Antibiotics and non-steroidal anti-inflammatory drugs. Anti-inflammatory nonsteroidal drugs

Anti-inflammatory nonsteroidal drugs (NSAIDs, NSAIDs) are a new generation of medicines that have anti-inflammatory, antipyretic and analgesic (analgesic) effects. Their mechanism of action is based on blocking certain enzymes (cyclooxygenase, COX), which are responsible for the formation of prostaglandins - chemicals that contribute to pain, fever, and inflammation.

• How NSAIDs work
  • When are NSAIDs used?
• • The main advantage of new generation NSAIDs
  • What are next-generation NSAIDs?
  • NSAID classification
  • Choice of dosage
  • Side effects
  • Use during pregnancy
• • Movalis
  • Celecoxib
  • Indomethacin
  • Ibuprofen
  • Diclofenac
  • Chondroprotectors - alternative drugs

The word “non-steroidal” in the name of these drugs indicates the fact that drugs in this group are not artificial analogs of steroid hormones - the most powerful anti-inflammatory hormonal drugs. The most popular NSAIDs are diclofenac, ibuprofen.

How NSAIDs work

While analgesics are meant to control pain, NSAIDs reduce two unpleasant symptoms of the disease: inflammation and pain. Many drugs in this group are considered non-selective inhibitors of the cyclooxygenase enzyme, which suppress the effects of both its isoforms (types) - COX-1 and COX-2.

Cyclooxygenase is responsible for the formation of thromboxane and prostaglandins from arachidonic acid, which is obtained, in turn, from the phospholipids of the cell membrane using the enzyme phospholipase A2. Among other functions, prostaglandins are regulators and mediators in the formation of inflammation.

When are NSAIDs used?

Most often, NSAIDs are used to treat chronic or acute inflammation that is accompanied by pain. Anti-inflammatory nonsteroidal drugs have gained great popularity due to the effective treatment of joints.

Let's list the diseases for which these medicines are prescribed:

NSAIDs should not be used during erosive and ulcerative lesions of the gastrointestinal tract, especially at the stage of exacerbation, cytopenias, pronounced disorders of the kidneys and liver, pregnancy, individual intolerance. They are obliged to be prescribed with caution to patients with asthma, as well as to people who have previously had negative reactions while taking any other NSAIDs.

Non-steroidal anti-inflammatory drugs: a list of NSAIDs for the treatment of joints

Consider the most effective and well-known NSAIDs that are used to treat joints and other diseases when antipyretic and anti-inflammatory effects are required:

Some medical drugs are weaker, not as aggressive, some are designed for acute arthrosis, if emergency intervention is necessary in order to stop dangerous processes in the body.

The main advantage of new generation NSAIDs

Side effects are noted during prolonged use of NSAIDs (for example, during the treatment of osteochondrosis) and consist in damage to the intestinal and stomach mucosa with the formation of bleeding and ulcers. This lack of indiscriminate NSAIDs was the reason for the creation of new generation drugs that block only COX-2 (an enzyme of inflammation) and do not affect the function of COX-1 (a protective enzyme).

That is, new generation drugs have almost no ulcerogenic side effects (damage to the mucous membranes of the digestive system) associated with prolonged use of non-selective NSAIDs, but increase the chance of thrombotic complications.

Of the disadvantages of new generation drugs, only their high cost can be distinguished, which makes them inaccessible to most people.

What are next-generation NSAIDs?

New generation anti-inflammatory nonsteroidal drugs act much more selectively, they inhibit COX-2 to a greater extent, and COX-1 remains almost unaffected. This can explain the rather high effectiveness of the drug in combination with a minimum of side effects.

List of effective and popular new generation anti-inflammatory non-steroidal drugs:

• Ksefokam. A drug based on Lornoxicam. Its characteristic feature is the fact that the drug has an increased ability to relieve painful sensations. According to this indicator, it is similar to morphine, but at the same time does not create addiction and does not have an opiate-like effect on the central nervous system.
• Movalis. Has antipyretic, well-pronounced anti-inflammatory and analgesic effect. The main advantage of this drug is that with the constant supervision of a doctor, it can be used for quite a long time. Meloxicam is produced in the form of a solution for intramuscular injections, in ointments, suppositories and tablets. The tablets of the drug are quite convenient in that they have a long-lasting effect, and it is enough to use one tablet throughout the day.
• Nimesulide. It is successfully used to treat arthritis, vertebral back pain, etc. Normalizes temperature, relieves hyperemia and inflammation. Taking the drug quickly leads to improved mobility and pain relief. It is also used in the form of an ointment for application to the problem area.
• Celecoxib. This drug significantly eases the patient's condition with arthrosis, osteochondrosis and other diseases, effectively fights inflammation and relieves pain. Side effects on the digestive system from the drug are minimal or completely absent.

In cases where long-term intake of anti-inflammatory nonsteroidal drugs is not needed, then drugs of the old generation are used. However, sometimes this is simply a necessary measure, since not all people can afford the course of treatment with these drugs.

NSAID classification

According to their chemical origin, these drugs come with non-acidic and acidic derivatives.

Acidic preparations:

Non-acidic preparations:

• Sulfonamide derivatives;
• Alcanones.

At the same time, non-steroidal drugs differ in intensity and type of action - anti-inflammatory, analgesic, combined.

According to the strength of the anti-inflammatory effect of medium doses, the drugs are arranged in the following sequence (from above the strongest):

• Flurbiprofen;
• Indomethacin;
• Piroxicam;
• Diclofenac sodium;
• Naproxen;
• Aspirin;
• Amidopyrine;
• Ibuprofen.

According to the analgesic effect, the drugs are arranged in the following order:

Most often, the above NSAID drugs are used for chronic and acute diseases that are accompanied by inflammation and pain. As a rule, anti-inflammatory nonsteroidal drugs are used to treat joints and relieve pain: injuries, arthrosis, arthritis, etc.

Often NSAIDs are used for pain relief for migraines and headaches, renal colic, postoperative pain, dysmenorrhea, etc. Due to the inhibitory effect on the synthesis of prostaglandins, these drugs also have an antipyretic effect.

Choice of dosage

Any drug that is new to the patient should be prescribed in the beginning in the minimum dose. With normal tolerance, the daily dose is increased after a few days.

Therapeutic dosages of NSAIDs are in a wide range, while recently there has been a trend towards an increase in single and daily doses of drugs that are excellently tolerated (ibuprofen, naproxen), while maintaining restrictions on the maximum dosage of indomethacin, aspirin, piroxicam, phenylbutazone. In some patients, the therapeutic effect is achieved only with the use of higher doses of NSAIDs.

Side effects

Long-term use of anti-inflammatory drugs at higher dosages can cause:

Treatment with NSAIDs must be carried out for the shortest possible time and in the minimum doses.

Use during pregnancy

It is undesirable to use drugs of the NSAID group during pregnancy, especially in the third trimester. Although no direct teratogenic effects are found, it is believed that NSAIDs can cause renal complications in the fetus and premature closure of the ductus arteriosus. There is also information about preterm birth. Despite this, aspirin in combination with heparin has been used successfully in women with antiphospholipid syndrome.

Description of nonsteroidal anti-inflammatory drugs

Movalis

It is a leader among non-steroidal anti-inflammatory drugs, which has a long duration of action and is approved for long-term use.

It has a pronounced anti-inflammatory effect, which makes it possible to use it for rheumatoid arthritis, ankylosing spondylitis, osteoarthritis. Protects cartilage tissue, is not devoid of antipyretic and analgesic properties. Used for headache and toothache.

Determination of doses, administration options (suppositories, injections, pills) depends on the type and severity of the disease.

