The widespread use of non-steroidal anti-inflammatory drugs in medicine is due to their pronounced therapeutic effect. They are able to eliminate the symptoms inherent in many diseases: pain, fever, inflammation. In recent years, the list of drugs in this group has been replenished with a list of non-steroidal anti-inflammatory drugs (NSAIDs) of a new generation with increased efficiency against the background of improved tolerability.

What is NSAID

Non-steroidal anti-inflammatory drugs (NSAIDs, NSAIDs) belong to a group of drugs aimed at symptomatic therapy of acute and chronic pathologies. They do not belong to steroid hormones, they have a pronounced therapeutic effect against inflammation, pain of varying intensity, and fever.

The action of non-steroidal NSAIDs is due to a reduction in the production of enzymes (cyclooxygenase) that trigger reactive processes in the body in response to the effects of pathological factors.

Anti-inflammatory NSAIDs, although similar in chemical structure, may differ in the strength of the effect, the presence and severity of side effects. The choice of the drug is carried out by the doctor, based on the type of pathology, its clinical manifestations. NSAIDs of the new generation are characterized by a high therapeutic result with low toxicity. This is due to their widespread use in medicine.

Non-narcotic analgesics, NSAIDs are successfully used all over the world to treat pathologies of the musculoskeletal system, to eliminate pain in various diseases and conditions (premenstrual syndrome, postoperative period, etc.). NSAIDs act on blood clotting, thinning it (by increasing plasma volume), reduce formed elements (cholesterol plaques), which is used in the treatment of a number of diseases of the heart and blood vessels (atherosclerosis, heart failure, and others).

Classification

NSAIDs are classified according to several criteria.

By belonging to the generation of medicines:

• First generation. The drugs of this group have long been present on the pharmacological market: Aspirin, Ibuprofen, Diclofenac, Voltaren, Naproxen and others.
• New generation. This group includes Nise, Nimulid, Movalis, Arcoxia and others.

By chemical composition NSAID drugs may refer to acids or non-acid derivatives.

• Salicylates: Aspirin.
• Pyrazolidines: metamizole sodium NSAIDs (analgin). Despite the difference between analgesics and NSAIDs in chemical structure, they have common pharmacological qualities.
• Propionic acid agents: NSAIDs Ibuprofen, Ketoprofen.
• Means of indolacetic acid: Indomethacin.
• Anthranilic acid agents: Mefenaminate.
• Means of phenylacetic acid: NSAIDs Diclofenac.
• Means of isonicotinic acid: Amizon.
• Oxicams: Piroxicam, Meloxicam. Differ in long effect and more expressed force of action.

Non-acid agents include Nimesulide, Nabumeton.

According to the mechanism of action:

• Non-selective inhibitors of COX-1 and COX-2 (cyclooxygenase enzymes) - inhibit both types of enzymes. Classical anti-inflammatory drugs belong to this species. The difference between NSAIDs of this group is in the blocking of COX-1, which are constantly present in the body. Their suppression can be accompanied by negative side effects.
• Selective NSAID COX-2 inhibitors. The use of these drugs is preferable, since they act exclusively on enzymes that appear in response to pathological processes in the body. However, their increased effect on the heart and blood vessels is noted (they can cause an increase in blood pressure).
• Selective NSAID COX-1 inhibitors. The group of such drugs is insignificant (aspirin), since by acting on COX-1, the active ingredient usually also affects COX-2.

The strength of the anti-inflammatory effect among NSAIDs, Indomethacin, Flurbiprofen, Diclofenac can be distinguished. Amidopyrine, Aspirin have a weaker effect.

By the strength of the analgesic action The classification of NSAIDs includes drugs with the maximum effect: Ketorolac, Ketoprofen, Diclofenac, and others. Naproxen, Ibuprofen, Aspirin have a minimal analgesic effect.

List of drugs

In pharmacology, a wide range of NSAIDs in various dosage forms is presented. Their action is distinguished by the strength of the therapeutic effect, duration, the presence of side effects, method of application. Modern effective NSAIDs are distinguished by a minimal risk of negative consequences of taking them, a quick and long-lasting result.

Tablets

The tablet dosage form of NSAID preparations is considered the most common. It has a high absorption of the active components of the drug into the systemic circulation, which ensures the therapeutic efficacy of drugs. However, NSAIDs in tablets more than other forms affect the patient's digestive tract, in some cases causing negative side effects.

Arcoxia

The active ingredient of the drug is etoricoxib. It has analgesic, anti-inflammatory, antipyretic properties. Selective suppression of COX-2 causes a reduction in the clinical manifestations of diseases without negative effects on the digestive tract and platelet function.

Contraindications: hypersensitivity, ulcerative lesions of the digestive tract, internal bleeding, hemostasis disorders, severe cardiac pathologies, severe renal and hepatic dysfunctions, coronary heart disease, peripheral arterial pathologies, pregnancy, lactation, age up to 16 years.

Side effects: epigastric pain, dyspepsia, stool disorders, gastric ulcer, headache, increased blood pressure, cough, edema, renal and hepatic dysfunction, bronchospasm, hyperreaction of the body to the drug.

denebol

The active ingredient of the drug is rofecoxib. By blocking COX-2, the drug has pronounced analgesic, decongestant, anti-inflammatory, anti-febrile effects. The absence of an effect on COX-2 ensures good tolerance of the drug, the minimum number of negative consequences of taking it.

Contraindications: hypersensitivity, oncology, asthma, pregnancy, lactation, age up to 12 years.

Side effects: intestinal disorders, dyspepsia, abdominal pain, hallucinations, confusion, renal and hepatic dysfunction, hypertension, circulatory disorders (coronary and cerebral), swelling of the legs, hypersensitivity reactions.

Xefocam

The active substance is lornoxicam. It has analgesic, anti-inflammatory, antipyretic properties. The drug inhibits the activity of cyclooxygenase enzymes, inhibits the production of prostaglandins, the release of free radicals. Does not affect the opioid receptors of the central nervous system, respiratory function. There is no addiction and dependence on the medication.

Contraindications: hypersensitivity, ulcers, bleeding in the gastrointestinal tract, severe renal and hepatic dysfunction, pregnancy, lactation, severe heart disease, dehydration, age under 18 years.

Side effects: visual impairment, hearing impairment, hepatic, renal dysfunction, headache, increased blood pressure, chills, peptic ulcers, bleeding from the gastrointestinal tract, dyspepsia, hypersensitivity reactions.

Movalis

The active ingredient is meloxicam. The drug has pronounced anti-inflammatory, antipyretic, analgesic qualities. It has a long-lasting effect and the possibility of long-term use. There are fewer side effects than when taking other NSAIDs. Does not affect the state of the platelet hemostasis system.

