What are anti-inflammatory pills? Characteristics of individual drugs Anti-inflammatory drugs list of drugs.

A bunch of pathological changes occurring in the body, accompanied by pain. To combat such symptoms, NSAIDs, or remedies, have been developed. They perfectly anesthetize, relieve inflammation, reduce swelling. However, drugs have a large number side effects. This limits their use in some patients. Modern pharmacology has developed the latest generation of NSAIDs. Such drugs are much less likely to cause unpleasant reactions, but they remain effective drugs for pain.

Impact principle

What is the effect of NSAIDs on the body? They act on cyclooxygenase. COX has two isoforms. Each of them has its own functions. Such an enzyme (COX) causes a chemical reaction, as a result of which it passes into prostaglandins, thromboxanes and leukotrienes.

COX-1 is responsible for the production of prostaglandins. They protect the gastric mucosa from unpleasant effects, affect the functioning of platelets, and also affect changes in renal blood flow.

COX-2 is normally absent and is a specific inflammatory enzyme synthesized due to cytotoxins, as well as other mediators.

Such an action of NSAIDs as inhibition of COX-1 carries many side effects.

New developments

It is no secret that the drugs of the first generation of NSAIDs had an adverse effect on the gastric mucosa. Therefore, scientists have set themselves the goal of reducing undesirable effects. A new release form has been developed. In such preparations, the active substance was in special shell. The capsule was made from substances that did not dissolve in the acidic environment of the stomach. They began to break down only when they entered the intestines. This made it possible to reduce irritant effect on the gastric mucosa. However, the unpleasant mechanism of wall damage digestive tract still preserved.

This forced chemists to synthesize completely new substances. From previous drugs, they are fundamentally different mechanism of action. NSAIDs of the new generation are characterized by a selective effect on COX-2, as well as inhibition of prostaglandin production. This allows you to achieve all the necessary effects - analgesic, antipyretic, anti-inflammatory. At the same time, NSAIDs of the latest generation make it possible to minimize the effect on blood clotting, platelet function, and the gastric mucosa.

The anti-inflammatory effect is due to a decrease in the permeability of the walls of blood vessels, as well as a decrease in the production of various inflammatory mediators. Due to this effect, irritation of the nerve pain receptors is minimized. The influence on certain centers of thermoregulation located in the brain allows the latest generation of NSAIDs to perfectly lower the overall temperature.

Indications for use

The effects of NSAIDs are widely known. The effect of such drugs is aimed at preventing or reducing inflammatory process. These drugs give an excellent antipyretic effect. Their effect on the body can be compared with the effect. In addition, they provide analgesic, anti-inflammatory effects. The use of NSAIDs is on the rise in clinical setting and in everyday life. Today it is one of the most popular medical drugs.

A positive impact is noted with the following factors:

1. Diseases of the musculoskeletal system. With various sprains, bruises, arthrosis, these drugs are simply irreplaceable. NSAIDs are used for osteochondrosis, inflammatory arthropathy, arthritis. The drug has an anti-inflammatory effect in myositis, herniated discs.
2. Strong pains. The drugs are quite successfully used for biliary colic, gynecological ailments. They eliminate headaches, even migraines, kidney discomfort. NSAIDs are successfully used for patients in the postoperative period.
3. Heat. The antipyretic effect allows the use of drugs for ailments of a diverse nature, both for adults and children. Such medicines are effective even in fever.
4. thrombus formation. NSAIDs are antiplatelet agents. This allows them to be used in ischemia. They are a preventive measure against heart attack and stroke.

Classification

About 25 years ago, only 8 groups of NSAIDs were developed. Today, this number has increased to 15. However, even doctors cannot name the exact number. Having appeared on the market, NSAIDs quickly gained wide popularity. Drugs have replaced opioid analgesics. Because they, unlike the latter, did not provoke respiratory depression.

The classification of NSAIDs implies a division into two groups:

1. Old drugs (first generation). This category includes well-known drugs: Citramon, Aspirin, Ibuprofen, Naproxen, Nurofen, Voltaren, Diklak, Diclofenac, Metindol, Movimed, Butadion .
2. New NSAIDs (second generation). Over the past 15-20 years, pharmacology has developed excellent drugs, such as Movalis, Nimesil, Nise, Celebrex, Arcoxia.

However, this is not the only classification of NSAIDs. New generation drugs are divided into non-acid derivatives and acids. Let's look at the last category first:

1. Salicylates. This group of NSAIDs contains drugs: Aspirin, Diflunisal, Lysine monoacetylsalicylate.
2. Pyrazolidins. Representatives of this category are drugs: Phenylbutazone, Azapropazone, Oxyphenbutazone.
3. Oxycams. These are the most innovative NSAIDs of the new generation. List of drugs: Piroxicam, Meloxicam, Lornoxicam, Tenoxicam. Medicines are not cheap, but their effect on the body lasts much longer than other NSAIDs.
4. Derivatives of phenylacetic acid. This group of NSAIDs contains funds: Diclofenac, Tolmetin, Indomethacin, Etodolac, Sulindac, Aceclofenac.
5. Anthranilic acid preparations. The main representative is the medicine "Mefenaminat".
6. Propionic acid agents. This category contains many excellent NSAIDs. List of drugs: Ibuprofen, Ketoprofen, Benoxaprofen, Fenbufen, Fenoprofen, Thiaprofenic acid, Naproxen, Flurbiprofen, Pirprofen, Nabumeton.
7. Derivatives of isonicotinic acid. The main medicine "Amizon".
8. Pyrazolone preparations. The well-known remedy "Analgin" belongs to this category.

