Ntau yam kev hloov pauv pathological uas tshwm sim hauv lub cev nrog rau qhov mob. Txhawm rau tiv thaiv cov tsos mob zoo li no, NSAIDs, lossis cov tshuaj uas tsis yog steroidal anti-inflammatory, tau tsim. Lawv zoo kawg nkaus anesthetize, txo o, txo o. Txawm li cas los xij, cov tshuaj muaj ntau yam kev phiv. Qhov no txwv lawv txoj kev siv hauv qee tus neeg mob. Niaj hnub nimno pharmacology tau tsim cov tiam tshiab ntawm NSAIDs. Cov tshuaj no tsis tshua muaj peev xwm ua rau muaj kev cuam tshuam tsis zoo, tab sis lawv tseem muaj cov tshuaj zoo rau qhov mob.
Impact principle
Dab tsi ua rau muaj txiaj ntsig ntawm NSAIDs ntawm lub cev? Lawv ua rau cyclooxygenase. COX muaj ob lub isoforms. Txhua tus ntawm lawv muaj nws tus kheej lub luag haujlwm. Xws li ib qho enzyme (COX) ua rau cov tshuaj tiv thaiv tshuaj, raws li qhov tshwm sim ntawm arachidonicCov kua qaub hloov mus rau prostaglandins, thromboxanes thiab leukotrienes.
COX-1 yog lub luag haujlwm rau kev tsim cov prostaglandins. Lawv tiv thaiv lub plab mucosa los ntawm cov teebmeem tsis zoo, cuam tshuam rau kev ua haujlwm ntawm platelets, thiab tseem cuam tshuam rau kev hloov pauv hauv lub raum cov ntshav.
COX-2 ib txwm tsis tuaj thiab yog ib qho tshwj xeeb inflammatory enzyme synthesized los ntawm cytotoxins thiab lwm tus neeg nruab nrab.
Kev ua ntawm NSAIDs raws li COX-1 inhibition muaj ntau yam kev phiv.
Kev txhim kho tshiab
Nws tsis yog qhov zais cia tias thawj tiam ntawm NSAIDs muaj kev cuam tshuam rau lub plab hnyuv. Yog li ntawd, cov kws tshawb fawb tau teeb tsa lawv tus kheej lub hom phiaj ntawm kev txo qis qhov tsis zoo. Daim ntawv tso tawm tshiab tau tsim. Nyob rau hauv xws li kev npaj, active tshuaj nyob rau hauv ib tug tshwj xeeb plhaub. Lub capsule yog tsim los ntawm cov khoom uas tsis yaj nyob rau hauv acidic ib puag ncig ntawm lub plab. Lawv pib tawg tsuas yog thaum lawv nkag mus rau hauv cov hnyuv. Qhov no tso cai rau txo qhov irritating nyhuv ntawm lub plab mucosa. Txawm li cas los xij, cov txheej txheem tsis zoo ntawm kev puas tsuaj rau phab ntsa ntawm lub plab zom mov tseem khaws cia.
Qhov no yuam cov kws tshuaj los ua cov tshuaj tshiab tag nrho. Los ntawm cov tshuaj yav dhau los, lawv yog cov txheej txheem sib txawv ntawm kev ua. NSAIDs ntawm tiam tshiab yog tus cwj pwm los ntawm kev xaiv cov txiaj ntsig ntawm COX-2, nrog rau inhibition ntawm prostaglandin ntau lawm. Qhov no tso cai rau koj kom ua tiav tag nrho cov teebmeem tsim nyog - analgesic, antipyretic, anti-inflammatory. Tib lub sijhawm, NSAIDs ntawm tiam tshiab tso caitxo cov nyhuv ntawm cov ntshav txhaws, platelet muaj nuj nqi, gastric mucosa.
Cov tshuaj tiv thaiv kab mob yog vim qhov txo qis permeability ntawm phab ntsa ntawm cov hlab ntsha, nrog rau kev txo qis hauv kev tsim ntau yam kab mob sib kis. Vim qhov no tshwm sim, irritation ntawm paj hlwb receptors yog txo. Kev cuam tshuam ntawm qee qhov chaw ntawm thermoregulation nyob rau hauv lub hlwb tso cai rau cov tiam tshiab ntawm NSAIDs kom txo tau qhov kub thiab txias tag nrho.