Celecoxib

COX-2 inhibitor, which has a pronounced analgesic and anti-inflammatory effect. When used in therapeutic doses, it has almost no negative effect on the gastrointestinal mucosa, since it has a rather low degree of affinity to COX-1, and therefore does not cause a violation of the synthesis of constitutional prostaglandins.

Indomethacin

It belongs to the most effective non-hormonal drugs. In arthritis, it reduces joint swelling, relieves pain, and has a strong anti-inflammatory effect. When using a medicine, you need to be careful, since it has a large list of side effects. In pharmacology, the drug is manufactured under the names Indovis EC, Indovazin, Indocollir, Indotard, Metindol.

Ibuprofen

It combines the ability to effectively reduce pain and temperature, relative safety, therefore, drugs based on it can be bought without a prescription. Ibuprofen is used as an antipyretic drug, including for newborns.

As an anti-inflammatory drug, it is not used so often, but the drug is very popular in rheumatology: it is used to treat osteoarthritis, rheumatoid arthritis and other joint diseases.

The most popular names include Nurofen, Ibuprom, MIG 400 and 200.

Diclofenac

Manufacturing form - capsules, tablets, gel, suppositories, injection solution. This drug for the treatment of joints perfectly combines both a high anti-inflammatory effect and a high anti-pain activity.

Manufactured under the names Naklofen, Voltaren, Diklak, Ortofen, Vourdon, Diklonac P, Dolex, Olfen, Clodifen, Dikloberl, etc.

Chondroprotectors - alternative drugs

Chondroprotectors are very often used to treat joints. People often do not understand the difference between chondroprotectors and NSAIDs. The latter quickly remove pain, but at the same time have many side effects. And chondroprotectors protect the cartilage tissue, but they must be used in courses. The most effective chondroprotectors contain two substances - chondroitin and glucosamine.

Anti-inflammatory nonsteroidal drugs are excellent helpers during the treatment of many diseases. But we must not forget that they only remove the negatively affecting symptoms on well-being, the treatment of diseases directly is carried out by other methods and drugs.

Non-steroidal anti-inflammatory ointments (NSAIDs): a list of drugs (creams, gels)

As a rule, anti-inflammatory ointments are used externally. But today you can buy products that have a creamy texture, which are taken orally, intervaginally and rectally.

Anti-inflammatory cream is used to treat joints, allergies and infections. But often such drugs are referred to as methods of auxiliary therapy.

In addition, almost all anti-inflammatory ointments have anesthetic and regenerative effects. Therefore, they are used to treat:

• diseases of the musculoskeletal system;
• bruises;
• injuries;
• local inflammation;
• pathologies of muscles and back.

The principle of the treatment of joint diseases and other diseases is to suppress the production of inflammatory substances - mediators (kinin, prostaglandins, lysosomal enzymes, histamine) by cells.

Also, anti-inflammatory ointments are intended for cutaneous use. However, there are agents that need to be inserted directly into the intestine into the vagina or applied to the mucous membrane.

Non-steroidal anti-inflammatory ointments are often used in a wide variety of medical fields. Today there are many ointments that are used:

1. for the treatment of joints;
2. in orthopedics;
3. gynecology;
4. infectology;
5. dermatology;
6. venereology.

The advantage of this form of release is that the gel or ointment does not spread along with the blood throughout the body, that is, their effect is local.

Anti-inflammatory drugs for ODA diseases

Today there are a lot of pathologies in which there is damage and destruction of bones and joints. The main component of the treatment of rheumatoid diseases is NSAIDs.

The pain syndrome in the case of osteochondrosis, gouty arthritis or arthrosis is so strong that the patient immediately seeks medical help.

The first drugs that the doctor prescribes are NSAIDs. For maximum effect, anti-inflammatory creams and anti-inflammatory joint ointments are also prescribed, which are applied topically.

There are several groups of drugs, each of which is based on a specific component:

• indomethacin;
• diclofenac;
• nimesulide;
• ibuprofen;
• piroxicam;
• ketoprofen.

Preparations for inflammation, the main active ingredient of which is diclofenac, are very effective after suffering injuries, with neurology and degenerative changes in the joints.

Diclofenac helps to quickly restore the mobility of the joint, it reduces swelling, local temperature in the affected area and has an analgesic effect. The trade name for NSAIDs based on diclofenac is Ortofen ointment, Diclofenac gel, Diclac-gel, Diclovit and Voltaren.

Note! Diclofenac gel or ointment should not be used to treat children under 6 years of age and pregnant women.

It is also forbidden to apply it to damaged skin areas, and people suffering from stomach and duodenal ulcers can use such drugs only after a doctor's approval.

Ibuprofen

Drugs that remove inflammation, which include ibuprofen (Nurofen, Dolgit), are indicated for the same symptoms as when using diclofenac-based drugs. That is, their main effect is pain relief and elimination of inflammation.

However, such funds cannot be used if you have:

• "Aspirin" asthma;
• kidney and liver diseases;
• children under 2 years old;
• gastrointestinal diseases;
• pregnancy;
• during lactation.

Cream that eliminates inflammation with ketoprofen is used for various injuries and degenerative changes in the joints. Ketoprofen also prevents blood clots from forming.

Products based on it should not be applied to damaged skin. Also NSAIDs with ketoprofen are contraindicated in children under 12 years of age and pregnant women.

The most common remedies, the main component of which is ketoprofen:

1. Febrofid;
2. Fastum gel;
3. Artrosilene;
4. Ketonal;
5. Febrofid.

Indomecin

To the means, the basis of which is indomethacin, referring: Indovazin, Sopharma, Indomethacin-Acri and - Sophara. Their action is similar to ketoprofan, however it is not so pronounced, and the indications and contraindications are similar to those of similar NSAIDs

Anti-inflammatory analgesic cream Finalgel belongs to the group of piroxicam-containing medicines. The gel restores joint health, relieves puffiness and relieves pain without overdrying the skin.

This remedy is used for osteoarthritis, periarthrosis and tendenitis. It is forbidden to use the gel for pregnant women and children.

Indovazin cream, the main active ingredient of which is nimesulide. This is the only medication from the entire group of NSAIDs designed for the safe treatment of joints.

Gel Indovazin in comparison with other drugs is not so toxic, therefore it does not have a harmful effect on the gastrointestinal tract. But despite this, like other drugs, Indovazin can be used only after a doctor's prescription, because it also has side effects, albeit less significant.

Contraindications to the use of the product are as follows:

• age up to 3 years;
• joint and bone injuries;
• osteochondrosis;
• bursitis;
• arthritis.

It should be noted that the process by which anti-inflammatory agents are rubbed into the skin helps to accelerate and improve the effect of the agent. Topical topical preparations for the treatment of joint diseases such as epicondylitis or arthritis are more effective when combined with phonophoresis.

This method of treatment improves the absorption of the active ingredient. At the same time, the amount of the applied product decreases, which significantly saves its consumption, and most importantly, it is safer for the body.

Non-steroidal anti-inflammatory drugs (NSAIDs) are drugs, the name of which indicates their composition, purpose and function.

Non-steroidal - not containing the nucleus of cyclopentanperhydrofenanthrene, which is part of hormones and biologically active substances.

Anti-inflammatory - have a pronounced effect on inflammatory processes in a living organism, interrupting the chemical process of inflammation.

History of drugs from the NSAID group

The anti-inflammatory properties of willow have been known since the 5th century BC. In 1827, 30 grams of salicin was isolated from the bark of this plant. In 1869, on the basis of salicin, an active substance was obtained - salicylic acid.

The anti-inflammatory properties of salicylic acid have been known for a long time, but the pronounced ulcerogenic effect has limited its use in medicine. The addition of an acetyl group to the molecule significantly reduced the risk of ulceration of the digestive tract.

