Theoretical foundations of bacterial research of the gastrointestinal tract. Treatment of diseases of the digestive system in children. Diseases of the biliary system. Dyskinesia. Acute and chronic cholecystitis. Plain X-ray of the abdominal cavity in a vertical position

Perhaps the most common symptom of gastrointestinal diseases is abdominal pain.

Drugs belonging to the group of antispasmodics help to weaken it. However, you shouldn’t get too carried away with these medications (and even less so if you prescribe them to yourself without first consulting a doctor).

If the dosage is incorrectly selected, they can cause serious side effects.

We emphasize: all information prepared by the author and presented below is for educational purposes only.

Commonly used antispasmodics: types and names

We won’t go deep into chemistry. Let us limit ourselves to general provisions that are of interest to the patient.

Myotropic drugs - sodium and calcium channel blockers, nitric oxide donors, phosphodiesterase inhibitors - have a direct effect on the smooth muscle myocyte.

These antispasmodics include:

drotaverine (as a separately existing medicine and active substance);
papaverine;
halidor;
spasmomen;
hymecromone;
dicetel;
duspatalin;
buscopan, etc.

A significant drawback of the “old” drugs - papaverine, drotaverine - is their systemic effect on all organs that have smooth muscles, incl. - on the vascular wall. For a course of treatment, doctors try to prescribe patients relatively recently developed antispasmodics with a selective effect - for example, duspatalin (mebeverine hydrochloride), buscopan (hyoscine butylbromide), spasmomen (otilonium bromide).

Most of the medications listed are sold without a prescription.

Means of another subtype - neurotropic- work indirectly. Among them are alkaloids, central and peripheral M-anticholinergic blockers.

They purposefully influence cholinergic or adrenergic receptors, correcting the conduction of impulses in the autonomic nervous system. Among them:

aprofen;
ganglefen;
atropine;
difacil;
buscopan.

N.N. Dekhnich points out (1):

Due to the nonspecific and systemic nature of the anticholinergic action of neurotropic antispasmodics, most drugs in this group cause atropine-like adverse drug reactions, and therefore are currently of limited use in gastroenterology.

As noted by A.A. Zvyagin, A.V. Pochivalov, E.D. Chertok (2), “the arsenal of antispasmodics is constantly being replenished.” This is not surprising - drugs that relieve pain are always in demand.

Indications for use

The main indication, of course, is spasms in functional disorders and chronic diseases of the gastrointestinal tract. The drugs of the group are prescribed for gastritis, gastric and duodenal ulcers, biliary dyskinesia, cholelithiasis, irritable bowel syndrome, renal and intestinal colic, pancreatitis.

E.A. Belousova writes (3):

For chronic gastrointestinal risk factors, all antispasmodics are used in courses of 2-3 weeks. It is this duration of administration that not only relieves pain, but also ensures the restoration of normal transit of intestinal contents. For acute episodes of functional pain, drugs can be used once or in shorter courses.

To completely normalize motor function and eliminate pain in the long term, monotherapy with antispasmodics is usually not enough, but they turn out to be a very effective component of complex treatment.

Main contraindications

The use of group products is usually contraindicated if the patient is suspected of having the following pathologies:

certain types of colitis;
toxic megacolon;
microbial intestinal diseases;
Crohn's disease;
tuberculosis.

Antispasmodics of both types are not recommended for pregnant women. They should not be used by people who spend many hours in front of dangerous moving mechanisms or behind the wheel - it is possible that there may be some loss of coordination and inhibition of psychomotor reactions.

Possible side effects

They are different for each drug (read the instructions carefully!). The most common adverse reactions to antispasmodics:

dry mouth;
visual impairment;
cardiopalmus;
nausea;
constipation;
headache;
skin redness;
deterioration of sleep.

If these and other changes in well-being are detected during the course of treatment, you must immediately inform the doctor about the current situation.

Literature:

N.N. Dekhnich, “The use of modern antispasmodics in gastroenterology”, “Bulletin of the Smolensk State Medical Academy”, No. 2, 2012
A.A. Zvyagin, A.V. Pochivalov, E.D. Chertok, “Anspasmodics in the treatment of gastroenterological diseases in children: comparative characteristics and possibilities of application,” “Pediatrics”, T.91, No. 4, 2012
E.A. Belousova, “Anspasmodics in gastroenterology: comparative characteristics and indications for use,” Pharmateka, No. 9, 2002
"Gastroenterology. National leadership" ed. V.T. Ivashkina, T.L. Lapina, Moscow, “GEOTAR-media”, 2008

In the development of gastrointestinal diseases, especially colitis, spastic mechanisms are of great importance. They cause a number of clinical symptoms, primarily pain. The use of antispasmodics for intestinal diseases is one of the most universal pharmacotherapeutic techniques aimed at eliminating spastic phenomena.
Antispasmodics, or drugs that reduce motility, are divided into 3 groups depending on the mechanism of action:
1. Myotropic antispasmodics- reduce muscle tone by directly influencing biochemical processes. Myotropic antispasmodics exhibit a certain tropism for individual smooth muscle organs; Of these, bronchodilators, vasodilators and gastrointestinal antispasmodics are isolated, which cause relaxation of the smooth muscles of the stomach, intestines, and biliary tract.
2. Neurotropic antispasmodics- have an antispasmodic effect by disrupting the transmission of nerve impulses in the autonomic ganglia or nerve endings that stimulate smooth muscles. The most important neurotropic antispasmodics are anticholinergics.
3. Combination drugsantispasmodics.
The action of most antispasmodics is not selective in relation to the gastrointestinal tract, which causes frequent complications when using them:
Myotropic drugs reduce blood pressure and can cause tachycardia.
Anticholinergics can provoke an attack of glaucoma, arrhythmia, urinary retention in elderly men, and cause deviations in mental reactions (lethargy or agitation).
Therefore, drugs with a more selective effect should be used, which can be achieved, in particular, due to slow absorption in the intestine.