Cov lus qhia rau kev siv
Cov teebmeem ntawm NSAIDs tau paub dav. Cov nyhuv ntawm cov tshuaj no yog tsom rau kev tiv thaiv lossis txo cov txheej txheem inflammatory. Cov tshuaj no muab cov nyhuv antipyretic zoo heev. Lawv cov nyhuv ntawm lub cev tuaj yeem muab piv nrog cov nyhuv ntawm narcotic analgesics. Tsis tas li ntawd, lawv muab analgesic, anti-inflammatory teebmeem. Kev siv NSAIDs mus txog qhov dav dav hauv qhov chaw kho mob thiab hauv lub neej txhua hnub. Niaj hnub no nws yog ib qho tshuaj kho mob uas nrov tshaj plaws.
qhov cuam tshuam zoo tau sau tseg nrog cov hauv qab no:
- Kab mob ntawm lub cev musculoskeletal. Nrog ntau yam sprains, bruises, arthrosis, cov tshuaj no tsuas yog irreplaceable. NSAIDs yog siv rau osteochondrosis, inflammatory arthropathy, mob caj dab. Cov tshuaj muaj cov tshuaj tiv thaiv kab mob hauv myositis, herniated discs.
- mob hnyav. Cov tshuaj tau zoo heev siv rau biliary colic, gynecological ailments. Lawv muab mob taub hau mustxawm migraine, raum tsis xis nyob. NSAIDs tau siv tau zoo rau cov neeg mob hauv lub sijhawm tom qab phais.
- Kub kub. Cov nyhuv antipyretic tso cai rau kev siv tshuaj rau cov kab mob ntawm ntau yam xwm txheej, ob qho tib si rau cov neeg laus thiab menyuam yaus. Cov tshuaj no siv tau txawm tias ua npaws.
- Thrombogenesis. NSAIDs yog cov tshuaj antiplatelet. Qhov no tso cai rau lawv siv rau hauv ischemia. Lawv yog cov prophylactic tiv thaiv lub plawv nres thiab mob stroke.
Kev faib tawm
Kwv yees li 25 xyoo dhau los, tsuas yog 8 pawg NSAIDs tau tsim. Niaj hnub no, tus lej no tau nce mus rau 15. Txawm li cas los xij, txawm tias kws kho mob tsis tuaj yeem sau tus lej lej. Tau tshwm sim ntawm kev ua lag luam, NSAIDs tau txais txiaj ntsig sai sai. Cov tshuaj tau hloov kho opioid analgesics. Vim lawv, tsis zoo li yav tas los, tsis ua rau kev nyuaj siab ua pa.
Kev faib tawm ntawm NSAIDs txhais tau tias kev faib ua ob pawg:
- Cov tshuaj qub (thawj tiam). Cov tshuaj no suav nrog cov tshuaj muaj npe nrov: Citramon, Aspirin, Ibuprofen, Naproxen, Nurofen, Voltaren, Diklak, Diclofenac, Metindol, Movimed, Butadion.
- NSAIDs tshiab (tiam thib ob). Tshaj li 15-20 xyoo dhau los, kws tshuaj tau tsim cov tshuaj zoo heev, xws li Movalis, Nimesil, Nise, Celebrex, Arcoxia.
Txawm li cas los xij, qhov no tsis yog qhov kev faib tawm ntawm NSAIDs nkaus xwb. Cov tshuaj tiam tshiab tau muab faib ua cov tshuaj tsis muaj kua qaub thiab cov kua qaub. Xav txog qeb kawg ua ntej:
- Salicylates. Cov pab pawg no ntawm NSAIDs muaj cov tshuaj: Aspirin, Diflunisal,"Lysine monoacetylsalicylate".
- YPyrazolidines. Cov neeg sawv cev ntawm pawg no yog cov tshuaj: Phenylbutazone, Azapropazone, Oxyphenbutazone.
