Вие сте в: Начало // Всички публикации, Научно-приложни статии // ?�?� ?? ??N�??N�???? ???�N?N�?�N�??????????N�?� ??N�??N�????????NS?�???�?�??N�?�?�???? N?N�?�??N?N�???�

?�?� ?? ??N�??N�???? ???�N?N�?�N�??????????N�?� ??N�??N�????????NS?�???�?�??N�?�?�???? N?N�?�??N?N�???�

?�???�???�N�?� N?NS??NSN�N?N�???� N�?????�???� ??N� N??�????N�?? N�?�?�???�???� ???? ????N??�?�??????N? ??N? ??NSN�. ??N? ?� ???�?�?�?? ???????�?�?�N�?�?� ?�?� ???�N�?�N?N�????N�?? ???� ?�??????N�?�. ?z???�?�??N????�???�N�?? ?? ?� ??N??????????� ?�?�???�N�?� ???� ?�?�N�?�?????�N�?? ??N� ??N�?�??????N?N�N�?� ???? ???�N??? ??????. ?�???�N�??N?N� ?�?�N�??N�?�?� ?� ?�???� N�???�??, ??????N�?? e ?????�?�?�???�???�?� ?�???�???�N�?� ???� N???????N�?� ???�N�???�??N�??.

?�???�N? ??N� N�N�??????N�???� ??N?N???N??�????-N????�?�?�N�???� ?�???�???� N?N�N�?�???�N� ???????�?? 100 ???�??. ?�??N�?????�??N�??.

?�???�???�N�?�, ??N�?????�?�???�?�N�?� ??N� ??N?N?N�??N�?? ???� ??NS?�???�?�?�?????�, ?� ???�???�N?N�???� ???�N�?? ????N�??N�?�??N�???????� ?�???�???�.

?�???�???�N�?� N? ??N�?????�N�???? ??N� ???�N�?????�N�?� N???N?N�?�???� – N�?�??N�N�?�?�???� ???�?? ???�N�??N�?�N�???�, N??� ???�N�??N�?� ???�??N�?????�N�???� /???�??N�?????�N�??N�???�/ ?�???�???�.

????N�??N�?�??N�????????N�?� ?? ???�??N�?????�N�??N�????N�?� ?????????????�??N�?? N�?�N?N�?? N??� ??N�????????N�?????�N�, ??N????�?�???? ??N�?? N?NSN?N�??N??????� ???� N�N�??????N�???� ?�???�???�, ???�?????�N�?? N?NS??NSN�N?N�???� N�?�?????�N�??N�????N�?� ?�?�?�???�N????�????N?.

??N�?�N�??N?N�?????�N�?� ???????�?�???�, N�?� ???�??-???�?????�?�???�????N�?� ???�???????�???�??N�?? ?�?� ??N?????N�?�???�N�?? ???� ?�???�???�N�?� ??N�?? N�?�?????�N�??N�???? ?�?�?�???�N????�????N? N??� ???�N?N�?�N�??????????N�?� ??N�??N�????????NS?�???�?�??N�?�?�???? N?N�?�??N?N�???� /?????Y?�??/. ?YN�??N�?????�N�?� ?�?� N???N�?????�N�?� ???? N?????N�N�?�?�?� ?� N????????�?�????N�?? N?NSN�?�N�?�?????� ???� N�N�?? ??N??????????? ?�N�?�??N�?�: ??N�??N�????????NS?�???�?�??N�?�?�?�??, ?�???�????N?N?????????N????�N� ?? N�?�?????�N�?�N�N?N�???????????�?�???�N�.

??N?N�??N�??N?N�?� ???� ?????Y?�?? ?�?�????N�???� ??N�?�?� 1899 ??. ?? ?�?�N�???�????N?, ???????�N�?? ?�?�?�????N? ????N�???�?? ??N� N�?�N�???�N�?�??N�??N�???�N�?� ?????????�????N? Bayer N?????N�?�?�??N�?� ??NSN�????N�?? ???�N?N�?�N�?????????? ??N�??N�????????NS?�???�?�??N�?�?�???? N?N�?�??N?N�???? Aspirin.

?zN�N�?????�???� N??� N?NS?�???�???�???? ???�?? 10 ??N�N????? ?????Y?�??, ??????N�?? N??� N? ???????�N�?� ??N� 50 N�?�?�?�??N�???? N�NSN�??????N????? ?????�???� ?? ?�?�?�???�N� N�?�N�??NSN�N�?? ??N?N?N�?? ???? ??N�?????�?�?�?? N??�?�?? ?�??N�???�????N�??N�??N�?�, N?NSN�???�N�????-N?NS????????N�?� ?? ??N???N�??N�N�????????N�?� ?�?�???�N�N?N�???�.

??N?N�?�???????�???? ?�, N�?� 30 ???�??. ??N?N??? ?????�?????? ???? N????�N�?� ??N�???�???�N� ?????Y?�??, N?NSN�?�N?N�???�???� N�?�N?N� ??N� ??????N�?? N??� ??N�?????�???�N� ?? ?�?�?� N�?�N�?�??N�?�.

?�??????N????? ?? N????�N�?� N??� N�?�?�?�???�??N�?�N� ???????�?? 470 ???�??. ??N�?�N???N�????N�???? ???� ?????Y?�??, ???�N�?? ??N� N�N?N� N??�???? ?? ?????� – 70 ???�??., ??NS?? ?�?�?�???????�N�??N�?�????N? – 20 ???�??., ?� ?? ?s?�???�???� a�� 10 ???�??. ??N�?�N???N�????N�????.

???�??-?????�N?????N�?? N�?�N�???�???????????�N�??N�???? ??N�?�????N?N�?�N?N�???? ???� ?????Y?�?? ?�, N�?� N??� ???�N�N�N??????�N� ?? ????????N�?�N�?? ???� ??NS?�???�?�?�?????�.

