From time to time, each person is concerned about pains of various genesis. After junk food, the stomach may become sick, after sleepless due to work or study at night, the head aches from pain impulses. For various reasons, it breaks bones, teeth, muscles, joints hurt. Usually in such cases, a person, without hesitation, grabs any analgesic that comes to hand - the problem goes away and life gets better. However, you need to know that many antipyretic, anti-inflammatory and analgesic drugs have side symptoms, one of which is an ulcerogenic effect.
What medications are worth considering?
Almost all medicines have mild or pronounced side effects with different likelihood of their manifestation. All of them must be indicated in the instructions for use. Despite the possible manifestation of negative symptoms after administration, it is impossible to do without some drugs in clinical practice. Non-steroidal anti-inflammatory drugs (abbreviated as NSAIDs) help to cope with pain, fever, fever and inflammation in the body. This is the familiar aspirin, diclofenac, paracetamol and many other drugs that fall into different subgroups. In medicine, NSAIDs are divided into several categories depending on the chemical structure and activity of the action. All of them are united by the presence of the mentioned ulcerogenic effect.
Effect characteristic
Most drugs in the NSAID group have one unpleasant side effect. It consists in a negative effect on the digestive system of the patient. With their prolonged use, when used in large doses, as well as with the use of two types of tablets at once, the formation of defects in the gastrointestinal mucosa is observed in patients. Quite often, this defect manifests itself in the form of erosive and ulcerative lesions, since the active substances of the drugs not only destroy the mucous cells, causing erosion, but can also provoke a relapse of peptic ulcer. This feature must be taken into account by the doctor when drawing up a treatment plan.
NSAID Classification
First of all, non-steroidal anti-inflammatory drugs in their structure and action are opposed to glucocorticoids (steroid drugs), which are prescribed and used in exceptional cases due to the huge number of side effects: hypertension, addiction, weight gain and decreased immunity. Back in the 1830s, since the discovery of salicylic acid, NSAIDs are beginning to replace opiates. At the moment, non-steroidal drugs are actively used in medical practice.
Depending on the chemical composition, effectiveness and mechanism of action, all NSAIDs are divided into several categories. Speaking about the chemical structure and effectiveness, the following groups can be distinguished: acids, non-acid derivatives and NSAIDs with weak anti-inflammatory activity. Of the acids, the subgroup of salicylates and its main representative, aspirin, which has the greatest ulcerogenic effect among the other representatives of the acids, are especially distinguished. Pyrazolidines, derivatives of indoleacetic and phenylacetic, prionic acids also belong to the group of acids.
Sulfonamide derivatives belong to the group of non-acid derivatives. The last group of NSAIDs with weak anti-inflammatory activity, allocated based on the effectiveness of the action, include pyrazolones and derivatives of anthranilic, heteroaryl acetic acids.
Features of the action of NSAIDs
Anti-inflammatory drugs work on the principle of inhibiting (slowing down enzymatic reactions) of cyclooxygenase, namely, its first and second varieties. The creation of prostaglandins responsible for the inflammatory process is inhibited. The absorption of steroid drugs occurs in the gastrointestinal tract, which causes the ulcerogenic effect of NSAIDs. The cells of the gastric mucosa are destroyed as a result of the accumulation of the drug in the cytoplasm, and penetration into the synovial fluid (elastic mass filling the joint SIM and facilitating the movement of joints) also occurs, which ensures reduction and elimination of joint pain.
The analgesic effect is achieved by changing the behavior of pain impulses in the spinal cord and by entering into the opioid receptors. The anti-inflammatory effect is associated with an inhibition of the activation of neutrophils and the subsequent weakening of inflammatory mediators. A side effect of drugs that have similar effects is the development of diseases of the stomach and duodenum.
Anti-inflammatory drugs and analgesics
The main function of NSAIDs, based on the decryption of the abbreviation itself, is to reduce the level of inflammation in the body. The drugs with the first group, acids, have the greatest anti-inflammatory effect. To stop the inflammatory process, aspirin, diclofenac, ibuprofen are used, much of which also ketorolac. Means of the second group have a weak anti-inflammatory effect, and in medical practice are often referred to as "non-narcotic analgesics." Moreover, for the onset of anti-inflammatory effect, it is necessary to take medication within 10-14 days, in contrast to the analgesic effect, which occurs within an hour, two or several hours after taking the drug.
