Nowadays, you need to move quickly to get everything done. It is rare to see people walking leisurely. After all, in the morning you go to work, then go home, there is also a lot that needs to be done. And so almost every day. And the legs most often suffer from this running around. We rarely go to the doctor right away; we usually go to the pharmacy and buy painkillers.
Nowadays there is such a wide range of drugs in pharmacies that you can get confused just by the names. As for what they are intended for and what they help with, you don’t always have time to read the package insert. But self-medication rarely helps, especially if you develop arthrosis of the knee joint.
IT IS IMPORTANT TO KNOW! The only remedy for JOINT PAIN, arthritis, arthrosis, osteochondrosis and other diseases of the musculoskeletal system, recommended by doctors! Read more.
Everyone should understand the importance of the fact that if you consult a doctor in a timely manner, arthrosis of the knee joint can be stopped and cured.
What is arthrosis of the knee joint? This is a chronic disease in which cartilage tissue is destroyed.
Here are the signs: if you have at least one or two, urgently contact a rheumatologist for check-up:
The doctor, after examining and determining the stage of development of the disease, prescribes comprehensive treatment. Let’s take a closer look at what medications are recommended for arthrosis of the knee joint.
They act not only on the inflammatory processes that occur in the knee joint, these medications also have an analgesic effect. But they have a number of contraindications, so you need to drink them very carefully.
1) Ointments and gels. They effectively relieve pain and inflammation in the first stage of arthrosis. And they have no side effects.
Ingredients: diclofenac sodium – a derivative of phenylacetic acid. Excipients.
Indications: relieves swelling, inflammation, pain during rheumatic processes in soft tissues, injuries, joint diseases. Effective for arthrosis and arthritis of any location (knee, ankle, etc.).
Application: Apply a thin layer to problem areas.
Duration of use: 10-14 days, 3-4 times a day.
Ingredients: diclofenac diethylamine. Excipients.
Indications: eliminates pain and swelling during inflammation. Effective for diseases of the joints and muscles, incl. arthrosis of the knee joint.
Application: The required amount depends on the area to be treated. It is necessary to apply a little at a time, gently rubbing the medicine.
Duration of use: 2 weeks 3-4 times a day.
Ingredients: ibuprofen. Excipients.
Indications: Radiculitis, rheumatism, injuries, myalgia, lumbago, arthritis and arthrosis of any location (knee, shoulder, ankle, etc.).
Application: apply a small amount of the medicine, rubbing in with light movements until completely absorbed. Apply to the affected area at intervals of 4 hours, no more than four times a day.
Duration of use: 2-3 weeks.
2) Non-steroidal anti-inflammatory drugs. The method of using the tablets is simple, but it is necessary to take into account the side effects that can cause in the gastrointestinal tract. After all, few people want to get a stomach ulcer after getting rid of arthrosis of the knee joint.
Ingredients: diclofenac sodium, excipients.
Indications: inflammatory, degenerative pathological processes in the musculoskeletal system. Reduces temperature, pronounced anti-inflammatory effect, analgesic effect.
Application: An individual dosage of the medicine is selected. 25-50 mg is taken orally 2-3 times a day.
Duration of use: At the discretion of the attending physician.
Ingredients: indomethacin. Excipients.
Indications: Pronounced anti-inflammatory, analgesic and antipyretic effects. Helps with inflammatory, degenerative diseases of the joint (arthrosis of the knee joint, arthritis, etc.), periarticular diseases, etc.
Application: The medicine is prescribed by the attending physician. They also set the dose and duration of administration. The initial dose is 25-50 mg 2-4 times a day. The maximum dosage is 200 mg per day.
3) Anti-inflammatory non-steroidal drugs (coxibs). This subgroup of drugs was developed specifically to treat the symptoms of arthrosis. But these medications also have side effects. They have a detrimental effect on the heart, kidneys, and liver. If there are serious diseases of these organs, these drugs are strictly prohibited for use. It is also necessary to monitor compatibility with other medications.
Ingredients: rofecoxib. Excipients.
Indications: treatment of symptoms of arthrosis of the knee joint and other locations, primary dysmenorrhea.
Application: Individual prescription of medication. The first course of treatment lasts 4-6 weeks. Minimum – 12.5 mg, maximum dose per day – 25 mg.
