Many pathological changes that occur in the body accompany the pain syndrome. To combat such symptoms, NSAIDs, or non-steroidal anti-inflammatory drugs, have been developed. They perfectly anesthetize, relieve inflammation, reduce swelling. However, the drugs have a large number of side effects. This limits their use in some patients. Modern pharmacology has developed the latest generation of NSAIDs. These drugs are much less likely to cause unpleasant reactions, but they remain effective drugs for pain.
Impact principle
What causes the effect of NSAIDs on the body? They act on cyclooxygenase. COX has two isoforms. Each of them has its own functions. Such an enzyme (COX) causes a chemical reaction, as a result of which arachidonicacid is converted to prostaglandins, thromboxanes and leukotrienes.
COX-1 is responsible for the production of prostaglandins. They protect the gastric mucosa from unpleasant effects, affect the functioning of platelets, and also affect the change in renal blood flow.
COX-2 is normally absent and is a specific inflammatory enzyme synthesized by cytotoxins and other mediators.
The action of NSAIDs as COX-1 inhibition has many side effects.
New developments
It's no secret that the first generation of NSAIDs had an adverse effect on the gastric mucosa. Therefore, scientists have set themselves the goal of reducing undesirable effects. A new release form has been developed. In such preparations, the active substance was in a special shell. The capsule was made from substances that did not dissolve in the acidic environment of the stomach. They began to break down only when they entered the intestines. This allowed to reduce the irritating effect on the gastric mucosa. However, the unpleasant mechanism of damage to the walls of the digestive tract is still preserved.
This forced chemists to synthesize completely new substances. From previous drugs, they are fundamentally different mechanism of action. NSAIDs of the new generation are characterized by a selective effect on COX-2, as well as inhibition of prostaglandin production. This allows you to achieve all the necessary effects - analgesic, antipyretic, anti-inflammatory. At the same time, NSAIDs of the latest generation allowminimize the effect on blood clotting, platelet function, gastric mucosa.
The anti-inflammatory effect is due to a decrease in the permeability of the walls of blood vessels, as well as a decrease in the production of a variety of inflammatory mediators. Due to this effect, irritation of the nerve pain receptors is minimized. The influence on certain centers of thermoregulation located in the brain allows the latest generation of NSAIDs to perfectly lower the overall temperature.
Indications for use
The effects of NSAIDs are widely known. The effect of such drugs is aimed at preventing or reducing the inflammatory process. These drugs give an excellent antipyretic effect. Their effect on the body can be compared with the effect of narcotic analgesics. In addition, they provide analgesic, anti-inflammatory effects. The use of NSAIDs reaches a wide scale in the clinical setting and in everyday life. Today it is one of the most popular medical drugs.
Positive impact is noted with the following factors:
- Diseases of the musculoskeletal system. With various sprains, bruises, arthrosis, these drugs are simply irreplaceable. NSAIDs are used for osteochondrosis, inflammatory arthropathy, arthritis. The drug has an anti-inflammatory effect in myositis, herniated discs.
- Severe pain. The drugs are quite successfully used for biliary colic, gynecological ailments. They take the headache awayeven migraine, kidney discomfort. NSAIDs are successfully used for patients in the postoperative period.
- Heat temperature. The antipyretic effect allows the use of drugs for ailments of a diverse nature, both for adults and children. Such medicines are effective even for fever.
- Thrombogenesis. NSAIDs are antiplatelet drugs. This allows them to be used in ischemia. They are a prophylactic against heart attack and stroke.
Classification
About 25 years ago, only 8 groups of NSAIDs were developed. Today, this number has increased to 15. However, even doctors cannot name the exact number. Having appeared on the market, NSAIDs quickly gained wide popularity. Drugs have replaced opioid analgesics. Because they, unlike the latter, did not provoke respiratory depression.
The classification of NSAIDs implies a division into two groups:
- Old drugs (first generation). This category includes well-known drugs: Citramon, Aspirin, Ibuprofen, Naproxen, Nurofen, Voltaren, Diklak, Diclofenac, Metindol, Movimed, Butadion.
- New NSAIDs (second generation). Over the past 15-20 years, pharmacology has developed excellent drugs, such as Movalis, Nimesil, Nise, Celebrex, Arcoxia.
However, this is not the only classification of NSAIDs. New generation drugs are divided into non-acid derivatives and acids. Consider the last category first:
- Salicylates. This group of NSAIDs contains drugs: Aspirin, Diflunisal,"Lysine monoacetylsalicylate".
- Pyrazolidines. Representatives of this category are drugs: Phenylbutazone, Azapropazone, Oxyphenbutazone.
- Oxycams. These are the most innovative NSAIDs of the new generation. List of drugs: Piroxicam, Meloxicam, Lornoxicam, Tenoxicam. Medicines are expensive, but their effect on the body lasts much longer than other NSAIDs.
