Anti-inflammatory drugs and medicines in dentistry. Antibiotics in dentistry The use of non-steroidal anti-inflammatory drugs in dentistry

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The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

It is a well-known fact that inflammation is nothing more than a simple defensive reaction. human body for some damaging factors. It can be both physical and chemical, infectious, as well as many other influences. In the case of the development of a very long and pronounced inflammatory reaction, numerous functional and morphological changes make themselves felt, which are simply impossible to get rid of without the help of anti-inflammatory drugs.

In the case of the development of dental pathologies that are accompanied by an inflammatory process, dentists prescribe non-steroidal anti-inflammatory drugs to their patients, or abbreviated NSAIDs. It is worth noting that these medicines are used in dentistry for a reason. The fact is that they tend to have not only anti-inflammatory, but also antipyretic, as well as analgesic effect. They can be prescribed to the patient both for toothache, and in case of certain pathologies of the mucous membrane oral cavity or periodontal disease, pathologies of the mandibular joint, and so on. Immediately, we note that the mechanism of action of these medicines is distinguished by its extraordinary complexity.

The antipyretic effect is primarily due to the calming effect on the hypothalamic centers of thermoregulation. As for the anti-inflammatory effect, it can be achieved by reducing the permeability of capillaries, as well as by reducing the activity of hyaluronidase. The analgesic effect is determined by the impact directly on the centers of pain sensitivity.

In the office of every dentist there are such non-steroidal anti-inflammatory drugs as metamizole, ketorolac, mefenamic acid, phenacetin, sulindac, ketaprofen, diclofenac and many others. In the fight against periodontitis, dentists prescribe anti-inflammatory drugs to their patients along with antibiotics, antihistamines, and antiseptics. In general, the greatest number of dental pathologies involve complex treatment.

In dentistry, an anti-inflammatory drug called indomethacin is especially popular. This remedy is prescribed in the fight against a huge number of inflammatory dental pathologies. It is produced in several pharmaceutical forms, namely in the form of suppositories, dragees, and capsules. Immediately, we note that against the background of its use, the following may make you aware of yourself side effects:

• Drowsiness;

Read more:

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• Drugs for toothache. Form of drugs. Painkillers for various types of toothache
• Indomethacin. Composition, types, analogues, instructions for use, indications for use
• Ketanov (tablets, injections) - instructions for use, analogues, reviews, price
• Dolgit (cream, gel) - instructions for use, analogues, price, reviews
• Pentalgin. Composition, release form, analogues. Instructions for use. Indications, contraindications, side effects

To relieve toothache, you can use tablets of two groups - analgesics (Ibufen, Nimesil) and non-steroidal anti-inflammatory drugs (Ketonal, Komistad). You can take them with severe toothache for first aid, and then contact your dentist for treatment. It is better not to take toothache tablets immediately before visiting a doctor, as well as in the presence of acute inflammation in the oral cavity, which can mask symptoms and make diagnosis difficult. There are separate medicines for children, adults, pregnant women, which are suitable for relieving pain of various origins. Drinking medications such as Ketonal or Ibufen is recommended immediately when a symptom appears, as they help to anesthetize and at the same time reduce the inflammatory process.

Let's analyze the main groups of analgesic and non-steroidal anti-inflammatory drugs (NSAIDs) that you can drink with severe toothache in children and adults.

Among anti-inflammatory drugs, it is worth highlighting Ketonal, Nurofen, Voltaren, Nise, Ketanov, Ksefokam. Complex preparations Sedalgin, Pentalgin, Tempalgin also help with pain.

Nurofen and Ketonal tablets

Nurofen medicine has a pronounced analgesic effect and helps with severe toothache in children and adults. It is less effective than Ketonal tablets in terms of pain relief, more aimed at relieving the inflammatory process, reducing fever. Preparations Nurofen, Ketonal can be drunk with acute pain of unknown etiology, as well as in case of chronic periodontitis or periodontal disease. Nurofen can also be drunk with pain after tooth extraction, surgical interventions in the oral cavity. The use of Nurofen is quite effective in the treatment of children, it is indicated from the age of three months.

Analgesic Ketonal is one of the most powerful painkillers in dental practice, it has a pronounced analgesic effect. Ketonal is allowed to drink to children from 12 years of age and adults with severe acute or chronic pain.

The main indications for the use of Ketonal tablets for adults and children are:

• postoperative period(tooth extraction, implantation);
• acute symptoms of pulpitis and periostitis;
• inflammation of the oral cavity, stomatitis with severe pain syndrome.

NSAIDs Voltaren

Anti-inflammatory non-steroidal tablets for toothache Voltaren are used in dental practice more often to relieve inflammation in the pathology of the temporomandibular joint, when moderate chronic symptoms need to be relieved.

Drinking them in the postoperative period or in case of severe pain from pulpitis is ineffective and it is better to take the analgesic Ketonal.

Ketanov and Nise - popular but useless drugs

Anti-inflammatory drugs Nise and Ketanov have recently been prescribed less and less for pain relief in adults. This is due to the toxicity and narrow focus of the tablets. Nise will not be able to anesthetize and remove even the most mild inflammation, but stomach problems can be expected if multiple tablets are taken. Also, the remedy is not prescribed for children and pregnant women.

The popularity of Ketanov and Nise is explained only by the cheapness and availability of medicines.

Strong painkillers

The main drugs that help with toothache in children and adults are Nimesil, Analgin, Ibuprofen.

Nimesil toothache powder is recommended as a first aid, it has a pronounced analgesic effect and helps relieve toothache in an adult. It can be used for acute pain or chronic pain.

How to effectively relieve symptoms with Nimesil powder?

1. You can drink the solution from the age of 12;
2. Take the solution after meals;
3. You need to prepare the solution at one time;
4. The powder is diluted in warm water and drunk immediately.

Most effective drugs against acute symptoms- Pentalgin and Analgin, they relieve severe pain with pulpitis, caries, but are not effective in case of inflammatory diseases periodontal.

Analgin can be taken infrequently, it helps with acute manifestations caries, pulpitis, after tooth extraction. The remedy can be drunk once a day, but no more, as it affects the functioning of the kidneys.

Ibuprofen is a medicine from the group of non-steroidal anti-inflammatory drugs, but its main action is aimed at pain relief. It can be drunk after 12 years, the maximum daily dose is 1300 mg, which is divided into several doses. The list of diseases for which you can drink Ibuprofen is quite wide, including many dental pathologies: acute pain in pulpitis, temporomandibular joint disease, carious cavities, gingivitis, periodontitis, periodontitis and periodontal disease.

Analgesics in dentistry

What other anti-inflammatory drugs can be taken for dental diseases?

