#7-2. Conservative Therapy

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2. Medicaion in phlebology

Conservative medication can alleviate symptoms of varicose veins but does not provide fundamental treatment. Drugs used in phlebology include vein tonic, capillary tonic, lymph tonic, diuretics, anti-inflammation drugs, vasodilator, anticoagulant, thrombolytic agent, antibiotics, sclerosis treatment, wound healing drugs, anticongestants, and analgesics. They can be selected depending on symptomatology.

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a. Vein tonic

Vein tonic improves elasticity of veins and reduces vein wall loss as well as other functional problems (leg spasms, throbbing pain, and edema). e.g. Venitol, Daflon 500.

b. Capillary tonic

It increases elasticity of capillary veins. The therapeutic actions include reduction of permeability and enhancement of resistance force.

c. Lymphatic duct tonic

It is used for lymph duct problems, especially, lymph duct induced edema.

d. Diuretics

Diuretics are used for treatment of edema.

e. Anti-inflammatory drugs

They used in varicophlebitis.

f. Vasodilators

Vasodilators can be used when there is congestion in extremities due to arteriospasm. This condition can cause tissue hypoxia from poor circulation.

g. Anticoagulants

Anticoagulants are necessary in severe phlebitis and are beneficial in circulatory disturbances of the foot and ankle. Treatment of deep phlebitis follow three steps; stopping thrombosis progression with anticoagulant, thrombolysis, and surgical removal of thrombus. Classican heparin in one of the longest used anticoagulant. Recently, low molecular weight heparin (LMWH) is used. Emoxaparine (Covenox, Clexane) is another type of anticoagulant.

h. Thrombolytic agents

In clinical practice, there is a gap between diagnosis and treatment initiation. This delay can be lethal in patients with pulmonary embolism. Phlebography (X-ray imaging of veins after IV injection) is a diagnostic tool for confirming thrombosis as well as treatment (therapeutic phlebography). Streptokinase (Streptase) is a drug that can prevent pulmonary embolism and formation of additional thrombus as well as promote rapid repermeability of thrombotic veins.

i. Antibiotics

They are used in lymphadenopathy, severe lower limb dermatitis and inflammatory ulcer. They can also be used in chronic ulcers after antimicrobial resistance test.

j. Sclerosis drugs

In continuous progression of varicose veins, circulatory disturbance of the foot and leg can cause sclerosis of the subcutaneous connective tissues.

k. Wound healing drugs

Wound healing drugs are used to activate the healing mechanism and promote removal of necrotic tissues and formation of new tissues.

l. Anticongestants

They act locally to relieve congestion.

m. the vegetable therapy

Vegetable therapy is a type of alternative medicine using vegetables.