Izidakamizwa eziyi-10 eziphezulu ezingezona ukuvuvukala (ama-NSAID)
Ama-NSAID – iphilisi “lomlingo” lekhanda elibuhlungu, amazinyo elibuhlungu, ukuya esikhathini, imisipha noma ubuhlungu bamalunga. Kubalulekile ukuqonda ukuthi izidakamizwa ezingezona ze-steroidal ezilwa nokuvuvukala ziqeda kuphela uphawu, kodwa ayithinti imbangela yobuhlungu.

Abantu abayizigidi ezingu-30 nsuku zonke basebenzisa imishanguzo engeyona i-steroidal eqeda ukuvuvukala ukuze baqede izinhlungu. Ake sithole ukuthi uyini umehluko phakathi kwamaqembu ahlukene e-NVPS, yiziphi izifo ezinqunyelwe zona, nokuthi yimiphi imiphumela emibi engase ibe nayo.

Uhlu lwemithi eyi-10 ephezulu engabizi futhi esebenzayo engeyona eye-steroidal eqeda ukuvuvukala ngokusho kwe-KP

1. I-Aspirin

I-Aspirin inqunyelwe ubuhlungu banoma yiluphi uhlobo (imisipha, ukujoyina, ukuya esikhathini) kanye nokushisa komzimba okuphezulu. Lesi sidakamizwa sifakwe ohlwini lwemithi ebalulekile ye-Russian Federation. I-Aspirin iphinde yehlise ukunamathela kwamaplatelet komunye nomunye futhi inciphise igazi, ngakho-ke inganqunyelwa ukusetshenziswa isikhathi eside ngethamo eliphansi lokuvikela izifo zenhliziyo. Umthamo omkhulu wansuku zonke ngu-300 mg.

Ukungafani:ukwanda kokuthambekela ukopha, izingane ezingaphansi kweminyaka engu-15 ubudala.

ifanele ubuhlungu banoma yiluphi uhlobo, intengo ethengekayo.
ngokusetshenziswa isikhathi eside, kunomphumela omubi esiswini; ukuthuthukiswa okungenzeka kwe-asthma ye-bronchial ehambisana ne-aspirin.
bonisa okuningi

2. I-Diclofenac

I-Diclofenac ivame ukunqunywa izifo ezivuthayo zamalunga (i-arthritis). Futhi, isidakamizwa sisetshenziselwa ubuhlungu bemisipha, i-neuralgia, ubuhlungu ngemva kokulimala noma ukuhlinzwa, i-syndrome yobuhlungu ngokumelene nesizinda sezifo ezivuthayo zokuphefumula okuphezulu kanye ne-pelvis encane (adnexitis, pharyngitis). Umthamo owodwa omkhulu ngu-100 mg.

Contraindication: ukopha kwemvelaphi engaziwa, isisu noma isilonda se-duodenal, i-trimester yokugcina yokukhulelwa.

ukusetshenziswa kwendawo yonke; kunezinhlobo eziningana zokukhululwa (ijeli, amaphilisi).
ngokuqapha kunqunywe kubantu asebekhulile; contraindicated ku-edema.

3. I-Ketanov

I-Ketanov inqunyelwe ubuhlungu obuphakathi nobukhulu obukhulu. Futhi, umuthi uyasebenza ku-syndrome yobuhlungu ehambisana nomdlavuza, nangemva kokuhlinzwa. Umphumela we-analgesic uvela ihora eli-1 ngemuva kokumunca, futhi umphumela omkhulu utholwa ngemuva kwamahora angama-2-3. Umthamo omkhulu wansuku zonke ngu-40 mg. Kuyafaneleka futhi ukukhumbula ukuthi i-Ketorolac ayisetshenziselwa ukwelapha ubuhlungu obungapheli. Ungasebenzisi ngaphezu kwezinsuku ezimbili ngaphandle kokubonisana nodokotela.

Ukungafani: ukukhulelwa, ukuncelisa, ukwehluleka kwesibindi, hypersensitivity to NSAIDs, izilonda erosive ulcer of the pheshana emathunjini esigabeni acute.

umphumela we-analgesic ophinyisiwe; kusebenza kunoma ibuphi ubuhlungu (ngaphandle kokungapheli).
umphumela onamandla omubi ku-mucosa yesisu.

4. Ibuprofen

Umuthi usetshenziselwa ukudambisa izinhlungu zesikhashana noma imfiva enomkhuhlane. Ubude besikhathi somphumela we-analgesic buhlala cishe amahora angu-8. Umthamo omkhulu wansuku zonke ngu-1200 mg, kuyilapho unganconywa ukuphuza umuthi isikhathi esingaphezu kwezinsuku ezi-3 ngaphandle kwezincomo zikadokotela.