1. Aertal is an anti-inflammatory drug with antipyretic and analgesic action, helps to relieve severe acute and chronic toothache;
2. Askofen is a non-narcotic analgesic that helps with severe pain of various etiologies, but the drug has an impressive list of contraindications, therefore, it cannot be taken with diseases of the gastrointestinal tract, kidneys, liver, CCC, joints and during pregnancy;
3. Spazmalgon is used for symptoms of varying severity, it is especially effective to use it for pulpitis, trigeminal neuritis;
4. Citropack - anti-inflammatory analgesic is used for pain and inflammation;
5. Solpadeine - the medicine can be taken for infectious pathologies of the oral cavity with fever, inflammation;
6. Nisit - anesthetizes, relieves inflammation, reduces temperature, is prescribed in case of pain syndrome of various etiologies.

Dental practice involves the use antibacterial drugs(ABP) in the following cases:

• Exacerbated chronic and acute purulent-inflammatory processes occurring in the jaw and face. This category includes diseases such as dentoalveolar abscess, odontogenic abscess, pericoronitis, periostitis, odontogenic sepsis, infected hilar cysts, gingivitis with bacterial complications, and others. infectious diseases oral cavity.
• Preventive measures to prevent the development of infectious complications after surgical interventions. Medications are prescribed before dental interventions in patients at risk. The use of ABP is shown in patients with heart valve diseases, diabetes, glomerulonephritis, as well as in those who take immunosuppressants, cytostatics, glucocorticosteroids, etc.
• Surgical interventions. The need for medication is determined by the doctor based on their situation. Drug treatment is recommended in the presence of such pathologies: acute purulent-inflammatory processes, operations performed on bone tissue, the need to sew the wound tightly, the use of osteoplastic materials or autotransplantation.

Do not apply in the following cases: open wounds of the oral cavity with an area of ​​\u200b\u200bless than 1 sq. cm, no signs of an inflammatory or chronic process, the wound on the mucous surface does not contain damage to the bone tissue and periosteum, the patient has viral gingivitis without bacterial complications.

For safe therapy, it is important to consider the patient's condition, as well as adverse reactions arising from the use of drugs. Frequent use drug treatment can lead to oppression immune system, the occurrence of disorders of the digestive system, allergic and toxic reactions.

Classification of dental antibiotics

There are several categories of antibacterial drugs that doctors use in dental practice.

Penicillin group

They affect the synthesis of microorganisms, affect gram-positive and gram-negative microorganisms, and are effective against anaerobic bacteria.

Today, inhibitor-protected penicillins (moxicillin + clavulanic acid) are widely used. Commercial names of medicines -, Amoklav ®.

The drugs are well tolerated, have a wide range of antimicrobial effects and rarely cause side effects.

Amoxicillin ® film-coated tablets

Cephalosporins

These drugs are used in the presence of odontogenic and periodontal inflammation, as well as in dental procedures with a high risk of developing bacterial complications.

There are 4 generations of cephalosporins. In dental practice, the 3rd generation () and 4th generation () are most often used.

Tetracyclines

They have a wide spectrum of action, have good absorption rates when taken orally. These include and. They are prescribed for inflammatory processes in the area of ​​soft, bone tissues, the dosage is determined by a specialist, based on the severity of the infectious-inflammatory process.

Imidazole, nitroimidazole their derivatives

The most popular are tinidazole ® and. The principle of action is based on the inhibition of DNA synthesis of microbial cells. This type of antibiotic penetrating into the bone tissue is used in the presence of large inflammatory foci of the oral cavity. In case of odontogenic infections, it is prescribed in the form of gels (metrogil-dent ®) or as part of combination therapy.

Macrolides

A category of drugs designed to eliminate gram-positive and gram-negative bacteria, as well as some types of anaerobes. Developed as an alternative to a group of beta-lactams, to which bacteria have developed resistance, and the amount allergic reactions patients has increased.

Macrolides have low toxicity and can be used by pregnant and breastfeeding women. The group is represented by (azithromycin®). The product has received its prevalence among patients who develop allergic reactions to penicillins and beta-lactams.

Antibiotics are widely used in all areas of medicine, dentistry is no exception. This group of drugs helps to reduce inflammation, inhibits the development of possible complications.

Dentists resort to antibiotic therapy for two reasons: firstly, the peculiarities of the treatment being carried out, and secondly, the individual factor in the case of each specific patient. Based on these data, the selection of specific drugs and the method of their use is carried out.

Indications for appointment

The degree of need for antibiotics is determined depending on the nature of the course of the disease and the body's response to this process.

Osteomyelitis

As a rule, antibiotics for toothache are prescribed in case of periodontitis or osteomyelitis.

If the patient was in the dentist's chair at the stage of exacerbation of the disease, especially in the presence of purulent inflammation, antibiotics are indicated after treatment. The urgent need for prescription drugs arises after surgical treatment periodontitis, meaning resection.

In addition, this group of medicines should be taken for gum disease (advanced cases, periodontal disease,). Any types of dental removal, especially purulent formations, opening of abscesses, phlegmon are also accompanied by the use of drugs of this class.

Appointment for preventive purposes

In some cases, the patient is shown prophylactic administration of such drugs. Then antibiotics in the treatment of teeth should be taken 1-3 days before the upcoming procedure.

Most often, such measures are necessary in case of a high risk of septic endocarditis. The group of such patients includes carriers of installed pacemakers, patients with artificial valves and those who suffer from heart failure, polyarthritis, endocarditis, etc. Patients with joint prostheses also join the above.

The appointment of antibiotics in these cases is so necessary because of the risk of tissue infection. This is especially true when performing dental procedures accompanied by bleeding.

Even the banal can lead to similar consequences. The result will be the entry of pathogens into the blood and the further development of an inflammatory disease.

The group of special patients requiring antibiotic therapy includes those suffering from chronic infections in the oral cavity, immunocompromised patients. The target group is also supplemented by patients diabetes, rheumatoid arthritis, etc.

The selection of drugs in case of need for prophylactic antibiotic therapy is also carried out on an individual basis.

Varieties of drugs used in dentistry

Studies show that dental diseases often develop due to a mixed bacterial microflora in the oral cavity. That is why among the recommended antibiotics in dentistry are broad-spectrum drugs.

Oral medications include:

• Ciprofloxacin;
• Metronidazole;
• Azithromycin etc.

In the form of injections in dentistry, the following drugs are prescribed:

Compositions that can be used topically by patients (in the form of gels):

• Metrogil Denta;
• Asepta.

Antibiotics that dentists "like" to prescribe

Among the most commonly prescribed antibiotics by dentists are the following.

Ciprofloxacin

An antibacterial drug with a spectrum of action. The drug in the context of the dental region is indicated for postoperative infectious complications - developing purulent-inflammatory processes and dental inflammation (complicated pulpitis).

The drug is taken with a dental infection in the form of tablets of 0.5 and 0.25 g. The dosage of the agent is determined by the specialist individually in each case.

The medicine usually does not cause side effects. In some cases, manifestation of allergic reactions in the form of a rash, itching is possible. Swelling of the face, vocal cords is not excluded. The list of undesirable consequences of taking the drug may include:

Taking the drug is accompanied by changes in the patient's blood test: a decrease in the number of leukocytes, granulocytes and platelets. Very rarely there are violations of taste perception.

During treatment with Ciprofloxacin, exposure to ultraviolet rays should be avoided in order to prevent an increase in skin sensitivity to sunlight.