- Phenylacetic acid derivatives. This group of NSAIDs contains funds: Diclofenac, Tolmetin, Indomethacin, Etodolac, Sulindac, Aceclofenac.
- Anthranilic acid preparations. The main representative is the drug Mefenaminate.
- Means of propionic acid. This category contains many excellent NSAIDs. Drug List: Ibuprofen, Ketoprofen, Benoxaprofen, Fenbufen, Fenoprofen, Thiaprofenic Acid, Naproxen, Flurbiprofen, Pirprofen, Nabumeton.
- Derivatives of isonicotinic acid. The main medicine "Amizon".
- Pyrazolone preparations. The well-known remedy "Analgin" belongs to this category.
Sulfonamides are non-acid derivatives. This group includes drugs: Rofecoxib, Celecoxib, Nimesulide.
Side effects
NSAIDs of the new generation, the list of which is given above, have an effective effect on the body. However, they practically do not affect the functioning of the gastrointestinal tract. These drugs are distinguished by another positive point: NSAIDs of the new generation do not have a devastating effect oncartilage tissues.
However, even such effective means can provoke a number of undesirable effects. They should be known, especially if the drug is used for a long time.
Major side effects can be:
- dizziness;
- drowsy;
- headache;
- fatigue;
- increased heart rate;
- pressure increase;
- slight shortness of breath;
- dry cough;
- indigestion;
- appearance of protein in the urine;
- increased activity of liver enzymes;
- skin rash (pinpoint);
- fluid retention;
- allergy.
At the same time, damage to the gastric mucosa is not observed when taking new NSAIDs. The drugs do not aggravate ulcers with bleeding.
Recommendations for use
Phenylacetic acid preparations, salicylates, pyrazolidones, oxicams, alkanones, propionic acid and sulfonamide preparations have the best anti-inflammatory properties.
Medications "Indomethacin", "Diclofenac", "Ketoprofen", "Flurbiprofen" most effectively relieve joint pain. These are the best NSAIDs for osteochondrosis. The above drugs, with the exception of the drug "Ketoprofen", have a pronounced anti-inflammatory effect. This category includes the tool "Piroxicam".
Effective analgesics are Ketorolac, Ketoprofen, Indomethacin, Diclofenac.
Movalis has become the leader among the latest generation of NSAIDs. This toolallowed to use for a long period. Anti-inflammatory analogues of an effective drug are Movasin, Mirloks, Lem, Artrozan, Melox, Melbek, Mesipol and Amelotex.
Movalis
This drug is available in the form of tablets, rectal suppositories and solution for intramuscular injection. The agent belongs to the derivatives of enolic acid. The drug has excellent analgesic and antipyretic properties. It has been established that in almost any inflammatory process, this medicine brings a beneficial effect.
Indications for the use of the drug are osteoarthritis, ankylosing spondylitis, rheumatoid arthritis.
However, you should be aware that there are contraindications to taking the remedy:
- hypersensitivity to any of the components of the drug;
- peptic ulcer in the acute stage;
- severe kidney failure;
- ulcer bleeding;
- severe liver failure;
- pregnancy, feeding baby;
- severe heart failure.
Not suitable for children under 12.
Adult patients diagnosed with osteoarthritis are recommended to use 7.5 mg per day. If necessary, this dose can be increased by 2 times.
For rheumatoid arthritis and ankylosing spondylitis, the daily allowance is 15 mg.
Extremely caution should be taken by patients prone to side effectseffects. People with severe renal failure who are on hemodialysis should take no more than 7.5 mg per day.
The cost of the drug "Movalis" in tablets of 7.5 mg, No. 20, is 502 rubles.
Consumer opinion about medicine
Reviews of many people who are prone to severe pain indicate that Movalis is the most suitable remedy for long-term use. It is well tolerated by patients. In addition, its long stay in the body makes it possible to take the medicine once. A very important factor, according to most consumers, is the protection of cartilage tissues, since the drug does not have a negative effect on them. This is very important for patients who use the remedy for osteochondrosis, arthrosis.
In addition, the medicine perfectly relieves various pains - toothache, headache. Patients pay particular attention to the impressive list of side effects. While taking NSAIDs, the treatment, despite the warning of the manufacturer, was not complicated by unpleasant consequences.
Celecoxib
The action of this remedy is aimed at alleviating the patient's condition with osteochondrosis and arthrosis. The drug perfectly eliminates pain, effectively relieves the inflammatory process. No adverse effect on the digestive system has been identified.
Indications for use given in the instructions are:
- psoriatic arthritis;
- osteoarthritis;
- rheumatoid arthritis;
- ankylosingspondyloarthritis.