???�N�?�?????�??NSN� ???� N????????�?�????N�?? ???? ???�??N?N�?????� N�?�?�??N�?????� ??N�??N�. ?�?�???? ?�?�???? ??N� ?�?�?�???????�N�??N�?�????N? ??N�?�?� 1971 ??., ??????N�?? N?N?N�?�??????N????�, N�?� ?????Y?�?? ?�?�??????N�?�N� ?�N�?�??N�?� ???� ???�NZN�???? ?�???�????, ???�N�?�N�?�?? N�?????�??????N??????�???�?�?�, ?�?�?�???????�N�?�?????� ???� ??????N�?? ??N� ?�N�?�N�?????????????�N�?� ????N??�?�?????� ?? N�?????�N?????N? ??N�???�?????�NS?? N??� ??N�????N?N�??N�?�N� N�?�?�?�??N�???? ??N�??N?N�?�???�?�??????????, ??N�??N?N�?�N�?????�???? /Pg I2/ ?? N�N�?????�????N??�?? ??2.

O??N�?�???�?�?�???? ??N�??N?N�?�???�?�?????????? N??� ?? ??N????????�N�?� ???� ??NS?�???�?�?�?????�N�??, ?� ??N�N�?�?? N??� ??N�????NSN�, ?�???�???�N�?� ?? ????????N??�?????�N�?? ???� N�?�?????�N�?�N�N?N�?�N�?�. ?? ?�?�??????N�?�???�N�?? ???� N�?????�??????N??????�???�?�?�N�?� N??� ????N�??N????� ??N�????N???N�??N?N�?� ???� ??N�??N?N�?�???�?�??????????, ????N�?�???? ?????�N�?? ???�???�?�N????�N� N???????N�??????N�?� ???� ??NS?�???�?�?�?????�N�?? /calor, dolor, rubor, oedema, f. laesa/.

?�?� N�?????� N??????� ??N�??N�??N�???� ??N�??N�. ?�?�???? ?�?�???? ?????�N?N�?�???� ?????�?�?�?????� ???�??N�?�???� ?�?� ???�????N�?????� ??N�?�?� 1981 ??. ?? N�??N�?�?�N�?� N?NSN� ??N� ?�?????�????N????�N�?� ??N�?�?�??N�?�.

?????Y?�?? N??� ??N�???�?�???�N� ?�?� N???????N�?????�N�??N�???? ?�?�N�?�?????� ??N�?? N??�?�??????N�?� ?�?�?�???�N????�????N? ?? N?NSN?N�??N?????N?:

- ?zN?N�?�???�N�N�N�???�?�

- ?�NS?�???�?�??N�?�?�???? ?�N�N�N�?????�N�???? – N�?�?????�N�???????�?? ?????�???�N�N�N�??N�, ??N???N�???�N�??N�?�?? ?�N�N�N�??N�, ?�???�?�N?N� ???� ?�?�N�N�?�N�?�??, N�?�?�??N�???????? ?�N�N�N�??N�??

- ?Y?????�??N�?� ?? ??N??�?????????????�??N�?�

- ???�????N�NS???�???�?? N�?�?????�N�???�NS?? – ???�N�???�N�N�N�??N�??, N�?�??????????N�??, N�?�????N???????????N�??, ?�N?N�N???N�??, ????N??�N�N�????????N�?? ?? ??N�.

- ?�??N????�????N�?�N?

- ?�?�?�?????�???�???� ?? ??????N�?�???�

- ?Y??N?N�?????�N�?�N�???????� ?�???�???�

- ???�N�?�N?N�?�N�??N�???� ????N?N�???� ?�???�???�

- ?�?�???� ???? N????�N�?�???� ?�???�???� ??N�?? ??NS?�???�?�?�?????� ?? N�NS???�?????? ???�N�?�??N????�????N?

- ???�?????�N�?�N�N?N�???? N?NSN?N�??N?????N?

- ?�NS?�N�?�N�???� ?????�?????�

?Y?????�N�?�N�?? ?????Y?�?? N??� N??�?�?�?? ????N??�?�?????? /pH 3 a�� 5/. ???� N??� ?�?�N???N�?�??N�?�N� ?????�N�?� ??N� N?N�?????�N????�N�?� ?? ????N�?�N?N�?????�?�???�N�?� ??N??????�?�. ?� ???�?? 95% N??� N???NSN�?�???�N� N? ???�?�?�???�????N�?� ??N�??N�?�??????, ???�???????????�???? N? ?�?�?�N????????�. ?Y?????�N�?�N�?? N??� ???�N�?�?�???�???�??N�?�N� ?? N�?�N�????N? ??N�???� ???? ???�?�??N�???????? ???�N�?�?�???�??N�??, ??????N�?? N??� ?�??N???N�?�N�??N�?�N� N? N?N�?????�N�?�.

?????�N� N�?�?�?�??N�???? ??N�?�???� ???� ?????�N??�??????N�. ???�??N�?????�N� Ibuprofen, Ketoprofen ?? Diclofenac ?????�N� ??N�?�N�???? ??N�?�???� ???� ?????�N??�??????N� (1,1-2,1 N�?�N??�). ?z??N??????�????N�?� (Piroxicam, Tenoxicam, Meloxicam) ?????�N� ??NS?�NS?? ?????�N??�??????N� (20-60 N�?�N??�), ???�??N�?? ?? Naproxen (14 N�?�N??�).

???�?�??N�?� ?� ????N�?????�?? N????�N�?????�?? ??????N� N? N�?�?�?�??N�????N�?� ?????Y?�??. ?????�?? ??????N� ???????�???� ?? ???? ?????�?�???? N�?�?�??N�?�N�?????�????N? ????N�?�???? ??????????N�?? ???�?�?�?�?�???? ?�?�???�N�N?N�???�???? N�?�?�??N�????.

?zN????�?? ???? ????N????�??N???N?, ???�???�???�, ??????N�NSN�?�???�, ???�N�?�???� ?�?�?? ??N�NS?????�N�?� ????N?N�, ?�??N�?�N�?????�N�??N?, ?????�?????????�N�??N? ?????Y?�?? ??????N?N� ???? ?�??????N�???�?�N?N�N�?�N??�???�N�?? N?NSN?N�??N?????N? ???�N�??:

- ???�??N�??N�???� N??�???�;

- ???�N�N�??N�?�N�??N?;

- ???�N?N�N�N???N�??N?;

- ??NSN�???�???�;

- N??�???? ???� N�?�N�???�N�?�.

