List Of Modern Medicines And Drugs For Joints

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

List of modern medicines and drugs for joints

Content:

• NSAIDs: ambulance for joints - pros and cons
• Chondroprotectors
• Means for introduction into the joint cavity
• Topical medications
• [Video] Scientific Review - What to Take for Joints? Alternatives to pills
• What is important to remember when using dietary supplements?

NSAIDs: ambulance for joints - pros and cons

Non-steroidal anti-inflammatory drugs (NSAIDs) are the most common group of drugs used for pain and inflammation of any organs.

The most famous representatives are:

• aspirin
• indomethacin
• diclofenac
• ibuprofen
• nimesulide
• diflunisal
• lysine monoacetylsalicylate
• sulindak
• aceclofenac
• etodolac
• lornoxicam
• ketoprofen
• flurbiprofen
• nabumetone

Mechanism of action

Widespread popularity is due to the rapid elimination of symptoms due to the triple effect of this group of medicines:

• anti-inflammatory;
• pain reliever;
• antipyretic.

The anti-inflammatory effect is due to other mechanisms than that of hormonal drugs, which is emphasized in the name - non-steroidal drugs. It is most pronounced in indomethacin, flurbiprofen and diclofenac, and the minimum anti-inflammatory effect should be expected from ibuprofen, amidopyrine and aspirin.

These medicines block prostaglandins, inflammatory mediators that are released when tissue is damaged. As a result, all symptoms of inflammation are reduced: redness, swelling, pain, fever and dysfunction.

Pain syndrome is better eliminated by ketorolac, ketoprofen, diclofenac and indomethacin. Aspirin, ibuprofen and naproxen have less analgesic activity.

The strength of the action of different drugs depends on the structure of the molecule. However, individual sensitivity to different drugs cannot be ruled out.

Adverse reactions

Long-term use of NSAIDs necessary in the treatment of gonarthrosis is limited by the development of dangerous adverse reactions, most often from the digestive tract and kidneys.

Since the anti-inflammatory effect is by blocking prostaglandins, a side effect is a decrease in the protective factors of the stomach. Most of the representatives of this group of medicines are acids, so they additionally irritate the gastric mucosa.

The result can be NSAID gastropathy: erosive or ulcerative defects in the mucous membrane of the gastrointestinal tract, the most severe manifestation of which is gastrointestinal bleeding.

It is believed that indomethacin, ketoprofen, piroxicam are more aggressive in this regard. Less commonly, such complications develop with small doses of ibuprofen and diclofenac.

How to avoid side effects from the gastrointestinal tract:

• With a high acidity of the stomach, gastritis and ulcers in history, severe concomitant pathology, in the elderly, the likelihood of gastrointestinal bleeding increases. In such situations, it is more justified to use selective drugs (meloxicam, nimesulide, celecoxib), which do not reduce the protective factors of gastric mucus and can be used for a long time.

• You can use drugs that reduce gastric acidity (proton pump inhibitors), but long-term therapy is assessed as economically disadvantageous.

Side effects of NSAIDs are often manifested by the development of cardiovascular complications in the form of strokes, heart attacks and thrombosis. Naproxen and ibuprofen are considered safer in this regard. The use of diclofenac significantly increases the risk of heart and vascular diseases.

The development of arterial hypertension, heart failure, acute renal failure may result from a decrease in blood flow in the renal vessels due to inhibition of prostaglandin synthesis.

Possible development of aspirin bronchial asthma, Reye's syndrome (bleeding) and many other side effects.

Such formidable undesirable reactions do not allow self-medication and dictate certain rules for use:

• NSAIDs should not be taken for a long time. They are used as a means of "first aid", quickly and effectively eliminating the symptoms of arthrosis of the knee joint.

• Taking anti-inflammatory drugs masks the picture of the disease, without eliminating its cause, which often causes a late visit to the doctor.
• The choice of drugs is wide, both in terms of potency and side effects. The doctor will be able to select the optimal drug in a safe dosage and prescribe the necessary studies to prevent the development of complications.

Chondroprotectors: is it possible to restore cartilage tissue?

Since arthrosis of the knee joint is caused by damage to the cartilage of the articular surfaces, the ideal drug should be able to restore them. This hope arose with the isolation of a group of chondroprotectors (CP), the most studied representatives of which were glucosamine (GA) and chondroitin sulfate (CS).

The last 25 years of numerous studies have accumulated an extensive base, both confirming the effectiveness of CP, and refuting it. Reviews on the use of drugs are just as controversial.

You should not expect a speedy recovery while taking chondroprotectors: the minimum results should be assessed no earlier than after 6 months of therapy. Reducing the dosage of NSAIDs in the treatment of arthrosis of the knee joint is the first symptomatic effect of the use of CP. These medicines are most effective at stages 1 and 2 of arthrosis.

Glucosamine and chondroitin, like non-steroidal drugs, have an anti-inflammatory effect by suppressing inflammatory cells (interleukins and prostaglandins). However, unlike NSAIDs, chondroprotectors are well tolerated.

Preventing the progress of the disease (on the roentgenogram - slowing down the rate of narrowing of the joint space) is also an important effect of this group of drugs.

At first, GA and CS were used in isolation and in the form of injectables, which limited their use. Oral formulations were then developed. Let's give an example of several drugs with a chondroprotective effect.