Ingredients: celecoxib. Excipients.
Indications: Treatment of symptoms of arthritis and osteoarthritis (including arthrosis of the knee joint). Can be used in children over 2 years of age (body weight 10 kg or more) to relieve the symptoms of juvenile idiopathic arthritis.
Application: Individually. Recommended - 200 mg per day.
Ingredients: nimesulide. Excipients.
Indications: Treatment of pain in diseases of the joints, muscles and bone tissue, including arthrosis of the knee joint, arthritis, myalgia, etc. Pain relief for injuries, diseases of the ENT organs, postoperative period in dentistry and gynecology.
Application: The prescription of the medicine is individual. Usually prescribed 100 mg 2 times a day. Maximum – 400 mg.
4) NSAIDs administered intramuscularly. They do not cause side effects on the gastrointestinal tract. This way, older people or those who are contraindicated to take these medications orally can receive treatment.
Ingredients: meloxicam. Excipients.
Indications: short-term treatment of symptoms of arthritis, arthrosis, ankylosing spondylitis.
Applications: Intramuscular injections should be done in the first 2-3 days. Then switch to other dosage forms.
If arthrosis of the knee joint is complicated by synovitis, or NSAIDs do not effectively cope with the treatment, the treating doctor prescribes intra-articular injections of corticosteroid drugs.
But you should know that these medications do not cure arthrosis, but only relieve symptoms: reduce swelling, relieve pain, reduce inflammation.
Composition: Triamcinolone acetonide, excipients.
Indications: administered intra-articularly for dysfunction of the joint capsule, articular hydrops, arthritis and arthrosis of any location. (Knee, elbow, ankle, etc.)
Application: 10-40 mg to 80 mg is injected into the affected joint. Repeated administration if necessary after 3-4 weeks.
Ingredients: betamethasone, excipients.
Indication: Positive effect on the treatment of arthritis and osteoarthritis (including knee, shoulder, etc.).
Application: individual prescription of medication. Single dose: 0.4-6 mg.
It is safe to say that chondroprotectors are a cure for arthrosis of the knee joint.
After all, these drugs act on the very cause of arthrosis – the destruction of cartilage tissue. They help strengthen and restore cartilage.
Two substances are involved in this process: chondroitin sulfate and glucosamine.
These medications may contain one of these substances or be combined.
Capsule composition: glucosamine - 500 mg, chondroitin sulfate - 400 mg, excipients.
Indications: Degenerative-dystrophic diseases of the joints and spine, stage 1-3 osteoarthritis, osteochondrosis.
Application: first 21 days, 1 capsule 3 times a day, then 1 capsule 2 times a day. Reception should be long-term from 2 to 3 months. Then a repeat course with an interval of 3 months.
Capsule composition: glucosamine – 500 mg, chondroitin sulfate – 500 mg, excipients.
Indications: arthrosis of peripheral joints and spine. Indispensable in the treatment of diseases associated with the destruction of cartilage tissue.
Application: 1 tablet per day for 6 months.
The medicine is available in the form of a powder and a solution for intramuscular injection.
Ingredients: glucosamine sulfate, excipients.
Indications: prevention and treatment of arthrosis of any location (hip, knee, etc.), periarthritis, chondromalacia of the patella. It has an analgesic effect and normalizes metabolic processes in the joint.
Application: powder: dilute 1 sachet with water, take once a day.
Solution: Ampoule A is mixed with ampoule B. Intramuscular injection 3 ml 3 times a week.
Ampoule composition: chondroitin sulfate, excipients.
Indications: Degenerative diseases of the joints and spine. Has an analgesic effect and improves joint mobility.
Application: dissolve the powder in 1 ml of water for injection and administer intramuscularly. A course of 25-30 injections. Medicine as prescribed.
Hyaluronic acid drugs, when administered intra-articularly, act on the cartilage: restoring it, ensuring easier gliding of the knee joint. Hyaluronic acid acts as synovial fluid to protect cartilage. If administered correctly there are almost no side effects. This is an almost ideal cure for arthrosis of the knee joint. The only negative is its cost.
Ingredients: sodium hyaluronate.
Indication: Relieves pain and improves mobility of the knee joint and other joints in which synovial fluid is present in patients with varying degrees of osteoarthritis.
