Pneumonia is an acute infectious disease in which the inflammatory process is localized in the lung tissue. Inflammation is caused by various microorganisms - bacteria, viruses, fungi, protozoa. At the Yusupov Hospital, pulmonologists prescribe comprehensive treatment for pneumonia. Individual treatment regimens include antibacterial drugs, agents that thin sputum and improve bronchial drainage function, and immunomodulators.
Patients with mild pneumonia are treated on an outpatient basis. In moderate and severe cases of the disease, patients with pneumonia are hospitalized in a therapy clinic. Particularly severe patients are treated in the intensive care unit.
Nosological classification (ICD-10)
- J06 Acute upper respiratory tract infections of multiple and unspecified localization
- J18 Pneumonia without specifying the pathogen
- J22 Acute respiratory infection of the lower respiratory tract, unspecified
- J40 Bronchitis, not specified as acute or chronic
- M25.5 Joint pain
- M42 Osteochondrosis of the spine
- M54.4 Lumbago with sciatica
- M79.1 Myalgia
- M79.2 Neuralgia and neuritis, unspecified
- R07.2 Pain in the heart area
- T14.3 Dislocation, sprain and damage to the capsular-ligamentous apparatus of a joint of an unspecified area of the body
Symptomatic therapy
For complex treatment of pneumonia, doctors at the Yusupov Hospital use drugs that affect the mechanisms of development of the pathological process and reduce the symptoms of the disease. These include:
- detoxification agents;
- bronchodilators and expectorants;
- immunomodulators.
Patients with severe symptoms of intoxication are given intravenous infusions of synthetic plasma-substituting solutions (hemodez, reopolyglucin) and protein hydrolysates.
Patients with pneumonia use non-steroidal anti-inflammatory drugs: voltaren, indomethacin, ibuprofen to reduce swelling and improve microcirculation of the lung tissue. In case of a sluggish course of the disease in combination with bronchospastic syndrome, glucocorticoid hormones are used. To improve the drainage function of the bronchi and restore bronchial patency, patients are advised to take bronchodilators (aminophylline, asthmapent, theophedrine, euspiran) and expectorants. At the onset of the disease, with a strong non-productive cough, antitussive drugs (codeine, libexin) are used. An integral component of complex therapy for pneumonia is the normalization of immune defense mechanisms and nonspecific reactivity of the body. To stimulate the immune system (thymalin, T-activin, prodigiosan, gamma globulin, aloe extract).
All patients with pneumonia are prescribed oxygen therapy. In case of severe disease, patients with pneumonia are hospitalized in the intensive care unit. If indicated, they are given artificial ventilation using the latest ventilators.
Symptomatic treatment of pneumonia at home is carried out in order to alleviate the patient’s general condition and level the symptoms of the disease. Doctors at the Yusupov Hospital prescribe mucolytic and bronchodilator drugs to patients. Mucolytics (ACC, carbocysteine and ambroxol) help remove mucus from the respiratory organs. Ambroxol enhances the effect of antibiotics. For inhalation of bronchodilators, patients use nebulizers at home.
Antipyretics (analgin, acetylsalicylic acid or non-steroidal anti-inflammatory drugs) are prescribed only if the patient is intolerant of high temperature. In the room where a feverish patient lies, the temperature should be ensured no higher than 18 degrees and an air humidifier should be installed. To reduce symptoms of intoxication, patients are recommended to drink at least 2.5-3 liters of fluid per day.
During treatment, food that is difficult for the stomach and contains large amounts of fat is excluded from the diet. The diet includes steamed dishes from lean meats and fish, lactic acid products, cottage cheese, and cheese. The menu should include freshly squeezed fruit juices.
