Many pathological changes occurring in the body accompany pain. To combat this symptom, NSAIDs, or non-steroidal anti-inflammatory drugs, have been developed. They perfectly anesthetize, relieve inflammation, and reduce swelling. However, drugs have a large number of side effects. This limits their applicability to some patients. Modern pharmacology has developed the latest generation of NSAIDs. Such drugs are much less likely to cause unpleasant reactions, but at the same time remain effective drugs against pain.
Principle of exposure
What determines 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 arachidonic acid 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 the change in renal blood flow.
COX-2 is normally absent and is a specific inflammation enzyme synthesized by cytotoxins and other mediators.
Such an action of NSAIDs, such as inhibition of COX-1, has many side effects.
New developments
It is no secret that drugs of the first generation of NSAIDs had an adverse effect on the gastric mucosa. Therefore, scientists have set a goal - to reduce unwanted effects. A new release form has been developed. In such preparations, the active substance was in a special shell. The capsule was made from substances that did not dissolve in the acidic environment of the stomach. They only began to break down when they enter the intestines. This has reduced the irritating effect on the gastric mucosa. However, the unpleasant mechanism of damage to the walls of the digestive tract is still preserved.
This made chemists synthesize completely new substances. From the previous drugs, they fundamentally differed in the mechanism of action. New generation NSAIDs 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, the latest generation NSAIDs can minimize the effect on blood coagulation, platelet function, and gastric mucosa.
The anti-inflammatory effect is due to a decrease in the permeability of the vessel walls, as well as a decrease in the production of a variety of inflammatory mediators. Due to this effect, irritation of nerve pain receptors is minimized. The effect on certain centers of thermoregulation located in the brain allows the latest generation of NSAIDs to perfectly lower the overall temperature.
Indications for use
NSAID effects are widely known. The impact of such drugs is aimed at preventing or reducing the inflammatory process. These drugs give an excellent antipyretic effect. Their effect on the body can be compared with the influence of narcotic analgesics. In addition, they provide analgesic, anti-inflammatory effects. The use of NSAIDs is widespread in clinical settings and in everyday life. Today it is one of the most popular medical drugs.
Positive effects are noted with the following factors:
- 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, hernias of the intervertebral discs.
- Severe pain. The drugs are quite successfully used for biliary colic, gynecological ailments. They eliminate headaches, even migraines, and kidney discomfort. NSAIDs are successfully used for patients in the postoperative period.
- Heat. The antipyretic effect allows the use of drugs for ailments of a diverse nature for both adults and children. Such medicines are effective even with fever.
- Thrombosis. NSAIDs are antiplatelet agents. This allows them to be used for ischemia. They are a preventive measure against heart attack and stroke.
Classification
About 25 years ago, only 8 NSAID groups were developed. Today this number has increased to 15. However, even the doctors can’t name the exact number. Having appeared on the market, they quickly gained widespread popularity of NSAIDs. The drugs replaced opioid analgesics. Since they, unlike the latter, did not provoke respiratory depression.
Classification of NSAIDs implies a division into two groups:
- Old drugs (first generation). This category includes well-known drugs: Citramon, Aspirin, Ibuprofen, Naproxen, Nurofen, Voltaren, Diklak, Diklofenak, Metindol, Movimed, Butadion .
- New NSAIDs (second generation). Over the past 15-20 years, pharmacology has developed excellent drugs, such as Movalis, Nimesil, Nise, Celebrex, Arkoxia.
However, this is not the only classification of NSAIDs. New generation drugs are divided into non-acid derivatives and acids. Initially, consider the last category:
- Salicylates. This group of NSAIDs contains drugs: Aspirin, Diflunizal, Lysinmonoacetylsalicylate.
- Pyrazolidines. Representatives of this category are drugs: "Phenylbutazone", "Azapropazone", "Oksifenbutazon."
- Oksikama. These are the most innovative new generation NSAIDs. List of drugs: Piroxicam, Meloxicam, Lornoxicam, Tenoxicam. Medicines are not cheap, but their effect on the body lasts much longer than other NSAIDs.
