikrein of the blood plasma and Hageman factor. These secret properties determine the protective antithrombotic effect of occupational therapy.

    The destabilase and pyogenic "prostanoids" secreted in a secret cause a thrombolytic effect when using medical leeches. Destabilase hydrolyses isopeptide bonds. The action of destabilase determines an earlier unknown mechanism of fibrinolysis - isopeptidolysis.Secreted compounds of the prostanoid nature, which, like stable prostacyclin analogues, inhibit platelet aggregation and stimulate the secretion of the 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 alirase, which cleaves the phosphoric acid residue from ATP, has an anti-inflammatory effect in the development of 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 action, which is determined by a symbiotic bacterium that lives in the intestinal canal of the 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 "engraft" autografts 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 an increase in the phagocytic activity of blood neutrophils due to the effect of secret components on the complement system.

    Indications:

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

    - Ophthalmic diseases: glaucoma.

    - Diseases of the circulatory system: ischemic heart disease (in the acute stage as an auxiliary); acute coronary syndrome (after the end of heparin therapy); congestion in the liver due to heart failure; phlebitis, acute thrombophlebitis: acute thrombophlebitis of hemorrhoids; acute and chronic thrombophlebitis of the veins of the lower extremities; phlebeurysm.

    Contraindications:

    Individual intolerance, anemia, hemophilia, severe arterial hypotension, pregnancy, children under 14 years.

    Dosing and Administration:Acute neuritis auditory nerves - hirudotherapy should be started from the third and fourth days of treatment, after detoxification therapy with leeches in the projection of both mastoid processes, receding 1 cm from the auricles, 2-3 leeches on each side, treatment course 5-9 sessions, every other day. Leeches are placed before independent departure. An aseptic dressing is applied.
    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 ear canal, 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. (At the right moment, leech with iodine or alcohol is brought to the front of the leech's body, and the leech disappears). An aseptic dressing is applied. The course of treatment 2-4 sessions.
    Acute middle non-perforated otitis media and adhesive otitis media - The leeches are placed on the tragus, as well as the BTE area. The number of leeches for 1 session is 2-5 pieces. The duration of the session is 3-5 minutes. An aseptic dressing is applied. The course of treatment for non-perforated average otitis media is 2-4 sessions, with an adhesive average otitis - up to 7 sessions.
    Diseases of the paranasal sinuses - with purulent inflammation of the paranasal sinuses 1-3 leeches are applied to the exit sites n. supraorbitalis and / or intraorbitalis, depending on the localization of pain. An aseptic dressing is applied.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 - 2-4 leeches put on the skin of the temple and mastoid process on the part of the diseased eye. Leeches are placed before independent departure. An aseptic dressing is applied. The course of treatment 1-4 sessions.
    In cardiology: places of setting leeches - mastoid processes and temporal region, at the sides of cervical vertebrae, coccyx, heart region within the pain zones. The number of leeches per session is 4-8 pieces. Leeches are placed before independent departure. An aseptic dressing is applied. The course of treatment - 2-4 sessions in 2-3 days.
    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 the area of ​​the sacrococcygeal articulation for 2-4 leeches per session. Leeches are placed before independent departure. An aseptic dressing is applied. The course of treatment - 2-4 sessions.
    Acute thrombophlebitis of the veins of lower extremities: leeches put in an amount of 12-14 pieces per session in the course of a painful vein in a staggered order at a distance of not less than 1 cm from the vein. The course of treatment 2-5 sessions. Leeches are placed before independent departure. An aseptic dressing is applied.
    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 the acute period, 2 -3 first sessions are conducted daily, then in 1-2 days. The course of treatment - 8-10 sessions. When the pain process abates, leeches can be placed in the area of ​​the sacrococcygeal articulation, also in the projection of 3-4 sacral orifices on both sides for 2-4 leeches per session. Leeches are placed before independent departure. An aseptic dressing is applied.
    Side effects:

    Redness and swelling of the skin, as well as skin itching at the site of suction of leeches, which pass by themselves. In places bite of leeches sometimes hyperpigmentation of the skin is observed.

    Allergic reactions are possible. In this case hirudotherapy should be stopped.

    Interaction:

    When carrying out a course of hirudotherapy, correction of the dose of anticoagulants during their joint application, up to their cancellation, is necessary.

    Special instructions:

    Place the setting of leeches do not drench with water for 3-5 days after a hirudotherapy session.

    Form release / dosage:Leeches are medical.
    Packaging:

    1. Use a can of polyethylene terephthalate, filled with 2/3 dechlorinated water. In a 0.5-liter jar, up to 50 leeches are placed, in a 1.0-liter jar - up to 100 leeches. The can is closed with a polyethylene lid. In such a package the medical leech can be no more than 24 hours.

    2. In a bag of cotton fabrics size 30x15 cm packed up to 100 leeches, in a bag size 30x30 cm - from 100 to 350 leeches. The bag is tied with twine, wrapped with cotton wool and wrapped in wrapping paper. In such a package the leech may not be more than 24 hours.

    3. In a bag of cotton fabric filled with peat, put the leeches. The free edge is tied with twine, wrapped with cotton wool and wrapped in wrapping paper.

    When transporting by mail, the packages are placed in a parcel box. Bags for shipment are used in the following sizes:

    - 30x15 cm - from 1 to 100 leeches,

    - 30x30 cm - from 100 to 500 leeches.

    When transporting up to 100 leeches, peat is taken in an amount whose weight exceeds the weight of leeches by a factor of 2, while transporting from 100 to 500 leeches - by 3 times. In the boxes of plywood stack bags with leeches. Drawer dimensions:

    - 17x16x13 cm -10-100 leeches (1 bag),

    - 23x20x15 cm - 150-300 leeches (1 bag),

    - 28x21x17 cm - 350-500 leeches (2 bags),

    - 33x28x18 cm - up to 1000 leeches (up to 4 bags).

    In such a package the leech can be kept for 5 days. To protect the leeches from freezing in winter, the space between the packing and the walls of the box is filled with sawdust.

    Storage conditions:

    Store at a temperature of 16-26 ° C in vessels filled with 2/3 of their capacity with dechlorinated water, for a maximum of 20 leeches per liter of water.

    Keep out of the reach of children.

    Shelf life:

    6 months.

    Do not use after the expiration date.

    Terms of leave from pharmacies:Without recipe
    Registration number:P N001949 / 01-2002
    Date of registration:26.12.2008
    The owner of the registration certificate:International Center of Medical Leeches, CJSCInternational Center of Medical Leeches, CJSC Russia
    Manufacturer: & nbsp
    Information update date: & nbsp13.02.2016
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