Vasoactive drugs in neurology. What medications are most effective in treating neuralgia?

We live in a country where you need to think, especially from the position of a parent. I, too, would like a lot... It is clear that everyone wants medicine at the European level, but it does not exist and will not exist in the foreseeable future, we are not in Europe.
Let’s agree right away: complaints about the quality of work of pediatric neurologists do not apply to me. I simply explained the situation in response to your confusion. 90% out of 100 that when you come to the clinic you will end up with just such a neurologist who prescribes an ultrasound of the brain without indication, and then treats the numbers on the piece of paper with diacarb and cortexin. Cortexin was developed in our country and is used only in our country, because Its effectiveness is unproven and its safety is questionable, especially given the method of production.
Of course, you won’t envy your parents. But it is better to be informed parents and not inject Actovegin with Cortexin in vain for healthy children, and if problems arise in a child, try to find a competent specialist. It is simply impossible to imagine how American or European children learn to walk without Cortexin and massages... And why is it 90% of us? children have neurological diagnoses, but somehow the people there are born much healthier... we generally treat everyone with Cotrexin now - recently one of the forum members wrote about Cortexin injections “in the back” - vertebral hernias were treated in a massage room.

Stop. Stop. First of all, the neurological status of the child. Ultrasound findings are not treated. Neurological status is the main thing. If the child's development corresponds to his age, the neurologist does not find pathological symptoms There is no need to treat anything. At the same time, if the neurologist begins to operate with the words “perinatal”, “hypoxic-ischemic encephalopathy”, “hydrocephalus”, “hypertonicity, which should not be present at 2 months, and you are already 2.5 months old” and most importantly, drugs are prescribed: actovegit , Cavinton, piracetam, gliatilin, diacarb, nicergoline and other tanakans and Huato boluses, just go away. In case of serious suspicion of cerebral pathology, neurosonography (ultrasound) data is not limited. If the recommendations are to “get treated” and repeat the ultrasound, leave. In most cases, when re-examined after a few months, nothing is found. Moreover, in those children who were not tortured with injections of nicergoline and piracetam.
For general information you can read

Yes, and do a search there, you will learn a lot of new and interesting things about things that actually do not need to be treated.

Sensitive subject. Even super sick. It is called the treatment of non-existent diseases. And also the treatment of existing diseases in the wrong way, in the wrong place, and in the wrong time. The result in the first case is often good if complications of the treatment itself do not occur, but these are “production costs,” so to speak. Everyone is happy, and the doctors absolutely sincerely believe that they helped, and the parents of the children, of course, the child is alive, healthy and cheerful, and his “eyes have stopped rolling”, “his chin has stopped trembling”, he has stopped “standing on his toes” and in At the appointed time he sat down, crawled, walked and spoke. One question: who set the time? Why should a month-old baby hold his head up? Statistics? I agree, but there is also options norms. There is no reason to take piracetam for your child if you have no headaches in a month or one day. He will keep her at one and a half, so what? So why does everyone have “Perinatal encephalopathy”? Ignorance? Maybe. Traditions? Fear of missing a “serious” pathology (and at least we’re getting “treated”)? Reporting? Yes, yes and yes. But why is there such embarrassment in the diagnosis: Healthy? I don't know. The zebra is asked, the zebra cannot answer (C). Our textbooks are like this. Why do the “damned bourgeoisie” have in their “bible” the pediatrician “Pediatrics” Nelson, which was published last year? eighteenth edition THERE IS NO SUCH DIAGNOSIS OF PEP? How do they live as poor people? And again, last year we began publishing a translation of the 16th edition of Nelson in five volumes (by the way, the price of one volume is about 1.5 kilo rubles, normal, right? What’s on the topic about the average salary of a doctor?). And what? They shoved in a PEP! Translators and reviewers! True, we must give them their due, in the most severe form, when the child is resuscitated during labor, and this same Apgar scale is no more than 3-4 points (this is very bad, this real hypoxia(lack of oxygen). And without shame (really well done!) they said:

Treatment: therapy is aimed at maintaining vital functions and depends on the manifestations of certain organs... There are no methods for treating brain damage

So what to do? Once again, I don't know. But what I know is that if the child grows and develops normally, then it doesn’t matter what “slight hydrocephalus” is found on the ultrasound. That PEDs do not need to be treated. That piracetam, Actovegin, Cerebrolysin, Cavinton and Diacarb do not treat anything neurological. This has been proven. There is a separate topic about Cortexin, Instenon, Semax, Mexidol and Cytoflavin, nothing about these at all really not known, this is our know-how. There is a theoretical basis that everyone is in trouble with, there are crooked studies that do not meet international criteria (and at the same time, research on animals is still going on). As with that arbidol, on which there was an RCT (the word implies that you can believe it). True, soldiers of the Chinese army took part in it, this is prohibited by the Helsinki Convention on clinical trials of drugs (well, like servicemen, forced people and all that) - but who cares about this here? Have you bought Arbidol recently? Well, God bless him with Arbidol. About neurology. What is the treatment? And also developmental activities. This includes physical therapy and special games with the child so that exactly those parts of the nervous system where there are problems develop (in short). This is the treatment. By the way, the same applies to adults with brain damage, such as stroke or injury. As soon as they were transferred from the intensive care unit, or immediately (if it didn’t get to the intensive care unit), or even right in the intensive care unit - activation, adaptation, the work of a speech therapist, a physical therapy doctor (that’s what we have), a psychologist (this is not only “getting around” but also special techniques and exercises aimed at restoring lost functions). Somehow like this. It's boiling.

