Hauv tshuaj, tshuaj tua kab mob feem ntau muab faib ua opioids thiab tsis yog opioids. Cov tshuaj uas tsis yog-narcotic (non-opioid) yog hu ua cov tshuaj uas txo qhov mob yam tsis muaj kev cuam tshuam tsis zoo rau kev ua haujlwm ntawm lub hauv nruab nrab paj hlwb. Cov tshuaj no tsis muaj cov nyhuv psychotropic, uas txawv ntawm cov tshuaj narcotic, thiab tsis ua rau lub paj hlwb. Ua tsaug rau cov nuances no, cov nyiaj tau siv dav hauv kev kho mob niaj hnub no.
Ua haujlwm thiab nws cov yam ntxwv
Non-opioid - ib pawg ntawm cov tshuaj tua kab mob, uas muaj cov nyhuv me me ntawm kev txo qhov mob hauv kev sib piv nrog cov tshuaj muaj zog. Yog hais tias tus mob no tau piav qhia los ntawm cov kab mob visceral, kev raug mob, cov tshuaj no siv tsis tau.
Cov tshuaj uas tau piav qhia tsis yog tsuas yog ua rau muaj kev ua xua xwb, tab sis kuj muaj tshuaj tiv thaiv kab mob. Tsis tas li ntawd, non-opioid analgesics yog cov tshuaj uas ua rau kub taub hau. Nrog rau kev siv cov nyiaj hauv cov tshuaj kho tau txo qisplatelet aggregation. Cov tshuaj cuam tshuam rau kev tiv thaiv kab mob hauv qib cellular.
Efficiency nuances
Opioid thiab non-opioid analgesics tau tshawb fawb los ntawm kws kho mob rau ntau tshaj kaum xyoo. Tam sim no, tseem tsis tau muaj peev xwm tsim kom tau raws nraim li cov ntsiab lus ntawm cov tshuaj pharmacological ntawm cov tshuaj uas tsis yog-narcotic. Muaj ntau qhov kev xav uas piav qhia qhov ua tau zoo ntawm cov khoom sib txuas. Qhov kev xaiv ntau tshaj plaws yog raws li hauv qab no: nyob rau hauv kev cuam tshuam ntawm cov khoom sib txuas hauv cov ntaub so ntswg ntawm lub cev, kev tsim cov prostaglandins tsis muaj zog, uas ua rau cov kev xav tau ntawm tus mob tag nrho.
Lub tshuab ua haujlwm ntawm cov tshuaj tsis yog opioid yog txuam nrog kev ua haujlwm ntawm cov chaw thalamic. Vim yog siv cov tshuaj, qhov kev ua ntawm qhov mob impulses mus rau lub hlwb cov chaw uas tau txais lawv qeeb. Qhov kev ua haujlwm hauv nruab nrab no txawv heev ntawm qhov muaj nyob hauv cov tshuaj narcotic. Cov tshuaj tsis-narcotic tsis kho lub peev xwm ntawm CNS los sau cov impulses.
YSalicylates
Raws li kev faib tawm ntawm cov tshuaj tsis yog opioid, salicylates yog cov tshuaj uas muaj peev xwm kho cov theem sib txawv ntawm cov saw hlau ua rau kev ua haujlwm ntawm kev ua kom pom kev mob. Nws tau raug tsim los hais tias cov txiaj ntsig tseem ceeb hauv kev ua tau zoo ntawm cov tshuaj no yog vim qhov inhibition ntawm kev tsim cov tshuaj lom neeg ntawm prostaglandins. Cov kev tshawb fawb soj ntsuam tau pom tias salicylates stabilize lub lysosomal daim nyias nyias, uas ua rau qeeb cov tshuaj tiv thaiv ntawm kev khaus, inhibits kev tso tawm ntawm proteases.
Salicylates - analgesics, qhov kev txiav txim uas cuam tshuam nrog cov tshuaj tiv thaiv protein: nquagcompounds tiv thaiv lub denaturation ntawm molecules. Cov tshuaj muaj cov nyhuv anticomplementary. Inhibition ntawm zus tau tej cov prostaglandins ua rau tsis muaj zog ntawm cov kev ua ntawm lub inflammatory tsom xam. Nyob rau tib lub sijhawm, cov nyhuv algogenic ntawm bradykinin txo qis. Cov tshuaj uas tsis yog opioid ntawm pab pawg no ua kom muaj kev sib txuas ntawm cov qog adrenal thiab cov qog pituitary, vim tias qhov tso tawm ntawm corticoids ua haujlwm ntau dua.