Contraindications: hypersensitivity, ulcers (acute period), bleeding in the gastrointestinal tract, severe renal and hepatic dysfunction, hemostasis disorders, pregnancy, lactation, age up to 12 years.

Side effects: manifestations of hypersensitivity, headache, perforation and bleeding from the gastrointestinal tract, colitis, gastropathy, abdominal pain, changes in liver function, increased blood pressure, acute renal dysfunction, urinary retention.

Nimesulide

The active ingredient of the drug is nimesulide. Selectively inhibits COX-2, reducing the production of prostaglandins. At the same time, it also affects their precursors (short-lived prostaglandins H2). This is due to the pronounced analgesic, anti-febrile, anti-inflammatory qualities of NSAIDs. The drug activates glucocorticoid centers, reducing inflammation in the tissues. It is effective in acute pain syndrome due to the rapid analgesic effect.

Contraindications: pregnancy, age up to 12 years, ulcers and bleeding in the digestive tract, hypersensitivity, severe renal and hepatic insufficiency.

Side effects: headache, gastralgia, dyspepsia, ulceration of mucous tissues, oliguria, hematuria, hypersensitivity reactions, changes in blood counts.

Celecoxib

NSAIDs of the coxibs class, has analgesic, anti-inflammatory, antipyretic properties. It is mainly used in rheumatology for the treatment of arthrosis, arthritis, ankylosing spondylitis. Effectively and quickly eliminates pain in the muscles, back, in the postoperative period. It is used to treat primary dysmenorrhea.

Contraindications: hypersensitivity, ulcers, bleeding in the gastrointestinal tract, coronary heart disease, severe renal and hepatic dysfunction, pregnancy, lactation, age up to 18 years.

Side effects: ulcers, bleeding from the gastrointestinal tract, renal, hepatic dysfunction, bronchospasm, cough, hypersensitivity reactions, epigastric pain, dyspepsia, headache.

Ointments

This dosage form is used externally. It has a local therapeutic effect without being absorbed in the body and without causing systemic side effects when used correctly.

Apizartron

Active components of the drug: methyl salicylate, bee venom, allyl isothiocyanate, Roymakur aquasols, rapeseed oil, ethanol denatured with camphor. The ointment has an analgesic, anti-inflammatory effect. Local irritant and vasodilating effects of the drug improve blood circulation in the damaged area. It is used for arthralgia, myalgia, neuritis, sprains and other problems. After spreading the ointment on the skin, it is recommended to keep the treated area warm.

Contraindications: acute arthritis, skin diseases, severe renal and hepatic dysfunction, pregnancy, hypersensitivity.

Side effects: local hypersensitivity reactions.

Ben Gay

The active ingredients of the drug are methyl salicylate, menthol. The ointment has an irritating effect on the skin receptors, a vasodilating effect on the capillaries. The use of the cream relieves muscle spasms, reduces pain, tension, improves blood circulation in tissues. As a result of therapy, the range of motion increases, inflammation in the affected area is reduced.

Contraindications: sensitivity to the components of the drug, damage to the skin, dermatological diseases, age up to 12 years, pregnancy, lactation.

Side effects: local hypersensitivity reactions (itching, urticaria, erythema, peeling, irritation).

Kapsikam

The active components of the drug are nonivamide, dimethyl sulfoxide, camphor, turpentine, benzyl nicotinate. The ointment has analgesic, irritating, warming qualities. As a result of application in the affected area, blood circulation improves. A decrease in pain syndrome is noted half an hour after application and lasts about 6 hours. A small amount of the drug is absorbed into the systemic circulation.

Contraindications: hypersensitivity, skin lesions, dermatological diseases, pregnancy, lactation, childhood.

Side effects: local hypersensitivity reactions (itching, tissue swelling, rash).

Mataren Plus

The active component of the cream is meloxicam, supplemented with pepper tincture. It has analgesic, anti-edematous, anti-inflammatory properties. The warming effect of the ointment improves blood circulation in the tissues. It is used for pathologies of the joints and spine, injuries, sprains.

Contraindications: skin damage or disease, hypersensitivity to components, age up to 12 years.

Side effects: local hypersensitivity reactions, manifested by irritation, rash, itching, burning, peeling.

Finalgon

The active ingredients of the ointment are nonivamide, nicoboxyl. The drug has analgesic, vasodilating, hyperemic effects. The combined effect of the drug improves blood supply to tissues, accelerates enzymatic reactions, metabolic processes. A decrease in clinical manifestations is observed already a few minutes after the distribution of the ointment on the skin and becomes maximum after half an hour.

Contraindications: hypersensitivity, age up to 12 years, damaged skin or its sensitive areas (lower abdomen, neck, etc.), dermatological diseases.

Side effects: manifestations of hypersensitivity, paresthesia, burning in the area of ​​application, cough, shortness of breath.

Candles

Suppositories are often used in gynecological, urological practice. They have less negative impact on the gastric mucosa. Designed for rectal administration.

denebol

The active ingredient of the drug is rofecoxib. Suppositories are applied rectally, are prescribed for acute pain syndrome of inflammatory origin, for the treatment of primary dysmenorrhea. Candles are placed twice a day, the course should not exceed 6 weeks.

Contraindications: oncological pathologies, bronchial asthma, age up to 12 years, pregnancy, lactation, hypersensitivity.

Side effects: soreness in the abdomen, bowel disorder, hallucinations, confusion, renal and hepatic dysfunction, circulatory disorders (coronary and cerebral), hypertension, swelling of the legs, hypersensitivity reactions.

Melbeck

The active active component of the selective NSAID is meloxicam. The drug has analgesic, antipyretic, anti-inflammatory properties. It is used for symptomatic treatment of various diseases of the musculoskeletal system, including for the relief of significant pain syndrome (with osteoarthritis and rheumatoid arthritis). Effective for relieving muscle, toothache.

Contraindications: hypersensitivity, severe renal and hepatic dysfunction, acute ulcers, bleeding in the gastrointestinal tract, asthma, pregnancy, lactation, age up to 18 years.

Side effects: dyspeptic manifestations, intestinal disorders, abdominal pain, stomach ulcers, increased blood pressure, blurred vision, headache, hypersensitivity reactions.

Movalis

The active ingredient in suppositories is meloxicam. NSAIDs are derivatives of enolic acid. The drug has pronounced anti-inflammatory, analgesic, anti-febrile qualities. Often prescribed for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis.

Contraindications: hypersensitivity, ulcers, bleeding in the digestive tract (exacerbation), severe renal and hepatic insufficiency, severe cardiac dysfunction, pregnancy, lactation, age up to 12 years.

