Tsis-narcotic thiab narcotic analgesics: mechanism ntawm qhov kev txiav txim thiab daim ntawv thov

Analgesics - qhov no txhais tau tias tsis muaj zog los yog tshem tawm cov nov ntawm nqaij tawv ntawm mob thaum tswj nco qab thiab lwm yam rhiab hom. Physiologically mob tshwm sim raws li ib tug tshwm sim ntawm excitation thiaj hu ua nociceptors, uas yog ib ncig ntawm daim tawv nqaij, txheej week thiab serous week, thiab nyob rau hauv lub thickness ntawm ntau yam nruab nrog cev thiab tshuab. Mob receptors yog zoo siab heev ntawm lub cev (mechanical, thermal, hluav taws xob, thiab lwm yam) thiab exogenous tshuaj (acids, bases, hnyav hlau salts, phenol, thiab lwm yam) thiab endogenous yam protein xwm (histamine, serotonin, bradykinin).

Yog li, tus mob yog ib tug muaj sia mechanism ntawm subjective ces ntawm ib tug tsis txaus nyob rau hauv lub cev, yog li ntawd, yog kev tiv thaiv. Tab sis tsis tshua muaj zog thiab kav ntev mob yog pathological, raws li nws depletes lub cev, cuam tshuam nrog cov kev ua ntawm kabmob tseem ceeb heev thiab muaj peev xwm txawm ua rau tuag ntawm kev poob siab. Los ntawm no seem yus pom, cov pab pawg neeg analgesics yog ntawm kuj zoo kawg tswv yim muaj nuj nqis, thiab keeb kwm yog ib tug tseem ceeb kev kawm tau ntawm noob neej.

Txo los yog cheem lub mob yuav ua tau ntau txoj kev. Qhov zoo tshaj thiab radical - yog los tshem tawm qhov ua rau, uas, Tu siab, tsis yog ib txwm ua tau, vim hais tias muaj tsis yeej ib txwm muaj peev xwm mus sai sai qhia nws. Yog li ntawd feem ntau nws muaj los mus ib ntus deaden mob siv medicaments ntawm ntau yam pharmacological pawg. Rau lub hom phiaj no yog ib tug muaj peev xwm siv yeeb tshuaj, lub zos ua kom loog, cholinolytic, spasmolytics, anticonvulsants, astringents, enveloping txhais tau tias.

Qhov xwm ntawm lub hauv paus poob siab system, lub keeb kwm thiab tshuaj xwm ntawm lub analgesics raug muab faib ua ob pawg: narcotic thiab uas tsis yog-narcotic.

Narcotic analgesics - yog opium thiab cov tshuaj uas muaj ib tug zoo li cov nyhuv. Lawv tsiag ntawv, saum toj no tag nrho, ib tug peculiar ntxim rau cov central lub paj hlwb. Muaj ib tug analgesic nyhuv, tshwj xeeb tshaj yog nyob rau hauv tus neeg mob uas tsis yog-inflammatory (thaum tseem ceeb poob plig, malignant qog). Opioids ua dua thawj coj nyob rau hauv cov neeg mob uas puas siab puas ntsws thiab lub cev nyob tos. Tshuaj nyob rau hauv pab pawg neeg no muaj zog mob pib rhiab heev. Tej cov kws kho mob muab cov tshuaj analgesics nyob rau mob heev nyob rau hauv lub xub ntiag ntawm kub nyhiab, raug mob, thiab lwm yam Tsis tas li ntawd, cov tshuaj yog tshuaj rau cov neeg mob nrog unresectable phem neoplasms. Narcotic analgesics pab txhawb lub hlwb lub xeev ntawm cov neeg mob. Cov tshuaj yuav tsum tsis txhob siv ntau tshaj peb los yog plaub hnub, txwv tsis pub muaj yog hom, thiab cov neeg ua addicted.