Myotropic antispasmodics

The selectivity of the action of some myotropic drugs (atylonium, mebeverine) is associated with different sensitivity of smooth muscles to them in different organs. Thus, the smooth muscles of only the digestive system are sensitive to otilonium (Spazmomen), and only the large intestine is sensitive to mebeverine (Duspatalin), which determines the specific use of these drugs.
The group of myotropic antispasmodics includes Papaverine hydrochloride, No-shpa, Halidor, Dicetel, Duspatalin, Spasmomen, Spasmol.

Antispasmodic drug: Halidor (Egis, Hungary)

Halidor is a highly effective, long-acting, antispasmodic and disaggregant anti-ischemic agent, a calcium channel blocker. Halidor is used for a variety of conditions accompanied by spasms of visceral smooth muscles, vasospasms, and has virtually no effect on normal tone, and therefore does not change blood pressure. The antispasmodic effect of the drug on the smooth muscles of internal organs significantly exceeds the effects of traditional therapeutic agents. By reducing peripheral resistance, it has a beneficial effect on peripheral blood circulation and improves tissue trophism. It has a positive effect on cardiac function, helping to increase coronary and collateral blood flow. Indications for use are the elimination of mental and neurological symptoms (dizziness, headache, tinnitus, sleep disorders due to cerebrovascular accidents of various origins, vascular diseases of the eyes, obliterating arterial diseases, sick sinus syndrome; sinus bradycardia; for coronary heart disease as means of additional therapy, elimination of spasms of smooth muscles of internal organs. Has a local anesthetic effect; inhibits platelet aggregation. Does not reduce blood pressure. Practically does not cause side effects.

Antispasmodic drug: Dicetel (Beaufour Ipsen International, France)

Distinctive features of Dicetel are its selective effect on the smooth muscles of the intestines and biliary tract with no effect on the cardiovascular system, which significantly reduces the undesirable effects of the drug. The drug is used for intestinal diseases accompanied by abdominal pain, discomfort and impaired motor skills, as well as for pain caused by biliary dyskinesia. When used as a course, Dicetel prevents the occurrence of pain and gradually normalizes stool. Available in the form of film-coated tablets containing 50 and 100 mg of the active substance (pinaverium bromide), in a package of 20 pieces. Use 50 mg 3-4 times a day. If necessary, the daily dose can be increased to 300 mg. The tablets should be taken with meals, with plenty of water, without chewing or dissolving. The drug is not recommended for use in children.

Antispasmodic drug: Duslatalin (Solvay Pharma, Germany)

It is a highly selective effective myotropic antispasmodic. Reduces the tone and reduces the contractile activity of the smooth muscles of the gastrointestinal tract (mainly the large intestine). Duspatalin is used for the symptomatic treatment of abdominal pain, stool disorders and discomfort associated with functional bowel diseases, irritable bowel syndrome, as well as for the treatment of secondary spasm of the gastrointestinal tract in organic diseases. In children over 3 years of age, the drug is used to treat functional disorders of the gastrointestinal tract accompanied by abdominal pain. Compared to anticholinergics, it has much fewer contraindications (only hypersensitivity to the components of the drug), so it can be used by patients with glaucoma and prostatic hyperplasia. The drug is well tolerated, very rarely it can cause weakness and skin reactions. Available in the form of tablets containing 135 mg of the active substance (mebeverine), in a package of 50 pieces; capsules (200 mg of active substance), 30 pcs. in a package. Take 135 mg orally 3 times a day. When the effect is achieved, the dose of the drug is gradually reduced over several weeks. Extended-release capsules have the added benefit of being easier and more convenient to take. A 200 mg capsule is taken 2 times a day. Duspatalin is recommended to be taken 20 minutes before meals.

Antispasmodic drug: No-Shpa (Sanofi-Synthelabo, France)

It has been successfully used in clinical practice for 35 years in more than 42 countries. It is superior to Papaverine in terms of severity and duration of action. No-Spa (drotaverine hydrochloride) acts directly on smooth muscles and leads to relaxation of smooth muscles, primarily at the site of spasm. No-Shpa can be used as an antispasmodic in cases where drugs from the group of anticholinergics are contraindicated (glaucoma, prostate hypertrophy, etc.). When administered intravenously, the effect of the drug appears within 2-4 minutes. The maximum effect develops after 30 minutes. Side effects: nausea, insomnia, constipation, feeling hot, sweating, headache, dizziness, tachycardia. Available in the form of tablets 0.04 g in packs of 20 and 100 pcs.; solution for injection, 2 ml in ampoule of 5 and 25 pcs. in a package (1 ml contains 0.02 g of active substance). Used internally by adults, 1-2 tablets. 3 times/day or 2-4 ml 1-3 times/day subcutaneously, intramuscularly or intravenously. The drug is administered intravenously slowly to relieve renal and hepatic colic. For children under 6 years of age, the drug is prescribed in a single dose of 10-20 mg; at the age of 6-12 years - 20 mg 1-2 times / day.

