Chizvarwa ichangobva pamusoro NSAIDs: wongororo, mazita mitengo

Zvimwe zvakasiyana-siyana zvechirwere chinoshanduka chinoitika mumuviri, chinosangana nemarwadzo ekurwadziwa. Kukunda zviratidzo zvakadaro, NSAIDs kana kuti kwete-steroidal anti-inflammatory drugs yakagadzirwa. Vanonyatsotadza, vanobvisa kutuka, kuderedza kuzvimba. Zvisinei, mishonga iyi ine mishonga yakawanda. Izvi zvinoderedza kukwanisa kwekushandisa kwavo kune vamwe varwere. Mazuva ano mishonga yemapurisa yakagadzira NSAID dzechizvarwa chekupedzisira. Mishonga yakadaro hainyanyi kukonzera kusagadzikana, asi inoramba ichishandisa zvinodhaka zvinorwadza kurwadziwa.

Nheyo yehutano

Chii chinokonzerwa neNSAID pamuviri? Dzinobata cyclooxygenase. COX ine maviri isoforms. Mumwe nomumwe wavo anotakura mabasa ake. Enzyme yakadaro (COX) inokonzera kemikari inopindurwa, zvichienderana nei arachidonic acid inopinda mu prostaglandin, thromboxanes uye leukotrienes.

COX-1 inokonzera kugadzirwa kwe prostaglandin. Vanochengetedza gastric mucosa kubva pamagumisiro asina kufadza, anokanganisa kushanda kweplatelet, uyewo zvinokanganisa kuchinja kwekudzivirira ropa kunowanikwa.

COX-2 inowanzosipo uye inokonzera kuvhiringidzika enzyme yakagadzirwa ne cytotoxins, pamwe chete nevamwe vamiririri.

Ichi chiito cheNSAIDs, sekudzivirira kwe COX-1, ine migumisiro yakawanda.

Zvitsva zviri kuitika

Hazvisi chakavigwa kuti kugadzirira kwechizvarwa chekutanga cheNSAID chaiva nemigumisiro yakaipa pamusana mucosa. Nokudaro, masayendisiti akaisa chinangwa - kuderedza mamiriro asina kunaka. Imwe nzira itsva yekubudiswa yakagadzirwa. Mukugadzirira kwakadaro, chinhu chakashanda chakanga chiri mune imwe shell inokosha. Iyo capsule yakagadzirwa kubva kune zvinhu zvakadai izvo hazvina kupera mumamiriro e-acidic emudumbu. Vakatanga kuputsa chete kana vachinge varova mumatumbo. Izvi zvakabvumira kuderedza kushungurudza kunokonzera kugunzva mucosa. Zvisinei, nzira isingafadzi yekukuvadza masvingo emugariro wekudya ichiri kuchengetedzwa.

Izvi zvakaita kuti makemikari agadzire zvinhu zvitsva zvakakwana. Kubva pamishonga yapfuura, iyo yakasiyana zvakasiyana siyana yekuita. NSAID dzechizvarwa chitsva chinoratidzwa nechisarudzo che COX-2, pamwe nekudzvinyirirwa kweprostaglandin. Izvi zvinokubvumira kuti uwane zvose zvinodiwa zvinokonzera - analgesic, antipyretic, anti-inflammatory. Panguva imwecheteyo, NSAIDs dzechizvarwa chekupedzisira dzinobvumira kuderedza kuitika kweropa coagulability, platelet function, uye gastric mucosa.

Izvozvo zvinopesana nekuvhiringidza kunokonzerwa nekuderera kwezvakakosha zvemadziro emadziro, pamwe nekuderera kwekugadzirwa kwemarudzi akasiyana-siyana evhiringidziri. Nokuda kweizvi, kushatirwa kwemashoko ekurwadziwa kwehutano kunoderedzwa. Kufurirwa kune dzimwe nzvimbo dze thermoregulation, iri muuropi, inobvumira NSAID dzechizvarwa chekupedzisira kukonzera zvakakwana kutonhora kwehuwandu.

Zviratidzo zvekushandiswa

Inonyatsozivikanwa NSAID migumisiro. Migumisiro yemishonga yakadaro inonangwa yekudzivirira kana kuderedza kupisa kwekuita. Iyi mishonga inopa hutano hwakanaka hwema antipyretic. Zvavanoita pamuviri zvinogona kufananidzwa nechinokonzerwa nevanorganics. Mukuwedzera, anopa mifananidzo, anti-inflammatory effect. Kushandiswa kweNSAID kunosvika pamwero wakawanda mumakiriniki epiriniki uye muupenyu hwezuva nezuva. Nokuti nhasi iyo ndeimwe yemishonga yakakurumbira yemishonga.

