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4SCIENTIFIC PROGRESS VOLUME 4 I ISSUE 2 I 2023 _ISSN: 2181-1601
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CORRECTION MAGNESIUM DEFICIENCY WITH TINCTURE TINCTURAE
MORUS
Bakhodirjon Sharipovich Samadov
Department of Pharmacology and Clinical Pharmacology, Bukhara state medical
institute named after Abu Ali ibn Sino
ABSTRACT
C Minerals are necessary to ensure the normal functioning of the body. They maintain the constancy of the internal environment, acid-base balance, water-salt metabolism. Almost all the chemical elements of the periodic table of D.I. Mendeleev are involved in the physiological and pathological processes of a person. The human body consists of 60% water, 34% organic substances and 6% inorganic substances. Scientists have long drawn attention to the fact that many diseases are associated with a lack of a chemical element in the body (hypoelementosis).
Keywords. Magnesium, Potassium, Deficiency, Correction, Vegetable Tincture, Tincturae Morus.
Relevance. Hypoelementosis can cause not only temporary disorders in the body, but also contribute to the development of serious diseases. In recent years, there has been an increasing interest in studying the biological role of macro and microelements [3,4]. It is not by chance that special attention is paid to potassium and magnesium as one of the most common in the human body. Potassium and magnesium in ionized form are positive ions - cations, respectively, with one (K+) and double positive charges (Mg2+). These are some of the most common elements on Earth. There is especially a lot of potassium and magnesium in the water of the World Ocean, the electrolyte composition of which is close to the electrolyte composition of blood serum [1,2]. Potassium is the main intracellular cation of tissues of various organs, approximately 98% of it is concentrated inside cells. Under normal conditions, its cell contains 150160 mmol/l, and in blood serum - 3.7-5.5 mmol/l. Most of the potassium in the body is located intracellularly, therefore, a significant loss of intracellular potassium is possible without major changes in its content in serum.
Materials and methods of research. Potassium plays an essential role in the bioelectric activity of cells and the maintenance of neuromuscular excitability and conduction [5,6]. Under normal conditions, potassium comes from food and is absorbed through the gastrointestinal tract (gastrointestinal tract), followed by the excretion of excess through the kidneys. Hypokalemia is a persistent decrease in serum potassium
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concentration (less than 3.5 mmol/l). The body of an adult weighing 70 kg contains 136.85 g or 3500 mmol of potassium [7,8].
Causes of hypokalemia:
1. Insufficient (less than 10 meq / day) intake of potassium into the body with food (with fasting or restriction of intake of products containing potassium, decreased intestinal absorption) [9,10].
2. Excessive excretion of potassium from the body as a result of: - chronic profuse diarrhea (intestinal secretions contain a large amount of potassium);
- repeated vomiting (the potassium content in gastric juice is low, but the development of hypovolemia causes secondary hyperaldosteronism and increased excretion of K + ions by the kidneys);
- increased excretion of potassium by the kidneys with improper use of diuretics, primary and secondary hyperaldosteronism, defects of the renal tubules (Bartter syndrome, renal tubular acidosis), damage to the renal tissue by nephrotoxic substances, including drugs (penicillin's, gentamicin, amphotericin B), hypomagnesemia (contributes not only to the release of potassium from cells, but also increases its excretion with urine) [11,12].
3. Redistribution of potassium ions from the blood and/or intercellular fluid into cells under conditions of:
- increased insulin levels in the blood;
- hypercatecholaminemia (as a result of the use of adrenaline, norepinephrine, dopamine, with pheochromocytoma, acute stress);
- overdose of folic acid or vitamin B12 (these substances stimulate cell proliferation and their consumption of potassium ions).