Many people live and do not know that they have a cyst in their head from birth, but in old age the discovery is discovered. You shouldn’t overdo it with medications either. About Piracetami, Cerobrolysins, Semax, Actovegin, PC-Merz, Ceraxon and others, a separate conversation and everything is ambiguous. BUT CHILDREN AND ELDERLY PEOPLE SHOULD NOT “DAMEND” WITH PIRACETAM.

I'll try to remain politically correct. We often come across the opinion that in a poor country with dirty water, poisoned air, poor-quality and unbalanced nutrition, a woman, after several abortions in adolescence, cannot give birth to a healthy child from an alcoholic father. Therefore, all our children are sick and need to be treated. Most of the “neurological diseases” diagnosed in the first year of life simply do not exist. For example, “hypotonicity.” There is no such disease. This is a symptom that cannot be considered in isolation from the rest. This is an axiom. PEP is a bug at 9/10. As does “neck injury.” Any acute brain injury (brain or spinal) should be treated in acute phase. Treatment is aimed at preventing additional damage. That's all. This is the only thing that is effective. The bulk of prescribed drugs are positioned by manufacturers as “brain restorative.” This position is introduced into the minds of doctors at numerous conferences, with the invitation of paid authorities, and they then write manuals and compile standards. In independently conducted large and reliable studies with an open design (that is, anyone can familiarize themselves with the progress and results of the studies and repeat the calculations), the effect of these drugs has not been proven. It turns out that they don’t really cure anything. But what about the statement “it was bad, they pierced the ***** and it got better? The first question is, was it bad? What is declared a “pathology” because “it shouldn’t be like this by this age” does not happen as it should according to the instructions in the textbook, but a little later. Second point. Even with existing neurological deficits, rehabilitation is effective. What it is? In a simple approximation, this is just a mother fussing with a child, playing with him, “hands, feet, give, take,” etc. If this happens against the background of “treatment,” then naturally, all the credit is attributed to him. With real neurological pathology, these drugs do not help. Briefly summarizing the options that the doctor says:
1. “Everything is fine with your child, the tone is a little disturbed, and the chin is trembling, so that there are no problems later, let’s pierce this and that and do a massage.” You can say thank you and leave with a clear conscience, throwing away the recipe.
2. “Your child has problems and needs treatment for this or that.” Ask for clarification of what the problems are, what scenarios are possible and possible courses of action.
a) “you don’t need anything except a course of this drug(s) and everything will go away” - look for another neurologist to clarify what the problem is.
b) “it is necessary to carry out a course of treatment and if after the problems persist, further examination (conduct an MRI, consult with a neurosurgeon, epileptologist, etc.)” - do not waste time on “courses of treatment”, but immediately go for further examination and consultation

Anti-cramp medications are prescribed for uncontrolled contractions of the muscles of the legs and arms, accompanied by pain. Seizure activity is unpleasant due to the loss of control over the body and pain, which can persist for several days after the attack.

The medicine for cramps in the legs and arms is designed to compensate for the lack of microelements, which provokes muscle contractions. Another type of medication to treat seizures is anti-epilepsy medications.

What medications should I take for limb cramps?

Random twitches (muscle contractions) are called spasms. They occur in a healthy person for the following reasons:

long walking or swimming, excessive stress;
being in cold water, freezing;
dehydration and diuretic use;
increased protein content in food;
lack of electrolytes (sodium, calcium and potassium), magnesium and vitamin D.

Sometimes seizure activity is provoked by diseases and even brain tumors. In older people, it can be a harbinger of thrombosis of the extremities. Before wondering what medications to take for seizures, it is best to visit a doctor. He will collect anamnesis and prescribe the necessary diagnostic procedures. And then he will prescribe an effective medicine against seizures.

People are afraid of sudden pain. After waking up several nights due to spasms in the calf muscles, many are worried: when their legs cramp, what should they do? Medicines are most often not needed in this case. It is enough to restore normal blood flow and fluid balance in the body.

Any specific medicine for cramps in the arms and legs in tablet form is usually not prescribed. Treatment usually consists of taking a vitamin-mineral complex, doing exercises, and using creams to stimulate blood circulation. For chronic diseases, medicine for leg cramps (tablets) is designed to cure the underlying disease. After this, muscle spasms will go away on their own.

If the leg is cramped, the medicine is prescribed containing vitamin D, magnesium and calcium. It is best to take medications in the evening. Medicine for muscle cramps with a high magnesium content should not be used if there are problems with the kidneys, adrenal glands, hypothyroidism, or a tendency to form blood clots.

What medications are taken for special types of seizures?

If the body temperature is high, the child may experience convulsions. Medicines are prescribed to relieve the seizure, and at the same time the temperature is brought down. For infants, a convulsive state is dangerous. Taking medications requires a very precise dosage.

Severe muscle cramps are associated with infectious, diabetic or toxic polyneuropathy. To treat such a cramp, a medicine (drug) is prescribed to improve the conductivity of nerve fibers and tissue nutrition, and lower sugar levels (for diabetes). The composition of the medicines includes B vitamins.