Nzira dzakanaka dzinoratidzika nezviitiko zvinotevera:

1. Zvirwere zve musculoskeletal system. Nezvakasiyana-siyana, maronda, arthroses, mishonga iyi inongoramba isingagoneki. Inoshandiswa NSAIDs ye osteochondrosis, kuvhiringidza arthropathy, arthritis. Chirwere ichi chinopesana nekuputira simba mu myositis, herniated intervertebral discs.
2. Simba rakasimba. Mishonga inoshandiswa kubudirira kune biliary colic, zvirwere zvepabonde. Vanopedza musoro, kunyange migraine, mafungiro asina kunaka. NSAIDs dzinoshandiswa zvakakonzerwa nevarwere munguva yeperioperative.
3. High kutonhora. Antipyretic effect inokubvumira kushandisa madhiragi kune zvirwere zvakasiyana-siyana kuvanhu vakuru nevana. Mishonga yakadaro inoshanda kunyange nefivha.
4. Thrombosis. Kugadzirira kweNSAID ndeyekusagadzikana. Izvi zvinovabvumira kushandiswa kweIschemia. Icho chigadziro chinodzivirira chekurwa kwemwoyo uye kurohwa.

Kurongwa

Anenge makore makumi maviri akapfuura, mapoka 8 eASAID chete akavakwa. Nhasi, nhamba iyi yakawedzera kusvika ku15 Zvisinei, chimiro chaiyo kunyange vanachiremba havagoni kudanwa. Sezvo vaonekwa pamusika, vakakurumidza kuwana mukurumbira wakazara weNSAIDs. Mishonga iyi yakashandurwa maangeoji opioid. Sezvo ivo, kusiyana nechechipiri, havana kukanganisa kufema kuora mwoyo.

Kuenzanisa kweNSAID kunoreva kupatsanurwa kuva mapoka maviri:

1. Dhidhiyo mishonga (chizvarwa chokutanga). Izvi zvinosanganisira mishonga inonyatsozivikanwa: Citramon, Aspirin, Ibuprofen, Naproxen, Nurofen, Voltaren, Diclac, Diclofenac, Metindol, Movidid, Butadion .
2. NSAID itsva (yechipiri chizvarwa). Mumakore 15-20 apfuura, pharmacology yakagadzira mishonga yakanakisisa, yakadai seMovalis, Nimesil, Naize, Celebrex, uye Arkoksia.

Zvisinei, iyi haisi yega yega yeASAIDs. Mishonga yechizvarwa chitsva inoparadzaniswa kuva nhengo dzisina asidi uye acid. Pakutanga, funga chikamu chokupedzisira:

1. Salicylates. Iri boka reNSAID rine zvigadzirira: "Aspirin", "Diflunizal", "Lysinmonoacetylsalicylate".
2. Pyrazolidines. Vamiririri vezvikamu izvi vari kugadzirira: "Phenylbutazone", "Azaprobane", "Oxyphenbutazone".
3. Oksikam. Idzi ndidzo NSAID dzakanakisisa dzechizvarwa chitsva. Urongwa hwezvinodhaka: "Piroxicam", "Meloksikam", "Lornoxicam", "Tenoxicam." Mishonga haisi shoma, asi maitiro avo pamuviri anogara kwenguva yakareba kupfuura dzimwe NSAIDs.
4. Phenylacetic acid inogadzirwa. Boka rakadaro reNSAID rine mari: Diclofenac, Tolmetin, Indomethacin, Etodolac, Sulindak, uye Aceclofenac.
5. Kugadzirira anthranilic acid. Mumiririri mukuru ndiye mushonga "Mefenaminat".
6. Zvinoreva propionic acid. Ichi chikamu chine NSAID dzakawanda dzakanaka. Urongwa hwezvinodhaka: Ibuprofen, Ketoprofen, Benoxaprofen, Fenbufen, Fenoprofen, Tiaprofenic acid, Naproksen, Flurbiprofen, Pirprofen, Nabumeton.
7. Derivatives of isonicotinic acid. Mushonga mukuru ndiAmizon.
8. Kugadzirira kwe pyrazolone. Kune chikamu ichi ndicho chinonzi "Analgin".

Non-acid derivatives dzinosanganisira sulfonamide. Iri boka rinosanganisira kugadzirira: "Rofecoxib", "Celecoxib", "Nimesulide".