Non-acid derivatives include sulfonamides. This group includes drugs: Rofecoxib, Celecoxib, Nimesulide.

Side effects

NSAIDs of the new generation, the list of which is given above, have an effective effect on the body. However, they practically do not affect the functioning of the gastrointestinal tract. These drugs are distinguished by another positive point: NSAIDs of the new generation do not have a devastating effect on cartilage tissue.

However, even such effective means capable of provoking unwanted effects. They should be known, especially if the drug is used long time.

The main side effects can be:

• dizziness;
• drowsiness;
• headache;
• fatigue;
• increased heart rate;
• increase in pressure;
• slight shortness of breath;
• dry cough;
• indigestion;
• the appearance of protein in the urine;
• increased activity of liver enzymes;
• skin rash (spot);
• fluid retention;
• allergy.

At the same time, damage to the gastric mucosa is not observed when taking new NSAIDs. The drugs do not cause an exacerbation of the ulcer with the occurrence of bleeding.

Phenylacetic acid preparations, salicylates, pyrazolidones, oxicams, alkanones, propionic acid and sulfonamide drugs have the best anti-inflammatory properties.

From joint pain most effectively relieve medications "Indomethacin", "Diclofenac", "Ketoprofen", "Flurbiprofen". These are the best NSAIDs for osteochondrosis. The above drugs, with the exception of the drug "Ketoprofen", have a pronounced anti-inflammatory effect. This category includes the tool "Piroxicam".

Effective analgesics are Ketorolac, Ketoprofen, Indomethacin, Diclofenac.

Movalis has become the leader among the latest generation of NSAIDs. This tool is allowed to be used for a long period. Anti-inflammatory analogs effective medicine are the drugs Movasin, Mirloks, Lem, Artrozan, Melox, Melbek, Mesipol and Amelotex.

The drug "Movalis"

This drug is available in the form of tablets, rectal suppositories and solution for intramuscular injection. The agent belongs to the derivatives of enolic acid. The drug has excellent analgesic and antipyretic properties. It has been established that in almost any inflammatory process this medicine brings a beneficial effect.

Indications for the use of the drug are osteoarthritis, ankylosing spondylitis, rheumatoid arthritis.

However, you should know that there are contraindications to taking the drug:

• hypersensitivity to any of the components of the drug;
• peptic ulcer in the acute stage;
• severe renal failure;
• ulcer bleeding;
• severe liver failure;
• pregnancy, child feeding;
• severe heart failure.

The drug is not taken by children under 12 years of age.

Adult patients diagnosed with osteoarthritis are recommended to use 7.5 mg per day. If necessary, this dose can be increased by 2 times.

For rheumatoid arthritis and ankylosing spondylitis daily rate is 15 mg.

Patients who are prone to side effects should take the drug with extreme caution. People who have severe renal failure and who are on hemodialysis should take no more than 7.5 mg throughout the day.

The cost of the drug "Movalis" in tablets of 7.5 mg, No. 20, is 502 rubles.

The opinion of consumers about the drug

Reviews of many people who are prone to severe pain indicate that Movalis is the most suitable remedy for long term use. It is well tolerated by patients. In addition, its long stay in the body makes it possible to take the medicine once. A very important factor, according to most consumers, is the protection of cartilage tissues, since the drug does not affect them. negative impact. This is very important for patients who apply arthrosis.

In addition, the medicine perfectly relieves various pains - toothache, headache. Patients pay particular attention to the impressive list of side effects. While taking NSAIDs, the treatment, despite the warning of the manufacturer, was not complicated by unpleasant consequences.

The drug "Celecoxib"

The action of this remedy is aimed at alleviating the patient's condition with osteochondrosis and arthrosis. The drug perfectly eliminates pain, effectively relieves the inflammatory process. No adverse effects on the digestive system have been identified.

The indications for use given in the instructions are:

• osteoarthritis;
• rheumatoid arthritis;
• ankylosing spondylitis.

This drug has a number of contraindications. In addition, the medicine is not intended for children under 18 years of age. Particular caution must be observed in people who are diagnosed with heart failure, as the drug increases the susceptibility to fluid retention.

The cost of the drug varies, depending on the packaging, in the region of 500-800 rubles.

Consumer opinion

Quite conflicting reviews about this medicine. Some patients, thanks to this remedy, were able to overcome joint pain. Other patients claim that the drug did not help. Thus, this remedy is not always effective.

In addition, you should not take the drug yourself. In some European countries, this medicine is banned because it has a cardiotoxic effect, which is quite unfavorable for the heart.

The drug "Nimesulide"

This medicine has not only anti-inflammatory and anti-pain effects. The tool also has antioxidant properties, due to which the drug inhibits substances that destroy cartilage and collagen fibers.

