ScienceRise: Pharmaceutical Science

Lavandula Angustifolia Mill. of Ukrainian origin: a comparative study of the chemical composition and antimicrobial potential of herb extracts

Olena Bogatyrova — 2024-10-14

Provide updated data on the antimicrobial activity and chemical composition of original dry extracts from Lavandula angustifolia herb of Ukrainian origin.

The aim – an experimental comparative study of the chemical profile and antimicrobial activity of the original dry extracts of Lavandula angustifolia herb and their effect on the ability to destroy biofilms of microbial cultures or prevent their formation in vitro.

Materials and methods. The objects of the study are dry extracts obtained from the lavender herb with purified water and ethanol solutions (40 and 70 %). The main biologically active substances (BAS) of the extracts were determined by the Thin-layer chromatography and Absorption spectrophotometry methods. The microbiological properties of the test samples of the investigated plant extracts were studied in vitro by the two-fold serial dilutions method. The ability of microorganisms to form a biofilm was determined by the method of adhesion to polystyrene in flat-bottomed plastic plates. The optical density of the initial bacterial suspension was measured on the Densi-La-Meter device, and the density of inoculated bacterial cells on the Multiskan EX photometer at a wavelength of 540 nm. The study of the antimicrobial activity of water and ethanol extracts of lavender herb in a wide range of concentrations was carried out by the agar diffusion method in the "wells" modification, which is commonly used in microbiological practice.

Results. Water and water-ethanol extracts of lavender of Ukrainian origin were obtained. Terpenoids (linalool, linylyl acetate and traces of 1,8-cineol), flavonoids (hyperoside, isoquercitrin), and hydroxycinnamic acids (rosmarinic, chlorogenic acids) were identified in the extracts. The total content of phenolic compounds is 2.02–2.60 mg/g, flavonoids – 1.46–3.17 mg/g. The largest amount of BAS was extracted with 70 % ethanol. According to the results of experimental studies, the extracts of the lavender herb, obtained by extraction with a water-ethanol solution (40 and 70 % ethanol) at a concentration of 1 mg/ml, have antimicrobial properties against a wide range of infectious agents (S. aureus, E. coli, K. pneumoniae, P. aeruginosa, C. albicans). Studies of the influence of test samples of lavender extracts at a concentration of 1 mg/ml on the ability of microorganisms (S. aureus, E. coli, K. pneumoniae, P. aeruginosa) to form biofilms demonstrated that the highest inhibitory activity against biofilm formation was found in the case of the action of test of a sample of phytoextract obtained by extraction with a water-ethanol solution (40 % ethanol), which accounted for S. aureus ‒ 57.8 %, P. aeruginosa – 66.7 %. A wide spectrum of antimicrobial action was established for the tested lavender phytoextracts under the conditions of application of the concentration range of 10-60 μg/ml. The best spectrum of antimicrobial action and the highest activity corresponds to the lavender extract, obtained by extraction with 70 % ethanol, with the effect depending on the concentration.

Conclusion. The lavender herb of Ukrainian origin is a promising and affordable source of potential antimicrobial active pharmaceutical ingredients (API). Water-ethanol lavender extract (70 % ethanol), according to research results, has shown high antimicrobial and antifungal potential. According to preliminary data, antimicrobial activity correlates with the content of phenolic compounds. The obtained results may be useful for the search for original substances for the complex correction of symptoms of neurological deficits of infectious etiology

Study of the effect of propylene glycol on the properties of poloxamer 338 solutions

Oleksii Liapunov — 2024-10-31

The aim. Study of the characteristics of 20 % solutions of poloxamer 338 (P338) in water and mixed solvents water – propylene glycol (PG) at various temperatures using rotational viscometry and the spin probe method.

Materials and methods. 20 % m/m solutions of P338 in water and water – PG mixtures were the objects of research. The solutions were studied by rotational viscometry at 25 °С, 32 °С і 37 °С; the flow behaviour, low-yield stress (t₀), hysteresis area (S_N) and dynamic or apparent viscosity (η) were determined. Spin probes based on fatty acids, which differ in molecular structure, solubility, and radical localisation, were added to the solutions. Electron paramagnetic resonance (EPR) spectra was obtained to determine their type and parameters.