Side effects: perforation in the gastrointestinal tract, dyspepsia, gastritis, colitis, abdominal pain, renal and hepatic dysfunction, diarrhea, cytopenias, bronchospasm, headache, palpitations, increased blood pressure, hypersensitivity reactions.

Revmoxicam

The active ingredient of the drug is meloxicam. Suppositories have pronounced anti-inflammatory, antipyretic, analgesic properties. The drug effectively reduces pain, inflammation in diseases of the musculoskeletal system. There is no effect on the activity of chondrocytes and the production of proteoglycan, which is important in diseases of the joints.

Contraindications: hypersensitivity, ulcers, bleeding in the digestive tract, severe renal, hepatic dysfunction, heart failure inflammation in the rectum, pregnancy, lactation, age up to 15 years.

Side effects: dyspeptic manifestations, epigastric pain, ulcers, bleeding in the gastrointestinal tract, hypertension, edema, arrhythmias, liver dysfunction.

Tenoxicam

The active ingredient in rectal suppositories is tenoxicam. The drug has anti-inflammatory, antipyretic, analgesic properties. Eliminates pain in muscles, spine, joints. Helps increase range of motion, get rid of morning stiffness and swelling in the joints. Normalization of the patient's condition is noted within a week of therapy.

Contraindications: ulcers, bleeding in the digestive tract, hypersensitivity to the components of the drug, severe renal dysfunction, pregnancy, lactation.

Side effects: dyspeptic manifestations, abdominal pain, headache, hypersensitivity reactions, hepatic dysfunction, gastric ulcer, local irritation, pain during defecation.

Gel

It is used for local effects on the affected area. The active components are minimally absorbed into the systemic circulation, which ensures good tolerability of the drug, the absence of negative consequences. May cause manifestations of hypersensitivity in the area of ​​application.

Amelotex

The active substance is meloxicam. It has pronounced local analgesic and anti-inflammatory properties. It is distinguished by the absence of a negative effect on cartilaginous tissue, which ensures the widespread use of the gel in degenerative-dystrophic changes in the skeletal system.

Contraindications: skin lesions in the area of ​​application, skin diseases, age up to 18 years, pregnancy, lactation, hypersensitivity.

Side effects: itching, burning, peeling, hyperemia, rash, photosensitivity.

denebol

The active components of the drug are rofecoxib, methyl salicylate, menthol, linseed oil. The drug has a local analgesic, anti-inflammatory effect. Methyl salicylate increases blood flow in the affected area, eliminating swelling and bruising. It is used for musculoskeletal pathologies (arthritis, arthrosis, neuralgia, osteochondrosis, etc.), injuries. The gel is applied externally 3-4 times a day with light rubbing movements.

Contraindications: hypersensitivity.

Side effects: itching, burning, peeling, irritation of the skin in the area of ​​application.

nise

The active component of the gel is nimesulide, when applied externally it has analgesic and anti-inflammatory effects. It is used for local therapy of pathologies of the spine, joints, muscle pain, injuries, sprains. As a result of treatment, pain at rest and movement, stiffness (in the morning), and swelling of the joints are reduced. Absorption of the drug into the systemic circulation is minimal.

Contraindications: hypersensitivity, ulcers, bleeding in the digestive tract, skin lesions and dermatological diseases, severe renal and hepatic dysfunction, pregnancy, lactation, age up to 7 years.

Side effects: overreaction of the body. With prolonged therapy and applying the gel to a large area of ​​the body, systemic negative phenomena may be observed.

Nimid

The active ingredient of the drug is nimesulide. When used externally, the absorption of the active component into the systemic circulation is minimal, which ensures good tolerability of the agent, its low toxicity. It is used to relieve pain, inflammatory symptoms in pathologies of the spine and joints, injuries, inflammation of soft tissues, etc.

Contraindications: hypersensitivity, damage to the skin, dermatological diseases in the area of ​​application of the product, age up to 12 years, 3rd trimester of pregnancy.

Side effects: local and general hypersensitivity reactions.

Nimulid

The active ingredient of the drug is nimesulide. The drug is applied topically, has analgesic, anti-inflammatory qualities. The gel is distributed in a thin layer over the painful area. Do not use more than 4 times a day, avoid contact with eyes. Therapy is usually long. With external use, the absorption of the active component into the systemic circulation is minimal, which ensures the absence of pronounced side effects.

Contraindications: hypersensitivity, damaged skin in the area of ​​​​application of the product.

Side effects: itching, burning, peeling, irritation of the skin at the site of application of the drug.

injections

The parenteral form of administration is often used to eliminate acute pain. It is usually used in the first days of therapy, after which a transition to other dosage forms is carried out.

denebol

The drug is presented in ampoules with a solution for intramuscular injection. The active ingredient is rofecoxib. It is forbidden to administer the drug intravenously. It is used for a quick analgesic effect in various diseases and conditions (arthritis, trauma, migraine, neuralgia, algomenorrhea). It has anti-edema, anti-inflammatory, antipyretic properties.

Contraindications: oncology, pregnancy, lactation, age up to 12 years, hypersensitivity, condition after a heart attack and stroke, progressive atherosclerosis, malignant hypertension.

Side effects: dyspeptic manifestations, abdominal pain, confusion, hallucinations, renal, hepatic dysfunction, hypertension, circulatory disorders (cerebral and coronary), congestive heart failure, hypersensitivity reactions.

Xefocam

The medicine is presented in the form of a powder for making a solution. The introduction is made intramuscularly or intravenously. Parenteral use is recommended for acute pain syndrome (after surgery, with sciatica). The drug has a rapid analgesic effect (after a quarter of an hour).

Contraindications: hypersensitivity, hemostasis disorders, ulcers, bleeding in the gastrointestinal tract, severe hepatic and renal dysfunction, asthma, heart failure, hemorrhagic stroke, pregnancy, lactation, age up to 18 years.

Side effects: headache, aseptic meningitis, hearing and vision disorders, renal and hepatic dysfunctions, dyspeptic manifestations, ulcers, bleeding in the gastrointestinal tract, hypersensitivity phenomena.

Meloxicam

The drug is intended for intramuscular injection. Differs in speed of therapeutic effect, possesses anti-inflammatory, febrifugal, analgesic action. Injections are made exclusively into the muscle, intravenous use is prohibited. Parenteral administration is indicated in the first days of therapy, then the transition to tablet forms is carried out.

Contraindications: hypersensitivity, severe cardiac dysfunction, ulcers in the gastrointestinal tract, internal bleeding, severe renal and hepatic dysfunction, pregnancy, lactation, age up to 12 years.

Side effects: dyspepsia, epigastric pain, intestinal disorders, ulcer, bleeding from the gastrointestinal tract, hepatic and renal dysfunction, headache, edema, bronchospasm, hypersensitivity reactions.