Epileptic seizures are associated with loss of consciousness. To relieve them, special medications for seizures are used. First, the patient is prescribed electroencephalography. After this, medication for seizures is prescribed for a long time (often for at least 2-3 years). Epilepsy is associated with disorders of the central nervous system. Drugs for the disease are prescribed with anticonvulsant, sedative and hypnotic effects. Some of these drugs are presented on the website of our online pharmacy “Medicine from Europe” in the Neurology section. For example: Abixa, Aricept, Branigen, Gliatilin, Zarontin, Carnitine, Liposome Forte, Neuroton, Nicetyl, Rilutek, Sabril, Susilep, Tricortin, Centrum, Citicoline and others. All drugs presented on the website are manufactured and certified in the European Union, which guarantees the highest treatment results when used correctly.

Drugs from the NSAID group - xefocam, diclofenac and others - will help reduce pain.

NSAIDs (non-steroidal anti-inflammatory drugs) are one of the most commonly used groups of drugs in medicine in general, and in neurology in particular. This fact is explained by the large number of clinical effects of NSAIDs. In addition to the anti-inflammatory effect, they have an analgesic, antipyretic, and in some cases antiaggregation and even immunosuppressive effects. In neurological practice, the role of NSAIDs cannot be overestimated, if only because they are first-line drugs in the treatment of neurological complications. Treatment cannot be done without NSAIDs, as well as most compression and ischemic origins. All over the world, aspirin (an NSAID) is used to prevent stroke. This article will focus on the role of NSAIDs in the treatment of neurological diseases. You will be able to familiarize yourself with the mechanism of action of NSAIDs, their varieties, the main list, side effects, and features of the use of individual drugs.

NSAIDs are a large group of substances with heterogeneous chemical structure. Today, their number has long exceeded a hundred, and the search for new and new drugs continues. The most common drugs: Acetylsalicylic acid, or Aspirin, Metamizole sodium, Phenylbutazone, Aceclofenac, Diclofenac, Indomethacin, Ketorolac, Ketoprofen, Ibuprofen, Naproxen, Nimesulide, Celecoxib, Etoricoxib, Lornoxicam, or Xefocam, Meloxicam, Piroxicam. And this is only a small part of them. In order to somehow organize information about NSAIDs, it is customary in medicine to use several classifications of these drugs. Previously, classification based on chemical structure was often used. However, it is understandable only to pharmacists and doctors.

Therefore, we will focus on a more understandable classification based on the mechanism of action of NSAIDs, since the range of their use largely depends on this. So, according to the mechanism of action, NSAIDs are usually divided into:

non-selective inhibitors of the enzyme cyclooxygenase (COX), that is, acting on COX-1 and COX-2;
selective COX-2 inhibitors.

Non-selective drugs include Acetylsalicylic acid, Metamizole sodium, Diclofenac, Aceclofenac, Indomethacin, Ketoprofen, Ibuprofen, Naproxen, Lornoxicam, and selective drugs include Nimesulide, Celecoxib, Etoricoxib, Meloxicam. To understand the need for such a separation, let's take a little look at how NSAIDs work.

How do NSAIDs work?

The human body contains a special enzyme - COX, which is involved in the production of prostaglandins. Prostaglandins are substances that influence the appearance of pain, inflammation, increased body temperature and many other reactions. COX has several varieties:

COX-1 controls the production of substances that ensure the normal structure of the mucous membrane of the gastrointestinal tract, platelet adhesion and blood circulation through the kidneys;
COX-2 is responsible for inflammation processes;
COX-3 provides a febrile reaction, that is, an increase in body temperature. Some researchers believe that COX-3 is part of COX-1, and do not distinguish it as a separate variety.

NSAIDs can block COX, which means they reduce the amount of prostaglandins. Due to this, pain and signs of inflammation are reduced, and platelet aggregation is inhibited. At the same time, some of the NSAIDs suspend the work of all COX fractions, that is, they are non-selective, and the other part are selective in this process, turning off only COX-2 (they are selective). Due to such multidirectional effects, NSAIDs have different properties, which are realized in practice. Thus, those NSAIDs that suppress COX-1 and COX-2 can cause ulcers in the gastrointestinal tract and impair renal blood flow. It is this fact that determines the indications and contraindications for the prescription of certain NSAIDs, causes adverse reactions, and also determines the market cost of the drugs. Based on all this, classification based on the selectivity of the action of NSAIDs has become more widespread than the chemical one.

All the subtleties of the mechanism of operation of NSAIDs are still not fully understood. In recent years, data have emerged on the COX-independent effect of NSAIDs, which determines the severity of the analgesic effect of this group of drugs. Therefore, non-selective NSAIDs retain their position in the treatment of many diseases, despite their side effects.

Effects of NSAIDs

According to the mechanism of action of NSAIDs, their main effects are:

anti-inflammatory;
anesthetic;
antipyretic;
antiaggregation (inhibition of platelet adhesion);
immunosuppressive (slightly expressed, realized by reducing capillary permeability, consists in reducing the contact of antigens with immune cells).

The severity of this or that effect varies among different NSAIDs. Acetylsalicylic acid, for example, has a very pronounced antiaggregation effect. Other NSAIDs cannot boast such an effect. Therefore, acetisalicylic acid is used as a means of preventing thrombus formation, and no other NSAID is used for this. The same can be said about the strength of the anti-inflammatory or analgesic effect of various NSAIDs. Each drug is unique in its combination of properties.

Neurology and NSAIDs

Patients with back pain due to osteochondrosis need NSAIDs.