Results. Depending on the content, PG affects the rheological properties of 20 % P338 solution. The ability of this solution to undergo thermally induced sol-gel transitions, resulting in the formation of gels with plastic flow behaviour at temperatures of 32 °C and 37 °C, is maintained at PG content of up to 20 %. At 37 °C and a 30 % PG content, an atypical thixotropic gel is formed. The rheological characteristics of gels containing 10-20 % PG at 32 °C and 37 °C are higher than those of gels without PG. The increase in the PG concentration from 0 to 40 % generally has little effect on the rotational correlation times (τ) and values of the order parameter (S) of the spin probes. In the case of the ammonium salt of 5-doxylstearic acid (5-DSA NH₄ salt), the anisotropic EPR spectra at a PG concentration of 40 % undergoes a transformation, becoming a triplet. This coincides with the loss of the ability of 20 % P338 solutions to thermally induced sol ↔ gel transitions. An increase in the concentration of PG (in contrast to ethanol) does not lead to the solvation of P338 micelle cores by the dispersion medium. The transformation of the EPR spectrum of the 5-DSA NH₄ salt into a triplet is probably the result of the interaction between PG and the hydrophilic shell of micelles through the formation of hydrogen bonds.

Conclusions. The rheological properties of 20 % P338 solution are affected by the PG, depending on its content. The P338 solutions can undergo a thermally induced sol ↔ gel transition, provided that the PG content does not exceed 30 %. A correlation has been identified between alterations in the rheological properties of 20 % P338 solution and the corresponding change in the types of EPR spectra observed for the 5-DSA NH₄ salt, namely a transition from anisotropic spectra to triplet. As the PG content in the P338 solution increases up to 40 %, the solvation of micelle cores by the dispersion medium does not occur. It may be posited that the alteration in the structure of P338 micelles is a consequence of the interaction between PG and their hydrophilic shell

The content and stability of ascorbic acid in commercial food supplements

Raal Ain — 2024-10-31

Ascorbic acid is a well-known compound found in many vegetables and fruits. In medical practice, it is used in the composition of many drugs and food supplements. Taking into account the different quality of production of food supplements on the one hand and the lability of ascorbic acid on the other, it is important to analyze the real content of ascorbic acid in food supplements containing it.

The aim. The aim of the study was to compare the content of ascorbic acid in food supplements from different manufacturers to establish the stability of ascorbic acid over time and the relationship between the content of ascorbic acid and the shelf life of food supplements, as well as to investigate the relationship between the stability of ascorbic acid and the nature of its origin.

Materials and methods. 13 preparations of food supplements containing ascobrinic acid, which were sold in Estonian pharmacies or online environments at the time of the work, were analysed. Quantitative analysis of ascorbic acid was performed using the HPLC method.

Research results. It was found that in 11 out of 13 food supplements, the ascorbic acid content ranged from 78.5 % to 115.2 % of the nominal. For two samples, the ascorbic acid content was very low compared to that provided by the manufacturer (54.6-56.3 %). The content of ascorbic acid in three preparations does not meet the standards set by the European Commission (from -20 % to +50 %). Аfter 16 months of storage, a statistically significant change in the content of ascorbic acid occurred only in four samples, in which its content decreased (p<0.05) by about 7-21 mg. The ascorbic acid content in the other samples did not change for 16 months after storage of the opened packages. Statistical analysis of the data showed that the relative amount of ascorbic acid present in the preparation relative to the nominal was related to the origin of the substance, whereas the content of ascorbic acid of natural origin in preparations relative to the nominal was significantly lower than in preparations with a synthetic active substance.

Conclusions. The actual content of ascorbic acid in most solid preparations roughly corresponds to that stated on the label, usually slightly below it. In solid supplements containing ascorbic acid, its amount practically does not change after 16 months of shelf life. In preparations containing ascorbic acid of natural origin, it is found relatively less than in preparations containing synthetic ascorbic acid

The application of arbutin in elimination resistance gramm-negative multidrug resistance bacteria of Pseudomonas aeruginosa and Enterobacter cloacea

Oleksandr Maslov — 2024-10-22

The basic therapy against microbial infections is the application of antibiotics. However, overuse of antibiotics has become the major factor for the emergence and dissemination of multidrug-resistant strains.

The aim. The purpose of our work was to investigate the in vitro and in silico elimination resistance of antibiotics (сlarithromycin, azithromycin, gentamycin, ciprofloxacin, levofloxacin, ceftriaxone, and chloramphenicol) against clinical multidrug-resistant strains of P. aeruginosa and E. cloacae by arbutin.

