Enzymatic drugs. The best enzyme preparations that improve digestion. Drinking with meals

How to take digestion tablets? When overeating, even a healthy person should take 1-2 tablets to improve food digestion.

Symptoms such as bloating and rumbling, a tendency to constipation or diarrhea are indicative of digestive problems.

In this case, the intake of enzymatic preparations is simply required. But it is best to first consult with your doctor and only then take pills for digestion.

Human health begins with the well-functioning of the stomach and intestines. And many diseases arise if a person neglects the laws of proper nutrition.

At first, pills for digestion help, the list of which is huge in our time.

But frequent errors in food eventually end in chronic diseases of the organs involved in the digestion of food. This causes the intake of toxins and low-quality "building blocks" for blood vessels, brain, heart, endocrine system into our body.

The body begins to resist, immunity and antioxidant systems are working to the limit. At this time, a person complains of constant fatigue, malaise, often catches a cold, pimples pop up on the skin, hair splits, nails break.

If during this period you do not switch to a Healthy Way of Life, and then a whole bunch of chronic diseases can develop.

What you will learn from this article:

How to eat right to prevent digestive problems

1. Avoid semi-finished products, vacuum-packed cuts, dairy desserts and useless yoghurts, smoked meats, pickles, canned food, margarine, ketchups, sweets and muffins;
2. Eat more vegetables and fruits, fish and seafood, seaweed, turkey meat, lean beef, grain bread, bran and cereals, sour milk products, vegetable oils, especially olive, flaxseed, legumes and nuts;
3. Eat more often - up to 5 times a day, drink clean water, use spices (ginger, turmeric, cardamom), natural coffee, green tea and cocoa;
4. Behave correctly while eating: chew food thoroughly, do not eat or drink too hot food and drinks, do not wash down food with water, eat the most high-calorie food in the morning. Lunch shouldn't be hearty, and dinner shouldn't be light. Drink kefir with cinnamon at night, never eat dry water;
5. Give up alcoholic beverages, but do not give up natural grape wines;
6. Make sure that you regularly empty your bowels and do not experience constipation, diarrhea;
7. Drink herbal teas: vitamin, anti-inflammatory, for digestion. Just for prevention !;
8. Arrange yourself " general cleaning»Intestines and after the holidays and abundant feasts.

What Causes Lead to Digestive Disorders

• If you do not follow all 8 of the previous points, then this will be one of the most important causes of impaired digestion of food. You will definitely need pills for digestion. You will see a list of them later in this article;
• Carious teeth, periodontal disease, inflammation of the gums do not allow thoroughly chewing food and processing the food lump with saliva;
• Chronic diseases (gastritis, ulcers, cholecystitis, gallstones, enterocolitis, etc.) are accompanied by enzymatic insufficiency;
• Postponed operations on the organs of the digestive system;
• The large intestine also contributes to the digestion process. If you have bloating, constipation, or, on the contrary, frequent loosening of the intestines, this also indicates dysbiosis, spasms or atony of intestinal smooth muscles, which also leads to impaired digestion.

Indications for the use of tablets to improve digestion

• Can a healthy person drink enzyme tablets for digestion? Even necessary! When overeating, nutritional errors, lovers of fatty or spicy foods;
• In the presence of symptoms of enzymatic deficiency: bloating, unstable stools (constipation-diarrhea), weight loss, increased fatigue, earthy color and dry skin, brittle nails, falling hair;
• For chronic pancreas, intestines, liver and after operations on the organs of the digestive system.

Pancreatin (Russia)- extract from the pancreas of domestic animals (pigs and cattle). It contains the main enzymes for the digestion of carbohydrate, protein and fatty foods - amylase, protease and lipase.

Pharmaceutical companies different countries this drug is produced under various trade names: Mezim forte, Creon (Germany), Panzinorm (Slovenia), Enzistal, Festal (India), Micrasim (Russia), etc.

Enzyme preparations differ among themselves:

• by the content of lipase activity in one tablet;
• by additional components (the presence of bile, hemicellulose, trypsin, chymotrypsin);
• the size of the drug microparticles, which for optimal absorption through the intestinal wall should not exceed 2 mm;
• by release form (tablets, capsules with microspheres);
• by price.

Similar features of the use of enzyme preparations:

• All preparations can be used both in case of errors in nutrition, and in case of enzymatic insufficiency caused by diseases of the digestive system, operations;
• Some of these drugs can be safely used on their own as a preventive measure for overeating and small, functional digestive problems. For example, pancreatin, mezim forte;
• Other enzymatic preparations have more stringent indications for use and should be prescribed only by the attending physician, based on your diagnosis and the severity of the disease, the degree of enzymatic deficiency;

• All enzyme preparations are used one to three times a day with food. The tablets should not be chewed, the capsules should not be opened, since enzymes lose their activity in the acidic environment of the stomach. Drink the medicine with a glass of clean water;
• You can drink from one to several tablets at a time. The dosage and course are set by the doctor. The drugs can be used for several days. And in many cases, people take pills for months and years:
• A common contraindication for taking enzyme preparations is acute inflammation of the pankreas (pancreas), intestinal obstruction.