?� ?????� ???????�?? 8 ???�??. ?�???�???? ?????�?????? ??N�???�???�N� ?????Y?�??. ?zN� N�N?N� ????????N????? N??� N�??N?????N�?�?�???�??N�?�N� 107A�000 ???? ?????????? ???� ???�N?N�N�??????N�?�N?N�?????�?�???? N?N�N�?�????N�???? N????�?�????N?, ?� 16A�500 ????????N????? N?????N�?�N�.

?� N????�N�?� N?????N�N�?�?�?�N�?� ???� ?????Y?�?? A�N?N�N�N????� ????????N????? ???????�?? 100 N�???�N????? N�?????�N????? ?�??????N�?�.

?�N�?? ?�?�N�?? ??N�?�?� ????N??�?�??????N�?� ???????????? N??� ??N�???�?�N? ??N??� ????-?????�N????? ?????????�?????� ???� N?NS??N�????N??�?????�N�?? ?????�?�?�/N�??N???.

?s?????� ?� ???�?�??N�?� ????????N??�?? N�??N??? ??N� N?N�?????�N?????-N�N�?�?????? ???�?�?�?�?�???? ?�?�???�N�N?N�???�???? N�?�?�??N�?????

1. ?�NS?�N�?�N?N�???? ?�???�???? /???�?? 65 ??./ ?YN�?? N�N?N� ?�?????�????N�?�N�?� ???�N�NS??N????�, N?N�?????�N?????N?N� ??N�NS????N�???? ???�???�?�N????�, ??N???N?N?????-?�?????�N�?�?????�N�???�N�?� ?�?�N�???�N�?� ?� N??�?�?�?�. ???�?�?? ?�???�???? N??� N? 3 ??NSN�?? ????-?????�N??? N�??N??? ??N� N???N�?�???? ???� ???�N?N�N�??????N�?�N?N�?????�?�????N? N�N�?�??N� ??N� ??N?N�?�???�?�?�N�?� ??????N??�?�N�??N?.

2. ?�??N??????� ?????�?� ?????Y?�??

??N?N�?�???????�???? ?�, N�?� ????N??????�N�?� ?????�?� ???� ????????N??�???� N�?�N�?�???�??N�??N�????N? ?�N�?�??N�, ?� N??�???? N????�?�??N�?�???� N�??N????� ??N� N?N�N�?�????N�???? N????�?�????N?. ???????� ???�???�N�?�???�, N�?� ?�???? ???�???�?? ???�N?NS???�N�?�?�?�???? ????N??????� ?????�?�, ?�?�N?N�N�?�N??�???�???� ?�??????N�?� ???� ?�???�????N?.

3. ?s?????�??????N�?�???� ???� ?????Y?�?? - N�?????� ?� ???�??-N�?�N?N�?�N�?� N�?�N�?�???�??N�??N�???� ??N�?�N????�, ??????N?N????�???� ?? ?????�N? ??N� N??�???�??????N�?� ?�?�???�N�?? ?? N????�N�???�?�??N?N�??N�?�.

?zN????????�?? ??N�????N�???? ???� ??N�???�?�???�???�N�?? ???� ?????Y?�?? ?� ???z???z???�?�???Y????????. ???????� ???�???�N�?�???�, N�?� ?????�?�?? ???� ???�?�???�N�?�???�???� N??�???? ?�?????? ?????Y?�??. ?�?????�?�?�???? ?�, N�?� ???????�?????�N�??N?N�?� ???� ?????Y?�?? /???�??N�. Piroxicam ?? Diclofenac/ ???� N????�?�??N�?�???� N�?�N�?�???�??N�??N�????N? ???? ?�N�?�??N�, ???? ?�?� N????�N�???� ???� N�?????� ?? ??NSN�?? N????�?�??N�?�???� N�??N????� ??N� N?N??�???�???�????N?, ??N????�?�???? ??N� N?N�N�?�???� ???� ?�????.

4. ???�???�???� ?�???�?�N?N�, ?�???�?????�?�?� ?�?� N?N�?????�N??�?? ??N�NS???????�?�????

5. ?YN�????NS?�?�??N�?�?�???� N?????N�N�?�?�?� ???� ?????Y?�??

20-50% ??N� ?�???�????N�?� ???� ?????Y?�??-N�?�N�?�????N? N??� N? N�?�?�?�??N�???? N?N�?????�N????? ?�?�?�????, ???????�?�?�???? N�???�N�?????�N?N�N�??N???????N?????. ?�?�?????�N�??N�???? ?�???�????N�?� ??N�???�???�N� ?????Y?�?? N? ????????????.

6. ?�????????N�?�???�?????? ??N�???�???�?�?????� ???� ?????Y?�?? N? ????N�N�??????N?N�?�N�????????, ?�??N�???????�??N??�?�??N�?? ?? ??N�N????? ???�???????�???�??N�??, N???N�?�?�???�N�?? ?�?????�????N�?�N�?� ???� ?�????.

7. ??NZN�NZ??????N?N??�???�, ?�?�????N�???�???�NS??, ????N�?�??N�??N? N? Helicobacter pylori cialis bestellen schweiz, cialis bestellen schweiz, cialis bestellen schweiz, cialis bestellen schweiz, cialis bestellen schweiz, cialis bestellen schweiz. - N�?�?�?? ?�???�???? N??� N? 10 ??NSN�?? ????-?????�N??? N�??N??? ??N� N???N�?�???? ???� ?�????.

8. ?Y?�N�???�??N�?? ?? N???N�?�???�???? ???�N�?? N?NSN?N�??N??????�, N?NSN? N??�N�?????�???? N?NS??NSN�N?N�???�N�?? ?�?�?�???�N????�????N?.

