Phytoneering medicines in the treatment of acute rhinosinusitis: an emphasis on effectiveness and safety of application

Authors

DOI:

https://doi.org/10.24959/cphj.20.1526

Keywords:

acute rhinosinusitis, treatment, the drug “Sinupret®”, multivector pharmacodynamics, evidence-based medicine and pharmacy

Abstract

The choice of an optimal drug is only one of the components of high-quality pharmacotherapy of acute rhinosinusitis, which is supplemented by providing a patient with full information about the action of the drug selected, its rational use and duration of drug administration, possible side effects, as well as drug and food interactions. There are no “good” or “bad” medicines because even the most effective drug can prove to be ineffective precisely through the wrong choice and insufficient information about its use. The solution to this problem will allow increasing not only the effectiveness, but also the safety of acute rhinosinusitis treatment. Today, phytoneering drugs occupy an important place in the treatment of patients with acute rhinosinusitis and have evidence-based effectiveness and safety. Thus, according to the EPOS 2020 recommendations, some herbal medicines are included into the treatment regimens for acute viral and post-viral rhinosinusitis with the level of evidence 1b by the GRADE methodology. A special place is occupied by the Sinupret products line manufactured by “BIONORIKA СE” company, Germany. All Sinupret drugs are related to the original plant raw material, the qualitative composition of the active substances that determine their pharmacological activity. “Sinupret®” contains standardized extracts of 5 plants: elder flowers (Sambucus nigra), primrose flowers (Primula versis), sorrel herb (Rumex acetosa), verbena herb (Verbena officinalis) and gentian root (Gentiana lutea). The high efficiency of each of the plants was confirmed by practical experience, and the therapeutic combination subsequently received a strong scientific basis. Due to the unique combination of biologically active substances of 5 medicinal plants “Sinupret®” exerts a versatile complex effect, breaking the “vicious circle” in rhinosinusitis. The pharmacodynamics of “Sinupret®” includes the following main effects: secretolytic and secretomotor, anti-inflammatory, anti-infective and immunomodulative. The administration of “Sinupret®” (taking into account the available pharmacodynamic effects) allows avoiding potentially problematic polypragmasia – simultaneous indication (in this context – unjustified) of several medicines to a patient, often for the treatment of the same symptom. This is especially true for the uncontrolled use of antibiotics without indications, and it has already led to the spread of such a dangerous phenomenon as antibiotic resistance all over the world.

Conclusions. Considering the weighty data of evidence-based medicine the “Sinupret®” line medicines is an alternative choice for the treatment of persons with non-complicated acute rhinosinusitis.

Author Biographies

T. S. Zhulai, National University of Pharmacy

teaching assistant of the Department of Clinical Pharmacology and Clinical Pharmacy

S. K. Shebeko, National University of Pharmacy

Candidate of Pharmacy (Ph.D.), associate professor of the Department of Clinical Pharmacology and Clinical Pharmacy

T. S. Sakharova, National University of Pharmacy

Doctor of Pharmacy (Dr. habil.), professor of the Department of Clinical Pharmacology and Clinical Pharmacy

N. P. Bezugla, National University of Pharmacy

Candidate of Medicine (Ph.D.), associate professor of the Department of Clinical Pharmacology and Clinical Pharmacy

I. A. Otrishko, National University of Pharmacy

Candidate of Pharmacy (Ph.D.), associate professor of the Department of Clinical Pharmacology and Clinical Pharmacy

References

Unifikovanyi klinichnyi protokol pervynnoi, vtorynnoi (spetsializovanoi) ta tretynnoi (vysokospetsializovanoi) medychnoi dopomohy: Hostryi rynosynusyt. (n.d.). Available at: https://medprosvita.com.ua/unifikovaniyklinichniy-protokol-gostriy-rinosinus-6.

Krivopalov, A. A. (2016). Rinosinusit: klassifikatsiya, epidemiologiya, etiologiya i lechenie. Meditsinskiy sovet, 6, 22–25.

Zupanets, I. A., Popov, S. B., Rudyk, Yu. S. (2018). Symptomy ta syndromy v praktychnii farmatsii. Pryntsypy terapii : navch. posib. dlia studentiv farmats. f-tiv vyshch. med. (farmats.) navch. zakl. osvit. Kharkiv: Zoloti storinky, 116.

