Compare yourself for a moment to a hinged iron man. What happens if the hinges are not lubricated? They will rust, wear out and stop working.
The same can happen to our joints. The cartilages and connective tissues in them carry out enormous loads every day - they allow our arms and legs, head and back to turn. But sooner or later, unfavorable factors such as excess weight, lack of certain substances in the body and lack of mobility lead to joint dysfunction - arthritis.
Even dinosaurs suffered from arthritis. But they did not have the achievements of modern medicine. Currently, there are hundreds of products on the pharmaceutical market to relieve acute symptoms, treat chronic arthritis, and prevent ligament diseases. Many of them can be purchased without a prescription during an exacerbation of the disease.
Ibuprofen. One of the most popular remedies for acute arthritis. Available in different dosage forms - tablets, ointment, rectal suppositories. Ibuprofen relieves pain and inflammation, has few side effects and is relatively inexpensive. On average, the price of a package of ibuprofen is no more than 30-40 rubles.
The drug is popular due to its fast action, low cost, and rapid relief of acute inflammation in the joint, but unfortunately, it has a number of side effects and accumulates in the internal organs.
Note: Pregnant women are allowed to take the medicine only after consulting a doctor; children under 6 years old should not take ibuprofen. With caution - people suffering from diseases of the liver, kidneys, and cardiovascular system.
Movalis. This medicine is suitable for people suffering from chronic arthritis. Movalis can be taken for several years in a row, relieving pain and supporting joints.
Take one tablet a day for indolent illness. Drugs identical to Movalis are Artrosan, Melox, Mataren and others.
Arthritis refers to deep damage to a joint. This condition is preceded by other diseases, which are easier to treat. And if you do it on time, arthritis can be avoided.
The very first “bell” from the joints is osteoarthritis. In osteoarthritis, cartilage is primarily affected. At the first stage of the disease, when the patient is only bothered by mild pain, diprospan, hydrocortisone and hyaluronic acid preparations will help. For pain, ibuprofen, ketoprofen and non-steroidal anti-inflammatory drugs are prescribed (depending on individual tolerance).
During this period, the disease can be stopped if drug treatment is combined with proper diet and physical therapy.
Rheumatoid arthritis is the next stage of the disease, in which the joints are destroyed so much that in 70 percent of cases people become disabled. Inflamed joints require the administration of drugs that are heavier than ibuprofen and its analogues - indomethacin, piroxicam, ketorolac.
Treatment with corticosteroids is prescribed at this stage: betamethosone, prednisolone, dexamethasone. These drugs relieve arthritis pain, but have a lot of side effects - from the development of osteoporosis to impaired kidney and liver function.
When treating rheumatoid arthritis, many doctors prescribe to patients
cytostatics are drugs that are used in the treatment of cancer patients: methotrixate, Arava, Remicade. Cytostatic drugs have many unwanted side effects, but these potent drugs can help 70-80 percent of patients with rheumatoid arthritis.
Elderly people are often tormented by gout, a particularly unpleasant, relapsing form of arthritis accompanied by the appearance of nodules on the joints. Treatment of such patients is complicated not only by the severity of the disease, but also by the age of the patient. Many older people are physically unable to tolerate large doses of strong medications. Therefore, such patients need special attention and care.
The worst thing is that arthritis can develop even in a child. According to research, every thousand baby is susceptible to this disease! It usually manifests itself in the form of multi-joint juvenile arthritis.
Antirheumatic drugs, immunosuppressants and corticosteroids in small doses can stop the course of the disease, but you will have to fight it for the rest of your life - with diet, exercise, and medications for exacerbations.
Arthritis is actually a death sentence for an athlete, writer, surgeon, jeweler and any other specialist who needs high finger mobility, quick reaction and healthy joints of the hands and feet. Therefore, modern pharmacology is constantly working on new drugs. The new wave of drugs includes leflunomide and biological drugs: etanercept, infliximab, tocilizumab.
For the fourth year now, Russian doctors have been successfully using the genetically engineered drug “Actemra” in the treatment of arthritis patients, administered intravenously once a month. This medicine receives the most positive reviews.
Foreign researchers are not lagging behind. One of the latest medical achievements in the fight against arthritis is Protelosa, a drug developed by scientists at Oxford University. The product is called a real revolution in the treatment of deforming arthritis. While it is still being tested, it is showing such excellent results that perhaps very soon people suffering from arthritis will receive a real panacea for joint pain.