Materials and methods. The molecular docking was performed using AutoDockTools 1.5.6; antimicrobial effects were evaluated by the well method. Isolates were obtained from clinical samples including tracheal aspirate and broncoalveolar lavage.

Results. Theoretical studies have found that none of the investigated antibiotics and arbutin highly selectively inhibit all "targets" mechanisms of antimicrobial action. In experimental studies, it was observed that adding arbutin to the antibiotic led to the emergence of sensitivity on the part of resistant strains. All Gramm-negative resistance strains of bacteria were sensitive to the action of arbutin. Moreover, arbutin increased the antimicrobial effect of antibiotics from 8 to 55 %. It was estimated exceptions such as clarithromycin and azithromycin when assessing antimicrobial activity against P. aeruginosa.

Conclusions. These studies have shown that inhibiting resistant strains of bacteria requires the use of combinations of "classical" antimicrobials and herbal drugs or dietary supplements based on extracts obtained from arbutin-containing medicinal plants such as lingonberry, bearberry, and cranberry. This approach is a “lifeline” for the development of antimicrobial agents against resistant bacteria and gives “a second chance to return to life” for outdated antibiotics

Research on the development of solid soap composition for the prevention and treatment of psoriasis relapse

Ivan Honcharov — 2024-10-31

The aim of the research is to develop the composition of solid soaps for the treatment and prevention of exacerbation of psoriasis using a classic recipe based on vegetable oils.

Materials and methods. The studied samples of solid soaps were made based on vegetable oils of domestic and foreign production using an aqueous solution of sodium hydroxide for their saponification. Citric acid (China, p. K707784), salicylic acid (China, p. Y1504007) and lactobionic acid (Poland, p. 20161118) were used as active pharmaceutical ingredients. Organoleptic (appearance, shape, color, smell) and physico-chemical (mass fraction of fatty acids, initial volume of foam, mass fraction of soda products) studies were carried out following DSTU 4537:2006 Solid toilet soap. General technical conditions. Indicators were chosen as standards for soap of the special - therapeutic brand.

Results. Samples containing a combination of coconut, avocado, castor, jojoba and palm oils, as well as a combination of castor, jojoba, macadamia, mango and avocado oils were found to have insufficient foaming capacity. Most samples are not firm enough, especially those containing rosehip oil. The composition of solid soap based on palm kernel oil, coconut oil, avocado oil, castor oil, almond oil, and olive oil, among others, showed the best organoleptic properties. All the studied samples were within the normal range according to the parameters of the mass fraction of soda products and the mass fraction of fatty acids. At the same time, introducing active substances into the composition did not lead to a deterioration of the developed solid soap's normative or controlled organoleptic and physicochemical properties.

Conclusions. The research conducted made it possible to obtain the optimal composition of solid soap, which can be used to prevent psoriasis exacerbation due to the introduction of pomegranate seed oil. Based on this, solid soaps were created for the treatment of psoriasis in the period of exacerbation, one of which includes lactobionic acid and the other – a combination of citric and salicylic acids

Finding the optimal solution in pharmaceutical technological research using statistical methods with quantitative factors

Olga Kutova — 2024-10-31

The aim. Developing a methodological approach to determining the optimal solution using statistical methods in pharmaceutical and technological research with quantitative factors on the example of establishing the optimal content of filler in a solid dispersion in the manufacture of granules.

Materials and methods. The methodology for finding an optimal solution is shown in the example of the development of granules containing a solid dispersion of quercetin with polyethylene oxide 6000. To determine the optimal amount of filler, the method of mathematical modelling was applied using statistical analysis and multiple criterion optimization. Software tools such as MS Excel and Mathcad 14 spreadsheets were used to process the experimental data and perform calculations.

Results. The problem is formalized in a form suitable for solving by experimental and statistical methods. The issues of constructing mathematical models in the form of regression equations characterizing the effect of the quantitative content of the filler on several pharmacy-technological parameters of granules based on experimental data are considered. Attention is focused on the peculiarities of using static methods for processing experimental data in pharmaceutical research, namely, on establishing the structure of regression equations and assessing their adequacy. The criterion of multi-criteria optimization is proposed, which is formed based on the obtained regression equations, considering the restrictions imposed on each individual criterion.

