Противовирусные средства: почему нельзя лечить грипп антибиотиками

{"article":{"error":null,"payload":{"id":317,"slug":"protivovirusnye-sredstva","title":"Противовирусные средства: почему нельзя лечить грипп антибиотиками","description":"По статистике ВОЗ, примерно миллиард людей в год заболевают гриппом, из них от 3 до 5 миллионов переносят заболевание тяжело, а от 290 тыс. до 650 тыс. человек умирают от осложнений. Далеко не все заболевшие обращаются к врачу, многие решают попробовать обойтись самолечением и зачастую бегут в аптеку за антибиотиком посильнее — чтобы наверняка уничтожить всех «микробов». Однако принимать антибиотики без назначения врача — крайне рискованно, а лечить ими грипп — и вовсе бесполезно.","href":"/news/protivovirusnye-sredstva/","published":{"display":"1 февраля 2024","rfc3339":"2024-02-01T13:12:54+00:00"},"image":{"isTouch":{"retina":null,"default":null},"isFromTablet":{"retina":null,"default":null}},"modified":{"display":"1 февраля 2024, 13:42:06","rfc3339":"2024-02-01T13:42:06.945410+00:00"},"content":"\u003cp\u003eСодержание:\u003c/p\u003e\r\n\r\n\u003cul\u003e\r\n\t\u003cli\u003e\u003ca href=\"#Вирусы и вирусные заболевания\"\u003e\u003cspan style=\"color:#2980b9\"\u003e\u003cu\u003eВирусы и вирусные заболевания\u003c/u\u003e\u003c/span\u003e\u003c/a\u003e\u003c/li\u003e\r\n\t\u003cli\u003e\u003ca href=\"#Как действует вирус\"\u003e\u003cspan style=\"color:#2980b9\"\u003e\u003cu\u003eКак действует вирус\u003c/u\u003e\u003c/span\u003e\u003c/a\u003e\u003c/li\u003e\r\n\t\u003cli\u003e\u003ca href=\"#Почему нельзя лечить вирусные заболевания антибиотиками\"\u003e\u003cspan style=\"color:#2980b9\"\u003e\u003cu\u003eПочему нельзя лечить вирусные заболевания антибиотиками\u003c/u\u003e\u003c/span\u003e\u003c/a\u003e\u003c/li\u003e\r\n\t\u003cli\u003e\u003ca href=\"#Противовирусные средства\"\u003e\u003cspan style=\"color:#2980b9\"\u003e\u003cu\u003eПротивовирусные средства\u003c/u\u003e\u003c/span\u003e\u003c/a\u003e\u003c/li\u003e\r\n\t\u003cli\u003e\u003ca href=\"#Вместо заключения: самолечение при ОРВИ\"\u003e\u003cspan style=\"color:#2980b9\"\u003e\u003cu\u003eВместо заключения: самолечение при ОРВИ\u003c/u\u003e\u003c/span\u003e\u003c/a\u003e\u003c/li\u003e\r\n\t\u003cli\u003e\u003ca href=\"#FAQ\"\u003e\u003cspan style=\"color:#2980b9\"\u003e\u003cu\u003eFAQ | Вопрос — ответ\u003c/u\u003e\u003c/span\u003e\u003c/a\u003e\u003c/li\u003e\r\n\u003c/ul\u003e\r\n\r\n\u003chr /\u003e\r\n\u003ch2\u003e\u003ca id=\"Вирусы и вирусные заболевания\" name=\"Вирусы и вирусные заболевания\"\u003e\u003cspan style=\"color:#000000\"\u003eВирусы и вирусные заболевания\u003c/span\u003e\u003c/a\u003e\u003c/h2\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003eВ детстве нам говорили, что надо тепло одеваться и избегать сквозняков, чтобы не простудиться. Однако вызывает простуду или грипп не холод, а возбудитель заболевания — вирус. Вирусы окружают нас повсюду, вызывая болезни человека, животных, растений и даже бактерий. При этом сами они даже \u003c/span\u003e\u003ca href=\"https://books.google.ru/books?id=ew1fR6ghsmgC&printsec=frontcover&hl=ru#v=onepage&q&f=false\" style=\"text-decoration:none\" target=\"_blank\"\u003e\u003cspan style=\"color:#000000\"\u003e\u003cu\u003eне являются\u003c/u\u003e\u003c/span\u003e\u003c/a\u003e\u003cspan style=\"color:#000000\"\u003e полноценными живыми организмами, они представляют собой лишь молекулу генетического материала (ДНК или РНК) и белковую оболочку (капсид). Вирусы не могут размножаться вне чужого организма — они встраиваются в другую клетку и заставляют её копировать свой генетический материал.\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003eНесмотря на простейшее устройство, вирусы вызывают целый спектр заболеваний — от банальных простуды и гриппа до таких опасных, как полиомелит, гепатит, оспа и СПИД. COVID-19, заставивший сидеть дома весь мир, тоже является вирусным заболеванием.