Application: The medicine is administered by a medical professional who has undergone special training. 1 to 3 injections are injected into the joint cavity once a week.
Ingredients: sodium hyaluronate, excipients.
Indications: Degenerative and traumatic changes in the knee, hip or other synovial joint, which are accompanied by pain and limitation of motor function.
Application: 1 time per week for 3-5 weeks. If necessary, repeat the course after 6 months.
Ingredients: Hyaluronic acid of non-animal origin, stabilized. Excipient: 0.9% sodium chloride solution.
Indications: Treatment of symptoms of arthrosis of the knee or hip joint.
Application: 1 injection inside the joint.
We must not forget that a joint is the interaction of not only bones, but also muscles and ligaments. Therefore, for effective treatment it is necessary to take not only drugs. For arthrosis of the knee joint, you need to follow an orthopedic regimen, as well as constantly attend physical therapy and massage. If necessary, adjust your weight and your menu by adding more grains and fruits.
In addition, medications must be taken constantly and preferably at the same time. This is the only way to achieve a positive effect.
You can use traditional medicine. There will be no harm from it, you just need to consult a doctor first. But the benefits can be noticeable, because if you apply a warming compress, the blood will circulate faster, which means the medications will get into the joint faster.
Non-steroidal anti-inflammatory drugs for arthrosis are used to reduce joint pain and suppress the inflammatory process. Most often, patients are prescribed “standard” NSAIDs: diclofenac, indomethacin, aceclofenac, ibuprofen, naproxen.
Diclofenac is a well-studied drug that has found widespread use in clinical practice. The combination of analgesic and anti-inflammatory effects, coupled with low cost, explain its popularity among patients and doctors. For arthrosis deformans, diclofenac is prescribed in tablets at a daily dose of 150 mg.
Aceclofenac is taken for exacerbation of pain. It is also quite effective and has better tolerability compared to other drugs in its group. The daily dose of the drug is 200 mg.
Relatively recently, a drug such as dexalgin appeared in the arsenal of doctors. Its peculiarity is that it begins to act within 30 minutes and quickly penetrates into the joint cavity. At the same time, it is also quickly eliminated from the body, which reduces the risk of many side effects. The rapid analgesic effect makes dexalgin stand out among other drugs. It is prescribed ?-1 tablet. 2-3 times a day.
Modern representatives of the class of non-steroidal anti-inflammatory drugs have a strong analgesic effect and quickly relieve inflammation. These include nimesulide (Nimesil, Nise), meloxicam (Melox), celecoxib (Cereblex).
In order to reduce pain and the dose of NSAIDs taken orally, anti-inflammatory ointments, gels and creams have been widely used. They often include ketoprofen (Fastum) and ortofen (Voltaren). Local therapy directly in the area of the affected joint allows you to quickly relieve the symptoms of an exacerbation and avoid many side effects, which is an undoubted advantage of this form of treatment.
It should be understood that anti-inflammatory drugs for arthrosis are symptomatic therapy; they do not stop the progression of the disease and do not heal the joints. Their long-term uncontrolled use can lead to gastropathy and ulcers of the stomach and duodenum due to the harmful effects on the mucous membranes of the gastrointestinal tract. That is why drugs in this group are taken as needed and not constantly.
It is not difficult to completely restore JOINTS! The most important thing is to rub this into the sore spot 2-3 times a day.
Traditionally, analgesics such as paracetamol are used to suppress pain. The daily dose is 2-4 g. If paracetamol is not effective enough and there are no signs of inflammation, you can take tramadol (tramal), which has high analgesic activity, in a daily dose of 100-200 mg.
Intra- and periarticular administration of glucocorticosteroids for arthrosis is indicated if the patient has a chronic inflammatory process and non-steroidal anti-inflammatory drugs do not relieve pain. This group of drugs, which includes hydrocortisone, Kenalog, Diprospan, has a very strong anti-inflammatory effect. However, injections into one joint are performed no more than 3-4 times a year due to the risk of disease progression. In addition, any intra-articular injections carry a risk of mechanical injury to the joint and infection. If after the first two procedures there is no effect, the very idea of glucocorticosteroid therapy should be abandoned.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are a group of non-hormonal drugs designed to reduce and eliminate inflammatory processes occurring in joints affected by arthrosis. An important component of the action of such drugs is a pronounced reduction in pain in the joint, which is very important for patients whose disease deprives them of the opportunity to fully live, work and move.