Preparations containing chondroitin sulfate

• Chondrolone (Russian company "Microgen") - is produced in the form of dry substance ampoules for intramuscular administration.
• Chondroitin AKOS (Sintez, Russia) - capsules for oral administration of 250 mg and ointment for topical use. You need to take 4 capsules per day.
• Struktum ("Pierre Fabre", France) - capsules of 250 and 500 mg. The daily dosage is 1000 mg.

Preparations containing glucosamine

A study conducted in Belgium showed that glucosamine is more effective in arthrosis of the knee joint than cholesterol.

• Elbona (CJSC Moscow Pharmaceutical Factory) is a preparation for intramuscular injection of 400 mg of active substance in an ampoule.
• Don ("Rottapharm") - is available in the form of powder and capsules for oral administration, as well as a solution for intramuscular injection. 1 sachet of powder contains 1500 mg of the active substance, and one capsule contains 250 mg.

Preparations containing HA and CS

Thanks to numerous studies, there is evidence that the effectiveness of the two components improves the result of treatment by 60%, and monotherapy - by 30.

Artra ("Unipharm", USA) and Teraflex ("Bayer", Germany) - complex preparations containing both chondroprotectors, slightly differ in dosages of the constituent components: 500 mg of HA and CH in the first and 500 mg of HA and 400 CH in the second.

Means for introduction into the joint cavity

With severe pain syndrome, the doctor may recommend the introduction of the drug directly into the joint cavity.

As drugs that quickly eliminate the symptoms of inflammation, glucocorticosteroids are more often used:

• Hydrocortisone
• Diprospan
• Kenalog
• Celeston

Optimal is the introduction of chondroprotectors, which are called "liquid prosthesis". Sodium hyaluronate in preparations:

• Dyuralan
• Ostenil
• Fermatron
• Synvisc

They practically replace the joint fluid, improving the nutrition of the cartilaginous surfaces. However, these medicines are not yet affordable for everyone.

Topical medications

Topical therapies are complementary treatments for knee arthrosis. Usually the active substance is an NSAID, such as in the preparations Voltaren-gel, Fastum-gel, Menovazin, diclofenac ointment, indomethacin and butadione. Therapeutic compresses with bischofite (oil derivative), Dimexide (anti-inflammatory agent), medical bile expand the range of therapeutic measures for gonarthrosis.

Absorption of the drug with local treatment is no more than 7-8%, so monotherapy is rarely effective.

Since the course of the disease is accompanied by periods of exacerbation and remission, it is important to combine different methods of treatment, apply effective physiotherapeutic procedures, spa treatment, and possibly traditional medicine.

The doctor will help with recommendations at any stage of the disease!

[Video] Scientific Review - What to Take for Joints? Alternatives to pills

Do joints hurt and crunch? True reasons. What to do? Author: Boris Tsatsulin.

What is important for the patient to remember when using dietary supplements?

1. Will the doctor help?

   The doctor cannot officially prescribe dietary supplements, since they do not belong to the group of medicines. However, he can advise them as an additional method of prevention and treatment. The doctor may have experience in the use of dietary supplements by other patients with similar pathology and long-term observations of the dynamics of the disease.

2. Can you treat dietary supplements as a waste of money?

   It is possible, except that 35% of world consumption of dietary supplements is in the United States, where the economic feasibility of spending every dollar is taken into account. In second place is Europe (32% of the market), in third place is Japan (a country of long-livers). The correct choice of the manufacturer and complete knowledge of the information that dietary supplements do not work quickly are important!

3. When to expect the result?

   When taking dietary supplements, it is important to follow the rules of admission (frequency and timing of use), but you should not treat them as drugs that should help instantly (for example, NSAIDs). The group of chondroprotectors are drugs with a delayed effect (the minimum course is 3 months). Dietary supplements act more gently, the result often has to wait longer than when taking medications.

4. How to evaluate the result?

   The result can be assessed objectively by reducing the intake of NSAIDs not earlier than six months after the start of the use of dietary supplements. This indicates a decrease in pain, stiffness, and improved joint function. Supplements for joint disease are used for life, treatment is carried out in courses.

5. Side effects and contraindications

   Supplements are usually well tolerated, no side effects have been described. This is due to the fact that the base is a 100% natural substance without preservatives, additives and colorants. Rarely there may be individual intolerance. There are usually very few contraindications for dietary supplements: pregnancy and lactation. There is no danger of addiction and overdose.

There are reviews of both the ineffectiveness of the use of dietary supplements and chondroprotectors. The reason for them is most often the discrepancy between expectations and reality: patients assume that after 1-3 months of use, the cartilage tissue should recover, and the pain syndrome should leave forever.

In fact, the correct approach to taking dietary supplements is to use them as an additional method of therapy for a long time. Dietary supplements, like chondroprotectors, will act more effectively in the early stages of the disease. The very first result can be considered a decrease in the dose of NSAIDs, which indicates a decrease in pain. Other effects in relation to cartilage tissue can be discussed no earlier than 1.5-2 years after administration. To suspend the course of the disease is already a huge result!

On the subject: List of effective dietary supplements for joints containing all 4 active substances

Author of the article: Alekseeva Maria Yurievna | Therapist

Education: From 2010 to 2016 Practitioner of the therapeutic hospital of the central medical-sanitary unit No. 21, city of elektrostal. Since 2016 she has been working in the diagnostic center No. 3.