Digestive pills. List of enzyme preparations

Friends! Subscribe to the updates of the Health Without Drugs blog! This can be done through the subscription form for the book " Folk remedies to improve memory ", which is located under the article. There is also a similar form at the top of the page on the right.

Digestion is a complex mechanism, on the work of which human health directly depends. Enzymes promote digestion by speeding it up. If they are not enough, violations develop. In order for the digestive function to work properly, you need to take medicines containing enzymes.

Why take enzymes

Enzymes play an important role: they speed up chemical reactions in the human body, make the process of digesting food faster. All enzymes can be divided into 3 main groups, each of which performs its own role.

Amylase

An enzyme group responsible for the processing of carbohydrates. Each type of carbohydrate has its own type of amylase. With saliva and gastric juice, enzymes enter the digestive tract, where they do their job.

Lipase

Lipase is responsible for the breakdown of fats (lipids) into their constituents. Enzymes of this group are formed in the pancreas and directly in the stomach.

Protease

This group of enzymes plays the main role in the processing of proteins (proteins). Protease is secreted together with gastric and pancreatic juices.

If the body lacks any digestive enzymes, enzyme deficiency occurs. In this case, the lack of enzymes leads to incomplete digestion of the food that has entered the body. This slows down the digestion process, causes heaviness in the stomach and other negative consequences.

Preparations containing enzymes are designed to rid the body of enzymatic deficiency and its symptoms. Most gastrointestinal disorders are indications for the use of enzymes.

Indigestion symptoms

Almost every third person has encountered gastrointestinal disorders at least once in his life. According to statistics, 37% of the population suffers from digestive disorders.

All of these problems are most common in people aged 30-45. Women are more susceptible to diseases of the gastrointestinal tract, but in men, pathologies of this kind are often found.

The symptoms of impaired digestion are varied. Therefore, you should pay attention to even the smallest malfunctions in the body. Such vigilance will help prevent the occurrence of serious diseases and get rid of disturbances in the digestive tract at the initial stage.

You should pay attention to the following symptoms.

Nausea and vomiting

These are some of the most noticeable symptoms. Most often, vomiting and nausea are caused by problems with the gastrointestinal tract.

Heartburn

Heartburn is a sure companion of any digestive problems. It appears due to the large amount of acid in the stomach and causes discomfort.

Heaviness in the stomach

Appears after eating heavy food. Most often, this worries a person after a hearty late dinner.

Stool problems

Diarrhea and constipation. If these symptoms appear regularly, it is worth considering a visit to a specialist and taking medications.

Indigestion can cause headaches and even migraines.

Chronic fatigue

Drowsiness, apathy, constant feeling of tiredness.

Decreased appetite

Appetite sharply worsens when any problems arise in the body.

Skin problems

Our skin is a kind of indicator of gastrointestinal diseases. If digestion is not working properly, it will affect appearance... An oily sheen, acne, or, conversely, dryness and sensitivity will appear.

If such signs appear, you need to see a doctor as soon as possible.

Causes of Digestive Disorders

The causes of digestive upset are many.

Regular stress

Regular stress is becoming one of the most common causes of digestive disorders. Try to minimize the presence of stressful situations, this will keep you healthy.

Improper nutrition

Eating fast food instead of healthy and healthy food is fraught with negative consequences for the gastrointestinal tract. Give up fatty and fried foods, replace semi-finished products fresh vegetables and fruits, and digestion will return to normal.

Binge eating

It is difficult for the body to digest large amounts of food, because of this, a feeling of heaviness and nausea appears. After overeating, it is recommended to take enzymes.

Eating food before bed

At night, biological processes in the human body slow down. Because of this, the body cannot fully digest food. Avoid eating 3-4 hours before bedtime.

Drinking with meals

Water and other drinks entering the stomach dilute the gastric juice, which contains digestive enzymes. This greatly slows down the process of digesting food, because of this, severity and other unpleasant symptoms appear.

Preparations for improving digestion

E If, after changing the diet, it is not possible to get rid of digestive problems, then it becomes necessary to take drugs containing enzymes. They will improve the functioning of the gastrointestinal tract, relieve severity, nausea and other symptoms.

Before you start taking any enzyme preparations, consult your doctor and take the necessary tests. This will help identify more serious health problems and prevent problems that may arise from self-treatment.

Medicines containing enzymes are conventionally divided into 3 groups:

1. Means in which the active ingredient is pancreatin. The drugs in this group are aimed at quickly eliminating the main symptoms of digestive disorders. They relieve heaviness, bloating, and nausea after overeating.
2. Enzymatic agents that contain, in addition to pancreatin, hemicellulose and bile acids. They are used to normalize digestion and in the complex therapy of diseases of the gastrointestinal tract.
3. Medicines that normalize the work of the pancreas. They make up for the deficiency of essential enzymes.

Enzyme preparations are available in two forms: tablets and capsules. Medicines released in capsules are preferable, since they enter not only the stomach, but also the intestines, while the tablets are completely dissolved under the influence of gastric juice. Enzymes in capsules have a therapeutic effect on the entire gastrointestinal tract.

For adults

Medicines that contain enzymes are in greatest demand among adults. Some drugs are more popular than their counterparts.

Pancreatin - light pink film-coated tablets. The preparation contains 4 types of enzymes:

• alpha amylase;
• lipase;
• trypsin;
• chymotrypsin.