Narcotic analgesics (opium) muaj ntau tshaj li 30 alkaloids thiab lwm yam, uas muaj xws li carbohydrates, cov nqaijrog, lipids, hnoos qeev, mineral ntsev, etc. Opium muaj ntau morphine (txog 12%), narcotine (10%), codeine (3-5%) thiab papeverina (1%).

Narcotic analgesics: nrov tshaj plaws tshuaj

Ntawm cov narcotic nyhuv txhais tau tias cov tseem ceeb tshaj plaws yog morphine hydrochloride, codeine phosphate, opium extract qhuav, ethylmorphine hydrochloride (dionin), tincture ntawm opium yooj yim, promedol, omnopon li al.

Tsis-narcotic analgesics - yog qhov nyiaj uas nws muaj analgesic, thiab antipyretic nyhuv antivovospalitelnoe. Tsis zoo li cov tshuaj, lawv kom tsis txhob los pab mob txuam nrog inflammatory dab nyob rau hauv cov pob qij txha, pob txha, cov nqaij leeg thiab lwm yam ntaub so ntswg (neuralgia, npag thiab articular bli, rheumatic, kho hniav txhab, thiab lwm yam). Qhov no qhia tau hais tias lub hauv paus kev ua kom loog yog ib tug anti-inflammatory nyhuv. Nyob rau hauv tas li ntawd, tsis yog-narcotic analgesics tsis ua hypnotic nyhuv thiab zoo siab, tsis txhob suppress hnoos, thiab ua pa chaw zov me nyuam.

Ntawm kuj zoo kawg tswv yim tseem ceeb yog lub antipyretic nyhuv uas tsis yog-narcotic analgesics. Nws yog lub npe hu hais tias lub cev kub nce nyob rau hauv cov kab mob vim qhov kev txiav txim ntawm pyrogenic tshuaj (cov khoom ntawm protein hydrolysates, amino acids, nucleic acids, microbial toxins, thiab lwm yam) rau interoreceptors uas kis excitation mus rau lub thermoregulatory chaw. Pog thermoregulation chaw, hloov cov kev siv ntawm tshav kub lawm thiab tshav kub hloov lwm lub tsev dab, yeej txhawb lub cev hyperthermia muaj ib qho tseem ceeb tiv thaiv. Txawm li cas los, nyob rau hauv tej rooj plaub hyperthermia yuav mus txog ib tug txaus ntshai theem rau lub neej ntawm lub cev, thiab kev tiv thaiv ntawm nws tus cwj pwm dhau mus ua pathological. Nyob rau hauv xws li mob nws yog advisable siv antipyretics.

Tsis-narcotic analgesics: kev faib

Xav tshuaj qauv ntawm cov tshuaj, lawv muab faib ua ob peb pab neeg: cov derivatives ntawm salicylic acid (methyl salicylate, acetylsalicylic acid, los yog aspirin), pyrazolone (analgin, phenylbutazone, phenazone), para-aminophenol (acetaminophen), indole acetic acids (indomethacin), propionic acid (naproxen, ketoprofen), anthranilic acids (mefenamic acid thiab flufenamic) pirrolizinkarboksilovoy acid (ketorolac).

Nyob rau hauv xyoo tsis ntev los, peb tau raug muab lwm pab pawg neeg ntawm painkillers - uas tsis yog-tshuaj analgesics. Cov feem nrov ntawm txoj kev no pab pawg neeg yog: piroxicam, diclofenac, indomethacin. Lawv mechanism ntawm qhov kev txiav txim yuav thaiv cov hlab lub synthesis ntawm cov enzyme - cyclooxygenase. Qhov no enzyme txhawb lub tsim ntawm prostaglandins - loj kev sib kho ntawm kev mob thiab inflammatory kev tig cev. Tsis tas li ntawd, cov nyiaj ntawm cov nyiaj no thaiv bradykinin, uas yog muab kev koom tes nyob rau hauv qhov tshwm sim thiab tis ntawm kev mob thiab o.