- Derivatives of phenylacetic acid. This group of NSAIDs contains funds: Diclofenac, Tolmetin, Indomethacin, Etodolac, Sulindak, Aceclofenac.
- Anthranilic acid preparations. The main representative is the medicine "Mefenaminate."
- Propionic acid agents. This category contains many excellent NSAIDs. List of drugs: Ibuprofen, Ketoprofen, Benoxaprofen, Fenbufen, Fenoprofen, Tiaprofen acid, Naproxen, Flurbiprofen, Pirprofen, Nabumeton.
- Derivatives of isonicotinic acid. The main medicine is Amizon.
- Pyrazolone preparations. The well-known “Analgin” remedy belongs to this category.
Non-acidic derivatives include sulfonamides. This group includes drugs: Rofecoxib, Celecoxib, Nimesulide.
Side effects
New generation NSAIDs, the list of which is given above, is distinguished by an effective effect on the body. However, they practically do not affect the functioning of the digestive tract. These drugs are distinguished by another positive point: a new generation of NSAIDs do not have a devastating effect on cartilage.
However, even such effective agents are capable of provoking a number of undesirable effects. They should be known, especially if the drug is used for a long time.
The main side effects may include:
- dizziness;
- drowsiness;
- headache;
- fatigue
- heart palpitations;
- increase in pressure;
- shortness of breath
- dry cough;
- digestion disorder;
- the appearance of protein in the urine;
- increased activity of liver enzymes;
- skin rash (pinpoint);
- fluid retention;
- allergy.
In this case, damage to the gastric mucosa is not observed when taking new NSAIDs. The drugs do not cause exacerbation of the ulcer with the occurrence of bleeding.
Recommendations for use
The best anti-inflammatory properties are possessed by phenylacetic acid preparations, salicylates, pyrazolidones, oxycams, alkanones, propionic acid and sulfonamide drugs.
The medications Indomethacin, Diclofenac, Ketoprofen, and Flurbiprofen most effectively relieve joint pain. These are the best NSAIDs for osteochondrosis. The above drugs, with the exception of the drug "Ketoprofen", have a pronounced anti-inflammatory effect. In this category means "Piroxicam".
Effective analgesics are the drugs "Ketorolac", "Ketoprofen", "Indomethacin", "Diclofenac".
The leader among NSAIDs of the last generation was the drug "Movalis". This tool is allowed to apply for a long period. Anti-inflammatory analogues of an effective drug are Movasin, Mirlox, Lem, Arthrosan, Melox, Melbek, Mesipol and Amelotex.
The drug "Movalis"
This drug is available in the form of tablets, rectal suppositories and a solution for intramuscular administration. The tool relates to derivatives of enolic acid. The drug is distinguished by excellent analgesic and antipyretic properties. It has been established that in almost any inflammatory processes, this medicine brings a beneficial effect.
Indications for 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;
- ulcerative bleeding;
- severe liver failure;
- pregnancy, feeding a child;
- severe heart failure.
The drug is not taken by children under 12 years of age.
Adult patients diagnosed with osteoarthrosis are recommended to use 7.5 mg per day. If necessary, such a dose can be increased by 2 times.
With rheumatoid arthritis and ankylosing spondylitis, the daily norm is 15 mg.
Patients 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 per day.
The cost of the drug "Movalis" in tablets of 7.5 mg, No. 20, is 502 rubles.
Consumer opinion about the drug
Reviews of many people who are prone to severe pain indicate that the drug "Movalis" is the most suitable remedy for long-term use. It is well tolerated by patients. In addition, its prolonged presence in the body makes possible a single dose of the drug. A very important factor, according to most consumers, is the protection of cartilage, as the drug does not have a negative effect on them. This is very important for patients who use the drug for osteochondrosis, arthrosis.
In addition, the medicine perfectly eliminates various pains - dental, headache. Patients pay special attention to an impressive list of side effects. While taking NSAIDs, treatment, despite the manufacturer's warning, was not complicated by unpleasant consequences.