- Oxycams. Cov no yog cov NSAIDs tshiab tshaj plaws ntawm cov tiam tshiab. Cov npe tshuaj: Piroxicam, Meloxicam, Lornoxicam, Tenoxicam. Cov tshuaj yog kim, tab sis lawv cov nyhuv ntawm lub cev kav ntev dua li lwm cov NSAIDs.
- Phenylacetic acid derivatives. Cov pab pawg NSAIDs no muaj cov nyiaj: Diclofenac, Tolmetin, Indomethacin, Etodolac, Sulindac, Aceclofenac.
- Anthranilic acid npaj. Tus neeg sawv cev tseem ceeb yog cov tshuaj Mefenaminate.
- txhais tau tias ntawm propionic acid. Pawg no muaj ntau yam NSAIDs zoo heev. Cov npe tshuaj: Ibuprofen, Ketoprofen, Benoxaprofen, Fenbufen, Fenoprofen, Thiaprofenic Acid, Naproxen, Flurbiprofen, Pirprofen, Nabumeton.
- Derivatives ntawm isonicotinic acid. Cov tshuaj tseem ceeb "Amizon".
- YPyrazolone npaj. Cov tshuaj paub zoo "Analgin" belongs rau pawg no.
Sulfonamides yog cov tsis muaj kua qaub. Cov pab pawg no suav nrog tshuaj: Rofecoxib, Celecoxib, Nimesulide.
Side effects
NSAIDs ntawm cov tiam tshiab, cov npe uas tau muab los saum toj no, muaj txiaj ntsig zoo rau lub cev. Txawm li cas los xij, lawv xyaum tsis cuam tshuam rau kev ua haujlwm ntawm lub plab zom mov. Cov tshuaj no txawv ntawm lwm qhov zoo: NSAIDs ntawm tiam tshiab tsis muaj kev cuam tshuam loj heev raupob txha mos.
Txawm li cas los xij, txawm tias cov txiaj ntsig zoo li no tuaj yeem ua rau muaj qhov cuam tshuam tsis zoo. Lawv yuav tsum paub, tshwj xeeb tshaj yog tias cov tshuaj siv tau ntev.
Cov kev mob tshwm sim loj tuaj yeem yog:
- kiv taub hau;
- drowsy;
- mob taub hau;
- faus;
- nce plawv dhia;
- siab nce;
- ua tsis taus pa me ntsis;
- hnoos qhuav;
- plab hnyuv;
- pom cov protein hauv cov zis;
- nce kev ua haujlwm ntawm daim siab enzymes;
- tawv pob khaus (pinpoint);
- dej tuav;
- ua xua.
Tib lub sijhawm, kev puas tsuaj rau lub plab hnyuv tsis tau pom thaum noj NSAIDs tshiab. Cov tshuaj tsis ua rau mob rwj nrog los ntshav.
Cov lus qhia rau kev siv
Phenylacetic acid npaj, salicylates, pyrazolidones, oxicams, alkanones, propionic acid thiab sulfonamide npaj muaj qhov zoo tshaj plaws tiv thaiv kab mob.
Tshuaj "Indomethacin", "Diclofenac", "Ketoprofen", "Flurbiprofen" feem ntau zoo txo qhov mob pob qij txha. Cov no yog cov NSAIDs zoo tshaj plaws rau osteochondrosis. Cov tshuaj saum toj no, tshwj tsis yog cov tshuaj "Ketoprofen", muaj cov txiaj ntsig zoo tiv thaiv kab mob. Pawg no suav nrog cov cuab yeej "Piroxicam".
Cov tshuaj tiv thaiv zoo yog Ketorolac, Ketoprofen, Indomethacin, Diclofenac.
Movalis tau dhau los ua tus thawj coj ntawm cov tiam tshiab ntawm NSAIDs. Cov cuab yeej notso cai siv rau lub sijhawm ntev. Anti-inflammatory analogues ntawm cov tshuaj zoo yog Movasin, Mirloks, Lem, Artrozan, Melox, Melbek, Mesipol thiab Amelotex.