Movalis

The drug is intended for intramuscular route of administration. The active ingredient is meloxicam. It is considered a popular, frequently prescribed and effective drug in the treatment of pathologies of the musculoskeletal system due to its pronounced medicinal properties and low toxicity. Actively inhibits COX-2 enzymes (and slightly COX-1), reducing the biosynthesis of prostaglandins. It has chondroneutrality, is often used for articular pathologies.

Contraindications: hypersensitivity, pronounced renal, hepatic dysfunction, ulcers, bleeding in the gastrointestinal tract, pregnancy, lactation, age up to 15 years.

Side effects: dyspeptic manifestations, abdominal pain, intestinal disorders, ulcers, bleeding in the gastrointestinal tract, renal, hepatic dysfunction, anemia, headache, edema, increased blood pressure, allergic reactions.

Revmoxicam

The drug is presented in an injectable form, the active ingredient is meloxicam. Indicated for use in degenerative pathologies of the skeletal system (including arthrosis, rheumatoid arthritis, spondyloarthritis). The drug is administered exclusively by intramuscular route. The dose and duration of therapy is determined by the doctor, based on the type of pathology and the patient's condition.

Contraindications: hypersensitivity, ulcers, bleeding in the gastrointestinal tract, severe renal, hepatic dysfunction, heart failure, inflammation in the rectum, pregnancy, lactation, age up to 15 years.

Side effects: dyspeptic manifestations, abdominal pain, ulcers, bleeding in the gastrointestinal tract, hypertension, edema, arrhythmias, liver dysfunction.

Drops

In ophthalmic practice, the use of NSAID drugs for topical use is common. In the vast majority of cases, the active ingredients of the drugs are diclofenac or indomethacin, as an alternative to glucocorticosteroids.

Broxinac

The active ingredient is bromfenac. Eye drops are used in the treatment of inflammation and pain after surgery for cataract extraction. The therapeutic effect (analgesic and anti-inflammatory) persists throughout the day.

Contraindications: hypersensitivity, age up to 18 years, pregnancy, lactation, bleeding tendency.

Side effects: discomfort, pain, itching in the eye area, their hyperemia, inflammation of the iris, erosion, corneal perforation, its thinning, headache, retinal hemorrhage, decreased vision, edema, hypersensitivity reactions.

diclofenac

The active component of the drops is diclofenac sodium. The drug has a pronounced local analgesic and anti-inflammatory effects. It is used for inhibition of miosis, prevention and treatment of cystic macular edema during cataract surgery, in the treatment of inflammation of non-infectious etiology.

Contraindications: hypersensitivity, pregnancy, childhood and old age, tendency to bleeding, violations of hemostasis.

Side effects: burning, itching, hyperemia of the eye area, blurred vision after application, nausea, vomiting, hypersensitivity reactions.

DIKLO-F

The active ingredient is diclofenac. The use of the drug reduces inflammation in the eye (after infection, trauma, surgery), reduces miosis during operations, the production of prostaglandins in the fluid of the anterior chamber of the eyes. The absorption of the drug into the systemic circulation is negligible and has no clinical significance.

Contraindications: violations of hemostasis, exacerbation of ulcerative lesions in the digestive tract, hypersensitivity.

Side effects: burning, blurred vision after application, clouding of the cornea, itching, redness of the eyes, hypersensitivity reactions.

Indocollier

The active ingredient is indomethacin. The drug has pronounced local anti-inflammatory and analgesic properties. Systemic absorption of the drug is minimal, which ensures its good tolerability. It is used for the treatment of inflammation after eye surgery, conjunctivitis of non-infectious origin, suppression of miosis during surgery due to cataracts.

Contraindications: hypersensitivity, violations of hemostasis.

Side effects: burning, blurred vision when using drops, hypersensitivity reactions.

Nevanak

The active component of the drops is nepafenac. When used locally, the active ingredient enters the cornea, where it is converted to amfenac, which inhibits the activity of cyclooxygenase. It is used for the treatment and prevention of pain, inflammation, the formation of macular edema (in people with diabetes) after surgery due to cataracts.

Contraindications: hypersensitivity, age up to 18 years, pregnancy, lactation.

Side effects: punctate keratitis, feeling of a foreign object in the eye, the formation of crusts on the edges of the eyelids, sinusitis, lacrimation, hyperemia, hypersensitivity reactions.

Indications

Indications for the use of NSAIDs are:

• Joint diseases. However, in most cases they have only a symptomatic effect, without affecting the course of the pathology. NSAIDs are used for arthritis (rheumatoid, gouty, psoriatic), rheumatism, ankylosing spondylitis, Reiter's syndrome. The use of NSAIDs for arthrosis greatly facilitates the clinical manifestations of the disease.
• Osteochondrosis, sciatica, sciatica, trauma, osteoarthritis, myositis. The course use of NSAIDs for hernia helps to eliminate pain.
• Inflammatory processes in soft tissues, bursitis, synovitis.
• Renal and hepatic colic. Drugs are used for the purpose of pain relief.
• Fever. The antipyretic effect of drugs is used at temperatures above 38 degrees. For this purpose, NSAIDs are often used for children, mainly in the form of suppositories or syrup.
• Pain of various etiologies(head, dental, postoperative).
• In the complex therapy of coronary heart disease, atherosclerosis, heart failure, in order to prevent arterial thrombosis.
• Dysmenorrhea and other gynecological pathologies. They are used to relieve pain and reduce blood loss.

Mechanism of action

Symptoms of most acute and chronic diseases include inflammation, pain, fever. Direct participation in the formation of these phenomena in the body is taken by bioactive substances - prostaglandins. Their production depends on cyclooxygenase enzymes, presented in two isoforms COX-1 and COX-2, which are targeted by the inhibitory effect of non-steroidal anti-inflammatory drugs.

• Anti-inflammatory effect achieved by reducing the production of inflammatory mediators, reducing the permeability of the vascular walls;
• blocking inflammation reduces irritation of nerve receptors, which helps to eliminate pain;
• Impact on body thermoregulation causes a decrease in temperature during fever.

The difference between new generation drugs and classic NSAIDs lies in the selectivity of action. Classical drugs usually suppress not only the direct inflammatory mediator COX-2, but also COX-1, which is constantly present in the body, providing a protective effect on the gastric mucosa, platelet viability. As a result, there are many negative side effects, especially on the digestive tract. Modern safe NSAIDs, inhibiting only COX-2, significantly reduce the risk of side effects.

NSAIDs, even with prolonged use, do not cause addiction and dependence.

Dosage

The choice of the drug is carried out by the doctor, based on the type of disease and the desired therapeutic effect. This takes into account the patient's history, the presence of contraindications for admission, tolerability of the drug. The dosage is also set by the doctor, it is recommended to start with the lowest effective dose. With good tolerance, the norm is increased after 2-3 days.