?�N�N????? N??�N�?????�???? ???�?�?�?�?�???? ?�?�???�N�N?N�???�???? N�?�?�??N�???? ??N� N?????N�N�?�?�?�N�?� ???� ?????Y?�?? N??� ???�N�?????????�N???N??�?�N�????N�?� N?N??�???�???�????N?: ??N?N�NSN� ?????????�N�???�?? ????N�?�N�??N�, ?????�?�?�?????� N?NSN�???�N�???� N???NSN�N�, ?�N�N�?�N�???�?�???� N�?????�N�N�??????N?, ?�?�N?N�???????� N?NSN�???�N�???� ???�????N?N�?�N�NSN�????N?N�.

?YN�??N?N�?�???�?�??????????N�?� N�?�??N??�??N�?�N� ?�NS?�N�?�N�????N? ??N�NS????N�????, ???�?????�N�N??�???�N�?� N�???�N�N�?�N�??N?, ??N�???�?�N????�N�?? ???� N�?�??????, ??????????N? N�N�?�??N?????N�N� ??N�?�?� N�N??�N??�??N�?�, ?????????�N�?� ???�??N????�. ?�N�?? ?�?�N�?? ????N�??N????�???�N�?? ???� ??N�??N?N�?�???�?�?????????????�N�?� N?????N�?�?�?� ??N� ?????Y?�?? ???????? ?? ???? ?�NS?�N�?�N�???? N???N�?�????, ?? N�.N�. ???�???�N� ?? N�N??????? – ????N�?�N�N?N�??N�???�?�?�?? ???�N�N�??N�, ???�N�N�??N�??N�?�?? N???????N�????, ??N?N�N�?� ?�NS?�N�?�N�???� ???�????N?N�?�N�NSN�????N?N�, ???�??N??�???� ???�?????�N�N??�???� N�???�N�N�?�N�??N?, ???�?????�?�N�???� ???�??N�???�?�.

?�??N????????? N�?�??N�??N�?? ?�?� ???�N�N�??N�????N???N�????N?N� N??�: ??NS?�N�?�N?N� > 65 ??., ???�?�??N�???� ???� N�?????�N�N�??????N? ??/???�?? ?????????�N?N�???????� N?NSN�???�N�???� ???�????N?N�?�N�NSN�????N?N�, ??N�???�?? ???� ????N?N�?�N�??N�?? ?? ??CE ????N�???�??N�??N�??.

??N�?�N�?�N� N??� N?NSN�?? N�?�???� N�?�N�??????N�???�???? N?N??�???�???�????N? – ???�??-N�?�N?N�?? ?�?�?�???�N�??N? ???� N�?�N�??????N�???�????N�?� ?�???�?????? ?? ????-N�N??????? N�?�N�??????N�???�???� ???�????N?N�?�N�NSN�????N?N�.

?zN� ?????Y?�?? N??� ???�N�?�?????? ?? ?????�???? ?? ?�?�?�N�????N�???? N�?�?�??N�????.

?YN�?? ???�N�???�??N�?? N? ?�N?N�???� ???�N?N�?�N�??????????N�?� ?Y?�?? ???????�N� ???� ??N�??????????N�?�N� ?�N?N�???�N�??N�???? ??N�??N?N�NS????.

?YN�?? ?�???�???? ???� ?�??N�???????�??N??�?�??N�???� N�?�N�?�????N? N�??N???NSN� ??N� ??NSN�???�???� ?� ????N?????, ????N�?�???? ?????�N�?? N??� N??�?�???? N�?�????N?N�?�?�?�N�?� ?? N??� ????????N�??N�??N�?� N?N�N�?????? ?????�??N�?�???�N�?? ???�??N�?? ???� ???�N?N�?�N�??????????N�?? N?N�?�??N?N�????, N�?�???� ?? ???� ?�??N�???????�??N??�?�??N�?�.

?????Y?�?? N??� ??N�??N�?????????????�?�?�???? ??N�??:

- ?�N�?�???�??????N?N�, ??N????�?�???? ??N�?�?� N�N�?�N�??N�?? N�N�?????�N??�N�???�. ?�NS??N�?�???? N�?� ???� N??� ????N�?�??N�???? N�?�N�?�N�?????�????, N�?� ???????�N� ???� ???????�???�N� ???? ??N�?�?????�N�??N�?�?�???? ?�?�N�???�N�N????� ???� N�?�N�?�?�????N? ductus arteriosus ?? ???? ?�NS?�N�?�N�???? N???N�?�?�???�????N? ???� ???�?????�;

- ??NSN�???�???�;

- ?�??N�???????� N?N�?????�N????� / ??N??????�???�?�???� N??�???�;

- N�?�????N�?�????N�???� ?????�N�?�?�?�,N�?�????N�???�??N?;

- ???�??N�?�?????�?�?� N�?�N�??????N�???�???�, ?�NS?�N�?�N�???�, N?NSN�???�N�???� ???�????N?N�?�N�NSN�????N?N�.

?�N???N�???? N�?????� ???�?�?�???� ??N�?? ??N�?�??????N????�???� ???� ?????Y?�?? ?�?�???�N�N?N� ???� ????N??�?? ?�?�:

- N�?�N�?�???�??N�??N�???�N�?� ?�N�?�??N�????????N?N� ???� ???�???????�???�??N�?�;

- ??NS?�?????�????N�?� ???�?�?�?�?�???? ?�?�???�N�N?N�???�???? N�?�?�??N�????;

- N�?�???�N�?� ???� N�?�?�?? ???�?�?�?�?�???? ?�?�???�N�N?N�???�???? N�?�?�??N�????.

??N????�??N?N�?� ???� ???�N??�?�???????�N�?�?�??N�?� ?? N�?�N�???�N�?�??N�??N�????N�?� ?????????�?????? N??� ???�N???N�?�???? ??NS?? ??N�??N�?????�???� ???� ????-???�?�???? N�????N???N�???? ?? ?�??N�?�N????????? ?????Y?�??.

?�???�N??? ???�??N�?�??NS?? ?? N�?????� ??N�????N??�?????� ?� ??N�??N�??N�???�N�?? ??N�?�?� 1991 ??., N�?� N�?????�??????N??????�???�?�?�N�?� N?NSN�?�N?N�??N????� ?? ?????� ???�??N�??N�????-COX1 ?? COX2.