Treatment of many neurological diseases cannot be done without NSAIDs, and often it is simply impossible. First of all, these drugs are indicated for:

osteochondrosis of the spine (and its neurological manifestations - cervicalgia, thoracalgia, cervicobrachialgia, lumboischialgia, radiculopathy, myelopathy);
headaches of various types;
neuropathy of the facial nerve;
compression-ischemic damage to nerve fibers ();
(as secondary prevention). In this case we are talking exclusively about Acetylsalicylic acid.

This is not the entire list of diseases for which NSAIDs may be needed. In general, we can say that almost any disease of the nervous system may require the use of NSAIDs. For example, during preventive therapy, there may be a need for this group of drugs, although usually the treatment of this disease does not require their use.

Whether or not to use NSAIDs in the treatment of a particular disease should be decided by the attending physician. Independent regular use of drugs in this group can lead to serious complications. NSAID drugs are freely available in pharmacies (they do not require a prescription), but this does not mean they are absolutely harmless. What are the risks of using them?

The insidiousness of NSAIDs

With long-term use of NSAIDs, especially in large doses, the risk of developing side effects from the gastrointestinal tract, as well as other organs and systems, increases.

When using any NSAIDs, the development of undesirable reactions is possible. It is believed that selective COX inhibitors are much less likely to cause side effects, which is directly related to the mechanism of action.

The main side effects of NSAIDs are:

problems with the gastrointestinal tract. The drugs can cause abdominal pain, nausea, diarrhea, the formation of erosions and ulcers mainly of the stomach and duodenum. In order to reduce the risk of such situations, it is recommended to combine NSAIDs with drugs that protect the mucous membrane. These include Misoprostol or Omeprazole;
nephrotoxicity. NSAIDs constrict the renal vessels and impair renal blood flow. Due to this, urine formation decreases, nitrogenous waste accumulates, edema and increased blood pressure may occur;
toxic effect on blood cells. It is most pronounced for NSAIDs of the pyrazolone group. They are able to reduce the number of leukocytes and erythrocytes until the development of anemia or agranulocytosis;
bleeding (due to decreased platelet aggregation);
toxic effects on liver cells, due to which the content of liver enzymes in the blood increases;
allergic reactions, including the development of bronchospasm (usually while taking Aspirin) and photodermatitis (when the skin breaks out in a rash in response to exposure to sunlight).

You need to understand that side effects do not always occur. With proper treatment planning, compliance with the dosage regimen, timing of use, and taking into account the patient’s concomitant pathology, the negative effects of NSAIDs can be minimized.

The most commonly used NSAIDs in neurology

Acetylsalicylic acid (Aspirin)

Sold without a prescription in the form of tablets of 100 mg, 300 mg and 500 mg. Blocks any COX.

It has a well-defined antiplatelet effect, that is, it is able to inhibit platelet aggregation, thereby improving blood fluidity. Therefore, in neurology the drug is used as the main means for preventing the development of ischemic stroke. For this purpose, low doses of the drug are usually prescribed - 100 mg once a day. Some Acetylsalicylic acid preparations contain an even smaller dose, as well as additional substances that protect the gastric mucosa (for example, Cardiomagnyl contains 75 mg of Acetylsalicylic acid and magnesium hydroxide). Low dosages, the addition of additional substances (such as magnesium hydroxide), a special coating that dissolves in the intestines and not in the stomach, relative cheapness - all this makes Acetylsalicylic acid a convenient and popular drug. In a dose of 500 mg, this drug is used in neurology as an anesthetic for various types of headaches (1-2 tablets orally with a glass of water). Higher doses require occasional use to avoid side effects.

Aceclofenac (Aertal, Asinak)

Sold without a prescription in the form of 100 mg coated tablets, 100 mg powder for oral suspension, and 100 mg cream for external use. Blocks any COX.

The drug is good both as an anti-inflammatory agent and as an analgesic. The presence of a soluble form (in the form of a suspension) allows you to quickly achieve an analgesic effect and is less irritating to the gastric mucosa. Aceclofenac can be taken regardless of meals, which is quite convenient. Usually prescribed 100 mg 2 times a day. In neurology, it is indicated mainly for osteochondrosis of the spine. According to statistics, Aceclofenac is well tolerated and rarely causes side effects (although they are listed in large quantities in the instructions). The drug is not recommended for use by women planning pregnancy as it reduces fertility.

Diclofenac (Voltaren, Diclovit, Dicloran, Almiral, Olfen, Diclak, Diklo-F, Diclobene, Naklofen and others)

Sold without a prescription in the form of tablets and capsules of 25 mg, 50 mg, 100 mg, rectal suppositories of 50 mg and 100 mg, injection solution 3 ml (75 mg), ointment and gel for external use, patch. Blocks any COX.

Perhaps one of the most common NSAIDs in neurological practice. This is due to a good balance between its main properties: effectiveness-quality-frequency of side effects-price. First of all, it is indicated for patients with spinal osteochondrosis and tunnel syndromes, with headaches, including migraines. The presence of a dosage form in the form of suppositories allows you to achieve the desired degree of pain relief at a lower dosage (for example, 100 mg taken orally, equivalent to 75 mg obtained as a suppository). It is also believed that suppositories have better tolerability. The injection solution is used strictly intramuscularly. It is advisable to use the drug under the cover of Omeprazole in order to reduce possible reactions from the gastrointestinal tract. For severe pain syndromes, the first 5 days are prescribed intramuscularly, and then switch to suppositories or tablets. This scheme also reduces the risk of side effects. It is possible to simultaneously use tablets or injection solution with local application of ointment or gel. In recent years, the Diclofenac patch has become popular. It sticks on for 12 hours, ensuring a gradual release of the active substance into the area of pain, and does not stain clothes at all, unlike ointment.

