Effective cure for headaches
Headache is the most common reasons that people turn to the experts. This symptom bothers people in case of 45 diseases. The frequency of occurrence of this symptom reaches 200 cases per 1000 inhabitants. Women are more likely to suffer migraine than men. However, 60% of people experiencing pain, are of working age. 20% of those headaches interfere with the ability to work and reduces the quality of life. Among children headache more worried about children of secondary school age (51%) than younger (39%).
The Group of nonsteroidal anti-inflammatory agents (or drugs) – NSAIDs for short (or NSAIDs).
They are often used in the relief of headache, for several reasons:
- a wide variety of drugs.
- Different forms of drugs (tablets, capsules, suppositories, ampoules for injection administration).
- Ability to take medicine for a headache at home.
Drugs are classified according to the structure:
- Salicylates are derivatives of salicylic acid: acetylsalicylic acid (aspirin).
- Oxicam – tenoxicam (examen), piroxicam (Potemin), lornoxicam (xefocam), meloxicam (Movalis).
- Metabolites phenylacetic acid, diclofenac (voltaren, ortofen).
- propionic acid Derivatives – naproxen (nalgesin), Ketoprofen (flomax).
- Alkaline – nabumeton (relafen).
- Sulfonamides – nimesulide (Nise), celecoxib (celebrex).
- Pyrazolones – Metamizole (baralgin, analginum), propifenazon (caffein).
- Antranilic – mefenamic acid (Genoa).
- Paraaminophenol – paracetamol, phenacetin (feedin).
- heteroarylboronic acid Derivatives – Ketorolac (Ketanov, Dolac).
NSAIDs act on COX (cyclooxygenase). There are two types (isomers) of this enzyme. COX-1 helps to regenerate the mucosa of the digestive tract, ensures the normal function of cells of the hematopoietic, respiratory and urinary systems.
Enzyme COX-2 contributes to the development of the inflammatory response (increases production of inflammatory agents, prostaglandins, thromboxanes, leukotrienes, etc.).
When a primary inhibition of the enzyme COX-1 often develop side effects of drugs. Effects on COX-2 contributes to the improved analgesic, antipyretic effects of drugs and minimizes side effects (the higher the degree of the impact of the drug on the enzyme COX-2, the higher the selectivity, in other words, these medicines are safe).
The Classification according to the degree of selectivity of drugs:
- Preferential effect on COX-1: Ketoprofen (Ketonal, flomax), indomethacin (indomethacin), diclofenac, ibuprofen (Nurofen).
- is Equal to the effect on enzymes COX-1 and 2: lornoxicam (xefocam).
- pre-Emptive suppression of COX-2: celecoxib (celebrex), rofecoxib (denebola), nimesulide (Nise), meloxicam (Movalis).
The Group of NSAIDs vary according to the severity of drug effects:
- Analgesic (painkilling): Ketorolac, Ketoprofen, diclofenac, Metamizole.
- anti-Inflammatory: indometacin.
- Antipyretic: paracetamol.
- Antiplatelet: aspirin.
Anti-migraine preferable to use drugs with the prevalence of analgesic effect.
Indications for use of NSAIDs:
- Pain syndrome of various origin (headache, toothache, articular, post-operative pain).
- musculoskeletal Diseases (rheumatism, arthritis, spondylitis, Reiter's syndrome, rheumatoid arthritis, osteoarthritis, myositis, tenosynovitis).
- Neurological diseases (sciatica, lumbago).
- Colic (hepatic and renal).
- Prevention of thrombosis.
With a strong pain syndrome is sometimes not possible to quickly relieve pain by using medications containing one active ingredient (so-called monotherapy). This is due to different pathophysiological mechanisms of pain in the patient. Increase the dosage of the drug the emergence of dangerous side effects that depend on dosage of the drug.
In this situation, an effective combination of headache tablets, which contain several active substances. These components affect different patterns of pathogenesis against pain. In addition, these combinations of components are better absorbed by the body, as into account all the peculiarities of pharmacokinetics and pharmacodynamics. Due to the high efficiency of these drugs, you can reduce the dosage, reducing it to a minimum.
Examples of combination analgesics:
- Caffetin (paracetamol + caffeine+ propyphenazone+ codeine phosphate).
- Pentalgin (Metamizole sodium + caffeine + naproxen, +phenobarbital + codeine).
- Solpadein (acetaminophen + codeine phosphate + caffeine).