Ukungafani: hypersensitivity to ibuprofen, izifo erosive and ulcerative kanye ukopha ipheshana emathunjini, isifuba somoya bronchial, inhliziyo eqinile, ukwehluleka kwezinso kanye hepatic, ukuphazamiseka kwegazi, ukukhulelwa (3rd trimester), izingane ezingaphansi kwezinyanga ezi-3 ubudala, ezinye izifo rheumatological (systemic lupus erythematosus).

ukusetshenziswa kwendawo yonke; umphumela we-analgesic isikhathi eside.
Uhlu olubanzi lwe-contraindication, alukwazi ukuthathwa isikhathi esingaphezu kwezinsuku ezi-3.
bonisa okuningi

5. I-Ketoprofen

I-Ketoprofen ivame ukunqunywa izifo ezivuthayo zamathambo, amalunga nemisipha - i-arthritis, i-arthrosis, i-myalgia, i-neuralgia, i-sciatica. Futhi, lesi sidakamizwa sisebenza kahle ekudambiseni ubuhlungu ngemva kokuhlukumezeka, ukuhlinzwa, i-renal colic. Umthamo omkhulu wansuku zonke ngu-300 mg.

Ukungafani: izilonda ze-peptic ze-gastrointestinal tract, izingane ezingaphansi kweminyaka engu-18 ubudala, ukukhulelwa (i-3rd trimester), ukwehluleka okukhulu kwesibindi nezinso.

umphumela we-analgesic ophinyisiwe; ilungele izinhlungu ezihlukahlukene.
ukusetshenziswa kanye kuphela kunconywa; kuthinta kabi umgudu wamathumbu.

6. INalgezin Forte

I-Nalgezin Forte isetshenziselwa ukudambisa izinhlungu ezifweni ezivuvukalayo zamalunga, amathambo, imisipha, ikhanda elibuhlungu kanye nemigraines. Futhi, umuthi uyasebenza emkhuhlaneni ngesikhathi somkhuhlane. Umthamo omkhulu wansuku zonke ngu-1000 mg. Ngokusetshenziswa isikhathi eside, kuyadingeka ukuqapha ukusebenza kwezinso.

Ukungafani: izilonda ezigugulekayo nezinezilonda emathunjini esigabeni esibucayi, ukuphazamiseka kwe-hematopoietic, ukukhubazeka okukhulu kwezinso nesibindi, izingane ezingaphansi kweminyaka engu-12 ubudala, i-hypersensitivity ku-naproxen namanye ama-NSAID.

ukusetshenziswa kwendawo yonke; isebenza njenge-antipyretic.
Uhlu olubanzi lwe-contraindication.

7. I-Meloxicam

I-Meloxicam inqunyelwe isifo samathambo (i-osteoarthritis noma i-rheumatoid arthritis), njengoba ikhulula ngokushesha nangempumelelo ubuhlungu nokuvuvukala. Kulokhu, kunconywa kakhulu ukuqala ukwelashwa ngesilinganiso esincane futhi ukwandise uma kunesidingo. Futhi, lapho uthatha i-Meloxicam, imiphumela emibi efana nobuhlungu besisu, isifo sohudo, i-flatulence, isicanucanu kungenzeka.

Ukungafani: i-hypersensitivity ezingxenyeni zomuthi, ukuhluleka kwenhliziyo okubolile, izilonda ezigugulekayo nokopha kwepheshana lesisu, ukukhulelwa nokuncelisa, izingane ezingaphansi kweminyaka engu-12 ubudala.

liphinyiselwe umphumela we-analgesic ezifweni ze-rheumatological.
imiphumela emibi engenzeka; isidingo sokukhetha ngokucophelela umthamo.

8. Nimesulide

I-Nimesulide isetshenziselwa izinhlobo ezihlukahlukene zobuhlungu: amazinyo, ikhanda, imisipha, ubuhlungu beqolo, kanye nasenkathini yangemva kokuhlinzwa, ngemva kokulimala kanye nemihuzuko. Umthamo owodwa omkhulu ngu-200 mg. Kulokhu, umuthi akufanele uthathwe umkhuhlane kanye ne-SARS. Odokotela baphinde baxwayise ngokuthi i-Nimesulide ingabangela imiphumela emibi njengesiyezi, ukozela, ikhanda elibuhlungu, ukujuluka ngokweqile, i-urticaria, isikhumba esilumayo.