Since NSAIDs do not contain hormones, they have a generally milder effect on the body and do not have such a large list of contraindications and side effects. However, these drugs are also not absolutely harmless and should be prescribed exclusively by the attending physician for each specific patient according to the indications.
Like most medications, NSAIDs have a number of contraindications. Following the recommendations for taking these medications will help avoid unpleasant consequences and protect against possible complications during the course of the disease.
All NSAIDs are two types of cyclooxygenase inhibitors. Among the most famous are:
Compliance with all doctor’s instructions and regular, correct use of prescribed medications will quickly bring relief and significant relief to the condition of a patient with arthrosis.
As a rule, the treatment of any arthrosis cannot be done without the use of non-steroidal (that is, non-hormonal) drugs. The popularity of these drugs is due to their analgesic, antipyretic and anti-inflammatory effects.
At the same time, medications in this group have a number of contraindications. Thus, non-steroidal anti-inflammatory drugs for arthrosis should not be taken in the following cases:
In order to avoid negative effects on the body and reduce the risk of unwanted side effects, it is enough to follow a few simple rules. It is advisable that the medicine and its dosage be selected by the attending physician. When taking non-steroidal anti-inflammatory drugs, you should drink them with a sufficient amount (about a glass) of water. Avoid drinking alcohol during treatment. You should not take several different types of medications from this group in one day.
Most often, experts prescribe the following non-steroidal anti-inflammatory drugs for arthrosis:
Despite the availability of non-steroidal anti-inflammatory drugs, you should consult your doctor before taking the drug you choose.
Nonsteroidal anti-inflammatory drugs for the treatment of joints were created for specific purposes. There are only two such tasks:
Currently, such drugs are widely used and show high effectiveness compared to other drugs. They can reduce the main manifestations of symptoms of joint diseases.
Non-steroidal anti-inflammatory drugs for the treatment of joints are not able to completely rid a person of arthrosis. Their task is to eliminate the painful symptoms of pathology. They do a great job with it. These medications provide relief from illness that other medications cannot achieve.
When arthrosis worsens, you cannot engage in physical therapy or do some physiotherapeutic procedures. Some patients are inclined to traditional medicine, but its methods work very slowly. In this situation, non-steroidal anti-inflammatory drugs for the treatment of joints can help.
There is a varied range of non-steroidal anti-inflammatory drugs that are designed to treat diseases such as arthrosis and arthritis. When used, the disease stops developing and symptoms decrease.
The most famous drugs are:
Each medicine has its own characteristics: some are weaker, and some are intended to treat the disease in an acute form. You should not decide on the choice of drug on your own; it should be prescribed by a doctor.
Various methods of using non-steroidal anti-inflammatory drugs have been developed. Here are the existing options:
When the joint disease is severe and the condition worsens, strong medications are used that have a wide range of side effects. The doctor uses injections for the joints so as not to cause much harm to the body. Often such procedures are done for gonarthrosis and coxarthrosis. At the same time, negative substances that affect the gastric mucosa do not penetrate into the gastrointestinal tract, unlike tablets. With the help of injections, beneficial elements are delivered in large quantities when compared with other methods of application.
Non-hormonal anti-inflammatory drugs are available for oral administration. They are made in tablet form.
The use of non-steroidal anti-inflammatory drugs is required under the strict instructions of a doctor. The specialist is obliged to issue a prescription that must be followed. If you use the drug in large doses, problems and complications will appear that can even lead to the death of a person.
People who have problems with the gastrointestinal tract, kidneys, allergies, liver cirrhosis, heart and vascular diseases should be careful. The action of the components that are part of non-steroidal anti-inflammatory drugs can reduce the effectiveness of other drugs that are used. Therefore, you need to combine drugs carefully; it is best to consult a specialist.
Therapy takes a long time. Patients are prescribed about 15 injections or 7 intra-articular injections. It all depends on the stage of the disease and sensitivity to the drug.
