From time to time, each person is concerned about pain of various origins. After unhe althy food, the stomach may get sick, after a sleepless night due to work or study, the head aches from pain impulses. For various reasons, bones break, teeth, muscles, joints hurt. Usually in such cases, a person, without hesitation, grabs any analgesic that comes to hand - the problem goes away and life gets better. However, you need to know that many antipyretic, anti-inflammatory and analgesic drugs have side effects, one of which is an ulcerogenic effect.
What drugs should I consider taking?
Almost all medications have mild or severe side effects with varying degrees of likelihood. All of them should be indicated in the instructions for use. Despite the possible manifestation of negative symptoms after administration, some drugs cannot be dispensed with in clinical practice. Cope with pain, fever, increasedNon-steroidal anti-inflammatory drugs (NSAIDs for short) help with body temperature and inflammation in the body. This is the familiar aspirin, diclofenac, paracetamol and many other drugs that are included in different subgroups. In medicine, NSAIDs are divided into several categories depending on the chemical structure and activity of action. All of them are united by the presence of the mentioned ulcerogenic effect.
Effect characteristics
Most drugs in the NSAID group have one unpleasant side effect. It consists in a negative impact on the organs of the patient's digestive system. With their long-term use, when used in large doses, as well as when using two types of tablets at once, patients experience the formation of defects in the mucous membrane of the gastrointestinal tract. Quite often, this defect manifests itself in the form of erosive and ulcerative lesions, since the active substances of the drugs not only destroy the cells of the mucosa, causing erosion, but can also provoke a relapse of peptic ulcer. This feature must be taken into account by the doctor when drawing up a treatment plan.
NSAID classification
First of all, non-steroidal anti-inflammatory drugs in their structure and action are opposed to glucocorticoids (steroid drugs), which are prescribed and used in exceptional cases, due to the huge number of side effects: hypertension, addiction, weight gain and weight loss.immunity. As early as the 1830s, with the discovery of salicylic acid, NSAIDs began to replace opiates. At the moment, nonsteroidal drugs are actively used in medical practice.
Depending on the chemical composition, effectiveness and mechanism of action, all NSAIDs are divided into several categories. Speaking about the chemical structure and effectiveness, the following groups can be distinguished: acids, non-acid derivatives and NSAIDs with weak anti-inflammatory activity. Of the acids, a subgroup of salicylates stands out and its main representative is aspirin, which has the greatest ulcerogenic effect among other representatives of acids. Pyrazolidines, derivatives of indolacetic and phenylacetic, priionic acids also belong to the group of acids.
Sulfonamide derivatives belong to the group of non-acidic derivatives. The last group of NSAIDs with weak anti-inflammatory activity, isolated on the basis of the effectiveness of the action, includes pyrazolones and derivatives of anthranilic, heteroarylacetic acids.
Features of NSAID action
Anti-inflammatory drugs work on the principle of inhibition (slowing down enzymatic reactions) of cyclooxygenase, namely its first and second varieties. There is an inhibition of the creation of prostaglandins responsible for the inflammatory process. The absorption of steroid drugs occurs in the gastrointestinal tract, which causes the ulcerogenic effect of NSAIDs. The cells of the gastric mucosa are destroyed as a result of the accumulation of the drug incytoplasm, it also penetrates into the synovial fluid (an elastic mass that fills the articular sims and facilitates joint movement), which reduces and eliminates joint pain.
Analgesic effect is achieved by changing the behavior of pain impulses in the spinal cord and entering into the work of opioid receptors. The anti-inflammatory effect is associated with inhibition of the process of neutrophil activation and subsequent weakening of inflammatory mediators. A side effect of drugs that have similar effects is the development of diseases of the stomach and duodenum.
Anti-inflammatory drugs and analgesics
The main function of NSAIDs, based on the decoding of the abbreviation itself, is to reduce the level of inflammation in the body. The drugs of the first group, acids, have the greatest anti-inflammatory effect. To stop the inflammatory process, aspirin, diclofenac, ibuprofen, and ketorolac are used. Means of the second group have a weak anti-inflammatory effect, and in medical practice are often referred to as "non-narcotic analgesics". Moreover, for the onset of an anti-inflammatory effect, it is necessary to take medications for 10-14 days, in contrast to the analgesic effect, which occurs one or two or several hours after taking the drug.