The main symptom of rheumatoid arthritis is inflammation of the joints. Usually the pain makes itself felt while walking or lifting heavy objects. This happens because when stressed, the affected joint swells, changes shape and loses mobility. The area of inflammation may turn red and develop a fever.
According to doctors, drug treatment for arthritis is most often prescribed with various groups of drugs. A brief overview of the characteristics and recommendations for taking medications for arthrosis helps patients take the treatment process seriously and responsibly.
The review of drugs contains the most effective drugs used in drug therapy. All of them are aimed at eliminating inflammation, mitigating the symptoms of the disease, and regenerating joint functions.
An effective local medicine for arthritis. It suppresses inflammatory reactions in joints well, reduces pain and relieves swelling. Regular external use eliminates morning stiffness and swelling of joints, and helps increase range of motion. Medicine for joint pain is prescribed for use several times a day. The ointment is squeezed out with a tube 20-50 mm long and thinly rubbed into the skin of painful areas. The maximum daily dose is 150 mm for adults and 75 mm for children.
Contraindications for use:
For patients suffering from allergic rhinitis, bronchial asthma, polyps in the nasal mucosa, the medicine is prescribed with great caution.
2. Voltaren emulgel.
A non-steroidal external drug is characterized by an anti-inflammatory and analgesic effect. Prescribed for arthritis of the knee joint, osteoarthritis. This medicine is also recommended in such cases:
Prescribed to adults and children over 12 years of age. It is applied to the skin in the area of inflammation and lightly rubbed. A single dose of emulgel depends on the size of the painful area. The effectiveness and advisability of further use of Voltaren emulgel are assessed 2 weeks after the start of therapy.
The topical medicine for rheumatoid arthritis contains diclofenac. For this reason, it is prescribed with caution to patients with diseases of internal organs, bronchial asthma or heart failure. The use of the drug by elderly people and women in the first and second trimester of pregnancy should only be done with the approval of the attending physician.
A selective anti-inflammatory drug that is prescribed when long-term pain relief is needed (psoriatic or rheumatoid arthritis, osteoarthritis, ankylosing spondylitis). The medicine rarely causes side effects from the gastrointestinal tract and practically does not cause complications.
The active substance in Movalis is meloxicam. The drug is available in three forms:
For ankylosing spondylitis, arthritis of the knee joint, toes, and hands, the maximum daily dose is 15 mg (1-2 tablets). Depending on the duration of treatment and effectiveness, it can be halved.
4. Minocycline (Minocin).
This medicine treats arthritis caused by a bacterial infection. The antibiotic successfully suppresses the growth of pathogenic flora that provokes inflammation in the joints. In addition, it prevents the appearance of purulent formations (abscesses, cellulitis) and prevents the spread of infection in the body. The drug also reliably blocks metalloproteinase enzymes that damage connective tissue and prevents joint destruction.
Antibacterial therapy is indicated for patients suffering from gonorrheal, purulent, tuberculous or rheumatoid arthritis. Minocycline is a slow-acting drug. To achieve a positive effect, it is necessary to take it for a long time. When treating arthritis of the toes, hands, knee and ankle joints, doses of 100 mg per day are prescribed (one tablet twice a day).
The drug belongs to the category of a broad group of chondroprotectors. Prescribed for the treatment of rheumatoid, reactive and other types of arthritis of the joints. The remedy has a positive effect on phosphorus-calcium metabolism in cartilage tissues and acts as a lubricating coating for joints. When used externally, Chondrogard helps slow the development of osteoarthritis, stabilizes metabolism in hyaline tissue, and stimulates the restoration of articular cartilage. The medicine is used in the form of a solution for intramuscular injection in ampoules. 1 ml contains 100 mg of chondroitin sulfate.
The steroid drug is prescribed as an addition to the main treatment with non-steroidal drugs. Most often recommended for arthritis of the ankle, toes and hands. The medicine is available in the form of tablets of 5 mg and solution for injection in ampoules of 30 mg. At the beginning of treatment, 20-75 mg is used. Then gradually reduce the dose to 5-25 mg. The duration is determined by the doctor. Prednisolone use should be limited to the minimum effective treatment volume.
The etiology of one of the most complex joint diseases is still considered unclear. The first symptoms may appear after injuries, infections, stress, hormonal imbalance, physical or emotional fatigue. The pathology can affect any joint, although in practice arthritis of the toes, hands, and wrists is most common.