Phenobarbital potentiates (enhances) the effect of analgesic. This substance in small doses has a mild sedative (hypnotic) effect, and also promotes muscle relaxation (myelomalacia).
Codeine works by affecting the opiate receptors. In small doses, has a sedative (sleeping pill) and analgesic (pain relieving) effect.
Caffeine helps in the absorption of the drug, making it possible to reduce the dosage of analgesic. In addition, caffeine has an affinity for specific (adenosine) receptors of brain cells, and contributes to the appearance of stimulatory effects (relief of tiredness, fatigue, sleepiness).
Can be used in case of pain syndrome of various origins:
- the migraine Attacks.
- Joint, toothache.
- Postoperative analgesia.
The Combination of analgesic and antispasmodic very successful, as the pain syndrome often appears due to spasm of the smooth muscle cells of brain vessels.
The Antispasmodic component acts on the muscular wall of the vessels. The point of application of this group of drugs is the fiber smooth-muscle cells. Under the influence of antispasmodic, smooth muscles relax, the diameter of the vessel increases. Improved blood circulation in tissues, normalization of the ratio inflow /outflow of the blood in the vessel.
The Combination of analgesic and antispasmodic promotes synergism (enhanced effects) of both components, allowing you to achieve the desired therapeutic effect in the home. This combination of ingredients helps to rid the person from the question of what to drink for a headache.
Examples of spasmolytics:
- no-spurgin (paracetamol+drotaverine hydrochloride).
- Spazmalgon (Metamizole sodium + pitofenone + fenpiverin).
- Andipal (Metamizole sodium + bendazol + papaverine + phenobarbital).
- Headaches of different origin, pain of vascular origin vascular spasm in the brain. In the classical migraine the use of these drugs is not recommended.
- Against other types of pain accompanied by spasm of smooth muscles.
Agonists alpha-adrenergic receptors
relief of migraine has to do with drugs headache from the group of ergotamine.
The substance is an agonist of alpha-adrenergic receptors located in blood vessels.
These drugs can be used against headache, caused by the paretic expansion of vessels with pathological stagnation of blood (discharge of blood from the arteries into the vein). This tool helps to increase the tone of blood vessels, blocks the pathological shunting, normalizes blood circulation.
Examples of mixtures
Kofetamin. (ergotamine + caffeine), which is used in:
- Migraine (vazopressina form).
Selective agonists of serotonin receptors
This group of drugs is the chemical derivative of hydroxytriptamine (triptana). They act on receptors located on the vascular wall, cause narrowing of the dilated vessels. The drug has a selective effect on blood vessels localized in the meninges, thus affect the vessels of the heart and peripheral circulation. Another effect of the drugs is to block the pain impulses at the level of the trigeminal nuclei. This is due to a decrease in pain.
Representatives of this group of medications:
- Zomig (zolmitriptan).
- Relpax (eletriptan).
Can be Used when migraine attacks medium and high intensity.
The following is a list of drugs (trade names) often used in the treatment of headache.
|drugs||the name of the drug (active substance)||Side effects of||Contraindications||Dosage, dosing frequency|
|NSAIDs||"Nalgesin" (naproxen sodium)||Nausea, flatulence, nasal lesions of the digestive tract (before bleeding), different allergic reactions, hearing loss, dizziness, anaemia.||Ulcers and erosions of the gastrointestinal tract, hepatitis, cardiovascular disease, renal failure, hypersensitivity to the drug.||1 tab. (275 mg) over 8-12 hours. To take a maximum of 3 PL./day|
|"Nise" (nimesulide)||Lesions of the gastrointestinal mucosa, toxic effects on the liver, dizziness, allergic reactions (bronchospasm, skin rash, possible anaphylactic shock), anemia (until the lack of blood).||Damage to mucosa of digestive tract, severe disease of the hepatobiliary and urinary systems, increased susceptibility to medication, skin diseases (dermatoses), pregnancy and lactation.|