The bulk of Diclofenac preparations on the pharmaceutical market is represented by diclofenac sodium. But there is also diclofenac potassium (Rapten Rapid). Its advantage over diclofenac sodium is the rapid onset of the effect and greater strength of pain relief. Rapten Rapid is considered one of the fastest-acting NSAIDs in tablet form.

Ketorolac (Ketorol, Ketalgin, Ketanov)

Sold without a prescription in the form of 10 mg tablets, 1 ml (30 mg) injection solution, and gel for external use. Blocks any COX.

Ketorolac is an NSAID with pronounced analgesic properties. Its effect, according to some sources, is comparable in strength to narcotic analgesics (morphine). The injection solution can be used intramuscularly and intravenously. Compared to other NSAIDs, it has a lower level of safety, so Ketorolac should be used for the shortest possible course (no more than 5 days, preferably once).

Ketoprofen (Ketonal, Artrosilene, Flamax)

Sold without a prescription in the form of tablets and capsules of 50 mg, 100 mg, 150 mg, suppositories of 100 mg, injection solution 2 ml (100 mg), cream and gel for external use. Blocks any COX.

If we compare the most common NSAIDs in terms of pain relief, Ketoprofen is among the leaders among them. Gives a quick effect both when taken orally and when administered intramuscularly. Sometimes it is administered intravenously when they want to achieve the effect of action “at the tip of the needle,” that is, instantly. The need for this may arise, for example, with migraine. The positive properties of the drug include its relatively low cost.

Ibuprofen (Nurofen, Mig, Dolgit, Brufen, Advil and others)

Sold without a prescription in the form of 200 mg and 400 mg tablets, rectal suppositories, ointment and gel for external use. Blocks any COX.

Despite the large list of adverse reactions, it is a relatively safe NSAID (compared to other non-selective COX inhibitors), therefore it is allowed even for infants. It has moderate analgesic, anti-inflammatory, and good antipyretic effects.

Xefocam (Lornoxicam, Zornica)

Sold without a prescription in the form of tablets 4 mg, 8 mg, lyophilisate 8 mg for the preparation of solution for injection. Blocks any COX.

This is a drug that has proven itself well due to its pronounced analgesic and anti-inflammatory effect and rapid action. You cannot take more than 16 mg per day. If there is a need for parenteral use, then you must wait until the drug is completely dissolved in the syringe. It is recommended to dissolve Xefocam in water for injection (it is included in the kit). Can be used both intramuscularly and intravenously. There is such a drug as Xefocam Rapid. It differs somewhat from simple Xefocam in the composition of additional substances. Due to this, it is absorbed faster and relieves pain 3 times faster.

Meloxicam (Movalis, Amelotex, Movasin, Artrosan, Melbek)

Sold without a prescription in the form of tablets 7.5 mg and 15 mg, rectal suppositories 7.5 mg and 15 mg, solution for injection 1.5 ml (15 mg). Suppresses only COX-2.

The drug is used once a day, providing a 24-hour blockade of prostaglandin formation. It should be consumed during meals. No more than 15 mg per day is prescribed. Can only be used intramuscularly (never intravenously). Due to its selectivity, of course, it is better tolerated.

Nimesulide (Nise, Nimesil, Nimegesic, Aponil, Remesulide)

Sold without a prescription in the form of 100 mg tablets, granules for oral suspension (100 mg), and gel for external use. Suppresses only COX-2.

The drug is well absorbed when taken orally. For a faster onset of effect, take it in the form of a suspension (dissolve the contents of one sachet in 100 ml of water). Eating slightly slows down absorption, but generally does not affect its degree. It is preferable to take Nimesulide after meals. Usually prescribed 100 mg 2 times a day. After a number of studies, due to possible negative effects on the liver, the drug was banned for use in children under 12 years of age.

Celebrex (Celecoxib, Zycel, Revmoxib, Flogoxib)

Sold without a prescription in the form of capsules of 100 mg and 200 mg. Suppresses only COX-2.

Usually prescribed 100-200 mg 2 times a day, regardless of meals. Do not exceed a dose of 400 mg per day. Like all selective COX inhibitors, it is well tolerated. There are interesting facts indicating an increase in the absorption of the drug when taken simultaneously with fatty foods. There are differences in changes in the concentration of the drug in the blood serum between Europeans and representatives of the Negroid race, and therefore the latter are prescribed lower doses.

Arcoxia (Etoricoxib)

Sold without a prescription in the form of tablets of 60, 90 and 120 mg. Suppresses only COX-2.

One of the new generation of NSAIDs. The drug is taken only once a day and is well tolerated. However, you have to pay for these positive aspects in the literal sense of the word - in comparison with other NSAIDs, Arcoxia is expensive.

It should be noted that in addition to the medications described above, you can also find combination medications in the pharmacy chain, that is, containing NSAIDs and other substances. For example, Neurodiclovit. It contains Diclofenac and B vitamins, which are so necessary for the peripheral nervous system. The drug is used for osteochondrosis of the spine with radicular syndrome.

Thus, NSAIDs are used quite actively in neurological practice. And there are a large number of them. All of them are sold without a prescription. Like any other medications, NSAIDs should not be taken uncontrolled. A one-time appointment is possible without a doctor’s prescription, but if they are needed for systematic treatment, then you cannot do without a certified specialist. We hope that this article has helped you understand a little about the use of NSAIDs in neurology.

