Pharmaceutical care for urolithiasis
General principles of pharmaceutical care in patients with urolithiasis:
- Identify "threatening" symptoms that require immediate medical attention.
- Focus patients' attention on non-drug corrections.
- Provide recommendations for the rational use of the selected drug.
- Threatening symptoms of urolithiasis that require immediate medical attention and hospitalization are:
- - acute pain in the lumbar region and hypochondrium, which often extends to the entire relevant half of the abdomen;
- - significant increase in blood pressure, bradycardia;
- - nausea, vomiting, painful urination;
- - blood in urine;
- - fever, chills.
- Regardless of the nature of stones, an important area of prevention of urolithiasis is a correct drinking regime. Fluid intake should correspond to the volume of at least 2 litres per day and more. When choosing a water load, you should consider that the drinking juices and beverages with high concentrations of vitamin C is undesirable in oxalate stones. In addition, watermelon juice should not be used for phosphaturia, and cabbage juice – for hyperuricemia. The best load is alkaline mineral water in case of urate stones.
The diet modification should be carried out taking into account the chemical composition of urinary stones. The liver, kidneys, tongue, brains, veal, cocoa, rich meat broths, legumes, cauliflower, sorrel, walnuts, and peanuts are excluded from the diet in uric acid stones. Phosphaturia and phosphate stones require a diet that promotes oxidation of urine. For this purpose, meat, lard, flour dishes, vegetable fats, limit milk and dairy products are mainly recommended and the consumption of vegetables and fruits is limited. The consumption (or exclude) of lettuce, spinach, sorrel, potatoes, milk and carrots is limited in case of oxalate stones. Dietary recommendations should be supplemented with herbal remedies. Herbal remedies have a mild effect on all parts of the disease pathogenesis and they are safe for long-term use as well. Phytocomplex Nokamen contains medicinal plants that have a complex effect on the main link in cystitis pathogenesis. Nokamen contains plants with litholytic properties (Saxifraga, Dolichos, Rubia, Boerhavia, Crateva, Tribulus terrestris, etc.), which are able to prevent the crystallization of oxalates, urate and phosphates in the urine and prevent the development of urolithiasis. In addition to the litholytic action, Nokamen also has an antibacterial effect against uropathogens due to Tribulus terrestris, Rosmarinus officinalis, Rubia, Saxifraga. The anti-inflammatory effect is provided by Crateva, Rubia, Butea, and immunostimulating properties – by asphaltum. Phytopreparations for the treatment and prevention of urolithiasis should be taken in courses, the duration and frequency of which is prescribed by the doctor. The occurrence of dyspeptic disorders (nausea, epigastric discomfort, etc.) while taking drugs based on herbal combinations is not a reason to discontinue the preparation. In this case, the preparation should be taken after meals. It should be considered that the most common side effect when using drugs based on herbal combinations are allergic reactions. Individuals on a salt-free diet should consider the sodium content in alkaline-citrate complexes of urolitholytic drugs.
- Yermolaenko T.I., Zhulay T.S. Pharmaceutical care with the use of a new urolithic remedy "Flarosuccin" in patients with urolithiasis // Pharmaceutical Journal.- No.4.- 2011.- P.113-116.
- Internet resource POG "MEDSTANDART", http://pharmopeka.net.