Pancreatin replenishes the lack of enzymes produced by the pancreas, accelerates the breakdown of proteins, fats and carbohydrates into amino acids, fatty acid and monoglycerins, glucose. The shell of the tablets does not dissolve under the influence of gastric juice, thanks to which the enzymes are not destroyed.

Pancreatin is used for the following diseases:

• chronic pancreatitis;
• cystic fibrosis (a disease that causes the exocrine glands to malfunction);
• dyspepsia (impaired digestive function and stomach activity);
• pancreatectomy (removal of the pancreas).

Also, the drug is used in the following cases:

• stool disorder: diarrhea or constipation;
• flatulence;
• diseases of the biliary tract;
• impaired digestion of food;
• preparation for the diagnosis of the digestive tract.

Pancreatin tablets are drunk with or after meals, with plenty of water. Doses of the drug depend on the patient's age; no more than 21 tablets can be consumed per day. The duration of the course of treatment is selected by the doctor depending on many factors. Most often, this period is 2 weeks.

Creon is a drug belonging to the group of enzyme agents. Specialists prescribe it for both treatment and prevention of diseases of the gastrointestinal tract.

It contains 3 enzymes:

1. Protease.
2. Amylase.
3. Lipase.

Available in capsule form in 3 dosages:

1. Creon 10000 is prescribed to patients in order to prevent and prevent the appearance of digestive disorders. The drug is taken 1 to 3 times a day during or after meals.
2. Creon 25000 is prescribed for enzymatic insufficiency, when the pancreas cannot cope with the production of necessary enzymes.
3. Creon 40,000 is applicable for the treatment of more serious diseases of the gastrointestinal tract, the daily dose and course of administration are selected by the doctor after the necessary tests.

Creon is prescribed for:

• diseases of the gastrointestinal tract, especially in chronic pancreatitis;
• cystic fibrosis;
• diseases of the pancreas;
• disorders of the bile ducts.

Mezim

Mezim is a medicinal product containing enzymes necessary for digestion. Like Creon, it contains 3 main enzymes:

• lipase;
• amylase;
• protease.

This is a new generation drug, it surpasses its counterparts in many ways. Mezim eliminates all the symptoms of indigestion. The drug normalizes the digestive tract, accelerates the process of food digestion.

Specialists prescribe Mezim to eliminate the following diseases:

• chronic pancreatitis;
• cystic fibrosis;
• inflammatory processes in the digestive tract;
• flatulence;
• diarrhea.

Festal

Festal is an enzyme preparation produced in the form of pills white... The drug shell cannot dissolve under the action of gastric juice, allowing the drug to enter the small intestine.

Festal contains the following enzymes:

• pancreatin;
• hemicellulose.

The drug is used to improve digestion and in the complex therapy of certain diseases:

• chronic pancreatitis;
• dysbiosis;
• flatulence and problems with bowel movements;
• enzymatic deficiency;
• diseases of the gastrointestinal tract.

Somilaza

Somilase is a drug, the main component of which is solizim, an enzyme responsible for the breakdown of fats. The drug compensates for the lack of enzymes in the body.

It must be taken if there are the following indications for use:

• chronic pancreatitis;
• stomach diseases, including gastritis;
• inflammation of the gastrointestinal tract;
• lack of enzymes;
• liver disease;
• gallbladder problems.

The drug should be taken strictly according to the instructions, and only the attending physician can appoint an appointment.

For children

Children are also prone to digestive problems. In order to get rid of them, children are prescribed enzyme preparations. Most often, the same remedies are used for the treatment of children as for adults, but the concentration of the active substance and the daily dose should be much lower. Typically, pediatricians recommend the following medications:

• Mezim forte;
• Festal;
• Enzistal;
• Panzinorm forte;
• Digestal.

It is necessary to use these drugs for children with extreme caution. Before that, you must definitely visit a doctor and pass the necessary tests.

Contraindications

Before using drugs that improve digestion, you must make sure that there are no contraindications. Most products containing enzymes should not be taken if you have the following conditions:

• acute pancreatitis;
• hepatitis B;
• intestinal obstruction;
• diabetes.

Before using drugs, make sure that there is no individual intolerance to the components of the drug. During pregnancy and lactation, drugs should be used with caution.

Where to buy drugs and how much do they cost

Most of the drugs on this list are affordable. The average cost of enzyme funds is within 240 rubles. You can buy it at any pharmacy. No prescription is required.

Enzymes perform important functions in the body: they speed up the digestion process, help to get all the necessary nutrients from food. If they are not enough, the person's condition worsens, there is heaviness and pain in the stomach, nausea, weakness. In order to get rid of all these symptoms, it is necessary to use products containing enzymes necessary for the body.

In contact with

The dynamic balance of metabolic processes in the body is regulated by biological catalysts (enzymes), inhibitors (antienzymes) and coenzyme. Enzyme preparations are medicines containing enzymes. Medicines used to suppress enzyme activity are called enzyme inhibitors. Coenzymes are involved in enzymatic catalysis, acting as active centers of enzymes.