Metronidazole (Trichopolum)

A highly effective remedy for various forms inflammation of the gums and teeth. The drug, through interaction with the DNA of harmful microorganisms, has a bactericidal effect on them. When taken orally, the drug is concentrated in the gingival fluid, favorably affecting dental plaque under the gum, this is especially evident with proper oral hygiene.

The drug is prescribed in the form of tablets of 0.5 g. It is usually taken 1 tablet three times a day. The course of therapy is 10 days.

Possible side effects include:

When taking Metronidazole, it is strictly forbidden to drink alcohol. Among the contraindications for use: heart failure, epilepsy, liver disease, etc. The greatest effectiveness of the drug can be achieved when the drug is combined with Amoxicillin.

Dental antibiotic - also called lincomycin. Medicine is prescribed for inflammation of the root of the tooth, for the treatment of periostitis (flux) and suppuration in the oral cavity. It is also prescribed in case of inflammation as a result of incorrect installation of orthopedic structures.

The drug destroys conditionally pathogenic microbes (staphylococci, streptococci, etc.), whose resistance to the antibiotic develops at a very slow pace.

In addition, the drug is able to accumulate in bone tissue, thereby preventing the spread of inflammatory processes to the jaw bones.

Lincomycin is available in pharmacies in the form of capsules, injection solution and ointments. In dental practice, the most common form of the drug is Diplen-Denta-L, which is an antibacterial self-adhesive patch.

In the case of severe periodontitis, the antibiotic is injected intravenously or intramuscularly.

Side effects of the described drug are as follows:

At the first manifestations of side effects of any of the antibiotics, you should immediately seek medical help.

After tooth extraction, antibiotics are also often prescribed:

Effectiveness of antimicrobials

The effectiveness of antibiotic therapy in the field of dentistry is difficult to dispute. The drugs of this group are able to "insure" the patient against the development of various complications in the course of treatment. In addition, at present, the spread of the trend of reducing the immunity of the population significantly increases the risks of all kinds of concomitant ailments.

Dentists are only concerned about the constant increase in the number of pathogens that have acquired or already had resistance to antibiotics.

So, most microbes no longer respond to first-generation drugs (Penicillin, Tetracycline, etc.).

For this reason, dentistry is forced to almost completely switch to 2nd and 3rd generation drugs - drugs from the group of lincosamides and macrolides, the effectiveness of which in some cases is also in question, in particular in case of violation of the rules of therapy.

Thus, the combination of antibiotic therapy with the main methods of treating dental ailments is indeed effective, subject to a competent approach on the part of a specialist, as well as the painstaking work of a research group in the dental industry.

All drugs in this group are inhibitors of the enzyme cyclooxygenase (COX), which acts on arachidonic acid to form important mediators of inflammation and pain - prostaglandins and thromboxanes. Most representatives of this group of drugs non-selectively inhibit both forms of the enzyme: type I cyclooxygenase (COX-I) constitutively presented in many cells, as well as type II cyclooxygenase (COX-Il) induced by inflammation and pain. One of the main side effects of NSAIDs is their ulcerogenic effect, due to a decrease in the production of gastroprotective prostaglandins in the gastric mucosa, which is associated with inhibition of COX-1 activity.

A newer representative of NSAIDs - the drug celecoxib (Celebrex) is a highly selective inhibitor of COX-P, and therefore does not cause ulceration in the stomach.

In dentistry, this group of drugs is used orally, as well as parenterally for toothache, neuralgia and myalgia. maxillofacial area, arthritis of the temporomandibular joint, lupus erythematosus and other collagenoses. Ketorolac tromethamine has the maximum analgesic effect (for some pains, it is only 3 times inferior to morphine), however, as an analgesic, this drug is not recommended for long-term (more than 5 days) administration due to a possible ulcerogenic effect on the stomach, even with parenteral administration.

When taking high doses of salicylates (acetylsalicylic acid, etc.), one should also take into account the possibility of bleeding (decrease in the production of thromboxane A2) and reversible toxic effects on auditory nerve. Long-term use of pyrazolone derivatives can cause hematopoiesis suppression (agranulosis, aplastic anemia), which can be manifested by ulceration of the oral mucosa.

As local analgesics and anti-inflammatory agents in dentistry, mafenamine sodium salt and benzydamine are used, which also inhibit COX, locally reduce the production of prostaglandins and reduce their edematous and algogenic effects. Systemic toxicity at local application these funds are not listed.

Aminophenazone(Aminophenazone). Synonyms: Amidopyrine (Amidopyrinum), Amidazophene (Amidazophen).

pharmachologic effect : has antipyretic, analgesic and anti-inflammatory effect. Unlike narcotic analgesics, it does not have a depressing effect on the respiratory and cough centers, does not cause euphoria and drug dependence phenomena.

Indications: in the conditions of an outpatient appointment, they are prescribed for removal pain of various origin (myositis, arthritis, neuralgia, headache and toothache, etc.) and in odontogenic inflammatory processes.

Mode of application: inside 0.25-0.3 g 34 times a day (maximum daily dose - 1.5 g).

Side effect : with individual intolerance, the development of anaphylactic reactions and the appearance of skin rashes. Causes oppression of hematopoietic organs (agranulocytosis, granulocytopenia).

Contraindications: individual intolerance and diseases of the hematopoietic system.

Release form: powder, tablets of 0.25 g in a package of 6 pcs. Amidopyrine is part of complex tablets (Piranal, Pirabutol, Anapirin), which are prescribed depending on the pharmacological action of the components that make up their composition. When taking combination tablets, you may experience Side effect characteristic of their constituent components.

Storage conditions: in a place protected from light. List B.

Acetylsalicylic acid(Acidum acetylsalicylicum). Synonyms: Aspirin (Aspirin), Plidol 100/300 (Plidol 100/300), Acenterin (Acenterin), Anapyrin (Anapyrin), Apo-Asa (Apo-Asa), Aspilyte (Aspilyte), Acylpyrine (Asu 1 pyrin), Kolfarit (Colfarit), Magnyl (Magnyl), Novandol (Novandol).

pharmachologic effect: non-steroidal anti-inflammatory agent. It has antipyretic, analgesic and anti-inflammatory effects, and also inhibits platelet aggregation. The main mechanism of action of acetylsalicylic acid is the inactivation of the cyclooxygenase enzyme, as a result of which the synthesis of prostaglandins is disrupted.

Indications: in dental practice, it is prescribed for pain syndrome of mild and moderate intensity various genesis(arthritis of the temporomandibular joint, myositis, trigeminal neuralgia and facial nerve etc.) and as a symptomatic remedy in the treatment of odontogenic inflammatory diseases.

Mode of application: administered orally at 0.25-1 g after meals 34 times a day. Drink plenty of fluids (tea, milk).

Side effect: possible nausea, anorexia, epigastric pain, diarrhea, allergic reactions, with prolonged use - dizziness, headache, reversible visual impairment, tinnitus, vomiting, impaired rheological properties and blood clotting, ulcerogenic effect.

