The aim of the study was to summarize and systematize the literature data, as well as the results of the carried out research in the field of medicinal plants used as diuretics in the Russian Federation and abroad.

Materials and methods. During the search for this review article materials, the abstract databases of PubMed, Google Scholar, as well as the ResearchGate and elibrary.ru were used. The search was carried out according to the publications for the period from 2005 to 2023. The keywords were as follows: herbal diuretics, diuretic drugs, kidney diseases, types of medicinal plant raw materials. The data from the authors’ previous scientific research on the analysis of the diuretic properties of certain types of medicinal plant raw materials, as well as individual substances of a phenolic nature isolated from them (simple phenols, flavonoids), were also reviewed.

Results. It was determined that the diuretic activity of most of the medicinal plants used, is due to such groups of biologically active compounds as terpenoids (essential oils and saponins), simple phenols, flavonoids and anthracene derivatives related to the secondary metabolites. It has been shown that, despite the fact that many herbal diuretics have concomitant anti-inflammatory, antimicrobial, antiviral, antihistamine and other properties relevant from the point of view of etiology and pathogenesis of the disease, it is reasonable to use them as part of collections of medicinal plants and other combined medicinal herbal preparations, as this is in accordance with the global trend. The types of medicinal plant raw materials that can be a promising source of new diuretic herbal medicines, have been examined in this review.

Conclusion. It has been determined that terpenoids and phenolic compounds make the greatest contribution to the manifestation of the diuretic activity of medicinal herbal preparations, among which the greatest structural diversity is noted for flavonoids. It has been established that in the composition of any drug, taking into account the peculiarities of etiology and pathogenesis of the disease, herbal diuretics can be both the main drug and an auxiliary component. The expediency of using medicinal plant raw materials with a diuretic effect as part of collections of medicinal plants and other combined preparations used in the treatment of kidney and urinary tract diseases has been also substantiated.

The aim of the study was to investigate the dynamics of inpatient consumption of direct oral anticoagulants in different regions of the Russian Federation for the period from 2017 to 2022.

Materials and methods. This study is a non-interventional, retrospective analysis of the electronic database records of Cursor Marketing LLC (Russia) about the announced by medical organizations and executed contracts for the purchase of direct oral anticoagulants (DOACs). The сonsumption was calculated on the basis of a DDD (defined-daily-dose) and estimated DDDTID (defined-daily-dose/1000-inhabitants/day) for each DOACs: rivaroxaban, dabigatran and apixaban. The Rosstat database available on its official website were used as a source of inhabitants data for the Russian regions.

Results. A total of 57 866 records were entered into the analyzed databases of Cursor Marketing LLC (Russia) from 2017 to 2022, 47.38% of which indicated rivaroxaban as the drug being procured, 26.51% indicated dabigatran, and 26.11% indicated apixaban. Edoxaban was not procured by healthcare organizations. During the period investigated, there was an increase in the consumption of all DOACs studied, with a higher increase for apixaban (by an average of 284.6% per year), then rivaroxaban (by 144.8% per year) and, to a lesser extent, dabigatran (by 92.5% per year). The analysis of DOACs consumption in general showed that compared to 2017, the need for these drugs in medical organizations in 2022 increased by 18 times. The Urals Federal District consistently exceeds the national average in terms of DDTID consumption. Noteworthy is the consumption dynamics of the regions of the Central Federal District and the North-Western Federal District, which made it possible to achieve DDDTID values above the national average for 5 out of 6 observation years. The lowest rates of DOACs consumption were observed in the Volga Federal District, which, despite positive growth dynamics, failed to reach the national average values. A high level of consumption (>10 DDDTID) of rivaroxaban was noted for the Arkhangelsk region (2018) and the Nenets Autonomous District (in 2021), dabigatran – only for the Arkhangelsk region (in 2018). Many more regions reached high levels of the apixaban consumption, especially in 2021.

Conclusion. Despite a number of limitations, the data on the volume of DOACs procurement can be used in the analysis of the consumption at both regional and national levels. When analyzing the DOACs consumption, the impact of COVID-19 pandemic and pharmacogenetic features of patients in different regions should be taken into account. During the studied period of time, a significant part of the Russian regions achieved a consumption level of rivaroxaban and apixaban, but not dabigatran, exceeding 1 DDDTID.

Alzheimer’s disease (AD) is a neurodegenerative disease that is a terminal form of dementia with an alarming spread rate. The treatment of AD usually involves symptomatic therapy, but the research field for new medicines to correct AD focus on the pathogenetic keys of the disease, i.e., a mitochondrial dysfunction.

The aim of the work was to evaluate the effect of trimethoxy-substituted monocarbonyl curcumin analogues on changes in the mitochondrial function of the hippocampus in AD rats.

Materials and methods. AD was modeled in female Wistar rats by the injection of β-amyloid aggregates 1-42 into the CA1 part of the hippocampus. The tested compounds AZBAX4 and AZBAX6 at a dose of 20 mg/kg each, as well as the reference donepezil at a dose of 50 mg/kg, were administered orally for 30 days after the surgery. After the specified time had passed, the changes in the cellular respiration, a citrate synthase activity, cytochrome-c-oxidase, succinate dehydrogenase, and adenosine triphosphate (ATP) concentrations were evaluated in the mitochondrial fraction of the rat hippocampus.