Enzymes- these are biological catalysts that accelerate biochemical reactions. Enzyme preparations - dosage forms of enzymes that are used to treat diseases (the so-called SE). The enzyme activity is determined by a biological method and is expressed in units of action. In medical practice, enzymes of animal (trypsin, chymotrypsin, pepsin, hyaluronidase), plant (papain, bromelain) and bacterial origin (clostridyl peptidase, streptokinase), as well as enzymes obtained by genetic engineering (alteplase) are used.

The international classification of enzymes is based on the type of reaction catalyzed by the enzyme and the substrate of this reaction. Pharmacological classification also takes into account the clinical use of enzymes and is as follows:

1. peptidase (pepsin).

2. Proteases (crystalline trypsin, crystalline chymotrypsin).

3. nucleases (ribonuclease, deoxyribonuclease).

4. Preparations of hyaluronidase (lidase, ronidase).

5. Fibrinolytic enzymes (fibrinolysin, streptokinase, urokinase, alteplase).

6. Oxidoreductases and enzyme preparations of another mechanism of action (superoxide dismutase, cytochrome C, penicillinase, L-asparaginase).

7. polyenzyme preparations (pancreatin, creon, festal, wobenzym).

The most important for the clinic are peptidases, proteases and nucleases, which

carry out hydrolytic cleavage of proteins, peptides or nucleic acids to low molecular weight compounds.

Peptidases. Pepsin is one of the main proteolytic enzymes in the digestive tract. It is produced in the cells of the gastric mucosa as the proenzyme pepsinogen, which is converted into an active enzyme in the gastric contents. In the acidic environment of the stomach, it hydrolyzes proteins to peptides.

Acidin-pepsin is the most commonly used pepsin drug. Its tablets contain pepsin and betaine hydrochloride (acidin). Pepsin breaks down proteins, and betaine hydrochloride (acidin) creates the optimal pH for its activity. Acidin-pepsin is used as a means of replacement therapy for reduced gastric acid secretion. Indications for use are hypo- and anacid gastritis, dyspepsia. When using acidin-pepsin, possible (rarely) mild nausea and heartburn. The drug is contraindicated in hyperacid gastritis, increased acidity of gastric juice.

Natural gastric juice is also a preparation of pepsin with hydrochloric acid. It is obtained through a gastric fistula from horses or dogs, purified and used as a means of replacement therapy for secretory gastric insufficiency.

Proteases. Trypsin and chymotrypsin are pancreatic proteases that hydrolysis peptide bonds and differ in site of action on the polypeptide chain of the protein. The trypsin absorption center interacts with the lysine / arginine residue. Chymotrypsin acts on the side chains of hydrophobic amino acids (phenylalanine, tyrosine, tryptophan). Trypsin and chymotrypsin are important not only in the digestion process, but also in the destruction of foreign protein material. These proteases have a particularly high affinity for denatured proteins that are formed during the filling process. Proteolysis of manure leads to its dilution, improves the evacuation of purulent exudate, accelerates the cleaning of wounds and bronchi (Fig. 11.1). In this regard, trypsin and chymotrypsin are widely used in the treatment of purulent processes.

Now the possibility of absorption of proteolytic enzymes in the intestine into the blood or lymph has been proven. The amount of absorption of proteases depends on their molecular weight and varies from hundredths of a percent to 30-40%. The suction mechanism includes

Rice. 11.1. The action of proteases and nucleases in the focus of purulent inflammation

absorption through the ends of microvilli, endocytosis on the surface of Peyer's patches, and absorption by migrating lymphocytes. After the introduction or absorption in the intestine, proteases bind to blood antiprotease proteins, the main of which is α2-macroglobulus and n. As part of these complexes, proteases retain their activity and are transported to damaged tissues. At the systemic level, they hydrolyze inflammatory peptides, control the state of immunoactive substances (cytokines, growth factors) and receptors that remove immune complexes and adhesion molecules, and activate fibrinolysis.

Crystalline trypsin available in the form of a lyophilisate for the preparation of a solution for injection and topical use. It is a protein with a relative molecular weight of 21 kDa, which is obtained from the pancreas of cattle.

Pharmacokinetics. For diseases of the respiratory system, the drug is used intramuscularly and in the form of inhalations, for diseases of the pleura - intrashneoplev - morally. In surgery, parenteral administration is combined with topical administration. In ophthalmology, it is injected into the posterior chamber of the eye or under the conjunctiva. In ENT practice, it is possible to introduce into the maxillary cavity and the middle ear cavity. In the blood, trypsin binds to α2-macroglobulin.

Pharmacodynamics. The enzyme is active at pH 5.0-8.0 with optimum activity at pH 7.0. He is able to break down dead tissue, fibrinous formations, viscous secretions and exudates. In relation to healthy tissues, the enzyme is inactive and safe due to the presence of trypsin inhibitors in them. The drug has anti-inflammatory and anti-edema effects, activates fibrinolysis.

Indications. The main indications for the use of trypsin are respiratory diseases with thick purulent sputum, purulent wounds, burns and bedsores, thrombophlebitis, purulent sinusitis, purulent otitis media and eustachitis with viscous exudate, retinal vascular thrombosis, vitreous opacification, cataract extraction.

Side effect. When using trypsin, fever, tachycardia, slight pain and hyperemia at the injection site, and allergic reactions are possible. The introduction into the respiratory tract sometimes causes irritation of the mucous membranes of the upper respiratory tract.