Migumisiro Yechiri

NSAID dzechizvarwa chitsva, urongwa hwezvakapiwa pamusoro, hunoratidzwa nemigumisiro inoshanda pamuviri. Muchiitiko ichi, zvinenge zvisingabatsiri kushanda kwemashoko ekudya. Misiyano pakati pezvinodhaka izvi ndeimwe yakakosha: NSAID dzechizvarwa chitsva hachikuvhiringidzi zvinokonzera mishonga inoputika.

Zvisinei, kunyange zvakadaro maitiro anoshanda anogona kukanganisa mhando dzakawanda dzisina kunaka. Vanofanirwa kuzivikanwa, kunyanya kana mishonga inoshandiswa kwenguva yakareba.

Iyo huru migumisiro inogona kuva:

• Dhizinesi;
• Kugona;
• Headache;
• Kuneta;
• Kuwedzera kwenhamba yemwoyo;
• Kuwedzera kwezvinetso;
• Edza kupfupika kwemhepo;
• Dry chikwama;
• Kushaya njodzi kudya;
• Kuonekwa kweprotheni mumuguta;
• Basa rakawedzerwa remakemikari anokonzera;
• Kurwiswa kweganda (gwapa);
• Fluid retention;
• Allergy.

Muchiitiko ichi, kukanganisa ku gastric mucosa hakuonekwi pakutora NSAID itsva. Kugadzirira hako kunokonzera kuwedzera kwechironda nekuonekwa kweropa.

Mazano ekushandiswa

Iyo yakanakisisa inopesana nekuvhiringidza zvinhu inogadzirwa zve phenylacetic acid, salicylates, pyrazolidones, oxicams, alkanones, propionic acid uye sulfonamide zvinodhaka.

Kubva pakurwadziwa pamwe chete, mishonga inobatsira zvikuru Indomethacin, Diclofenac, Ketoprofen, uye Flurbiprofen. Iyi ndiyo NSAID yakanakisisa ye osteochondrosis. Mishonga inotaurwa pamusoro apa, kunze kweKetoprofen, ine chirevo chekurwisa-kupisa simba. Izvi zvinosanganisira zvinoreva "Piroxicam".

Mafuta anorgesics anobudirira ari kugadzirira Ketorolac, Ketoprofen, Indomethacin, Diclofenac.

Mutungamiri pakati peNSAID dzekupedzisira chizvarwa chaive chirwere "Movalis". Iyi shanduro inobvumirwa kushandisa nguva yakareba. Zviratidzo zveAn anti-inflammatory yemishonga inoshanda inogadzirira "Movasin", "Mirloks", "Lem", "Arthrosan", "Meloks", "Melbek", "Mesipol" uye "Ameloteks".

Mushonga we "Movalis"

Ichi chemishonga chinowanikwa mune mahwendefa, rectal suppositories uye sarudzo yejovo yepramuscular. Zvinoreva zvinoreva zviwanikwa zve enol acid. Kugadzirira kunopesana zvakanakisisa anesthetizing uye antipyretic properties. Yakave yakasimbiswa kuti zvinowanikwa nehupi hwekuvhiringidza kwemishonga iyi mishonga inounza maitiro akanaka.

Zviratidzo zvekushandiswa kwemishonga ndeye osteoarthritis, ankylosing spondylitis, rheumatoid arthritis.

Zvisinei, iwe unofanirwa kuziva kuti pane zvinopesana nekutora mishonga:

• Hypersensitivity kune chero chezvinhu zvechirwere;
• Peptic ulcer mumutsara wekuwedzera;
• Kunyanya kuderedza kusakwanira;
• Kuchema kubuda ropa;
• Yakanyanya kushaya hepatic;
• Kubata, kupa mwana;
• Kuoma mwoyo kukanganisa.

Usatora mushonga uyu kune vana pasi pemakore gumi nemaviri.

Vakuru vanoonekwa kuti vane osteoarthritis vanokurudzirwa kushandisa 7.5 mg pazuva. Kana zvichidiwa, chiyero ichi chinogona kuwedzerwa kaviri.

Ne rheumatoid arthritis uye ankylosing spondylitis, musimboti wezuva nezuva ndewe 15 mg.

Inonyanya kuchenjerera kutora varwere vezvinodhaka vanotaridzika kune zvinoitika pamigumisiro. Vanhu vane kushaya simba kwetsvina uye avo vari pa hemodialysis havafaniri kutora zvinopfuura 7.5 mg zuva rose.

Mari yezvinodhaka "Movalis" mu mahwendefa e 7.5 mg, Nha. 20, ndiyo 502 rubles.