Compound
Mustard plaster
| Plate | 1 plate |
| active substance: | |
| mustard powder | 1.1 g |
| contact gel lubricant for ultrasonic devices is used to fix the powder |
Mustard plaster package
| Powder for external use | 1 pack |
| active substance: | |
| mustard powder | 3.3±0.4 g |
Universal mustard plaster package
| Powder for external use | 100 g |
| mustard powder, premium and first grade | 24 g |
| a mixture of mustard cake and crushed mustard seed kernels | 76 g |
| (mustard cake with a particle size of 600-700 microns - 8 parts; crushed mustard seed kernels with a particle size of 600-700 microns - 2 parts) |
Mustard plaster with eucalyptus oil
| Powder for external use | 1 pack |
| mustard powder, premium and first grade | 24% |
| a mixture of mustard cake and crushed mustard seed kernels | 75% |
| (mustard cake - 8 parts; crushed mustard seed kernels - 2 parts; eucalyptus oil - 1%) |
Do mustard plasters help with coughs?
Mustard plasters in adults and children have anti-inflammatory, analgesic and expectorant properties, and help improve immunity. Most often they are used for pathologies of the respiratory system and diseases of the nasopharynx. For a dry cough, they thin the mucus; for a wet cough, they accelerate its elimination and provide an expectorant effect.
Why are they useful?
The product helps well with a lingering cough; it is an excellent solution for the prevention of diseases due to hypothermia. Mustard plasters show effectiveness in the treatment of the following diseases:
- tracheitis;
- bronchitis;
- sinusitis;
- pleurisy;
- pneumonia;
- cough;
- insomnia.
In addition, mustard plasters for coughs can be used for other diseases not related to the respiratory system. They are recommended to be applied to the bruised area; they are excellent for treating diseases of the musculoskeletal system. Despite the fact that the remedy is most often prescribed for coughs, the method does not show effectiveness for all ailments of the respiratory system.
Description of the dosage form
Mustard plaster is a rectangular sheet of paper 8x12.5 cm, covered with an even layer of mustard yellow powder with dark inclusions and a characteristic odor.
Mustard plaster package - yellow mustard powder with dark inclusions, free of lumps, with a specific odor characteristic of mustard powder, placed in a bag measuring (13.2 × 9.5) ± 0.5) cm, made of heat-sealable, non-soaking paper, porous on both sides or made of heat-sealable, non-wetting, porous paper on one side and a combined paper-based material on the other, divided by seams into four cells, measuring (5.7 × 3.7) ± 0.3) cm.
Universal mustard plaster is a mustard mixture of grayish-yellow, yellowish-brown color with dark inclusions, with an odor specific to mustard cake.
Mustard plaster-package with eucalyptus oil is a mustard mixture from light yellow or grayish-yellow to yellowish-brown or brown with darker inclusions, with an odor specific to mustard cake and eucalyptus oil.
Treatment of pneumonia in Moscow
Patients can be treated at home and undergo physiotherapeutic procedures in the rehabilitation department of the Yusupov Hospital: diathermy, inductothermy, microwave, UHF. Resorption of inflammation in the lungs is facilitated by chest massage and physical therapy.
Get advice from an experienced and qualified doctor by calling. Doctors at the Yusupov Hospital treat mild to moderate pneumonia at home. Pulmonologists individually draw up a treatment regimen for each patient, taking into account his individual characteristics and the course of the disease.
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Directions for use and doses
Locally.
Mustard plaster
Mustard plaster is dipped in water heated to a temperature of 37 °C for 15–20 s, then applied to the skin. To enhance the effect, the mustard plaster is covered with PE film and pressed tightly to the body with an elastic bandage or other bandage. The procedure time is 5–20 minutes (until persistent redness appears), in children - 2, 3, 5 or 10 minutes, depending on the age of the child, the irritant effect and the individual sensitivity of the patient. If you feel a strong burning sensation, you need to loosen the pressure of the mustard plaster to the body for a while or remove it.