|"Xefocam" (lornoxicam)||epigastric Pain, nausea, bloating, damage to the mucous of the digestive system, stomatitis, hepatitis, severe violations of the liver, pancreatitis, Allergy (skin rash, rhinitis, fever). Weakness, dizziness, loss of sleep, suppression of hematopoiesis (leukopenia and thrombocytopenia), reduced clotting ability of blood (bleeding), high blood pressure, heart palpitations, nephrotoxicity, nephritis.||Violation of coagulative ability of blood, ulcerative and erosive diseases of the digestive system, colitis, severe insufficiency of liver and kidney damage, dehydration, asthma, pregnancy, breastfeeding, hypersensitivity to the components of the drug, failure of the heart.||4-8 mg with a multiplicity of 4 hours, maximum dose per day is 16 mg.|
|"Ketonal" (Ketoprofen)||Dyspeptic symptoms, diarrhea, vomiting, possible bleeding from the digestive tract, dizziness, drowsiness, the appearance of Allergy to the drug (rashes on skin).||Erosion and ulcers gastrointestinal tract (especially in the acute stage), impaired liver function and kidney function, anemia, impaired clotting ability of blood, high susceptibility to this drug.||1 caps. 2-3 R/day. The limit is 300 mg/day.|
|Analgin (Metamizole sodium)||Nausea, discomfort in the epigastria, vomiting, possible ulceration of the gastrointestinal tract, dizziness, decreased performance fatigue, blurred vision, angina, syncope, feeling of increased heart rate, impaired hematopoiesis, nephrotoxicity, hepatotoxicity, allergic to the drug (dermatitis, angioedema, possible anaphylactic shock, Lyell's syndrome, bronchospasm).||Decompensate diseases of buds, liver failure; Diseases associated with bronhoobstrukcia (COPD, asthma), suppression of bone marrow, disease of the inner ear inflammation of the optic nerve, hemolytic anemia hereditary origins, individual susceptibility to the drug, pregnancy and lactation.||1 table. 1-3 p/day. Do not take more than 3 days.|
|Combined analgesics||"Kaffetin" (paracetamol + caffeine+ propyphenazone+ codeine)||Suppression of bone marrow hematopoiesis, increased activity of transaminases, nausea, epigastric discomfort, increased excitability, dermatitis, angioedema, pruritus.||Insomnia, impaired hematopoiesis, atherosclerosis of the coronary vessels, decompensation of kidney disease and the liver, heart failure, increased susceptibility of the organism to the medication, does not exclude the influence on the fetus during pregnancy.||1 tab. with frequency of 3-4 times/day, take a maximum of 6 tables. Per day|
|"Pentalgin" (Metamizole sodium + caffeine + naproxen + pentobarbital + codeine)||Dyspepsia, loss of appetite, damage to the mucous membrane of the digestive system to ulcer formation, suppression of bone marrow function, skin reactions (urticaria), tachycardia, drowsiness, ringing in the ears, dizziness, hepato - and nephrotoxicity||erosive and Ulcerative processes in the gastrointestinal tract, diseases of the hepatobiliary, urinary and cardiovascular systems in the stage of decompensation, high sensitivity of the organism to the drug with caution during pregnancy, increased intracranial pressure, infarction, a violation of hematopoiesis.||1 table. 1-3 times/day, the dose is per day up to 4 table.|
|"Solpadein" (paracetamol + codeine + caffeine)||Dyspepsia, impaired renal function, toxic necrolysis, erythema (syndrome Stevens-Johnson), anaphylactic shock, hearing loss, erosions and ulcers of the stomach and duodenum.||Hemophilia, hypertension, hypersensitivity to drug, glaucoma, damage to the mucous of the digestive system, liver and kidney failure, predisposition to bleeding, it is possible the impact on the fetus.||1 tab. with an interval of 4-6 hours. The maximum dose of 8 tab./day|
|Spasmolytic||"But-salgin" (paracetamol+ drotaverine)||Syncopal status, reduction of pressure, rapid heartbeat, hot flashes, depression blood disorders (thrombocytopenia, agranulocytosis), spasm of the respiratory tracts, skin rash, swelling of the nasal cavity.||Violation of liver function, worsening of conduction (AV block 2 and 3 degrees, heart failure, conditions accompanied by spasm of the bronchi, head injury, pregnancy, lactation, increased intracranial pressure, drug addiction, alcoholism, taking drugs from the group of MAO inhibitors, hypersensitivity to the components of the drug.||table 1-2. (once). A maximum of 4 tabl./day|
|"Spazmalgon" (Metamizole + pitofenone + fenpiverin)||kidney dysfunction (nephritis, urine may be red hue, the appearance in the urine protein), suppression of hematopoiesis, allergic manifestations (rash, itching of the skin, Lyell's syndrome, Stevens-Johnson, angioedema).||Individual susceptibility to the drugileus, glaucoma (closed angle), prostatic hyperplasia, cardiac arrhythmia (tachyarrhythmia), diseases of the excretory system in decompensation, liver failure, megacolon.||On the table 1-2. At intervals 2-3 times/day. Not to exceed limit 6 table. A day.|