Antispasmodic drug: No-Shpa forte (Sanofi-Synthelabo, France)

A new form, characterized by ease of dosing: 1 tablet. contains 0.08 g of drotaverine hydrochloride, 20 pcs. packaged; 4 ml ampoules, 5 pcs per pack. A double dose allows you to halve the number of tablets you take, and also provides significant convenience in using the injection form of the drug.

Antispasmodic drug: Papaverine hydrochloride (ICN Polypharm, Russia)

Opium alkaloid has a myotropic antispasmodic effect on the smooth muscles of the intestines, biliary and urinary tracts. Unlike other alkaloids, opium does not affect the central nervous system when used in moderate therapeutic doses. Papaverine has a maximum antispasmodic effect on the colon; further in decreasing order of effect - on the duodenum, antrum of the stomach. In addition to its effect on the organs of the gastrointestinal tract, Papaverine causes dilation of arteries and helps increase blood flow, including cerebral blood flow. In addition, it has a bronchodilator effect. Papaverine is available in the form of tablets of 0.01 and 0.04 g, rectal suppositories 0.02 g, solution for injection (1 ml - 0.01 or 0.02 g of active substance). The drug is administered intramuscularly, subcutaneously or intravenously. A single dose for adults is 10-20 mg; the interval between administrations is at least an hour. Orally prescribed 40-60 mg 3-5 times a day. Papaverine can cause a number of side effects: nausea, constipation or diarrhea, headache, dizziness, allergic skin reactions, drowsiness, increased sweating; with rapid intravenous administration, as well as with the use of high doses, the development of AV block and heart rhythm disturbances is possible.

Antispasmodic drug: Spasmomen (Berlin-Chemie, Germany)

It is characterized by high selectivity of action on the smooth muscles of the gastrointestinal tract. The effect of the drug has the greatest effect on contractions of the colon, while both the amplitude and frequency of contractions decrease, in contrast to Papaverine, which reduces the amplitude of contractions of the colon to a greater extent. Spasmomen does not have anticholinergic properties. Unlike all other antispasmodics. Spasmomen is a highly selective agent due to its very low absorption - no more than 5% of the drug is absorbed; 95% is excreted unchanged through the gastrointestinal tract. Therefore, Spasmomen acts exclusively locally, in the intestines, and does not have any systemic effects, including side effects. Due to the mechanism of action, Spasmomen is most effective in cases of increased motor activity of the colon, which is often observed in the most common intestinal disease - irritable bowel syndrome. Available in the form of film-coated tablets containing 40 mg of active
substances (octylonium bromide), 30 pcs. in a package. Take 1-2 tablets. 2-3 times/day.

Antispasmodic drug: Spasmol (ICN Leksredstva, Russia)

Antispasmodic myotropic action. The active ingredient, drotaverine hydrochloride, has a stronger and longer-lasting effect than papaverine. Acts directly on smooth muscles. Does not affect the autonomic nervous system, does not penetrate the central nervous system. Spasmol lowers the tone of the smooth muscles of internal organs, reduces their motor activity, and dilates blood vessels. The drug is available in tablets containing 40 mg of drotaverine hydrochloride. Adults take the drug 1-2 tablets 2-3 times a day, children under 6 years old - 1/3-1-2 tablets 1-2 times a day.

Anticholinergic antispasmodics

Anticholinergic (atropine-like) drugs have the best antispasmodic effect in the upper gastrointestinal tract: they are 3-10 times more effective on the stomach than on the colon. The number of side effects and low efficiency make the use of anticholinergic drugs very limited for intestinal diseases.

Anticholinergic drugs include Buscopan, Riabal, No-spasm.

Antispasmodic drug: Buscopan (Boehringer Ingelheim, Germany)

It is a selective m-anticholinergic blocker, has a pronounced antispasmodic effect on the smooth muscles of internal organs, including the gastrointestinal tract, biliary tract and genitourinary system. It is used for spastic constipation, biliary dyskinesia, urinary tract spasms, dysmenorrhea, and stomach ulcers. Due to its chemical structure, Buscopan does not cause side effects from the central nervous system and salivary glands, characteristic of other atropine-type drugs. It has several release forms. Available in the form of dragees containing 10 mg of the active substance (hyoscine butyl bromide), in a package of 20 pieces; in the form of rectal suppositories containing 10 mg of active substance, 10 pcs. in a package; in the form of a solution for injection, 1 ml in an ampoule, in a package of 5 pieces, containing 20 mg of active substance per 1 ml. Used in adults and children over 6 years of age, 10-20 mg 3-5 times a day. in the form of dragees or in the form of suppositories. For acute attacks of spastic pain, 20-40 mg of Buscopan (1-2 ampoules) can be administered subcutaneously, intramuscularly or intravenously. Injections can be done several times a day. Side effects: with parenteral administration, tachycardia is sometimes observed; with parenteral administration in large doses, a temporary disorder of accommodation may occur that goes away on its own, rarely - urticaria, shortness of breath.