The remedy is used for:

• arthritis;
• arthrosis;
• osteoarthritis;
• myalgia;
• arthralgia;
• bursitis;
• fever
• various pain syndromes.

In this case, the drug has an analgesic effect very quickly. As a rule, the patient feels relief within 20 minutes after taking the drug. That is why this remedy is very effective in acute paroxysmal pain.

Almost always, the medicine is well tolerated by patients. But sometimes side effects may occur, such as dizziness, drowsiness, headache, nausea, heartburn, hematuria, oliguria, urticaria.

The product is not approved for use by pregnant women and children under 12 years of age. With extreme caution should take the drug "Nimesulide" people who have arterial hypertension impaired functioning of the kidneys, vision or heart.

The average price of a medicine is 76.9 rubles.

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Non-steroidal anti-inflammatory drugs (NSAIDs, NSAIDs) are one of the main drugs used to treat inflammatory joint diseases.

They are prescribed in periodic courses for chronic processes, if necessary - for exacerbations of diseases and acute inflammatory processes. NSAIDs exist in various dosage forms - tablets, ointments, injection solutions. The choice of the necessary remedy, dosage and frequency of its use, should be carried out by the doctor.

NSAIDs - what is this group of drugs?

The group of NSAIDs is quite extensive, and includes various chemical structure drugs. The name "non-steroidal" shows their difference from another large group of anti-inflammatory drugs - corticosteroid hormones.

The common properties of all drugs in this group are their three main effects - anti-inflammatory, analgesic, antipyretic.

This is the reason for another name for this group - non-narcotic analgesics, as well as a huge breadth of their application. These three effects are expressed differently with each drug, so they cannot be completely interchangeable.

Unfortunately, all drugs of the NSAID group have similar side effects. The most famous of them is a provocation peptic ulcer stomach, liver toxicity and hematopoiesis suppression. For this reason, you should not exceed the dosage indicated in the instructions, and also take these drugs if you suspect these diseases.

It is impossible to treat abdominal pain with such medicines - there is always a risk of worsening your condition. Various dosage forms of NSAIDs have been invented to improve their effectiveness in each specific situation and reduce potential harm to health.

History of discovery and formation

Application herbal remedies, which have anti-inflammatory, antipyretic and analgesic effects, is described in the writings of Hippocrates. But the first accurate description of the effect of NSAIDs dates back to the 18th century.

In 1763, the English physician and priest Edward Stone wrote in a letter to the chairman of the Royal Society of London that an infusion of willow bark growing in England has antipyretic properties, described the recipe for its preparation and method of application in feverish conditions.

Almost half a century later, in France, I. Lear isolated a substance from the willow bark that caused it medicinal properties. By analogy with the Latin name for willow is salix, he called this substance salicin. This was the prototype of modern acetylsalicylic acid, which was learned to be obtained chemically in 1839.

The industrial production of NSAIDs was launched in 1888, the first drug that appeared on the pharmacy shelves was acetylsalicylic acid under the trade name Aspirin, produced by Bayer, Germany. She still owns the rights to trademark Aspirin, so other manufacturers produce acetylsalicylic acid under an international non-proprietary name or create their own (for example, Upsarin).

More recent developments have led to the emergence of a number of new drugs. Research continues to this day, more and more safe and effective means are being created. Oddly enough, but the first hypothesis about the mechanism of action of NSAIDs was formulated only in the 20s of the XX century. Prior to this, drugs were used empirically, their dosages were determined by the patient's well-being, and side effects were not well studied.

Pharmacological properties and mechanism of action

The mechanism of the development of an inflammatory reaction in the body is quite complex, and includes a chain chemical reactions that launch each other. One of the groups of substances involved in the development of inflammation is prostaglandins (they were first isolated from prostate tissue, hence the name). These substances have a dual function - they are involved in the formation of protective factors of the gastric mucosa and in the inflammatory process.

The synthesis of prostaglandins is carried out by two types of the cyclooxygenase enzyme. COX-1 synthesizes "gastric" prostaglandins, and COX-2 - "inflammatory", and is normally inactive. It is in the activity of COX that NSAIDs interfere. Their main effect - anti-inflammatory - is due to the inhibition of COX-2, and the side effect - a violation of the protective barrier of the stomach - inhibition of COX-1.

In addition, NSAIDs interfere quite strongly in cellular metabolism, which is the reason for their analgesic effect - they disrupt the conduction of nerve impulses. This is also the cause of lethargy, as a side effect of taking NSAIDs. There is evidence that these drugs stabilize lysosome membranes by slowing down the release of lytic enzymes.

Entering the human body, these drugs are absorbed mostly in the stomach, in small quantities - from the intestines.

Absorption varies, with new drugs bioavailability can reach 96%. Enteric-coated drugs (Aspirin-cardio) are absorbed much worse. The presence of food does not affect the absorption of drugs, but since they increase acidity, it is advisable to take them after meals.

Metabolism of NSAIDs occurs in the liver, which is associated with their toxicity to this organ and the inability to use when various diseases liver. A small part of the received dose of the drug is excreted through the kidneys. Current developments in the field of NSAIDs are aimed at reducing their effect on COX-1 and hepatotoxicity.