The first medical NSAID was synthesized in 1897 by Bayer. It was obtained by acetylation of salicylic acid. He received the patented name - "Aspirin". Only the drug of this pharmaceutical company has the right to be called aspirin.

Until 1950, aspirin remained the only non-steroidal anti-inflammatory drug. Then, active work began to create more effective tools.

However, the importance of acetylsalicylic acid in medicine is still great.

The mechanism of action of NSAIDs

The main point of application of NSAIDs are biologically active substances - prostaglandins. The first ones were found in the secretion of the prostate gland, hence their name. Two main types are more studied:

• Cyclooxygenase of the first type (COX-1), which is responsible for the synthesis of protective factors of the gastrointestinal tract and the processes of thrombus formation.
• Cyclooxygenase of the second type (COX-2), which is involved in the main mechanisms of the inflammatory process.

By blocking enzymes, the effects of reducing pain, reducing inflammation and lowering body temperature are achieved.

There are drugs of selective and non-selective action. Selective agents block the COX-2 enzyme to a greater extent. Reduces inflammation without affecting the processes in the digestive tract.

The action of the second type of cyclooxygenase is directed:

• to increase vascular permeability;
• release of inflammatory mediators in the damaged area;
• increased edema in the area of \u200b\u200binflammation;
• migration of phagocytes, mast cells, fibroblasts;
• an increase in the general temperature of the body, through the centers of thermoregulation in the central nervous system.

Inflammation

The process of inflammation is a universal response of the body to any damaging effect and has several stages:

• stage of alteration develops in the first minutes of exposure to a damaging factor. Damage agents can be physical, chemical, or biological. Biologically active substances are released from the destroyed cells, starting the subsequent stages;
• exudation (soaking), characterized by the effect on mast cells of substances from dead cells. Activated basophils release histamine and serotonin into the lesion, causing an increase in vascular permeability for the liquid part of the blood and macrophages. Edema occurs, the local temperature rises. Enzymes are released into the blood, attracting even more immunocompetent cells, triggering a cascade of biochemical and protective processes. The reaction becomes excessive. Pain arises. It is at this stage that non-steroidal anti-inflammatory drugs are effective;
• proliferation stage, occurs when the second stage is resolved. The main cells are fibroblasts, which form the connective tissue matrix, to restore the destroyed structure.

The stages do not have clear time frames and are more often included in combination. With a pronounced stage of exudation, proceeding with a hyperergic component, the stage of proliferation is delayed. Prescription of NSAID drugs promotes early recovery and facilitates the general condition of the patient.

The main groups of non-steroidal anti-inflammatory drugs

There are many classifications. The most popular ones are based on the chemical structure and biological effects of substances.

Salicylates

The most studied substance is acetylsalicylic acid. The analgesic effect is very moderate. It is used as a drug to lower the temperature in febrile conditions and as a means of improving microcirculation in cardiology (in small doses it reduces blood viscosity by blocking the first type of cyclooxygenase).

Propionates

Propionic acid salts have moderate analgesic and pronounced antipyretic effects. The best known is ibuprofen. Due to its low toxicity and high bioavailability, it is widely used in pediatric practice.

Acetates

Acetic acid derivatives are well known and widely used in medicine. They have a pronounced anti-inflammatory effect and a strong analgesic effect. Due to the great influence on the first type of cyclooxygenase, they are used with caution in case of peptic ulcer disease and the risk of bleeding. The most famous representatives: Diclofenac, Ketorolac, Indomethacin.

Selective COX-2 inhibitors

The most modern selective drugs today are considered Celecoxib and Rofecoxib... They are registered on the Russian market.

Other drugs

Paracetamol, nimesulide, meloxicam... They mainly operate on TsOG-2. They have a pronounced analgesic and antipyretic effect of central action.

The most popular NSAID drugs and their cost

• Acetylsalicylic acid.

An effective and inexpensive drug. Available in a dosage of 500 milligrams and 100 mg. The average price on the market is 8-10 rubles for 10 tablets. Included in the list of vital.

• Ibuprofen.

Safe and inexpensive drug. The price depends on the form of release and the manufacturer. It has a pronounced antipyretic effect. It is widely used in pediatrics.

Tablets of 400 milligrams, coated, Russian-made, cost from 50-100 rubles for 30 tablets.

• Paracetamol.

A popular drug all over the world. Dispensed in European countries without a doctor's prescription. The most popular forms are 500 milligram tablets and syrup.

It is a part of combined drugs as an analgesic and antipyretic component. Has a central mechanism of action, without affecting hematopoiesis and the gastrointestinal tract.

The price depends on the brand. Russian-made tablets cost about 10 rubles.

• Citramon P.

A combined preparation containing anti-inflammatory and psychostimulating components. Caffeine increases the sensitivity of brain receptors tropic to paracetamol, enhancing the effect of the anti-inflammatory component.

Available in tablets of 500 milligrams. The average price is 10-20 rubles.

• Diclofenac.

It is produced in various dosage forms, but it is most in demand in the form of injections and local forms (ointments and plasters).

The cost for a pack of three ampoules is from 50 to 100 rubles.

• Nimesulide.

Selective drug that has a blocking effect on the second type of cyclooxygenase. It has a good analgesic and antipyretic effect. It is widely used in dentistry and the postoperative period.

Available in the form of tablets, gels and suspensions. The average cost on the market is from 100-200 rubles for 20 tablets.

• Ketorolac.

The drug is characterized by a pronounced analgesic effect, comparable to the action of non-narcotic analgesics. It has a strong ulcerogenic effect on the mucous membrane of the gastrointestinal tract. Used with caution.

Must be dispensed strictly by prescription. The release forms are varied. Tablets of 10 milligrams cost from one hundred rubles per pack.

The main indications for the use of NSAIDs

The most common reasons for taking this class of substances are diseases associated with inflammation, pain and fever. It should be remembered that drugs are rarely used for monotherapy. Treatment should be comprehensive.

Important.Use the information in this paragraph only if an emergency does not allow you to contact a qualified technician soon. All questions of treatment should be discussed with your doctor.

Arthrosis

A disease that causes a change in the anatomical structure of the articular surface. Active movements are extremely painful, due to joint swelling and increased synovial fluid effusion.

In severe cases, treatment is reduced to joint replacement.

NSAIDs are indicated for moderate or moderate severity of the process... With pain syndrome, 100-200 milligrams of nimesulide is prescribed. No more than 500 mg per day. It is taken in 2-3 doses. Drink with a little water.

Rheumatoid arthritis

- inflammatory process of autoimmune etiology. Multiple inflammatory processes occur in various tissues. The joints and endocardial tissues are mainly affected. NSAIDs are the drugs of choice when combined with steroid therapy. Endocardial damage always leads to the deposition of blood clots on the surface of the valves and chambers of the heart. Taking acetylsalicylic acid 500 milligrams per day reduces the risk of thrombosis by 5 times.

Pain in soft tissue injuries

Associated with edema at the point of application of the traumatic factor and surrounding tissues. As a result of exudation, small venous vessels and nerve endings are compressed.

There is stagnation of venous blood in the damaged organ, which further enhances metabolic disorders. This creates a vicious circle that worsens the conditions for regeneration.

With an average pain syndrome, it is possible to use local forms of Diclofenac.

Apply to the area of \u200b\u200binjury or sprain three times a day. The damaged organ needs rest and immobilization for several days.

Osteochondrosis

In this pathological process, compression of the roots of the spinal nerves occurs between the upper and lower vertebrae, which form the channels for the exit of the spinal nerves.

With a decrease in the lumen of the canal, the nerve roots, innervating organs and muscles, experience compression. This leads to the development of inflammatory processes and edema of the nerves themselves, which further disrupts trophic processes.

To break the vicious circle, local ointments and gels containing Diclofenac are used in combination with injectable forms of the drug. Three milliliters of Diclofenac solution is injected intramuscularly once a day.