Antispasmodic drug: No-Spasm (Hikma, Jordan)

It has a selective antispasmodic effect and relieves pain associated with spasms of the gastrointestinal tract, biliary and urinary tracts, and suppresses the production of hydrochloric acid in the stomach. Highly effective when taken orally and rectally. It is used in patients of any age. When taken in average therapeutic doses, it does not affect the heart rate or the central nervous system. It is used for intestinal diseases such as enteritis, colitis, irritable bowel syndrome. Side effects are rare (dry mouth, impaired accommodation, constipation). Contraindicated in glaucoma, prostate adenoma. It has a variety of release forms: film-coated tablets containing 30 mg of the active substance (priphinium bromide), 20 pcs. in a package; suppositories 30 mg, 30 pcs. in a package; syrup 60 ml in a bottle (7.5 mg in 5 ml); solution for injection, 2 ml in ampoule, pack of 6 pcs. (in 1 amp. 15 mg).
A single dose for adults is 30-60 mg; for children aged 6-12 years - 15-30 mg. Frequency of application 3 times/day. The injection solution is used mainly for biliary and renal colic; it is administered subcutaneously, intramuscularly or intravenously in a dose of 1-2 ml; if necessary, administration can be repeated after 6-8 hours. No-spasm is available in a special form for children under 6 years of age - syrup for children. A single dose depends on the age of the child and is 1 ml for children under 3 months; 3-6 months - 1-2 ml; 6-12 months - 2 ml; 1-2 years - 5 ml (1 tsp); 2-6 years - 5-10 ml (1-2 tsp). Frequency of appointment - every 6-8 hours.

Antispasmodic drug: Riabal (Laboratoires Jacques Logeais, France)

An anticholinergic drug used mainly in children for abdominal pain, vomiting, and psychogenic spasms of the gastrointestinal tract. The average daily dose is 1 mg/kg of the child’s body weight. Apply 3 times/day. It features a convenient release form for children - an oral solution in a 50 ml bottle with a 0.4 ml pipette. 1 pipette filled to the red line contains a dose of 2 mg (0.4 ml). Side effects: dry mouth, possible dilated pupils, impaired accommodation, drowsiness.
Combined drugs have the most powerful antispasmodic and analgesic effect, since they contain substances with different mechanisms of action. In case of irritable bowel syndrome, there is reason to give preference to drugs containing analgesics (Baralgin and its analogues: Maxigan, Minalgan, Spazvin, Spazgan, Spazmalgon, etc.). The drugs in this group are identical in composition, doses and effects.

Antispasmodic drug: Baralgin (Aventis, France-Germany)

Contains analgin, an antispasmodic, acting like papaverine, and a ganglion blocker. It is a highly effective remedy for intestinal, gastric, renal and biliary colic, painful menstruation, since it has a pronounced analgesic and antispasmodic effect, which occurs quite quickly. Available in the form of tablets, in a package of 20 pcs., and in the form of a solution for injection, 5 ml in an ampoule, 5 pcs. packaged. Take 1-2 tablets. 4 times/day. For colic, administer 5 ml (1 amp.) IV slowly over 5-8 minutes. Repeated administration is possible after 6-8 hours. Long-term use may cause granulocytopenia, so it is recommended to monitor blood tests. May cause allergic reactions.

Antispasmodic drug: Meteospasmil (Laboratoires Mayoly Spindler, France)

Along with the myotropic antispasmodic alverine (close in properties to No-shpe), it contains simethicone, which reduces gas formation in the intestines. Meteospasmil regulates intestinal activity, prevents the accumulation of gases, envelops and protects the intestinal wall, and has an antispasmodic and analgesic effect. It has no side effects and no contraindications. It is used as a symptomatic treatment for functional digestive disorders accompanied by flatulence. Available in capsule form: 20 pcs per pack. (1 capsule contains 60 mg of alverine citrate and 300 mg of simethicone). Take 1-2 capsules. 2-3 times/day before meals.

Antispasmodic drug: Novigan (Dr. Reddy's Laboratories, India)

A combined drug that contains ibuprofen, an antispasmodic ketone and an anticholinergic antagonist of central and peripheral action amide. Ibuprofen, inhibiting the biosynthesis of prostaglandins, has an analgesic, anti-inflammatory and antipyretic effect. In women with primary dysmenorrhea, it reduces the increased level of prostaglandins in the myometrium and thereby reduces intrauterine pressure and the frequency of uterine contractions. Ketone has a direct myotropic effect on the smooth muscles of internal organs and causes its relaxation. The amide has an additional relaxing effect on smooth muscles. The combination of these three components of the drug leads to a mutual enhancement of their pharmacological action. Novigan is used for moderate pain syndrome associated with spasms of smooth muscles of internal organs - spastic dysmenorrhea, intestinal spasms, biliary dyskinesia, renal and hepatic colic. The drug is also used to relieve headaches, including migraine headaches. As a symptomatic therapy, the drug is used for joint pain, neuralgia, and myalgia. It is used as an antipyretic for colds and infectious and inflammatory diseases. Novigan is intended for episodic and short-term treatment - up to 5 days. Longer use is possible under medical supervision. The recommended dose is 1-2 tablets 1 hour before meals or 3 hours after meals, up to 4 times a day. The drug is usually well tolerated. Sometimes allergic reactions may occur, extremely rarely - dizziness and dyspeptic disorders. Available in tablet form, 20 pieces per pack.