Indications for use - scope

Diseases and pathological conditions in which NSAIDs are prescribed are diverse. Tablets are prescribed as an antipyretic for infectious and noncommunicable diseases, and also as a remedy for headache, dental, joint, menstrual and other types of pain (except for abdominal pain, if its cause is not clarified). In children, NSAID suppositories are used to relieve fever.

Intramuscular injections of NSAIDs are prescribed as an analgesic and antipyretic agent in a serious condition of the patient. They are necessarily part of the lytic mixture - a combination of drugs that allow you to quickly bring down a dangerous temperature. Treatment with intra-articular injections severe lesions joints caused by inflammatory diseases.

Ointments are used for local effects on inflamed joints, as well as for diseases of the spine, muscle injuries to relieve pain, swelling and inflammation. Ointments can only be applied to healthy skin. In diseases of the joints, all three dosage forms can be combined.

The most famous drugs of the group

The very first NSAID to be marketed was acetylsalicylic acid under the brand name Aspirin. This name, despite being commercial, is strongly associated with the drug. It is prescribed to reduce fever, relieve headaches, in small doses - to improve the rheological properties of blood. In diseases of the joints is rarely used.

Metamizole (Analgin) - no less popular than aspirin. Used to relieve pain various genesis, including articular. Banned in many European countries, as it has a strong inhibitory effect on hematopoiesis.

- one of the most popular drugs for the treatment of joints. Included in many ointments, available in and. It has a pronounced anti-inflammatory and analgesic effect, with almost no systemic effect.

Side effects

As with any drug, there are numerous side effects associated with taking NSAIDs. The most famous among them is ulcerogenic, i.e. provoking an ulcer. It is caused by inhibition of COX-1 and is almost completely absent in selective NSAIDs.

Acid derivatives have an additional ulcerogenic effect due to an increase in acidity. gastric juice. Most NSAIDs are contraindicated in gastritis with hyperacidity, gastric ulcer and duodenum, GERD.

Another common effect is hepatotoxicity. It can be manifested by pain and heaviness in the abdomen, digestive disorders, sometimes - a short-term icteric syndrome, skin itching, and other manifestations of liver damage. For hepatitis, cirrhosis and liver failure NSAIDs are contraindicated.

Inhibition of hematopoiesis, which, when the dosage is constantly exceeded, leads to the development of anemia, in some cases - pancytopenia (lack of all blood cells), impaired immunity, bleeding. NSAIDs are not prescribed for serious illnesses bone marrow and after his transplant.

Effects associated with a violation of well-being - nausea, weakness, inhibition of reaction, decreased attention, feeling tired, allergic reactions up to asthmatic attacks - occur individually.

Classification of NSAIDs

To date, there are many drugs of the NSAID group, and their classification should help the doctor in choosing the most appropriate drug. In this classification, only international non-proprietary names are indicated.

Chemical structure

According to the chemical structure, such non-steroidal anti-inflammatory drugs are distinguished.

Acids (absorbed in the stomach, increase acidity):

• salicylates:
• pyrazolidins:
• indoleacetic acid derivatives:
• derivatives of phenylacetic acid:
• oxicams:
• propionic acid derivatives:

Non-acid derivatives (do not affect the acidity of gastric juice, are absorbed in the intestines):

• alkanones:
• sulfonamide derivatives:

According to the effect on COX-1 and COX-2

Non-selective - inhibit both types of enzyme, these include most of the NSAIDs.

Selective (coxibs) inhibit COX-2, do not affect COX-1:

• Celecoxib;
• Rofecoxib;
• Valdecoxib;
• Parecoxib;
• Lumiracoxib;
• Etoricoxib.

Selective and non-selective NSAIDs

Most NSAIDs are non-selective because they inhibit both types of COX. Selective NSAIDs - more modern drugs, affecting mainly COX-2, and minimally affecting COX-1. This reduces the risk of side effects.

However, the full selectivity of the action of drugs has not yet been achieved, and the risk of side effects will always be.

New generation drugs

The new generation includes not only selective, but also some non-selective NSAIDs that have a pronounced effectiveness, but are less toxic to the liver and hematopoietic system.

Non-steroidal anti-inflammatory drugs of the new generation:

• - has an extended period of action;
• - has the strongest analgesic effect;
• - prolonged period of action and a pronounced analgesic effect (comparable to morphine);
• Rofecoxib- the most selective drug, approved for patients with gastritis, peptic ulcer without exacerbation.

Non-steroidal anti-inflammatory ointments

The use of NSAIDs in the form for local application(ointments and gels) has a number of advantages, first of all, the absence of a systemic effect and a targeted effect on the focus of inflammation. In diseases of the joints, they are almost always prescribed. The most popular ointments:

• Indomethacin;

NSAIDs in tablets

The most common dosage form of NSAIDs is tablets. It is used to treat various diseases, including articular.

Of the advantages - they can be prescribed for the treatment of manifestations of a systemic process that captures several joints. Of the shortcomings - pronounced side effects. The list of NSAID drugs in tablets is quite long, these include:

General application features

Non-steroidal anti-inflammatory drugs for the treatment of joints are prescribed in courses or as needed, depending on the course of the disease.