Therapeutic dosages of drugs differ, while there is a tendency to increase the daily and single dose of drugs (Ibuprofen, Naproxen), which have a minimum number of side effects. Restrictions on the maximum intake per day of Aspirin, Indomethacin, Phenylbutazone, Piroxicam remain. The frequency of taking drugs in this group also varies and ranges from 1 to 3-4 times a day.

In some pathologies, the effectiveness of the use of these drugs is observed only at high dosages of drugs, while the combination of several NSAIDs is impractical (except for Paracetamol, which is combined with other drugs to enhance the effect).

Ways to receive

When using NSAIDs, one should take into account their features and adhere to certain rules for use:

• Topical agents (gels, ointments), which are considered the safest NSAIDs, are distributed over the painful area. It is necessary to wait for absorption and only then put on clothes. Water procedures can be taken after a few hours.
• When taking NSAIDs, it is necessary to strictly observe the dose prescribed by the doctor, not exceeding the daily dose. If symptoms persist, it is recommended to consult a doctor to change the drug to a more potent one.
• Dosage forms for oral administration are preferably taken after eating, minimizing the damaging effect on the mucosa of the digestive tract. For a faster effect, it is possible to use half an hour before meals or 2 hours after. The protective shell from the capsules is not removed, you need to drink the product with a sufficient amount of water.
• When using suppositories, a faster therapeutic effect is noted than with a tablet form. This method of administration is used in young children. To do this, the child is placed on the left side, and the suppository is inserted rectally, the buttocks are compressed. Within 10 minutes, make sure that the drug does not come out.
• Injection requires sterility and certain medical skills.
• When using medications, it is necessary to consult a doctor, since the action of NSAIDs is directed more to the elimination of symptoms than to treatment. In some cases, the analgesic effect can mask the symptoms of dangerous diseases (gynecological, digestive tract, etc.).
• It is necessary to take into account the possible interaction of drugs with other medications taken. The joint use of NSAIDs with antibiotics (aminoglycosides), digoxin increases the toxicity of the latter. During therapy, there may be a weakening of the therapeutic effect of antihypertensive drugs. NSAIDs can increase the effect of indirect anticoagulants and hypoglycemic drugs.
• The combined use of NSAIDs and alcohol significantly increases the likelihood of developing negative phenomena in the body.

Contraindications

When prescribing and taking NSAIDs, it is necessary to take into account possible contraindications to their use:

• a pronounced degree of allergy to NSAIDs in history (bronchospasm, rash);
• ulcers, bleeding in the digestive tract;
• period of pregnancy and lactation;
• severe heart disease;
• pathology of the liver and kidneys of severe course;
• violations of hemostasis;
• old age (with prolonged therapy);
• alcoholism;
• children's age (for some dosage forms and preparations);

With caution, NSAIDs are prescribed to patients with bronchial asthma.

Side effects

NSAIDs of the new generation minimize the risk of negative effects, without irritating the mucous tissues of the digestive tract and hyaline cartilage. However, some side effects from taking NSAIDs, especially with prolonged therapy, are still present:

• hypersensitivity reactions;
• digestive dysfunctions: stool disorder, dyspepsia, gastropathy;
• fluid retention in tissues, edema;
• the presence of protein in the urine;
• bleeding, mainly in the gastrointestinal tract;
• increased activity of liver indicators;
• aplastic anemia, agranulocytosis;
• headaches, weakness, dizziness, increased blood pressure;
• dry cough, bronchospasm.

Non-steroidal anti-inflammatory drugs (NSAIDs, NSAIDs) are drugs that have analgesic (analgesic), antipyretic and anti-inflammatory effects.

Their mechanism of action is based on the blocking of certain enzymes (COX, cyclooxygenase), they are responsible for the production of prostaglandins - chemicals that contribute to inflammation, fever, pain.

The word "non-steroidal", which is contained in the name of the group of drugs, emphasizes the fact that the drugs in this group are not synthetic analogues of steroid hormones - powerful hormonal anti-inflammatory drugs.

The most famous representatives of NSAIDs: aspirin, ibuprofen, diclofenac.

How do NSAIDs work?

If analgesics fight directly with pain, then NSAIDs reduce both the most unpleasant symptoms of the disease: both pain and inflammation. Most of the drugs in this group are non-selective inhibitors of the cyclooxygenase enzyme, inhibiting the action of both of its isoforms (varieties) - COX-1 and COX-2.

Cyclooxygenase is responsible for the production of prostaglandins and thromboxane from arachidonic acid, which in turn is obtained from cell membrane phospholipids by the enzyme phospholipase A2. Prostaglandins, among other functions, are mediators and regulators in the development of inflammation. This mechanism was discovered by John Wayne, who later received the Nobel Prize for his discovery.

When are these drugs prescribed?

Typically, NSAIDs are used to treat acute or chronic inflammation accompanied by pain. Non-steroidal anti-inflammatory drugs have gained particular popularity for the treatment of joints.

List the diseases that prescribe these drugs:

• (menstrual pain);
• bone pain caused by metastases;
• postoperative pain;
• fever (increased body temperature);
• intestinal obstruction;
• renal colic;
• moderate pain due to inflammation or soft tissue injury;
• lower back pain;
• pain at .

Non-steroidal anti-inflammatory drugs are a large group of pharmacological agents characterized by pronounced anti-inflammatory, analgesic and antipyretic effects.

Note:nonsteroidal anti-inflammatory drugs (NSAIDs) are abbreviated as NSAIDs or NSAIDs.

Important:such a common pain reliever and howParacetamol , does not belong to the group of NSAIDs, because it does not affect the inflammatory process, and is used only to relieve symptoms.

How do non-steroidal anti-inflammatory drugs work?

The action of NSAIDs is aimed at inhibiting the production of the cyclooxygenase (COX) enzyme, which in turn is responsible for the synthesis of biologically active substances - thromboxane, prostaglandins (PG) and prostacyclins, which act as inflammatory mediators. A decrease in the level of PG production contributes to the reduction or complete relief of the inflammatory process.

Different varieties of cyclooxygenase are present in a variety of organs and tissues. The COX-1 enzyme, in particular, is responsible for the normal blood supply to the mucous membrane of the digestive organs and maintaining a stable pH of the stomach by reducing the synthesis of hydrochloric acid.

COX-2 is normally present in tissues in small amounts, or not detected at all. An increase in its level is directly related to the development of inflammation. Drugs that selectively inhibit the activity of this enzyme act directly on the pathological focus. Due to this, there is no indirect negative effect on the organs of the digestive tract.