?�?????�??????N�????N�?� ?�N�?�??N�?? ???� COX1 N??� N???NSN�?�?�???? N? ??NS?�???�??N?N�?????� ???� N�???�?????�??????N�???? ??N�??N�?�N???, ?� ???� COX2 – N? ???�N�???�??????N�???? N�?�???????�.

COX1 N?N�????N??�??N�?� N?????N�?�?�?�N�?� ???� N�???�?????�??????N�????N�?� ??N�??N?N�?�???�?�?????????? – Pg I2-??N�??N?N�?�N�?????�????, PgE2 ?? ???� ??N�?????�????N??�?? ??2. ?z??N�?�???�?�N? N??� ???�N�?? a�???????N?N�??N�N?N�???????� COXa�?. ???�?�??N�?� ?� ?? ?�??N�?�????N�?� N�NS???�???? ?? ??N�???�???? – N?N�?????�N????� ??N??????�?�, ?�NS?�N�?�N�???? N�N??�N??�??, N?NS???????? ?�??????N�?�?�???? ???�?�N�????, N�N�?????�??N�??N�??.

PgE 2 ?? ?YN�??N?N�?�N�?????�???? ??????N?N� ???? ?�N�????N�???????�?�N�?�N�??N?, ??N�??N�?�??N�??N? ???� N?N�?????�N????�N�?� ?�?????�????N�?�, ???�?�???????�?�N�?�N�??N? ?? ?????????�N�N????�???� ???� ?�NS?�N�?�N�????N? ???�?�?�????N�????.

COX2 ???�??N�??N�???�N�?� ?� ??????N?N�??N�N??�???� ??N� N�?�?�?�??N�???? ???�N�?????�?????? N?N�????N??�?? /???�??-N�?�N?N�?? ??N� ??N�????NS?�???�?�??N�?�?�???? N�??N�??????????/ ?? ?�?�?�???????�N�?�?????� ???� ???�N? N??� N?????N�?�?�??N�?�N� N�.???�N�. ???�N�???�??????N�???? ??N�??N?N�?�???�?�??????????. ???????� ?� ??N�??N�?????�N�?� N�???�?? ?�???�???? ???� N??� o??N�?�???�?�N? ???�N�?? a�????�N�???�??????N�???� COXa�?.

?YN�?? ??NS?�???�?�?�?????� ??????N�?�??N�N�?�N�??N?N�?� ?? ???�N�?�N?N�???� ???? 80 ??NSN�?? ?? ????????N�?�N�?? ???� ??NS?�???�?�?�?????�N�??. ?Y?�N�???�??????N�????N�?� ??N�??N?N�?�???�?�?????????? ??????N?N� ???? N?????N�?�?� ???� ???�?????�N�??N�??N�?� ???� ?�???�???�N�?�, ??NS?�???�?�?�?????�N�?? ?? N�?�?????�N�?�N�N?N�?�N�?�. COX2 ?? N�?�?????? N??�N?N�?�?? ?????�?� ???� N??� ??N�??N�???� ?? ?�??N�?�???? ??N�???�???? – ??N�??N?N�?�N�?�, N�?�N?N�??N???, ???�N�???�, N???N�????N�??, ?�NS?�N�?�N�??, ????N?N�??, N�N�N?N�N??�?? ?? ?????�NS??, ??N??�?�??N?N�?????� ???� N�???�?????�??????N�???? N?N�????N??�??.

COX-??????N�?�??N�??N?N�?� ??N�?????�???? ????N�?�?????? ???�?�N???N�?????�N�??N?N�?� ???� ?????Y?�??, N�?�?�???�?�N??????? ???? ???� ?????� ??N??????????? ??N�N????? a�� ?????????�??N�???????�?�???? /???�N??�?�?�??N�????????/ ?????Y?�?? ?? COX2- ????N�???�??N�??N�??.

???�N??�?�?�??N�????????N�?� ?????Y?�?? ????N�??N????�N� ???�??N�?? COX1, N�?�???� ?? COX2 ???�??N�??N�???�N�?�.

?�N???N�???? ???�N??�?�?�??N�???????? ?????Y?�?? N??� N? ???????�?�?�???� ?�N�?�??N�????????N?N�, N? ????N????� N�?�???� – ????N�?�???? N?NSN�?�N?N�??N????�???�N�?? ???� ???�???�N�??N�???? ???�N�???�??N�??, N? N???N�?????? N�?�?�??N�??N?N�N�?�???�?????�.

?Y??N�??N????�???�N�?? ???� COX1 ???�??N�??N�???�N�?� ???�?�N�?� ?� ??N�??N�?????�N�?� ?�?� ?�?�??N??�?� ???� ??N�??N�?�??N�??N?N�?� ???� N?N�?????�N?????-N�N�?�?????�N�?� ?�?????�????N�?� ??N� PgI2 /??N�??N?N�?�N�?????�????/ ?? PgE2. ???????� N�?�?�N??�N�??N�?� ?? ????N????� ???� ???�N�?� N????????�???�N�??N�?� ????-????N�?� ???�N?N�?�N�?????????� ???�N?N�N�?????�N�??N?, ?�??N�?�N�?????�N�??N?, ?????�?????????�N�??N?. ????N�???�??N�?�???�N�?? ???� COX1 ???????? ??N�?� ???? N�?????�N�N�??????N?, ?�?�??N�NS?�???� ???� N�?�N�????N?N�??, ???�N�N�??N�????N???N�????N?N�, ?????????�N?N�???????� N?NSN�???�N�???� ???�????N?N�?�N�NSN�????N?N� ?? N?NSN�???�N�????-N?NS???????? N?N??�???�???�????N?, ???�???�N�?????????? ?� ????????N??�???? ?????????�?????� ??N�?? ???????�??????N�?�???� N? ?�??N�???????�??N??�?�??N�??.

