Promethazine reduces the permeability of capillaries, node of the mucous membranes, itching. Has adrenolytic, rational non-essential and significant cholinolytic action. Inhibits histamine-N-methyltransferase, blocks inside histamine H3 receptors. Oppresses the median nervous organization, has a sedative, anxiolytic, antipsychotic and hypnotic effect, lowers torso temperature. Reduces the excitability of the vestibular receptors, eliminates dizziness. Has antiemetic effect.
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Phenergan (Vaquez disease, erythremia, erythrocytosis) is a disease of the group of chronic leukemias, characterized by increased production of red blood cells, platelets and leukocytes, an increase in blood volume, and splenomegaly. The disease is a rare form of leukemia. 4-5 new cases of polycythemia per 1 million population are diagnosed annually. Erythremia develops mainly in patients of the older age group (50-60 years), somewhat more often in men. The relevance of promethazine is due to the high risk of developing thrombotic and hemorrhagic complications, as well as the likelihood of transformation into acute myeloblastic leukemia, erythromyelosis, and chronic myeloid leukemia.
The development of polycythemia is preceded by mutational changes in the pluripotent hematopoietic stem cell, which gives rise to all three bone marrow cell lines.
The most common mutation detected is the JAK2 tyrosine kinase gene with the replacement of valine by phenylalanine at position 617. Sometimes there is a familial incidence of erythremia, for example, among Jews, which may indicate a genetic correlation. In the pathogenesis of erythremia, the leading role belongs to enhanced erythropoiesis, which results in absolute erythrocytosis, impaired rheological and coagulation properties of blood, myeloid metaplasia of phenergan pills. High blood viscosity causes a tendency to vascular thrombosis and hypoxic tissue damage, and hypervolemia causes increased blood supply to internal organs. At the end of polycythemia, depletion of hematopoiesis and myelofibrosis are noted.
In hematology, there are 2 forms of polycythemia - true and relative. Relative polycythemia develops with normal red blood cell counts and decreased plasma volume. This condition is called stress or false polycythemia and is not discussed within the scope of this article. Polycythemia vera (erythremia) can be primary or secondary in origin. The primary form is an independent myeloproliferative disease, which is based on damage to the myeloid lineage of hematopoiesis.
Characterized by anemia, thrombocytopenia, leukopenia, myeloid transformation of the liver and spleen, secondary myelofibrosis. Possible outcomes of promethazine into other hemoblastoses. The most characteristic feature of polycythemia is the development of plethoric syndrome, caused by pancytosis and an increase in blood volume. Evidence of plethora is telangiectasia, cherry-red coloring of the skin (especially the face, neck, hands and other open areas) and mucous membranes (lips, tongue), hyperemia of the sclera. A typical diagnostic sign is Cooperman's sign - the color of the hard palate remains normal, but the soft palate acquires a stagnant cyanotic hue.
Another distinctive symptom of polycythemia is skin itching, which intensifies after water procedures and sometimes becomes unbearable. Specific manifestations of polycythemia also include erythromelalgia - a painful burning sensation in the fingertips, which is accompanied by their hyperemia. The consequence of ineffective erythropoiesis in polycythemia is an increase in the synthesis of uric acid and a violation of purine metabolism. This finds clinical expression in the development of the so-called urate diathesis - gout, urolithiasis, renal colic. The result of microthrombosis and disruption of the trophism of the skin and mucous membranes are trophic ulcers of the leg, gastric and duodenal ulcers. The most common complications in the polycythemia clinic are vascular thrombosis of the deep veins, mesenteric vessels, portal veins, cerebral and coronary arteries.