Mankhwala 10 Apamwamba Opanda Kutupa (NSAIDs)
NSAIDs - mapiritsi a "matsenga" a mutu, kupweteka kwa mano, kusamba, kupweteka kwa minofu kapena mafupa. Ndikofunika kumvetsetsa kuti mankhwala osagwiritsa ntchito steroidal odana ndi kutupa amangochotsa chizindikirocho, koma samakhudza chomwe chimayambitsa ululu.

Anthu 30 miliyoni tsiku lililonse amagwiritsa ntchito mankhwala osagwiritsa ntchito steroidal anti-inflammatory kuti athetse ululu. Tiyeni tiwone kusiyana kotani pakati pa magulu osiyanasiyana a NVPS, matenda omwe amaperekedwa, ndi zotsatira zotani zomwe angakhale nazo.

Mndandanda wa mankhwala 10 otsika mtengo komanso othandiza omwe si a steroidal anti-inflammatory malinga ndi KP

1. Aspirin

Aspirin amaperekedwa chifukwa cha ululu wamtundu uliwonse (minofu, mgwirizano, kusamba) ndi kutentha kwa thupi. Mankhwalawa akuphatikizidwa pamndandanda wamankhwala ofunikira a Russian Federation. Aspirin amachepetsanso kuphatikizika kwa mapulateleti wina ndi mnzake ndikuchepetsa magazi, chifukwa chake amatha kuperekedwa kwa nthawi yayitali pamlingo wocheperako popewa matenda amtima. Mlingo waukulu watsiku ndi tsiku ndi 300 mg.

Contraindications:kuchuluka chizolowezi magazi, ana osakwana zaka 15 zakubadwa.

oyenera kupweteka kwamtundu uliwonse, mtengo wotsika mtengo.
ndikugwiritsa ntchito nthawi yayitali, zimakhala ndi zotsatira zoyipa m'mimba; zotheka chitukuko cha mphumu bronchial kugwirizana ndi aspirin.
onetsani zambiri

2. Diclofenac

Diclofenac nthawi zambiri amaperekedwa kwa matenda otupa a mafupa (nyamakazi). Komanso, mankhwalawa amagwiritsidwa ntchito mwakhama pa ululu wa minofu, neuralgia, kupweteka pambuyo pa kuvulala kapena opaleshoni, kwa matenda opweteka kumbuyo kwa matenda otupa a m'mwamba ndi m'chiuno (adnexitis, pharyngitis). Mlingo umodzi waukulu kwambiri ndi 100 mg.

Zoyipa: magazi osadziwika chiyambi, m'mimba kapena duodenal chilonda, trimester yotsiriza ya mimba.

kugwiritsa ntchito konsekonse; pali mitundu ingapo ya kumasulidwa (gel osakaniza, mapiritsi).
mosamala amaperekedwa kwa okalamba; contraindicated mu edema.

3. Ketanov

Ketanov amaperekedwa kwa ululu wapakati kapena woopsa kwambiri. Komanso, mankhwalawa ndi othandiza pa matenda opweteka omwe amatsagana ndi khansa, komanso pambuyo pa opaleshoni. Mphamvu ya analgesic imachitika ola limodzi mutadya, ndipo zotsatira zake zimatheka pambuyo pa maola 1-2. Mlingo waukulu watsiku ndi tsiku ndi 3 mg. Ndikoyeneranso kukumbukira kuti Ketorolac sagwiritsidwa ntchito pochiza ululu wosatha. Musagwiritse ntchito masiku oposa awiri popanda kufunsa dokotala.

Contraindications: mimba, mkaka wa m`mawere, chiwindi kulephera, hypersensitivity kuti NSAIDs, anam`peza erosive zotupa za m`mimba thirakiti pachimake siteji.

kutchulidwa analgesic zotsatira; imagwira ntchito pa ululu uliwonse (kupatulapo nthawi yayitali).
amphamvu zoipa mmene chapamimba mucosa.