Contraindications The drug is contraindicated in decompensated heart failure, pulmonary emphysema with respiratory failure stage III, complicated forms of pulmonary tuberculosis, severe liver disease, pancreatitis, increased bleeding. Trypsin should not be injected into the inflammation focus, as well as applied (like other proteolytic enzymes) to the surface of malignant tumors. It is forbidden to administer the drug intravenously.

Crystalline chymotrypsin has pharmacological properties and uses similar to trypsin. It is distinguished by a slightly greater stability in the body and other restriction sites, which hydrolyze mainly the bonds formed by aromatic amino acids and cause deeper cleavage of the protein.

Nucleases. This class of hydrolytic enzymes includes ribonuclease and deoxyribonuclease. Ribonuclease depolymerizes RNA to mono- and oligonucleotides. Deoxyribonuclease is an albumin-type protein that hydrolyzes (cleaves) DNA into deoxyribonucleotides. For clinical use, it is important that the nucleus

basics reduce the density and viscosity of manure, which always contains a large number of nucleic acids formed from destroyed leukocytes.

Ribonuclease produced in the form of a lyophilisate for the preparation of solutions, obtained from the pancreas of cattle. According to the localization of the pathological process, the agent is administered intramuscularly, endotracheally, in the body cavity, and applied topically. The drug depolymerizes RNA and, as a result, liquefies pus, mucus, viscous purulent sputum; has an anti-inflammatory effect, which is secondary. It delays the multiplication of some RNA viruses. The main indications for the use of ribonuclease are respiratory tract diseases with viscous purulent sputum, periodontal disease, gingivitis; osteomyelitis, fistulas, abscesses, trophic ulcers, sinusitis, otitis media, thrombophlebitis; tick-borne encephalitis; viral meningitis. During treatment, irritation of the mucous membranes of the respiratory tract, allergic reactions may occur. Ribonuclease is contraindicated in hypersensitivity, chronic heart, respiratory and hepatic failure, open form of tuberculosis, bleeding.

Deoxyribonuclease causes DNA depolymerization and manure dilution. It has the ability to delay the development of herpes viruses, adenoviruses and other viruses containing DNA. This enzyme preparation is used for herpes and adenovirus infections, as well as to reduce viscosity and improve the evacuation of sputum and pus in patients with purulent lung diseases.

Hyaluronidase preparations. Hyaluronidase causes the breakdown of hyaluronic acid, which is a "cementing" intermediate connective tissue, and thus leads to an increase in tissue permeability and an improvement in the movement of intercellular fluid. This mechanism determines the participation of this enzyme in the regulation of inflammation, edema, transport of substances, elasticity of connective tissue (Fig. 11.2). The effect of hyaluronidase is reversible.

Rice. 11.2. The mechanism of action of hyaluronidase

Lidaza- an enzyme preparation from the testes of cattle, the active basis of which is hyaluronidase. Lidase is injected subcutaneously, under scar tissue, intramuscularly, by electrophoresis or by application to mucous membranes (in ophthalmic practice). The duration of action reaches 48 hours. The effect of the drug is the appearance of joint mobility, softening of scars, elimination or reduction of contractures, resorption of hematomas. The action is most pronounced in the early stages of pathological processes. Indications for lidase are joint contractures, ankylosing spondylitis, scarring of the skin, hematomas, chronic ulcers, scleroderma. Used in ophthalmic practice, as well as in the productive nature of pneumonia. Lidase is used to accelerate the absorption of various drugs (local anesthetics, antibiotics, glucocorticoids). The drug is well tolerated, but sometimes allergic reactions can occur. The use of this enzyme is contraindicated in malignant neoplasms, acute inflammatory processes, pulmonary hemorrhage and hemoptysis.

Ronidase- a preparation of hyaluronidase, in its origin and pharmacological properties is close to lidase. At the same time, ronidase has a lesser degree of purification and is applied only topically in the form of wet dressings for the treatment of joint contractures, scars, hematomas, chronic tendovaginitis, wounds that do not heal for a long time.

Fibrinolytic enzymes. Fibrinolytic enzymes include fibrinolysin and activators of fibrinolysis ( streptokinase , urokinase , alteplase). By their mechanism of action, they are all proteases, but pharmacodynamics and application for thrombolytic therapy provide grounds for the isolation of these enzymes into a separate classification unit. These drugs are discussed in detail in the section "Drugs affecting blood clotting and fibrinolysis".

Oxidoreductase and other enzymes. Cytochrome C is an enzyme that is involved in tissue respiration. This enzyme is used for asphyxiation of newborns, as well as for the treatment of hypoxic conditions that occur in bronchial asthma, heart failure, ischemic heart disease. Orally administered at high physical exertion.

Superoxide dismutase- a key enzyme of antioxidant protection of cells, which inhibits FRO processes. It is used in ophthalmology to treat eye diseases accompanied by tissue hypoxia and oxidative stress.

Penicillinase- an enzyme produced by some types of microorganisms and has the ability to inactivate penicillin. It is used for acute allergic reactions and anaphylactic shock caused by antibiotics of the penicillin group.