The results obtained and their discussions. The symptoms of violations of potassium homeostasis depend on its content in the body (at the same time, the concentration indicators of potassium in plasma inaccurately reflect the state of potassium balance, although they have a fairly narrow limit of fluctuations) [13,14]. The main manifestations of hypokalemia are associated with a violation of the electrical properties of the membranes of excitable tissues. Complaints and symptoms accompanying a decrease in potassium levels in the body are diverse and nonspecific, which allows us to speak not about the clinical picture, but about numerous clinical masks of hypokalemia [15,16]. The most frequent of them are neuromyopathic and psych emotional disorders, cardiac syndrome, polyuria and polydipsia syndrome. An imbalance of potassium leads to a violation of the polarization and depolarization of cell membranes, a violation of the function of folinesterase. The main result of these shifts is a disorder of the process of transmission of excitation from the nerve to the muscle, which is clinically expressed by fatigue, muscle weakness, leg muscle spasms,
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paresthesia in the extremities, extinction of tendon reflexes in old age [17,18]. Nonspecific symptoms of hypokalemia - loss of appetite, loss of concentration, apathy. Hypokalemia is also manifested by disorders of cardiovascular activity, characterized by inhibition of the contractile function of the myocardium, the occurrence of systolic noise at the apex of the heart and the expansion of its cavities, a decrease in blood pressure [19,20]. The cardio reducing effect of potassium iron deficiency in the body is reflected early on the ECG, and therefore it can be used as an indicator of latent hypokalemia. Permanent, albeit nonspecific and ECG signs are frequent ventricular extra systoles, QRS prolongation, ST segment decrease, depression or inversion of the T wave, pronounced U wave. Patients taking cardiac glycosides are particularly sensitive to hypokalemia [21,22]. As applied to gastroenterology and urology, this means that damage to smooth muscles leads to intestinal paresis, weakening of intestinal noises, vomiting, flatulence, constipation, and bladder atony [23, 24]. Chronic hypokalemia is accompanied by functional and structural damage to the central and peripheral nervous system. CNS dysfunction is realized by psych emotional disorders in the form of shallow asthenic, anxiety-depressive or hypochondriac syndromes. Polymorphic sensory disorders are represented by mild paresthesia of the face and limbs, or loss of pain and tactile sensitivity, or, on the contrary, pronounced hyperesthesia. Neuromotor symptoms usually correlate with the depth and duration of hypokalemia, ranging from limb muscle weakness and low tendon reflexes to general paralysis, including respiratory muscles [25, 26]. Magnesium is a cofactor of many enzymes involved in intracellular biochemical reactions. In addition, magnesium is a natural physiological antagonist of calcium, a universal regulator of biochemical and physiological processes in the body, provides ATP hydrolysis, reducing the separation of oxidation and phospholation, regulates glycolysis, reduces the accumulation of lactate. Magnesium contributes to the fixation of potassium in cells, providing polarization of cell membranes, controls the spontaneous electrical activity of the nervous tissue and the conducting system of the heart, controls the normal functioning of the cardio myocyte at all levels of subcellular structures [27, 28]. Clinical manifestations of magnesium deficiency - increased heart rate, increased diastolic blood pressure, sleep disorders, increased excitability, chronic fatigue syndrome. Low magnesium concentration in erythrocytes is combined with increased blood pressure at rest and under stress, as well as with coronary artery spasm. On an ECG, magnesium deficiency is manifested by a slowdown in atrioventricular conduction, a broadening of the QRS complex, an elongation of the QT interval, a nonspecific decrease in the ST interval, a flattening of the T wave and the formation of a pronounced U wave. The consequence of potassium-magnesium deficiency in clinical practice is quite often cardiac arrhythmias [29, 30]. One of them is atrial fibrillation (AF), characterized by uncoordinated electrical foci of