The course of treatment is at least 5 days. Given the high ulcerogenicity of the drug, proton pump blockers and antacids should be taken (Omeprazole 2 capsules twice a day and Almagel one or two scoops three times a day).

Lumbar pain

With this localization, it is most often affected. The painful sensations are quite intense. is formed from the spinal roots that emerge in the intervertebral foramen of the sacrum, leaving in a limited area into the shallow tissues of the gluteal region. This predisposes to its inflammation, with hypothermia.

Ointments with NSAIDs containing Diclofenac or Nimesulide are used... With severe pain, blockade of the nerve exit site is performed with an anesthetic drug. Local dry heat is applied. It is important to avoid hypothermia.

Headache

It is caused by various pathological processes. The most common cause is the brain. The brain itself has no pain receptors. Painful sensations are transmitted from its membranes and receptors in the vessels.

Non-steroidal anti-inflammatory drugs have a direct effect on prostaglandins, which regulate pain in the center of the thalamus. Pain causes vasospasm, metabolic processes decrease, and pain sensations increase. NSAIDs, relieving pain, relieve spasm, interrupting the pathological process. Ibuprofen preparations are most effective at a dose of 400 milligrams.

Migraine

It is caused by a local spasm of the cerebral vessels. More often the head hurts on one side. There is an extensive neurological focal symptomatology. Experience shows that non-steroidal analgesics are most effective in combination with antispasmodics.

Fifty percent metamizole sodium solution (analgin) in the amount of two milliliters and two milliliters Drotaverine in one syringe intramuscularly or intravenously... Vomiting occurs after injection. After a while, the pain is completely stopped.

Acute gout attack

The disease is caused by impaired metabolism of uric acid. Its salts are deposited in various organs and tissues of the body, causing widespread pain. NSAIDs help stop. Ibuprofen preparations are used at a dosage of 400-800 milligrams.

Complex. Includes a diet low in purine and pyrimidine bases. In the acute period, animal products, broths, alcohol, coffee and chocolate are completely excluded.

Shown are products of plant origin, except for mushrooms, and large volumes of water (up to three to four liters per day). When the condition improves, you can add low-fat cottage cheese to the food.

Dysmenorrhea

Painful periods or pain in the lower abdomen before them are common in women of fertile age. It is caused by spasms in the smooth muscles of the uterus with mucosal rejection. The duration of the pain and its intensity are individual.

For relief, Ibuprofen preparations at a dose of 400-800 milligrams or selective NSAIDs (Nimesulide, Meloxicam) are suitable.

Treatment for painful periods may include the use of biphasic estrogen drugs that normalize the body's hormones.

Fever

An increase in body temperature is a nonspecific pathological process that accompanies many painful conditions. Normal body temperature is between 35 and 37 degrees Celsius. With hyperthermia above 41 degrees, protein denaturation occurs and death can occur.

At normal body temperature, most of the biochemical processes in the body take place. Thermoregulation mechanisms of higher organisms are of neurohumoral nature. In maintaining temperature homeostasis, a small section of the hypothalamus called the funnel plays a major role.

Anatomically, it connects the hypothalamus and thalamus at the junction of the optic nerves.

Substances - pyrogens - are responsible for the activation of the hyperthermic reaction. One of the pyrogens is prostaglandin, which is produced by immune cells.

Its synthesis is regulated by cyclooxygenase. Non-steroidal anti-inflammatory drugs are able to influence prostaglandin synthesis, indirectly lowering body temperature. Paracetamol acts on COX-1 in the center of thermoregulation, providing a quick but short-lived antipyretic effect.

In fever, the greatest antipyretic activity is shown by Ibuprofen, acting indirectly. A regimen with both drugs is warranted to reduce fever at home.

500 milligrams Paracetamol and 800 milligrams Ibuprofen... The first quickly reduces the temperature to acceptable values, the second slowly and for a long time maintains the effect.

Teething Fever in Children

It is a consequence of the destruction of bone tissue during the rapid growth of the tooth. Biological active substances are released from the destroyed cells, which have a direct effect on the centers of the hypothalamus. Macrophages contribute to the inflammation process.

The most effective drug that eliminates inflammation and reduces fever is Nimesulide at a dose of 25-30 milligrams, taken once or twice, completely stops the phenomenon in 90-95 percent of cases.

Risks when using NSAIDs

Studies have shown that long-term use of non-selective drugs has a detrimental effect on the mucous membrane of the stomach and intestines. The ulcerogenic effect of acetylsalicylic acid has been confirmed. Long-term use of non-selective agents, it is recommended to carry out in conjunction with proton pump blockers (omeprazole).

Selective NSAIDs increase the risk of coronary heart disease tenfold with prolonged use. Aspirin is the only exception to this list. The antiplatelet properties of acetylsalicylic acid are used for the prevention of thrombosis, preventing and blockage of the great vessels.

Cardiologists warn that patients who have recently had a heart attack should stop taking NSAIDs. According to research data, Naproxen is considered the least dangerous from this point of view.

Studies have been published that long-term use of NSAIDs can cause erectile dysfunction. However, these studies were more based on the feelings of the patients themselves. No objective data were provided on testosterone levels, semen studies, and physical testing methods.

Conclusion

A hundred years ago, the world's population was just over a billion people. Over the past twentieth century, mankind has made a huge breakthrough in all areas of its activity. Medicine has become an evidence-based, effective and progressive science.

Today there are more than seven billion of us. The three main discoveries that influenced the survival of the human race are called:

• vaccines;
• antibiotics;
• non-steroidal anti-inflammatory drugs.

There is something to think about and something to strive for.

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Interesting

The abbreviation NSAIDs - does it tell you anything? If not, then we propose to broaden your horizons a little and find out what these mysterious four letters mean. Read the article and everything will become absolutely clear. We hope that it will be not only informative, but also interesting!

NSAIDs - transcript

Let's not torment our readers for a long time in the dark. NSAIDs stand for non-steroidal drugs - drugs in our time are very popular and in demand, since they are able to simultaneously eliminate pain and relieve inflammation in various organs of our body. If, until now, you have never needed to take NSAIDs, this can be considered almost a miracle. You are one of the rare lucky ones, really, your health can be envied!

We are ahead of the next question and immediately tell you about the decoding of the word "non-steroidal". This means that these drugs are non-hormonal, i.e. do not contain any hormones. And this is very good, because everyone knows how unpredictable and dangerous hormonal drugs can be.

Most Popular NSAIDs

If you think NSAIDs are drugs whose names are rarely pronounced in everyday life, then you are wrong. Many people do not even realize how often we have to use non-steroidal anti-inflammatory drugs to cure various ailments that have accompanied the human race since the expulsion of Adam and Eve from the heavenly booths. Read the list of such remedies, for sure some of them are in your home medicine cabinet. So, NSAIDs include medications such as:

• "Aspirin".
• "Amidopyrine".
• "Analgin".
• "Piroxicam".
• "Bystrumgel".
• "Diclofenac".
• "Ketoprofen".
• "Indomethacin".
• "Ketorol".
• "Naproxen".
• "Ketorolac".
• Flurbiprofen.
• "Voltarengel".
• "Nimesil".
• "Diclofenac".
• "Ibuprofen".
• "Indopan".
• "Ypren".
• "Upsarin UPSA".
• "Ketanov".
• "Mesulid".
• "Movalis".
• "Nise".
• Nurofen.
• "Ortofen".
• "Thrombo ASS".
• "Ultrafen".
• "Fastum".
• "Finalgel".

Yes, they are all NSAID drugs. The list turned out, although large, but, of course, far from complete. And yet, it gives an idea of \u200b\u200bthe variety of modern non-steroidal anti-inflammatory drugs.