\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003cp\u003e\u003cimg alt=\"\" src=\"https://vseapteki.ru/cropping/thumbnails/253/340/phoneMedium_retina/\" style=\"height:427px; width:640px\" /\u003e\u003c/p\u003e\r\n\r\n\u003ch2\u003e\u003ca id=\"Как действует вирус\" name=\"Как действует вирус\"\u003e\u003cspan style=\"color:#000000\"\u003eКак действует вирус\u003c/span\u003e\u003c/a\u003e\u003c/h2\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003eПрежде всего вирусу необходимо проникнуть в организм хозяина. Заражение может быть воздушно-капельным (вирус простуды или гриппа), фекально-оральным — через заражённую пищу или воду (ротавирусы), через кровь или половую систему (ВИЧ). Далее вирус прикрепляется к оболочке клетки и проникает внутрь. Это необходимо для того, чтобы освободить свой генетический материал и заставить клетку воспроизводить вирусный геном и синтезировать вирусные белки. В большинстве случаев заражённые вирусом клетки погибают.\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003ch2\u003e\u003ca id=\"Почему нельзя лечить вирусные заболевания антибиотиками\" name=\"Почему нельзя лечить вирусные заболевания антибиотиками\"\u003e\u003cspan style=\"color:#000000\"\u003eПочему нельзя лечить вирусные заболевания антибиотиками\u003c/span\u003e\u003c/a\u003e\u003c/h2\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003eАнтибиотики «настроены» на борьбу с бактериями. Чем в первую очередь отличается бактерия от вируса? Тем, что это клетка — примитивная, но клетка. У нее есть клеточная оболочка, есть генетический материал, бактерии сами синтезируют белок, необходимый для функционирования клетки. Несмотря на то, что некоторые бактерии являются облигатными (обязательными) внутриклеточными паразитами и не могут размножаться вне клетки хозяина, большая часть этих микроорганизмов размножается самостоятельно. \u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003eАнтибиотики были разработаны, учитывая особенности бактериальной клетки. Например, пенициллин \u003c/span\u003e\u003ca href=\"https://www.nkj.ru/archive/articles/24629/\" style=\"text-decoration:none\"\u003e\u003cspan style=\"color:#000000\"\u003e\u003cu\u003eблокирует\u003c/u\u003e\u003c/span\u003e\u003c/a\u003e\u003cspan style=\"color:#000000\"\u003e строительство бактериальной клеточной оболочки, тетрациклин связывается с бактериальными рибосомами, органеллами клетки, в которых происходит синтез белка, и мешает их функционированию, а сульфаниламиды не дают бактериям размножаться. Однако всё это не работает с вирусами: у них нет клеточной оболочки (только белковый капсид), их ДНК или РНК отличается от бактериальной, а синтезом белка они заставляют заниматься рибосомы хозяина. \u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003eКроме того, надо отметить, что не все бактерии являются патогенами (возбудителями болезней). Много видов бактерий обитают у нас в полости рта или кишечника, где защищают нас от других микроорганизмов (например, от грибковой инфекции) или участвуют в переваривании пищи. Они также будут уничтожены антибиотиками. Получается, что антибиотики, как минимум, не помогут от вирусной инфекции, как максимум, навредят полезной бактериальной флоре, которая обитает у нас в полости рта или кишечника.\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003ch2\u003e\u003ca id=\"Противовирусные средства\" name=\"Противовирусные средства\"\u003e\u003cspan style=\"color:#000000\"\u003eПротивовирусные средства\u003c/span\u003e\u003c/a\u003e\u003c/h2\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003e\u003cimg alt=\"\" src=\"https://vseapteki.ru/cropping/thumbnails/253/342/phoneMedium_retina/\" style=\"height:427px; width:640px\" /\u003e\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003eПротивовирусные лекарства направлены на блокировку или подавление одного из этапов жизненного цикла вирусов: слияния с клеточной оболочкой, проникновения в клетку, высвобождения генома и размножения вируса.