The main feature of their use is that it is not necessary to take several drugs of this group at the same time in the same dosage form (especially for tablets), since this increases side effects, and therapeutic effect remains the same.

It is permissible to use different dosage forms at the same time, if necessary. It is important to remember that contraindications to taking NSAIDs are common to most drugs in the group.

NSAIDs remain the most important means for the treatment of joints. They are difficult, and sometimes almost impossible to replace by any other means. Modern pharmacology is developing new drugs from this group in order to reduce the danger of their side effects and increase the selectivity of action.

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

Nonsteroidal- not containing in its composition the core of cyclopentanperhydrophenanthrene, 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 fifth century BC. In 1827, 30 grams of salicin was isolated from the bark of this plant. In 1869, on the basis of salicin, the active substance, salicylic acid, was obtained.

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

First medical preparation from the group of NSAIDs was synthesized in 1897 by Bayer. It was obtained by acetylation of salicylic acid. He received a proprietary name - "Aspirin". Aspirin has the right to be called only the drug of this pharmacological company.

Until 1950, aspirin was the only non-steroidal anti-inflammatory drug. Then, active work began on the creation of more effective means.

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

Mechanism of action of NSAIDs

The main point of application of NSAIDs are biologically active substances - prostaglandins. The first of them were found in the secretion of the prostate gland, hence their name. Two main types have been 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 thrombosis.
• Cyclooxygenase type 2 (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 selective and non-selective drugs. Selective agents block the COX-2 enzyme to a greater extent. Reduce inflammation without affecting the processes in the digestive tract.

The action of cyclooxygenase of the second type is directed:

• to increase vascular permeability;
• release of inflammatory mediators in the damaged area;
• increased swelling in the area of ​​inflammation;
• migration of phagocytes, mast cells, fibroblasts;
• an increase in the overall 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:

• alteration stage develops in the first minutes of exposure to a damaging factor. Damage causing agents can be physical, chemical or biological. Biologically active substances are released from the destroyed cells, triggering the subsequent stages;
• exudation (impregnation), is characterized by the effect on mast cells of substances from dead cells. Activated basophils release histamine and serotonin into the site of damage, 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 overbearing. There is pain. It is at this stage that non-steroidal anti-inflammatory drugs are effective;
• proliferation stage, occurs at the moment of resolution of the second stage. The main cells are fibroblasts, which form a connective tissue matrix to restore the destroyed structure.

Stages do not have a clear time frame and are often included in combination. With a pronounced stage of exudation occurring with a hyperergic component, the proliferation stage is delayed. The appointment of NSAID drugs contributes to the speedy recovery and facilitates general state sick.

The main groups of non-steroidal anti-inflammatory drugs

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

Salicylates

The most studied substance is acetylsalicylic acid. The analgesic effect is very moderate. It is used as a drug to reduce temperature in febrile conditions and as a means of improving microcirculation in cardiology (in small doses it reduces blood viscosity by blocking type 1 cyclooxygenase).

Propionates

Salts of propionic acid have an average analgesic and pronounced antipyretic effect. The best known is ibuprofen. Due to low toxicity and high bioavailability, it is widely used in pediatric practice.

Acetates

Derivatives of acetic acid are well known and widely used in medicine. They have a pronounced anti-inflammatory effect and a strong analgesic effect. Due to the large effect on type 1 cyclooxygenase, they are used with caution in 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. Predominantly act on COX-2. They have a pronounced analgesic and antipyretic effect of central action.

The most popular NSAID drugs and their cost

• Acetylsalicylic acid.

Efficient and inexpensive drug. Available in dosages of 500 milligrams and 100 mg. average price on the market 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. Widely used in pediatrics.

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

• Paracetamol.

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

Included in combined drugs as an analgesic and antipyretic component. It has a central mechanism of action, without affecting the hematopoiesis and the gastrointestinal tract.

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

• Citramon P.

Combined drug containing anti-inflammatory and psychostimulant components. Caffeine increases the sensitivity of receptors in the brain, tropic to paracetamol, enhancing the action 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 is most in demand in the form of injections and local forms (ointments and patches).

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

• Nimesulide.

A selective drug that has a blocking effect on type 2 cyclooxygenase. It has a good analgesic and antipyretic effect. Widely used in dentistry and 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, characterized by a pronounced analgesic effect, comparable to the action of non-narcotic analgesics. It has a strong ulcerogenic effect on the mucosa of the gastrointestinal tract. Applied with caution.

Must be dispensed strictly by prescription. 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 accompanied by inflammation, pain and fever. It should be remembered that drugs are rarely used for monotherapy. Treatment must be comprehensive.

Important. Use the data in this paragraph only if emergency situation does not allow you to contact a qualified specialist in the near future. Coordinate all treatment issues 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 swelling of the joint and increased effusion of synovial fluid.

In severe cases, treatment is reduced to joint prosthetics.

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 a small amount of water.

Rheumatoid arthritis

- inflammatory process of autoimmune etiology. There are multiple inflammatory processes in various tissues. Joints and endocardial tissues are predominantly affected. NSAIDs are the drugs of choice in combination with steroid therapy. The defeat of the endocardium always leads to the deposition of blood clots on the surface of the valves and chambers of the heart. Taking acetylsalicylic acid at 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, compression of small venous vessels and nerve endings occurs.

stagnation occurs venous blood in the damaged organ, which further enhances metabolic disorders. There is 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 ​​injury or sprain three times a day. The damaged organ needs rest and immobilization for several days.