Conclusions. A methodological approach to determining the optimal solution in pharmaceutical technological research with quantitative factors using experimental and statistical methods and the theory of multi-criteria optimization has been tested on the example of determining the optimal content of filler in a solid dispersion in the manufacture of granules. The optimal ratio of filler to solid dispersion was determined, which ensures the maximum approximation of all studied pharmacy-technological parameters of granules to their optimal values. None of the indicators exceeds the limits set by the researcher and has the minimum possible deterioration relative to the individually determined optimum

Synthesis, determination of physico-chemical parameters, structure confirmation, and antioxidant activity of compounds based on 3,5-bis(5-mercapto-4-R-4Н-1,2,4-triazole-3-yl)phenol

Yurii Sameliuk — 2024-10-31

In this study, the potential of using 3,5-bis(5-mercapto-4-R-4H-1,2,4-triazol-3-yl)phenol as a critical component for the synthesis of new compounds is considered, which may be of significant importance in various fields of science and technology. The relevance of the research is due to the fact that studying the properties of new synthetic derivatives of 1,2,4-triazole is a promising direction in modern chemistry. This study opens new opportunities for creating biologically active substances with antioxidant activity and the prospect of their further use as individual and combined drugs for correcting pathological processes associated with oxidative stress.

The aim of the study. The main objective of the research is to find new, low-toxic, and highly effective antioxidant compounds based on derivatives of 3,5-bis(5-mercapto-4-R-4H-1,2,4-triazol-3-yl)phenol, as well as to confirm the individuality, structure, and establish their physicochemical constants.

Materials and methods. The article investigates the synthesis and establishes the structure of a series of compounds, in particular, diacetic acids and dibenzoic acids, derivatives of 3,5-bis(5-mercapto-4-R-4H-1,2,4-triazol-3-yl)phenol, which were chosen as the material for the search for highly effective antioxidants. The methods used in this work are as follows: organic synthesis, physicochemical methods for determining the structure of synthesized substances (elemental analysis, UV spectrophotometry, 1H NMR spectroscopy, mass- and chromato-mass spectrometry), and a biological method for determining antioxidant activity using the free radical method with DPPH.

Results of the study. The results showed that some of the synthesized compounds have significant potential as antioxidants, which may be important in the context of their application in various fields, particularly in medicine and the food industry. Among the obtained results, it is especially worth noting ethyl 3,3'-((((5-hydroxy-1,3-phenylene)bis(4-R-4-phenyl-1,2,4-triazol-5,3-diyl))bis(sulfandiyl))bis(methylene))dibenzoate (compound 7c) and propyl 3,3'-((((5-hydroxy-1,3-phenylene)bis(4-R-4-methyl-1,2,4-triazol-5,3-diyl))bis(sulfandiyl))bis(methylene))dibenzoate (compound 7d), which showed the highest level of antioxidant activity among all the studied compounds.

Conclusions. The obtained results indicate the possible application of the studied compounds as potential antioxidants in the production of materials and products, which may be of great significance for further research in this area

Selection of the base for a topical pharmaceutical form for stump care after prosthetic fitting

Inna Kovalevska — 2024-10-31

The aim of the work. Rehabilitation of patients with amputation of the lower limbs is an urgent task of society. Currently, the pharmaceutical market of Ukraine lacks medicinal products for stump care of domestic production. Therefore, the aim of this work was to research the selection of the basis of soft medicine for the care of stumps after prosthetics.

Materials and methods. The objects of the study were samples of a soft medicinal product on an emulsion basis. Gelling agents (aristoflex, xanthan gum, aerosil) were used as regulators of the structural and mechanical parameters of soft medicine. Research was conducted using a set of studies to determine organoleptic and structural-mechanical indicators.

Results. According to the results of the organoleptic analysis, according to the indicators of homogeneity, the presence of delamination, samples were selected for further research, where aristoflex and xanthan gum were used as a thickener. According to the results of structural and mechanical studies, it was established that the samples with xanthan gum have a satisfactory degree of spreading and adhesiveness, which increases with increasing exposure to mechanical forces. The determined values of static and dynamic coefficients of friction testify to the sliding properties of samples with xanthan gum.