Results. During the study, it was shown that the use of AZBAX4 and AZBAX6 compounds contributed to an increase in the intensity of aerobic metabolism by 83.9 (p <0.05) and 35.9% (p <0.05), respectively, while reducing the activity of anaerobic one by 27.7 (p <0.05) and 20.6% (p <0.05), respectively. Against the background of the tested compounds AZBAX4 and AZBAX6 administration, there was also a significant increase in the activity of citrate synthase, succinate dehydrogenase and cytochrome-c-oxidase, as well as the level of ATP in the hippocampal tissue by 112.8 (p <0.05) and 117.1% (p <0.05), respectively. The use of donepezil led to a significant increase in the intensity of aerobic reactions – by 24.0% (p <0.05), a citrate synthase activity– by 80.0% (p <0.05) and the ATP concentration – by 68.5% (p <0.05). Against the background of the use of the analyzed substances, a decrease in the apoptosis-inducing factor and mitochondrial hydrogen peroxide is also worth noting.

Conclusion. Based on the obtained data, it can be assumed that the use of AZBAX4 and AZBAX6 compounds contributes to an increase in the functional activity of the mitochondria of hippocampal cells of AD rats, while surpassing the reference donepezil. It is perspective to continue a further study of AZBAX4 and AZBAX6 compounds as possible medicines of a pathogenetic correction of AD.

Earwaxes lead to a decrease in the quality of life. A rational and effective way to eliminate earwaxes without a participation of medical personnel is to use ear drops and solutions to dissolve sulfur masses. In this regard, therapeutic and hygienic drops of а cerumenolytic action are of a particular relevance in the pharmaceutical market.

The aim of the work was to develop a composition and technology of ear drops of a cerumenolytic action based on thick Viscum Album L. leaves extract.

Materials and methods. The objects of the study were thick Viscum Album L. leaf extract, chitosan, sodium alginate, polyethylene oxide of various degrees of polymerization, propylene glycol, sodium hyaluronate, preservatives (benzalkonium chloride, nipagine and nipazole). At the screening stage, 9 experimental formulations were proposed. The cerumenolytic activity of the developed formulations was evaluated in a dissolution test of reproduced artificial earwax in comparison with a 3% hydrogen peroxide solution, TEA-cocoyl hydrolyzed collagen (A-Cerumen Plus, Gilbert Laboratories, France) and a 0.9% sodium chloride solution. Physical and chemical parameters (a degree of liquid coloring, turbidity and transparency, pH, density and viscosity) were determined according to of the State Pharmacopoeia of the Russian Federation (XV ed.). The microbiological study was performed using the agar diffusion method.

Results. In the course of the study, it was shown that the composition of ear drops of a cerumenolytic action based on thick Viscum Album L. leaves extract, exceeds the level of a lipolytic, proteolytic and general cerumenolytic kinds of activity of the compositions containing surfactants; in its effectiveness, it was comparable with the comparison drug – A-Cerumen drops. To obtain the optimal rate of the onset effect and its duration, it is advisable to use sodium hyaluronate in the amount of 0.2 g per 25 ml of drops as an adjuvant. The most preferred preservative was benzalkonium chloride. The developed ear drops met the requirements of the State Pharmacopoeia of the Russian Federation (XV ed.) for this dosage form, while the pH was 5.86± 0.1, and the viscosity was 4.2676±0.2 MPa×s.

Conclusion. The conducted research has shown the prospects for further work on the development and implementation of ear drops of a cerumenolytic action in practice. The recommended composition is the following: thick Viscum Album L. leaf extract, sodium hyaluronate, benzalkonium chloride, purified water.

The efficacy of the antihypertensive therapy may be related to genetic factors that can influence not only the degree of the blood pressure (BP) elevation but also contribute to the interindividual variability of response to the antihypertensive treatment.

The aim of the work was to study pharmacodynamic parameters of the therapy efficacy with angiotensin II receptor blockers in the form of monotherapy and as part of combined drugs in patients with the arterial hypertension depending on the genetic features of patients – polymorphism of the gene encoding angiotensin-converting enzyme, or I/D-polymorphism.

Materials and methods. The study included 179 patients of the Moscow region with a first-diagnosed arterial hypertension (AH) of 1–2 degree, including 141 (78.8%) women and 38 (21.2%) men aged from 32 to 69 years. By a simple randomization method, the patients were randomly allocated into groups receiving irbesartan and valsartan as mono- or combination therapy with hydrochlorthiazide. After 3 weeks of this pharmacotherapy, the presence of rs4646994 Alu Ins / Del genetic polymorphism of the angiotensin-converting enzyme (ACE) gene and the minimum equilibrium concentration of angiotensin II receptor blockers (ARBs) were determined.

Results. The patients treated with irbesartan, the D/D genotype carriers, were significantly less likely to reach the target BP and more likely to require a pharmacotherapy intensification compared to I/D heterozygotes (p=0.042 and p=0.058, respectively) and I/I homozygotes (p=0.011 and p=0.011, respectively). The patients treated with valsartan, the D/D genotype carriers, significantly more often reached the target BP and significantly less often required a pharmacotherapy intensification than the I/D genotype carriers (p=0.05 and p=0.05, respectively). Herewith, at the end of the study, according to the results of the office BP measurements and daily BP monitoring, the target BP achievement was not significantly correlated with the I/D polymorphism of the ACE gene.

Conclusion. When personalizing the AH therapy in patients of the Moscow region, the genotype I/I carriers by I/D polymorphism of the ACE gene, can be recommended irbesartan in the form of mono- or bicomponent therapy as a starting therapy of ARBs; the D/D genotype carriers can be recommended valsartan. A more pronounced decrease in the daytime systolic BP (SBP), the daytime diastolic BP (DBP) and the nighttime SBP variabilities in the valsartan group of patients, the D allele carriers may indicate a more persistent effect of the antihypertensive therapy.