\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003ch2\u003e\u003cspan style=\"color:#000000\"\u003e1. Противовирусные средства, препятствующие слиянию с клеточной оболочкой\u003c/span\u003e\u003c/h2\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003eЭти препараты \u003c/span\u003e\u003ca href=\"https://cyberleninka.ru/article/n/protivovirusnye-preparaty/viewer\" style=\"text-decoration:none\" target=\"_blank\"\u003e\u003cspan style=\"color:#000000\"\u003e\u003cu\u003eпрепятствуют\u003c/u\u003e\u003c/span\u003e\u003c/a\u003e\u003cspan style=\"color:#000000\"\u003e адсорбции (поглощению) вируса клеткой, а также ингибируют (подавляют) проникновение вируса в клетку. Проще говоря, вирус не сможет прикрепиться к оболочке клетки или попасть внутрь неё.\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003ch4\u003e\u003cspan style=\"color:#000000\"\u003e\u003cstrong\u003eБлокаторы М2-каналов\u003c/strong\u003e\u003c/span\u003e\u003c/h4\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003eНа поверхности капсида вируса гриппа А находится М2-белок — фермент, помогающий проникнуть через клеточную мембрану. Производные адамантана, амантадин и римантадин, воздействуют на М2-белок, не дают вирусу проникнуть в клетку и высвободить генетический материал. Однако вследствие мутаций М2-белка многие штаммы вирусов гриппа становятся устойчивыми к этим средствам.\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003ch4\u003e\u003cspan style=\"color:#000000\"\u003e\u003cstrong\u003eИнгибиторы нейраминидазы\u003c/strong\u003e\u003c/span\u003e\u003c/h4\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003eЭти препараты подавляют нейраминидазу, фермент, который помогает проникнуть вирусу через клеточную оболочку и высвободить геном. К таким средствам относятся занамир (Реленза) и осельтамивир (Тамифлю).\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003ch4\u003e\u003cspan style=\"color:#000000\"\u003e\u003cstrong\u003eИнгибиторы гемагглютинина\u003c/strong\u003e\u003c/span\u003e\u003c/h4\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003eЭти противовирусные средства подавляют фермент гемагглютинин на поверхности вирусного капсида, из-за чего вирусу становится труднее прикрепиться к клеточной мемране. К таким препаратам относится умифеновир (Арбидол).\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003ch2\u003e\u003cspan style=\"color:#000000\"\u003e2. Противовирусные средства, подавляющие синтез генетического материала\u003c/span\u003e\u003c/h2\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003eЧем меньше будет синтезироваться вирусной ДНК или РНК, тем медленнее будет размножаться вирус, а значит, тем меньше клеток он поразит.\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003ch4\u003e\u003cspan style=\"color:#000000\"\u003e\u003cstrong\u003eПроизводные аномальных нуклеозидов\u003c/strong\u003e\u003c/span\u003e\u003c/h4\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003eНуклеозиды — азотистые соединения, которые в ходе химической реакции могут превращаться в нуклеотиды — «кирпичики», из которых состоят ДНК и РНК всех живых организмов на земле. Их производные могут встраиваться в формирующиеся цепи вирусной ДНК либо другим способом блокировать синтез вирусного генетического материала и препятствовать размножению вирусов. К таким веществам относятся лекарства, используемые при лечении ВИЧ (зидовудин, ламивудин, залцатабин, абакавир, ставудин, диданозин), антигерпетические средства (пенцикловир, фамицикловир, ацикловир, валацикловир, ганцикловир, рибавирин, цитарабин).