Osteochondrosis

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

With a decrease in the lumen of the channel nerve roots, innervating organs and muscles, experience compression. This leads to the development of inflammatory processes and swelling 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 administered 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 to two scoops three times a day).

Pain in the lumbar region

With this localization, it is most often affected. The pain is quite intense. is formed from the spinal roots emerging in the intervertebral foramina of the sacrum, leaving in a limited area in the shallow tissues of the gluteal region. This predisposes to its inflammation, with hypothermia.

NSAID ointments containing Diclofenac or Nimesulide are used. With severe pain, a 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. Pain sensations are transmitted from its membranes and receptors in the vessels.

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

Migraine

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

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

Acute attack of gout

The disease is caused by metabolic disorders uric acid. Its salts are deposited in various organs and tissues of the body, causing widespread pain. NSAIDs help to 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.

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

Dysmenorrhea

Painful periods or pain in the lower abdomen in front of them are common in women of childbearing age. Caused by spasms in the smooth muscles of the uterus with rejection of the mucosa. The duration of pain and their intensity is individual.

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

Treatment painful menstruation may include the use of biphasic estrogenic drugs that normalize hormonal background organism.

Fever

An increase in body temperature is nonspecific pathological process accompanying 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 temperature body, most of the biochemical processes in the body take place. The mechanisms of thermoregulation in higher organisms are of a neurohumoral nature. In maintaining temperature homeostasis, the main role is played by a small section of the hypothalamus, called the infundibulum.

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 can affect the synthesis of prostaglandin, indirectly reducing body temperature. Paracetamol acts on COX-1 in the center of thermoregulation, providing a quick, but short-lived antipyretic effect.

With fever, Ibuprofen exhibits the greatest antipyretic activity, acting indirectly. To reduce fever at home, a regimen with both drugs is justified.

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 the result of bone destruction rapid growth tooth. From the destroyed cells, biologically active substances are released that have a direct effect on the centers of the hypothalamus. Macrophages contribute to the inflammation process.

Most effective drug, which eliminates inflammation and reduces temperature, is Nimesulide at a dose of 25-30 milligrams, taken once or twice, completely stops the phenomena in 90-95 percent of cases.

Risks when using NSAIDs

Studies have shown that long-term use of non-selective drugs adversely affects the mucous membrane of the stomach and intestines. Ulcerogenic effect of acetylsalicylic acid is confirmed. Long-term use of non-selective agents is recommended to be carried out in conjunction with proton pump blockers (omeprazole).

Selective NSAIDs tenfold increase the risk of developing coronary disease heart and long-term use. Aspirin is the only exception to this list. The antiplatelet properties of acetylsalicylic acid are used to prevent thrombosis, preventing blockage of the main vessels.

Cardiologists warn that patients who have recently experienced 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 largely based on the feelings of the patients themselves. No objective data were provided on testosterone levels, seminal fluid studies, or physical examination 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 branches of its activity. Medicine has become an evidence-based, effective and progressive science.

There are over seven billion of us today. 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

Joint pain significantly complicates life and interferes with a full life. Pain does not go away on its own. Therefore, treatment is accompanied, first of all, by anti-inflammatory drugs. Their list is quite wide. In structure, they differ from others in the absence of steroid hormones, which allows a large group of patients to take the medicine.

Non-steroidal anti-inflammatory drugs are used to treat large and small joints, as well as ligaments. The disease is accompanied by swelling, pain and hyperthermia. At the same time, prostaglandins are formed in the body - substances that activate the production of hormones in the blood. As a result of the influence on the vessels, the body temperature rises, and inflammatory reactions intensify, which leads to arthritis, osteochondrosis and other unpleasant diseases.

The enzyme cyclooxygenase (COX) is blocked by the non-hormonal action of NSAIDs. Swelling and redness decrease, the temperature returns to normal, inflammation subsides.

NSAIDs have a positive effect on diseases:

• relieve inflammation;
• have analgesic properties;
• effectively lower the temperature;
• have an antiaggregatory effect - eliminate the adhesion of platelets.

Do not forget that drugs - immunosuppressants, help in the treatment of rheumatism, but have a depressing effect on immune system generally.

Classification of drugs

It is worth noting that COX is divided into two types. The first produces prostaglandin, which protects the lining of the stomach and intestines from damage. And the second connects prostaglandins that increase the temperature.

Therefore, drugs are usually differentiated into two parts:

• selective (they inhibit COX2);
• non-selective.

The latter, in turn, are also grouped. Some act equally on both COX, others on COX1.

The former are prescribed for acute respiratory viral infections, after operations, for injuries, infections, others save from rheumatism and diseased joints, have anti-inflammatory properties.

Indications for the use of NSAIDs for the treatment of joints

Anti-inflammatory drugs are safe for short-term use and in the absence of contraindications.