In the treatment of pain caused by pinched nerve roots as a result of muscle spasms, various diseases of the spine, stressful situations, hypothermia, hernial protrusions, tumors, medications for neuralgia are prescribed. Their list includes various groups of pharmaceuticals characterized by a wide spectrum of action.

Neuralgia is a serious disease that requires timely treatment when the first signs of a painful attack appear. Timely seeking help from a qualified specialist provides an opportunity to avoid aggravation of the situation, difficulty breathing, clouding of consciousness, and the development of complications.

Drug therapy is in first place in the treatment regimen for acute pain attacks caused by pinched nerve endings in various areas of the human body. Prescribing medications for neuralgia involves achieving certain goals. These include:

reducing the intensity of pain caused by pinched nerve roots;
adjustment of treatment after the removal of combat syndrome, aimed at improving metabolic processes in nerve fibers;
achieving anti-inflammatory, stabilizing, analgesic, sedative, analgesic effect;
strengthening the immune system, which determines the protective functions of the human body;
restoration of the activity of nerve endings after relief of pain, their stimulation
preventing relapse of neuralgia;
increasing the content of vitamins, minerals, microelements in the patient’s body.

Strict adherence to the recommendations and prescriptions of the attending physician is an important condition for achieving positive results when diagnosing neuralgia. Independent choice of tablets and other forms of medications to relieve pain can cause a deterioration in the patient’s health and the development of complications caused by side effects from the medications taken.

Various forms of medications are used to treat neuralgia. Their list includes: tablets, capsules, emulsions, ointments, gels, injections. Proper administration of drug therapy involves strict adherence to the doses and frequency of medication prescribed by a neurologist.

Analgesics to eliminate neuralgia

To effectively solve the problem of pinched nerve roots in different areas of the human body, different groups of pharmacological agents are intended, which differ in their multidirectional action, properties, speed of action on the source of inflammation, and side effects. What medications to take for neuralgia are determined only by the attending physician. The results of diagnostic measures form the basis for their choice. Among the common components of pharmacotherapy that successfully eliminate the manifestations of a pathological condition, as well as effectively eliminate the main causes of its development, it is necessary to note analgesics, which are painkillers. Their action is aimed at relieving painful neuralgic syndrome caused by pinched nerve roots.

Painkillers are available in the form of tablets, capsules, creamy substances, ointments, gels, and injection ampoules. A variety of analgesics provide the opportunity to use them externally, orally or as intramuscular injections. The most popular analgesics include: Sedalgin, Baralgin, Spazmalgon, Analgin, Tempalgin, Bral. The use of novocaine and lidocaine blockades allows you to eliminate acute pain that cannot be treated with tablets and topical agents. Painkillers are recommended to be used for 3-4 days. Longer use of analgesics can lead to inflammation of the gastrointestinal tract.

NSAID medications

Pharmacy products NSAIDs are non-steroidal drugs characterized by a pronounced anti-inflammatory effect. With their help, it is possible to localize neuralgic syndrome, reduce the intensity of pain and attacks, and significantly improve the general condition of patients faced with a disease of the nervous system. Such properties of NSAID drugs, which have the ability to influence not only the inflammatory process, but also the thermal state of the sick person’s body, pain, play an important role in the treatment of pathology.

Drug therapy for neuralgia involves the use of a wide range of medications of this type. The most common of them include: Diclofenac, Ortofen, Ibuprofen, Ketoprofen, Piroxekam, Voltaren, Indomethacin. Such drugs and their analogues are available in the form of tablets and capsules. It is recommended to take them no more than 1-2 times a day. It is strictly forbidden to exceed the dosage prescribed by your doctor. Ignoring the recommendations of a neurologist can lead to the development of diseases of the gastrointestinal tract, including ulcerative conditions of the mucous membranes of the stomach and duodenum, gastritis and other pathologies. The course of drug therapy based on non-steroidal anti-inflammatory drugs is 5-7 days.

In addition to the form of tablets and capsules, NSAID drugs are available in the form of rectal suppositories and injections. Ointments, creams, gels, and special patches are produced for external use. These include Diprilif, Voltaren, Ketonal, Nise, Diclofenac and other analogues with a similar composition. When using NSAIDs for external use, it is recommended to handle them carefully, carefully rubbing them into areas of pain, excluding pressing and massaging the inflamed areas. Special patches, which include Ketonal Thermo, are considered a modern alternative to applications with ointments, creams, and gels.

Muscle relaxants, vitamin complexes, neuroprotectors

When diagnosing neuralgia, medications intended to relieve muscle spasms play an important role in drug therapy. They are called muscle relaxants. Their use makes it possible to achieve positive results, significantly reduce the intensity of pain due to relaxation of muscle fibers and reduce the amount of pressure on the affected nerve process, as well as alleviate the patient’s condition. The list of popular muscle relaxants includes: Clonazepam, Baclofen, Sirdalud, Mydocalm, Tizanidine. The treatment course is prescribed by the attending physician.

Complexes based on B vitamins are designed to replenish their deficiency in the patient’s body and effectively combat the inflammatory process. The purpose of neuroprotectors is due to their ability to improve and normalize metabolic processes in brain tissue and the peripheral nervous system. Their list includes: Mexidol, Actovegin, Milgama, Neurobion. In addition to the above drugs

Ointments based on bee or snake venom, as well as pepper patches, the use of which can produce excellent results, deserve the attention and praise of patients.

