Etiotropic treatment: striking the pathogen
Etiotropic treatment is the foundation of combating infection. Its main target is the infectious agent itself. The therapy is aimed at a direct action on the pathogen using specific groups of drugs.
Depending on the type of pathogen, four main categories of medicines are distinguished:
- Antibacterial agents. Include a broad spectrum of drugs: classical antibiotics and sulfonamides, quinolones, diaminopyrimidines, as well as nitroimidazole and nitrofuran derivatives. In addition, bacteriophages and specific immunoglobulins (Ig) are successfully used to combat bacteria.
- Antiviral drugs. To suppress viral activity, immunoglobulins, interferons (IFN), adamantane derivatives, nucleotide analogues, as well as protease inhibitors, reverse transcriptase inhibitors, and DNA polymerase inhibitors are used.
- Antifungal agents. Represented by such pharmacological groups as azoles, allylamines, flucytosine, and griseofulvin.
- Antiprotozoal drugs. Aimed against protozoan microorganisms. This broad group includes sulfonamides, sulfones, chloroquine, sulfadoxine, quinine, artemisinin, and metronidazole.
Pathogenetic therapy: interrupting the chain of disorders
The goal of pathogenetic treatment is the reliable blockade of key links in the mechanism of development of the infectious process. Even if the pathogen has already been destroyed, the cascades of pathological reactions triggered by it may continue to destroy the patient's body.
The main directions of pathogenetic therapy include five crucial aspects:
- Organism detoxification. To eliminate accumulated toxins, antitoxic sera, hemodilution methods (blood dilution), and extracorporeal purification methods—hemodialysis and plasmapheresis—are used.
- Anti-inflammatory therapy. Based on suppressing excessive mechanisms of inflammation caused by the infection.
- Immunotherapy and immunocorrection. Includes the use of specific sera and vaccines, adaptogens, immunomodulators, and desensitizing interventions to restore an adequate immune response.
- Normalization of organ and system functions. Aims at targeted correction of disorders in the cardiovascular, respiratory, digestive, and nervous systems that have arisen due to the development of the infection.
- Correction of basic homeostasis parameters. The physician restores the acid-base balance (ABB), ion balance, mass and rheological properties of circulating blood, and normalizes blood gas partial pressures (pO2, pCO2).
Symptomatic therapy: relieving the condition
Symptomatic therapy does not directly affect the cause or complex mechanisms of the disease, but its goal is extremely important—it is the relief of the patient's condition. It aims to eliminate distressing, painful sensations that exhaust the patient and aggravate the overall course of the disease.
Symptomatic support agents include:
- Pain-relieving drugs (analgesics) and specific agents that eliminate headache.
- Drugs that relieve the feeling of emotional tension or fear, which is critically important for stabilizing the patient's nervous system.
- Sleeping pills to ensure full rest and restoration of the body's physical strength.
Briefly: answers to topical questions
What methods of organism detoxification exist in the infectious process?
Methods of organism detoxification in the infectious process within pathogenetic therapy:
- use of antitoxic sera;
- hemodilution;
- hemodialysis;
- plasmapheresis.
What is the mechanism of action of adamantane derivatives in viral infections?
The main mechanism of action of adamantane derivatives consists in blocking the M2 proton channels of the virus.
These drugs prevent protons from penetrating inside the virion, thereby preventing the acidification of its internal environment. As a result, the dissociation of ribonucleoproteins from the matrix is disrupted, and the release of the viral genome into the cytoplasm is blocked. Thus, the drugs disrupt the uncoating process of the viral genome at an early stage of viral reproduction.
How do bacteriostatic antibacterial agents differ from bactericidal ones?
The main difference according to the cited sources is related to the death of the microbial cell.
| Characteristic | Bacteriostatic agents | Bactericidal agents |
|---|---|---|
| Effect on the cell | Do not cause cell death | Indicated as drugs with a bactericidal type of action |
| Example from sources | Spectinomycin: disrupts protein synthesis at the translocation stage and does not cause cell death | Trimethoprim + sulfonamides: the combination has a bactericidal type of action; a bactericidal mechanism is also indicated for synthetic broad-spectrum antibacterial agents |
Individual components trimethoprim or sulfamethoxazole are contrasted with the combination in the source: a bactericidal effect is indicated for the combination, in contrast to the bacteriostatic action of the individual components.
The abbreviation EPS will help remember the three pillars of treatment: Etiotropic (striking the enemy), Pathogenetic (fixing breakdowns), Symptomatic (relieving pain).
Class and exam questions
What is the difference between etiotropic and pathogenetic therapy?
Etiotropic therapy acts directly on the cause of the disease (the pathogen), while pathogenetic therapy blocks the mechanisms of disease development and restores disturbed body functions.
Do immunoglobulins belong to etiotropic therapy?
Yes, specific immunoglobulins are able to directly bind and neutralize bacteria and viruses, which is why they are used for direct action on the pathogen.
Why is symptomatic therapy needed if we are already treating the cause?
It is necessary to relieve the patient's condition. Pain, fear, and insomnia exhaust the nervous system and exacerbate the severity of the disease, so their elimination is an important part of comprehensive treatment.
What else to study on this topic
- Mechanisms of action of antibacterial drugs (quinolones, sulfonamides)
- Methods of extracorporeal detoxification: hemodialysis and plasmapheresis
- Immunotherapy and immunocorrection in infectious diseases
- Correction of acid-base balance (ABB) and blood gases
- Antiviral drugs: protease and reverse transcriptase inhibitors
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