Ukungafani: ukukhulelwa nokuncelisa, i-bronchospasm, urticaria, i-rhinitis ebangelwa ukuthatha ama-NSAID, izingane ezingaphansi kweminyaka engu-12 ubudala.

umphumela we-analgesic ende (ngaphezu kwamahora ayi-12).
contraindicated in fever ngesikhathi umkhuhlane, kuthinta kabi ipheshana emathunjini.

9. ICelecoxib

I-Celecoxib ibhekwa njengenye ye-NSAID ephephe kakhulu. Isidakamizwa sisetshenziselwa ukukhulula ubuhlungu obuhlangene, ubuhlungu bemisipha, futhi sisetshenziselwa ukukhulula ukuhlaselwa kobuhlungu obukhulu kubantu abadala.1. Odokotela batusa ukuqala ukwelashwa ngomthamo omncane futhi bandise uma kunesidingo.

Ukungafani: ukwephulwa okukhulu kwezinso nesibindi, ukungezwani komzimba ekuthatheni i-acetylsalicylic acid noma amanye ama-NSAID emlandweni, i-III trimester yokukhulelwa, ukuncelisa.

iphephile ku-mucosa yamathumbu, isiza ngezinhlobo ezahlukene zobuhlungu.
Kudingeka ukukhetha umthamo.

10. I-Arcoxia

Isithako esisebenzayo esiqukethwe ekubunjweni yi-etoricoxib. Umuthi uhloselwe ukwelapha ubuhlungu obungapheli (kuhlanganise nezifo ze-rheumatological), kanye nobuhlungu ngemva kokuhlinzwa kwamazinyo.2. Umthamo omkhulu wansuku zonke ngu-120 mg.

Ukungafani: ukukhulelwa, ukuncelisa, izinguquko ezigugulekayo kanye nezilonda kulwelwesi lwamafinyila lesisu noma i-duodenum, ukopha okusebenzayo kwamathumbu, ukopha kwe-cerebrovascular noma okunye, izingane ezingaphansi kweminyaka eyi-16.

umphumela we-analgesic ophinyisiwe.
ayinciphisi imfiva, ngeke isize kuzo zonke izinhlobo zobuhlungu.

Ungakhetha kanjani izidakamizwa ezingezona ukuvuvukala

Zonke izidakamizwa ezingezona ukuvuvukala zihlukaniswe ngamaqembu amaningana. Ziyahluka ngesikhathi sokusebenza, ukusebenza kahle ekudambiseni ubuhlungu nokuvuvukala, kanye nesakhiwo samakhemikhali.3.

Ngokwesikhathi sokusebenza, ukusebenza okufushane (isikhathi sokuchayeka cishe amahora ayi-6) kanye nesikhathi eside (isikhathi sokuchayeka esingaphezu kwamahora ayi-6) kuhlukaniswa izidakamizwa ezingezona ukuvuvukala.

Futhi, ama-NSAID ahluke ekusebenzeni komphumela wokulwa nokuvuvukala kanye nomphumela we-analgesic. Umphumela wokulwa nokuvuvukala (kusuka kokuphezulu kuya kokuncane) ube: indomethacin - diclofenac - ketoprofen - ibuprofen - aspirin. Ngokusho kobunzima bomphumela we-analgesic (kusuka kwephezulu kuya kokuncane): ketorolac - ketoprofen - diclofenac - indomentacin - ibuprofen - aspirin4.

Ukubuyekezwa kodokotela mayelana nezidakamizwa ezingezona ukuvuvukala

I-Celecoxib iye yanconywa odokotela abaningi njengokwelashwa okuphumelelayo kobuhlungu obungapheli be-rheumatic. Ngaphezu kwalokho, i-Celecoxib ibhekwa "njengezinga legolide" lengozi ephansi yezinkinga zesisu.

Futhi, ochwepheshe batusa i-Naproxen, ebekezelelwa kahle iziguli futhi ingabangeli imiphumela emibi uma isetshenziswa isikhathi esingekho ngaphezu kwezinsuku ezingama-21.5.

Abaningi be-rheumatologists baqokomisa isidakamizwa i-Etoricoxib (Arcoxia), esisebenza kahle ezimweni eziningi ezibandakanya ubuhlungu. Enye yezinzuzo zayo eziyinhloko irejimeni ye-dosing elula kanye nesivinini sokuqala komphumela.