Kev xaiv: nyiaj ntau
Cov npe ntawm cov tshuaj tsis yog opioid yog qhov dav heev, thiab cov txiaj ntsig ntawm cov tshuaj no txawv heev. Tej zaum tus nto moo tshaj plaws tuaj yeem raug hu ua kev nyab xeeb:
- YAcetylsalicylic acid.
- Nise.
- Ibufen.
Qhov sib txawv ntawm qhov muaj zog yog cuam tshuam nrog lub peev xwm ntawm cov tshuaj uas twb muaj lawm kom nkag mus rau hauv cov ntaub so ntswg, uas txawv. Nws yog ib txwm ua kom paub qhov txawv ntawm ntau pawg tseem ceeb ntawm cov tshuaj tua kab mob: yooj yim antipyretics, antiphlogistics, anti-inflammatory non-hormonal tshuaj. Qhov feem pua ntawm cov tshuaj uas tau nthuav tawm hauv cov khw muag tshuaj yog cov kua qaub uas tsis muaj zog uas tuaj yeem nkag mus rau hauv lub hom phiaj ntawm cov txheej txheem pathological. Nyob rau hauv cov ntaub so ntswg mob, pharmacologically active compounds accumulates. Kev tawm ntawm lub cev rau feem ntau yog cov yam ntxwv ntawm cov zis, ib feem me me - nrog cov kua tsib. Feem ntau tsis yog-opioid analgesics ntawm lub hauv paus kev txiav txim yog tshem tawm nyob rau hauv daim ntawv ntawm metabolic khoom ntawm lub siab. Cov tshuaj tau txais hauv cov tshuaj tiv thaiv no tsis muaj txiaj ntsig.
Cov yam ntxwv ua haujlwm: nws ua haujlwm li cas?
Tau noj lub hauv paus uas tsis yog opioidanalgesic, tus neeg mob sai sai xav tias tsis muaj zog ntawm qhov mob, kub taub hau subsides. Cov nyhuv desensitizing tsim me ntsis qeeb dua, lub hom phiaj ntawm qhov mob yog suppressed. Yuav kom ua tiav cov txiaj ntsig tau tshwm sim hauv ob qhov haujlwm no, koj yuav tsum tau noj cov tshuaj txaus txaus. Qhov no cuam tshuam nrog qhov tshwm sim ntawm cov teeb meem, cov kev mob tshwm sim vim yog inhibition ntawm kev tsim cov prostaglandins. Feem ntau, cov tshuaj ua rau tsub zuj zuj ntawm sodium, tsim ntawm ulcerated cheeb tsam nyob rau hauv lub plab hnyuv ib ntsuj av, o thiab ib tug nyiam los ntshav. Tsis tas li ntawd, kev siv cov tshuaj analgesic ntev ntev, tshwj xeeb tshaj yog nyob rau hauv cov koob tshuaj loj, ua rau lub cev lom. Cov tshuaj muaj nyob rau hauv cov kev npaj inhibits hematopoietic muaj nuj nqi, txhawb cov methemoglobinemia thiab lwm yam mob hnyav. Tag nrho cov tam sim no paub lub hauv paus ua yeeb yam uas tsis yog-opioid analgesics tuaj yeem ua rau muaj kev tsis haum tshuaj thiab kev ua xua rau lub cev.
Kev siv cov txheej txheem thaum lub sijhawm yug menyuam tuaj yeem ua rau muaj kev tsim txom, ua haujlwm qeeb, thiab kaw lub ductus arteriosus ua ntej. Raws li txoj cai, nyob rau hauv thawj peb lub sij hawm, cov tshuaj no tsis raug sau tseg tag nrho vim muaj kev pheej hmoo ntawm cov kab mob tshwm sim, txawm hais tias kev sim tsiaj tau ua rau feem pua ntawm cov tshuaj uas tau ua pov thawj tias tsis muaj cov nyhuv teratogenic..
Kev tshawb fawb tsis nyob twj ywm
Tshawb nrhiav opioid thiab tsis yog-opioid analgesics, cov kws tshawb fawb tau pom tias qee yam tshuaj muaj peev xwm, thaum tsis muaj cov nyhuv narcotic, ib txhij inhibitKev tsim tawm tsis tau tsuas yog prostacyclin, PG, thromboxane, tab sis kuj leukotrienes. Qhov zoo no yog hu ua "inhibition of lipoxygenesis". Cov tshuaj uas muaj ob qho tib si ntawm cov teebmeem no yog qhov tshiab, tab sis cov kev taw qhia zoo li pheej hmoo heev. Lawv qhia tau hais tias muaj kev tiv thaiv kab mob ntau dua, tab sis qhov tshwm sim ntawm cov lus teb paraallergic raug txo kom tsawg. Nws yuav luag tsis tuaj yeem ua rau mob hawb pob, pob khaus, ua kua ntswg, "aspirin triad".