Movalis
Cov tshuaj no muaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj, qhov quav suppositories thiab tshuaj rau intramuscular txhaj. Tus neeg sawv cev belongs rau derivatives ntawm enolic acid. Cov tshuaj muaj zoo heev analgesic thiab antipyretic zog. Nws tau raug tsim los hais tias nyob rau hauv yuav luag txhua tus txheej txheem inflammatory, cov tshuaj no coj cov txiaj ntsig zoo.
Cov lus qhia rau kev siv tshuaj yog osteoarthritis, ankylosing spondylitis, rheumatoid mob caj dab.
Txawm li cas los xij, koj yuav tsum paub tias muaj contraindications rau noj cov tshuaj:
- hypersensitivity rau ib yam ntawm cov tshuaj ntawm cov tshuaj;
- peptic ulcer nyob rau theem mob;
- mob raum tsis ua haujlwm;
- plab ntshav;
- mob siab ua tsis taus pa;
- cev xeeb tub, pub mis rau menyuam;
- mob plawv tsis ua hauj lwm.
Tsis haum rau cov menyuam yaus hnub nyoog qis dua 12.
Cov neeg mob laus uas kuaj mob osteoarthritis raug pom zoo siv 7.5 mg ib hnub. Yog tias tsim nyog, koob tshuaj no tuaj yeem nce ntxiv 2 zaug.
Rheumatoid mob caj dab thiab ankylosing spondylitis, qhov nyiaj pub txhua hnub yog 15 mg.
yuav tsum ceev faj heev los ntawm cov neeg mob uas muaj kev phivteebmeem. Cov neeg uas muaj lub raum tsis ua haujlwm hnyav uas nyob rau hauv hemodialysis yuav tsum tsis pub ntau tshaj 7.5 mg ib hnub twg.
Tus nqi ntawm cov tshuaj "Movalis" hauv ntsiav tshuaj ntawm 7.5 mg, No. 20, yog 502 rubles.
kev xav txog tshuaj
Kev tshuaj xyuas ntawm ntau tus neeg uas muaj qhov mob hnyav qhia tau tias Movalis yog cov tshuaj uas tsim nyog rau kev siv mus ntev. Nws yog zoo zam los ntawm cov neeg mob. Tsis tas li ntawd, nws nyob ntev hauv lub cev ua rau nws tuaj yeem noj cov tshuaj ib zaug. Ib qho tseem ceeb heev, raws li cov neeg siv khoom feem ntau, yog kev tiv thaiv cov pob txha mos, vim tias cov tshuaj tsis cuam tshuam rau lawv. Qhov no yog qhov tseem ceeb heev rau cov neeg mob uas siv cov tshuaj rau osteochondrosis, arthrosis.
Tsis tas li ntawd, cov tshuaj zoo kawg nkaus txo ntau yam mob - mob hniav, mob taub hau. Cov neeg mob them nyiaj tshwj xeeb rau daim ntawv teev cov kev mob tshwm sim. Thaum noj NSAIDs, kev kho mob, txawm hais tias cov chaw tsim khoom tau ceeb toom, tsis nyuaj los ntawm qhov tshwm sim tsis zoo.
Celecoxib
Qhov kev txiav txim ntawm qhov kev kho no yog txhawm rau txo tus neeg mob tus mob nrog osteochondrosis thiab arthrosis. Cov tshuaj zoo kawg nkaus tshem tawm qhov mob, zoo relieves inflammatory txheej txheem. Tsis muaj kev cuam tshuam rau lub plab zom mov tau raug txheeb xyuas.
Cov lus qhia rau kev siv tau muab hauv cov lus qhia yog:
- psoriatic mob caj dab;
- osteoarthritis;
- mob caj dab rheumatoid;
- kev hlubspondyloarthritis.
Cov tshuaj no muaj ntau yam contraindications. Tsis tas li ntawd, cov tshuaj tsis yog rau cov menyuam yaus hnub nyoog qis dua 18 xyoo. Kev saib xyuas tshwj xeeb yuav tsum tau saib xyuas rau cov neeg uas kuaj pom tias muaj lub plawv tsis ua haujlwm, vim tias cov tshuaj ua rau muaj kev cuam tshuam rau cov kua dej khaws cia.