\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003ch4\u003e\u003cspan style=\"color:#000000\"\u003e\u003cstrong\u003eПроизводные дезоксиуридина\u003c/strong\u003e\u003c/span\u003e\u003c/h4\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003eДезоксиуридин — это нуклеозид. Идоксуридин, являющийся его производным, включается в структуру вирусной ДНК и нарушает синтез нуклеиновых кислот, входящих в состав ДНК. Этот препарат применяется для лечения кератита (воспаления роговицы глаза), вызванного вирусом герпеса.\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003ch4\u003e\u003cspan style=\"color:#000000\"\u003e\u003cstrong\u003eАналоги пирофосфата\u003c/strong\u003e\u003c/span\u003e\u003c/h4\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003eПирофосфатами называют соли пирофосфорной кислоты. Одна из них, фоскарнет натрия, блокирует ферменты, участвующие в синтезе вирусной ДНК, тем самым препятствуя размножению вирусов. Средство используется для лечения различных видов герпеса, а также заболеваний, вызванных онковирусами.\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003ch2\u003e\u003cspan style=\"color:#000000\"\u003e3. Противовирусные средства, стимулирующие иммунную систему организма\u003c/span\u003e\u003c/h2\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003eЭти средства основаны на действии белков интерферонов. Эти белки вырабатываются в самом организме клетками, пораженными вирусом. Интерферон не действует напрямую на вирус, однако он вызывает изменения в соседних клетках, подавляя в них синтез белка, а значит, и вирусы не смогут заставить эти клетки синтезировать свои белки. Кроме того, интерфероны способны стимулировать иммунную систему, повышая эффективность работы лейкоцитов, в том числе макрофагов и натуральных киллеров, уничтожающих заражённые клетки.\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003ch4\u003e\u003cspan style=\"color:#000000\"\u003e\u003cstrong\u003eЛейкоцитарные интерфероны\u003c/strong\u003e\u003c/span\u003e\u003c/h4\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003eВ их состав входят интерфероны, полученные из крови человека и животных, зараженных вирусами. Это неспецифическое лекарственное средство, которое может применяться при лечении различных вирусных заболеваний. В эту группу входят такие препараты, как интерферон лейкоцитарный человеческий, интерфероны альфа, бета и гамма.\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003ch4\u003e\u003cspan style=\"color:#000000\"\u003e\u003cstrong\u003eИндукторы интерферона\u003c/strong\u003e\u003c/span\u003e\u003c/h4\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003eЭти препараты стимулируют синтез собственного интерферона. Некоторые из них также оказывают антибактериальное и противоопухолевое действие. В эту группу входят полудан (полиадениловая и полиуридиловая кислоты), ридостин (рибонуклеат натрия), амиксин (тилорон), циклоферон (акридонацетат милумина), неовир (оксодигидроакридинилацетат натрия) и кагоцел.\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003ch2\u003e\u003ca id=\"Вместо заключения: самолечение при ОРВИ\" name=\"Вместо заключения: самолечение при ОРВИ\"\u003e\u003cspan style=\"color:#000000\"\u003eВместо заключения: самолечение при ОРВИ\u003c/span\u003e\u003c/a\u003e\u003c/h2\u003e\r\n\r\n\u003cp\u003e\u003cimg alt=\"\" src=\"https://vseapteki.ru/cropping/thumbnails/253/341/phoneMedium_retina/\" style=\"height:427px; width:640px\" /\u003e\u003c/p\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003eПростуда и грипп считаются «лёгкими» заболеваниями, поэтому люди часто не обращаются к врачу, а пытаются обойтись самолечением. Вы можете попытаться помочь себе сами, однако запомните несколько советов:\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003col\u003e\r\n\t\u003cli style=\"list-style-type:decimal\"\u003e\u003cspan style=\"color:#000000\"\u003eНе принимайте антибиотики без назначения врача\u003c/span\u003e\u003c/li\u003e\r\n\t\u003cli style=\"list-style-type:decimal\"\u003e\u003cspan style=\"color:#000000\"\u003eНе принимайте специфические (направленные на борьбу с конкретным видом вируса) лекарства без точного диагноза и назначения врача. Болезни могут вызываться разными видами и даже разными штаммами вирусов: не зная, что именно является причиной заболевания, вы в лучшем случае потратите деньги и время на бесполезное лекарство, в худшем — навредите себе.