The main difficulty of treatment is that the disease often spreads to several joints at once. The active stage of arthritis constantly alternates with periods of remission (decreased severity of the pathological process). Effective drug treatment consists of two stages:
Treatment of the active stage of arthritis is carried out under the supervision of a rheumatologist. Basically, it is aimed at pain relief and reducing inflammation in the joints. For these purposes, different groups of drugs are used.
1. Nonsteroidal anti-inflammatory drugs (NSAIDs), which effectively inhibit the enzyme that controls physiological and inflammatory reactions. The most commonly prescribed medications are Diclofenac, Indomethacin, Naproxen, and Ibuprofen. They are produced in the form of injection solutions, tablets, suppositories, ointments, and gels.
These drugs for the treatment of arthritis have some features of administration:
2. Selective anti-inflammatory drugs (cyclooxygenase-2 inhibitors) - drugs that suppress the enzyme that supports the inflammatory process in the joints. These include Meloxicam, Piroxicam, Celebrex, Nimulid. They are available in the form of injections and tablets. Selective drugs have few side effects, so they are prescribed for arthritis of the knee joint or fingers of the extremities to patients with diseases of the gastrointestinal tract, liver and other internal organs.
3. Glucocorticoids (GCST) – hormones of natural or synthetic production. They take part in various types of metabolism and have immunosuppressive and anti-inflammatory properties. In practice, Prednisolone and Methylprednisolone are most often used.
When treating arthritis of the toes, hands, or ankles with glucocorticoid hormones, the physician must take several factors into account:
To minimize side effects, it is recommended to start taking hormonal drugs with small doses, gradually increasing the volume. During treatment, it is necessary to maintain a daily rhythm of taking the medication. After the therapeutic effect is achieved, the amount of the drug is reduced little by little every 5-7 days to the minimum maintenance dose or completely stopped.
Biological therapy is an innovative method for eliminating arthritis of the knee, fingers and ankle. The use of biologically active components blocks the actions of tumor necrosis factor (TNFa) in joints. The most commonly used biological drugs are Inflikimab, Adalimumab, and Etanercept. The main disadvantage is the high price. In addition, long-term use leads to a decrease in immunity.
Inflammation of the joints, that is, arthritis, is the most common disease of the musculoskeletal system.
Arthritis is accompanied by pain, swelling, and movement restrictions, which interfere with many daily activities.
Arthritis requires long-term treatment, since with inactivity the condition of the joints deteriorates greatly. As a rule, the main medicine for arthritis is tablets, that is, medications are the basis of treatment.
Anti-arthritis tablets are one of the elements of complex treatment. There is no miracle cure for arthritis that would completely eliminate the disease, however, properly selected medications will effectively relieve symptoms, slow down the progression of arthritis and prevent complications.
Treatment involves the use of groups of medications:
The group of NSAIDs includes:
NSAIDs do an excellent job of treating painful symptoms. They reduce the synthesis of prostaglandins, substances that regulate pain and inflammation.
These drugs help the patient increase the mobility of diseased joints, which significantly improves overall well-being and quality of life.
During the acute phase, administration of drugs in injection form is most effective.
After removing the main symptoms, tablets are included in the course of treatment as the main medicine for arthritis.
Basic remedies for pain:
The use of painkillers, that is, analgesics, for arthritis is the only way to reduce the symptoms of the disease. Non-narcotic drugs relieve pain well and rarely have side effects, however, unlike NSAIDs, analgesics are not anti-inflammatory drugs.
Painkillers are used when joint pain is severe, for example, with the development of osteoarthritis.
This group includes:
GCS or glucocorticosteroids are hormonal anti-inflammatory medications that are used in the form of intra-articular injections during an exacerbation of the disease. GCS quickly relieve pain, stop the inflammatory process and improve joint mobility.
In rare cases, a doctor may prescribe GCS in tablet form. The dosage of the drug is constantly reduced as the patient's condition improves.
Long-term hormonal treatment can cause serious problems, such as:
These are the following drugs:
The listed remedies can not only alleviate symptoms, they have anti-inflammatory effects and also inhibit the formation of arthritis. These medications prevent bones from deforming.
The action of the drugs is based on immunosuppressive activity. The main manifestations are anti-inflammatory effects on the body.
Basic therapy is used for some types of the disease, for example, rheumatoid arthritis. One common drug is sulfasalazine. This remedy has anti-inflammatory and antimicrobial functions.
