Non-hormonal anti-inflammatory drugs (IVC II). All drugs in this group affect the activity of the enzyme system — cyclooxygenase or prostaglandino-synthetase, which are involved in the synthesis of prostaglandins from arachidonic acid. This causes their relatively close anti-inflammatory effect and common adverse reactions.
The experience of long-term use of NSAIDs is increasingly convincing that the final anti-inflammatory effect of all drugs is the same and it depends more on the dose of the drug than on its type. From this point of view, the main problem in the choice of drugs is currently related to its tolerance to the patient, which is very individual. The same facts determine the current position in the optimal set of NSAIDs, which is that there is probably no need for a wide variety of such drugs and their number at the physician’s disposal may be limited to 4-6 drugs. Ya. A. Sigidin, for example, believes that such drugs are: acetelsalicylic acid,
Brufen, Naproxin, Indomethacin (Metindol) and Voltaren. Finally, the above considerations allow us to recommend a certain tactic for prescribing NSAIDs, which is determined by the following two provisions. First – insufficient antiinflammatory effect uc n yaolzuemogo preparation with good tolerability for Kazan is at its destination more (1.5-2 times) cal-therapeutic dose.
The second is that the initial ineffectiveness of the drug (the first two weeks) does not always mean the absence of anti – inflammatory action in longer periods. In other words, the drug should not be rushed to be canceled if it is well tolerated and at an adequate dose, since with long-term administration it can be very effective.
Nevertheless, it is well known that different drugs in conventional doses have different effects on the majority of patients and are differently tolerated.
However, it should be emphasized once again that these data may not concern a specific patient, for example, it is quite possible that a particular patient will have a more pronounced anti-inflammatory effect aspirin, and a voltarenna will cause a side effect. In this regard, the task of the doctor in the treatment of UHA and RA is to select a helping drug for this patient.