Contraindications: peptic ulcer stomach and duodenum, individual intolerance, blood diseases, kidney dysfunction, pregnancy (I and III trimesters). For children under 2 years of age, the drug is prescribed only for life Indications m. With caution prescribed for liver diseases.

Release form: acetylsalicylic acid - tablets of 0.1; 0.25; 0.5 g

Aspirin - coated tablets, 325 mg, pack of 100 pcs.

Plidol - tablets of 100 mg, in a package of 20 pcs and 300 mg, in a package of 500 pcs.

Acenterin - enteric tablets 500 mg, pack of 25 pcs.

Anopirin - enteric-coated buffer tablets, 30, 100 and 400 mg, in a package of 10 and 20 pcs.

Apo-Asa - 325 mg tablets, 1000 pcs.

Acylpyrine - tablets of 500 mg, 10 pcs in a pack.

Aspilight - coated tablets, 325 mg, in a package of 100 pcs.

Kolfarit - tablets of 500 mg, in a package of 50 pcs.

Magnil - tablets of 500 mg, in a package of 20, 50 and 100 pcs.

Novandol - tablets of 300 mg, in a package of 10 pcs.

Storage conditions: at room temperature, protected from light.

Benzydamine(Benzydamine). Synonyms: Tantum (Tantum), Tantum Verde (Tantum verde).

pharmachologic effect: a representative of a new class of non-steroidal anti-inflammatory drugs of the indazole group for topical and systemic use. Anti-inflammatory analgesic action is due to a decrease in the synthesis of prostaglandins and stabilization of cell membranes of mast cell neutrophils, erythrocytes and platelets. Benzydamine does not irritate tissues and does not have an ulcerogenic effect when used systemically. When applied to mucous membranes, it promotes re-epithelialization.

Indications: when used systemically, it is indicated as an anti-inflammatory and analgesic agent in surgery, orthopedics, dentistry, otorhinolaryngology, gynecology, pediatrics.

In dentistry, the drug benzydamine tantum verde is used topically (with proven clinical efficacy) for symptomatic therapy in inflammatory diseases of the oral mucosa with pain syndrome - acute and chronic herpetic oral lesions of the mucous membrane, catarrhal stomatitis, recurrent aphthous stomatitis, red lichen planus, desquamative gloss, non-specific forms of stomatitis, as well as for the treatment of periodontal disease, oral candidiasis (in combination with anti-candidiasis drugs), reducing pain after tooth extraction and injuries of the oral cavity.

Mode of application: locally - 15 ml of tantum verde solution is used to rinse the mouth 4 times a day. When rinsing, do not swallow the solution. The duration of treatment depends on the severity of the inflammatory process. With stomatitis, the approximate duration of the course is 6 days. Aerosol "Tantum Verde" is used for irrigation of the oral cavity, 4-8 doses every 1.5-3 hours. This dosage form especially suitable for use in children and postoperative patients unable to rinse. For children aged 6-12 years, the aerosol is prescribed 4 doses, and at the age of 6 years - 1 dose for every 4 kg of body weight (no more than 4 doses) every 1.5-3 hours. 34 times a day.

Systemically: Tantum tablets for oral administration are prescribed for adults and children over 10 years old, no 1 pc (0.05 g) 4 times a day. Contraindications: at topical application- individual intolerance to the drug. The rinse solution is not recommended for use in children under 12 years of age. Systemic use - pregnancy, lactation, phenylketonuria.

Side effect: when applied topically, numbness of the tissues of the oral cavity or a burning sensation, allergic reactions are rarely noted.

Interaction with other drugs: not noted.

Release form:

1) mouth and throat rinse - 0.15% solution of benzydamine hydrochloride in a 120 ml vial.

Other Ingredients: Glycerol, Saccharin, Sodium Bicarbonate, Ethyl Alcohol, Methylparaben, Polysorbitol;

2) aerosol in vials of 30 ml (176 doses), containing 255 mcg of benzydamine hydrochloride in 1 dose;

3) oral lozenges containing 3 mg of benzydamine hydrochloride (20 per pack);

4) tablets for oral administration containing 50 mg of benzydamine hydrochloride.

Storage conditions: at room temperature.

Diclofenac(Diclofenac). Synonyms: Diclonate P (Diclonat P), Dicloreum (Dicloreum), Apo-Diklo (Apo-Diclo), Veral (Veral), Voltaren (Voltaren), Diclac (Diclac), Diclobene (Diclobene), Diclomax (Diclomax), Diclomelan ( Diclomelan), Diklonak (Diclonac), Dicloran (Dicloran), Revodina (Rewodina), Rumafen (Rheumafen).

pharmachologic effect: non-steroidal anti-inflammatory agent. Is an active substance a large number medicines produced in the form of tablets (see synonyms).

It has an anti-inflammatory, analgesic and moderate antipyretic effect due to the inhibition of the synthesis of prostaglandins, which play a major role in the pathogenesis of inflammation, pain and fever.

Indications: pain syndrome after traumas, operations. Inflammatory edema after dental operations.

Mode of application: administered orally at 25-30 mg 2-3 times a day (maximum daily dose - 150 mg). For children over 6 years of age and adolescents, the daily dose - 2 mg / kg of body weight - is divided into 3 doses.

Side effect: possible nausea, anorexia, pain in the epigastric region, flatulence, constipation, diarrhea, as well as dizziness, agitation, insomnia, fatigue, irritability; in predisposed patients - edema Contraindications: gastritis, peptic ulcer of the stomach and duodenum, hematopoietic disorders, pregnancy, hypersensitivity to diclofenac. Do not administer to children under 6 years of age.

: simultaneous reception with acetylsalicylic acid leads to a decrease in its concentration in plasma. Reduces the effect of diuretics.

Release form: retard tablets, pack of 20 (each tablet contains 100 mg of diclofenac sodium); solution for injection in ampoules of 3 ml, in a package of 5 pcs (in 1 ml - 50 mg of diclofenac sodium).

Dicloreum - tablets of 50 mg, in a package of 30 pcs; retard tablets 100 mg, pack of 30; solution for injections of 3 ml in ampoules, in a package of 6 pcs (1 ml contains 25 mg of diclofenac sodium).

Storage conditions: in a dry, cool place.

ibuprofen(Ibuprofenum). Synonyms: Apo-ibuprofen (Apo-lbuprofen), Bonifen (Bonifen), Burana (Burana), Ibupron (Ibupron), Ibusan (Ibusan), Ipren (Ipren), Markofen (Marcofen), Motrin (Motrin), Norsvel (Norswel) , Paduden.

pharmachologic effect: has anti-inflammatory, antipyretic and analgesic properties. The antipyretic effect is superior to phenacetin and acetylsalicylic acid. The latter is inferior to ibuprofen and analgesic action. The mechanism of action is associated with the inhibition of prostaglandins. Analgesic effect occurs 1-2 hours after taking the drug. The most pronounced anti-inflammatory effect is observed after 1-2 weeks of treatment.