In medical practice, situations have been noted when the patient, after receiving the result, feels relief, lack of pain, and quits treatment. But arthrosis or arthritis has not yet been defeated. When the symptoms have disappeared, the person needs to diligently begin to treat the underlying disease. There are the following ways to do this:
If you take nonsteroidal drugs for a long time, the production of new cells by cartilage tissue is disrupted, and this function is inhibited. But arthrosis is characterized by the destruction of cartilage. Consequently, these drugs accelerate the deformation process. They disrupt the synthesis of proteoglycans, which causes water loss. Therefore, the duration of treatment with non-steroidal drugs should also be monitored. You need to know which joint ointments to use in a particular case so as not to cause harm.
Nonsteroidal anti-inflammatory drugs are relatively safe medications. But they also have some side effects:
These drugs are contraindicated for people with bronchial asthma.
Nonsteroidal anti-inflammatory drugs show excellent results in treatment. But there are some nuances:
Depending on the manifestation of the disease, the doctor may prescribe the following medications:
When using non-steroidal drugs, you must follow certain rules:
Reduces fever and relieves headaches with Ibuprofen (tablets). Instructions for use include various nuances of using the drug. In large doses it is used for diseases of the joints and spine.
You should be careful as side effects often occur, such as:
There are other side effects and contraindications. You need to read them carefully to avoid complications. It is best to consult a doctor and then follow his instructions.
One of the effective remedies is Diclofenac (ointment). Its price is affordable for many people. The drug has a strong analgesic effect. Doctors often recommend it for joint or back pain.
The downside of the medicine is the presence of side effects, so it cannot be used for a long time. Diclofenac can cause dizziness, headache, and tinnitus. In this case, the activity of the liver is disrupted. It should not be used if you have asthma, pregnancy or breastfeeding.
"Panoxen" is an effective remedy that contains two powerful components. The drug reduces pain with:
Side effects do not differ from those of diclofenac. Has the following contraindications:
Just like diclofenac, indomethacin relieves inflammation and relieves pain. But this drug is considered outdated, as it has a number of side effects and contraindications. This product should not be used by children under 14 years of age.
There are various anti-inflammatory ointments for joints, creams, tablets, injections, suppositories that do not contain hormones. They show themselves effectively in the treatment of arthrosis, arthritis and other diseases. Such drugs will not be able to completely get rid of the disease, but will only suppress the symptoms. Non-steroidal anti-inflammatory drugs are relatively harmless when compared with hormonal ones. They perfectly relieve signs of the disease, relieve pain, after which the patient can begin comprehensive treatment.
If you ask doctors of any specialty which group of drugs they use most often in their clinical practice, the answer most often given is “nonsteroidal anti-inflammatory drugs.” According to statistics, every third drug prescribed by local therapists belongs to this pharmacological group.
The international medical research database PubMed contains more than 200 thousand articles devoted to the study of NSAIDs, and every tenth of them are the results of controlled clinical trials. In this regard, NSAIDs are rightfully considered the most studied drugs, the mechanism of action, effectiveness and safety of which has been clinically proven.
According to market research data, the market for non-steroidal anti-inflammatory drugs is growing from year to year. So,
A strong evidence base, a wide variety of drugs within the pharmacological group, a wide range of release forms and affordable prices - all this makes non-steroidal anti-inflammatory drugs leaders in the pharmaceutical industry and medicine in general.
The beneficial properties of willow bark are used in modern medicine and pharmaceuticals.
The history of the search for an effective remedy that can overcome any pain is rooted in the deep past. Already in the papyri of Ancient Egypt there are references to the analgesic effect of medicines made from willow bark.
The Latin name of this plant subsequently gave the name to the central chemical group of NSAIDs - salicylates (willow in Latin will be salyx ).
Salicylic acid was isolated from willow bark by the Italian chemist Rafael Piria and then synthesized by him
Due to large-scale historical collisions that occurred in Europe in the Middle Ages, the healing recipe of ancient doctors was forgotten for a long time. Only in the 18th century was it remembered again, when it began to be prescribed for joint pain.
In the first half of the 19th century, an active substance called “salicylin” was first isolated from willow bark. However, salicylic acid began to be produced on an industrial scale only in 1860 (the author of this technique was the German biochemist Adolf Kolbe).
By the end of the 19th century, the arsenal of medicine was replenished with a number of effective, even by modern standards, but toxic painkillers. These included pyrazolone derivatives such as phenazone (antipyrine) and aminophenazone. For a long time they were considered the “gold standard” for the treatment of rheumatological diseases and were used until the 70s of the 20th century, but later they were replaced by more effective and safe drugs.