This drug has a number of contraindications. In addition, the medicine is not intended for children under 18 years of age. Particular care should be taken in people who are diagnosed with heart failure, as the drug increases the susceptibility to fluid retention.
The cost of the drug varies, depending on the packaging, in the region of 500-800 rubles.
Consumer Opinion
Reviews about this medicine are rather contradictory. Some patients, thanks to this remedy, were able to overcome joint pain. Other patients claim that the drug did not help. Thus, this remedy is not always effective.
Also, do not take the drug yourself. In some European countries, this medicine is banned because it has cardiotoxic effects, which is quite unfavorable for the heart.
Drug "Nimesulide"
This medicine has not only anti-inflammatory and anti-pain effects. The tool also has antioxidant properties, due to which the drug inhibits substances that destroy cartilage and collagen fibers.
Used when:
- arthritis;
- arthrosis;
- osteoarthritis;
- myalgia;
- arthralgia;
- bursitis;
- fever;
- various pain syndromes.
At the same time, the drug has an analgesic effect very quickly. As a rule, the patient feels relief within 20 minutes aftertaking the drug. That is why this remedy is very effective in acute paroxysmal pain.
Almost always the medicine is well tolerated by patients. But sometimes there may be side effects such as dizziness, drowsiness, headache, nausea, heartburn, hematuria, oliguria, urticaria.
The product is not approved for use by pregnant women and children under 12 years of age. With extreme caution should take the drug "Nimesulide" people who have arterial hypertension, impaired functioning of the kidneys, vision or heart.
The average price of a drug is 76.9 rubles.
What are consumers saying?
Reviews about the drug are almost always positive. Since the medicine perfectly eliminates pain and reduces high temperature, it perfectly fights inflammatory processes.
Many patients report that the relief of symptoms comes quickly enough, and the duration of its effect is about eight hours.
Excellent remedy perfectly eliminates dental, traumatic, arthritic pain. The drug is able to relieve the discomfort caused by pinched nerve.
Xefocam
This medicine belongs to the group of oxycams. This group of NSAIDs is characterized by an increased half-life, as a result of which the effect of the drug is prolonged. This made it possible to significantly reduce the frequency of taking the medication. Therefore, the risk of side effects is reduced.
The drug "Ksefokam" has the highestthe ability to relieve pain. Its analgesic effect is comparable in strength to that of morphine. However, unlike the latter, the remedy is not addictive and does not affect the central nervous system.
During testing, it was noted that the drug eliminates pain for 12 hours.
The cost of the drug in tablet form (8 mg) for package No. 10 is 205 rubles.
Rofecoxib
The drug has an anti-inflammatory analgesic, decongestant and antipyretic effect. An effective remedy is prescribed for the following ailments:
- chronic periarthritis;
- rheumatoid arthritis;
- tendinitis;
- bursitis;
- injuries to tendons, ligaments, muscles.
At the same time, Rofecoxib quite effectively eliminates a variety of pain symptoms caused by neuralgia, osteochondrosis, pulpitis. The tool perfectly relieves lumbago, toothache, radicular syndrome.
The drug should not be taken by patients with bronchial asthma, after a heart attack, stroke. Do not use it for people with cancer, hypertension and atherosclerosis. The drug is prohibited for children under 12 years of age. In addition, it is advisable to carefully study possible side effects before use.
Parecoxib
This is an excellent tool to reduce inflammatory reactions and help reduce the sensitivity of pain receptors. The drug is in demand for patients undergoing surgery.
He eliminatespain syndromes of moderate and severe intensity. It is prescribed after endoprosthetics of the hip and knee joints, hysterectomy, coronary artery bypass grafting, used in dental practice.
Dose of the drug is purely individual. It depends on the clinical situation and indications. The medicine is not intended for children under 18.
Arcoxia preparation
The drug has another name - "Etoricoxib". The tool has high anti-inflammatory, analgesic properties. The drug contributes to the inhibition of the pain impulse.
Patients with diseases of the musculoskeletal system with the help of this remedy get rid of morning stiffness. They have an improvement in joint mobility, the intensity of inflammation decreases, and the pain syndrome is perfectly stopped. After taking the therapeutic effect occurs within twenty-four minutes. The active substance of the drug is perfectly absorbed from the bloodstream. The drug has a high bioavailability. This indicator is 100%.
Only a doctor can prescribe the dose of the drug. As a rule, it varies from 60 mg to 120 mg throughout the day.
This product is not intended for use by pregnant women and children under 16.
Conclusion
Modern pharmacology does not stand still. New, more effective NSAIDs are being developed. The list of excellent new generation drugs above allows you to choose the best remedy for any pathology. However, it should be rememberedthat these drugs are not able to cure the disease. They only have an anti-inflammatory and analgesic effect.