Mustard plaster package
Before use, the mustard plaster package is shaken horizontally to distribute the powder evenly among the cells, dipped in water heated to a temperature of 37 °C for 15–20 s, then applied to the skin with the porous side. To enhance the effect, the mustard plaster package is covered with PE film and pressed tightly to the body with an elastic bandage or other bandage. Procedure time: from 5 to 20 minutes (until persistent redness appears); in children - 2, 3, 5 or 10 minutes, depending on the age of the child, the irritant effect and the individual sensitivity of the patient. If you feel a strong burning sensation, you need to loosen the pressure of the mustard plaster package to the body for a while or remove it.
Universal mustard plaster package
The universal mustard plaster package is lowered, without changing the horizontal position, into water heated to a temperature of 37 °C for 15–20 s, then applied to the skin. To enhance the effect, the mustard plaster is covered with PE film and pressed tightly to the body with an elastic bandage or other bandage. The procedure time is 5–20 minutes (until persistent redness appears), in children - 2, 3, 5 or 10 minutes, depending on the age of the child, the irritant effect and the individual sensitivity of the patient. If you feel a strong burning sensation, you need to loosen the pressure of the mustard plaster to the body for a while or remove it by rinsing the area of skin to which it was applied with water.
Mustard plaster with eucalyptus oil
Before use, the mustard plaster package (4 cells) is shaken to distribute the powder evenly throughout all cells of the package. Place the bag in warm water for 15–20 seconds, then apply it to the skin with the porous side of the paper. Cover with a dry, thick cloth, press tightly to the body and leave for 2, 3, 5 or 10 minutes (until persistent redness appears), depending on the patient’s age and skin sensitivity. If you feel a strong burning sensation, you need to loosen the pressure of the mustard plaster to the body for a while or remove it.
Antibacterial therapy
The basis of treatment for pneumonia is antibacterial therapy. At the Yusupov Hospital, pulmonologists use the latest drugs registered in the Russian Federation. When a sick patient enters a therapy clinic, the choice of antibiotic is made empirically. Doctors take into account the epidemiological and clinical situation, and lung radiography data.
Since the disease is most often caused by pneumococci, initial therapy begins with penicillins and aminopenicillins. Second-line drugs are cephalosporins. If you are allergic to β-lactam antibiotics, all these medications are not used. Alternative agents are macrolides.
In cases of severe pneumonia, doctors at the Yusupov Hospital choose broad-spectrum antibacterial agents for initial treatment. They use combinations of antibiotics to suppress the maximum number of possible infectious agents. The drugs are administered intravenously and intramuscularly.
In the therapy clinic, doctors widely use a new generation of fluoroquinolones to treat pneumonia:
- levofloxacin;
- moxifloxacin;
- sparfloxacin.
They are highly effective, suppressing gram-positive and gram-negative microflora, as well as intracellular microorganisms (mycoplasma, chlamydia, legionella).
In nosocomial pneumonia, the most common pathogens are gram-negative bacilli and staphylococci. In these cases, combinations of metronidazole with third-generation cephalosporins or ciprofloxacin are used to treat pneumonia. Patients after traumatic brain injuries are treated with monotherapy with IV generation cephalosporins or ciprofloxacin; if necessary, a combination of a III generation cephalosporin with ciprofloxacin or aminoglycosides is used.
Release form
Mustard plaster
Powder for external use, 1.1 g. Applied on a paper plate 8x12.5 cm. 2, 5, 10, 15 or 20 mustard plasters in a PE (or polypropylene) bag or wrapped with a label and placed in a film bag.
Mustard plaster package
Powder for external use. The mass of the powder in one mustard plaster package is (3.3±0.4) g (from 2.9 to 3.7). 10, 15, 20 mustard plasters packages in a pre-labeled PE bag, sealed hermetically by heat sealing. 10, 15, 20 mustard plasters in a PE bag, hermetically sealed, packed in a pre-labeled cardboard box.
Universal mustard plaster package
Powder for external use. In a paper bag, divided by seams into 4 cells, 3 g. 2, 5, 10, 15 or 20 universal mustard plasters in a protective bag.