???�N??�?�?�??N�????????N�?� ?????Y?�?? ?????�N� ?�??????N�??N�?�N� ?�N�?�??N� ??NSN�N�N? ???�N�????????N�??N�?�??N�????????N�?� N???????N?N�???� ???� Aspirin, ?????�N�?? ?�?�N�N�N?????N????� ?�?�N�?�?????�N�?? ???� ?�???�????, N?N�N�?�???�N�?? ?�????????N�?�???�?????? ??N� N?N�?�?????? ?? N?NSN�???�N�????-N?NS???????? ?�?�?�???�N????�???�.

?zN??????????? ??N�N????? ???�N??�?�?�??N�???????? ?????Y?�??:

1. ?s?�N�?�????N????�?????????? ????N??�?�??????:

- ???�?�??N�???�?�N�?? – Aspirin

- ??N�?�N�?????? ????N??�?�?????? a�� Diclofenac /Voltaren/, Indometacin, Sulindac, Tolmetin /Tolectin/

- ?�?�N�?????�N�?? ???� ??N�???????????????�N�?� ????N??�?�?????� a��?setoprofen /Profenid/, Ibuprofen, Naproxen

2. ?�?????�????o???? ????N??�?�??????:

- ?Y??N�?�?�???�?????????????? ???�N�?????�N�?? – Phenylbutazone

- ?z??N??????�???? – Piroxicam, Tenoxicam /Tilcotil/

?�???�N??? N?N????�N� ?? N�?�?�????N�???�N�?? ???� N?NS??N�?�???�?????�N�?� N�?�N�???�N�?�??N�??N�???� ???�N????� ?? ??????N?N?N�N�??N? ?� N?NS?�???�???�???�N�?? ???� COX2 ????N�???�??N�??N�??N�?�, ??????N�?? N?NSN�N�?�??N????�N� N�???�?????�??????N�????N?,?????�?�?�?�?? ???�???�???�???? COX1 ?? ????N�??N????�N� ???�N�???�??????N�????N? ???�???�???�???? COX2 ?? N???NSN�?�?�????N�?� N? ???�???? ???�N�???�??????N�???? ??N�??N�?�N???.

?�?�?�???????�N�?�?????� ???� N�N?N�???�N�?� N?????N�N�?�?�?� N??�N�?????�???? N??� N�?�??N?N�??N�?�???? ???�N?N�N�??????N�?�N?N�?????�?�????N�?� ?? ?�NS?�N�?�N�????N�?� N?N??�???�???�????N?. ?�??N???NSN� ??N� ???�?�?�?�?�???? ?�?�???�N�N?N�???�???? N�?�?�??N�???? ??N� N?N�N�?�???� ???� ?�???? ???�???�?�N????� N? 40%, ?� N�??N???NSN� ??N� ???�N?N�?�N�?????????� ?�??N�?�N�?????�N�??N? ???�???�?�N????� N? ?�?�???�?? 50%.

COX2 ????N�???�??N�??N�??N�?� N??�:

  1. ?YN�?�N�?�N�?�??N�???�?�???? COX2 ????N�???�??N�??N�??, ??????N�?? N??�???? ??NS?? ????N??????? ?????�?? ????N�???�??N�?�N� COX1: Meloxicam /Movalis/ ?? Nimezulide /Aulin/

Meloxicam /Movalis/ e N? ????N??????�N�?� ?�N�?�??N�????????N?N� ???� ???�N??�?�?�??N�????????N�?� ?????Y?�?? – Naproxen, Ibuprofen, Ketoprofen, Piroxicam, Diclofenac, ???? ?�?� N�?�?�?�?????� ??N� N�N?N� ?� N? ???????�?�?�???? ????N?NS?? N�??N??? ??N� ???�N?N�N�??????N�?�N?N�?????�?�????, ???�N�?????????�N???N??�?�N�????, N�N�?????�?�???�???�??N�????, N�?�N�??????N�???�????, ?�NS?�N�?�N�???? ?? ?????�???? N?N�N�?�????N�???? N????�?�????N?, ?????�N�?? ???? ??N�?�???? N? ???�??-?????�NSN� ??N�??N�???� ???� ?�?�?�?????�N?????N?N�.

Nimezulide/Aulin/ ?�NSN�?�?? ????N?N�?????� ?�N�?�??N�???????? ??????N�?�??N�N�?�N�???? ?? ???�?�?�???� ?? N????????????�?�???� N�?�N�????N?N�, ?????�N�?? ???????? ???? ?�N�?�??N�???????? ?�?�??????N�?�???� ???� COX2 ???�??N�??N�???�N�?�. ?????�?�???�N�??N�????N?N� ??N? ?�N�?�??N� ?????� ?????????? ????-?�NSN�?�?? ???�N�?�?�?? ?? N?N�?�?????�?????� N? ??N�N?????N�?� ?????Y?�??.

?�?????�?�?�???? ?�, N�?� COX2 ????N�???�??N�??N�??N�?� ???� ??N�?�N�?�N� ???� ???�N�????????N�??N�?�??N�????????N? ?�N�?�??N� ???� Aspirin.

  1. ???�?�?�??N�???????? COX2 ????N�???�??N�??N�??, ??????N�?? ???� ????N�???�??N�?�N� COX1:

- Celecoxib /Celebrex/, caps. 0.100

- Parecoxib /Dynastat/, amp. 0,040

- Arcoxia /Etoricoxib/, tb. 0,060; 0,090; 0,120

?�?�N�?� ?????� ???�??????N�???? ???�?????? ?? ?�??N????�N�?????�??N�?�?�???? N�?�?�N??�N�?�N�??, ??????N�?? ???? ???�???�N� ??N????????�?????� ???� ??N�?�???????�?�???�???�, N�?� COX2 N??�?�?�??N�????????N�?� ????N�???�??N�??N�?? ?????�N� ?�???�?�???�N�??N�?�?? ?�N�?�??N�, ??N�???�?�???? ??N� N�?�N�????N�?� ???�?�N???N�?�N????? ??N�??N�????????NS?�???�?�??N�?�?�???? N???????N?N�???�. ?s?�N�?? N???N�?????� ???�N�?�????N�??N? N�?� ???????�N� ???� ??N�????N?N�??N�?�N� N?????N? ?�???�?�???�N�??N�?�?? ?�N�?�??N�, ???�N�?? ???�??N?N�???�N� ?? ?????� N�?�?�?�??N�???? ???�N?N�?�:

- ?? ???�N�??N�?�N�??N?N�?�, ???�N�?? ?�?�??????N�?�N� ??N�??N?N�?�???�?�??????????N�?� ?? ??N?N?N�??N�?? ???� ??NS?�???�?�?�?????�N�?? (?????????�???? ???� ???�?�N???N�?�N?????N�?� ?????Y?�??);

- N�?�??N�N�?�?�????, ???�N�?? ?�?�??????N�?�N� ??N??????�???�???�???�???�N�?? ???� ??N�??N?N�?�???�?�?????????? ?? N�?�??N�N�?�?�???�N�?� ???�N�?????� N???N?N�?�???�.