Sulfasalazine in its structure is a combination of 5-aminosalicylic acid and sulfapyridine. The course of treatment lasts 6 weeks. At first, sulfasalazine is taken at 500 mg per day, then the amount is increased. To avoid side effects, sulfasalazine should be taken with plenty of water.
If the patient has allergies, bronchial asthma, as well as liver and kidney dysfunction, then sulfasalazine should not be taken. Sulfasalazine is also strictly contraindicated for pregnant women and nursing mothers.
Sulfasalazine has a long breakdown process and accumulates in the blood, which can result in the following symptoms:
If side effects occur, you should consult a doctor and, if possible, change sulfasalazine to another drug.
Sulfasalazine and other basic drugs act slowly, so you should not expect a clear effect right away. The use of medications can continue for at least two months.
While waiting for results from basic therapy, NSAIDs and glucocorticosteroids can be prescribed in parallel for a faster effect.
Muscle relaxants are arthritis medications that relieve muscle spasms associated with painful joints. Pain in the area of the affected joint is relieved, blood circulation improves, and muscle tension goes away.
Muscle spasm is a kind of protective reaction of the joints, which protects them from strong pressure and deformation.
Thus, these drugs must be used very carefully - such drugs for arthritis are needed only in combination with chondroprotectors.
The most common drugs are:
The use of chondroprotectors (glucosamine sulfate and chondroitin preparations) inhibits the development of arthritis and restores joints. Chondroprotectors accelerate the healing of the cartilaginous surfaces of joints and stimulate the release of joint fluid.
These drugs act slowly, so the course of treatment can last from 0.5 to 1.5 years.
Competent drug treatment, started on time and combined with physiotherapy, massage and a healthy lifestyle, will make it possible to improve the condition of the joints and body, allowing you to return to your usual daily activities.
In the process of treating arthritis of various etiologies, one of the most important components is medications. Arthritis tablets are divided into several different groups:
Among the indications for the use of tablets:
Shark tablets include shark cartilage and other natural ingredients that allow you to restore the cartilaginous surface of joints and bones naturally. The combination of plant elements and 2 chondroprotectors allows you to accelerate the effect of the drug. It should be noted that the anti-inflammatory effect of Shark cartilage does not have the side effects that are inherent in NSAIDs.
Stop Arthritis tablets are a drug used as a prophylactic against rheumatic diseases. Since it affects the cartilage of the joints, their (as well as the spine) pain and stiffness are reduced. The medicine prevents subsequent destruction of cartilage and also has a positive effect on the recovery process.
Methotrexate is a cytostatic drug that is part of the group of antimetabolites that act as folic acid antagonists. The drug has a pronounced immunosuppressive effect in small dosages.
For the treatment of rheumatoid arthritis, basic medications are mainly used. Typically, in such cases, drugs are used that can be divided into 5 main groups:
Standard medications used to treat arthritis prevent destruction of the articular surfaces of the joints, and they are also used as a treatment for concomitant autoimmune diseases, such as systemic lupus erythematosus, ankylosing spondylitis and Sjögren's syndrome. The drugs included in this drug group prevent the development of arthritis, but do not eliminate its manifestations (this is how they differ from NSAIDs).
Basic medications have a long-term effect - 3-6 months may pass from the start of therapy until the first changes towards improvement appear. Typically, these drugs are prescribed together with NSAIDs and glucocorticosteroids.
To select the necessary basic medications, it takes some time to check the effectiveness of several groups of drugs, which helps to achieve the maximum effect. If the medications are well tolerated, you should complete a full treatment course, waiting out the initial stage of therapy, during which obvious symptoms of improvement are not yet observed.
If the drugs are selected successfully and the treatment produces results, basic drugs are used for many years.
Immunomodulatory drugs are usually used in cases of advanced, severe forms of the disease, when other drugs do not provide the desired effect. But you need to understand that when using these drugs, to achieve the desired result, you need complex treatment in combination with other medications.
Arava is a basic medicine with antirheumatic action. The drug has anti-inflammatory, immunomodulatory, and antiproliferative effects. It is used in the treatment of adult patients suffering from active rheumatoid arthritis. The medicine helps reduce the severity of the symptoms of the disease, and also prevents the destruction of the structure of the articular surfaces of the joints.
