Choleretic funds can be divided into 2 groups: means that enhance the formation of bile and bile acids (Choleretica or Cholesecretica), and means that promote the secretion of bile from the gallbladder into the intestine (Cholagoga, or Cholekinetica).
The I subgroup includes preparations containing bile acids and bile: allohol, liobil, cholenzyme, etc., a number of plant-based products (immortelle flowers, corn silk, flacumin, convaflavin, berberine, etc.), as well as some synthetic drugs (oxafenamide, nikodin, tsikvalon).
The mechanism of action of choleretic substances is due to reflexes from the intestinal mucosa (especially when using preparations of bile and bile acids and preparations containing essential oils), as well as their effect on the secretory function of the liver parenchyma. They increase the amount of secreted bile, increase the osmotic gradient between bile and blood, which increases osmotic filtration into the bile capillaries of water and electrolytes, increases the bile flow through the bile ducts and the content of cholates in bile, reduces the possibility of bile cholesterol precipitates, which prevents the formation of bile cholesterol. gallstones. They also enhance the secretory and motor functions of the gastrointestinal tract.
Preparations containing bile and bile acids can serve as means of substitution therapy for endogenous bile acid deficiency.
Preparations that promote the secretion of bile can act by increasing the tone of the gallbladder (cholekinetics) and / or lowering the tone of the biliary tract and the Oddi sphincter (cholespasmolytic).
Magnesium sulfate, barberry and some other drugs have a cholekinetic effect. The relaxation of the biliary tract tone is caused by various antispasmodics (papaverine, no-spa, olimethin, etc.), anticholinergics, as well as nitrates, aminophylline, etc.
Most choleretic drugs have a combined effect, enhancing the secretion of bile and facilitating its entry into the intestine, and some drugs have both anti-inflammatory (cycvalone) and antibacterial (nicodin) effects.
It should be borne in mind that the effect of choleretic drugs to a certain extent is <hepatoprotective> character. By alleviating the flow of bile and reducing the burden on the liver parenchyma, facilitating blood flow, reducing inflammation, cholagogue helps to improve the overall functional state of the liver.
- Berberine bisulfate (Berberini bisulfas)
- Vigeratin (Vigeratinum obductae)
- Hymecromone (Hymecromone)
- Konvaflavin (Convaflavinum)
- Liobil (Liobilum)
- Nicodinum (Nicodinum)
- Oxaphenamide (Oxaphenamidum)
- Bars with corn stigmas (Stylicum stigmatis Zea Maydis)
- Tanacechol (Tanacecholum)
- Cholenzim (Cholenzynum obductae)
- Flowers of immortelle sandy (Flores Helichrysi arenarii)
- Cyclaval (Cycvalonum)