Note:COX-3 does not affect the dynamics of the inflammatory process, but is responsible for the development of pain and febrile reaction due to hyperthermia (rise in overall body temperature).

Classification of non-steroidal anti-inflammatory drugs for joints

According to the selectivity of the impact, all NSAIDs are divided into:

1. Non-selective, inhibiting all types of COX, but mainly - COX-1.
2. Non-selective, affecting both COX-1 and COX-2.
3. Selective COX-2 inhibitors.

The first group includes:

• Acetylsalicylic acid;
• Piroxicam;
• Indomethacin;
• Naproxen;
• Diclofenac;
• Ketoprofen.

The representative of the second category is Lornoxicam.

The third group includes:

• Nimesulide;
• Rofecoxib;
• Meloxicam;
• Celecoxib;
• Etodolac.

Important:Acetylsalicylic acid and Ibuprofen mainly reduce body temperature, and Ketorolac (Ketorol) reduces the intensity of pain. To reduce inflammation of the joints, they are ineffective, and can only be used for symptomatic therapy.

Pharmacokinetics

Systemic NSAIDs when taken per os are very rapidly absorbed. They are characterized by very high bioavailability (it varies from 70 to 100%). The process of absorption slows down somewhat with an increase in the pH of the stomach. The highest content in the blood serum is reached 1-2 hours after ingestion.

If the drug is administered intramuscularly, it is conjugated (connected) with plasma proteins (the level of binding is up to 99%). The resulting active complexes freely penetrate into the joint tissues and synovial fluid, mainly concentrating in the focus of inflammation.

The active substances of NSAIDs and their metabolites are excreted by the kidneys.

Contraindications

It is highly undesirable for women to use systemic NSAIDs (enteral or parenteral forms) for the treatment of joints during pregnancy. Some drugs in this category may be prescribed by the attending physician if the intended benefit to the mother is higher than the possible risk to the fetus.

Contraindications also include:

• individual hypersensitivity to the drug;
• and erosion of the digestive tract;
• leukopenia;
• thrombopenia;
• and/or liver failure.

Side effects of non-steroidal anti-inflammatory drugs

Drugs that inhibit COX-1 can provoke the development or exacerbation of gastrointestinal diseases, including hyperacid and ulcerative-erosive lesions of the walls of the digestive tract.

Often noted side effects are dyspeptic disorders (, severity "in the pit of the stomach",).

Regular use of NSAIDs or exceeding the recommended dosages often causes a violation of blood clotting, manifested by bleeding. With prolonged use, a decrease in the number of blood cells is possible, up to the development of such a serious disease as aplastic anemia.

Many NSAIDs have a nephrotoxic effect, leading to a decrease in the functional activity of the kidneys, and provoking. With prolonged use, they contribute to the development of nephropathy. Drugs can have a negative effect on liver function.

There is also a possibility of developing bronchospasm while taking non-steroidal anti-inflammatory drugs for the treatment of joints.

The specifics of anti-inflammatory therapy

All means of this group should be used only as prescribed by a doctor, followed by control of the dynamics of the inflammatory process. The patient should immediately notify the attending physician about all negative changes in the condition. Therapy is carried out at the lowest effective doses for the shortest possible time!

Preparations in the form of capsules or tablets should preferably be taken after meals with plenty of liquid (preferably clean water). So you can reduce the damaging effect of drugs on the mucous membrane of the digestive tract.

With the local use of anti-inflammatory gels and ointments, the likelihood of side effects is almost zero, since the active ingredients almost do not enter the systemic circulation.

Selected NSAIDs for the treatment of joint inflammation

When choosing a drug, the doctor takes into account the nature of the disease, the severity of the pathological process, as well as the individual characteristics of the patient's body (including the presence of chronic diseases and age).

Most often used:

Indomethacin

This medicine is available in the form of capsules and tablets. Standard single dosages are from 25 to 50 mg, and the frequency of administration is 2-3 times a day. Against the background of taking Indomethacin, the side effects characteristic of NSAIDs are especially common, so other, safer means are increasingly being preferred.

diclofenac

Analogues of this drug are Voltaren, Naklofen and Diklak. Diclofenac is produced by pharmacological companies in the form of tablets and capsules, an injection solution, gels for application to the affected joint area, and in the form of suppositories. Inside, it is prescribed at a dose of 50-75 mg 2-3 times a day, and the daily dose should not exceed 300 mg. The solution is injected intramuscularly (in the buttock), 3 ml each, observing the time interval between at least 12 hours. Injections are carried out in courses of no more than 5-7 days. The gel should be applied in the projection of the affected joint 2-3 times a day.

Etodolac

The analogue of the drug is Etol Fort. Etodolac is available in 400 mg capsules. It is selective, preferentially inhibiting the activity of COX-2. The drug is prescribed for both emergency care and course therapy, ankylosing spondylitis and osteoarthritis. Single dose - 1 capsule (1-3 times a day after meals). If there is a need for a course, the attending physician adjusts the dosage every 2-3 weeks after assessing the dynamics of the process. Side effects are relatively rare.

Important:Etodolac may reduce the effectiveness of some blood pressure medicines.

Aceclofenac

Analogues of the drug - Zerodol, Diclotol and Aertal. Aceclofenac is a good alternative to Diclofenac in terms of effectiveness. It is produced in tablets of 100 mg, and is used both for urgent relief of symptoms and for course treatment. It is advisable to take tablets 1 pc. 2 times a day with meals. Against the background of admission, pain in the abdominal region is also possible (symptoms are observed in almost 10% of patients), so it is advisable to treat the joints with minimally effective doses and short courses.

Piroxicam

The drug is available in tablets of 10 mg and in the form of a solution for injection; analogue of Piroxicam - Fedin-20. The active substance penetrates into the synovial fluid of the joints, acting directly in the focus of inflammation. Depending on the nosological form and the activity of the process (severity of symptoms), dosages vary from 10 to 40 mg per day (taken simultaneously or divided into several doses). The analgesic effect develops already 30 minutes after taking the tablets and lasts an average of a day.

Tenoxicam

Tenoxicam (Texamen-L) is sold as a powder for the preparation of an injection solution for intramuscular administration. The standard dosage is 2 ml, which corresponds to 20 mg of the active substance (administered 1 time per day). When during the period of exacerbation, a course of treatment is recommended for 5 days (up to 40 mg is administered to the patient daily).

Lornoxicam

The medicine is available in tablets (4 and 8 mg each), as well as in the form of a powder (8 mg) for dilution. Analogues - Lorakam, Ksefokam and Larfiks. The usual dosage of Lornoxicam is 8 to 16 mg 2-3 times a day before meals. Tablets should be taken with a large amount of liquid. The solution is intended for intravenous or intramuscular administration of 8 mg 1-2 times a day. The maximum allowable daily dose for the injection form is 16 mg.