Plaquenil has an immunosuppressive and anti-inflammatory effect on the body in rheumatoid arthritis (its chronic and acute forms). The active substance of the drug, hydroxychloroquine, has cumulative activity. The effect of taking the medicine may appear only after a few weeks, but side effects may occur much earlier. To achieve the desired result, you need to take the medicine for several months. If no objective improvement is observed within six months of taking Plaquenil, you should stop using it.
Neoral is an immunosuppressive drug, polymyxin, which includes 11 amino acids. Used to treat rheumatoid arthritis (in active, severe forms, when standard long-acting antirheumatic drugs do not have the required effect or when they cannot be used).
In the treatment of rheumatoid arthritis, the drug Imuran has a strong therapeutic effect without combination with corticosteroids. The medicine has an immunosuppressive effect.
Cytoxan is an antitumor drug that has an alkylating effect, in addition to also having an immunosuppressive effect. It is used for psoriatic and rheumatoid arthritis.
Analgesics help reduce pain, but they cannot relieve inflammation in the joints - this distinguishes them from NSAIDs. Painkillers are usually prescribed to treat severe forms of arthritis with severe painful symptoms, such as osteoarthritis. These medicines may contain substances such as paracetamol, but also codeine or aspirin, or other similar substances in combination.
Diclofenac is usually prescribed to treat arthritis. The use of aspirin is sometimes accompanied by side effects from the gastrointestinal tract in the form of pain and discomfort in the abdomen, so you should not take it if you have a stomach ulcer, gastritis, or on an empty stomach. It is advisable to take these medications with milk. Codeine may cause constipation or nausea. In general, any medicine should be prescribed by the attending physician after a thorough examination of the patient in order to assess the advisability of using certain medications, taking into account the presence of concomitant diseases that he has in addition to arthritis.
Treatment for osteoarthritis usually begins with the use of aspirin. Although this drug is successfully used for many medicinal purposes, it is not effective enough for the treatment of arthritis and arthrosis. It is often replaced with other medications.
It should be noted that aspirin should be prescribed with caution if the patient has blood diseases, because this drug reduces blood clotting.
NSAIDs (among these drugs the most well-known are indomethacin, ketoprofen, diclofenac, as well as piroxicam, ibuprofen and butadione) are prescribed to eliminate the inflammatory process and pain in the joints, as well as their swelling. These drugs are the best known and most commonly used group of drugs used for arthritis. They successfully cope with the main manifestations of the disease, but cannot resist the destruction of joints, and therefore are not able to influence the development and course of the disease.
NSAIDs prevent the production of hormone-like elements, as well as prostaglandins, which cause the development of the inflammatory process and the appearance of pain. These drugs should be used with caution, as they can lead to erosive and ulcerative complications in the stomach. Sometimes they are prescribed in combination with other medications that reduce the effect of non-steroidal anti-inflammatory drugs on the gastrointestinal tract.
Diclofenac is one of the most popular and well-known NSAIDs. This drug helps in the treatment of arthrosis. It combines effective anti-inflammatory properties, as well as a strong analgesic effect.
Ibuprofen is used in the treatment of joint diseases. It is less effective than indomethacin in terms of its analgesic and anti-inflammatory properties, but it is much better tolerated by patients without causing severe adverse reactions.
Indomethacin has highly effective anti-inflammatory properties and also has a strong analgesic effect. The drug is available in 25 mg tablets. Although it is considered one of the most effective remedies for arthrosis or arthritis, it must be borne in mind that this medicine has an extensive list of side effects.
Ketoprofen is an NSAID, a derivative of arylcarboxylic acid. The medicine has antipyretic, analgesic, and anti-inflammatory properties. It helps reduce pain in the joints both at rest and during movement, reduces their swelling and stiffness in the morning, and also increases the range of movements carried out by the joints.
Movalis is one of the most famous drugs, the active ingredient of which is meloxicam. The main advantage of this medicine is that it can be used for long courses (several months or even years), but only under the supervision of the attending physician. The drug is available in tablet form. This form of manufacture allows the medicine to act for a long time, so taking only 1 tablet per day is sufficient. You can take it both in the morning and before bed after meals.
Celecoxib has powerful analgesic and anti-inflammatory properties, helping to get rid of pain from arthrosis and arthritis, and at the same time causes almost no adverse reactions from the gastric mucosa and the gastrointestinal tract in general. This drug is available in capsule form with a dosage of 200 or 100 mg.