L-asparaginase is an enzyme that breaks down the amino acid asparagine. Asparagine deficiency is a factor that limits the division and development of leukemic cells. This drug is used to treat acute leukemia and hematosarcomas.

Polyenzyme preparations. Polyenzyme preparations contain several enzymes that have a complex effect on the body. they can be divided into two groups: means that improve digestion processes in gastrointestinal tract(pancreatin, creon, festal), and SE agents (wobenzym).

Pancreatin- Polyenzyme preparation, improves digestion. It contains trypsin, amylase and lipase. In diseases of the pancreas, the drug compensates for the insufficiency of its exocrine function and improves digestion. Pancreatin is prescribed for chronic pancreatitis, cystic fibrosis, chronic inflammatory-dystrophic diseases of the stomach, intestines, liver, gallbladder. The drug can be used in persons with normal function of the gastrointestinal tract in case of inaccuracies in nutrition. The dose is selected individually. The course of treatment can last from several days to several months or even years if permanent substitution therapy is required.

Creon is the original dosage form of pancreatin. Its capsules contain pancreatin in mini-microspheres that are resistant to the action of gastric juice. After the capsule dissolves in the stomach, the pancreatin granules are mixed with the chyme and enter the duodenum, where the protective membrane quickly dissolves and releases enzymes. This ensures the physiological process of digestion and avoids waste enzymatic activity... Indications for the use of Creon, as well as for pancreatin, are diseases accompanied by exocrine pancreatic insufficiency. The drug is well tolerated, but in some cases gastrointestinal disorders are possible.

Festal- polyenzyme preparations to improve digestion. It contains pancreatic enzymes (protease, amylase, lipase) and bile components. The presence of bile components stimulates the secretion of bile and promotes the emulsification of fats, which makes them available for pancreatic lipase. Festal has advantages in cases where the insufficiency of the exocrine function of the pancreas is combined with disorders of bile secretion.

Wobenzym- polyenzyme preparations for SE, that is, the resorptive action of a complex of hydrolytic enzymes of plant and animal origin on pathophysiological processes. It contains pancreatin, papain, bromelain, lipase, amylase, trypsin, chymotrypsin, rutin. After ingestion, part of the enzymes is absorbed in the small intestine into the blood, where it reaches its maximum concentration after 2-4 hours, the rest are involved in digestion. In the blood, proteolytic enzymes bind to a2-macroglobulin and are transported to damaged tissues, where they realize their therapeutic effect. The half-life is 8:00. The drug has anti-inflammatory, immunomodulatory and fibrinolytic properties. It is used as a non-specific component of therapy for: inflammation of the ENT organs and respiratory tract, pancreatitis, ulcerative colitis, Crohn's disease, multiple sclerosis, ischemic heart disease, myocardial infarction, rheumatoid arthritis, rheumatism, osteoarthritis, ankylosing spondylitis, post-traumatic and postoperative edema, thrombophlebitis, post-thrombotic syndrome, vasculitis, thromboangiitis obliterans, lymphedema, inflammation of the urinary tract, mastitis, prostatitis inflammatory processes of soft tissues, dislocations. During treatment with wobenzym, possible dyspeptic symptoms, rarely - allergic reactions. The drug is contraindicated in case of hypersensitivity to its components, bleeding disorders, diseases with an increased likelihood of bleeding.

Enzyme preparations

Enzymes - highly specific proteins that guarantee the role of biological catalysts.

Enzyme preparations - These are drugs, the active principle of which are enzymes.

1900 - the first mention of enzymes (pepsin + HCl).

Immobilized enzymes - subjected to immobilization.

Immobilization - physical or chemical binding of enzymes to the carrier matrix.

Started to apply native enzymes .

Their disadvantages:

storage violation;

are inactivated in tissues;

have antigenic properties;

Benefits of immobilized enzymes:

great stability of the drug substance;

protect against inactivated effects (thermo-, pH stable, less sensitive to inhibitors);

prolonged action;

cheaper treatment;

decrease in antigenicity.

Immobilization methods

Physical :

adsorption on a carrier;

inclusion in the gel;

microencapsulation.

Chemical : 1) with the formation of covalent bonds (streptodecase is bound by polyglucin);

2) suturing the enzyme to the carrier using an intermediary.

Inorganic substances (silicogel) and organic substances (5., polysaccharides) can be used as a matrix.

Matrices can be: 1) biodegradable - destroyed in the wound (collagen). Advantages: do not stick to the wound, do not need physical removal.

Disadvantages: they collapse and function, getting into the wound in their native form.

2) Insoluble - not destroyed in the wound (cellulose).

Advantages: can be used as a dressing material.

Disadvantage: an obstacle to the rapid fusion of the edges of the wound.

Classification

By origin

Animal preparations

Pepsin, trypsin, pancreatin

2) Plant origin

Papain, carinazim (from papaya), bromelain (from pineapple)

3) microbiological origin

- terrilitin, clostridiopeptidase, subtimuin - for the treatment of the wound process (protease); somim (lipase, resistant to HCl).

By clinical use

Drugs used mainly for purulent-necrotic processes - trypsin, chymotrypsin, chymopsin, pankipsn, terrilitin, collagenase, profuim, karipazim, fibrogan, geruksol, lysosorb - combined .

Nucleic acid cleaving drugs

- ribonuclease, deoxyribonuclease.