Antispasmodic drug: Spasmoveralgin (Slovakofarma, Slovenia)

A combined drug, which, along with an analgesic, papaverine and atropine, includes codeine (increases the analgesic effect, inhibits peristalsis, increases the tone of the intestinal sphincters), phenobarbital (has a calming effect, reduces sensitivity to irritants) and ephedrine (increases intestinal tone, reduces the rate of progress of digested food, enhances the secretion of digestive juices; compensates for the excessive inhibitory effect of phenobarbital). This composition provides Spasmoveralgin with high effectiveness for various disorders of the gastrointestinal tract, accompanied by pain and spastic syndromes. Available in tablet form, 10 pcs per pack. Used by adults: 1 tablet 1-3 times/day. Children aged 6-15 years are recommended to use 1/2-3/4 tablet. 1-3 times/day. Side effects: possible leukopenia up to agranulocytosis, allergic skin reactions, dry mouth, accommodation disturbances, tachycardia, constipation, difficulty urinating. It may become addictive and may reduce the ability to concentrate; you should not drink alcohol during treatment.

Herbal antispasmodics

Herbal preparations that can relieve spastic phenomena of the gastrointestinal tract include Altalex and Intestin.

Antispasmodic drug: Altalex (Lek, Slovenia)

The drug is based on medicinal plants and contains a mixture of essential oils from 11 medicinal herbs, the most famous of which is lemon balm. Aptalex is prepared according to an ancient recipe, proven by a hundred years of experience in its use. Due to its composition, it has an antispasmodic, choleretic effect, and reduces gas formation in the intestines. In addition, Altalex increases appetite and has a sedative effect. Available in the form of drops in a 50 ml bottle. For intestinal diseases, take 10-20 drops orally in hot mint tea.

Antispasmodic drug: Intestin (Diet Pharma, Germany)

It is a preparation of natural origin containing oils of Japanese mint, chamomile and fennel. The active substances contained in Intestin normalize the processes of fermentation and putrefaction in the intestines, prevent excessive formation of gases, and also have a mild antispasmodic effect and reduce intestinal colic. Available in the form of drops for oral administration, in a 10 ml bottle. Take 5-7 drops on a piece of sugar or with 100 g of warm water 2-3 times a day.

Every person at least once in his life has encountered one of the types of the body’s defensive reaction to negative factors of the internal and external environment - spastic pain. It occurs due to contraction of smooth muscle tissue, which is present in almost all vital systems: digestive, excretory, musculoskeletal, etc.

Spastic pain often occurs when a dangerous pathology appears, disturbances in the functioning of the nervous system or hormonal changes in men and women. The spasm can affect either one muscle or several groups. During this process, blood flow to the contracted tissues is severely limited. This increases the pain syndrome.

In order to get rid of painful contraction of smooth muscle tissue, medical specialists prescribe targeted drugs - antispasmodics.

Antispasmodics: classification, list of the most popular drugs

Antispasmodics are medications whose main effect is to reduce the number and intensity of spasms and eliminate pain arising from them. They are the first choice drugs for abdominal pain syndrome ().

Depending on the nature of the spastic reaction on which these drugs act, antispasmodics are divided into the following groups:

Neurotropic antispasmodics (M-anticholinergics) . They prevent nerve impulses from being transmitted through the autonomic nervous system. A muscle that has not received a physiological or pathological command to contract from the brain relaxes quite quickly. In addition, they may have an additional antisecretory effect. Depending on the mechanism of action, M-anticholinergics are divided into the following groups:
- neurotropic antispasmodics of central and peripheral action. These include drugs containing atropine and belladonna extract;
- Peripheral m-anticholinergics. These include preparations of hyoscine (buscopan), methocynium bromide and priphyria bromide;
- centrally acting antispasmodics. Difacil, aprofen and other drugs with similar active ingredients fall under this classification.
Myotropic antispasmodics . They influence the processes occurring directly in the contracted muscle. Sometimes spasm is the result of a deficiency or excess of various substances necessary for muscle fibers to function normally, and can also occur due to enzymatic and hormonal activity, for example, during women. The substances contained in myotropic antispasmodics prevent muscle fibers from contracting, taking a closed position and contracting sharply and intensely. TO The group of myotropic antispasmodics includes the following types of drugs:
- non-selective calcium channel antagonists - pinaveria bromide, otilonium bromide (spasmomen), verapamil;
- phosphodiesterase inhibitors - papaverine, drotaverine (), bencyclane;
- sodium channel blockers - mebeverine;
- xanthine derivatives - theophylline, aminophylline, aminophylline, dibazole;
- analogues of cholecystokinin - hymecromone;
- nitrate preparations used in the field of cardiology - nitroglycerin, isosorbide dinitrate, erinite, nitrospray, nitrong.
There are also combined antispasmodic analgesics , combining various active medicinal substances. As a result, the drug can not only reduce the intensity of spasms and relax smooth muscle tissue, but also relieve pain with the help of an analgesic component. Such medications include benalgin, spasmalgon, sedalgin-neo.
Often used as antispasmodics infusions and decoctions of medicinal herbs containing substances that can affect the contractility of internal organs. In folk medicine, flowers, fruits and leaves of elderberry, hawthorn, tansy, and St. John's wort are used. The complex of active components in these herbs helps normalize the tone of smooth muscle tissue and improves blood circulation.

note

It is important to remember that modern people cannot use herbs as monotherapy, only in complex treatment.

Mechanism of action of antispasmodics

The main effect of antispasmodics is their ability to influence the processes of physiological or pathological contraction of muscle fibers. The analgesic effect is achieved precisely by reducing the number of spastic contractions. This is especially noticeable on internal organs, in which smooth muscle tissue lines the walls.