Pfungwa dzevatengi nezvemishonga

Kuongororwa kwevanhu vakawanda vanogadzirisa kurwadziwa kukuru, kuratidza kuti mishonga "Movalis" - ndiyo nzira yakanakisisa yekutambira kwenguva refu. Yakanyatsorambidzwa nevarwere. Mukuwedzera, kuvapo kwaro kwenguva yakareba mumuviri kunoita kuti zvikwanise kutora chirwere chimwe chete chechirwere. Chinhu chakakosha zvikuru, maererano nevatengi vese, ndiko kuchengetedzwa kwemakemikari emakumbo, sezvo mushonga wacho hauna kuvhiringidza. Izvi zvakakosha zvikuru kuvarwere vanoshandisa mushonga we osteochondrosis, arthrosis.

Mukuwedzera, mushonga wacho unogadzirisa zvakakwana marwadzo akasiyana-siyana - mazino, musoro. Kunyanya kubhadharwa kunobhadharwa nevarwere kusvika kune rumwe ruzha rwemigumisiro. Munguva yekudyiwa kweNSAIDs, kurapwa, pasinei nenyevero yemhizha, kwakanga kusina kuoma nemigumisiro isingafadzi.

Mushonga we "Celecoxib"

Chiito chemugadziro uyu chinangwa chekuderedza chirwere chemurwere ne osteochondrosis uye arthrosis. Mushonga wacho unopedza zvachose marwadzo ehutano, zvinobudirira zvinobvisa chirwere chinopisa. Pakanga pasina kuipa kwakanyanya pamagetsi.

Zviratidzo zvekushandiswa, zvakapiwa mumirairo ndezvi:

• Psoriatic arthritis ;
• Osteoarthritis;
• Rheumatoid arthritis;
• Ankylosing spondylitis.

Ichi chemishonga ine zvinyorwa zvinopesana. Mukuwedzera, mushonga hauna kuitirwa vana vasati vava nemakore gumi nemana. Kuchengetedzwa kwakanyanya kunofanira kutorwa kune vanhu vanoonekwa kuti vane mwoyo kusakwanisa, nokuti mishonga inowedzera izvo zvigadziriswa kusvika pakugadzirisa mvura.

Mutengo wemishonga unosiyana, zvichienderana nekuputika, munharaunda ye500-800 rubles.

Maonero evatengi

Zvimwe zvinopesana zvidzidzo pamusoro pechirwere ichi. Vamwe varwere vakakwanisa kukurira kurwadziwa kwepamuviri pamusana pekugadzirisa iyi. Vamwe varwere vanoti mushonga uyu hauna kubatsira. Nokudaro, iyi shanduro haisi nguva dzose inoshanda.

Mukuwedzera, usatora mushonga iwe pachako. Mune dzimwe nyika dzeEurope, mushonga uyu unorambidzwa, sezvo une cardiotoxic effect, iyo inenge isina kunaka pamwoyo.

Mushonga we "Nimesulide"

Ichi chinodhaka hachina kungopesana nekuputika uye kupesana nemarwadzo. Chigadzirwa chacho chine antioxidant, iyo inoshandiswa nemishonga inhibits zvinhu zvinoparadza mavara uye makorogen.

Iyo mumiriri inoshandiswa apo:

• Arthritis;
• Arthrosis;
• Osteoarthritis;
• Myalgia;
• Arthralgia;
• Bursitis;
• Fever;
• Utano hwakasiyana-siyana syndromes.

Izvozvo zvinoshandiswa nemishonga iyi inokurumidza zvikuru. Kazhinji, murwere anonzwa akasunungurwa mukati maminitsi makumi maviri mushure mekutora mishonga. Ndosaka chigadzirwa ichi chinoshanda kwazvo mukurwadziwa kwakaoma kwepodoxysmal.

Anenge nguva dzose mishonga inorambidzwa zvakanaka nevarwere. Asi dzimwe nguva pane zvingava nemigumisiro yakadai sokuzorora, kubata, kuora musoro, kuchema, kuora mwoyo, hematuria, oliguria, urticaria.

Mhinduro haina kubvumirwa kuvakadzi vane pamuviri nevana vasati vava nemakore gumi nemaviri. Nokuchenjerera kwakanyanya, vanhu vane hypertension, kushanda kwetsvo, meso, kana mwoyo inofanira kutora Nimesulide.

Ivhareji yemutengo wemishonga ndeye 76.9 rubles.

Vanotaurei vanoti?

Ongororo pamusoro pemishonga inenge iri nguva dzose inofadza. Nokuti mishonga yacho inonyatsobvisa marwadzo uye inoderedza kupisa, inorwisana zvachose nezvirwere zvinopisa.

Varwere vazhinji vanocherechedza kuti kununurwa kwezviratidzo kunoitika nekukurumidza, uye nguva yaro inenge inenge maawa masere.