August 10, 1897 is the birthday of the famous aspirin. The father of acetylsalicylic acid was the German chemist Felix Hoffmann, who worked at Bayer.
Aspirin was originally a prescription drug and came in powder form. Since 1904, the company began producing it in tablet form. Since 1915, anyone could purchase aspirin, which brought it truly “rabid” popularity.
The vast majority of all currently available NSAIDs were synthesized in the 20th century. Thus, in 1920, the German company Hoechst AG produced metamizole sodium, better known as analgin. It quickly gained popularity, but already in the 1930s there were reports of its toxic effect on the hematopoietic system.
Leading European countries also abandoned it.
NSAIDs are a group of drugs that differ in their chemical properties and structure. However, they have the same point of application - a cascade of reactions associated with the transformation of arachidonic acid, which is the central biochemical mechanism of the inflammatory reaction.
Changes in the concentration of arachidonic acid metabolites in the blood determine the effects inherent in this group of drugs:
Due to the first three effects, non-steroidal anti-inflammatory drugs are widely used in the treatment of infectious diseases as symptomatic therapy. This allows you to mitigate the symptoms of intoxication and improve the general condition of patients.
The analgesic and anti-inflammatory effects of NSAIDs make them the drugs of choice in the treatment of rheumatological diseases accompanied by joint damage. Patients are forced to take these drugs, if not for life, then for an indefinitely long time. If in the last century such therapy was often accompanied by serious side effects, modern NSAIDs make it possible to make the treatment safer for the life and health of patients.
Non-steroidal anti-inflammatory drugs are characterized by a number of undesirable side effects, in some cases representing a real danger to life. As a rule, they develop when there is a need for long-term use of these drugs, which is most important for patients with rheumatological diseases.
The most significant side effects of NSAIDs are:
Due to their effect on the arachidonic acid cascade, NSAIDs reduce the concentration of certain fractions of prostaglandins, which have a protective effect on the gastric mucosa. The less of these substances, the more vulnerable it is to the aggressive environment of gastric juice, the greater the risk of erosions and ulcers.
Aspirin has also been described as having a strange side effect in the form of asthma attacks. Subsequently, it was proven that “aspirin” asthma is a type of bronchial asthma and develops, as a rule, in individuals predisposed to this disease. Attacks of bronchial obstruction are also typical for other NSAIDs, and they are often combined with nasal polyposis and other manifestations of allergies.
Nephrotoxicity, or adverse effects on the kidneys, is due to inhibition of prostaglandin E2 synthesis.
Clinically, this is manifested by peripheral edema, increased blood pressure, and changes in urine analysis.
The phenomena of hematotoxicity, or the effect on blood and hematopoiesis, were first identified in analgin. The range of these changes is quite wide and extends from minor changes in the general blood test to a profound suppression of all hematopoiesis, which may require a bone marrow transplant. A classic example of the effect of analgin on hematopoiesis is the appearance of agranulocytosis in the blood.
At the beginning of the 20th century, many doctors noted that some patients with infectious diseases who took NSAIDs developed unexplained bleeding gums, or even more serious bleeding. Further deciphering of biochemical processes showed that NSAIDs, to one degree or another, suppress the blood coagulation system and platelet function. However, the undesirable effect has found its application, and due to the adverse effect on blood clotting, NSAIDs are widely used in cardiological practice.
Active research into the hepatotoxic effect of NSAIDs began after a series of deaths of children who were prescribed analgin and aspirin to reduce fever. Clinically, this was manifested by depression of consciousness, severe speech impairment, convulsions, jaundice, and at autopsy, serious damage to the liver and brain was revealed.
Subsequently, this condition entered the medical literature as Reye's syndrome, and the only antipyretic drug that was approved for use in pediatric practice was paracetamol. The toxic effects of NSAIDs on liver function are also detected in adults, but mainly in those individuals who are forced to take these drugs constantly or who already suffer from any liver diseases.
The target of nonsteroidal anti-inflammatory drugs is the arachidonic acid cascade, a stepwise biochemical process that occurs in both healthy and inflamed tissues.
