TY - JOUR AU - Shmanko, Oleh PY - 2019/11/07 Y2 - 2024/03/28 TI - An Analysis of the use of Tiocetam in Hepatic Encephalopathy JF - Asian Journal of Pharmaceutics (AJP) JA - AJP VL - 13 IS - 04 SE - ORIGINAL ARTICLES DO - 10.22377/ajp.v13i04.3400 UR - https://www.asiapharmaceutics.info/index.php/ajp/article/view/3400 SP - AB - <p>Aim and Scope: Hepatic encephalopathy in liver cirrhosis affects up to 40% of patients. It is important that the<br />hepatic encephalopathy has a potentially reversible nature on the initial stages and is irreversible on the final stages.<br />Therefore, the application of an effective treatment is important for the prognosis of the disease. In the treatment of<br />hepatic encephalopathy, it is important to have a protein restriction diet and drugs that reduce the level of ammonia in<br />the body. Along with this, there is still an insufficiently studied influence of hepatic encephalopathy medications with<br />cerebroprotective capabilities on the clinical symptoms. Taking into account, the multifactorial effects of piracetam<br />and thiotriazoline on metabolic and bioenergetic mechanisms in the body, a combined drug was developed – tiocetam,<br />which consists of 0.2 g of piracetam and 0.05 g of thiotriazoline. In recent years, clinical trials have been conducted<br />on the effectiveness of the use of tiocetam in neurology, which have shown its positive effects on the functional state<br />of the central nervous system, and taking into account, the known hepatoprotective properties of thiotriazoline, it<br />makes sense to study its possible effectiveness in the treatment of hepatic encephalopathy. Therefore, the purpose<br />of our work was to study the effectiveness of tiocetam in patients with hepatic encephalopathy due to liver cirrhosis.<br />Materials and Methods: For the study, 62 patients with liver cirrhosis, Class B (Child–Pugh score) with the signs of<br />hepatic encephalopathy of Grades I and II, were selected. All of them underwent 2 weeks of common treatment, which<br />included milk thistle, S-adenosylmethionine, diuretics, enzyme replacement therapy, and systemic enzyme therapy. All<br />patients were divided into two groups, randomized by age, sex, and severity of manifestations of liver cirrhosis and<br />hepatic encephalopathy: The comparison group – 20 patients, who continued the above course of common treatment;<br />the main group – 42 patients, who were additionally prescribed tiocetamin 2 tablets 3 times/day for 1 month. The<br />control group consisted of 20 healthy individuals. To assess treatment results, the dynamics of clinical manifestations<br />of liver cirrhosis was studied. The degree of sleep disturbance was expressed in points: Mild – 1 point, moderate –<br />2 points, and severe (lethargy) – 3 points. The state of cognitive function was evaluated using the 10 words memory<br />test; the severity of depression was evaluated applying Hamilton Depression Scale and Beck Depression Inventory.<br />Results and Discussion: An assessment of the general condition of patients 1 month after the beginning of the study<br />revealed a positive dynamics of clinical symptoms in 90.5% of patients in the main group and in 65.0% of patients in the<br />comparison group; furthermore, there was a marked improvement of several biochemical parameters in both treatment<br />groups relative to the control group and to the levels before treatment. There was also an improvement in the quality of<br />sleep, the state of cognitive function, and the severity of depression in the main group relative to the comparison group<br />and to the levels before treatment. Conclusion: The analysis of the results of the use of a combined drug – tiocetam,<br />which consists of 0.2 g of piracetam and 0.05 g of thiotriazoline, in the treatment of hepatic encephalopathy of Grades I<br />and II in patients with subcompensated liver cirrhosis, showed significant clinical effect, namely: Reliable improvement<br />of general condition, several key biochemical parameters, sleep disturbances, cognitive function, and also resulted in a<br />reduction of manifestations of depression, all of which improved the quality of life of patients.</p> ER -