??NS?? ???�N�?? N�?� ???� ???�?�?????????�??N?N�???�N� N? COX1, ?�????N????� ???????�??N????�???� ??NSN�N�N? N�N�?????�??N�??N�???�N�?� ?�??N�?�???�N�??N?, ????N�?�???? ?????�N�?? N??� N??????�???? ?�?� ??N�???�???�?�?????� ??N�?�???? ?????�N�?�N�???????� ????N�?�N�???�??N�??N?.

?�?�????N?N�N�??N�?�????N�?� ?? N�?�????N�?� ??N�??N?N�???�????N? N??�N?N�?�?? ???� ????????N??�?? N?NSN�???�N�????-N?NS?????? N�??N??? ???????�???� ???? ??N�N�?�???�N????�N�?? ??N� N????�N�????????N? N�?�N�???�N�?�??N�??N�?�?? ???�?�?�N� ???� rofecoxib /Vioxx/ ?? valdecoxib ??N�?�?� 2004 ??., ?� ??????N?N??�N�?�N�????????N?N� ????????N�?�N� ???� FDA ???�?�N?N????� ??N�??N�???? N�?�????N?N�N�?�N�??N?N�?� ???� etoricoxib ?�?� ?�?�N�?�?????�N�?? ???� OA.

Vioxx ?�?�N??� ???�N�?�???�?�?? ?? ??N� ?�NS?�???�N�N?????N? N�?�N�???�N�?�??N�??N�?�?? ???�?�?�N� ??N�?�?� 2004 ??.

?s?�?? N?N�???? ??NS??N�??N?NSN� N? Celecoxib?

O???�?�?� N??�,N�?� N?NSN�???�N�????-N?NS????????N?N� N�??N??? ??N�?? ???�????????N�?? ??N�???�???�?�?????� ?� N?N�?????�?? N? N�???�?? ???� ???�?�N???N�?�N?????N�?� ???�N?N�?�N�?????????? ?????Y?�?? ?? N??� ???�?�??N�?� ??N???N�???? ???�???�N�?????????? ???????�?�?�N�?�?�N?N�???� ?�?� ???�??????N�???�N�?� ?�N�?????�N?????N?N� ?? ????-?????�N�??N? ??N�??N�???� ???� ?�?�?�?????�N?????N?N� ?? N�?�???????????�??N�?�???? ???�??????N�???? ??N�??N?N�???�????N?,???�N�???�N�?�N�?? ???�?? 80A�000 ???�N�???�??N�?? ???? N????�N�?� .

?YN�??N?N�???�????N?N�?� A�N�?�?�??N�?????�N� ??N�?�????N?N�?�N?N�???�N�?� ???� ??N�????N???N�?� ??N�?�?? ???�?�N???N�?�N?????N�?� ?????Y?�?? ?? ???�?�????N?N�N�?� ??N? ??N�?? ?�?�N�?�?????�N�?? ???� ??N?N�?�???�N�N�N�???�?�N�?� ?? N�?�?????�N�??????????N? ?�N�N�N�??N� ??N�?? N??�?�??????N�?� ??N�N????? ???�N�???�??N�??:

- ????N???????N�??N????????? ???�N�???�??N�?? N? ???�N?N�N�??????N�?�N?N�?????�?�???? ??NSN�???�???� ??N�?�?� ????N??�?�??????N�?� 5 ????????????;

- ???�N�???�??N�?? ???�?? 65 ????????????;

- ???�N�???�??N�??, ???�?????�?�???�N�?? ?�??N�???????�??N??�?�??N�??;

- ???�N�???�??N�?? ???� N�N�??????N�???� ????N�N�??????N?N�?�N�?????????� N�?�N�?�????N?.

?�?� ??N???N�???? N�?�?�?? ????N???????N�??N????????? ??N�N????? N??� ???????�?�?�???? ?????�?�??N�?� ???�??N�?? ?�?� N??�????N�?� ???�N�???�??N�??, N�?�???� ?? ???? ??N�????N??�?????� ???� ???�???�?�?�?????�N�?? ???� ?�??N�?�??????N�?� N�?�?�N�??????.

?� ???????�??N�?� N??� ??N�?????�?�???� ???�??-?????�N?????N�?? ???�?�??N????�N�???????? ???�N??�?�?????�???� ?�?� ??N�?�?????� ???� N?NSN�???�N�????-N?NS????????N? N�??N??? ??N�?? ??N�???�???�?�?????� ???� COX2 ????N�???�??N�??N�?? ?? ???�N??�?�?�??N�???????? ?????Y?�??, ?????�N�?? ?????�NZN�???� 20 000 ?�???�???? N? ?�N�N�N�??N�, ??????N�?? N??� ??N�?�?�?????�?�?? ?????????�N�???�?? ????N�?�N�??N�, ????N?N??�N�, ?�??N�N�??????N�?????�N�?�?? ?�?�?????�N?, ???????�?�??N�??N�?�???� ???� N?N�?�??N�, ???�?? ?????�N� N?N�?�???????�N�????N? ???�?? ?????�?�?�N�.