Fokkens, W. J., Lund, V. J., Hopkins, C., Hellings, P. W., Kern, R., Reitsma, S., … Alobid, I. (2020). European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology Journal, 1–464. https://doi.org/10.4193/rhin20.600

Popovych, V. I., Koshel, I. V., Kuderska, N. M. (2015). Hostryi rynosynusyt: ratsionalna kompleksna farmakoterapiia. Zhurnal vushnykh, nosovykh i horlovykh khvorob, 5, 142–144.

Ryazantsev, S. V., Krivopalov, A. A., Shamkina, P. A. (2017). Sekretoliticheskaya terapiya ostryih sinusitov. Meditsinskiy sovet, 16, 78–83.

Passali, D., Cambi, J., Passali, F. M., Bellussi, L. M. (2015). Phytoneering: a new way of therapy for rhinosinusitis. Acta Otorhinolaryngol Ital, 35(1), 1–8.

Koch, A. K., Klose, P., Lauche, R., Cramer, H., Baasch, J., Dobos, G. J., & Langhorst, J. (2016). A Systematic Review of Phytotherapy for Acute Rhinosinusitis. Complementary Medicine Research, 23(3), 165–169. https://doi.org/10.1159/000447467

Kovalenko, V. N. (2018). Kompendium 2018 – lekarstvennye preparaty. Kyiv: Morion, 2560.

Zupanets, I., Zhulai, T., Sakharova, T., & Andrieieva, O. (2017). The significance of selecting phytopreparations for individualized therapy of acute rhinosinusitis. Clinical Pharmacy, 21(4), 52–58. https://doi.org/10.24959/cphj.17.1444.

Zupanets, I. A., Popovych, V. I., Zhulai, T. S. (2020). Farmatsevtychna opika patsiientiv pry likuvanni hostroho rynosynusytu: metod. rek. 2-he vyd., dopov. Kharkiv: Zoloti storinky, 36.

Palm, J., Steiner, I., Abramov-Sommariva, D., Ammendola, A., Mitzenheim, S., Steindl, H., … Bachert, C. (2017). Assessment of efficacy and safety of the herbal medicinal product BNO 1016 in chronic rhinosinusitis. Rhinology Journal, 55(2), 142–151. https://doi.org/10.4193/rhin16.103

Popovich, V., Koshel I. (2017). Sinupret as add-on therapy to saline irrigation for children with acute Post-Viral Rhinosinusitis. Clinical Phytoscience. [Electronic resourse]. – Available at: https://clinphytoscience.springeropen.com/articles/10.1186/s40816-017-0047-6

Popovych, V. I., Koshel, I. V., Piletska, L. I. (2017). Vyvchennia efektyvnosti preparatu Synupret v likuvanni hostroho pisliavirusnoho rynosynusytu u ditei. Zhurnal vushnykh , nosovykh i horlovykh khvorob, 3, 120.

Popovych, V. I., Koshel, I. V. (2014). Porivnialna efektyvnist roslynnoho fitonirynhovoho preparatu z kompleksnoiu diieiu ta syntetychnoho protyzapalnoho zasobu v likuvanni ditei z nehniinymy formamy hostroho rynosynusytu. Pryrodna medytsyna, 3(19), 6–10.

Yund, R., Mondliger, M., Shtammer, H., Stierna, P., Bahert K. (2016) Rastitelnyiy preparat BNO 1016 – bezopasnoe i effektivnoe sredstvo dlya le-cheniya ostrogo virusnogo rinosinusita. Visnik № 1. Prirodna meditsina, 21(394), 22-24.

Popovich, V., Beketova, H. (2018). Results of a randomised controlled study on the efficacy of a combination of saline irrigation and Sinupret syrup phytopreparation in the treatment of acute viral rhinosinusitis in children aged 6 to 11 years. Clinical Phytoscience. [Electronic resourse]. – Available at: https://link.springer.com/article/10.1186/s40816-018-0082-y

Published

2020-06-03

Issue

Section

Clinical Pharmacology and Pharmacotherapy