Tus nqi ntawm cov tshuaj sib txawv, nyob ntawm qhov ntim, hauv cheeb tsam ntawm 500-800 rubles.
Kev xav tau
Kev tshuaj xyuas txog cov tshuaj no yog qhov tsis sib xws. Qee cov neeg mob, ua tsaug rau qhov kev kho no, muaj peev xwm kov yeej qhov mob ntawm pob qij txha. Lwm cov neeg mob hais tias cov tshuaj tsis pab. Yog li, qhov kev kho no tsis yog ib txwm siv tau.
Tsis txhob noj tshuaj koj tus kheej. Hauv qee lub tebchaws nyob sab Europe, cov tshuaj no raug txwv vim nws muaj cov teebmeem cardiotoxic, uas yog qhov tsis zoo rau lub plawv.
Tshuaj "Nimesulide"
Cov tshuaj no tsis yog tsuas yog tshuaj tiv thaiv kab mob thiab tiv thaiv mob. Cov cuab yeej kuj muaj cov khoom antioxidant, vim tias cov tshuaj inhibits cov tshuaj uas ua rau cov pob txha mos thiab collagen fibers.
Siv thaum:
- mob caj dab;
- arthrosis;
- osteoarthritis;
- myalgia;
- arthralgia;
- bursitis;
- fever;
- ntau yam mob syndromes.
Tib lub sijhawm, cov tshuaj muaj cov nyhuv analgesic sai heev. Raws li txoj cai, tus neeg mob hnov mob hauv 20 feeb tom qabnoj tshuaj. Tias yog vim li cas qhov kev kho no zoo heev hauv qhov mob paroxysmal.
Yuav luag ib txwm cov tshuaj tau txais txiaj ntsig zoo los ntawm cov neeg mob. Tab sis qee zaum kuj yuav muaj kev phiv xws li kiv taub hau, tsaug zog, mob taub hau, xeev siab, kub hnyiab, hematuria, oliguria, urticaria.
Cov khoom no tsis pom zoo siv los ntawm cov poj niam cev xeeb tub thiab cov menyuam yaus hnub nyoog qis dua 12 xyoos. Kev ceev faj heev yuav tsum noj tshuaj "Nimesulide" cov neeg uas muaj ntshav siab, ua haujlwm tsis zoo ntawm lub raum, tsis pom kev lossis lub plawv.
Tus nqi nruab nrab ntawm cov tshuaj yog 76.9 rubles.
Cov neeg siv khoom hais li cas?
Kev tshuaj xyuas txog cov tshuaj yuav luag txhua qhov zoo. Txij li cov tshuaj zoo kawg nkaus tshem tawm qhov mob thiab txo qhov kub thiab txias, nws zoo kawg nkaus tua cov txheej txheem inflammatory.
Ntau tus neeg mob tau tshaj tawm tias qhov kev tshem tawm ntawm cov tsos mob tuaj sai sai, thiab lub sijhawm ntawm nws cov nyhuv yog li yim teev.
tshuaj zoo kawg nkaus tshem tawm cov hniav, mob, mob caj dab. Cov tshuaj muaj peev xwm txo tau qhov tsis xis nyob los ntawm cov hlab ntsha pinched.
Xefocam
Cov tshuaj no yog pab pawg ntawm oxycams. Cov pab pawg no ntawm NSAIDs yog tus cwj pwm los ntawm kev nce ib nrab-lub neej, vim tias cov nyhuv ntawm cov tshuaj no ntev. Qhov no ua rau nws ua tau kom txo tau qhov zaus ntawm kev noj tshuaj. Yog li ntawd, qhov kev pheej hmoo ntawm kev mob tshwm sim raug txo.
Cov tshuaj "Ksefokam" muaj qhov siab tshaj plawslub peev xwm los txo qhov mob. Nws cov nyhuv analgesic yog piv rau lub zog ntawm morphine. Txawm li cas los xij, tsis zoo li yav tas los, kev kho mob tsis yog tshuaj thiab tsis cuam tshuam rau lub hauv paus paj hlwb.