Depending on the pharmacological group, antispasmodics can have the following effects:

m-anticholinergics they do not allow the impulse to be transmitted through type 3 receptors located in the areas of smooth muscles and type 1 receptors located in the autonomic nerve ganglia. Lack of potential helps to relax muscle tissue and reduce the secretory activity of internal glands;
neurotropic antispasmodics of central action have a similar, only more enhanced effect. In addition, they can have a significant sedative effect;
sodium channel and calcium channel blockers do not allow active substances that provoke spastic contractions to enter or interact with receptors and muscle tissue. This disrupts the chain of reactions that trigger the process of contractile muscle activity;
phosphodiesterase inhibitors inhibit the activity of the enzyme of the same name, which is responsible for the delivery of sodium and calcium to muscle fibers. A decrease in the level of calcium in the cell leads to a gradual decrease in the frequency and intensity of contractions;
nitrates form various compounds inside the human body when they react with them. The resulting substances actively synthesize cyclic guasine monophosphate, which reduces calcium levels and relaxes cells;
cholecystokinin analogues act mainly on the gallbladder, as well as on the sphincters of the bladder. By relaxing smooth muscle tissue, they help the outflow of bile fluid into the duodenum and reduce the pressure inside the biliary tract.

Indications for the use of antispasmodics

Due to their rapid and long-lasting effect, as well as their complex mechanism of action, antispasmodics can be used in various areas:

at . Reduce cerebral vascular spasm, restore impaired cerebral circulation, alleviate an attack that occurs in mild stages of the disease;
during menstruation . They help remove spastic contractions of the reproductive organs, stabilize blood flow;
at and . They lower the tone of the bladder, reduce the number of urges to urinate, relieve pain and restore natural excretory processes in the body. A decrease in the tone of smooth organs and the urinary tract accelerates the removal of stones from the kidneys;

Since the drugs have a strong relaxing effect, you should not engage in activities that require constant concentration during therapy.

Side effects of antispasmodics

Side effects that occur when taking antispasmodics may vary depending on the nature of the drug itself, the method of its administration and the individual reaction of the body.

There are several general effects that antispasmodic drugs can have on the body:

dry mucous membranes;
urinary retention;
mydriasis;
paresis of aacommodation;
blurred vision;
weakness;
ataxia;
confusion;
slowness of action;
allergic reactions;
decreased potency and;
nervousness.

In order to reduce the risk of side effects, it is necessary to take the drug strictly according to the instructions in doses recommended by a medical specialist. While taking antispasmodics, it is very important to monitor your physical condition and consult a doctor if undesirable reactions of the body occur.

AKABEL

A combined drug containing an antispasmodic (an agent that relieves spasms) bevonium methyl sulfate and a non-narcotic analgesic analgin.

Pharmachologic effect. It has broncho- and antispasmodic properties (expands the lumen of the bronchi and relieves spasms).

Indications for use. Bronchial asthma, bronchospastic syndrome (narrowing of the bronchial lumen), peptic ulcer of the stomach and duodenum, pylorospasm (spasm of the muscles of the pylorus of the stomach), postoperative spastic pain, spastic constipation, cholestasis (stagnation of bile), cholangitis (inflammation of the bile ducts), postcholecystectomy syndrome (condition after surgery to remove the gallbladder), chronic hepatopathy (general name for liver diseases) and pancreatitis (inflammation of the pancreas), various diseases of the kidneys and urinary tract. Prenatal and postpartum pain, dysmenorrhea (menstrual cycle disorder), adnexitis (inflammation of the uterine appendages), endometritis (inflammation of the inner surface of the uterus), ovarian dysfunction, tumor of the genitals (genital organs).

Method of administration and dose. Akabel is prescribed orally 1-2 tablets 2-3 times a day, suppositories (adults only) - 1 suppository 2-3 times a day. Intramuscularly or intravenously, a l/i-ampule of Akabela is slowly administered 3 times a day.

Side effect. With intramuscular administration of the drug, transient local pain is possible. Long-term use causes dry mouth, increased heart rate, difficulty urinating, and dilated pupils.

Contraindications. Glaucoma (increased intraocular pressure), tachycardia (rapid heartbeat), adenoma (benign tumor) of the prostate, organic stenosis (narrowing of the lumen) of the gastrointestinal tract, megacolon (significant dilation of part or all of the colon), antidepressant therapy. Allergy to pyrazolone derivatives, with granulocytopenia (decreased granulocyte content in the blood). Subcutaneous and intra-arterial administration of the drug should be avoided, as well as use during pregnancy, especially in the first 3 months.

Release form. Tablets containing bevonium methyl sulfate 0.05 g, analgin 0.25 g; candles containing

bevonium methyl sulfate 0.03 g, analgin 1 g; ampoules of 5 ml containing bevonium methyl sulfate 0.0025 g, analgin 2.5 g.

Storage conditions.

ALPROSTADIL

Synonyms: Vazaprostan, Prostavazin, Minprog, Prostandin, Prostin VR.

Pharmachologic effect. A drug from the prostaglandin group (prostaglandin Ei). Causes a contraction of the muscles of the uterus, intestines and other smooth muscle organs, but at the same time has a pronounced peripheral vasodilator effect, increases blood flow in peripheral vessels, improves microcirculation, inhibits platelet aggregation (gluing) and has a disaggregation effect.

