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he liver is one of the organs most often affected by medication (MP) intake. Drug-induced liver damage with cholestasis (LIPCH), on the one hand, rarely leads to death in comparison with the hepatocellular type, but, on the other hand, is more often characterized by a long, in some cases chronic course. This type of liver damage is characterized by an increase in the activity of alkaline phosphatase (ALP) > 2 upper limits of normal (ULN) or the ratio of alanine aminotransferase (ALT) / ALP < 2 in chronic course. Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most readily available (including over-the-counter) and widely used drugs in clinical practice and are often the cause of LIPCH. This article summarizes the available data at the time of preparation of the article on the prevalence, mechanisms of development and features of LIPPH while taking NSAIDs. A separate section is highlighted on the features of the management of such patients. In particular, in accordance with both domestic and foreign clinical guidelines for the drug genesis of liver damage, it is recommended to stop taking the inducer drug and prescribe ursodeoxycholic acid (UDCA). The efficacy of UDCA in patients with LIPCH, including those associated with the use of NSAIDs, has been confirmed by the results of a large number of randomized placebo-controlled clinical trials. Among the UDCA preparations on the market of the Russian Federation, one cannot fail to pay attention to Exho® (CJSC «Canonpharma Production»), which is bioequivalent to the reference drug, is produced in compliance with GMP standards on a high-tech production base, which ensures its quality, and an affordable price and a large the choice of dosage forms makes it possible to successfully use this drug, including in special categories of patients, for example, elderly patients and/or those suffering from dysphagia.

The paper presents literary and original data on the problems of falling for elderly patients. The relationship between the occurrence of a fall and the initiation of drug therapy with a known negative effect on the risk of falling is considered. Data on the frequency and structure of falls by patients with cardiovascular diseases over the age of 75 who received treatment at a multidisciplinary hospital are presented. The data analysis showed a tendency of fall prevalence: a fall was observed in 33.8% of patients in the first 5 days of the hospital stay. This may be associated with a high drug burden and the prescription of new drugs to the patient. The study noted that the therapy was chosen on the first day. Additional drugs were often prescribed, which led to the polypharmacy state. Analysis of individual groups of drugs allowed reliable confirmation of the relationship between the prescription of drugs that increase the fall risk and occurrence in relation to the ophthalmic form of β-blockers (p = 0.04). Polypharmacy as a risk factor of falling in gerontological patients, which was described in the scientific literature, also confirmed the negative effect in our study. Thus, patients who are newly administered drugs known to have negative effect on fall development can be attributed to the risk group for falling.

This article presents an overview of data of Russian and foreign literature on possible associations between cognitive impairment and atrial fibrillation (AF). It includes modern classification of cognitive impairment, mechanisms of the effect of AF on cognitive functions and development of dementia, recommendations for the prevention of cognitive impairment in patients with AF. Special attention is paid to the assessment of cognitive status, and safe anticoagulant therapy, which is a priority in the prevention of cognitive impairment in patients with AF. Analysis of literature showed greater efficacy and safety of drugs from the group of Non-vitamin K Antagonist Oral Anticoagulants (NOAC), rivaroxaban in particular, in comparison with warfarin. Drugs from the NOAC group can be recommended for prevention stroke, cognitive impairment and dementia in elderly patients with AF.

The functional condition of endothelium is investigated at 36 patients with arterial hypertension II-III of a stage (aged 44-80 years) during 3 monthly treatments by fixed combination metoprolol succinate + felodipine (Logimax). Blood pressure (BP) was monitored for 24 hours. Endothelial vasodilatation function and thickness of a complex intimae - media were evaluated with ultrasonic duplex scanning of arteries. It has been revealed reduced endothelium-dependent vasodilatation and structural remodeling of peripheral arteries in elderly hypertensives. Alongside with high antihypertensive activity, indapamid retard positively influenced on structural and functional characteristics of humeral arteries.