Peptidergic and adenosinergic drugs administration to comatose patients caused by alcohol consumption on early hospital period

Introduction. Medical care for patients diagnosed with the toxic effect of ethanol (according to ICD-10 code T51.0) it turns out to be in specialized toxicological centers or in emergency departments of multidisciplinary hospitals. The purpose of this study was to study the effectiveness of the drug моликсан^® (molixаn) at different levels of medical care for patients diagnosed with the toxic effect of ethanol.

Material and method. 128 patients were included in the study, of which 76 patients were taken to the emergency department of St. Petersburg State Medical Institution "Alexandrovskaya Hospital" and 52 patients were taken to the intensive care unit No. 11 of the St. Petersburg Scientific Research Institute of Emergency Medicine named after I.I. Dzhanelidze. All patients met the inclusion criteria: age 18–60 years; impaired consciousness of alcoholic genesis 21–30 points on the Glasgow–Pittsburgh coma scale (PBSS: Pittsburg Brain Stem Score, Kelsey S.F., et al. 1991); ethanol concentration in the blood is more than 2.5%. 72 patients were included in the моликсан^® group, 56 patients in the Placebo group.

Results. The use of the drug моликсан^® has a positive effect on the dynamics of restoring the level of consciousness, which is reflected in higher values of the Glasgow–Pittsburgh scale after 1, 3 and 6 hours from the start of therapy (p<0.01), reducing the period of stay of the patient in a coma from 150 [75; 178] minutes to 60 [50; 161.5] minutes (p<0.05) and restoration of consciousness to a clear level after 3.5± 0.3 hours (p<0.05).It was also revealed, that in the group of patients using моликсан^®, normalization of heart rate (p<0.05) and a decrease in the frequency and severity of tremor (p<0.05) were noted. The hepatoprotective efficacy of моликсан^® was shown, which manifested itself in a decrease in ALT, AST, GGTP, alkaline phosphatase, total and direct bilirubin (p<0.001).

Limitations. The clinical efficacy of моликсан^® in the toxic effects of severe ethanol was carried out in patients with depression of consciousness and elevated levels of ALT, AST, GGTP, alkaline phosphatase, total and direct bilirubin, which indicated the presence of alcoholic hepatopathy.

Conclusion. The conducted study showed the expediency of using моликсан^® at a dosage of 3.0 mg/kg intravenously with the toxic effect of ethanol of moderate and severe severity of the disease.

Compliance with ethical standards. The study was performed in compliance with the ethical principles of conducting medical research with the participation of people as subjects of research in accordance with the Helsinki Declaration of the World Medical Association "Ethical Principles of conducting Scientific medical research with human participation" as amended in 2013 and the "Rules of Clinical Practice in the Russian Federation", approved by Order of the Ministry of Health of the Russian Federation No. 266 dated 06/19/2003. Each participant The researcher gave informed voluntary written consent to participate in the study and publish personal medical information in an impersonal form.

Authors contribution:
Buzanov D.V., Shikalova I.A. – concept and design of the study, collection and processing of material, analysis and interpretation of data, text writing;
Lodyagin A.N. – concept and design of the study, data analysis and interpretation, editing;
Batocirenov B.V. – analysis and interpretation of data;
Afanasiev V.V. – concept and design of the study, literature analysis, analysis and interpretation of data.
All co-authors – approval of the final version of the article, responsibility for the integrity of all parts of the article.

Conflict of interests. The authors declare no conflict of interests.

Funding. The study had no sponsorship.

Received: February 28, 2024 / Accepted: July 10, 2024 / Published: August 30, 2024