Indications for use. It is used mainly for chronic obliterating diseases of the lower extremities (inflammation of the inner lining of the arteries of the extremities with a decrease in their lumen / obliterating atherosclerosis, etc. The drug is more effective in stages II-III of ischemia (insufficient blood supply) of the lower extremities.

Method of administration and dose. Alprostadil is used intravenously and intra-arterially.

For intravenous use, the contents of 2 ampoules (40 mcg of the drug) are diluted in 250 ml of isotonic sodium chloride solution. Administered dropwise (over 2 hours) 1 time, in severe cases 2 times a day. If there is such a need, the dose is increased to 60 mcg (3 ampoules) and administered over 3 hours.

For intra-arterial administration, dilute 20 mcg (1 ampoule) in 50 ml of isotonic sodium chloride solution. Initially, 10 mcg ("/2 ampoules, i.e. 25 ml) are administered over 60-120 minutes; if well tolerated, 40 mcg can be administered in the future (during the same time). Injections are made 1-2 times a day. Long-term infusion through a catheter is possible.

The course of treatment lasts 15-25 days.

Side effect. When using alprostadil, a decrease in blood pressure, loss of appetite, diarrhea (diarrhea), dull pain in the limb being treated, a burning sensation, and redness at the site of catheter insertion are possible.

Contraindications. The drug is contraindicated during pregnancy and breastfeeding. It should be taken into account that

alprostadil enhances the effect of antihypertensive (lowering blood pressure) and antiaggregation (preventing platelet aggregation) agents.

Release form. In ampoules containing 0.02 mg (20 mcg) of alprostadil, 10 pieces per package.

Storage conditions. List B. In a dark place at room temperature.

ANDECALIN (Andecalinum)

Purified porcine pancreas extract that does not contain insulin.

Pharmachologic effect. Dilates peripheral blood vessels, lowers blood pressure.

Indications for use. Obliterating endarteritis (inflammation of the inner lining of the arteries of the extremities with a decrease in their lumen), Raynaud's disease (narrowing of the lumen of the vessels of the extremities), sluggishly healing wounds, spasms (sharp narrowing of the lumen) of cerebral vessels, circulatory disorders in the retina, scleroderma, the initial stages of hypertension ( persistent increase in blood pressure).

Method of administration and dose. Intramuscularly 1 time per day 10-40 units (depending on the severity of the condition) for 2-4 weeks; after a 2-3 month break, the course of treatment is repeated. Orally before meals, 2 tablets 3 times a day. After 6-10 days, the dose can be increased gradually to 9-12 tablets per day. Duration of treatment is 1 month. After a 2-3 month break, the course of treatment can be repeated.

Side effect. Allergic reactions.

Contraindications. Increased intracranial pressure, malignant neoplasms.

Release form. Lyophilized (dried by freezing under vacuum) andecalin for injection in bottles of 40 units complete with injection solvent; tablets of 15 units, film-coated, in a package of 50 pieces.

Storage conditions. The drug in dry (lyophilized form) is stored in a dry place at a temperature not exceeding +18 ° C. When dissolved, it can be stored in a bottle for no longer than 3 days at a temperature of +5 °C; tablets - in a dry place at a temperature not exceeding +20 ° C.

BARALGIN (Baralginum)

Synonyms: Maxigan, Spazmalgon, Trigun, Spazgan.

A combined drug containing a non-narcotic analgesic analgin, an antispasmodic (a drug that relieves spasms) similar to papaverine, and a ganglion blocker.

Pharmachologic effect. It has a pronounced antispasmodic (relieving spasms) and analgesic effect.

Indications for use. Spasms of smooth muscles, especially renal colic, spasms of the ureters, bladder tenesmus (false painful urge to urinate), hepatic colic, spasms of the stomach and intestines, spastic dysmenorrhea (the general name for menstrual disorders that occur with pain).

Method of administration and dose. Orally, 1-2 tablets 3 times a day, in severe cases - intramuscularly or intravenously slowly.

Side effect. Allergic reactions are possible; with long-term use, granulocytopenia (a decrease in the content of granulocytes in the blood) requires discontinuation of the drug.

Contraindications. Granulocytopenia (decrease in the content of granulocytes in the blood), tachyarrhythmia (type

heart rhythm disturbances), coronary (cardiac) circulatory insufficiency, glaucoma (increased intraocular pressure), hypertrophy (increase in volume) of the prostate.

Release form. Tablets in a package of 20 pieces; ampoules of 5 ml in a package of 5 pieces.

Storage conditions. List B. In a dry place, protected from light.

HAWTHORN FRUITS AND FLOWERS (Fructus et Flores Crataegi)

Pharmachologic effect. Hawthorn preparations increase the contraction of the heart muscle and reduce its excitability, improve blood circulation in the vessels of the heart and brain, and increase the sensitivity of the heart to the action of cardiac glycosides.

Indications for use. Functional disorders of the heart, hypertension (persistent rise in blood pressure), angioneurosis (impaired vascular tone), atrial fibrillation, paroxysmal tachycardia (heart rhythm disturbances).

Method of administration and dose. Orally 30 minutes before meals as an infusion (1 teaspoon per glass of boiling water) - 1 tablespoon 2-3 times a day, tincture - 20 drops 3 times a day, liquid extract - 20-30 drops 3-4 once a day.

Release form. Fruits in a package of 50 g; tincture in 25 ml bottles; liquid extract in 25 ml bottles; flowers in a package of 100 g.

Storage conditions. In a dry, cool place.

Hawthorn extract is also included in the preparations Cardompin and Cardiovalen.