Indications: used for arthralgia of the temporomandibular joint of rheumatic and non-rheumatic origin (arthritis, deforming osteoarthrosis), myalgia, neuralgia, postoperative pain.

Mode of application: administered orally after meals, 0.2 g 3-4 times a day. Daily dose - 0.8-1.2 g.

Side effect: possible occurrence of heartburn, nausea, vomiting, sweating, skin allergic reactions, dizziness, headache, gastric and intestinal bleeding, edema, color vision disorders, dry eyes and mouth, stomatitis.

Contraindications: peptic ulcer of the stomach and duodenum, ulcerative colitis, bronchial asthma, parkinsonism, epilepsy, mental illness, pregnancy and lactation, hypersensitivity to ibuprofen. Use with caution in persons of operator professions, with violations of blood clotting, liver and kidney function.

Interaction with other drugs: the drug enhances the effect of sulfonamides, difenin, indirect anticoagulants.

Release form: tablets of 0.2 g, film-coated. Storage conditions: in a dry, dark place. List B.

Indomethacin(Indometacin). Synonyms: Indobene (Indobepe), Indomelan (lndomelan), Indomin (lndomin), Indotard (1pdotard), Metindol (Metindol), Elmetatsin (Elmetacin).

pharmachologic effect: has anti-inflammatory, antipyretic and analgesic properties. The antipyretic effect is superior to phenacetin and acetylsalicylic acid. The latter is inferior to indomethacin and analgesic action.

Indications: recommended for arthritis and arthrosis of the temporomandibular joint of various origins; as a short term addition to complex therapy myalgia and neuropathy; with pain and inflammation after dental surgery. It can also be used for reactive hyperemia of the pulp after tooth preparation for fixed dentures or an extensive filling, inlay.

Mode of application: administered orally during or after meals 34 times a day, starting from 0.025 tons. Depending on tolerance, the dose is increased to 0.1-0.15 g per day. The course of treatment is 23 months. With hyperemia of the pulp, the drug is used for 57 days. It can be used as an ointment, which is rubbed into the joint area 2 times a day.

Side effect: possible occurrence of stomatitis, ulceration of the mucous membrane of the stomach, intestines, pain in the epigastric region, dyspeptic symptoms, gastric and intestinal bleeding, headache, dizziness, hepatitis, pancreatitis, allergic reactions, agranuloiitis, thrombocytopenia.

Contraindications: not recommended for gastroduodenal ulcers, bronchial asthma, blood diseases, diabetes, individual intolerance, during pregnancy and lactation, mental illness, childhood up to 10 years old.

Interaction with other drugs: in combination with salicylates, the effectiveness of indomethacin decreases, its damaging effect on the gastric mucosa increases. The effect of the drug is enhanced when combined with glucocorticoids, pyrazolone derivatives.

Release form: dragee 0.025 g; tubes with 10% ointment. Storage conditions: in a dry, cool place. Ketoprofen (Ketoprofen). Synonyms: Ketonal (Ketonal), Pro-, Phenide (Profenid), Fastum (Fastum).

pharmachologic effect: has anti-inflammatory, antipyretic and analgesic effect, inhibits platelet aggregation. The mechanism of action is associated with a decrease in the synthesis of prostaglandins. The anti-inflammatory effect is noted. begins at the end of the first week of treatment.

Indications: symptomatic treatment of inflammatory and inflammatory-degenerative diseases of the joints. Pain syndrome of various origins, including postoperative post-traumatic pain.

Mode of application: administered orally, in a daily dose of 300 mg in 23 doses. Maintenance dose - 50 mg 3 times a day. Locally apply the gel, which is applied to the affected surface 2 times a day, long and gently rubbed, after rubbing, you can apply a dry bandage.

Side effect: during treatment with the drug, nausea, vomiting, constipation or diarrhea, gastralgia, headache, dizziness, drowsiness may occur. When prescribing the gel - itching skin rash at the site of application of the drug.

Contraindications: when taken orally - diseases of the liver, kidneys, gastrointestinal tract, pregnancy and lactation, age up to 15 years, hypersensitivity to ketoprofen and salicylates. With topical application of the gel - dermatoses, infected abrasions, wounds.

Interaction with other drugs: when administered simultaneously with anticoagulants, the risk of bleeding increases.

Release form: coated tablets, 100 mg, in a package of 25 and 50 pcs; retard tablets 150 mg, pack of 20 Gel in tubes of 30 and 60 g (1 g contains 25 mg active substance), cream in tubes of 30 and 100 g (1 g contains 50 mg of the active substance).

Storage conditions: in a dry, cool place.

Ketorolac tromethamine(Ketorolac tromethamine). Synonym: Ketanov.

pharmachologic effect: non-narcotic analgesic with a very strong analgesic effect and moderate anti-inflammatory and antipyretic properties. It is a derivative of pyrrolopyrole. In terms of analgesic activity, it surpasses all known non-narcotic analgesics, with intramuscular and intravenous administration at a dose of 30 mg causes an analgesic effect equivalent to the effect of intramuscular injection of 12 mg of morphine. It inhibits the cyclooxygenase pathway of arachidonic acid metabolism, reducing the production of prostaglandins, mediators of inflammation and pain. Unlike narcotic analgesics, it has a peripheral effect, does not depress the central nervous system, respiration, cardiac activity and other autonomic functions. Does not cause euphoria and drug dependence. Ketorolac is not characterized by tolerance. Like other non-steroidal anti-inflammatory drugs, it inhibits platelet aggregation, prolongs the mean bleeding time. The duration of action for intramuscular and oral administration is 46 hours.

Indications: used for short-term pain relief with severe and moderate pain syndrome, after operations in the maxillofacial region, with traumatic injuries of bones and soft tissues, toothache, including after dental interventions, arthrosis of the temporomandibular joint, oncological pain.

Mode of application: first dose (10 mg) for acute severe pain administered intramuscularly. If necessary, a subsequent dose (10-30 mg) is administered every 45 hours. The maximum daily dose of the drug for any route of administration for adults is 90 mg, in elderly patients it should not exceed 60 mg. The maximum duration of ketorolac injection is 2 days. After cupping acute pain and with a pain syndrome of moderate intensity, the drug can be administered orally at 10 mg (one tablet) every 46 hours. The duration of use with enteral administration should not exceed 7 days.

Side effect: Ketorolac is well tolerated. In rare clouds, nausea, vomiting, diarrhea, headache, and sweating may occur. As with the use of other non-steroidal anti-inflammatory drugs, irritation of the gastric mucosa, exacerbation of peptic ulcer, and gastrointestinal bleeding are possible. These phenomena are characteristic mainly for enteral administration.

Contraindications: Do not administer during pregnancy, lactation, and patients under the age of 16 years. Contraindicated in peptic ulcer of the stomach and duodenum, especially in the acute stage, individual intolerance to non-steroidal anti-inflammatory drugs, including "aspirin asthma". Use with caution in diseases of the liver and kidneys, and it is necessary to reduce the dosage.