Preparations depolymerizing hyaluronic acid

Lidaza, ronidase.

3) Drugs that improve digestion

Pepsin, acidin - pepsin, natural gastric juice, abomin

3.2) Oraza and enzyme preparations containing pancreatin

Pancreatin

Mezim-forte

Pakreoflat

Trienzyme

Festal N

Micrease

Pancitrate

Digestal

Enzistal

Ipental

Pancinorm

3.5) Combined enzyme preparations with antibacterial action

Lixaza

3.6) Possessing lipolytic activity

Migedaza

Somilase (somim + amylase)

4) Fibrinolytic agents

Fibrinomezime, streptokinase and its preparations, urokinase, reptilase, arvin

5) Various enzyme preparations

Penicillinase, asparaginase, cytochrome C.

Digestion improvement drugs

Types of therapy with enzyme preparations:

local - wound process, treatment of scleroderma, inhalation for bronchitis.

resorptive - parenteral administration and for adhesions, sinusitis, ENT - diseases.

substitutional - with insufficient secretion of digestive enzymes.

Preparations containing enzymes of gastric juice

Pepsin - protein breakdown, obtained from the mucous membrane of pigs, optimal pH = 1.5 - 4.0 (HCl is necessary).

Acidin pepsin - contains 1 part of pepsin and 4 parts of acidin (betaine hydrochloride, hydrolyzed in the stomach in HCl in a small amount of liquid).

Natural gastric juice - contains all the enzymes of the stomach.

Obamin - the sum of proteases obtained from the mucous membrane of calves and lambs.

Indications: gastritis with secretory insufficiency, achilia, with some dyspepsia.

Enzyme preparations containing pancreatin and oraza.

Oraza Is a complex of factors (amylase, maltose, protease, lipase) obtained from Aspergillum fungi. They are not destroyed by gastric juice. Has some antispasmodic effect on the muscles. Produced in granules, take 1 tsp. while eating.

Pancreatin - a complex of factors produced by the pancreas. Contains trypsin, lipase, amylase. Obtained from animals. It is inactivated in the stomach. Active in the alkaline environment of the intestine. Assign 15-20 minutes before meals, wash down with 100-200 ml of liquid. Enzyme preparations of animals are more active. Pancreatin must be coated.

Mezim - applied before meals. The rest - during and before meals, especially creon, lycrease, pancitrate - are microcapsules / microtablets with an acid-resistant shell. They are packed in a regular capsule that disintegrates in the stomach. The microtablet is mixed with a food lump and enters the duodenum. AF containing pancreatin and being in the stomach for 1.5 - 2 hours loses up to 30% of the enzyme activity.

Indications for prescribing enzyme preparations with a low lipase content

Food excesses, dyspepsia, gastroduodenitis and enterocolitis. Condition after gastric resection, bowel support for diagnostic examination, cystic fibrosis, chronic pacreatitis - in large doses (3-5 table. For 1 reception).

Indications for prescribing drugs with a high lipase content

Chronic pancreatitis, condition after pancreatectomy. In chronic pancreatitis, AF is used for replacement therapy and elimination of pain syndrome. when enzymes enter the duodenum, the secretion of the pancreas decreases (functional rest).

Creon, pancreon contain dimethicone (adsorb gases).

Preparations containing pancreatin:

bile components. Contains pancreatin, bile components and an enzyme

hemicellulose. The components of bile provide a choleretic effect, emulsify fats, activate lipase and stimulate its release, promote the absorption of fat-soluble substances, activate intestinal motility, and prevent the development of putrefactive processes. Hemicellulose - breaks down fiber, which reduces gas formation and fermentation.

Indications - digestive disorders with stagnation of bile, chronic obstruction of the biliary tract.

Contraindications - pancreatitis (stimulates secretion),

Obstructive jaundice.

Preparations containing enzymes of gastric juice, pancreatin and bile components

- panzinorm, 2 layers: 1) outer - contains highly active proteases (pepsin, cathepsin) and a / c, stimulating the secretory activity of the stomach. Coated with a shell (acid-unstable).

inner - acid-resistant core. Covered with an acid-resistant shell. Contains pancreatin and bile extracts.

Indications - indigestion in the stomach and duodenum.

Contraindications - see above.

Combined

Lycra, 3 layers: 1) outer - bromelain (acid-resistant protease, works at pH = 3 - 8); 2) medium - contains pancreatin + folic acid (cholagogue); 3) internal - enteroseptol, a quinol derivative (antibacterial component). All except mexase have no side effects: headache, nausea, heartburn, peripheral neuritis and optic nerve damage *.

Mexaza is used for intestinal infections.

Drugs with lipolytic activity - used for steatorrhea. Low activity, resistant to acidic environment.

Requirements for digestive AF:

non-toxicity

good tolerance

no side effects

optimum action at pH = 4 - 7

long shelf life

Preparations used for purulent-necrotic processes

Action:

necrolytic - causes lysis of coagulated bacteria. Alive. tissues do not work, because there are inhibitors.

dilute pus - a more active outflow of wound contents.

anti-inflammatory - they destroy the fibrin barrier around the focus of inflammation, promote the penetration of antibiotics and phagocytes.

promote the active penetration of antibacterial agents into the inflammation focus.