4. Ibuprofen

Mankhwalawa amagwiritsidwa ntchito kuti athetse kupweteka kwakanthawi kochepa kapena kutentha thupi ndi chimfine. Kutalika kwa mphamvu ya analgesic kumatenga pafupifupi maola 8. Mlingo wambiri watsiku ndi tsiku ndi 1200 mg, pomwe sikulimbikitsidwa kumwa mankhwalawa kwa masiku opitilira 3 popanda malangizo a dokotala.

Contraindications: hypersensitivity to ibuprofen, erosive and ulcerative matenda komanso magazi am'mimba, mphumu ya bronchial, mtima waukulu, aimpso ndi chiwindi kulephera, kutsekeka kwa magazi, mimba (3 trimester), ana osakwana miyezi itatu, matenda ena a rheumatological (systemic lupus). erythematosus).

kugwiritsa ntchito konsekonse; zotsatira za analgesic kwa nthawi yayitali.
mndandanda waukulu wa contraindications, sangatengedwe yaitali kuposa 3 masiku.
onetsani zambiri

5. Ketoprofen

Ketoprofen nthawi zambiri zotchulidwa matenda yotupa mafupa, mafupa ndi minofu - nyamakazi, arthrosis, myalgia, neuralgia, sciatica. Komanso, mankhwalawa ndi othandiza kuthetsa ululu pambuyo povulala, opaleshoni, renal colic. Mlingo waukulu watsiku ndi tsiku ndi 300 mg.

Contraindications: zilonda zam`mimba thirakiti m`mimba, ana osapitirira zaka 18, mimba (3 trimester), kwambiri chiwindi ndi impso kulephera.

kutchulidwa analgesic zotsatira; oyenera zowawa zosiyanasiyana.
kugwiritsa ntchito kamodzi kokha kumalimbikitsidwa; kumakhudza kwambiri m`mimba thirakiti.

6. Nalgesin Forte

Nalgezin Forte amagwiritsidwa ntchito kuthetsa ululu mu matenda otupa a mafupa, mafupa, minofu, mutu ndi migraines. Komanso, mankhwalawa ndi othandiza kutentha thupi pa chimfine. Mlingo waukulu watsiku ndi tsiku ndi 1000 mg. Pogwiritsa ntchito nthawi yayitali, ndikofunikira kuyang'anira ntchito ya impso.

Contraindications+

kugwiritsa ntchito konsekonse; amagwira ntchito ngati antipyretic.
mndandanda waukulu wa contraindications.

7. Meloxicam

Meloxicam amaperekedwa kwa nyamakazi zosiyanasiyana (osteoarthritis kapena nyamakazi), chifukwa amachepetsa ululu ndi kutupa. Pankhaniyi, tikulimbikitsidwa kuti tiyambe kumwa mankhwalawa ndi mlingo wocheperako ndikuwonjezera ngati kuli kofunikira. Komanso, mukatenga Meloxicam, zotsatira zoyipa monga kupweteka kwa m'mimba, kutsegula m'mimba, flatulence, nseru ndizotheka.

Contraindications: hypersensitivity kwa zigawo zikuluzikulu za mankhwala, decompensated mtima kulephera, erosive zotupa ndi magazi m`mimba thirakiti, mimba ndi yoyamwitsa, ana osapitirira zaka 12 zakubadwa.

kutchulidwa analgesic zotsatira mu rheumatological matenda.
zotheka zotsatira zoyipa; kufunika kosankha mosamala mlingo.

8. Nimesulide

Nimesulide ntchito zosiyanasiyana ululu: mano, mutu, minofu, kupweteka kwa msana, komanso postoperative nthawi, pambuyo kuvulala ndi mikwingwirima. Pazipita mlingo umodzi ndi 200 mg. Pankhaniyi, mankhwala sayenera kumwedwa chimfine ndi SARS. Madokotala amachenjezanso kuti Nimesulide zingayambitse mavuto monga chizungulire, kugona, mutu, thukuta kwambiri, urticaria, kuyabwa khungu.

Contraindications: mimba ndi mkaka wa m`mawere, bronchospasm, urticaria, rhinitis chifukwa kutenga NSAIDs, ana osakwana zaka 12 zakubadwa.

nthawi yayitali ya analgesic (maola opitilira 12).
contraindicated kutentha thupi pa chimfine, kumakhudza kwambiri m`mimba thirakiti.