Mustard plaster with eucalyptus oil
Powder for external use. In a paper bag, divided by seams into 4 cells, 3 g. 10 or 20 mustard plasters with eucalyptus oil in a protective bag.
Antibacterial therapy on an outpatient basis
Treatment of pneumonia in adults at home is possible in patients of two groups that differ in the causative agent of the infectious disease and the tactics of antibacterial therapy.
The first group included patients without concomitant pathology under the age of 60 years. In them, an adequate clinical effect can be obtained by using antibiotics for oral administration. Doctors at the Yusupov Hospital provide monotherapy to these patients with amoxicillin or macrolide antibiotics. In case of intolerance to β-lactams or suspicion of an atypical nature of the disease, preference is given to macrolides. Fluoroquinolones are used as alternative drugs.
The second group included elderly people and patients with concomitant diseases that are risk factors for poor prognosis in pneumonia. This:
- chronic obstructive pulmonary disease;
- diabetes;
- chronic renal or liver failure;
- heart failure;
- body weight deficiency;
- alcoholism and drug addiction.
Patients in this group obtain adequate clinical benefit when prescribed oral antibiotics. In the presence of concomitant diseases in the development of pneumonia in this category of patients, the likelihood of the presence of gram-negative microorganisms increases. Therefore, the use of amoxicillin clavulanate is indicated. Due to the high probability of the chlamydial nature of pneumonia, patients are treated with β-lactams and macrolides. An alternative to combination therapy is the use of respiratory fluoroquinolones (levofloxacin, moxifloxacin).
The advantage of parenteral antibiotics over oral administration in an outpatient setting has not been proven, so they are administered intramuscularly only in exceptional cases. For patients over 60 years of age in the absence of concomitant diseases, ceftriaxone is administered intramuscularly. The drug can be prescribed in combination with macrolides or doxycycline.
An initial assessment of the effectiveness of treating pneumonia at home is carried out 48–72 hours after the start of treatment, during a re-examination by a doctor at the Yusupov Hospital. The main performance criteria that allow doctors to conclude that there is positive dynamics are:
- normalization of temperature;
- reduction of symptoms of intoxication;
- reducing the intensity of shortness of breath and other symptoms of respiratory failure.
If the patient’s symptoms progress or high fever and signs of intoxication persist, the treatment is considered ineffective, the tactics of antibacterial therapy are reviewed, and the advisability of hospitalization is re-evaluated. If there is no adequate effect when treating with amoxicillin, it is replaced with a macrolide antibiotic.
In case of mild pneumonia, antibiotics are discontinued if the body temperature is stable for 3–4 days. With this approach, the duration of treatment is from 7 to 10 days. In patients with mycoplasma or chlamydial pneumonia, the duration of therapy is 14 days.
The persistence of individual clinical, laboratory or radiological signs of pneumonia is not an absolute indication for continued antibiotic therapy or its modification. In the overwhelming majority of patients with pneumonia, resolution occurs independently or under the influence of symptomatic therapy. If clinical, laboratory and radiological symptoms of pneumonia persist for a long time, doctors at the Yusupov Hospital carry out differential diagnosis with diseases such as tuberculosis, lung cancer, and congestive heart failure.
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Mechanism of action
The main active component is considered to be essential mustard oil, which is released after the powder is wet. In the area of contact with the skin, chemical irritation of the receptors is observed, then a local inflammatory reaction occurs. The process is accompanied by dilation of blood and lymphatic vessels, hyperemia occurs, the temperature rises, and mild itching and burning appear.
Under the influence of the active substance, adrenaline is released, stimulating the functioning of many organs. As a result of the activation of phagocytes, harmful microorganisms die, dead and dying cells are separated. Due to increased local blood circulation, inflammatory reactions decrease, intoxication of the body occurs, and pain disappears.
The healing properties of the substances contained in mustard powder:
- synargin in black mustard/sinalbin - in white mustard - regulate the release of adrenaline;
- phytosterols, unsaturated fatty acids - bactericidal properties;
- Myrosin - antiseptic properties.