Each drug, even if they are in the same group, has a different percentage of side effects, the main of which is precisely the ulcerogenic effect. Also, non-steroidal drugs are often taken to relieve pain in muscles and joints, with pain in the teeth or headache, since they have an analgesic effect. However, with extremely severe pain, for example, due to a cancerous tumor, NSAIDs are considered ineffective and do not bring the desired result. In this case, the doctor resorts to extreme measures and prescribes narcotic analgesics that are part of the morphine group, which are quite dangerous for the human body and are addictive.
Antipyretic drugs and antiplatelet agents
Speaking of NSAIDs, one can not help but mention the drugs that are used to lower body temperature, deviating from normal values. Also, some NSAIDs are antiplatelet agents whose job it is to prevent blood clots from forming in blood vessels. It occurs by inhibiting the process of combining platelets and red blood cells. Blood flow remains at an acceptable level, it does not clot, thereby not forming a blood clot.
Drugs aimed at lowering body temperature to normal levels have only a symptomatic effect, which means that the drugs have no antibacterial and antiviral activity. They do not cure the disease, but only suppress its symptom in the form of high fever. Therefore, if it lasts for more than 3 days, if fever and muscle pain, headaches persist, then hospitalization and professional medical care are necessary.
Side effects of drugs
As noted above, almost all non-steroidal drugs have side effects, the possibility of manifestation of which varies from drug to drug. From 30 to 40% of patients regularly and regularly taking NSAIDs receive complaints about problems from the gastrointestinal tract. They manifest as pain in the stomach, intestines, nausea, and vomiting. Their complex is dyspeptic disorders.
A smaller number of patients (10-20%) have more serious problems - erosive damage in the stomach and intestines, as well as the occurrence of peptic ulcer. Side effects of NSAIDs in 2-3% of cases include internal bleeding. So, the patient, due to bleeding wounds in the stomach or intestines, can lose up to 5 ml of blood daily with stool.
List of non-steroid drugs
As for the list of NSAIDs, it is better to build it in accordance with the division of drugs according to the principle of chemical composition, namely, acids and non-acid derivatives. Separately, NSAIDs with weak anti-inflammatory activity can also be distinguished.
The main representative of acids is aspirin. Acids also include: phenylbutazone (used for toothache, headache, dermatitis, arthritis); diclofenac (for arthritis, osteochondrosis, hernias, various pains) and piroxicam; ibuprofen (arthritis, gout, sciatica, toothaches and headaches) and ketoprofen.
These include only sulfonamide derivatives: nimesulide, celecoxib, rofecoxib. These drugs, like other NSAIDs, serve to reduce pain, reduce high body temperature and the strength of the inflammatory process. Symptomatically well affect gout, arthrosis and other diseases that cause severe pain.
- NSAIDs with weak anti-inflammatory activity.
Among them, two main representatives can be distinguished - this is paracetamol and ketorolac. Paracetamol is known to almost everyone and is used primarily to lower fever during illness. Including in the composition of such drugs as Fervex and Teraflu. As for the second representative, in pharmacies they often ask about what Ketorolac comes from. It is well suited to reduce pain: in the teeth, with various injuries, dislocations and sprains, radiculitis.
NSAIDs for gastrointestinal problems
The use of non-steroidal drugs should be particularly controlled in patients who have erosion or ulcers in the stomach, duodenum. The destructive effect of drugs on the cells of the mucous membrane of the digestive system can be reduced by the simultaneous use of drugs such as Misoprostol and Omeprazole, which prevent the development of ulcers and erosion.
Side effects of drugs can also be reduced by reducing the dose, by switching to rectal or local administration of the drug. In terms of reducing the load on the digestive tract, it is best to use enteric-coated tablets. Treatment of patients particularly susceptible to erosion and ulceration should be accompanied by constant endoscopic monitoring.
General conclusion
Unfortunately, many drugs, including NSAIDs, treat one and cripple the other. Such drugs as aspirin, diclofenac, ibuprofen, paracetamol, ketorolac, which can not be dispensed with in medical practice, tend to destroy the cells of the mucous membrane of the digestive system. Regular use of anti-inflammatory, antipyretic drugs, analgesics increases the risk of erosion and ulcers in the stomach and duodenum. A list of non-steroidal anti-inflammatory drugs and side effects from their administration can be found above.