|"Andipal" (Metamizole + bendazol + papaverine + phenobarbital)||Flatulence, vomiting, constipation, impaired hematopoiesis, skin rashes, itching, possible anaphylaxis, sedation (due to phenobarbital).||the Violation of atrioventricular conduction. The impaired liver, severe kidney disease, suppression of hematopoiesis, 1st trimester of pregnancy, lactation, myasthenia gravis, porphyria, high sensitivity to the drug.||On the table 1-2. with frequency of 2-3 times/day.|
|alpha-blockers Drugs ergotamine||"Kofetamin." (ergotamine + caffeine)||Fainting, tinnitus, anxiety, increased heart rate, pain in the projection of the heart, vomiting, diarrhea, nausea, allergic reactions (skin rash), weakness in the lower extremities.||Hypersensitivity to medication, severe heart diseases, it is dangerous in pregnancy, causes contraction of the muscular fibres of the uterus, and lactation, hypertension of the 3rd degree, widespread atherosclerosis, peripheral circulatory disorders.||1 tab. At intervals of 12 hours, maximum dose per day - 4 table.|
|Selective agonists of serotonin receptors (triptana)||"Zomig" (zolmitriptan)||Dry mouth, drowsiness, muscle weakness, dizziness, muscle pain, a sense "tingling" in my limbs.||Individual susceptibility to the drug, high blood pressure, rhythm disturbance of the heart. Not exclude the influence on the fetus.||1 tab. (2.5 mg) with 4-6 times magnification. Limit daily intake to no more than 25 mg.|
|"Rolex" (eletriptan)||feeling a "tightness" in my throat, pharyngitis, bronchial asthma, emotional excitability, feelings of euphoria, change in voice, eye pain, ringing in the ears, palpitations, tachycardia, constipation, hot flashes, increased pressure.||Renal failure, severe liver disease, poor circulation of cerebral ischemic attacks in the anamnesis, hereditary lactose intolerance, hypersensitivity to the drug, ischemic heart disease, arterial hypertension.||1 table. (40 mg) every 8-12 hours. The limit is 160 mg per day.|
the Concept aboutuse pain
The Availability of most drugs, as well as the possibility of their acquiring over-the-counter and uncontrolled reception, led to the emergence of the so-called aboutuse (or medicinal) pain.
With long-term use of medicines with neglect permitted dosages appears one of the side effects – headache, which is considered aboutuse.
The circle is complete. The patient takes medication against migraine – exceeds dosage and dosing frequency, accumulates the excess concentration of the drug causing side effects is a headache.
To treat this type of migraine need to stop taking the medicine or reduce its dosage. Be sure to consult your doctor for examination of the causes of headaches. Based on these data, the doctor will prescribe drugs for headaches, what you need and will give recommendations on application rules.
Headache significantly affects the quality of life, reduces work capacity. To ensure you can pick up some headache pills, which quickly docked pain syndrome. There is a huge choice of drugs for the treatment of migraine, but the effect is fundamentally different, the impact is on different pathogenetic mechanisms of pain.
for Example, drugs from the group of spasmolytics and agonists alpha-adrenoceptor antagonistic effect on the vascular wall. The first group promotes vasodilation in their spasm, and the second, on the contrary, eliminates pathological paresis (extension) of the vascular wall, increases the tone of blood vessels. For this reason, the medication can increase pain.
In addition, incorrect choice of dosage and frequency of administration can lead to the emergence of drug headache. You will not be able to choose the best remedy for headache. Therefore it is important to consult a doctor to identify the causes of pain. Correctly matched therapy can effectively relieve headache and to avoid chronicity.
- Headache in General practice. Y. E. Azimova, V. V. Osipov, sbei HPE First MSMU n. A. I. M. Sechenov of rmph, Moscow Magazine "doctor", No. 5, 2014.
- Headache, Stem V. N., 2007
- Treatment of headache. M. A. Wayne, E. G. Filatova, MMA. N. M. Sechenov, Moscow Magazine "doctor", No. 4, 2003.
- on the main page. Drugs in Russia, 2012
- Pharmacology and pharmacotherapy, Osichkina L. (head “NSAIDs”).