Some historical facts

The first primitive NSAID drugs were known to people in ancient times. For example, in ancient Egypt, willow bark, a natural source of salicylates and one of the first non-steroidal anti-inflammatory drugs, was widely used to relieve heat and pain. And even in those distant times, healers treated their patients suffering from joint pain and fever with decoctions of myrtle and lemon balm - they also contain salicylic acid.

In the middle of the 19th century, chemistry began to develop rapidly, which gave impetus to the development of pharmacology. At the same time, the first studies of the compositions of medicinal substances obtained from plant materials began to be carried out. Pure salicin from willow bark was synthesized in 1828 - this was the first step towards the creation of the familiar "Aspirin".

But it will take many more years of scientific research before this drug is born. The grandiose event took place in 1899. Doctors and their patients quickly appreciated the benefits of the new drug. In 1925, when the worst flu epidemic hit Europe, Aspirin became a savior for a huge number of people. And in 1950, this non-steroidal anti-inflammatory drug hit the Guinness Book of Records as the most-sold pain reliever. Later, pharmacists have created other non-steroidal anti-inflammatory drugs (NSAIDs).

For what diseases are anti-inflammatory nonsteroidal drugs used?

The range of use of NSAIDs is very wide. They are very effective in the treatment of both acute and chronic diseases accompanied by pain and inflammation. Nowadays, studies are in full swing to study the effectiveness of these drugs in the treatment of diseases of the heart and blood vessels. And today almost everyone knows that they can be used for pain in the spine (NSAIDs for osteochondrosis are a real salvation).

Here is a list of painful conditions, in the event of which the use of various non-steroidal anti-inflammatory drugs is shown:

• Fever.
• Headaches, migraines.
• Renal colic.
• Rheumatoid arthritis.
• Gout.
• Arthrosis.
• Osteoarthritis.
• Dysmenorrhea.
• Inflammatory arthropathies (psoriatic arthritis, ankylosing spondylitis, Reiter's syndrome).
• Postoperative pain syndrome.
• Pain syndrome from mild to moderate severity with injuries and various inflammatory changes.

Classification of NSAIDs by their chemical structure

By reading this article, you have already had the opportunity to see that there are a lot of non-steroidal anti-inflammatory drugs. In order to navigate among them at least a little better, let's start the classification of these tools. First of all, they can be divided as follows: a group - acids and a group of NSAIDs - non-acidic derivatives.

The first are:

Salicylates (you can immediately remember about "Aspirin").

Phenylacetic acid derivatives (Aceclofenac, Diclofenac, etc.).

Pyrazolidines (sodium metamizole, known to most of us as "Analgin", "Phenylbutazone, etc.).

Oxycams ("Tenoxicam", "Meloxicam", "Piroxicam", "Tenoxicam").

Indoleacetic acid derivatives (Sulindak, Indomethacin, etc.).

Derivatives of propionic acid ("Ibuprofen", etc.).

The second group is:

Sulfonamide derivatives (Celecoxib, Nimesulide, Rofecoxib).

Alcanones ("Nabumeton").

Classification of non-steroidal anti-inflammatory drugs by their effectiveness

The use of NSAIDs in osteochondrosis and in the treatment of other joint diseases can literally work wonders. But, unfortunately, not all drugs are the same in their effectiveness. The undisputed leaders among them are:

• "Diclofenac".
• "Ketoprofen".
• "Indomethacin".
• Flurbiprofen.
• Ibuprofen and some other drugs.

The listed medicines can be called basic; that is, on their basis, new NSAIDs can be developed and supplied to the pharmacy chain, but under a different name and often at a higher price. To avoid wasting your money, study the next chapter well. The information contained in it will help you make the right choice.

What to look for when choosing a medicine

NSAIDs are, for the most part, excellent modern drugs, but when coming to the pharmacy, it is better to be aware of some of the nuances. Which ones? But read it!

For example, you have a choice of what is better to buy: "Diclofenac", "Ortofen" or "Voltaren". And you are trying to ask the pharmacist which of these drugs is better. Most likely, you will be advised the one that is more expensive. But the fact is that the composition of the listed drugs is almost identical. And the difference in the names is due to the fact that they are produced by different companies, which is why the trademarks differ from each other. The same can be said, for example, about "Metindol" and "Indomethacin" or "Ibuprofen" and "Brufen", etc.

To sort out the confusion, always carefully look at the packaging, because the main active ingredient of the drug must be indicated there. Only it will be written, most likely, in small letters.

But that's not all. Rather, not everything is so simple! Taking an NSAID analogue of a drug you are familiar with can unexpectedly cause an allergic reaction or side effects that you have never seen before. What's the matter here? The reason may lie in additional additives, about which, of course, nothing was written on the packaging. This means that you also need to study the instructions.

Another possible reason for the different outcomes of analog drugs is the difference in dosage. Ignorant people often do not pay any attention to this, but in vain. After all, small tablets may contain a "horse" dose of the active substance. Conversely, oversized pills or capsules sometimes have as much as 90 percent fillers.

Sometimes drugs are also produced in retarded form, that is, as drugs of long-term (prolonged) action. An important feature of such drugs is the ability to be absorbed gradually, so that their effect can last for a whole day. Such a drug does not need to be drunk 3 or 4 times a day, a single dose will be enough. This feature of the medicine should be indicated on the package or right in the name. For example, "Voltaren" in prolonged form is called "Voltaren-retard".

List of analogues of known drugs

We are publishing this little cheat sheet in the hope that it will help you better navigate the many beautiful pharmaceutical packaging. Let's say you immediately need an effective NSAID for arthrosis to relieve excruciating pain. Take out your cheat sheet and read the following list:

In addition to the already mentioned "Voltaren" and "Ortofen", there are also "Diclofen", "Dicloran", "Diclonac", "Rapten", "Diklobene", "Artrosan", "Naklofen".

- "Indomethacin" is sold under such brands as "Indomin", "Indotard", "Metindol", "Rheumatin", "Indobene", "Inteban".

Analogs of "Piroxicam": "Erazon", "Pirox", "Roxicam", "Pirokam".

Analogs of "Ketoprofen": "Flexen", "Profenid", "Ketonal", "Artrosilen", "Knavon".

The popular and inexpensive "Ibuprofen" is included in such drugs as "Nurofen", "Reumafen", "Brufen", "Bolinet".

Rules for taking NSAIDs

Taking NSAIDs can be accompanied by a number of side effects, so it is recommended that when taking them, observe the following rules:

1. Familiarization with the instructions and following the recommendations contained in it are mandatory!

2. If taken orally, take a capsule or tablet with a glass of water to protect your stomach. This rule must be adhered to, even if you drink the most modern drugs (which are considered safer), because extra precaution never hurts;

3. Do not lie down after taking the drug for about half an hour. The fact is that the force of gravity will facilitate a better passage of the capsule down the esophagus;

4. It is better to refuse alcoholic beverages, since NSAIDs and alcohol linked together are an explosive mixture that can cause various diseases of the stomach.

5. Do not take two different non-steroidal drugs on the same day - this will not increase the positive result, but, most likely, summarize the side effects.

6. If the medication does not work, check with your doctor if the dose is too low.

Side effects and nonsteroidal gastropathy

Now you have to learn what NSAID gastropathy is. Unfortunately, all NSAIDs have significant side effects. They have a particularly negative effect on the gastrointestinal tract. Patients may be disturbed by manifestations such as

• Nausea (sometimes very severe).
• Heartburn.
• Vomiting.
• Dyspepsia.
• Gastrointestinal bleeding.
• Diarrhea.
• Duodenal and gastric ulcer.