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excitation of the atrial myocardium with deterioration of their contractile function. AF tends to become more frequent with age, can be accompanied by severe hemodynamic disorders and in the vast majority of cases is a consequence of a violation of the intracellular potassium-magnesium balance in cardio myocytes [31, 32]. AF is observed in approximately 1% of patients under 60 years of age and more than 6% over 80 years of age, and adjusted for age, the prevalence of AF is higher in men. Paroxysms of AF as a cause of hospitalization of patients with CVD account for more than 1/3 of all hospitalizations for cardiac arrhythmias. AF is most often associated with coronary heart disease (CHD), chronic heart failure (CHF), arterial hypertension (AH). In restoring the sinus rhythm in AF, the state of potassium-magnesium balance is important, providing a membrane-stabilizing effect. Another type of supraventricular and ventricular arrhythmias caused by a lack of potassium and magnesium are extra systoles [33, 34]. The occurrence of extra systoles is influenced by the state of the nervous system: they are often observed in neurosis and emotional stress (joy, anger, fright, fear, etc.), accompanied by an intense loss of potassium and magnesium. Magnesium deficiency can be decisive in the occurrence of ectopic foci, especially in patients taking cardiac glycosides. Chronic magnesium deficiency adversely affects the course of coronary heart disease. This is due to impaired endothelial function, activation of peroxidation processes, accelerated progression of atherosclerosis, increased ectopic activity of the myocardium [35, 36]. In CHD, many different factors are involved in the mechanisms of development of the protective effect of ischemic preconditioning. Mitochondrial Ca2+-activated K+ channels and their influence on oxidative phosphorylation in mitochondria play a leading role in maintaining a normal intracellular energy-phosphate balance [37, 38]. Pharmacological discovery of ATP-dependent K+ channels using membrane-stabilizing potassium-magnesium preparations reproduces the protective effect of ischemic preconditioning - protection of cardio myocytes from ischemic damage. In addition, chronic magnesium deficiency increases the basal tone of coronary vessels and their tendency to vasospasm [39, 40]. Based on the described role of magnesium and potassium in CVD, timely replenishment of their reserves in the body is an urgent task. Taking into account the antiatherogenic effects of magnesium preparations, correction of its deficiency may contribute to slowing the progression of coronary heart disease [41, 42]. In the study The Atherosclerosis Risk in Communities (ARIC), after 4-7 years of follow-up of 13,922 patients, risk factors accounting showed that hypomagnesemia is associated with the development of coronary heart disease [43, 44]. The most pronounced magnesium deficiency is found in individuals with an increased content of atherogenic lipids. Studies conducted in recent years to study the role of magnesium and potassium in CVD can open up new opportunities for their preparations. However, it is not always with the modern rhythm
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of life that we manage to pay due attention to our diet and daily include foods rich in potassium and magnesium in it. Thus, the optimal ratio of potassium and magnesium is the basis for the normal functioning of the body. Within the framework of a large-scale strategic campaign in the field of healthcare, which is carried out by specialists in order to preserve the health of the population and prevent the progression of chronic CVD, much attention is paid to lifestyle modification, as well as the use of herbal preparations. Mulberry fruits contain a huge amount of elements, are a rich source of natural antioxidant. The great scientist Abu Ali ibn Sino described in his treatises the useful and healing properties of mulberry. Mulberry fruits contain many vitamins and minerals necessary for the body, such as Calcium - 39 mg, Iron - 1.85 mg, Magnesium - 18 mg, Phosphorus - 38 mg, Potassium - 194 mg, Sodium - 10 mg, Zinc - 0.12 mg. Mulberry tincture (Tincturae Morus) is an alcoholic extraction of mulberry fruits from vegetable raw materials. It is used for hypokalemia, hypomagnesemia and their correction in elderly people. The use of Tincturae Morus is possible for prophylactic purposes in patients with vegetative-vascular dystonia, arterial hypertension, diabetes mellitus, chronic heart failure, as well as for the correction of endothelial dysfunction and atherosclerosis [45, 46]. The content of the natural antioxidant resveratrol in Tincturae Morus tincture has a positive metabolic effect on myocardial metabolism, and potassium and magnesium reduce the toxicity of glycoside preparations in the treatment of CHF, without adversely affecting their positive inotropic effect [47,48]. Indications for the use of Tincturae Morus are mineral deficiency conditions, as part of complex therapy in the treatment of heart failure, myocardial infarction, metabolic syndrome (obesity, hypertension, impaired glucose tolerance, type 2 diabetes mellitus) [49].
Conclusions. The development of potassium and magnesium deficiency is accompanied by a variety of cardiovascular disorders, especially in patients who already have heart and vascular diseases, taking antiarrhythmic, diuretic drugs in old age. The purpose of herbal tincture Tincturae Morus is a kind of substitution therapy and as a goal pursues the restoration of physiological processes that occur with the participation of these electrolytes. A herbal preparation containing a huge amount of important trace elements is considered effective in the combination therapy of cardiovascular diseases in old age.
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