Interaction with other drugs: well combined with morphine and other narcotic analgesics, which allows for postoperative pain to reduce the dosage of narcotic analgesics by 1/3. This combination does not enhance the inhibitory effect of narcotic analgesics on breathing. Ketorolac can potentiate the effects of indirect anticoagulants by displacing them from their association with plasma proteins. High doses of salicylates can increase the level of the free fraction of ketorolac in plasma and enhance its effect, while a decrease in the dosage of the drug is necessary.

Release form: coated tablets, pack of 10 pcs (1 tablet contains 10 mg of ketorolac tromethamine); ampoules and syringe-tubes of 1 ml of a solution containing 30 mg of ketorolac tromethamine.

Storage conditions: in a place protected from light at room temperature.

Metamizole sodium(Metamizoli sodium). Synonyms: Analgin (Analginum), Baralgin M (Baralgin M), Nebagin (Nebagin), Optalgin-Teva (Optalgin-Teva), Spasdolzin (Spasdolsin), Toralgin (Toralgin).

Formacological action: is a derivative of pyrazolone. It has a pronounced analgesic and antipyretic effect. The analgesic effect is due to the suppression of the biosynthesis of a number of endogenous substances (endoperoxides, bradykinins, prostaglandins, etc.). It prevents the conduction of painful extero- and proprioceptive impulses along the Gaulle and Burdach bundles and increases the excitability threshold at the level of the thalamus. The antipyretic effect is due to the suppression of the formation and release of pyrogenic substances.

Indications: in dental practice, it is prescribed as an anesthetic (toothache, myositis, neuritis and neuralgia of the trigeminal and facial nerve, pain after tooth extraction and filling root canal, alveolitis and other odontogenic inflammatory diseases, postoperative period, painful medical manipulations, etc.), anti-inflammatory and antipyretic agent for feverish conditions, including those of odontogenic origin. Used for premedication with other analgesics, tranquilizers and hypnotics.

Mode of application: when taken orally, a single dose for adults - 200-500 mg (maximum - 1 g); for children aged 23 years 100-200 mg, 57 years 200 mg, 8-14 years 250-300 mg. Multiplicity of appointment - 2-3 times a day.

Intramuscularly or intravenously slowly, adults are prescribed 1-2 ml of a 25% or 50% solution 23 times a day. Children are parenterally prescribed at a dose of 50-100 mg per 10 kg of body weight. Long-term use of the drug requires monitoring of the picture of peripheral blood.

Side effect: when applied, skin rash, chills, dizziness may occur; there may be changes in the blood (leukopenia, agranulocytosis). With intramuscular injection, infiltrates are possible at the injection site.

Contraindications: pronounced disorders of the kidneys and liver, blood diseases, hypersensitivity to pyrazolone derivatives. Use with caution during pregnancy, children in the first 3 months of life.

Release form: tablets of 0.5 g with a risk for children, in a package of 10 pcs, a solution of analgin for injection in ampoules of 1 and 2 ml, 10 pcs in a package (1 ml - 250 mg of the active substance).

Storage conditions: in a dry, cool place.

Mefenamin sodium salt (Mephenaminum sodium).

pharmachologic effect: has a local anesthetic and anti-inflammatory effect, stimulates the epithelization of the damaged oral mucosa.

Indications: used in the treatment of periodontal diseases and ulcerative lesions of the oral mucosa, as well as in the treatment of traumatic complications caused by various designs of dentures.

Mode of application: used in the form of a 0.1-0.2% aqueous solution for application 1-2 times a day or 1% paste, which is injected into the dentogingival pockets after 1-2 days (68 sessions per course). The solution and paste are prepared immediately before use. As the basis for the preparation of the paste, isotonic sodium chloride solution is used and white clay.

Side effect: when using solutions with a concentration above 0.3% or a paste with a concentration of more than 1%, there may be irritation of the oral mucosa.

Contraindications: individual intolerance.

Release form: powder 3 kg in plastic bags.

Storage conditions: in a dry, dark place. List B,

Nabumeton(Nabumetone). Synonym: Relafen.

pharmachologic effect: non-steroidal anti-inflammatory drug, inhibits the synthesis of prostaglandins. It has anti-inflammatory, analgesic and antipyretic effects.

Indications: used in dentistry as a symptomatic remedy in complex treatment diseases of the temporomandibular joint.

Mode of application: appoint inside 1 g 1 time per day, regardless of the meal.

Side effect: possible sleep disorders, headache and dizziness, blurred vision, shortness of breath, pain in the epigastric region, changes in the picture of peripheral blood, urticaria.

Contraindications: hypersensitivity to the drug and other NSAIDs, pregnancy and lactation, gastrointestinal diseases and impaired renal function. Not intended for children

Interaction with other drugs: do not prescribe with drugs that have a high binding to plasma proteins.

Release form: Relafen [Smith Klein Beecham| : film-coated tablets, beige, in a package of 100 and 500 pcs (1 tablet contains 750 mg of nabumetone); coated tablets, white color, in a package of 100 and 500 pieces (1 tablet contains 500 mg of nabumetone).

Storage conditions: in a dry, cool place.

Naproxen(Naproxen). Synonyms: Apo-naproxen (Aro-pargohep), Daprox Entero (Daprox Entero), Naprobene (Naprobene), Apranax (Apranax), Naprios (Naprios), Pronaxen (Pronahep), Naprosin (Narposyn), Sanaprox (Sanaprox).

pharmachologic effect: is a derivative of propionic acid, has anti-inflammatory, analgesic and antipyretic effects. Suppresses the synthesis of inflammatory mediators and prostaglandins, stabilizes lysosome membranes, prevents the release of lysosomal enzymes that cause tissue damage during inflammatory and immunological reactions. Relieves pain, including joint pain, reduces swelling. The maximum anti-inflammatory effect is achieved by the end of the 1st week of treatment. With prolonged use, it has a desensitizing effect. Reduces platelet aggregation.

Indications: used for arthritis, including the temporomandibular joint ( rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, articular syndrome with gout, pain in the spine), myalgia, neuralgia, traumatic inflammation of the soft tissues and the musculoskeletal system. As an adjuvant, it is used for infectious and inflammatory diseases of the upper respiratory tract, headache and toothache.

Mode of application: administered to adults orally in a daily dose of 0.5-1 g, in two divided doses. The maximum daily dose is 1.75 g, the maintenance daily dose is 0.5 g. It is also used as rectal suppositories at night (1 suppository each containing 0.5 g of the drug). At rectal application toxic effect on the liver is excluded.

Side effect: with prolonged use, dyspeptic symptoms (pain in the epigastric region, vomiting, heartburn, diarrhea, bloating), tinnitus, dizziness are possible. In rare cases, there are thrombocytopenia and granulocytopenia, Quincke's edema, skin rash. When using suppositories, local irritation is possible.

Contraindications: fresh peptic ulcer of the stomach, "aspirin" asthma, hematopoietic disorders, severe disorders of the liver and kidneys. Use with caution during pregnancy. Do not appoint children under one year.

Interaction with other drugs: reduces the diuretic effect of furosemide, potentiates the effect of indirect anticoagulants. Antacids containing magnesium and aluminum reduce the absorption of naproxen from the gastrointestinal tract.