Nimesulide has a powerful anti-inflammatory and analgesic effect, helping to eliminate the main symptoms of arthrosis. It also has antioxidant properties and helps reduce the activity of elements that have a destructive effect on cartilage tissue, proteoglycans, and collagen fibers.
Etoricoxib is available in tablets under the trade name Arcoxia. When taking the drug in low dosages (no more than 150 mg/day), it does not cause serious side effects and does not affect the gastric mucosa (like other drugs from the COX-2 drug group). During the treatment of arthrosis, the medicine is prescribed in a dosage of 30-60 mg/day.
Since the drug of this group can negatively affect the organs of the cardiovascular system, at the initial stage of use it is necessary to perform regular blood pressure checks.
Corticosteroids are drugs that have the properties of the hormonal substance cortisol. In the body it is produced by the adrenal cortex. Cortisol affects various systems in the body, including the immune system, among others.
Corticosteroids reduce prostaglandin levels and also affect T and B lymphocytes, which are involved in immune reactions. In this way, inflammation processes in the joints are influenced.
These medications are fast-acting and are often used for arthritis and other musculoskeletal diseases. Compared to NSAIDs, corticosteroids have more powerful anti-inflammatory properties, and they also effectively cope with autoimmune diseases, in which it is necessary to prevent the development of autoimmune aggression against the body’s own tissues. But it should be borne in mind that due to immunosuppression, the body’s vulnerability to any infections increases - this is the main disadvantage of this group of drugs.
The active component of the drug is betamethasone, a synthetic systemic glucocorticoid. Since betamethasone acts as a synthetic derivative of prednisolone, it has powerful antiallergic, anti-inflammatory, and antirheumatic properties. Celeston has increased GCS activity, as well as a weak mineralocorticoid effect.
Prednisolone is a synthetic substance that may have similar characteristics to the hormones hydrocortisone and cortisone produced by the adrenal glands. When used orally, this component is 4-5 times more active than cortisone and 3-4 times more active than hydrocortisone. In addition, the difference between prednisolone and these substances is that it does not cause noticeable water and sodium retention, and also rarely causes hyperkalemia. The drug also has powerful anti-inflammatory properties.
Diprospan is a medicine from the group of glucocorticoids that has an immunosuppressive, anti-allergenic and anti-inflammatory effect on the body. This drug is used to treat autoimmune diseases of the connective tissue and musculoskeletal system (such as osteoarthritis or rheumatoid arthritis).
A synthetic glucocorticoid drug used to treat rheumatoid arthritis (also ankylosing spondylitis and juvenile rheumatoid arthritis).
Metypred inhibits the development of tissue reactions to various agents (mechanical and thermal, chemical and immunological, as well as infectious). This allows glucocorticoids to affect the symptoms of the disease, reducing its manifestations, but without affecting the very cause of its occurrence. Methylprednisolone has strong anti-inflammatory properties, which are at least 5 times higher than those of hydrocortisone.
The main element of the mechanism of action of NSAIDs is the suppression of the process of synthesis of PGs (prostaglandins) from the so-called arachidonic acid by slowing down the enzyme PG synthetase.
PGs have versatile bioactivity:
It has recently been revealed that there are at least 2 COX isoenzymes that are inhibited by NSAID drugs. The first of them is COX-1, which controls the process of PG synthesis and regulates the integrity of the gastrointestinal mucosa, blood circulation in the kidneys, and the functioning of platelets. The second, COX-2, is induced by the process of inflammation. It should be taken into account that COX-2 is absent under natural conditions, being formed only under the influence of individual tissue factors that provoke the appearance of an inflammatory reaction (these can be cytokines, growth factors, etc.). As a result, it is believed that the anti-inflammatory properties of NSAID drugs arise due to the inhibition of COX-2, and adverse reactions arise as a result of the inhibition of COX-1.
The indicator of the proportions of activity of NSAID drugs when blocking COX-1/COX-2 substances makes it possible to determine the possible level of their toxicity. The lower it is, the higher the level of selectivity of the drug to COX-2, and with it, accordingly, the lower the toxicity rate.
Having passed the cell membrane, they bind to a special steroid receptor in the cytoplasm, as a result of which the combined complex is activated, which passes into the cell nucleus, binds to DNA and further promotes the process of formation of messenger RNA. Subsequently, various regulatory proteins begin to be synthesized on ribosomes. Among them, one of the most important is lipocortin, which inhibits the enzymatic substance phospholipase-A2. As a result of this action, the synthesis of leukotrienes and PGs, which are the main causes of the development of the inflammation process, is suppressed.
