Forewarned is forearmed. This phrase applies to survivors. If it works incorrectly. And this also applies to medicines. It is not clear that the pharmacology of the various groups of drugs. And we begin, perhaps, with the most frequently used drugs – analgesics. They are divided into 2 large groups – non-narcotic and narcotic analgesics.
Narcotic analgesics it stimulates the activity of the antinociceptive system, increasing its inhibitory effect.
The pattern of painful sensations increases, the pattern of pain and sensation significantly changes. It is largely due to the fact that it is a condition of euphoria. pain.
Euphoria is one of the main reasons for the development of drug addiction. There is a tendency for the physical condition. It is assumed that narcotic analgesics, activating “opiate” receptors, inhibit release and production of endogenous peptides. After the abolition of narcotic analgesics, there is a failure and endogenous peptide. Develops abstinence syndrome (the phenomenon of “deprivation”), manifested in the form of mental, vegetative, cardiovascular and other changes. Autonomic disorders include tear and drooling, sweating, pupil dilation, nausea, vomiting, diarrhea, tachycardia, muscle aches, paresthesias, etc. Seeking to get you the drug, which is exacerbates mental and physical dependence.
The danger of addiction limits the use of narcotic analgesics. In addition, it is a weakening of action that naturally develops, therefore, it is necessary. Classic representative narcotic analgesics is morphine. It causes depression of the origins. Opium (frozen milky juice) It has been used in medical practice since the prehistoric times.
Opium contains more than 20 alkaloids, which possess both properties of narcotic analgesics (morphine, codeine), or isoquinoline (papaverine and others.) –
Narcotic analgesics by origin they are divided into:
- natural, derived from opium – morphine, codeine, omnophone;
- synthetic – trimeperidine hydrochloride (promedol), fentanyl, pentazocine (lexir, fortral), pyritramide (dipidolor), tramadol (tramal).
Analgesics isolated opioids are commonly referred to as opioids or opiate-like drugs.
Narcotic analgesics used for any injuries (domestic, operating rooms, injuries, etc.), diseases associated with severe pain syndrome (malignant neoplasms, myocardial infarction, etc.).
Almost all effects narcotic analgesics, In addition to painkillers, they are undesirable, especially when it comes to morphine-like drugs.
Acute poisoning narcotic analgesics characterized by respiratory depression, a sharp constriction of the pupil (with severe hypoxia, they can be expanded), cyanosis, hypothermia, a comatose state. Death occurs from paralysis of the respiratory center. The main treatment is aimed at restoring breathing; artificial lung ventilation with tracheal intubation is the most effective.
Antagonists of morphine-like agents are “pure” opiate antagonists, deprived of morphine-like activity – naloxone, naltrexone. It has been repeatedly washed with a 0.05-0.1% solution of potassium permanganate (oxidized morphine) and a suspension of activated carbon. . Assign salt laxative.
Non-narcotic analgesics their pharmacological properties are significantly different from the morphine group. These drugs are significantly inferior in strength to analgesic action. narcotic pain killers. Their effect is manifested mainly in inflammatory pain (arthritis, myositis, neuralgia, etc.).
Non-narcotic analgesics do not depress respiration, do not cause a hypnotic effect, do not affect the cough center. This group of drugs clearly shows the anti-inflammatory and antipyretic effects of narcotic analgesics do not have. The advantage of these drugs is narcotic effect, in practice. Pronounced anti-inflammatory action are called “nonsteroidal anti-inflammatory drugs“(NSAIDs).
For analgesic activity, non-narcotic analgesics significantly different. The strongest analgesic effects have indomethacin, diclofenac sodium (ortofen), ibuprofen, ketoprofen, naproxen, mefenamic acid. Somewhat weaker act metamizole sodium (analgin), paracetamol, acetylsalicylic acid.
The antipyretic body temperature effect Antipyretic drugs are used above 38.5 ° C-39 ° C, when there is a risk of hypoxia with cerebral edema, hyperthermic convulsions, impaired microcirculation of blood flow and heart activity. It has been activating the body’s defense mechanisms. According to the following row: indomethacin, ibuprofen, analgin, paracetamol, acetylsalicylic acid.
For example, analgin, paracetamol, and, moreover, often gives complications. To reduce body temperature and apply analgin. It doesn’t have a “convulsive” effect. amidopirin), can be administered both inside, and intramuscularly, and intravenously. However, like other derivatives pyrazolone (amidopyrine), analgin inhibits blood formation, causing leukopenia, anemia, and sometimes agranulocytosis. As a rule, it is used as a febrifuge. paracetamol, especially in children. Profitable combination paracetamol with acetylsalicylic acid (for antipyretic and analgesic effects), as they mutually reinforce each other’s effects.
A high risk of gastrointestinal tractutadion, indomethacin, piroxicam, acetylsalicylic acid. If you are taking these drugs, you should take a meal, or take it in combination with antacids.
Dangerous complication NSAIDs is bronchospasm. NSAIDs reduce diuresis and cause edema (especially prior of butadion, diclofenac sodium, ketoprofen, mefenamic acid). Butadion, In addition, it increases the sensitivity of the kidney receptors to the antidiuretic hormone (diuresis decrease).
Along with the listed NSAIDs It is a number of other side effects: skin, liver, central nervous system, skin.
- Severe hematological disorders (leukopenia and even agranulocytosis, aplastic anemia) are characteristic of the pyrazolone derivatives (butadion, amidopirin, analgin).
- Hematopoietic disorders can cause indomethacin, mefenamic acid.
- Various forms of liver damage, including toxic hepatitis (long-term administration), develop indomethacin, sulindaca, diclofenac sodium (ortofen).
- It has been found that the treatment of acetylsalicylic acid (tinnitus, hearing loss, dizziness, hyperventilation), indomethacin (dizziness, severe headaches, depression, and sometimes hallucinations. Convulsions);
- (Pruritus, limited or generalized urticaria, erythroderma) – especially when using butadion, indomethacin, oxicam.
- NSAIDs (in particular, naproxen, ketoprofen, piroxicam) can cause aphthous stomatitis.
It can be clear that the NSAIDs should not be prescribed during the period. Treatment of NSAIDs is also risky, because it sometimes contributes to the narrowing of the fetal hemodynamics.
It is dangerous to prescribe these drugs (especially indomethacin).
Editor’s Note. And now the most important thing. “There may be complications.” There will definitely be complications. ” Do you think that you’re preoccupied with doctors? There are no rules for the accident. For example, it would be a little bit more than an “average ward.” Therefore, it is better to affect the liver.
And yes, there are no drugs without side effects. Where everything is interconnected. If they’re not badly checked, they’re really badly checked in or out. In any case, it should be.