Tsis muaj kev cia siab tsawg dua yog cov tshuaj tsis yog opioid uas ua rau muaj kev cuam tshuam rau ntau yam ntawm cyclooxygenases hauv lub cev. Cov tshuaj twb tau tsim los uas cuam tshuam tsuas yog thromboxane synthetases, PG F2-alpha, thiab COX-2 synthetases. Thawj hom yog Ibufen, raws li ibutrin, qhov thib ob yog tshuaj ntawm thiaprofen. Lawv tsis tshua muaj tshwm sim o, ulceration, los yog bronchial spasm vim tsis muaj F2 PG. Thaum kawg, hom kawg tau nthuav tawm rau kev muag khoom los ntawm Nise series, powered by nimesulide.
NSAIDs
Cov npe tshuaj kho mob hauv pawg no suav nrog cov npe uas paub txog yuav luag txhua tus neeg uas tau siv tshuaj tua kab mob tsawg kawg ib zaug hauv nws lub neej. Xws li:
- Voltaren.
- YDiclofenac.
- Ketoprofen.
Cov nyiaj no yog siv yog tias qhov mob mob hauv articular, cov leeg nqaij raug cuam tshuam, yog tias kuaj pom lub taub hau mob lossis neuralgia. Cov tshuaj yog qhia rau cov txheej txheem inflammatory nyob rau hauv cov cheeb tsam ntawm localization. Raws li kev ua npawsNSAIDs tuaj yeem siv tau yog tias tus neeg mob kub taub hau, qhov kub siab tshaj 39 degrees. Tsis yog-opioid analgesics hauv pab pawg no tuaj yeem ua ke nrog vasodilators, tshuaj tiv thaiv kab mob, thiab tshuaj tiv thaiv kev puas siab puas ntsws los pab ua kom cov nyhuv antipyretic.
Kev ceev faj yog qhov tseem ceeb ntawm kev kho mob
Non-opioid analgesics - salicylates nyob rau hauv thawj qhov chaw - tuaj yeem ua rau kev loj hlob ntawm Reye's syndrome, yog li nws yuav tsum tau sau cov tshuaj no kom zoo rau menyuam yaus. Cov pab pawg muaj kev pheej hmoo rau cov teeb meem suav nrog cov neeg mob hnub nyoog qis dua kaum ob xyoos nrog tus kab mob etiology ntawm tus kab mob. Amidopyrine, indomethacin tuaj yeem ua rau qaug dab peg. Paracetamol suav hais tias yog qhov kev hloov pauv zoo tshaj plaws.
Ntxiv rau cov lus piav qhia tsis yog opioid analgesics, desensitizing zoo thiab inhibition ntawm inflammatory foci yog cov yam ntxwv ntawm derivatives ntawm indole-, phenylacetic, propionic, fenamic acids. Thaum sau tshuaj kho mob raws li qhov nuances thiab mob, tus kws kho mob yuav tsum nco ntsoov tias aniline derivatives yog xyaum tsis ua haujlwm hauv foci ntawm qhov mob, thiab txawm hais tias pyrazolone tuaj yeem pab tau qee qhov, nws yog siv tsis tshua muaj vim nws muaj peev xwm inhibit hematopoietic. muaj nuj nqi. Tsis tas li ntawd, cov tshuaj kho tau muaj nyob hauv cov tshuaj no yog qhov nqaim.
Txhua NSAIDs yog txwv tsis pub siv yog tias muaj kev tsis haum tshuaj, kev ua xua ntawm lub cev tau kuaj pom thaum kawm lossis tau pom yav dhau los. Koj tsis tuaj yeem siv cov tshuaj no nrog rau lub plab hauv plab, kev ua haujlwm ntawm hematopoietic ntawm lub cev, nrog rau thawj feem peb ntawm lub sijhawm yug menyuam.