?�NS??N�?�???? ??N???N�???? ???????�?�?�???? ??N�?�??????N?N�???� ?????Y?�?? ???�N�?? ??N�N????� ?�?�???�N�N?N�???� ?????�N� ?? N???????N�?� N??�N�?????�???? ???�????N?N�?�N�NSN�??. ?Y??N??�?�??????N�?� N??� ?? ??N�??N�?????�N�?�, ????N�?�???? ????N?N�?? ?????�N�?????�??N????�N�?� ?�???�??N�??N? ?�?� N�N�?�????N�?� ?? ?�?�???�N�N?N�???�N�?� /FDA/ ???�N?N�??N? ??N�?�?� ?�??N�???� 2005 ??. ???� N??� ??N?NSN�?�N?N�??N?N� N�?�????N�?� ???�?�???? ??N�?????�???? ?? ?�?�???�N�N?N�???�????N�?� ????N?N�N�N???N�???? ???� ?????Y?�??.

FDA ???�N�?�???? ???� ??N???N�???? ??N�?????�????????N�?�?�?? ???� ?????Y?�??, ???�????N????�???? N? N�?�N�?�??N�?�, ?� ?? ?�?� N�?�?�??, ??????N�?? N??� ??N�?????�???�N� ?�?�?� N�?�N�?�??N�?� /OTC/, ???� ?????�NZN�?�N� ??N�?�??N???N�?�?�???�?????� ??NS?? ?�?�???�N�??N�?� ?�?� ????N�?�??N�???�?�?�?? ????????N??�?? N�??N??? ??N� N?NSN�???�N�????-N?NS???????? ???�?�?�?�?�???? N�?�?�??N�???? ?? ??NSN�???�???� ??N� ?�????. ?Y???????�???? ??N�?�??N???N�?�?�???�????N? ?� ?�?�??NS?�?�??N�?�?�???? ???� ?????� ?? ?? ?�?�???�N�N?N�???�????N�?� N???NSN�???�????N? ?�?� ???�N�???�??N�??N�?�.

?�?�??N??�?�N�??N�???�N�?� ?�???�??N�??N? ?�?� ?�?�???�N�N?N�???� ?? ???�????N�????N????? ??N�????N???N�?? ??NS?? ?�?�?�???????�N�??N�?�????N? ??N�?�????N�NSN�???� ???�?????�?�???�???�N�?? ???� ???�??-????N????�N�?� ?�N�?�??N�???????� ?????�?� ???� ?????Y?�?? ?�?� ??NS?�?????�???? ???�??-??N�?�N�????N? ????N�?????�?�?�?? ???�N�?????? ??N� ??N�?�???�.

?�-N� ?�?????????� ???�?????z?�?z?�??

9 Отговори to " ?�?� ?? ??N�??N�???? ???�N?N�?�N�??????????N�?� ??N�??N�????????NS?�???�?�??N�?�?�???? N?N�?�??N?N�???� "

  1. Чрез прилагането на инжекционни форми на мовалис избягват ли се отрицателните въздействия върху стомашно-чревния тракт.

  2. При използването на инжекционните форми на лекарствата, рискът от услажнения в стомашно-чревния тракт намалява значително, но все пак съществува, защото лекарствата може да въздействат на стомашната лигавица и по кръвен път, не само директно след поглъщане на таблетката.

  3. В няколко публикации вече чета за протектори, пазещи стомашната лигавица при употреба на нестероидни противовъзпалителни средства. Страдам от гонартроза на двете колена. Над 65 години съм. Имам дуоденална язва, но от близо 15 г. е в ремисия.При особено нетърпими болки използвам диклак но много рядко и винаги заедно с ранитидин. Не съм сигурна, обаче че това е достатъчна защита. Какво бихте ме посъветвали?

  4. Преди 10 години направих жестока алергична реакция към „безвредния“ АУЛИН и оттогава имам непоносимост към почти всякакъв вид и род медикаменти, категорично съм против нестероидните противовъзпалителни, трябва да се предписват от доктор, не да се продават свободно. И трябва да се прибягва до тях при абсолютна необходимост

  5. Имам гонартроза на коленете. Понякога, когато не издържам на болката, взимам “ Пироксикам“ или Волтарен“ за 3-4 дни.За съжаление от няколко месеца се налага да взимам синтетичен калций след прекарана операция. Забелязах учестяване на крампи по мускулите на прасеца по време, в което взимам цитираните лекарства.Дали наистина съществува тази връзка?

  6. Никола казва:

    При липса на ефект от прилагането на даден НПВС (монотерапия), след колко време той може да бъде подменен с друг?

  7. Ели казва:

    Точно д-р Р. Несторова ми предписа Тросикам за 20 дни без едновременно с него да прибави и протектор на стомаха, а пише такива хубави статии! И други лекари постъпват точно така, нехаят за страничните ефекти на НСПВС, а не трябва!!! Затова вие внимавайте! Не си мислете, че ако нямате болка в гастроинтенстиналния тракт при прием на НСПВС, той не се уврежда – НСПВС имат точно болкоуспокоително действие и няма да усетите дори да се получи язва. Винаги при прием на каквото и да е НСПВС пийте и т.нар. инхибитор на протонната помпа (имената на медикаментите са посочени по-горе и се продават без рецепта), заедно с пробиотик и ентерол, може би и храносмилателни ензими. Не знам дали вършат работа, но си струва да го направите, за да не завършите като мен с язва на 12-тоипръстника а в последствие и с рефлукс. Ужасно е, диетата е постоянна и решение за киселините засега не съм открила.

  8. анита казва:

    За справяне с рефлукса и киселини на мен ми помогна взимането три месеца на фамотидин -сутрин и вечер – винаги около 22часа.Вече повече от година нямам тези симптоми.

  9. … разклатена изк.тазоб.стКава.Големи болки при движение.Изписаха ми АРКОСИЯ 90.Имам прескачане и взимам СИНТРОМ и ДИГОКСИН.АРКОКСИЯ само при нужда.Опасностите за сърцето остават ли? На 73г.съм.

Отговори

Copyright © 2009 ФОРУМ МЕДИКУС. All rights reserved.
   
Designed by My. Modified by ForumMedicus. Powered by WordPress.