Drug treatment of pathology with strict adherence to the recommendations and doctor’s prescriptions is the key to a successful solution to the problem of pinched nerve roots, acute pain syndrome, and also to avoid relapse.

Unfortunately, an increasing number of diseases, especially in older people, are associated with impaired blood circulation in the brain. This kind of problem entails a lot of negative consequences, including loss of the ability to move, speak and think, and often leads to death. It is incredibly difficult to see a loved one in such a state. However, any negative consequences can be avoided or at least slowed down the development of the disease, preventing it from getting worse, by promptly contacting a competent specialist who can select the appropriate treatment. Increasingly, in such cases, vasoactive drugs are used in neurology (a list of drugs that belong to this group will be given later in the article). The use of this type of remedy in most cases gives positive results, provided that the remedy is selected correctly and all recommendations of the attending physician are carefully followed.

However, you should not rush to agree to any treatment prescribed to you. First you need to ask yourself a number of questions. For example, vasoactive drugs: what are they? In what cases are they applicable? What are the benefits of vasoactive drugs? Classification of these substances? What are the contraindications to their use? Do they cause adverse reactions? This article will help you understand all these and some other issues.

Vasoactive drugs

In neurology, specialized pharmacological substances are increasingly being used that significantly improve the blood supply to nerve cells. This, in turn, helps to accelerate a number of important metabolic processes, which effectively help restore the once lost properties of certain neurons. Vasoactive drugs are also used for osteochondrosis (thoracic, lumbar or cervical spine).

Classification

The means under consideration are actively used by modern specialists. Vasoactive drugs are usually divided into several separate groups:

Substances that improve blood supply to the nervous tissue of the brain by correcting the tone of blood vessels. Another name for them is myotropic antispasmodics.
Angioprotectors (vasoactive drugs that strengthen the walls of blood vessels).
Substances that influence metabolic processes in nervous tissue.
Vasoactive drugs that directly nourish nerve cells.
Neurotransmitter substances. This kind of means effectively establishes signal transmission between individual neurons and promotes the formation of new intercellular connections.

Vasoactive drugs are sometimes prescribed in groups in order to significantly speed up and enhance their effect. This is especially true for the treatment of serious diseases such as Alzheimer's disease or stroke.

Myotropic antispasmodics

Vasoactive drugs of this group actively affect the walls of blood vessels. These substances have another specific effect on the body. They also belong to the group of "vasoactive calcium antagonists". The drugs block calcium channels and effectively dilate blood vessels. Thus, the overall peripheral vascular resistance decreases. It is precisely because of this that vasoactive drugs play such an important role in neurology - they increase blood flow to the nervous tissue. This helps improve many conditions.

This group includes the following vasoactive drugs (list):

"No-Shpa."
"Cinnarizine".
"Galidor."
"Vincamine."
"Flunarizine".
"Diprofen".

Only a specialist can prescribe a specific medicine.

Agioprotectors

The group under consideration includes vasoactive drugs (the names of some of them will be given below), the main purpose of which is to strengthen blood vessels and protect their walls from mechanical damage by aggregated platelets or atherosclerotic plaques, reducing the level of potential blood clot formation. This effect is achieved by reducing the formation of coagulation factors.

This group includes the following vasoactive drugs (list):

"Alprostan".
"Parmidine."
"Xanthinol nicotinate."

Drugs that affect the metabolism of nervous tissue

This group of substances has a unique effect on the human body. Vasoactive drugs, the purpose of which is to accelerate the breakdown of glucose with the help of oxygen and enhance cellular energy processes, are included in the following list:

"Memoplant".
"Piracetam."
"Actovegin".
"Trental."
"Mexican".
"Cavinton".

Drugs that act as nutrients for nerve tissue

Nutrition of cells is necessary for their normal functioning. The following tools help to set up this process:

"Gliatilin".
"Cortexin".
"Succinic acid".
"Adenosine phosphate".
"Aspartic acid".

The main purpose of their use is to improve the transmission of nerve impulses and participation in metabolic processes.

Products containing neurotransmitters

Sometimes a special kind of vasoactive therapy is required. Drugs that are used to effectively establish synoptic connections during a stroke or delay the impulse include specialized substances - mediators. Such medicines include the following:

"Glycine".
"Gliatilin"
"Aminalon".

"Vinpocetine"

The drug contains the active ingredient of the same name. Other components are: ascorbic sorbitol, benzyl alcohol, water for injection, sodium metabisulfite. The drug is available in the form of a clear solution for infusion.

The drug in question should also be used with extreme caution in elderly patients, although there are no particular contraindications for them, since the active substance does not accumulate. Therefore, it can be safely used by those patients who suffer from kidney or liver diseases.

The main indications for the use of vasoactive drugs are the following: post-stroke condition, vascular dementia, cerebral atherosclerosis, vascular diseases of the choroid and retina (including thrombosis), hearing loss, toxic hearing damage, tinnitus, Meniere's disease.

The main contraindications to the use of the drug in question are the following: severe forms of arrhythmia, coronary heart disease, individual intolerance to vinpocetine, acute stage of hemorrhagic stroke.

The pharmacological drug should be used parenterally. You should be careful when using the drug when prescribing it to patients who suffer from bradycardia.