Conclusion. It was established that the addition of xanthan gum to the composition of the base would provide all the necessary characteristics for a soft medicine that is planned to be used in the care of the stump after prosthetics

Modern approaches to typologization and modeling in the health technology assessment

Mykhailo Babenko — 2024-10-07

The aim: to develop a typology of the current management systems for health technology assessment (HTA) based on the identification of typological features in order to scientifically and practically substantiate a typological model that combines the most stable properties and can be implemented in a variety of modifications, taking into account the dynamic development of the health care system (HCS).

Materials and methods: The study used scientific publications, official information from the websites of national or regional bodies/agencies, international organizations on HTA, reports, databases and official documents of the World Health Organization (WHO). The research used the following methods: the system analysis, content analysis, institutional analysis, structural-functional analysis, generalization, comparison, systematization, classification, synthesis, typology, and modeling. To conduct a typological analysis, 34 countries were selected in which the HTA has been implemented in the decision-making process for the use and financing of medical technologies (MTs).

Research results. An institutional analysis of national HTA systems was conducted. The status of HTA in the national health care systems of the selected countries and, in particular, the role of HTA in the decision-making process regarding the use of certain MTs were studied. The author analyzes the institutional capacity of the HTA system (availability of a special authorized body, level of centralization/decentralization, financing, regulatory framework and human resources). The functionality and areas of activity of HTA bodies (organizations), the level of accountability, openness and interaction with various stakeholders are analyzed. The systematization and generalization of foreign experience made it possible to conduct a typological analysis by characteristic features). Four types of HTA management systems are identified (starting, centralized, decentralized, and balanced).

Conclusions: The study identifies and analyzes the areas of activity of the bodies/organizations in most countries of the world that carry out HTA in terms of their mission, vision and functionality, as well as assesses the level of their openness and interaction with various stakeholders. The scientific generalization and systematization of modern approaches and models of HTA systems made it possible to typologize them on the basis of certain characteristic classification features

Investigation of the influence of the extract of the herb of umbellate wintergreen on the structural and functional state of the kidneys of rats

Oleksiy Kovregin — 2024-10-31

Experimental studies were carried out as part of a preclinical study of the umbellate wintergreen herb extract regarding the possibility of using the phytoremediсal agent in diseases of the kidneys and urinary tract.

The aim. Study of the effect of umbellate wintergreen herb extract on the structural and functional state of kidneys in rats.

Materials and methods. The kidneys of rats were studied after: a single subcutaneous injection of 2.5 % potassium chromate solution at a dose of 0.7 ml/kg on the first day of the experiment - control pathology; administration of an alcoholic extract of the umbellate wintergreen herb (UWH) at a dose of 3 ml/kg or a reference preparation of a solution of lespefril at a dose of 3 ml/kg starting from the second day of the experiment (after the induction of renal failure) daily for 20 days in the form of aqueous solutions prepared on a physiological solution; intact rats that received an equivalent amount of physiological solution.

The following morphological indicators were used to assess the condition of the renal corpuscles: degree of expansion of the Shumlyansky-Bowman capsule, mesangium; segmental intracapillary proliferation. The degree of expressiveness of atrophy, edema, vacuolar dystrophy and disorganization of the nephrothelium, tubulohidrosis was evaluated.

Results. After treatment with umbellate wintergreen extract in rats with chromate-induced renal failure, more preservation of the cytoarchitectonics of the renal tissue was observed. In most of the renal corpuscles, the size of the urinary space is clearly reduced. In the vascular glomeruli, as a rule, the pattern of the capillary network is clear, the thickening of the BM of the capillaries is not observed. The saturation of mesangial and endothelial cells in most glomeruli is close to the intact control. In general, the expressiveness of changes in the glomerular apparatus in rats after administration of UWH decreased by 44.87 % compared to rats with renal failure that were not treated with the extract.

Conclusions. The extract of the umbellate wintergreen herb helps to protect the morphostructure of the kidney tissue of rats with chromate-induced renal failure, reducing the degree of damage to the renal corpuscles and tubules. In terms of the expressiveness of its nephroprotective properties, the extract of umbellate wintergreen was inferior to the reference drug Lespefril solution in its effect on the state of the glomerular apparatus and ahead of it in its effect on the state of the tubular system.