Release form: tablets of 0.125; 0.25; 0.375; 0.5; 0.75; 1 g; rectal suppositories of 0.25 and 0.5 g.

Storage conditions: List B.

Niflumic acid(niflumic acid). Synonym: Donalgin.

pharmachologic effect: non-steroidal anti-inflammatory agent for oral administration, which has anti-inflammatory and analgesic effects.

Indications: pain with fractures of the jaws, dislocations and subluxations of the temporomandibular joint, soft tissue injuries of the maxillofacial region, periostitis, arthritis, osteoarthritis, pain dysfunction of the joint, as well as pain syndromes after tooth extraction, various dental procedures, etc.

Mode of application: administered orally 1 capsule 3 times a day during or after meals. The capsule is swallowed whole, without chewing. In severe cases, especially with exacerbation of chronic inflammatory processes, the daily dose can be increased to 4 capsules. After the onset of clinical improvement, the maintenance daily dose is 1-2 capsules per day.

Side effect: possible nausea, vomiting, diarrhea, sometimes stomach pain.

Contraindications: pregnancy, diseases of the liver, kidneys, peptic ulcer of the stomach and duodenum. It is not recommended to prescribe to children, as well as in case of hypersensitivity to the drug.

Interaction with other drugs: simultaneous reception of donalgin and glucocorticosteroids allows you to reduce the dose of the latter. In patients taking indirect anticoagulants, it is necessary to constantly monitor the prothrombin index.

Release form: gelatin capsules, pack of 30 pcs (1 capsule contains 250 mg of niflumic acid).

Storage conditions: in a dry, cool place.

Paracetamol(Paracetamol). Synonyms: Brustan (Brustan), Dafalgan (Dafalgan), Ibuklin (Ibuclin), Calpol (Calpol), Coldrex (Coldrex), Panadein (Panadeine), Panadol (Panadol), Plivalgin (Plivalgin), Saridon (Saridon), Solpadein (Solpadeine) ), Tylenol (Tylenol), Efferalgan (Efferalgan).

pharmachologic effect: It is an analgesic, anti-inflammatory and antipyretic agent. Inhibits the synthesis of prostaglandins responsible for early stages inflammatory response and sensation of pain. It inhibits the hypothalamic center of thermoregulation, which is manifested by an antipyretic effect. It is a metabolite of phenacetin, but differs from the latter in significantly lower toxicity, in particular, it forms methemoglobin much less often and does not have a pronounced nephrotoxic property. Unlike other non-steroidal anti-inflammatory drugs (salicylates, oxicams, pyrazolones, propionic acid derivatives), it does not irritate the gastric mucosa and does not inhibit leukopoiesis.

Indications: used for arthritis and arthrosis of the temporomandibular joints, myalgia, neuralgia, inflammatory diseases dental system. It is used for pain syndrome of low and medium intensity with inflammation, fever, infectious and inflammatory diseases, in combination with codeine (Panadeine) - for migraine.

Mode of application: administered orally alone or in combination with phenobarbital, caffeine, etc. in tablets or powders for adults at a dose of 0.2-0.5 g, for children from 2 to 5 years old - 0.1-0.15 g each, 6-12 years - 0.15-0.25 g per reception 23 times a day.

Side effect: generally well tolerated. With prolonged use in high doses, a hepatotoxic effect is possible. Rarely causes thrombocytopenia, anemia and methemoglobinemia, allergic reactions.

Contraindications: individual intolerance to the drug, blood diseases, severe liver dysfunction.

Interaction with other drugs: in combination with antispasmodics relieves spastic pain, with caffeine, codeine, antipyrine, the toxicity of paracetamol decreases and increases therapeutic effect mixture components. In combination with phenobarbital, methemoglobinemia may increase. The combination with phenylephrine hydrochloride helps to reduce swelling of the nasal mucosa with colds and flu.

The half-life of paracetamol increases with the simultaneous use of barbiturates, tricyclic antidepressants, and also with alcoholism. Analgesic activity may decrease with long-term use of anticonvulsants.

Release form: tablets of 0.2 and 0.5 g. In addition to monocomponent preparations of paracetamol, paraceta is currently the most common.

Panadol soluble (Panadol soluble) - tablets of 0.5 g;

Panadol baby and infant (Panadol baby end infant) - a suspension in vials containing 0.024 g of paracetamol in 1 ml;

Panadol-extra (Panadol extra) - tablets containing 0.5 g of paracetamol and 0.065 g of caffeine;

Panadeine (Panadeine) - tablets of 0.5 g of paracetamol and 8 mg of codeine phosphate;

Solpadeine (Solpadeine) - soluble tablets containing 0.5 g of paracetamol, 8 mg of codeine phosphate, 0.03 g of caffeine.

From these drugs in dentistry with a pain syndrome of moderate intensity (pain after tooth extraction, with pulpitis, periodontitis), preference can be given to fast-acting and active drugs containing, in addition to paracetamol, codeine and caffeine - Panadeine and Solpadeine. Caffeine has the ability to enhance the analgesic effect of paracetamol and other non-narcotic analgesics. Codeine, being a weak agonist of opiate receptors, also significantly potentiates and prolongs the analgesic effect. The drugs are prescribed for adults 1-2 tablets up to 4 times a day. The drugs are safe, well tolerated and can be prescribed to patients with comorbidities such as diseases of the gastrointestinal tract and bronchial asthma. They are contraindicated in severe violations liver and kidney function, as well as children under the age of 7 years. Despite the minimal content of codeine, the possibility of addiction should be borne in mind.

Brustan (Brustan): tablets containing 0.325 g of paracetamol and 0.4 g of ibuprofen. The drug is indicated for adults with pain syndrome of moderate intensity (traumatic pain, dislocations, fractures, postoperative pain, toothache). As an analgesic for adults, the drug is prescribed 1 tablet 34 times a day. Side effects: see Ibuprofen.

Plivalgin (Plivalgin): tablets containing 0.21 g of paracetamol, 0.21 g of propyphenazone, 0.05 g of caffeine, 0.025 g of phenobarbital, 0.01 g of codeine phosphate. The drug is indicated for pain of moderate intensity. Adults are prescribed in a single dose of 2-6 tablets per day. Contraindicated in serious illnesses liver, blood diseases, pregnancy, lactation, hypersensitivity to the components of the drug.

Storage conditions: in a dry, dark place. Piroxicam. Synonyms: Apo-piroxicam (Apo-piroxicam), Piricam (Piricam), Pirocam (Pirocam), Remoxicam (Remoxicam), Sanicam (Sanicam), Hotemin (Hotemin), Erazon, (Erason), Felden (Feldene).

pharmachologic effect: is a derivative of the oxicam class, has anti-inflammatory, analgesic and antipyretic effects. It inhibits cyclooxygenase and reduces the production of prostaglandins, prostacyclins and thromboxane, reduces the production of inflammatory mediators. After a single application, the effect of the drug lasts one day. Analgesic action begins 30 minutes after taking the drug.