All of the above troubles are NSAID gastropathy. Therefore, doctors so often try to prescribe to their patients the lowest possible dose of classic non-steroidal anti-inflammatory drugs. To minimize the harmful effects on the stomach and intestines, it is recommended never to take such drugs on an empty stomach, but only after a large meal.

But digestive problems are not all the side effects that some of the NSAIDs can produce. Certain drugs can be bad for the heart as well as the kidneys. Sometimes taking them can be accompanied by headache and dizziness. Another serious nuisance is that they have a destructive effect on the intra-articular cartilage (of course, only with prolonged use). Fortunately, today there are new generation NSAIDs commercially available, which are largely freed from these disadvantages.

New generation non-steroidal anti-inflammatory drugs

In the past two decades, several pharmaceutical companies have simultaneously been intensively developing new modern NSAIDs, which, along with effective elimination of pain and inflammation, would have as few side effects as possible. The efforts of pharmacists were crowned with success - a whole group of new generation drugs, called selective, was developed.

Imagine - these drugs can be drunk under the supervision of a doctor for very long courses. Moreover, the terms can be measured not only by weeks and months, but even by years. Medicines from this group do not have a destructive effect on the articular cartilage, side effects are much less common and practically do not cause complications.

New generation NSAIDs are drugs such as:

• "Movalis".
• "Nise" (aka "Nimulid").
• "Arcoxia".
• "Celebrex".

We will tell you about some of their advantages using Movalis as an example. It is available both in traditional tablets (7.5 and 15 mg), and in 15 mg suppositories, and in glass ampoules for intramuscular administration (also 15 mg). This medicine works very mildly, but at the same time it is extremely effective: only one tablet is enough for the whole day. When a patient is shown long-term treatment for severe arthrosis of the hip or knee joints, "Movalis" is simply irreplaceable.

The different forms in which NSAIDs are produced

Most of the popular non-steroidal anti-inflammatory drugs can be purchased and used not only in the form of tablets and capsules for oral administration, but also in suppositories and in injection solutions. And this, of course, is very good, since such a variety makes it possible in some cases to avoid harm during treatment while obtaining a faster therapeutic effect.

So, new generation NSAIDs, used in the form of injections for arthrosis, have much less effect on the gastrointestinal tract. But there is also a downside to this coin: when administered intramuscularly, almost all non-steroidal drugs can cause complications - muscle tissue necrosis. That is why NSAID injections are never practiced for a long time.

Basically, injections are prescribed for exacerbation of inflammatory and degenerative-dystrophic diseases of the joints and spine, accompanied by severe intolerable pain. After the patient's condition improves, it becomes possible to switch to tablets and external agents in the form of ointments.

Usually doctors combine different dosage forms, deciding what and when can bring the greatest benefit to the patient. The conclusion suggests itself: if you do not want to harm yourself by self-treatment of such common ailments as osteochondrosis or arthrosis, contact a medical institution for help, it is there that they can help you.

Can NSAIDs be used during pregnancy

Doctors strongly discourage pregnant women from taking NSAIDs (especially this prohibition applies to the third trimester), as well as mothers who are breastfeeding. It is believed that drugs in this group can adversely affect the bearing of the fetus and cause various malformations in it.

According to some reports, such a harmless medicine, according to many as Aspirin, can increase the risk of early miscarriage. But sometimes doctors, according to indications, prescribe this drug to women (in a limited course and in minimal doses). In each case, the decision must be made by a medical professional.

During pregnancy, women often have back pain and there is a need to solve this problem with the help of non-steroidal anti-inflammatory drugs as the most effective and fast-acting. In this case, the use of "Voltaren gel" is permissible. But - again - its independent use is possible only in the first and second trimester, in late pregnancy, the use of this strong drug is allowed only under the supervision of a doctor.

Conclusion

We told you what we knew ourselves about NSAIDs. Deciphering the abbreviation, the classification of medicines, the rules for taking them, information on side effects - this can come in handy in life. But we want our readers to have a need for medicines as little as possible. Therefore, in parting, we wish you good good health!

There is practically no such disease in which non-steroidal anti-inflammatory drugs (NSAIDs, NSAIDs) would not be used. This is a huge class of injectable tablets and ointments, the ancestor of which is the usual Aspirin. The most common indications for their use are joint diseases accompanied by pain and inflammation. In our pharmacies, both long-proven, well-known drugs and anti-inflammatory non-steroidal drugs of a new generation are popular.

The era of such drugs began quite a long time ago - from 1829, when salicylic acid was first discovered. Since then, new substances and dosage forms have begun to appear that can eliminate inflammation and pain.

With the creation of Aspirin, NSAIDs were isolated into a separate group of non-steroidal anti-inflammatory drugs. Their name has determined that in their composition they do not contain hormones (steroids), and have less pronounced side effects than steroid ones.

Despite the fact that in our country most NSAIDs in pharmacies can be bought without a prescription, there are some points that you need to know about. Especially for those people who are thinking about what is better to choose - drugs offered for years, or modern NSAIDs.

The principle of action of NSAIDs is the effect on the enzyme cyclooxygenase (COX), namely, on its two varieties:

1. COX-1 is a protective enzyme of the gastric mucosa, which protects it from acidic contents.
2. COX-2 is inducible, meaning a synthesized enzyme that is produced in response to inflammation, or damage. Thanks to him, an inflammatory process is played out in the body.

Since non-steroids of the first generation are non-selective, that is, they act on both COX-1 and COX-2, along with the anti-inflammatory effect, they also have strong side effects. It is fundamentally important to take these tablets after meals, as they irritate the stomach and can lead to erosions and ulcers. If you already have gastric ulcers, you need to take them with proton pump inhibitors (Omeprazole, Nexium, Controloc, etc.), which protect the stomach.

Time does not stand still, non-steroids develop and become more and more selective in relation to COX-2. Now at the moment there are drugs that selectively affect the COX-2 enzyme, on which inflammation depends, without affecting COX-1, that is, without damaging the gastric mucosa.

About a quarter of a century ago, there were only eight groups of NSAIDs, but today there are more than fifteen of them. Having gained widespread popularity, non-steroidal pills quickly replaced the opioid pain reliever group of analgesics.

Today, two generations of non-steroidal anti-inflammatory drugs are distinguished. The first generation - NSAID drugs, mostly non-selective.

These include:

• Aspirin;
• Citramon;
• Naproxen;
• Voltaren;
• Nurofen;
• Butadion and many others.

Next-generation nonsteroidal anti-inflammatory drugs (NSAIDs) are safer in terms of side effects and have a greater ability to relieve pain.

These are such selective non-steroids as:

• Nimesil;
• Nise;
• Nimesulide;
• Celebrex;
• Indometaxine.

This is not a complete list and is not the only classification of new generation NSAIDs. There is their division into non-acidic and acidic derivatives.

Among the latest generation NSAIDs, the most innovative drugs are oxycams. These are non-steroidal anti-inflammatory drugs of a new generation of the group of acidic agents that affect the body much longer and brighter than others.

This includes:

• Lornoxicam;
• Piroxicam;
• Meloxicam;
• Tenoxicam.

The acidic group of drugs also includes the following series of non-steroids:

Non-acidic drugs, that is, they do not affect the gastric mucosa, include NSAIDs of a new generation of the sulfonamide group. Representatives of this group are "Nimesulide", "Rofecoxib", "Celecoxib".

The widespread use and popularity of new generation NSAIDs have won due to their ability not only to relieve pain, but also to provide an excellent antipyretic effect. The drugs stop the inflammatory process, do not allow the development of the disease, therefore they are prescribed for:

• Diseases of the musculoskeletal tissue. Nonsteroids are used to treat injuries, wounds, bruises. They are irreplaceable for arthrosis, arthritis and other diseases of a rheumatic nature. Also, with hernias of intervertebral discs and myositis, the funds have an anti-inflammatory effect.
• Severe pain syndromes. They are successfully used in the postoperative period, with biliary and renal colic. The tablets have a positive effect on headaches, gynecological pains, and successfully relieve migraine pain.
• The risk of blood clots. Since nonsteroids are antiplatelet, that is, they thin the blood, they are prescribed for ischemia, and for the prevention of strokes and heart attacks.
• High temperature. These pills and injections are the first antipyretic agent for adults and children. They are recommended to be used even in febrile conditions.