Each drug, even if they are in the same group, has a different percentage of side effects, the main one beingulcerogenic effect. Also, nonsteroidal drugs are often taken to relieve muscle and joint pain, toothache or headaches, since they have an analgesic effect. However, with extremely severe pain, for example, due to a cancerous tumor, NSAIDs are considered ineffective and do not bring the desired result. In this case, the doctor resorts to extreme measures and prescribes narcotic analgesics that are part of the morphine group, which are quite dangerous for the human body and are addictive.
Antipyretics and antiplatelet agents
Speaking of NSAIDs, one cannot fail to mention the drugs that are used to lower body temperature that deviates from normal levels. Also, some NSAIDs are antiplatelet agents, whose task is to prevent the formation of blood clots in the blood vessels. It occurs by inhibiting the process of association of platelets and erythrocytes. The fluidity of the blood remains at an acceptable level, it does not clot, thereby preventing the formation of blood clots.
Drugs aimed at lowering body temperature to normal levels have only a symptomatic effect, which means that the drugs have no antibacterial and antiviral activity. They do not cure the disease, but only suppress its symptom in the form of high fever. Therefore, if it persists for more than 3 days, if fever and muscle aches, headaches persist, then hospitalization and professional medical attention are necessary.
Drug side effects
As it was beforenoted above, almost all nonsteroidal drugs have side effects, the possibility of which varies from drug to drug. From 30 to 40% of patients who regularly and systematically take NSAIDs complain of problems from the gastrointestinal tract. They manifest as pain in the stomach, intestines, nausea and vomiting. Their complex is dyspeptic disorders.
Fewer patients (10-20%) have more serious problems - erosive lesions in the stomach and intestines, as well as the occurrence of peptic ulcers. Side effects of NSAIDs in 2-3% of cases include internal bleeding. So, a patient, due to bleeding wounds in the stomach or intestines, can lose up to 5 ml of blood daily with stool.
List of non-steroid drugs
As for the list of NSAIDs, it is better to build it in accordance with the division of drugs according to the principle of chemical composition, namely, into acids and non-acid derivatives. Separately, NSAIDs with weak anti-inflammatory activity can also be distinguished.
Acids
The main representative of acids is aspirin. Acids also include: phenylbutazone (used for toothache, headache, dermatitis, arthritis); diclofenac (for arthritis, osteochondrosis, hernia, various pains) and piroxicam; ibuprofen (arthritis, gout, sciatica, toothaches and headaches) and ketoprofen.
Non-acid derivatives
These include only sulfonamide derivatives: nimesulide, celecoxib, rofecoxib. Datadrugs, like other NSAIDs, serve to reduce pain, reduce high body temperature and the strength of the inflammatory process. Symptomatically good effect on gout, arthrosis and other diseases that cause severe pain.
NSAIDs with weak anti-inflammatory activity
Among them, two main representatives can be distinguished - paracetamol and ketorolac. Paracetamol is known to almost everyone and is mainly used to lower the temperature during illness. Including in the composition of such drugs as Fervex and Teraflu. As for the second representative, pharmacies often ask about what Ketorolac is from. It is well suited to reduce pain: in the teeth, with various injuries, sprains and sprains, sciatica.
Taking NSAIDs for gastrointestinal problems
Non-steroid drugs should be especially monitored in patients who have erosions or ulcers in the stomach, duodenum. The destructive effect of drugs on the cells of the digestive mucosa can be reduced by the simultaneous use of drugs such as Misoprostol and Omeprazole, which prevent the development of ulcers and erosions.
The side effects of drugs can also be reduced by reducing the dose, switching to rectal or topical administration of the drug. In terms of reducing the load on the gastrointestinal tract, it is best to use enteric-coated tablets. Treatment of patients particularly susceptible to the development of erosions andulcers, should be accompanied by constant endoscopic monitoring.
General conclusion
Unfortunately, many drugs, including NSAIDs, treat one thing and cripple another. Means such as aspirin, diclofenac, ibuprofen, paracetamol, ketorolac, which cannot be dispensed with in medical practice, tend to destroy the cells of the mucous membrane of the digestive organs. Regular intake of anti-inflammatory, antipyretic drugs, analgesics increases the risk of erosions and ulcers in the stomach and duodenum. See above for a list of NSAIDs and their side effects.