Indications: used for arthralgia (rheumatoid arthritis, osteoarthritis, including arthritis of the temporomandibular joint, ankylosing spondylitis, gout), myalgia, neuralgia, traumatic inflammation of soft tissues and the musculoskeletal system, acute infectious and inflammatory diseases of the upper respiratory tract.

Mode of application: administered orally 1 time per day at a dose of 10-30 mg. Higher doses can be used in acute severe cases such as gout attacks. At the same time, it is possible intramuscular injection at a dose of 20-40 mg 1 time per day until the relief of acute events, after which they switch to maintenance therapy with tablets. The drug is also administered rectally in the form of suppositories, 20-40 mg 1-2 times a day.

Side effect: When ingested in high doses, nausea, anorexia, abdominal pain, constipation, diarrhea are possible. The drug can cause erosive and ulcerative lesions of the gastrointestinal genesis. Rarely, toxic effects on the kidneys and liver, oppression of hematopoiesis, adverse effects from the central nervous system - insomnia, irritability, depression. When applied rectally, irritation of the rectal mucosa is possible.

Contraindications: erosive and ulcerative lesions of the gastrointestinal tract in the acute phase, severe violations of the liver and kidneys, "aspirin" asthma, hypersensitivity to the drug, pregnancy, lactation.

Interaction with other drugs: enhances the side effects of other non-steroidal anti-inflammatory drugs. The toxicity of piroxicam increases when taken simultaneously with indirect anticoagulants.

Release form: tablets of 0.01 and 0.02 g; solution in ampoules (0.02 g in 1 ml and 0.04 g in 2 ml). Rectal suppositories of 0.02 g.

Storage conditions: list B.

Sulindak(Sulindac). Synonym: Clinoril (Clinoril).

pharmachologic effect: is a derivative of indenacetic acid, an indene derivative of indomethacin. However, it is devoid of some of the side effects of this drug. In the body forms an active metabolite - sulfide. It has anti-inflammatory, analgesic and antipyretic effects. Reduces the synthesis of prostaglandins and inflammatory mediators, reduces the migration of leukocytes to the area of ​​inflammation. Compared with salicylates, it rarely causes side effects from the gastrointestinal tract, does not cause headaches, which are characteristic of indomethacin. Reduces joint pain at rest and during movement, eliminates swelling. The maximum anti-inflammatory effect develops by the end of the 1st week of treatment.

Indications: see Piroxicam.

Mode of application: administered orally in a daily dose of 0.2-0.4 g in 1 or 2 doses. The maximum daily dose is 0.4 g. If necessary, reduce the dose. Take the drug with liquid or food. With acute gouty arthritis average duration treatment is 7 days.

Side effect: as a rule, the tolerability of the drug is satisfactory. The most common disorders of the gastrointestinal tract: nausea, anorexia, epigastric pain, constipation, diarrhea. In rare cases, erosive and ulcerative lesions of the stomach and bleeding occur. Possible sleep disturbances, kidney function, paresthesia, changes in the blood picture.

Contraindications: do not use during pregnancy, lactation, in childhood (up to 2 years), with erosive and ulcerative lesions of the gastrointestinal tract in the acute phase, "aspirin" asthma, individual intolerance to non-steroidal anti-inflammatory drugs.

Interaction with other drugs: increases the effect of anticoagulants of indirect action.

Release form: tablets of 0.1; 0.15; 0.2; 0.3 and 0.4 g.

Storage conditions: list B.

Phenylbutazone(Phenylbutazone). Synonym: Butadion (Butadionum).

pharmachologic effect: has analgesic, antipyretic and anti-inflammatory effect.

By anti-inflammatory activity significantly superior to amidopyrine, is one of the main non-steroidal anti-inflammatory drugs. Butadione is an inhibitor of prostaglandin biosynthesis, and more powerful than acetylsalicylic acid.

Indications: used to treat inflammatory diseases of periodontal tissues, with symptoms of xerostomia in patients with rheumatism, lupus erythematosus, acute purulent-inflammatory diseases of the maxillofacial region, neuritis and neuralgia, arthritis of the temporomandibular joint, burns of 1 and II degree of a small area, inflammation skin at the site of intramuscular and intravenous injections, traumatic injuries of soft tissues.

Mode of application: administered orally and topically as an ointment. Inside take during or after a meal. The dose for adults is 0.1-0.15 g 4-6 times a day. The maintenance daily dose is 0.2-0.3 g. Children from 6 months are prescribed 0.01-0.1 g 34 times a day (depending on age). The course of treatment lasts 25 weeks or more. Locally use "Butadiene Ointment", containing 5% butadione. The ointment is applied to the oral mucosa or injected into periodontal pockets for 20 minutes daily until exudative phenomena are eliminated.

Side effect: when taken orally, fluid retention, nausea, vomiting, pain in the stomach (associated with ulcerogenic action), skin rashes and other skin allergic reactions, leukopenia and anemia, hemorrhagic manifestations are possible. Hematological changes and allergic reactions are indications for discontinuation of the drug.

Contraindications: peptic ulcer of the stomach and duodenum, diseases of the hematopoietic organs, leukopenia, impaired liver and kidney function, circulatory failure, disorders heart rate hypersensitivity to pyrazolones.

Interaction with other drugs: Maybe combined application with other non-steroidal anti-inflammatory drugs. Able to delay the release of various drugs (amidopyrine, morphine, penicillin, oral anticoagulants, antidiabetic drugs) by the kidneys. When prescribing butadione, it is recommended to limit the introduction of sodium chloride into the body.

Release form: coated tablets of 0.15 g, in a package of 10 pcs (in 1 tablet - 50 mg of phenylbutazone): butadiene ointment 5% in tubes of 20 g.

Storage conditions: in a place protected from light.

Flurbiprofen(Flurbiprofen). Synonyms: Anseid (Ansaid), Flugalin (Flugalin).

pharmachologic effect: has a pronounced analgesic, anti-inflammatory and antipyretic activity. The mechanism of action is associated with inhibition of the cyclooxygenase enzyme and inhibition of prostaglandin synthesis.

Indications: symptomatic therapy for diseases of the temporomandibular joint and soft tissue injuries of the maxillofacial region.

Mode of application: administered orally at 50-100 mg 23 times a day with meals.

Side effect: Dyspepsia, heartburn, diarrhea, abdominal pain, headache, nervousness, sleep disorders, allergic skin reactions may occur.

Contraindications: diseases of the gastrointestinal tract in the acute phase, bronchial asthma, vasomotor rhinitis, intolerance to acetylsalicylic acid, as well as pregnancy and lactation. Use with caution in diseases of the liver and kidneys, arterial hypertension, chronic heart failure.

Interaction with other drugs: when used together with anticoagulants, there is an increase in their action, with diuretics - a decrease in their activity.

Release form: tablets of 50 and 100 mg, in a package of 30 pcs.

Storage conditions: in a dry, cool place.

The dentist's guide to medicines
Edited by Honored Scientist of the Russian Federation, Academician of the Russian Academy of Medical Sciences, Professor Yu. D. Ignatov