NSAIDs are today a dynamically developing class of drugs. This is due to the wide range of applications of this pharmaceutical group, which has anti-inflammatory, antipyretic and analgesic activity.
- 1 Features of the action of NSAIDs and their main effects
- 2 Indications for use NSAIDs
- 3 Undesirable effects and contraindications
Features of the action of NSAIDs and their main effects
NSAIDs block the action of the enzyme cyclooxygenase( COX), inhibiting the synthesis of prostaglandins from arachidonicacid. Prostaglandins in the body are mediators of inflammation, lower the threshold of sensitivity to pain, inhibit lipid peroxidation and inhibit the aggregation of neutrophils.
The main effects of NSAIDs are:
- Anti-inflammatory. Suppress the exudative phase of inflammation, and, to a lesser extent, proliferative. Diclofenac, Indomethacin represent the most powerful for this effect drugs. But the anti-inflammatory effect is less pronounced than in glucocorticosteroids.
Practical physicians use the classification according to which all NSAIDs are divided into: drugs with high anti-inflammatory activity and agents with weak anti-inflammatory activity. Aspirin, Indomethacin, Diclofenac, Piroxicam, Ibuprofen and many others are highly active. This group includes a large number of different drugs. Low anti-inflammatory activity has Paracetamol, Metamizol, Ketorolac and some others. The group is not numerous.
- Painkiller. The most pronounced in Diclofenac, Ketoralak, Metamizol, Ketaprofen. Used for pain of low and medium intensity: dental, muscular, headache. Effective in renal colic, tk.do not have spasmogenic effect. Compared with narcotic analgesics( a group of morphine), do not exert a depressant effect on the respiratory center, do not cause addiction.
- Antipyretic. All drugs have this property to varying degrees. But it manifests itself only in the presence of fever.
- Antiaggregation. Is manifested by suppressing the synthesis of thromboxane. This effect is most pronounced in Aspirin.
- Immunosuppressive. It manifests itself again, due to the deterioration of the permeability of the capillary walls.
Indications for use NSAIDs
The main indications are:
- Rheumatic diseases. Include rheumatism, rheumatoid arthritis, Bechterew's disease, gouty and psoriatic arthritis, Reiter's disease. With these diseases, the use of NSAIDs is symptomatic, without affecting pathogenesis. Ie to slow down the development of the destructive process with rheumatoid arthritis, to prevent deformity of the joints, the intake of drugs of the NSAID group can not. But patients' complaints about pain, joint stiffness in the initial stages of the disease become less frequent.
- Diseases of the musculoskeletal system are non-rheumatic. This includes injuries( bruises, sprains), myositis, tendovaginitis. With the above diseases, NSAIDs are administered orally, as injections. And very effective external means( ointments, creams, gels) that have in their composition the active substances of this group.
- Neurological diseases. Lumbago, radiculitis, myalgia. Often appoint a combination of different forms of release of drugs( ointment and tablets, injections and gel, etc.)
- Renal, hepatic colic. Preparations of the NSAID group are effective for all types of colic, tk.do not cause additional spasm of smooth muscle structures.
- Pain symptoms of various etiologies. Pain relief in the postoperative period, dental and headache.
- Dysmenorrhea. NSAIDs are used to stop the pain syndrome with primary dysmenorrhea and to reduce the amount of blood loss. A good effect is Naproxen, Ibuprofen, which is recommended to take on the eve of menstruation and then three days. Such short-term courses prevent the appearance of undesirable effects.
- Fever. Antipyretic drugs recommend taking at a body temperature of more than 38.5 ° C.
- Prevention of thrombosis. To prevent thrombus formation, Acetylsalicylic acid is used in low dosage. It is prescribed to prevent heart attacks, strokes with various forms of coronary heart disease.
Undesirable effects and contraindications
Drugs of the NSAID group have a negative effect on:
- Stomach and intestine
- Nervous system
The stomach most often suffers from NSAID administration. It manifests itself with nausea, diarrhea, epigastric pains and other dyspeptic complaints. There is even such a syndrome - NSAID-gastropathy, the occurrence of which is directly related to the intake of NSAIDs. Especially at risk of pathology patients of advanced age, with the presence of a gastric ulcer in an anamnesis, taking simultaneously glucocorticosteroid drugs.
The probability of NSAID-gastropathy increases with prolonged use of drugs in high doses, as well as with the intake of two or more NSAIDs. To protect the stomach mucosa, omeprazole, lansoprazole, esomeprazole and other inhibitors of the proton pump are used. The defeat of the liver can be in the form of severe toxic hepatitis, and can manifest as transient function disorders with an increase in the level of transaminases in the blood.
The liver is most often affected by taking Indomethacin, Phenylbutazone, Aspirin. From the kidneys can decrease diuresis, acute renal failure, nephrotic syndrome, as a result of the defeat of the renal tubules. The greatest danger is represented by Ibuprofen, Naproksen.
In the blood there is a violation of the processes of coagulation, anemia occurs. Dangerous for side effects from the blood system Diclofenac, Piroxicam, Butadion. Often, unwanted effects from the nervous system occur when taking Aspirin, Indomethacin. And manifested headache, noise in the ears, nausea, and sometimes vomiting, mental disorders. Admission of NSAIDs is contraindicated in the case of:
- Gastric or intestinal ulcers
- Pregnancy and during lactation
- Presence of bronchial asthma
- Epilepsy, Parkinsonism, mental disorders
- Hemorrhagic diathesis, thrombocytopenia
- Arterial hypertension and heart failure( not all drug groups)
- Individual intolerance of drugmeans
Aspirin is a representative of the NSAID group. About its benefits and harm to the human body in the video:
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