The drug "Celecoxib"
The action of this tool is aimed at alleviating the condition of the patient with osteochondrosis and arthrosis. The drug perfectly eliminates the pain syndrome, effectively relieves the inflammatory process. There were no adverse effects on the digestive system.
Indications for use given in the instructions are:
- psoriatic arthritis ;
- osteoarthrosis;
- 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 care must be taken by people who are diagnosed with heart failure, since the drug increases the predisposition to fluid retention.
The cost of the drug varies, depending on the packaging, in the region of 500-800 rubles.
Consumer opinion
Reviews about this medicine are quite controversial. Some patients, thanks to this tool, were able to overcome joint pain. Other patients claim that the drug did not help. Thus, this tool is not always effective.
In addition, you should not take the drug yourself. In some European countries, this medicine is prohibited, since 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 tool 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 tool is very effective in acute paroxysmal pain.
Almost always, the medicine is well tolerated by patients. But sometimes side effects, such as dizziness, drowsiness, headache, nausea, heartburn, hematuria, oliguria, urticaria, may occur.
The drug is not approved for use by pregnant women and children under 12 years of age. With special care should take the drug "Nimesulide" people who have arterial hypertension, impaired functioning of the kidneys, vision or heart.
The average price of a drug is 76.9 rubles.
What do consumers say?
Reviews about the drug are almost always positive. Since the medicine perfectly eliminates pain and reduces fever, it fights inflammatory processes perfectly.
Many patients note that symptomatic relief comes quickly enough, and its exposure lasts about eight hours.
An excellent tool perfectly eliminates tooth, traumatic, arthritic pain. The drug is able to relieve the discomfort caused by a pinched nerve.
The drug "Xefocam"
This medicine is part of the oxycam group. This group of NSAIDs has an increased half-life, as a result of which the effect of the drug is prolonged. This has significantly reduced the frequency of taking the medication. Consequently, the risk of side effects is reduced.
The drug "Xefocam" has the highest ability to relieve pain. Its analgesic effect on the strength of manifestation is comparable to morphine. However, unlike the latter, the drug is not addictive and does not affect the central nervous system.
During testing, it was noted that the drug eliminates pain for 12 hours.
The cost of the medicine in tablet form (8 mg) per pack No. 10 is 205 rubles.
The drug "Rofecoxib"
The medicine has an anti-inflammatory analgesic, decongestant and antipyretic effect. An effective remedy is prescribed for the following ailments:
- chronic periarthritis;
- rheumatoid arthritis;
- tendonitis;
- bursitis;
- injuries of tendons of ligaments, muscles.
At the same time, the Rofecoxib drug quite effectively eliminates a variety of pain symptoms caused by neuralgia, osteochondrosis, and pulpitis. The tool perfectly eliminates lumbago, toothache, radicular syndrome.
The drug is not to be taken by patients with bronchial asthma, after a heart attack, stroke. Do not use it for people with cancer, arterial hypertension and atherosclerosis. The drug is prohibited for children under 12 years of age. In addition, it is advisable to carefully study possible side effects before use.
The drug "Parecoxib"
This is an excellent tool to reduce inflammatory reactions and helps to reduce the sensitivity of pain receptors. The drug is in demand for patients undergoing surgery.
It eliminates moderate to severe pain syndromes. It is prescribed after endoprosthetics of the hip and knee joints, hysterectomy, coronary artery bypass grafting, and is used in dental practice.
Dosage of the drug is purely individual. It depends on the clinical situation and indications. For children under 18 years of age, the medicine is not intended.
The drug "Arkoxia"
The medicine has another name - "Etoricoxib." The tool is characterized by high anti-inflammatory, analgesic properties. The drug contributes to the inhibition of the pain impulse.
Patients with ailments of the musculoskeletal system using this tool get rid of morning stiffness. They have an improvement in joint mobility, the intensity of inflammation decreases, the pain syndrome is well stopped. After taking the therapeutic effect occurs within twenty-four minutes. The active substance of the drug is perfectly absorbed with the bloodstream. The drug is highly bioavailable. This indicator is 100%.
The dose of the drug can only be prescribed by a doctor. , 60 120 .
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Conclusion
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