After treatment with the extract in rats with chromate-induced renal failure, more preservation of the cytoarchitectonics of the renal tissue was noted. In most of the renal corpuscles, the size of the urinary space is clearly reduced. In the vascular glomeruli, as a rule, the pattern of the capillary network is clear, the thickening of the BM of the capillaries is not observed. The saturation of mesangial and endothelial cells in most glomeruli is close to the intact control

Public-private partnership as a factor in the development of the pharmaceutical industry economy of the Republic of Kazakhstan

Nurlyaiim Issatayeva — 2024-10-31

The aim. Public-private partnership is a qualitative method of accelerating the growth rate of the country's economy and its individual components. However, it is also important to skillfully apply the features of this method, assessing the peculiarities of the functioning of a particular country or sector. This makes it relevant to consider the specifics of public-private partnerships in the Republic of Kazakhstan and, in particular, in the pharmaceutical industry. Thus, the main purpose of the study was to assess the peculiarities of the development of the pharmaceutical industry of the Republic of Kazakhstan and the impact of public-private partnerships on it. This includes understanding the role public-private partnerships play in enhancing the efficiency and innovation of the industry.

Materials and methods. This study focuses specifically on the Republic of Kazakhstan, as the public-private partnership model varies significantly across countries. The main methods used were analysis, historical method, deduction, and modelling. The specific legislative framework, local economic conditions, and the unique challenges of Kazakhstan's pharmaceutical sector were considered to provide relevant insights.

Results. The authors showed that this area is actively developing; every year, many projects are implemented in various sectors of the economy with the help of this type of interaction. Certain results are also observed in the healthcare industry, which borders the pharmaceutical industry. However, in the context of the production of medicines or the latest technologies, there are certain problems. This industry receives insufficient investment, which is why it does not have the opportunity to develop effectively. This indicates the urgency of more decisive state intervention, including through the use of public-private partnerships. In addition, the study describes some projects that have already been implemented in Kazakhstan and shows the benefits that the state has achieved from their implementation.

Conclusions. The paper brings new knowledge in the context of the investigation of public-private partnership as a method of increasing the efficiency of the functioning of the economy as a whole, and also allows for a better understanding of some features of the development of the Republic of Kazakhstan as a whole and its pharmaceutical industry in particular

Determination of the socially oriented role of pharmacists in the prevention, diagnosis and treatment of patients with viral hepatitis

Alla Kotvitska — 2024-10-31

Viral hepatitis (VH) is one of the most significant medical and social problems worldwide, posing a global threat to public health.

The aim of the study was to determine the socially oriented role of pharmacists in the prevention, diagnosis and treatment of patients with VH, in particular in the implementation of decentralization of VH diagnostic services in Ukraine.

The study was based on statistical reports of the WHO, the Public Health Centre of the Ministry of Health of Ukraine, international WHO guidelines on the diagnosis and pharmacotherapy of viral hepatitis, and scientific publications.

Results of the study. Taking into account the results of the analysis of world experience and based on the WHO Concept in cooperation with FIP ‘Seven Star Pharmacist’ and its modern interpretation, we have identified the current role of pharmacists in the prevention, diagnosis and treatment of patients with VH.

Based on the recommendations of the WHO and the Ministry of Health of Ukraine, which define the pharmacist as a link in the support of pharmacotherapy for patients with VH, a model of information and advisory pharmaceutical service is proposed, which provides for the involvement of resources of the state and regional levels at the stages of need assessment, planning and control of the service, resources of health care facilities and pharmacies, and the stages of planning and implementation of the pharmaceutical service.

Noting the successful international experience and peculiarities of modern pharmaceutical care provided to patients with hypertension, we propose an adapted model of patient-pharmacist-physician interaction. This model is based on the fact that the pharmacist is one of the professional implementers of the state policy on providing the population of Ukraine with medicines and medical devices, and through the implementation of interaction with the patient and the doctor, based on the basic principles we have developed.

Thus, the analysis of approaches to defining the socially oriented role of pharmacists in the prevention, diagnosis and treatment of patients with hypertension has become the basis for the development of models for the provision of information and advisory pharmaceutical services and a model of patient-pharmacist-physician interaction.

Conclusions. The implementation of the model of information and advisory pharmaceutical service and the model of patient-pharmacist-physician interaction in practice will facilitate the timely detection of threatening symptoms of a socially dangerous disease and, accordingly, the diagnosis of potential VH patients and their visit to a doctor and, as a result, will be a way to prevent irrational self-medication and ensure timely, economically justified pharmacotherapy for this category of patients