Indications :

wounds, burns, bedsores, trophic ulcers;

diseases of the bronchopulmonary system (bronchitis, lung abscesses, pleurisy, bronchiectasis);

ENT - diseases (otitis media, sinusitis);

osteomyelitis;

gynecological diseases.

Contraindications:

individual intolerance;

violation of the blood coagulation system;

can not be injected into the focus of inflammation, bleeding cavity, applied on the ulcerated surface of the tumor.

Enzymes, or enzymes, are substances without which the human body cannot function normally, since they play an important role in the gastrointestinal tract. These components are produced by various glands and organs. These include salivary secretions, gastric and intestinal juices. The main action of enzymes is the breakdown of food components into simple components that the body assimilates.

• Show all

  Types of enzymes

  The action of enzymes is aimed at breaking down simple and complex substances. They are divided into the following types: amylase (acts on carbohydrates), nuclease (separates nucleic acids), lipase (responsible for the breakdown of fats) and protease (participates in the division of proteins).

  The human body is unable to digest lactose, for this it needs microorganisms such as E. coli and lactobacilli. Almost all other processes are regulated by enzymes produced by all systems.

  The reasons for the shortage

  It is necessary to take additional enzymes in cases where they are not enough. The most common causes of enzyme deficiency are:

  • binge eating;
  • monotonous food;
  • taking certain medications (antibiotics that destroy the intestinal microflora);
  • constant haste while eating;
  • diseases of the digestive tract of an inflammatory nature (diseases of the pancreas, gallbladder, intestines);
  • eating food that has undergone insufficient temperature processing;
  • disruption of the intestines;
  • congenital or acquired lack of digestive enzymes;
  • operations;
  • period of pregnancy.

  

  Types of drugs to normalize digestion

  The rate of food digestion depends on the activity of enzymes and their amount in human body... If they are not produced effectively enough, you need to take drugs that help improve the condition. They are used for a short-term effect, but they can also be part of a complex long-term therapy. If there is a possibility of a complete restoration of metabolism, the very cause of problems with enzymes (disease, unhealthy diet) should be eliminated.

  Preparations containing enzymes are available in the form of enteric-coated tablets with gelatin capsules or dragees. Medications are conventionally divided into 5 types:

  1. 1. Preparations containing pancreatin.
  2. 2. Medicines containing hemicellulase and bile acids.
  3. 3. Herbal medicines, the key component of which is rice fungus.
  4. 4. Preparations of complex action, where the basic element is pancreatin in combination with vitamins or other enzymes.
  5. 5. Simple enzymes.

  

  Medicines with pancreatin

  These are drugs like Creon, Penzital, Pancreatin, Pancreon, Mezim Forte, etc. They are used for problems such as:

  • intestinal dysbiosis;
  • overworking of hydrochloric acid stomach;
  • dysfunction of the pancreas;
  • congenital enzyme deficiency;
  • infectious diseases (acute and chronic), if they are accompanied by insufficient absorption of nutrients in the small intestine.

  Creon is prescribed for both adults and children, including infants. Pancreatin can be used for a short time during pregnancy.

  
  

  Products with hemicellulase

  If the agent contains pancreatin, hemicellulase and bile acids, these drugs belong to the second group of medicines aimed at treating enzyme deficiencies. Bile elements help not only the pancreas, but also the intestines, enhancing its motor function, the gallbladder. Hemicellulase is designed to break down complex plant carbohydrates and reduce gas formation in the intestine. Such a composition allows the use of such drugs for:

  • belching if it is accompanied by an acute or chronic bowel disease;
  • constipation;
  • increased gas production.

  Drugs of this kind include:

  • Festal;
  • Kadistal Kotazim forte;
  • Digestal;
  • Panzinorm;
  • Pankral;
  • Menzim;
  • Pancurman;
  • Enzistal;
  • Ipental.
  
  

  Contraindications include pancreatitis, food poisoning with diarrhea, duodenal ulcer and stomach ulcer, inflammatory bowel pathology, hepatitis. Festal is used by pregnant women if there are no contraindications.

  Herbal preparations

  The third group consists of herbal preparations used in cases of intolerance to the body of beef or pork meat, if the pancreas produces an insufficient amount of secretion. These include medications such as:

  • Pepfiz;
  • Oraza;
  • Nigedaza;
  • Unienzyme;
  • Solizim;
  • Somilase.

  The last two drugs are not used for penicillin intolerance.

  Plant and animal enzymes and vitamins

  The fourth group (a combination of pancreatin with other plant enzymes or vitamins) includes the following list of remedies:

  • Merkenzyme;
  • Phlogenzyme;
  • Wobenzym.
  
  

  These drugs work in the same way - they help the pancreas to produce enzymes, but drugs of predominantly herbal origin have a reduced effect compared to similar medicines based on enzymes of animal origin. Medications of the 4th group cannot be used for bronchial asthma, fungal intolerance.

  Simple enzymes

  Simple enzymes, which are included in the last group, are products containing enzymes of animal origin (Pepsin, Abomin, Betaine). Usually used if the patient has gastritis with low acidity. The drugs increase the production of gastric juice, increase the motor function of the intestines. Pepsin can be used during the period of gestation.