Statutory, legal, scientific and productive aspects of conditions and prospects of development of antidote therapy in the Russian Federation

The modern period in the development of the world community and the Russian Federation in particular is characterized by the globalization of chemical danger. The increase of chemical hazards is determined by the growing potential of the chemical industry in developed countries, widespread use of highly toxic substances in industry, presence of not destroyed stockpiles of chemical weapons abroad, bolstering terrorist manifestations etc. In these circumstances one of the components of the concept of medical support for chemical safety is the existence of a scientifically based system for the development and application of medical technologies for the treatment and prophylaxis of chemical poisoning. The system of emergency specialized toxicological assistance that exists in the Russian Federation suggests the use of means of antidote therapy. However, the analysis of the reports of centers / departments of acute poisoning indicates the lack of significant means of specific pharmacotherapy there. Also there are no important antidotes to cyanides, irritants or alcohol substitutes on Russia's pharmaceutical market. After the analysis of the state of the scientific, technological and industrial base, as well as the analysis of the potential hazards of a chemical nature, it is necessary to underline, that the main directions for the optimization of the antidote therapy system in the Russian Federation should include experimental and clinical studies aimed at the development and creation of innovative antidotes (or adaptation and licensing of various pharmacopeial drugs). The short-term tasks of research, production and regulatory development of the antidote therapy system in the Russian Federation are connected with the completion of the development, registration and acceptance of domestic means of antidote therapy (antidotes to cyanides, combustion products, irritants, psychodisleptics), improvement of technical means of applying existing antidotes, legal regulations in the sphere of providing access to antidotes for medical units and organizations.

1. Medical toxicology: national leadership / Ed. E.A. Luzhnikov. Moscow: GEOTAR-Media, 2012. 928 p. (in Russian).

2. Ellenhorn M. Dzh. Medical toxicology: diagnosis and treatment of human poisoning. Transl. from Engl. V. 1. Moscow: Meditsina, 2003. P. 1004 (in Russian).

3. The Encyclopedia of poisons and antidotes / Ed. Turkington C., Mitchell D. New York, 2010. 324 р.

4. Guideline for poison control. WHO publication. Geneva, 1998. V. IX. Transl. from Engl. М.: Meditsina, 1998. P. 113 (in Russian).

5. Conceptual approaches to the development of the antidote system of the Russian Federation / Ed. Uyba V.V., Nazarov V.B., Gladkikh V.D. М.: «Comment» Publishing House, 2013. P. 300 (in Russian).

6. Antidote therapy of poisoning with highly toxic substances in emergency situations. Guide / Ed. Gladkikh V.D., Sarmanayev S.Kh., Ostapenko Yu.N. M.: «Comment» Publishing House, 2014. P. 271.

7. Nazarov V.B., Gladkih V.D., Belovolov A.Y. Antidote therapy in protection arrangement system aimed to eliminate medical and sanitary consequences in emergency situations: status and prospects // Medicine of Extreme Situations. 2013. № 1 (43). P. 6–18 (in Russian).

8. Nazarov V.B., Gladkih V.D., Belovolov A.Y., Nikolayev V.A. Conceptual aspects of scientific and legal development of the antidote therapy system in the Russian Federation / In: Materials of the Scientific and Practical Conference «The State and Prospects for the Development of Medical Protection from Extreme Factors» Moscow: 2012. P. 9–22 (in Russian).

9. Ostapenko Yu.N., Nikolaev V.A., Nazarov V.B., Gladkikh V.D. On the issue of the determination of the nomenclature of means of antidote therapy intended for the elimination of medical and sanitary consequences of chemical emergencies / In: Materials of the scientific and practical conference «Actual issues of radiation medicine and industrial toxicology». Krasnoyarsk, 2012. P. 148– 151 (in Russian).

10. Nazarov V.B., Gladkikh V.D., Belovolov A.Yu. et al. The role and place of antidote therapy in the system of medical care for acute industrial poisoning with highly toxic chemicals / In the book: Materials of the scientific and practical conference «Actual issues of health care of chemically hazardous facilities». Volgograd, 2012. P. 119–124 (in Russian).

11. Gladkikh V.D., Chizh I.M., Belykh V.G. Antidote therapy in the system of measures aimed at eliminating the health consequences of emergency situations // Medicine of Extreme Situations. 2015. № 3. P. 29–33 (in Russian).

12. Simonenko V.B., Sarmanaev S.Kh., Gladkikh V.D., Prostakishin G.P. Acute chemical injury: current issues in the organization of emergency assistance // Health. Medical ecology. The science. 2012. V. 1–2. No. 47–48. P. 102–103 (in Russian).

13. Chizh I.M., Gladkikh V.D., Belykh V.G. et al. On the issue of the formation of the reserves of means of antidote therapy for the elimination of medical and sanitary consequences of emergency situations // Kremlin medicine. Clinical Herald. 2015. No. 2. P. 119– 124 (in Russian).

14. Methodological aspects of the formation of regional reserves of means of specific pharmacotherapy of acute poisoning, taking into account the assessment of the potential impact of non-stationary environmental factors in emergency situations of chemical nature: monograph / Ed. Gladkikh V.D., Viktorov A.A., Nazarov V.B. M.: «Comment» Publishing House, 2015. P. 272. 2013. P.300 (in Russian).

15. Conceptual approaches to the development of antidote security of the Russian Federation / Ed. Uiba V.V., Nazarov V.B., Gladkikh V.D. M .: FMBA, 2013. 304 p. (in Russian).

16. Ostapenko Yu.N., Rozhkov P.G., Kazachkov V.I. et al. Acute poisoning in Russia and the state of toxicological assistance. // Collection of materials of the All-Russian scientific and practical conference «Actual directions of development of medical means of protection against extreme factors». M. 2017. P. 25–30 (in Russian).

17. Gladkikh V.D., Druzhkov A.V., Balandin N.V. The state and prospects for the development of antidotes and antiradiation drugs in the Russian Federation // News of the Russian Military Medical Academy, 2017. V. 36. No. 2 (Appendix 1). P. 134 (in Russian).

18. Gladkikh V.D. Acute poisoning with hazardous chemicals. Diagnosis and treatment. Guide. M. Publishing House «Comment», 2018. P. 264 (in Russian).

19. Gladkikh V.D., Belykh V.G., Timoshevsky A.A., Chizh I.M. Special means of medical anti-chemical and radiation protection: current status and development prospects // Military Medical Journal, 2018. V. 339. № 1. P. 29–36 (in Russian).

20. Gladkikh V.D., Belovolov A.Yu., Balandin N.V. Regulatory, scientific and production aspects of the state of antidote support in the Russian Federation // Biomedical journal, 2015. V. 16, 2. P. 8–18 (in Russian).