Antipyretic drugs, pills and remedies for adults
For many decades the most popular drugs in the world are painkillers and, of course, antipyretics. And during the epidemic of influenza and SARS they did sweep the shelves of pharmacies. In this article you will know that tells about the most popular antipyretic drugs are the main clinical pharmacologist of St. Petersburg - Alexander Hagedis. He will tell you how they differ, what are the advantages and disadvantages, and how to make the right choice drugs.
About a year ago during an epidemic of Russian doctors urged patients not to use these popular yet another generation of drugs like "Aspirin"and"Aspirin". "Paracetamol" in the black list not yet hit, but its advised to only take strictly according to instructions. With such hard sayings of our today's expert disagrees. Alexander Hagedis is confident that these drugs will not cause harm to the body, if not abused and to adhere to the correct dosage:
– Formulations based on paracetamol today used worldwide. I don't think the physicians of all countries are so ignorant that prescribe their patients a toxic drug.
Today there is a whole group of non-steroidal anti-inflammatory drugs. It's not hormones that combine antipyretic, analgesic and anti-inflammatory properties. They will not help to cure the common cold or flu, but will relieve their symptoms, by facilitating the well-being of the patient. Here is what is says about these drugs, Alexander Hagedis:
– Drugs that can cure influenza and SARS, to date units. This benefits them not so much: the viruses live for about 5-7 days and use of drugs in any way, this term cannot reduce. It turns out that you are in any case sick time, so loading the body with unnecessary drugs is not worth it. But to relieve the symptoms is another matter. Throughout the week, suffer from headaches, runny nose or high temperature, quite hard. Symptomatic treatment will save you from the discomfort, but it is important to remember that taking these or other symptoms, the disease you are treating, you merely facilitate it. Therefore, always assess the risk from taking certain drugs. If your health is not too heavy, it is better to suffer a headache than to harm yourself with drugs, that still does not speed up the recovery.
What are antipyretic medicines for?
Our expert told an interesting fact:
- Today, there are 15 groups of non-steroidal anti-inflammatory drugs (25 years ago there were only 8). And if the original drugs around the world, there are about 150 generic drugs for thousands.
When there is a non-steroidal anti-inflammatory drugs, they quickly replaced opioid analgesics and in a short time has gained immense popularity. This success NSAIDs can be explained by the fact that they do not depress respiration and do not have many other side effects that were inherent in the drugs of previous generations. And let their analgesic effect is somewhat weaker, they are still quite effective.
NSAIDs are divided into two categories:
- Preparations of the first generation (also called "old") – phenylbutazone ("Butadiene"), indomethacin ("Movied", "Indomethacin"), diclofenac ("Diklak", "Diclofenac", "Voltaren"), ibuprofen ("MIG", "Naproxen", "Nurofen", "Ibuprofen"), acetylsalicylic acid ("Citramon", "Aspirin").
- Drugs second-generation, selective inhibitors of cyclooxygenase-2 (COX) ("new", appeared on the market in the last twenty years) – a group of coxibs (etoricoxib"Arcoxia", celecoxib "celebrex"), nimesulide ("Nise", "Nimesil", suspension NIMULID), meloxicam ("Movalis" - it is a drug that originally belonged to the first generation, but subsequently he was found to have selective effect).
- Only in the early 70-ies was opened mechanism of action of NSAIDs: they all inhibit the enzyme cyclooxygenase. In the early ' 90s, it became known that this enzyme has two pottermania: cyclooxygenase-1 and cyclooxygenase-2. Of course, the action of drugs will depend on what kind of enzyme they inhibit. The scientists who discovered the mechanism of action of NSAIDs, was awarded the Nobel prize in medicine. comments this point the main clinical pharmacologist of St. Petersburg.
Preparations of the first generation are non-selective and act on every podpromie, therefore I can provide direct and analgesic and antipyretic effect. These include "Aspirin"and "Ibuprofen".
Side effectsthey can cause, are typical of NSAIDs:
Oliguria (amount of urine produced by the body decreases)
Ulcerogenic effect (provokes the development of peptic ulcer formations)
Approximately 25% of patients manifest these side effects after taking any of the drugs belonging to the first generation. But it is important to understand that these drugs are dangerous not only for its side effects, as the fact that we tend to take them for no reason. Often unnecessarily, not observing the recommended dosage.
Ending theme side effects, it is worth noting that they are not too pronounced and rather quickly pass. Often doctors don't even have time to note their presence. This leads to the fact that certain side effects cannot be taken into account when prescribing the drug to patients. They themselves may not always understand that certain manifestations caused by the use of these drugs. Here is what it says about Alexander Hagedis:
For example, after twice taking the drug indomethacin ("Indomethacin"), the patient decreased urine output. But this effect is transient and not apparent, so doctors simply do not have time to record it.
Much less side effects have drugs of second generation. But in the course of studies and observations revealed that they cardiotoksicnae, that is, the negative impact on the cardiovascular system. This is because the drugs have lost effect property, which was typical of the first generation, meaning they can trigger the formation of blood clots. Alexander Hagedis admits serious effects, but considers that they can appear, if you use drugs not course, and for relieving certain symptoms:
- In order to get rid of the symptoms of SARS or influenza do not need to be fever constantly. Feeling unwell – take one tablet and this will be enough. If doctors prescribe regular medication for several days, be wary. After all, in single dose the effect is the same, and the risk of side effects is much lower.
Acetylsalicylic acid ("Aspirin")
There is hardly in our country at least one family whose home kit no"Aspirin".
— If I was offered to go on a desert island with just three things, I would take an Aspirin. This broad-spectrum drug: has antiplatelet, anti-inflammatory, analgesic and antipyretic effect, says Alexander Hagedis. – But it is important to be able to handle. If you take "Aspirin"with SARS, it can cause Central nervous system and the liver. Also very carefully need to take the drug for those who have problems with the gastrointestinal tract.