The funds are also used for gout and intestinal obstruction. In case of bronchial asthma, it is not recommended to use NSAIDs on their own; prior consultation with a doctor is required.

Unlike non-selective anti-inflammatory drugs, new generation NSAIDs do not irritate the gastrointestinal system of the body. Their use in the presence of stomach ulcers and duodenal ulcers does not lead to exacerbation and bleeding.

However, their long-term use can cause a number of undesirable effects, such as:

• increased fatigue;
• dizziness;
• dyspnea;
• drowsiness;
• destabilization of blood pressure.
• the appearance of protein in the urine;
• indigestion;

Also, with prolonged use, the manifestation of allergies is possible, even if previously no susceptibility to any substances was observed.

Non-selective non-steroids such as Ibuprofen, Paracetamol, or Diclofenac are highly hepatotoxic. They have a very strong effect on the liver, especially "Paracetamol".

In Europe, where all NSAIDs are prescription, over-the-counter Paracetamol (taken as a pain reliever up to 6 tablets a day) is in great demand. There appeared such a medical concept as "paracetamol liver damage", that is, cirrhosis while taking this medication.

Several years ago, a scandal erupted abroad over the influence of modern non-steroids - coxibs on the cardiovascular system. But our scientists did not share the concerns of their foreign colleagues. The Russian Association of Rheumatologists acted as an opponent to Western cardiologists, and proved that the risk of heart complications while taking new generation NSAIDs is minimal.

It is absolutely impossible to use most anti-inflammatory nonsteroids during pregnancy, especially in the third trimester. Some of them can be prescribed by a doctor in the first half of pregnancy with special indications.

By analogy with antibiotics, NSAIDs of the new generation should not be taken in too short courses (drank for 2-3 days and stopped). This will be harmful, because in the case of antibiotics, the temperature will go away, but the pathological flora will acquire resistance (resistance). The same is with non-steroids - they must be taken for at least 5-7 days, since the pain can go away, but this does not mean that the person has recovered. The anti-inflammatory effect occurs a little later than the pain reliever and proceeds more slowly.

1. In no case should you combine non-steroids from different groups. If, for pain in the morning, you take one pill, and then another, their beneficial effect is not summarized, and does not increase. And the side effects increase exponentially. Especially not to combine cardiac Aspirin (Aspirin-Cardio, Cardiomagnet) and other NSAIDs. In this situation, there is a danger of a heart attack, since the action of aspirin, which dilutes the blood, is blocked
2. If a joint hurts, it is better to start with ointments, for example, based on ibuprofen. They need to be applied 3-4 times a day, especially at night, and rubbed intensively into the sore spot. You can self-massage the sore spot with ointment.

The main condition is peace. If you continue to actively work or play sports during the treatment, then the effect of the use of drugs will be very small.

The best drugs

Coming to the pharmacy, each person thinks about which non-steroidal anti-inflammatory drugs to choose, especially if he came without a doctor's prescription. The choice is huge - non-steroids are available in ampoules, tablets, capsules, ointments and gels.

The greatest anti-inflammatory effect is possessed by tablets - derivatives of acids.

A good analgesic effect in diseases of the musculoskeletal tissue is possessed by:

• Ketoprofen;
• Voltaren or Diclofenac;
• Indomethacin;
• Xefocam or Lornoxicam.

But the most powerful drugs against pain and inflammation are the newest selective NSAIDs, coxibs, which have the least side effects. The best non-steroidal anti-inflammatory drugs from this series are Arcoxia, Nise, Movalis, Celecoxib, Ksefokam, Etoricoxib.

Ksefokam

An analogue of the remedy is Lornoxicam, Rapid. The active ingredient is xefocam. An effective medicine with a pronounced anti-inflammatory effect. Does not affect heart rate, blood pressure and respiratory rate.

Produced in the form:

• tablets;
• injections.

For elderly patients, a special dosage is not required in the absence of renal failure. In case of kidney disease, the dose must be reduced, since the substance is excreted by these organs.

With an excessive duration of treatment, manifestations in the form of conjunctivitis, rhinitis and shortness of breath are possible. In asthma, it is used with caution, since an allergic reaction in the form of bronchospasm is possible. With the introduction of an injection intramuscularly, pain and hyperemia at the injection site is possible.

The drug Arcoxia, or its only analogue, Exinev, is a drug used in acute gouty arthritis, osteoarthritis of the rheumatoid type, and in the treatment of postoperative conditions associated with pain. Available in the form of tablets for oral administration.

The active ingredient of this drug is etoricoxib, which is the most modern and safe substance among selective COX-2 inhibitors. The remedy perfectly relieves pain, and begins to act on the focus of pain after 20-25 minutes. The active substance of the drug is absorbed from the bloodstream and has a high bioavailability (100%). It is excreted in the urine unchanged.

Nimesulide

Most sports traumatology specialists isolate such a non-steroid as Nise or its analogues Nimesil or Nimulid. There are many names, but they have one active ingredient - nimesulide. This drug is quite cheap, and occupies one of the first places in sales.

This is a good pain reliever, but Nimesulide-based products should not be used in children under 12 years of age, as there is a high probability of allergic reactions.

Produced as:

• powders;
• suspensions;
• gels;
• tablets.

It is used in the treatment of arthritis, arthrosis, with ankylosing spondylitis, sinusitis, lumbago, and pain of various localization.

Movalis is much more selective for COX-2 than Nise, and therefore has even fewer side effects on the stomach.

Release form:

• candles;
• pills;
• injections.

With prolonged use, the risk of developing cardiac thrombosis, heart attacks, angina pectoris is increased. Therefore, people with a predisposition to these diseases need to be careful in their use. It is also not recommended for women planning pregnancy, as it affects fertility. It is excreted in the form of metabolites, mainly in the urine and feces.

Celecoxib

In the group with the most proven base in terms of safety - the new generation NSAIDs Celecoxib. It was the first drug in the Selective Coxibs group to combine the three strengths of this class - the ability to reduce pain, inflammation, and reasonably high safety. Release form - capsules of 100 and 200 mg.

The active ingredient celecoxib acts selectively on COX-2 without affecting the gastric mucosa. Rapidly absorbed into the bloodstream, the substance reaches its highest concentration after 3 hours, but simultaneous intake with fatty foods can slow down the absorption of the drug.

Celecoxib is prescribed for soriatic and rheumatoid arthritis, osteoarthritis and ankylosing spondylitis. This remedy is not prescribed for hepatic and renal failure.

Rofecoxib

The main substance rofecoxib effectively helps to restore the motor function of the joints, quickly relieving inflammation.

Produced as:

• injection solutions;
• tablets;
• candles;
• gel.

The substance is a highly selective inhibitor of cyclooxygenase 2, which, after ingestion, is rapidly absorbed by the gastrointestinal tract. The substance reaches its maximum concentration in the blood after 2 hours. It is excreted mainly in the form of inactive metabolites by the kidneys and intestines.

Long-term use may result in disorders of the nervous system - sleep disorder, dizziness, confusion of consciousness. It is recommended to start treatment with injections, then switch to pills and external agents.

When choosing any NSAIDs, one should be guided not only by the price and their modernity, but also take into account the fact that all such drugs have their own contraindications. Therefore, you should not self-medicate, it is best if they are prescribed by a doctor, taking into account age and the presence of diseases in the anamnesis. It should be remembered that the thoughtless use of drugs may not only not bring relief, but also force a person to treat many complications.