It is prohibited to use this substance during pregnancy and breastfeeding, as it penetrates the placenta. However, studies have not revealed any toxic effect on the embryo. The substance also passes into breast milk.

Research into whether the drug in question affects the ability to drive a personal car or any dangerous machinery has never been conducted before. However, it is important to consider that the occurrence of some adverse reactions from the nervous system is quite possible. This danger should not be underestimated.

It is important to use the medication in question exclusively for the treatment of adult patients. The infusion rate must be incredibly slow.

It is prohibited to use the drug subcutaneously, intramuscularly, or in concentrated form intravenously.

The initial working dose for an adult patient per day is twenty milligrams per five hundred milliliters of solution for infusion. The maximum dosage, in turn, is one milligram per kilogram of the patient’s body weight per day. However, such therapy should not last longer than three days. The total course of treatment should not exceed fourteen days.

After the expected clinical effect has been achieved, it is recommended to gradually reduce the dosage used and switch to using another form of release of the drug in question - tablets.

Vinpocetine should be taken with caution in patients suffering from impaired functioning of the kidneys and liver. However, the standard dosage can be used.

It is forbidden to use the drug for children.

The shelf life of the drug in question is four years. It is prohibited to use the product after the expiration date, as the substance loses its beneficial properties and can be dangerous for the patient.

"Sermion"

The proportions of the components included in the composition of the drug in question may differ slightly. As a rule, differences in composition depend on the form of release and the concentration of the main active ingredient.

So, the following distinctive features are distinguished:

The release form of the drug is tablets. The amount of nicergoline can be five, ten or thirty milligrams. In this case, additional substances such as calcium hydrogen phosphate dihydrate, sodium carboxymethylcellulose, and sodium stearate are used. Among other things, titanium dioxide, sucrose, talc, acacia resin, magnesium carbonate, rosin, yellow sunset, and sandarac resin are used in production.
Release form: powder, white porous mixture. Used for injection. In this case, the main active ingredient is nicergoline, and the excipients are purified water, lactose monohydrate, benzalkonium chloride, tartaric acid, sodium chloride.

The main purpose of the drug in question is to normalize blood circulation (peripheral and cerebral). Helps improve metabolic processes in the brain, as well as blood flow in this area. The drug effectively thins the blood and significantly reduces the number of platelets.

If therapy is carried out long enough, a decrease in the manifestations of behavioral disorders, as well as a significant improvement in general physical condition, become obvious.

The drug in question is absorbed in the gastrointestinal tract for a short time when taken orally. If we are talking about injection, then the rate of absorption doubles. The product can be used regardless of meals.

The maximum concentration of the drug in the blood is achieved four hours after oral administration and two hours after injection.

Mainly, the main active ingredient is excreted through urine. Only a small amount (about twenty percent) leaves the human body in feces. The patient is completely cleared of the drug in question within a period of seventy to one hundred hours. If the patient suffers from serious renal impairment, the elimination time may double.

This medicine passes into breast milk and is therefore not recommended for use during breastfeeding.

The drug dosage regimen should be drawn up exclusively by a specialist (your attending physician), who can correctly adjust it taking into account the form and severity of a particular disease. He also recommends whether you need to take pills or have injections.

The regimen for taking the drug in question may look like this:

If you have a malnutrition of the brain, have recently experienced a stroke, or have any vascular disorders, you should take ten milligram tablets three times a day for a period of three to five months.
If we are talking about vascular dementia, the drug is recommended to be used twice a day, thirty milligrams. The duration of therapy should be determined by a specialist, taking into account the individual characteristics of the patient.
If there are any circulatory disorders of other organs, you should take ten milligrams three times a day.
Ischemic stroke is a direct indication for parenteral administration of the drug in question. After the course of injections is completed, you should continue to take the medicine orally. The working dose should be individually prescribed by a specialist.

Indications for the use of "Sermione" are: hypertensive crisis, circulatory disorders of the extremities, cerebral circulatory disorders of various origins.

Contraindications to the use of the drug are the following: acute bradycardia, recent myocardial infarction, childhood, individual sensitivity to individual components of the drug, failure of orthostatic regulation, lack of isomaltase, internal bleeding, pregnancy, breastfeeding.

Patients who suffer from gout or hyperurecemia should be especially careful when taking the drug in question. In this case, therapy should take place exclusively under the constant supervision of the attending physician, who will be able to provide the necessary assistance and correctly adjust the treatment regimen.

Side effects from using the drug can be varied. For example, sometimes patients experience headaches or dizziness, sleep disturbances (either absolute insomnia or, on the contrary, excessive sleepiness), increased body temperature, metabolic disorders, decreased blood pressure, a sharp increase in the concentration of uric acid, allergic manifestations (rash, itching). ).

The substance should be stored in a dark, dry place at room temperature (tablets) or in the refrigerator (ampoules).

The permissible shelf life of the drug is three years. After this point it is prohibited to use it.

Generalization

Vasoactive drugs are a group of medicinal substances whose main pharmacological effect is to improve the blood supply to nerve tissue cells. This kind of means is widely used by specialists to combat serious diseases, in the process of rehabilitation after a recent heart attack or stroke. It is important to remember that the choice of a specific drug, determination of the appropriate dosage and development of a treatment regimen must be entrusted to a specialist. Just because a product helped someone you know doesn’t mean it will help you too. The attending physician will be able to competently take into account all existing individual characteristics. This treatment will be truly effective.

Don't forget about your health and the health of your loved ones. Listen to doctors' recommendations. And always be healthy!