\u003c/span\u003e\u003c/li\u003e\r\n\t\u003cli style=\"list-style-type:decimal\"\u003eНеспецифические средства— \u003cu\u003e\u003ca href=\"https://eda.yandex.ru/search?query=интерферон\" target=\"_blank\"\u003e\u003cspan style=\"color:#2980b9\"\u003eинтерфероны\u003c/span\u003e\u003c/a\u003e\u003c/u\u003e и \u003cu\u003e\u003ca href=\"https://market.yandex.ru/catalog--apteka/54734/list?text=иммуномодулятор&hid=8475840\" target=\"_blank\"\u003e\u003cspan style=\"color:#2980b9\"\u003eиммуномодуляторы\u003c/span\u003e\u003c/a\u003e\u003c/u\u003e\u003cspan style=\"color:#000000\"\u003e — не направлены на борьбу с конкретным вирусом, а помогают работе иммунной системе организма, а значит, их можно принимать при различных видах ОРВИ.\u003c/span\u003e\u003c/li\u003e\r\n\t\u003cli style=\"list-style-type:decimal\"\u003e\u003cspan style=\"color:#000000\"\u003eОбязательно обратитесь к врачу, если симптомы ОРВИ длятся больше недели, появляется одышка и очень высокая температура, которая не снижается или незначительно снижается после приёма жаропонижающих средств.\u003c/span\u003e\u003c/li\u003e\r\n\u003c/ol\u003e\r\n\r\n\u003ch2\u003e\u003ca id=\"FAQ\" name=\"FAQ\"\u003e\u003cspan style=\"color:#000000\"\u003eFAQ\u003c/span\u003e\u003c/a\u003e\u003c/h2\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003e\u003cstrong\u003e- Зачем врачи назначают антибиотики при вирусных заболеваниях?\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003e- Несмотря на то, что антибиотики не помогают от вирусов, врачи иногда назначают их при вирусных заболеваниях. Это делается в двух случаях: если организм ослаблен, и есть риск поражения бактериальной инфекцией, помимо вирусной. Либо до конца неизвестно, чем именно вызвано заболевание: например, простуда может быть вызвана как вирусами, так и бактериями.\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003e\u003cstrong\u003e- Надо ли сбивать температуру при вирусном заболевании?\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003e- Врачи не рекомендуют сбивать температуру ниже 38–38,5 градусов, так как повышенная температура является одним из проявлений иммунного ответа организма.\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003e\u003cstrong\u003e- Есть ли прививки от вирусных заболеваний?\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003e- Да, от многих вирусных заболеваний есть прививки.\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003e\u003cstrong\u003e- Почему надо прививаться от вирусных заболеваний, если все равно можно заболеть?\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003e- Привитый человек легче переносит заболевание, даже если заразится им. Кроме того, прививки поддерживают так называемый коллективный иммунитет, благодаря которому снижается скорость распространения заболеваний.\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003e\u003cstrong\u003e- Надо ли прививаться от гриппа?\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\r\n\r\n\u003cp\u003e\u003cspan style=\"color:#000000\"\u003e- ВОЗ рекомендует прививаться от гриппа, так как в результате его осложнений ежегодно погибает до 650 000 человек. Однако необходимо посоветоваться с врачом, чтоб узнать, какой именно штамм гриппа наиболее распространен в данный период в вашем 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