9. Celecoxib

Celecoxib imatengedwa kuti ndi imodzi mwa NSAID zotetezeka kwambiri. Mankhwala ntchito kuthetsa olowa, kupweteka kwa minofu, komanso ntchito kuthetsa kuukira kwa ululu pachimake akuluakulu.1. Madokotala amalangiza kuti ayambe kulandira chithandizo ndi mlingo wocheperako ndikuwonjezera ngati kuli kofunikira.

Contraindications: kuphwanya kwakukulu kwa impso ndi chiwindi, matupi awo sagwirizana ndi kumwa acetylsalicylic acid kapena NSAID zina m'mbiri, III trimester ya mimba, kuyamwitsa.

otetezeka kwa m'mimba mucosa, kumathandiza ndi mitundu yosiyanasiyana ya ululu.
kusankha mlingo kumafunika.

10. Arcoxia

Zomwe zimagwiritsidwa ntchito muzolembazo ndi etoricoxib. The mankhwala cholinga zochizira ululu aakulu (kuphatikizapo rheumatological matenda), komanso ululu pambuyo opaleshoni mano.2. Mlingo waukulu watsiku ndi tsiku ndi 120 mg.

Contraindications: mimba, mkaka wa m`mawere, erosive ndi anam`peza kusintha mucous nembanemba m`mimba kapena duodenum, yogwira m`mimba magazi, cerebrovascular kapena magazi ena, ana osapitirira zaka 16.

kutchulidwa analgesic kwenikweni.
sichichepetsa kutentha thupi, sichithandiza ndi mitundu yonse ya ululu.

Momwe mungasankhire mankhwala osagwiritsa ntchito steroidal odana ndi kutupa

Mankhwala onse omwe si a steroidal odana ndi kutupa amagawidwa m'magulu angapo. Amasiyana nthawi yakuchita, mphamvu pakuchotsa ululu ndi kutupa, komanso kapangidwe ka mankhwala.3.

Malinga ndi nthawi yakuchitapo kanthu, mankhwala osagwiritsa ntchito steroidal odana ndi kutupa amasiyanitsidwa (nthawi yowonekera pafupifupi maola 6) komanso nthawi yayitali (nthawi yowonekera yopitilira maola 6).

Komanso, ma NSAID amasiyana pakuchita bwino kwa anti-inflammatory effect ndi analgesic effect. Anti-inflammatory effect (kuyambira pamlingo wocheperako) ali ndi: indomethacin - diclofenac - ketoprofen - ibuprofen - aspirin. Malinga ndi kuopsa kwa zotsatira za analgesic (kuchokera pazipita mpaka zochepa): ketorolac - ketoprofen - diclofenac - indomentacin - ibuprofen - aspirin4.

Ndemanga za madokotala za non-steroidal odana ndi kutupa mankhwala

Celecoxib yayamikiridwa ndi madokotala ambiri ngati mankhwala othandiza kwa ululu wosaneneka wa rheumatic. Kuphatikiza apo, Celecoxib imatengedwa ngati "golide muyezo" pachiwopsezo chochepa cha zovuta zam'mimba.

Komanso, akatswiri amalangiza Naproxen, yomwe imalekerera bwino ndi odwala ndipo sichimayambitsa zotsatira zoyipa ikagwiritsidwa ntchito kwa masiku osapitilira 21.5.

Akatswiri ambiri a nyamakazi amatsindika za mankhwala a Etoricoxib (Arcoxia), omwe amathandiza pazochitika zambiri zomwe zimaphatikizapo ululu. Imodzi mwa ubwino wake waukulu ndi yabwino dosing regimen ndi liwiro isanayambike zotsatira.

Mafunso ndi mayankho otchuka

Tinakambirana nkhani zofunika zokhudzana ndi mankhwala osagwiritsa ntchito steroidal odana ndi kutupa ndi wothandizira onse gulu lapamwamba Tatiana Pomerantseva.

Chifukwa chiyani mankhwala osagwiritsa ntchito steroidal odana ndi kutupa ali owopsa?

