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The clinical picture of influenza and other acute respiratory infections

The clinical picture of influenza and other acute respiratory infections consists of: - a typical symptom complex of acute respiratory infections of varying severity;

- syndromes of emergency conditions developing in severe and extremely severe acute respiratory infections;

- manifestations of the complicated course of acute respiratory infections.

A typical symptom complex of diseases is characterized by:

- fever;

- general intoxication syndrome;

- respiratory tract lesion syndrome at its various levels (rhinitis, pharyngitis, tracheitis, bronchitis, etc.).

Pneumonia has recently been seen as a complication of influenza and other acute respiratory infections. The general condition of the patient in most cases, while remaining satisfactory, is disturbed due to weakness, weakness, excessive sweating, and sometimes dizziness. Changes in the hemogram are expressed with a bacterial infection with accelerated ESR and leukocytosis with a shift of the leukocyte formula to the left. In case of a viral infection - leukopenia, neutropenia, eosinopenia, monocytosis.

Fever is a general stereotypic reaction of the body in the form of an increase in body temperature, regardless of the ambient temperature. Along with an increase in body temperature during fever, there is observed: a change in metabolism, respiratory, excretory, cardiovascular system, restructuring of the immune system. Infectious fever is caused by the action on the neurons of the centers of thermoregulation of pyrogens - pathogenic microorganisms, their toxins and tissue decay products. The sympatho-adrenal system causes a decrease in heat transfer and an increase in heat production in the human body, resulting in an increase in body temperature. Hyperthermia, in turn, helps to activate metabolism and increase heat production. Only after removing pyrogens from the body, that is, after eliminating the cause of the increase in body temperature, is thermoregulation normalized. ARI is characterized by a constant type of fever, at which the body temperature, having risen to febrile values, remains at a constant level for several days. Moreover, the difference between morning and evening temperatures does not exceed 1 ° C. The functions of organs and systems change: breathing quickens, heart rate increases (and an increase in body temperature by 1 ° C is accompanied by an increase in heart rate by 10 per minute). With fever, digestive function suffers: dry mucous membranes of the oral cavity, thickening of the oropharyngeal secretion, swelling in the tongue, weakening of intestinal motility, flatulence, and decreased appetite are noted. As a rule, the patient’s body weight is reduced. For the functional state of the central nervous system, excitation is replaced by inhibition. Delusions and hallucinations are possible, especially against the background of febrile temperature.
A frequent complaint of patients is a headache.

In the treatment of patients with influenza and acute respiratory infections, as a rule, the need arises for the use of symptomatic agents, including antipyretic, painkillers, antitussive drugs, vasoconstrictor drops and sprays. Antipyretic drugs usually also simultaneously have anti-inflammatory, analgesic and anti-congestive effects.

Taking into account the protective reaction of fever, antipyretic drugs are indicated at a body temperature of 39 ° C or higher, accompanied by severe headache. Paracetamol, non-steroidal anti-inflammatory drugs can be the drugs of choice. Acetylsalicylic acid with the flu is contraindicated. Avoid the use of acetylsalicylic acid in childhood and adolescence, since against the background of a viral infection, ASA-containing drugs can lead to Reye's syndrome, a serious disease with a mortality rate of up to 50%. Perhaps the use of paracetamol in children.

Paracetamol is by far one of the safest analgesics. The drug is an NSAID that blocks COX, mainly in the central nervous system, affecting the centers of pain and thermoregulation; It has an analgesic, antipyretic and moderately pronounced anti-inflammatory effect. Paracetamol reduces the pyrogenic effect of prostaglandins on the thermoregulation center in the hypothalamus, enhances heat transfer, disrupts the conduct of pain impulses in the afferent pathways.

According to recent data, paracetamol is able to exert a stimulating effect on a number of factors of the immune system, and on those that play a crucial role in the very early stages of acute respiratory viral infections, when the corresponding activation of the body's defenses can contribute to a less pronounced symptomatology and the course of the disease in a milder form.

Thus, under the influence of paracetamol, an increase in the antitoxic effect of the C – reactive protein is noted in the initial stage of the pathogen – organism reaction. A possible mechanism of this effect is associated with the effect of paracetamol on cell membranes, in particular, with its membrane-stabilizing effect. In addition, the antioxidant properties of paracetamol can play an important role in realizing this effect. The end result of this complex action is to increase the protective properties of the membrane, which prevents the penetration of the pathogen into the cell.

Immunostimulating effects are dose-dependent, and when prescribing paracetamol in low doses, the effect is weakly pronounced, when used in medium therapeutic doses, a proportional dependence is observed, and a further increase in doses is not accompanied by an increase in efficiency.
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The clinical picture of influenza and other acute respiratory infections

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