Qeb thiab hom
txhawm rau ua kom yooj yim rau kev taw qhia ntawm ntau cov tshuaj tua kab mob uas tsim los ntawm kev lag luam, nws yog ib qho kev faib nyiaj tsis yog rau hauv opioid thiab non-opioid, tab sis kuj siv tshuaj sib xyaw. Ntawm cov tshuaj uas tsis yog-narcotic, antipyretics, ua ke formulations, tshuaj nrog ib tug central thiab peripheral nyhuv yog txawv. Spasmoanalgesics yog ib pawg ntawm cov tshuaj uas muaj ntau yam active tshuaj. Piv txwv li, Deegan yog tsim nrog cov suav nrog nimesulide, dicyclomine hauv cov mis.
Kev sib xyaw tshuaj tua kab mob muag hauv ntau lub npe lag luam yog raws li cov khoom hauv qab no:
- "Solpadeine" - paracetamol yog ua ke nrog caffeine thiab codeine.
- "Benalgin" - caffeine kuj ntxiv rau metamizole, ntxiv rau, thiamine muaj nyob hauv cov mis.
- "Paradik" - kev sib xyaw ntawm diclofenac, paracetamol.
- "Ibuklin" - tshuaj muaj paracetamol, ibuprofen.
- "Alka-prim" yog tshuaj raws li acetylsalicylic acid, uas aminoacetic acid ntxiv.
- Alka-Seltzer yog cov khoom muaj citric acid, acetylsalicylic acid thiab sodium carbonate dej.
Nce thiab qhov sib txawv
Cov tshuaj tsis yog opioid tsis cuam tshuam rau opioid receptors thiab tsis ua rau muaj kev quav tshuaj rau tus neeg mob. Lawv tsis zoo li muaj cov tshuaj pharmacodynamic antagonists. Cov tshuaj tsis tuaj yeem ua rau tsis muaj zog ntawm kev ua haujlwm ntawm qhov chaw hnoos thiab ua pa ntawm lub cev, tsis txhob ua rau quav quav (cem quav). Tag nrho cov khoom no txawvlawv nyob tom qab ntawm cov tshuaj kho mob narcotic.
tshuaj tsis yog tshuaj opioid yog muab rau kev raug mob me me - nqaij tawv thiab pob. Cov tshuaj muaj txiaj ntsig zoo hauv kev tawg ntawm ligaments thiab pab kom txo tau qhov mob thaum muaj cov ntaub so ntswg raug mob. Kev sib xyaw tuaj yeem siv tau yog tias mob thab plaub hauv lub sijhawm postoperative, lub syndrome raug ntsuas raws li qhov nruab nrab hauv qib. Cov tshuaj yog qhia rau mob taub hau, mob hniav, nrog spasms ntawm cov zis, kua tsib. Lawv siv ua npaws.
Nws thiaj li tshwm sim tias cov tshuaj tua kab mob uas tsis yog tshuaj yeeb tau paub ntau thiab feem ntau siv los ua ib feem ntawm kev kho tus kheej, uas yog, tsis muaj leej twg los tswj kev siv cov tshuaj. Qhov no ua rau muaj teeb meem ntawm cov teeb meem thiab cov kev mob tshwm sim tshwj xeeb tshaj yog cuam tshuam.
Salicylic acid thiab pyrazolone
Derivatives ntawm ob yam tshuaj no yog siv los ua ntau yam tshuaj. Qhov zoo tshaj plaws paub rau cov neeg ua haujlwm yog "Aspirin", uas nws cov txiaj ntsig zoo yog vim yog acetylsalicylic acid. Tsis tas li ntawd, methyl salicylate, salicylamide yog muaj nyob rau hauv kev lag luam kws tshuaj. Cov tshuaj raws li sodium salicylate, acelysin muaj npe nrov rau lawv cov txiaj ntsig. Rau tag nrho cov txhais tau tias ntawm chav kawm no, muaj peev xwm lom lom tsawg tsawg yog yam ntxwv. Cov kev ntsuam xyuas tau pom tias: qhov ua kom tuag ntawm cov tshuaj acetylsalicylic acid yog 120 g. Tib lub sijhawm, kuj tseem muaj qhov tsis muaj zog: kev ua kom khaus khaus, uas yuav ua rau los ntshav thiab ulcerated cheeb tsam. Cov nyiaj no tsis siv rau cov neeg mob hnub nyoog qis dua kaum ob.
Ntawm cov tshuaj tau los ntawm pyrazolone, tsim los ntawm txhua tuspaub "Analgin", uas nws lub ntsiab tseem ceeb yog metamezol. Tsis tshua muaj neeg nyiam yog Butadion, uas ua haujlwm los ntawm suav nrog phenylbutazone hauv cov mis, thiab Antipyrin, ua rau phenazone. Cov tshuaj "Amidopyrin" muaj lub koob npe nrov, cov ntsiab lus tseem ceeb ntawm cov aminophenazone.