Medicines are used in chronic and acute inflammatory processes:

• migraine;
• trauma;
• arthritis, rheumatism, ankylosing spondylitis;
• toothache;
• gout;
• renal and hepatic colic;
• inflammatory diseases of the spine, muscles, musculoskeletal system, joints and bones;
• sciatica, sciatica, neuralgia;
• painful critical days;
• infections;
• metastases in cancer.

List of non-steroidal anti-inflammatory drugs

Acetylsalicylic acid (aspirin).

In practice for over a hundred years. Assign to fight SARS, relieve headaches. Together with other substances, they are used for the treatment of osteoarthritis. But in acute inflammation, aspirin is replaced by more powerful medicines.

Diclofenac.

Available in tablets, suppositories, gel and injection. The popular pain reliever is absorbed within twenty minutes and understands the fever.

Ibuprofen.

Release form - candles, tablets. It is easy to carry, has a low price tag. It is prescribed for neuralgia, bursitis, hematomas, sprains, influenza, SARS, rheumatoid arthritis, gout, Bechterew's disease, osteoarthritis, feverish conditions. Ibuprofen has many analogues in different price categories.

Nimesulide.

When using it, the temperature normalizes, the body becomes mobile as a result of anesthesia. The ointment is applied to the arthritic area. There is a slight redness, so the effect of the drug is manifested.

Indometacin is one of the strongest drugs with analgesic effect.

Produced in the form of ointments, suppositories, tablets. Although the medicine is cheap, this does not prevent it from having an incomparable effect on arthritic and arthrotic joints. Before use, a doctor's consultation is required due to the impressive list of side effects.

Meloxicam belongs to the group of NSAIDs.

Available in tablets and in solution for intramuscular injection. pharmachologic effect- analgesic anti-inflammatory with antipyretic effect. Indicated for symptomatic therapy reducing pain and inflammation. Treats osteoarthritis, rheumatoid arthritis, ankylosing spondylitis. It is allowed to use meloxicam under the supervision of a specialist even for several years. Long-term exposure allows you to take one tablet during the day. It is possible to purchase a substance under various names - Movalis, Melbek, Melox, Artrozan, Mesipol, Mataren, etc.

Some drugs, under the strict supervision of a doctor, are allowed to be taken by pregnant women in case of vital necessity, in no case in the third trimester.

The doctor may prescribe:

• diclofenac;
• ibuprofen;
• aspirin;
• ketorolac;
• indomethacin;
• naproxen.

It is forbidden to drink medicines on your own.

NSAIDs of a new generation for the treatment of joints

Medical technology does not stand still. Every day, hundreds of scientists are trying to develop the latest pills and modernize the time-tested. Non-steroidal anti-inflammatory drugs have not been spared either. New generation drugs act more selectively and thoroughly suppress inflammation. The most important thing here is the absence of a serious impact on gastrointestinal tract and cartilage.

List of new generation non-steroidal anti-inflammatory drugs

Among the useful "drugs", Movalis with the active ingredient in the form of meloxicams became the most effective. With arthrosis, a real lifesaver. Long-term use has practically no effect on the work of the stomach and intestines. Analogues work in the same area - Melbek, Mesipol, Mirloks.

The drug Ksefokam has the ability to stretch the effect of the panacea, so that patients do not feel pain for about twelve hours. Most importantly, Ksefokam is not addictive, and the ability to relieve pain is comparable to morphine. However, the high cost does not allow everyone to purchase the drug in the first-aid kit. Produced by prescription.

The antioxidant Nimesulide blocks the action of substances that break down collagens and cartilage. Arthrosis of the joints is treatable, the pain becomes dull, the inflammation disappears. Sold in granules for solution, tablets, in the form of a gel.

Celecoxib was originally called Celebrex. Release form - capsules 200 and 100 mg. A pronounced fight against arthrosis arthritis does not affect the functioning of the gastrointestinal tract, the mucous membrane remains normal.

Etoricoxib is sold under the brand name Arcoxia. Reception up to 150 mg per day does not affect the functioning of the intestines and stomach. The average dose for arthrosis is approximately 30-60 mg per day.

The cost of medicines varies. On the advice of a doctor, the patient can buy a more expensive drug or its analogue, in accordance with contraindications and side effects. Means stop unbearable pain and eliminate inflammation. After taking them, another treatment should be prescribed.

General application rules

Take on an independent guide to medicines is not worth it. Contacting a specialist will help you understand the methods and rules of treatment. To do this, you need to prepare all statements about previous or comorbidities and take tests so that the doctor chooses the right treatment.

Tablets are taken immediately after meals with half a glass of water or low-fat milk to assimilate and protect the gastrointestinal tract from harmful effects. In parallel, bifidobacteria should be taken.

If long-term use is planned, then start with a minimum dose, gradually increasing the amount.

Side effects of non-steroidal anti-inflammatory drugs

1. Allergy.
2. Bronchospasms.
3. Dyspeptic disorders.
4. Violation renal function(nephropathy, vessels constrict).
5. Ulcerogenic action (development of erosion or stomach ulcers).
6. Increased blood activity in the liver.
7. miscarriages.
8. In rare cases, bleeding disorders.

Contraindications to the use of NSAIDs

Any, even the most harmless drug, has contraindications. NSAIDs have several of them:

• pregnancy;
• individual intolerance;
• disorders in the work of the kidneys and liver;
• peptic ulcers of the gastrointestinal tract and duodenum;
• thrombo- and leukopenia.