Important:special care in the treatment of Loraxicam should be observed in patients suffering from diseases of the stomach.

Nimesulide

The most common analogues of this drug include Nimesil, Remesulide and Nimegezik. This NSAID is available in the form of granules for suspension, 100 mg tablets and gel for topical external use. The recommended dose is 100 mg 2 times a day after meals. The gel is recommended to be applied to the skin in the projection of the affected joint with light rubbing movements 2-4 times a day.

Important:patients with renal or hepatic insufficiency are assigned smaller doses. The drug has a hepatotoxic effect.

Meloxicam

Other trade names for Meloxicam are Melox, Recoxa, Movalis and Revmoxicam. This remedy for the treatment of inflammation of the joints is produced in the form of tablets of 7.5 or 15 mg, as well as in the form of a solution in ampoules of 2 ml (corresponding to 15 mg of the active ingredient) and suppositories for rectal administration.

The drug selectively inhibits COX-2; it rarely has a negative effect on the stomach and does not lead to nephropathy. At the very beginning of the course of treatment, Meloxicam is prescribed for intramuscular injection (1-2 ml each), and as the activity of the inflammatory process decreases, the patient is prescribed tablets. A single dosage of this NSAID is 7.5 mg, and the frequency of administration is 1-2 times a day.

Rofecoxib

Rofecoxib (another trade name is Denebol) is sold in pharmacies as an injection solution (2 ml ampoules contain 25 mg of the active substance) and in tablets. The degree of negative impact of this NSAID on the kidneys and gastrointestinal tract of this drug is extremely low. The standard therapeutic dose is 12.5-25 mg. The frequency of admission (or intramuscular injection) - 1 time per day. With intense joint pain at the beginning of the course, the patient is prescribed 50 mg of Rofecoxib.

Celecoxib

This selective COX-2 inhibitor is produced in the form of capsules containing 100 or 200 mg of the active substance. Analogues of Celecoxib are Flogoxib, Revmoksib, Celebrex and Zycel. NSAIDs rarely provoke the development or exacerbation of gastrointestinal pathologies if the prescribed treatment regimen is strictly followed. The recommended daily dose is 100-200 mg (at the same time or in 2 doses), and the maximum is 400 mg.

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.

The first medical drug from the NSAID group 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 the general condition of the patient.

The main groups of non-steroidal anti-inflammatory drugs

There are many classifications. The most popular 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 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.

An effective and inexpensive drug. Available in dosages 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. 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 the combined preparations, as an anesthetic 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 paracetamol receptors in the brain, 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 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 an emergency situation prevents you from contacting 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.

There is a stagnation of 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 canal, the nerve roots that innervate 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 a violation of the metabolism of 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.

Showing products of 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 of painful periods may include the use of biphasic estrogenic drugs that normalize the hormonal background of the body.

Fever

An increase in body temperature is a nonspecific pathological process that accompanies many disease states. 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 proceed. 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 a consequence of the destruction of bone tissue during the rapid growth of the 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.

The most effective drug that 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 coronary heart disease 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.

Related videos

Interesting

Pain, inflammation and swelling, the main symptoms of many diseases, can be treated with non-steroidal inflammatory drugs. What are their advantages and disadvantages of PSVS, what groups are they divided into?

How do NSAIDs work?

Relieve soreness, eliminate fever, block the inflammatory response - all these functions can be performed by non-steroidal anti-inflammatory drugs.

They are called non-steroidal because they do not contain synthetically analogous steroid hormones of the human body (corticosteroids and sex hormones responsible for the regulation of vital processes).

What are the benefits of non-steroidal anti-inflammatory drugs (NSAIDs):

• unlike conventional painkillers, NSAIDs act in three directions at the same time: relieve pain, inflammation, swelling;
• do not have a negative effect on the body;
• a wide range of applications for different age groups;
• quite a small list of contraindications.

According to the characteristics of the composition and effects on the body, drugs of the group of non-steroidal anti-inflammatory drugs share:

1. With a pronounced anti-inflammatory function: Diclofenac, Indomethacin, Phenylbutazone.
2. With a pronounced antipyretic function: Aspirin, Mefenamic acid,.
3. With a pronounced analgesic function: Metamizole, Ketoprofen, Ketorolac.
4. With pronounced anti-aggregation functions (suppression of thrombus formation, normalization of blood microcirculation): Aspecard, Cardiomagnyl.

When are these drugs prescribed?

NSAIDs are indicated in the treatment of acute and chronic stages of the disease, which are accompanied by pain with inflammation.

These are febrile conditions, myalgia, menstrual, postoperative pain, renal colic.

NSAID preparations are effective in the treatment of bones with joints: arthritis, arthrosis, post-traumatic injuries.

Osteochondrosis of the spine of any department is inevitably accompanied by pain, inflammation. The main task of treatment is to stop the pain syndrome, to remove the inflammatory reaction. NSAIDs are used primarily. NSAIDs are selected individually, taking into account the history and predominant symptoms.

Indications for use

NSAIDs are effective for the treatment of most pathologies accompanied by pain, inflammation, fever, and swelling.

In therapeutic, neurological practice: renal and hepatic colic, inflammatory diseases of internal organs, myalgia, inflammatory neurological diseases.

NSAIDs with antiaggregatory action are prescribed as a prevention of heart attacks and strokes.

In trauma practice: arthritis, arthrosis, degenerative changes in the spine, hernial protrusions, traumatic injuries (fractures, bruises, sprains).

Contraindications

According to the instructions, pregnant women should refrain from taking NSAIDs.

Anti-inflammatory nonsteroidal drugs are not indicated in therapy if the patient suffers from severe diseases of the heart, blood vessels, erosive or ulcerative lesions of the gastrointestinal tract, severe disorders of the liver, kidneys.

They are contraindicated in people with intolerance to the constituent components of NSAIDs.

According to the instructions, pregnant women should refrain from taking NSAIDs, especially during the third trimester.

There is evidence that NSAIDs can cause disturbances in placental blood flow, miscarriages, premature birth, renal failure in the fetus.

Side effects

The most dangerous side effects of NSAIDs include:

1. Impact on the cellular composition of the blood. With the ability to reduce clotting, drugs can cause hemorrhages.
2. Negative effect on the mucosa. Medicines can cause erosion, ulceration in the stomach and duodenum.
3. Medicines can provoke allergic manifestations: itching, urticaria, Quincke's edema.

Despite the fact that NSAIDs are available over the counter, uncontrolled intake can adversely affect the health of the patient.