Tag nrho cov tshuaj tau teev tseg muaj qhov nqaim ntawm kev kho mob ua haujlwm, txawm li cas los xij, cov nyhuv inhibitory ntawm hematopoietic muaj nuj nqi kwv yees yog qhov tseem ceeb heev. Qhov no ua rau muaj kev txwv rau lub sijhawm kho: tsuas yog cov chav kawm luv luv xwb.
Metamezole nyob rau hauv qhov chaw nyob ruaj khov yog feem ntau tau muab tshuaj txhaj tshuaj, vim tias cov tshuaj muaj ntau soluble hauv dej. Nws tuaj yeem raug txhaj rau hauv cov leeg nqaij, cov leeg lossis hauv qab ntawm daim tawv nqaij yog tias xav tau cov tshuaj loog hauv zos sai, qhov kub thiab txias. Thaum xaiv cov tshuaj, koj yuav tsum nco ntsoov tias thaum menyuam yaus, thaum siv amidopyrine, qhov pib ntawm convulsions raug kho, diuresis txo qis.
Para-aminophenol thiab indoleacetic acid
Paracetamol, phenacetin tau txais hauv tshuaj lom neeg muaj feem cuam tshuam nrog para-aminophenol. Ob leeg ntawm cov tshuaj no tsis muaj txiaj ntsig tiv thaiv kev mob siab rau lub cev, lawv tsis muaj cov nyhuv antirheumatic thiab muaj peev xwm kho cov ntshav viscosity. Kev siv cov formulations yog txuam nrog tsawg tsawg ntawm kev tsim cov kab mob rwj, thiab cov tshuaj muaj kev nyab xeeb rau lub raum thiab tsis cuam tshuam cov kev ua ntawm lub cev. Qhov pib ntawm convulsive npaj xyaum tsis hloov. Ntawm qhov kub thiab txias, lub ntsiabCov tshuaj uas xaiv yog paracetamol. Qhov no yog qhov tseeb tshwj xeeb rau kev kho cov menyuam yaus. Kev siv phenacetin ntev ntev tuaj yeem ua rau lub plawv nres.
Nrog kev koom tes ntawm indolacetic acid, sulindac, stodolac, indomethacin tau txais. Cov tom kawg yog ib tug siv nyob rau hauv cov nqe lus ntawm anti-inflammatory nyhuv. Nws ntseeg tau tias nws yog indomethacin uas muaj nyob rau hauv lub zog loj tshaj plaws. Nyob rau tib lub sijhawm, cov tshuaj cuam tshuam rau cov txheej txheem metabolic nrog cov neeg nruab nrab ntawm lub hlwb, qhov concentration ntawm GABA txo qis. Kev siv cov tshuaj analgesic yog nrog los ntawm kev pw tsaug zog, ntxhov siab, ntshav siab, convulsions. Nrog kev puas siab puas ntsws, qhov tshwm sim ntawm exacerbation ntawm tus mob yog siab. Sulindac, nkag mus rau hauv tib neeg lub cev, hloov mus rau hauv indomethacin. Cov tshuaj no muaj cov nyhuv qeeb, ntev ntev.
YPhenylacetic thiab propionic acids
Thawj tus tsim cov tshuaj diclofenac sodium, cov khoom tseem ceeb rau Voltaren thiab Ortofen npaj. Cov tshuaj no tsis tshua muaj provokes cov tsos ntawm ulceration nyob rau hauv lub plab hnyuv ib ntsuj av, feem ntau cov tshuaj yog siv los tawm tsam cov txheej txheem inflammatory thiab tawm tsam rheumatism.
Nrog kev koom tes ntawm propionic acid, cov tshuaj tiv thaiv tau txais keto-, ibu-, pirprofen, naproxen, thiaprofenic acid pib. Qhov kev ua haujlwm tshaj plaws hauv kev mob plab foci yog muaj nyob rau hauv pirprofen, naproxen. Rau thiaprofen, ib qho kev xaiv siab tau tsim, vim tias qhov tshwm sim tsis zoo los ntawm txoj hnyuv, kab mob ua pa, thiab kev ua me nyuam yaus tsis tshua pom. Ibuprofen zoo ib yam li diclofenac ntau txoj hauv kev.