Non-steroidal anti-inflammatory drugs are used for various pathologies, they relieve pain, fever and inflammation in the tissues. Most orthopedic problems can not do without this group of drugs, as patients are concerned about fairly severe pain that disrupts the quality of life.

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

Assortment of funds

Non-steroidal anti-inflammatory drugs are excellent pain syndromes, reduce high temperature and inhibit the inflammatory process in the tissues of the body. This effect is provided due to the inhibition of 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 plus of the drug, compared with analgesics, which only relieve pain.

Classification

A couple of decades ago, only 7 groups of non-steroidal anti-inflammatory drugs were known, in our time there are already more than 15. NSAIDs are quite popular due to their complex action and good effect, thus they forced opioid analgesics, which depress 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. Old drugs include Ibuprofen, Diclofenac, Voltaren, Nurofen, etc. NSAID drugs new generation is Nimesulide and others.

Depending on whether NSAIDs are acids, 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 with anthranilic acid. This acid is used to make dyes and flavors.
• Pyrazolone preparations.
• Preparations made using isonicotinic acid.
• Derivatives of propionic acid.
• Salicylates.
• Oxycams.
• Pyrazolidins.

New generation

It's no secret that older NSAIDs have a large number of side effects, while they do not have a strong enough anti-inflammatory effect. Conventionally, this can be explained in such a way that the drugs inhibit 2 types of COX-1 and COX-2 enzymes, 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 disturbances in the stomach, as 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 side effects, and at the same time increase the effectiveness of the drug, if we develop a drug that will suppress COX-2, practically without affecting COX-1 enzymes. In recent years, new generation NSAIDs have been developed that do just that. Below is a look at the most popular new tools.

It is one of the most popular non-steroidal anti-inflammatory drugs of the new generation. It is produced in Germany and Spain, and is produced in the form of tablets, ointments, injections and suppositories. Movalis is very well anesthetized, 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, for gout attacks, for Bechterew's disease, for severe pain in the joints. A big plus 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 convenient to use, you need to drink only one tablet a day, as the drug acts for a long time. The cost of a package with 20 tablets of the product is approximately 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 plus of this remedy is that it not only relieves inflammation, fever and pain, but also neutralizes 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 tool can be purchased in the form of tablets, gel for external use, powder for suspension. For 20 pcs of Nise tablets and 20 grams of gel, you will have to pay about 200 rubles.

Xefocam

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, Ksefokam is equated in action with Morphine, but at the same time it does not affect the central nervous system and is not addictive. The drug has side effects, so 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 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 injection will cost around 700 rubles.

Rofecoxib

This drug relieves pain, swelling, inflammation. It is used mainly for orthopedic pathologies, in particular for osteochondrosis, arthritis, arthrosis, and also for toothaches. Such a remedy is sold under the name Denebol in the form of ointments and tablets.

Celecoxib

This drug is very effective for severe pain, while it does not have a negative effect on the gastric mucosa, which is a big plus of the drug. It is produced 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 use of NSAIDs in children. New generation drugs are indicated in the following cases:

• Arthritis, osteoarthritis, gout;
• ankylosing spondylitis;
• Pain in various diseases of the bones and joints;
• Osteochondrosis;
• Soft tissue inflammation, synovitis, bursitis;
• Toothache;
• Pain after surgery;
• Fever.

Contraindications

New generation funds have the following contraindications:

• Intolerance to the components of the drug;
• Gastric ulcers in the acute stage;
• Bleeding in the gastrointestinal tract;
• Reaction to acetylsalicylic acid (in particular rash, bronchospasm);
• Severe pathology of the heart;
• Severe kidney pathology;
• Severe liver pathology;
• Violation of blood clotting;
• Old age with prolonged use;
• Alcoholism;
• Pregnancy and lactation;
• Children's age up to 12 years.

During the period of treatment, it is not recommended to drink alcohol and smoke, and it is also necessary to treat with caution if the patient is taking anticoagulants, glucocorticosteroids, serotonin reuptake inhibitors, antiplatelet agents.

Side effects

New generation non-steroidal anti-inflammatory drugs have been developed specifically to reduce the effect of their administration on the gastrointestinal mucosa. Therefore, these funds do not have a devastating effect on the gastrointestinal tract, and on hyaline cartilage too. But still, with prolonged use, some side effects may occur:

• Allergic reactions to the components of the drug;
• Fluid retention in the body, edema;
• The appearance of protein in the urine;
• Increased activity of liver enzymes;
• digestive problems;
• Headaches;
• General weakness and drowsiness;
• dizziness;
• Increased blood pressure;
• Fast fatiguability;
• The occurrence of dry cough;
• Dyspnea.

To avoid the occurrence of side effects, it is necessary to consult a doctor before taking the remedy, and study the instructions for the drug. It is very important to use the remedy correctly, do not 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 its reception with the help of various folk remedies: rubbing, ointments, compresses. But you should not abuse such methods and neglect the main treatment, you can provoke a worsening of the condition.

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

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 slurry into the affected joint twice a day.

And comfrey.

About funds (video)