Therefore, for the full effect of glucocorticoids to appear, several hours must pass after taking them. These substances reach their maximum pharmacological activity when the peak of their saturation in the blood plasma has already passed.
All drugs from the NSAID category are well absorbed from the gastrointestinal tract. They almost completely combine with plasma albumin, in return displacing some other substances. For example, in newborns they displace bilirubin, which can then cause bilirubin encephalopathy. The most dangerous in these cases are phenylbutazone, as well as salicylates. Most NSAID drugs are well absorbed into the joint synovial fluid. NSAIDs are metabolized in the liver and excreted through the kidneys.
After internal administration, glucocorticoids are quite quickly and almost completely absorbed in the upper parts of the small intestine. They reach maximum saturation in the blood in 0.5-1.5 hours. When taken with food, their absorption rate slightly decreases, but the degree of activity remains the same.
Glucocorticoids are able to penetrate the placental barrier. Non-fluoridated natural medicines do not lead to the development of Cushing's syndrome in the child in the womb, as well as suppression of the hypothalamic-pituitary adrenal system, and are therefore safe for the fetus. But long-term use of fluorinated glucocorticoids can negatively affect the fetus, causing, for example, congenital deformity.
Contraindications for the use of drugs from the glucocorticoid group are conditional, so they are taken into account only in case of long-term treatment. The following are diseases for which the use of glucocorticoids may be prohibited:
NSAID medications may be prohibited for erosive and ulcerative pathologies of the gastrointestinal tract (especially at the acute stage), severe kidney or liver diseases, individual hypersensitivity, cytopenia, and also during pregnancy. It is not allowed to prescribe phenylbutazone or indomethacin on an outpatient basis to patients who, due to their professional activities, require increased concentration.
When using NSAIDs, the most common adverse reaction is destruction of the gastrointestinal mucosa. 30-40% of patients taking medications in this group suffer from dyspeptic disorders, 10-20% from ulcers or erosion of the duodenum and stomach, and 2-5% from perforation or bleeding.
Adverse reactions of the body when using drugs from the glucocorticoid category:
If arthritis tablets from the NSAID group (any drug) are new to the patient, they should be prescribed at the very minimum dosage at first. If it turns out that the medicine is well tolerated, after 2-3 days the daily dosage is increased. Therapeutic doses of NSAID drugs have a fairly wide range, and recently there has been a tendency to increase single and daily doses of drugs that are well tolerated by patients (these are ibuprofen and naproxen). But restrictions remain on the maximum dosage of drugs such as phenylbutazone, indomethacin, as well as piroxicam and aspirin. But it should be understood that the therapeutic effect in individual patients can only be achieved when very high dosages are used.
In rheumatology, tablets from the NSAID category are prescribed for a long treatment course - in this case, it is recommended to take the medicine after eating food. Although, in order to get a quick antipyretic or analgesic effect, it is preferable to take the tablets half an hour before a meal or 2 hours after it (drink 0.5-1 glass of water). It is advisable not to lie down for 15 minutes after using the drug - this is necessary as a preventive measure for the development of esophagitis.
The moment of taking the medicine can be selected in accordance with the time when the signs of the disease (feeling of stiffness and pain in the joints) appear most clearly - i.e., taking into account the chronopharmacology of the drug. It is also possible to deviate from the standard dosage regimen (2-3 times a day) and use NSAIDs at any time of the day - in this way, an increase in the effectiveness of the drug is achieved, while the daily dosage is reduced.
In case of overdose, the following symptoms may occur: vomiting with nausea, abdominal pain, depression, drowsiness and lethargy. Metabolic acidosis, decreased blood pressure, tinnitus, development of renal failure (in acute form), respiratory arrest, headache, tachycardia and bradycardia, as well as shock or coma and atrial fibrillation are possible. An overdose may also result in dizziness, confusion, shortness of breath, pain in the epigastric region, increased blood pressure and bleeding in the gastrointestinal tract. Children may experience bleeding and myoclonic seizures, impaired renal or hepatic function, and abdominal pain.
NSAIDs can enhance the effectiveness of oral hypoglycemic drugs, as well as indirect anticoagulants. At the same time, they also reduce the effectiveness of antihypertensive drugs, increase the toxic properties of digoxin, aminoglycoside antibiotics and some other drugs - this plays a significant role in the prescription of drugs.