Arachidonic acid is a substance that is formed from ordinary phospholipids that make up the cell membrane. Under the action of at least three different enzymes, arachidonic acid is converted into a number of biologically active molecules:
Thus, a cascade biochemical reaction occurs: arachidonic acid is released from the phospholipids of cell membranes, and biologically active substances, including cytokines, are synthesized from it.
The immediate point of application of NSAIDs is cyclooxygenases. Older generation drugs block both enzymes, providing a powerful anti-inflammatory, analgesic and fat-reducing effect. However, precisely because of the lack of any selectivity, these drugs have inherent side effects and are not recommended for long-term use.
Modern new generation analgesics selectively (selectively) block COX-2, without affecting COX-1 in any way. As a result, the synthesis of exclusively pro-inflammatory cytokines is suppressed and there is no effect on the biologically active substances necessary for the body.
To avoid confusion, and also for practical purposes only, the variety of non-steroidal anti-inflammatory drugs requires a certain classification. From the point of view of chemical structure, all NSAIDs are divided into the following groups:
In most cases, dividing NSAIDs by chemical structure is of no practical use for therapeutic purposes. In clinical practice, the most frequently used classification is based on selectivity, duration of action and primary effectiveness.
Based on selectivity, all NSAIDs are divided into two groups from the list:
Non-selective NSAIDs have the full range of adverse effects described above. These drugs are recommended to be used for a short time.
Based on the duration of action, NSAIDs are divided into three groups from the list:
NSAIDs with a short duration of action are optimal for reducing body temperature, and therefore are widely used in the clinic of infectious diseases. Medications with medium and long duration of action are recommended for patients suffering from rheumatological diseases. These drugs are not recommended for short courses.
Finally, according to their predominant activity, NSAIDs are divided as follows:
Despite the fact that the combination of analgesic, anti-inflammatory and antipyretic effects is characteristic of all NSAIDs, each of these drugs has one or another preferential effect, which must be taken into account when selecting symptomatic therapy.
Although non-steroidal anti-inflammatory drugs are prescribed primarily for infectious, rheumatological diseases, as well as pain, there are a number of unusual indications for which these drugs can be very effective.
The most significant example is the use of acetylsalicylic acid in the treatment of diseases of the cardiovascular system. Thus, with atrial fibrillation, which often occurs in older people, blood circulation is somewhat impaired, as a result of which blood clots are deposited on the walls of the heart. This is a potentially dangerous process that can lead to stroke, heart attack, gangrene of the lower extremities and mesenteric thrombosis. Acetylsalicylic acid disrupts blood clotting and prevents thrombus formation, and therefore is widely used in cardiological practice (drugs Thrombo ACC ®, Aspirin ® Cardio and others).
Indomethacin tablets have an unusual use. In addition to its powerful anti-inflammatory effects, it is sometimes used to treat diarrhea, especially in patients with food poisoning and cardiovascular disease. Indomethacin blocks the synthesis of prostaglandins, which increase the permeability of the intestinal wall, as a result of which fluid is not excreted from the body.
Indomethacin is also prescribed in pediatric cardiac surgery. It has been shown that it promotes the rapid closure (overgrowth) of open arterial disease - a common heart defect in which venous blood enters the aorta from the pulmonary artery. Often, it is thanks to indomethacin therapy that it is possible to achieve recovery without the need for surgical treatment.
Nonsteroidal anti-inflammatory drugs are one of the most commonly prescribed groups of drugs during pregnancy. For a long time, there was no consensus among doctors about the effect of NSAIDs on the fetus. However, today it is believed that paracetamol can be safely used at all stages of pregnancy, and diclofenac - in the first and second trimesters. Selective COX-2 inhibitors (meloxicam, celecoxib and others) cannot be used because they increase the risk of spontaneous abortion and congenital defects.
Despite the fact that many NSAIDs are available in pediatric dosages, both in the form of tablets and syrups, in order to avoid the development of severe complications, especially Reye's syndrome, it is recommended that children under 12 years of age be given only paracetamol (including in the form of ready-made mixtures) . In older adolescence, it is permissible to use other drugs from the NSAID group.
NSAIDs are contraindicated in the following cases:
In general, in most cases, NSAIDs are very well tolerated, even with long-term use. Powerful anti-inflammatory, analgesic and antipyretic effects make this group of drugs the most popular drugs among doctors and patients. However, before taking these medications on your own, you should definitely consult with a specialist.