What Is the Accessory Nerve?

Adjuvant drugs are defined as: drugs that help increase the effect of the main therapeutic drug or increase its effect by affecting the absorption, mechanism of action, and metabolism of the main therapeutic drug; or on the basis of conventional treatment of the disease, it helps Drugs for the prevention and treatment of diseases or disorders. ^[1]

Adjuvant drugs are defined as: drugs that help increase the effect of the main therapeutic drug or increase its effect by affecting the absorption, mechanism of action, and metabolism of the main therapeutic drug; or on the basis of conventional treatment of the disease, it helps Drugs for the prevention and treatment of diseases or disorders. ^[1]

Chinese name

Adjuvant medication

Foreign name

Adjuvant drugs

Auxiliary medicines according to clinical application habits generally include nutrition support drugs, prevention of complications, and conditioning proprietary Chinese medicines. They are mainly used in anesthesia, tumor, surgery, liver disease, cardiovascular and cerebrovascular diseases, diabetes and infectious diseases. It can be divided into the following categories.

1 Enhance tissue metabolism

The drugs that affect tissue metabolism mainly refer to glucocorticoids and trace element drugs. Glucocorticoids (hereinafter referred to as glucocorticoids) are widely used in the diagnosis and treatment of various diseases in various clinical departments, mainly for anti-inflammatory, anti-toxic, anti-shock and immunosuppression, and their applications involve multiple clinical specialties. Because the pharmacological effects and clinical indications of glucocorticoids are relatively clear, the treatment plan is strictly regulated, and the clinical application is effective, so glucocorticoids should not be used as an adjuvant drug. Trace elements are components of enzymes, hormones and certain vitamins, and also regulators of the reaction rate of biochemical reactions, including zinc, copper, iron, selenium, chromium, molybdenum, manganese, etc. Trace elements are inorganic micronutrients necessary for the body. The human body requires very little in the diet, but they are very important for health and disease conditions. Clearly defined deficiency syndromes exist in the elements copper, iodine, iron, selenium, and zinc; although other trace element deficiencies are also possible, because they are widely present in the diet, their deficiency syndromes have not been clearly defined. Trace element preparations can be used for clinical supply of trace element deficiency and supplementary special needs, and can also be used as an adjuvant for certain diseases. But trace elements should not be used as nutritional products without restriction.

2 Vitamins

Vitamins are organic substances that the body needs in small amounts for many metabolic processes. Vitamin deficiency can be caused by an inappropriate diet, it can be due to increased body demand (such as during pregnancy), or it can be caused by disease or medication. Vitamins can be used clinically to prevent or treat specific vitamin deficiencies, but they should be supplemented as needed by the body. If the diet is reasonable and there are no special needs, taking vitamins as supplements is sometimes harmful. As a drug supplement, adequate dietary vitamin intake is essential for good health, but it remains controversial as to whether vitamin drug supplementation is effective or even worthwhile in the presence of any verifiable deficiency, Therefore, this class of drugs is listed as adjuvant drugs.

3 Electrolytes

Electrolytes can be used to correct body fluid and electrolyte homeostasis, as well as acid-base balance, and to reestablish osmotic pressure balance of certain ions. Water, electrolyte, and acid-base balance are necessary for the metabolism of human cells, and are also necessary for maintaining human life and physiological functions of various organs. When the balance is out of balance due to disease, trauma, infection, physicochemical factors and inappropriate treatment, if the body lacks the ability to adjust or exceeds the body's compensatory capacity, water, electrolyte and acid-base balance disorders will occur. Need to be corrected.

4 Enteral and parenteral nutrition

Enteral and parenteral nutrition drugs are mainly used for clinical nutrition support for critically ill patients, and are generally used for patients with severe nutritional deficiencies, severe trauma, and long-term inability to eat well. The clinically defined nutritional deficiencies are defined as: a state in which subcellular, cellular, and organ function changes due to dietary changes, which lead to an increased risk of disease and death in the human body, and this state can also be achieved through adequate The nutritional support is reversed. Inpatients with severe underemissions or weight loss greater than 10% of their pre-morbid body mass for more than 7 days can be considered to be undernourished or have a high risk of developing malnutrition, and nutritional support treatment must be given to these patients. However, the clinical application of parenteral and parenteral nutrition drugs does not follow the above treatment principles, and patients are not evaluated to determine whether special nutritional support is needed. Such drugs are used, for example, after admission or surgical treatment. These drugs are applied from the beginning. Although enteral and parenteral nutrition is an important adjuvant treatment for a variety of diseases, inappropriate application or excessive use may easily cause adverse reactions to patients, such as the occurrence of complications, so it should be standardized. To strengthen the management of this class of drugs.

5 Neurotrophic

Neurotrophic drugs refer to a series of proteins that promote the development of the nervous system and maintain the function of the nervous system. Early neurotrophic agents were neurotrophic factors. Neurotrophic drugs are commonly used in the treatment of cerebral ischemia, brain injury, Alzheimer's disease, and Parkinson's disease in common cerebrovascular diseases. Common neurotrophic drugs include calcium channel antagonists, free radical scavengers, and GABA receptors. Body agonists, cell membrane stabilizers, neurotrophic factors, brain protein hydrolysates, gangliosides, etc. The purpose of applying neurotrophic drugs for neuroprotection is to intervene in the pathobiochemical cascade of the penumbra to prevent or delay cell death.