Imibuzo nezimpendulo ezidumile

Sixoxisane ngezindaba ezibalulekile eziphathelene nezidakamizwa ezingezona ukuvuvukala udokotela ojwayelekile isigaba esiphezulu Tatyana Pomerantseva.

Kungani izidakamizwa ezingezona ukuvuvukala ziyingozi?

- I-NVPS iyingozi ngoba ingabangela imiphumela emibi. Okuvame kakhulu kubo:

• I-NSAID - i-gastropathy (ku-68% yeziguli ezithatha izidakamizwa okungenani amasonto angu-6) - iboniswa ngokubunjwa kwezilonda, ukuguguleka, ukuphuma kwesisu, ukubhoboza;

• izinso - ukuhluleka okukhulu kwezinso, ukugcinwa kwamanzi;

• uhlelo lwenhliziyo - ukwephulwa kwezinqubo zokuvala igazi;

• isimiso sezinzwa - ikhanda, izinkinga zokulala, izinkinga zenkumbulo, ukucindezeleka, isiyezi;

• i-hypersensitivity - ingozi eyengeziwe yokuthuthukisa i-asthma ye-bronchial;

• ukulimala kwesibindi.

Uyini umehluko phakathi kwezidakamizwa ze-steroid nezingezona ama-steroid?

- Izidakamizwa ezilwa nokuvuvukala yizidakamizwa ze-hormonal. Futhi izidakamizwa ezingekho-steroidal ziyi-organic acid. Ngokungafani nama-NSAID, izidakamizwa ze-steroid zithinta izinqubo ze-metabolic emzimbeni namasosha omzimba. Izidakamizwa ze-steroid zinqunywa uma kwenzeka umsebenzi wesifo esiphezulu, phambi kwezinqubo ze-pathological ezivela kwezinye izitho nezinhlelo, ubuhlungu obungapheli, ubuhlungu obuhlangene (ku-rheumatology), uma kwenzeka ukungasebenzi kwe-NSAID noma ukuphikisa kubo.

Izidakamizwa ezingezona i-steroidal zingasetshenziswa isikhathi esingakanani?

Ama-NSAID amaphilisi ezinhlungu angalaphi imbangela yobuhlungu. Ngakho-ke, ungathatha izidakamizwa uwedwa isikhathi esingekho ngaphezu kwezinsuku ezi-5. Uma ubuhlungu buqhubeka, kufanele nakanjani uthintane nodokotela.

Indlela yokuvikela i-mucosa yesisu emiphumeleni enolaka yama-NSAID?

- Kudingeka ukuthatha i-proton pump inhibitors (PPIs) ngokuhambisana nenkambo yama-NSAID. Ama-PPI afaka i-Omeprazole, i-Pariet, i-Nolpaza, i-Nexium. Le mithi inciphisa ukukhishwa kwe-hydrochloric acid ngamaseli akhethekile we-mucosal futhi inikeze ukuvikeleka okuthile ku-mucosa yesisu.

Ingabe akhona ama-NSAID aphephile?

Awekho ama-non-steroidal anti-inflammatory drugs aphephe ngokuphelele empilweni. Ukuthi nje ubukhali bemiphumela engemihle kweminye imithi buncane kakhulu. I-Naproxen ne-Celecoxib zithathwa njengeziphephe kakhulu.
  1. I-Karateev AE Celecoxib: ukuhlolwa kokusebenza kahle nokuphepha eshumini lesibili lekhulu le-2013 // I-Modern Rheumatology. 4. No. XNUMX. I-URL: https://cyberleninka.ru/article/n/tselekoksib-otsenka-effektivnosti-i-bezopasnosti-vo-vtorom-desyatiletii-xxi-veka
  2. Kudaeva Fatima Magomedovna, Barskova VG Etoricoxib (arcoxia) ku-rheumatology // I-rheumatology yesimanje. 2011. No. 2. URL: https://cyberleninka.ru/article/n/etorikoksib-arkoksia-v-revmatologii
  3. 2000-2022. UKUBHALISA IMITHI YE-RUSSIA® RLS ®
  4. Shostak NA, Klimenko AA Izidakamizwa ezingezona ukuvuvukala - izici zesimanje zokusetshenziswa kwazo. Udokotela. 2013. No. 3-4. I-URL: https://cyberleninka.ru/article/n/nesteroidnye-protivovospalitelnye-preparaty-sovremennye-aspekty-ih-primeneniya
  5. Tatochenko VK Nakulokhu mayelana ne-antipyretics // VSP. 2007. No. 2. URL: https://cyberleninka.ru/article/n/eschyo-raz-o-zharoponizhayuschih-sredstvah

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