Thaum kuaj, nws tau sau tseg tias cov tshuaj tshem tawm qhov mob rau 12 teev.
Tus nqi ntawm cov tshuaj hauv daim ntawv ntsiav tshuaj (8 mg) rau pob No. 10 yog 205 rubles.
Rofecoxib
Cov tshuaj muaj cov tshuaj tiv thaiv kab mob inflammatory, decongestant thiab antipyretic nyhuv. Txoj kev kho kom zoo yog muab rau cov kab mob hauv qab no:
- mob periarthritis;
- mob caj dab rheumatoid;
- tendinitis;
- bursitis;
- raug mob rau cov leeg, ligaments, cov leeg.
Tib lub sijhawm, Rofecoxib tau zoo tshem tawm ntau yam mob tshwm sim los ntawm neuralgia, osteochondrosis, pulpitis. Cov cuab yeej zoo kawg nkaus relieves lumbago, toothache, radicular syndrome.
Cov tshuaj yuav tsum tsis txhob noj los ntawm cov neeg mob uas muaj mob hawb pob, tom qab mob plawv, mob stroke. Tsis txhob siv rau cov neeg mob qog noj ntshav, ntshav siab thiab atherosclerosis. Cov tshuaj yog txwv tsis pub rau cov menyuam yaus hnub nyoog qis dua 12 xyoos. Tsis tas li ntawd, nws raug nquahu kom ua tib zoo kawm cov kev mob tshwm sim ua ntej siv.
Parecoxib
Qhov no yog ib qho cuab yeej zoo heev los txo cov kev mob tshwm sim thiab pab txo qis qhov mob rhiab heev. Cov tshuaj yog nyob rau hauv kev thov rau cov neeg mob raug phais.
Nws tshem tawmmob syndromes ntawm nruab nrab thiab hnyav siv. Nws yog tshuaj tom qab endoprosthetics ntawm lub duav thiab lub hauv caug pob qij txha, hysterectomy, coronary artery bypass grafting, siv nyob rau hauv kev kho hniav.
koob tshuaj yog tus kheej xwb. Nws nyob ntawm qhov chaw kho mob thiab cov lus qhia. Cov tshuaj tsis yog tsim rau cov menyuam yaus hnub nyoog qis dua 18 xyoo.
Arcoxia npaj
Cov tshuaj muaj lwm lub npe - "Etoricoxib". Cov cuab yeej muaj siab anti-inflammatory, analgesic zog. Cov tshuaj pab txhawb rau inhibition ntawm qhov mob impulse.
Cov neeg mob uas muaj kab mob ntawm lub cev musculoskeletal nrog kev pab los ntawm cov tshuaj no tshem tawm thaum sawv ntxov tawv. Lawv muaj kev txhim kho hauv kev sib koom ua ke, qhov kev siv ntawm qhov mob txo qis, thiab qhov mob syndrome tau zoo kawg nkaus. Tom qab noj cov tshuaj kho mob tshwm sim li ntawm nees nkaum plaub feeb. Cov tshuaj nquag ntawm cov tshuaj yog absorbed los ntawm cov hlab ntsha. Cov tshuaj muaj bioavailability siab. Qhov ntsuas no yog 100%.
Tsuas yog kws kho mob tuaj yeem sau cov tshuaj. Raws li txoj cai, nws txawv ntawm 60 mg mus rau 120 mg ib hnub.
Cov khoom no tsis yog siv los ntawm cov poj niam cev xeeb tub thiab menyuam yaus hnub nyoog qis dua 16.
Zoo kawg
Tsev tshuaj kho mob tsis nyob twj ywm. Tshiab, zoo dua NSAIDs tau raug tsim. Cov npe ntawm cov tshuaj tiam tshiab zoo tshaj plaws saum toj no tso cai rau koj xaiv cov tshuaj zoo tshaj plaws rau txhua yam kab mob. Txawm li cas los xij, nws yuav tsum nco ntsoovtias cov tshuaj no kho tsis tau tus kab mob. Lawv tsuas muaj cov tshuaj tiv thaiv kab mob thiab tshuaj tua kab mob.