Today, many doctors suggest to take 150 mg acetylsalicylic acid daily to prevent blood clots and protect the cardiovascular system. This really is an effective preventive measure. But, if you want to check for yourself the validity of the expression"one of the treats and the other cripples", then take an Aspirin with alkaline drinks (the easiest option – mineral water). The drug is still acidic, and this measure will significantly reduce the risk to earn a stomach ulcer. The only alkaline environment reduces absorption of the drug and lowers the efficiency of its use. So you can decide what has priority for you.
The development of ulcers is a side effect, which is caused by virtually all NSAIDs at their excessive consumption. It does not matter whether you use the form of tablets or an injection. In order to reduce the risk of developing ulcers, producers try to minimize the contact of drug with the stomach lining (combine drugs that produce effervescent tablets). Popular today, "Cardiomagnyl", for example, a combination of alkaline and acid environment (magnesium hydroxide and acetylsalicylic acid). But this leads only to the fact that the drug becomes ineffective, as two hostile component simply cancel each other out.
Our expert, chief clinical pharmacologist of St. Petersburg, on the first places in the list of antipyretic drugs paracetamol puts. It has no additional antiinflammatory effect as a similar tool, but has many side effects of NSAIDs.
Alexander Hagedis believes that paracetamol and does not cause any negative consequences if it is not systematically and only for relieving symptoms. Only in very rare cases may appear rashes or develop tissue hypoxia. Sometimes referred to hepatoxicity paracetamol (its negative effects on the liver). But this is true only in the caseif you use the drug for a long time, exceeding all conceivable dosage. To ensure that the liver is affected, you need to drink 20 paracetamol tablets of 0.5 grams. Thus, we can only consciously to harm your body, as accidentally take a dose just unreal.
If you have no diseases of the kidneys and liver, you can safely take paracetamol as antipyretic. If you suffer from alcoholism or renal insufficiency, it is better to choose a different tool. You also need to carefully combine paracetamol with other drugs that contain phenobarbital or other inducers of liver enzymes (including ethanol). Alexander Hagedis also warns:
- If you have any liver disease, closely monitor its condition when the temperature and taking medicines. In acute hepatitis, for example, paracetamol is much better metabolized in the liver. As a consequence, the body increases the amount of metabolites (toxic breakdown products of medicines). For cirrhosis, when liver function is reduced, an even higher probability of a toxic effect of the drug, in rare cases may be fatal.
In order to avoid side effects, use single. Fever – drank the required dose. Take it during the day, "prevention" is not necessary.
Metamizole sodium (Analgin)
– Toxico-allergic effects of metamizol sodium was proved by American scientists 25 years ago. After the first dose may receive acute allergic reaction, and it does not depend on the dosage of the drug, explains Alexander Hadidi, Most allergenic drugs – penicillins. Anaphylactic shock they cause in one case in five million. welcome "cold sores"can cause anaphylactic shock in one case out of fifty thousand. And"Analgin", in contrast to penicillins, is in every medicine Cabinet and is often taken spontaneously, without compliance with a specific dosage, often without a special need. For reference: anaphylactic shock is a real threat of death.
Today, scientists have proven that Analgin causes agranulocytosis. Under his influence the number of white blood cells in the blood decreases, with the result that the body becomes vulnerable to various fungi and bacteria. According to Alexander Ajidica, this side effect is not only Analgin but also other drugs from the group of pyrazolones. The drug relievespain, but even after two applications in a row can lead to electrolyte disorders and cause oliguria that may affect the cardiovascular system.
– Studies have shown, the probability of toxic-allergic reaction to Analgin depends on the presence of a particular genetic defect. The inhabitants of the Balkan Peninsula, such a defect does not have and calmly accept "Analgin". But the Americans were forced to completely abandon this drug. But today they returned the drug, even as a backup, — commented on this point, Alexander Hagedis.
For a long time it was thought that the only advantage of "Analgin"in front of the other analgesic and antipyretic drugs is the ability to use it in the form of injections. About five years ago there was another such drug is for parenteral administration –"Perfalgan". But its cost in comparison with "cold sores"in the times higher.
If Analgin will be blacklisted and disappear from Russian pharmacies and hospitals, you will need to recall a product such as"Ketorolac". It is not inferior in its effectiveness, the risk of side effects from taking it are much less.
Ibuprofen and diclofenac
The safest antipyretic drugs on the basis of diclofenac and ibuprofen. Alexander Hadidi says in this regard:
– In our country somehow at a temperature take "Paracetamol", and from the pain – "Analgin". But this is absurd, because all NSAIDs have antipyretic and analgesic action at the same time. I started teaching 20 years ago, and then I told my students that soon, "Aspirin" will be replaced by new, more modern drugs. And indeed they were, just as fever is not positioned. One example is the "I"that is aware of the few effectively throw heat.
To take a combination of drugs, according to our expert, should be wary. They are effective, but side effects they will be much more. One of the clearest examples of such drugs –"Pentalgin". It contains feniramina maleate, paracetamol, naproxen, caffeine and drotaverine and therefore all the side effects characteristic of these components. Some combination drugs that contain phenobarbital and paracetamol, which is impractical because under the influence of phenobarbital toxicity of paracetamol is greatly increased.
Alexander Hadidi told us that NSAIDs will not help with headache ortoothache. If you suffer from pains that are caused by bursitis or arthritis, you need to choose the drug, which has the most strong anti-inflammatory effect (for this indicator, winning products based on diclofenac).
He is most famous for is "no-Spa"and"Drotaverine" do not relieve pain which is inflammatory in nature. These drugs are generally not used anywhere in the world except Hungary and Russia.