Mushonga wakanakisisa unopedza zvachose meno, kushushikana, kurwadziwa kweArthritic. Mishonga inokwanisa kukonzera kusagadzikana kunokonzerwa nepineching yemutsipa.

Mushonga we "Xefokam"

Mushonga uyu ndeweboka rei oxycomas. Iri boka reNSAID rine huwandu hwehupenyu hunowedzera, zvichiguma nekuratidzwa kwenguva refu kumushonga. Izvi zvakabvumira kunyanya kuderedza kuwandisa kwemishonga. Somugumisiro, njodzi yemigumisiro inoderera.

Chirwere ichi "Xefokam" chinoratidzirwa nekanhu hukuru hwekugadzirisa marwadzo. Kubwinya kwaro kunoita simba rekuratidzwa kwakafanana ne morphine. Zvisinei, kusiyana nemagetsi ekupedzisira, mushonga wacho hausi kupindwa muropa uye hahupindi hurumende yepamusoro yenheyo.

Panguva yekuedzwa, zvakaonekwa kuti mishonga inopedza marwadzo kwemaawa gumi nemaviri.

Mutengo wechirwere mupepeti (8 mg) pakutevedza Nhamba 10 ndeye 205 rubles.

Mushonga we "Rofecoxib"

Iyo mishonga ine anti-inflammatory analgesic, anti-edematous uye antipyretic effect. Ipa mushonga unoshanda wezvirwere zvinotevera:

• Chronic periarthritis;
• Rheumatoid arthritis;
• Tendonitis;
• Bursitis;
• Kutambudzwa kwetendon yemagetsi, misumbu.

Zvakakwana zvinobudirira kubvisa zvinodhaka "Rofecoxib" dzakasiyana-siyana anorwadza zviratidzo anokonzerwa neuralgia, osteochondrosis, papurupiti. Zvinoreva zvakakwana Unotsigira lumbago, ndichinzwa zino, radicular syndrome.

The mushonga hakufaniri pasi nokugamuchirwa varwere asima, pashure kutambura mwoyo kurwisa, sitiroko. Hazvina zvakafanira kuti kurishandisa, uye vanhu vane oncological zvirwere, BP uye atherosclerosis. The mushonga hakubvumidzwi vana pasi pemakore 12. Uyezve, usati kushandisa zvinokurudzirwa kunyatsofunga zvingakonzerwa nemishonga.

Drug "Parecoxib"

Uyu rakanakisisa huchashandiswa kuderedza anogumbura mhinduro uye kuita kuti rutapudzo pamusoro nehanya kurwadziwa receptors. The mushonga ari kudiwa varwere achirapwa kuvhiyiwa.

It anobvisa marwadzo syndromes kuti mwero kuti zvikuru zvikuru. Raitongwa pashure zvachose hudyu uye ibvi yokutsiva, chibereko, coronary tsinga ndavhiyiwa, aishandiswa mazino tsika.

Chipimo chemushonga kuchinja chinokuvadzwa nomumwe. It kunobva kunotoda ezvinhu uye chiratidzo. Children pasi pemakore 18 emishonga haana kuitirwa.

Drug "Arcoxia"

The mushonga ane rimwe zita - "Etorikoksib". The nzira kunoratidzwa yakakwirira antiinflammatory, unonyaradza marwadzo ehupfumi. Kugadzirira rinokurudzira chinovhiringidza kurwadziwa chido chacho.

Varwere Zvirwere of zvetsandanyama nemapfupa ino tichibatsirwa chokushandisa ichi kubvisa mangwanani kuomarara. Vakaita nani kwemajoini mufambo, akazoita kusimba chokutsva, zvakakwana azorodzwa uchirwadziwa. Pamusoro kugamuchira kuchirapa mugumisiro kunoitika mukati maminitsi makumi maviri nezvina. The rinoita mushonga fuma zvakanaka yokuita zvinoitwa muropa. Kugadzirira kunoratidzwa kumusoro bioavailability. indekisi Iri 100%.

The dose of zvinodhaka anogona kupiwa chete nachiremba. It kazhinji anoda kubatsira kubva 60 MG kusvika 120 MG kwemazuva.

The mushonga hauna aiendeswa kushandisa vakadzi vane pamuviri uye vana kusvika makore 16.

mhedziso

Modern pharmacology haisi akamira. Development idzva, tibudirire NSAIDs. List zvimwe pane rudzi rutsva zvinodhaka, kumusoro, kunoita kuti asarudze zvakanaka chishandiso chero pathologies. Zvisinei, ziva kuti mishonga iyi havagoni kurapa chirwere. Vane chete ane Anti-anogumbura uye marwadzo kushanda.