Non-steroidal anti-inflammatory drugs are used for various pathologies, they relieve pain, fever and inflammation in the tissues. Most orthopedic problems are not complete without this group of drugs, since patients are worried about quite pronounced pains that disrupt the quality of life.

NSAIDs should be prescribed by a doctor, taking into account the indications and contraindications of a particular drug, especially if there is a need to take the drug for a long time. Despite their effectiveness, such drugs have severe side effects, the risk of which increases with prolonged use of the drug.

Range of products

Non-steroidal anti-inflammatory drugs perfectly remove pain syndromes, reduce high fever and inhibit the inflammatory process in the tissues of the body. This effect is provided by inhibiting enzymes that provoke the production of prostaglandins.

Prostaglandins are substances that are responsible for inflammatory processes in the body, in addition, they make a person more sensitive to pain. Thus, non-steroidal anti-inflammatory drugs dull pain and stop the development of the inflammatory process, this is a big advantage of the drug, compared to analgesics, which relieve only pain.

Classification

A couple of decades ago, only 7 groups of non-steroidal anti-inflammatory drugs were known, nowadays there are already more than 15 of them. NSAIDs are quite popular due to their complex action and good effect, thus they ousted opoid analgesics that suppressed respiratory function from the market.

There are two classifications of such drugs. They are divided into new and old, as well as acidic and non-acidic. The old drugs include, and other NSAID drugs of the new generation - this and others.

Depending on whether acids are NSAIDs, they are divided into the following types:

• Preparations based on phenylacetic acid. This acid is used in perfumery because it smells like honey. Also, this substance is part of amphetamine and is under control in the Russian Federation.
• Products made using anthranilic acid. This acid is used to make dyes and flavors.
• Pyrazolone preparations.
• Preparations made using isonicotinic acid.
• Propionic acid derivatives.
• Salicylates.
• Oxycams.
• Pyrazolidines.

New generation

It's no secret that old NSAIDs have a large number of side effects, while they do not have a strong enough anti-inflammatory effect. Conditionally, this can be explained so that the drugs inhibit 2 types of enzymes COX-1 and COX-2, the first is responsible for protecting the body, and the second for the inflammatory process.

Thus, with long-term use of NSAIDs of the old generation, patients experienced abnormalities in the stomach, since its protective layer was destroyed. As a result, ulcers and other problems with the gastrointestinal tract appeared.

As it turned out, it is quite possible to reduce the side effects, and at the same time increase the effectiveness of the drug, if you develop a tool that will suppress COX-2, practically without affecting the COX-1 enzymes. In recent years, a new generation of NSAIDs have been developed that work in this way. Below are the most popular new tools.

It is one of the most popular new generation non-steroidal anti-inflammatory drugs. It is produced in Germany and Spain, and is available in the form of tablets, ointments, injection solutions and suppositories. Movalis is very good at pain relief, relieves high fever and inflammation, while it has a small number of contraindications.

It is taken for inflammatory and degenerative diseases of the joints, in particular for various arthritis and arthrosis, with gouty attacks, with, with strong. The big advantage of this remedy is the ability to take it for a long time under the supervision of a doctor, which is just necessary for severe articular pathologies.

Movalis is very easy to use, you need to drink only one tablet a day, since the drug works for a long time. The cost of a package with 20 tablets of the product is about 600 rubles.

Nimesulide

Another popular new generation remedy is Nimesulide. It is actively used for various diseases, in particular for pathologies of the musculoskeletal system. The big advantage of this remedy is that it not only relieves inflammation, fever and pain, but also detoxifies enzymes that destroy cartilage tissue.

Nimesulide tablets are not expensive, for 20 pieces you will have to pay no more than 40 rubles. There are also analogues, for example Nise. This product can be purchased in the form of tablets, gel for external use, powder for suspension. For 20 pieces of Nise tablets and for 20 grams of gel, you will have to pay about 200 rubles.

Ksefokam

This drug is especially effective for severe pain, it is often prescribed for unspecified pain, as well as for joint pain, for example, with gout, with rheumatoid arthritis, with severe stages of arthrosis and arthritis, with ankylosing spondylitis.

Interestingly, the action is equated to Morphine, but it does not affect the central nervous system and is not addictive. The drug has side effects, therefore, before use, you need to consult a specialist who can calculate the minimum dosage, depending on the severity of the disease.

Ksefokam is produced in the form of tablets and a solution for intravenous and intramuscular administration. The cost of tablets ranges from 300 to 500 rubles, depending on the required dosage, and 5 ampoules for injections will cost around 700 rubles.

Rofecoxib

This drug relieves pain, swelling, inflammation. It is used mainly for orthopedic pathologies, in particular for arthritis, arthrosis, as well as for toothaches. Such a remedy called Denebol is sold in the form of an ointment and tablets.

Celecoxib

This drug is very effective for severe pain, while it does not have a negative effect on the gastric mucosa at all, which is a big plus of the drug. It is released in the form of capsules of 100 and 200 mg. The cost of 10 capsules is 250 rubles.

Indications

NSAIDs are used for various inflammatory diseases, fever, pain of various etiologies. These drugs have an excellent antipyretic effect, while the effect lasts quite a long time, which makes it convenient to use NSAIDs in children. New generation drugs are indicated in the following cases:

• ankylosing spondylitis;
• Pain in various diseases of the bones and joints;
• Osteochondrosis;
• Inflammation of soft tissues;
• Toothache;
• Pain after surgery;
• Fever.

Contraindications

New generation products have the following contraindications:

• Intolerance to the components of the drug;
• Stomach ulcers in the acute stage;
• Bleeding in the gastrointestinal tract;
• Reaction to acetylsalicylic acid (in particular, rash, bronchospasm);
• Severe heart disease;
• Severe kidney pathology;
• Severe liver pathologies;
• Blood clotting disorder;
• Advanced age with prolonged use;
• Alcoholism;
• Pregnancy and breastfeeding;
• Children up to age 12.

Side effects

New generation nonsteroidal anti-inflammatory drugs have been specially developed to reduce the effect of their intake on the gastrointestinal mucosa. Therefore, these funds do not have a destructive effect on the digestive tract, and on hyaline cartilage too. But still, with long-term use, some side effects may occur:

• Allergic reactions to the components of the drug;
• Fluid retention in the body;
• The appearance of protein in the urine;
• Increased activity of liver enzymes;
• Digestive problems;
• Headache;
• General weakness and drowsiness;
• Dizziness;
• Increased blood pressure;
• Fast fatiguability;
• Dry cough;
• Dyspnea.

To avoid the appearance of side effects, it is necessary to consult a doctor before taking the drug and study the instructions for the drug. It is very important to use the product correctly, not to exceed the dosage, then the risk of side effects will be minimal.

What to replace

There are situations when the pain is taken by surprise, and there is no drug prescribed by the doctor at hand. In this case, you can temporarily replace it with the help of various folk remedies: rubbing, ointments, compresses. But do not abuse such methods and neglect the main treatment, you can provoke a worsening of the condition.

To remove body temperature above 38.5 degrees, rubbing is done. For this, the patient needs to be undressed, while eliminating drafts in the room. The body should be wiped off with warm water and left to dry on the skin on its own, so the body will cool faster. Adults can be wiped at high temperature with vodka diluted with water, or a little vinegar can be added to the water. Children are wiped exclusively with water.

You can relieve pain in articular pathologies with the help of rubbing from iodine, analgin and vodka. To do this, 8 tablets of analgin need to be ground into powder, pour 50 ml of alcohol and 50 ml of iodine, mix everything well. Rub the resulting gruel into the sore joint twice a day.

And comfrey.

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