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Classification of drugs NSAIDs

NSAID group chemical composition is divided into two subgroups:

1. Oxycams (acid-based). With indoacetic - Indomethacin. With propionic - Ketoprofen. With acetylsalicylic acid Aspirin. With phenylacetic - Diclofenac. With pyrazolonic acid Metamizol, Phenylbutazol. With atranilic acid Mefenaminate.

1. Non-acid NSAIDs include alkanes and derivatives with a sulfanilide base - Refecoxib, Nimesulide.

In turn, in terms of efficiency, novelty of developments, competitiveness of NSAIDs divided into the following categories:

• First generation drugs. These are Aspirin, Ibuprofen, Voltaren, Nurofen, Butadion.
• Medicines of the second (new) generation. This is Nise et al.

New generation NSAIDs

Treatment of many diseases involves long-term use of NSAIDs.

To minimize adverse reactions and complications, new generations of drugs have been developed and continue to be developed.

NSAIDs give a minimum of side effects and do not affect hematological parameters.

New generation NSAIDs act selectively, selectively. Their anti-pain indicators are close to the opiate-like action.

The anti-inflammatory and anti-edematous parameters of the new generation of NSAIDs are also significantly higher, the therapeutic effect is longer.

Medicines of the new generation do not inhibit or excite the processes of the central nervous system, do not give addiction.

The list of the most widely used NSAIDs includes the following drugs::

1. Movalis (Meloxicam). It is produced in all dosage forms: tablets, injection solutions, rectal suppositories, gels. Approved for long-term treatment.

1. Xefocam (Lornoxicam). It has a high degree of pain suppression. According to the analgesic effect, the drug is equated to opiates. The drug is not addictive, does not affect the processes in the central nervous system.
2. Celecoxib. Long-term treatment with a drug without influence and side effects on the gastrointestinal mucosa. Effectively relieves pain in severe forms of osteochondrosis, arthrosis.
3. Nimesulide. Gives a good antipyretic effect. It is used in the treatment of pathologies of the musculoskeletal system. The drug effectively eliminates bone and joint pain, improves mobility in the joints.

Forms of release of a group of drugs

Routes of administration of NVPS may be different. NSAIDs are available in liquid injectable and solid forms. Many drugs are also represented by rectal suppositories, creams, ointments, gels for external use.

With osteochondrosis, systemic administration of NSAIDs is indicated: dosage forms are combined with each other

Tablets and capsules

In solid dosage form, NSAIDs are available: Advil, Aktasulide, Biksikam, Viox, Voltaren, Glucosamine, Diclomelan, Meloxicam, Mesulid, Metindol, Naklofen, Nalgezin, Nimesulide, Remoxicam.

Ampoules and solutions

Injectable forms of NSAIDs are prescribed for pathologies in the acute stage, with severe forms of the course of the disease.

NSAIDs are administered intramuscularly or intravenously.

NSAID injections can quickly relieve pain, relieve swelling in a short period, and have a powerful anti-inflammatory effect.

From liquid dosage forms (injectable NSAIDs) physicians tend to prefer:

• Tenoxicam;
• Lornoxicam;
• ibuprofen;

Ointments and creams

External forms of NSAIDs are less effective. But topical application reduces the likelihood of unwanted side reactions.

Ointments, gels and creams of NSAIDs are effective when the pain syndrome is not yet acute enough in the initial stage of the disease.

Also, external agents are used in complex treatment together with tablets and injections of NSAIDs. Butadion, Indomethacin ointment, Voltaren and Nise gel are applied to the affected area.

In order for the penetration depth to be greater, the outer forms must be rubbed with massage movements.

List of medicines

Basically, NSAIDs of a new generation are used to treat acute forms of osteochondrosis. The choice of drug depends on which symptomatology is expressed to a greater or lesser extent.

If the pain syndrome is pronounced, Nimesulide is prescribed.

In the line of NSAIDs, it has the most effective analgesic effect, surpasses many similar drugs.

The medicine is indicated for paroxysmal pain, pinching of nerve endings, joint, bone pain. Nimesil is well tolerated, side effects are extremely rare.

The drug is produced in suspension granules, ready-made suspension, tablets, gel.

A drug from the group of NSAIDs with a prolonged action (the duration of the drug is 12 hours).

According to the anti-pain effect, the drug is equated to opiates, but does not give drug dependence.

NSAIDs Ksefokam does not depress the work of the central nervous system.

The drug is available in the form of tablets 4, 8 mg and lyophilized powder 8 mg with a special solvent.

Rofecoxib

The drug belongs to the group of anti-inflammatory and antirheumatic drugs.

Rofecoxib is indicated in the treatment of polyarthritis, bursitis, rheumatoid arthritis.

NSAID Rofecoxib is prescribed to relieve pain caused by neurological pathology, osteochondrosis.

The drug is available in the form of tablets, suspensions for oral administration.

The drug has a pronounced anti-inflammatory property, gives a good analgesic effect.

The solid form is represented by gelatin capsules. Drug analogues: Celebrex, Dilaxa, Arcoxia, Dynastat.

In the pharmaceutical market, this drug is considered the most common and popular.

NSAID Diclofenac is available in the form of tablets, capsules, injection solutions, rectal suppositories, gel.

The drug combines a high degree of analgesic activity with anti-inflammatory action.

Analogues of the drug are known as Voltaren, Diklak.

It has a good anti-inflammatory effect, combines anti-pain and antipyretic functions. Acetylsalicylic acid is used as a monopreparation, and as a component of a sufficiently large number of combined drugs.

Acetylsalicylic acid is a first-generation NVP. The drug has several serious drawbacks. It is gastrotoxic, inhibits the synthesis of prothrombin, increases the tendency to hemorrhages.

Also, the side effects of Acetylsalicylic acid include a high probability of bronchospasm and allergic manifestations.

Butadion

The anti-inflammatory effect is superior to Acetylsalicylic acid. Treatment with Butadione can provoke the development of adverse reactions and complications, so it is indicated only if other NSAIDs are ineffective. Type of medicinal product: ointments, dragees.

Naproxen and indomethacin

NSAID Naproxen is prescribed in the symptomatic treatment of inflammatory and degenerative diseases of the musculoskeletal system: rheumatoid, juvenile, gouty arthrosis, spondylitis, osteoarthritis.

The drug effectively relieves moderate pain syndrome with myalgia, neuralgia, radiculitis, toothache, tendonitis. It is prescribed to patients suffering from pain in oncological diseases, with post-traumatic and postoperative pain syndrome.

As an analgesic and anti-inflammatory drug, Naprosken is prescribed in gynecological practice, diseases of the ENT organs, and infectious pathologies.

The anti-inflammatory effect of the use of NSAIDs appears only at the end of treatment, after about a month. The drug is available in the form of tablets, dragees and oral suspension.