- NVPS ndi yowopsa chifukwa imatha kuyambitsa zovuta. Odziwika kwambiri mwa iwo:

• NSAIDs - gastropathy (mu 68% ya odwala omwe amamwa mankhwala kwa milungu yosachepera 6) - amawonetseredwa ndi mapangidwe a zilonda, kukokoloka, kutuluka kwa m'mimba, kuphulika;

• impso - kulephera kwaimpso pachimake, kusunga madzimadzi;

• mtima dongosolo - kuphwanya magazi kuundana;

• dongosolo lamanjenje - mutu, vuto la kugona, mavuto a kukumbukira, kuvutika maganizo, chizungulire;

• hypersensitivity - chiopsezo chowonjezeka cha mphumu ya bronchial;

• kuwonongeka kwa chiwindi.

Kodi pali kusiyana kotani pakati pa steroid ndi non-steroid mankhwala?

- Mankhwala a steroid odana ndi kutupa ndi mankhwala a mahomoni. Ndipo nonsteroidal mankhwala ndi organic zidulo. Mosiyana ndi ma NSAID, mankhwala a steroid amakhudza kagayidwe kachakudya m'thupi komanso chitetezo chamthupi. Mankhwala a steroid amaperekedwa ngati ali ndi matenda aakulu, pamaso pa njira zowonongeka kuchokera ku ziwalo zina ndi machitidwe, kupweteka kwapang'onopang'ono, kupweteka kwapakati (mu rheumatology), ngati kulephera kwa NSAID kapena zotsutsana nazo.

Kodi mankhwala osagwiritsa ntchito steroidal angagwiritsidwe ntchito nthawi yayitali bwanji?

NSAIDs ndi mankhwala opha ululu omwe sachiza chomwe chimayambitsa ululu. Chifukwa chake, mutha kumwa mankhwala nokha kwa masiku osapitilira 5. Ngati ululu ukupitirira, muyenera ndithudi kukaonana ndi dokotala.

Momwe mungatetezere chapamimba mucosa ku zotsatira zaukali za NSAIDs?

- M'pofunika kutenga proton pump inhibitors (PPIs) mofanana ndi njira ya NSAIDs. PPIs monga Omeprazole, Pariet, Nolpaza, Nexium. Mankhwalawa amachepetsa katulutsidwe ka hydrochloric acid ndi maselo apadera a mucosal ndipo amapereka chitetezo cham'mimba mucosa.

Kodi pali ma NSAID otetezeka?

Palibe mankhwala osagwiritsa ntchito steroidal odana ndi kutupa omwe ali otetezeka kwathunthu ku thanzi. Kungoti kuopsa kwa zotsatirapo za mankhwala ena kumakhala kochepa kwambiri. Naproxen ndi Celecoxib amaonedwa kuti ndi otetezeka kwambiri.
  1. Karateev AE Celecoxib: kuwunika kogwira mtima ndi chitetezo mzaka khumi zachiwiri zazaka za 2013 // Modern Rheumatology. 4. No. Ulalo: https://cyberleninka.ru/article/n/tselekoksib-otsenka-effektivnosti-i-bezopasnosti-vo-vtorom-desyatiletii-xxi-veka
  2. Kudaeva Fatima Magomedovna, Barskova VG Etoricoxib (arcoxia) in rheumatology // Modern rheumatology. 2011. No. 2. URL: https://cyberleninka.ru/article/n/etorikoksib-arkoksia-v-revmatologii
  3. 2000-2022. REGISTER YA MANKHWALA A RUSSIA® RLS ®
  4. Shostak NA, Klimenko AA Non-steroidal anti-inflammatory drugs - zinthu zamakono zomwe zimagwiritsidwa ntchito. Dokotala. 2013. No. 3-4. Ulalo: https://cyberleninka.ru/article/n/nesteroidnye-protivovospalitelnye-preparaty-sovremennye-aspekty-ih-primeneniya
  5. Tatochenko VK Apanso za antipyretics // VSP. 2007. No. 2. URL: https://cyberleninka.ru/article/n/eschyo-raz-o-zharoponizhayuschih-sredstvah

Siyani Mumakonda