It is recommended to avoid the combined use of diuretics and arthritis tablets from the NSAID group, since, firstly, in this case the diuretic effect is reduced, and secondly, this can cause renal failure. The most dangerous combination is triamterene and indomethacin.
There are also medications that, when combined with NSAIDs, can have different effects on their effectiveness:
Arthritis is a multifactorial inflammatory disease of the joints. The main causes of its occurrence include hypothermia, infection (developed inside the body or penetrated from the outside), metabolic disorders, stress, various injuries and excessive physical activity. This is a very common disease that affects not only the elderly, but also very young people, and even small children.
In order for the treatment to be effective, the medicine for arthritis is selected taking into account the cause that triggered the development of the disease. Only a doctor can choose the right medications. Drug therapy must be carried out in combination with other treatment methods, taking into account the general condition of the patient, the nature of the disease and the mechanism of damage.
So, what groups of drugs are used to treat the disease?
Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to suppress inflammatory reactions and reduce joint pain. They also have an antipyretic effect. Most often, indomethacin, diclofenac, piroxicam, ketorolac, ibuprofen, butadione are prescribed for arthritis.
NSAIDs are available in the form of injection solutions, suppository tablets, gels and ointments.
Medicines in this group have serious contraindications, and in case of long-term use they can cause side effects. They are contraindicated for gastrointestinal diseases and can provoke the development of allergies and other functional disorders.
Selective anti-inflammatory drugs (cyclooxygenase-2 inhibitors) are drugs that are much less likely to cause side effects from the gastrointestinal tract and practically do not cause complications. In the treatment of arthritis, they are prescribed when long-term pain relief is required (for example, in rheumatoid and psoriatic arthritis). The most commonly used are movalis, celebrex or nimulid.
These medications come in the form of tablets and injections.
To eliminate the symptoms of a bacterial infection that provoked the development of the disease, antibacterial drugs are used. They inhibit the growth of pathogenic microorganisms and other substances that cause inflammation.
Antibacterial therapy, according to medical indications, is prescribed to patients suffering from rheumatoid, tuberculosis, gonorrheal or purulent arthritis. In this case, taking antibiotics prevents the spread of infection along with the bloodstream (hematogenous spread) and the formation of purulent inflammations (abscesses and phlegmons).
Also, an antibiotic (most often used is minocycline) blocks enzymes that damage joint tissue and prevents joint destruction.
For any disease, unjustified prescription of antibacterial drugs is contraindicated. Treatment is carried out purely individually and always under the supervision of the attending physician.
Glucocorticoids (steroids) are used only when NSAIDs are not effective enough, or there is high activity and extra-articular manifestations of the disease. Most often in this situation, prednisolone is prescribed, which has a pronounced anti-inflammatory effect. Immediately after relief of the condition, the dose of the drug is gradually reduced, and then the drug is completely discontinued. Generally, steroids are recommended in the treatment of rheumatoid and psoriatic arthritis.
Long-term use of drugs in this group leads to the destruction of articular surfaces.
In particularly severe cases, the use of immunosuppressive drugs is indicated, which suppress the activation of special T cells and reduce the aggressiveness of the immune system.
Basic drugs that modify the course of the inflammatory process significantly reduce pain and prevent the spread of inflammation to other joints. These include methotrexate and sulfasalazine, which, like glucocorticoids, are used in the treatment of rheumatoid and psoriatic arthritis. Therapy is carried out in long courses, the therapeutic effect appears only several weeks or even months after the start of use. In parallel, to prevent the development of side effects, patients are prescribed folic acid.
Muscle relaxants are medications that can relax muscles. With severe joint pain, the muscles involuntarily tense, limiting movement in the inflamed joint. If the pain does not go away for a long time, the muscles are not able to relax on their own and begin to suffer from a lack of oxygen, nutrients, and an excess of accumulated metabolic products. In this condition, patients are prescribed muscle relaxants - sirdalud, baclofen, mydocalm.
Fish oil, linoleic acid, boron and ademetionine (a substance of natural origin that has anti-inflammatory properties and improves joint mobility) have proven themselves well.
Today, drug treatment for arthritis is one of the most effective ways to combat the disease. Properly selected medications in combination with other methods of therapy can relieve the patient of most negative symptoms. However, to do this, you must strictly follow the recommendations of your doctor and in no case self-medicate.