6 Free radical scavengers

Free radical scavengers are a general term for a class of substances that can combine with and eliminate free radicals in the body, thereby protecting the body from oxidative damage caused by free radicals. There are many types of free radical scavengers, which can generally be divided into enzyme scavengers and non-enzyme scavengers. Enzyme scavengers are generally antioxidant enzymes, including superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX), etc .; non-enzyme free radical scavengers include Vitamin C, Vitamin E, reduced glutathione (GSH), lipoic acid, edaravone, etc. [12]. Free radicals are widely present in the body, and the mechanism of damage to the body is complicated, leading to a variety of diseases. With the research progress of free radical scavengers, free radical scavengers have become more and more widely used in clinical practice, especially in cerebrovascular diseases.

7 immunomodulators

Immune adjuvant drugs refer to chemicals that increase, stimulate, activate, enhance or regulate the level of cellular or humoral immune response. Immunomodulatory drugs, also known as immune-enhancing drugs or immune-activating drugs, are a class of drugs that improve immune-active cell functions, increase the phagocytic function of the mononuclear phagocyte system, and thereby improve the body's immune function. The mechanism of action of immune-enhancing drugs is not fully understood, and there are many types. According to the prerequisites of their effects, they can be divided into three categories: immune replacement drugs, immune recovery drugs and immune adjuvants. The main indications include immunodeficiency diseases, adjuvant treatment of malignant tumors, and autoimmune diseases. In recent years, a large number of immunomodulatory drugs have developed rapidly and are widely used in clinical treatment of tumors. They have a certain relief effect on tumors, improve the immune function of the human body and improve the quality of life of patients. In place and other factors, there is some unreasonable drug administration, which brings certain risks and financial burden to patients. Therefore, it is necessary to strengthen the supervision of this class of drugs and promote their reasonable clinical application.

8 Chinese medicine for activating blood and removing blood stasis

Activating blood circulation and removing blood stasis medicine are mainly used to treat blood stasis, with the main effects of clearing blood vessels, improving blood circulation and dissipating blood stasis. Most of these drugs are traditional Chinese medicine injections, proprietary Chinese medicines, and prescriptions, and they have the same characteristics: complex drug components, unclear pharmacological effects, and unclear and unpredictable clinical safety. On the other hand, this class of drugs is mainly used for the treatment of blood stasis syndrome. Blood stasis syndrome is a clinical syndrome of TCM that is manifested in multiple systems and distributed throughout the body. The main clinical manifestations of different diseases vary widely, so they are also used in the treatment. It is difficult to unify and each has its own characteristics. Therefore, it is necessary to strengthen the management of the clinical application of drugs for promoting blood circulation and removing blood stasis, improve the level of drug application, and ensure the safety of clinical medication.

9 Adjuvant drugs for liver disease

The commonly used drugs for treating liver diseases can be divided into 9 categories: antiviral drugs, auxiliary drugs for protecting liver cells, immunomodulatory drugs, plant drugs and active ingredients of traditional Chinese medicine, drugs for treating cholestasis, drugs for preventing and treating hepatic encephalopathy, antidote, anti- Fibrosis drugs and drugs for the treatment and prevention of portal hypertension and varicose vein bleeding. Auxiliary drugs in liver diseases mainly have the functions of reducing enzymes, promoting detoxification, promoting energy metabolism, promoting protein synthesis, jaundice, protecting liver cell membranes, improving microcirculation, regulating immunity, and anti-fibrosis. These uses can reduce complications in patients with liver disease And adverse reactions, regulating the immune system and improving quality of life. Because the prevention and treatment of hepatobiliary system diseases is relatively complicated, there are no effective drugs for the treatment of the etiology. Various drugs commonly used for hepatobiliary diseases can be used as some adjuvant treatments. The mechanism of action and the exact effect need to be determined. It is particularly important to use these drugs reasonably in order to obtain more suitable therapeutic drugs and effects for patients with liver disease.

10 tumor adjuvant drugs

The "Guiding Principles for the Clinical Use of Adjuvant Therapy for Malignant Tumors in Fujian Province (Trial)" defines the adjuvant drugs for malignant tumors as follows: Patients with malignant tumors should undergo prevention, treatment, and treatment of related toxic and side effects during surgery, radiation, and chemotherapy. Non-cytotoxic drugs that are used sexually or with antitumor effects, including proprietary Chinese medicines and the regulation of immune response. As anti-tumor adjuvant drugs can reduce the adverse reactions of radiotherapy and chemotherapy, increase the tolerance of patients, improve the quality of life of patients, and promote the smooth progress of clinical chemotherapy programs, they are more and more favored by medical workers and patients. However, the current lack of application standards and norms for anti-tumor adjuvant medications, no objective evaluation methods and indicators in clinical treatment, mostly empirical medications, which can easily lead to increased treatment costs, and patients do not really benefit.

At present, the definition of the scope of auxiliary medicine is not very clear, and the above definition and classification of auxiliary medicine are not absolute. Therefore, the definition and classification of auxiliary drug use need to be further explored, clarified, unified and standardized in order to achieve personalized, scientific, and refined management of clinical drug use.