HALIDOR

Synonyms: Bencyclane fumarate, Bencyclamide.

Pharmachologic effect. Antispasmodic (relieving spasms) and vasodilator.

Indications for use. Endarteritis (inflammation of the inner lining of the arteries), thromboangiitis (inflammation of the artery wall with blockage), spasms (sharp narrowing of the lumen) of the brain vessels and coronary vessels (heart vessels), peptic ulcer, spasms of the urinary tract, cholecystitis (inflammation of the gallbladder).

Method of administration and dose. Orally 0.05-0.1 g 2-4 times a day, intramuscularly (if necessary intravenously) 1-2 ml of a 2.5% solution. The course of treatment is 15-20 days. For obliterating diseases of the arteries of the extremities (inflammation of the inner lining of the arteries of the extremities with a decrease in their lumen), treatment is effective mainly in stage II of the disease; administered intramuscularly (0.05 g 1-2 times a day for 15-20 days).

Side effect. Dyspeptic symptoms (digestive disorders), allergic reactions, dizziness, headache.

Contraindications. Severe circulatory and respiratory disorders.

Release form. Tablets of 0.1 g in a package of 50 pieces; ampoules of 2 ml of 2.5% solution in a package of 10 pieces.

Storage conditions. List B. In a dry place, protected from light.

GANGLERON (Gangleronum)

Synonyms: Ganglefen hydrochloride.

Pharmachologic effect. Blocks the N-cholinoreactive systems of the parasympathetic and sympathetic autonomic ganglia and the central nervous system.

has a myotropic antispasmodic (relieving spasms of smooth muscles), weak local irritant and anesthetic effect.

Indications for use. Angina pectoris, peptic ulcer of the stomach and duodenum, spastic dyskinesia (impaired mobility) of the gastrointestinal tract, etc.:

Method of administration and dose. Orally 0.04 g 3-4 times a day before meals; intramuscularly or subcutaneously, 1 ml of a 1.5% solution 3-4 times a day with a gradual increase in a single dose to 3 ml. The highest single dose for adults orally is 0.075 g, the daily dose is 0.3 g, the highest single dose subcutaneously and intramuscularly is 4 ml of a 1.5% solution, the daily dose is 12 ml of a 1.5% solution.

Side effect. Dizziness; upon contact with mucous membranes, a quickly passing sensation of irritation followed by anesthesia.

Release form. Capsules of 0.04 g in a package of 50 pieces; ampoules of 2 ml of 1.5% solution in a package of 10 pieces.

Storage conditions. List B. In a dry place, protected from light.

DATISCAN (Datiscanum)

It is a mixture of flavonoids, the main component of which is the glycoside datiscine. It is obtained from the Danish hemp herb.

Pharmachologic effect. Antispasmodic (a drug that relieves spasms).

Indications for use. Diseases of the gastrointestinal tract, accompanied by spasm of smooth muscles (muscles of blood vessels and internal organs).

Method of administration and dose. Orally 15 minutes before meals, 0.05-0.1 g 2-3 times a day daily for 10-20 days.

Side effect. Allergic reactions, headache, nausea, stomach pain, diarrhea.

Contraindications. Individual intolerance to the drug.

Release form. Tablets of 0.05 g in a package of 50 pieces.

Storage conditions. In a dry place, protected from light.

DIBAZOL (Dibazolum)

Synonyms: Bendazole, Bendazole hydrochloride, Tromasedan.

Pharmachologic effect. Vasodilator, antispasmodic (relieves spasms) and hypotensive (lowers blood pressure) agent.

Indications for use. Diseases accompanied by spasms of blood vessels (angina pectoris, hypertensive crisis /rapid and sharp rise in blood pressure/), smooth muscles of internal organs (peptic ulcer, spasms of the gastrointestinal tract), treatment of nervous diseases, mainly residual effects of poliomyelitis, peripheral paralysis of the facial nerve and etc.

Method of administration and dose. Take 0.02-0.05 g orally 2-3 times a day, usually for 3-4 weeks. or shorter courses. In the treatment of nervous diseases, dibazole is prescribed 5 to 10 times at a dose of 0.005 g (for adults) once a day or every other day. In 3-4 weeks. the course of treatment is repeated. Subsequent courses are carried out with a break of 1-2 months. Higher doses for adults orally: single - 0.05 g, daily - 0.15 g. Children are prescribed (for the treatment of diseases of the nervous system) in the following doses: up to 1 year - 0.001 g, 1-3 years 0.002 g, 4-8 years - 0.003 g, 9-12 years - 0.004 g, over 12 years -

0.005 g. If necessary, the course of treatment is repeated after 3-4 weeks. Dibazol is taken orally 2 hours before meals or 2 hours after meals.

Side effect. Dibazole is usually well tolerated. It is not advisable to prescribe the drug long-term as an antihypertensive drug to elderly patients, since the hypotensive effect is associated with a decrease in cardiac output and a possible deterioration in electrocardiogram parameters.

Release form. Tablets 0.02; 0.002; 0.003 and 0.004 g; 0.5% or 1% solution in ampoules of 1; 2 and 5 ml.

Storage conditions. List B. In a dry place, protected from light.

Dilminal

Synonyms: Dilminal-D.

Pharmachologic effect. Dilates blood vessels.

Indications for use. Diseases of peripheral vessels and associated trophic disorders: spastic forms of endarteritis (inflammation of the inner lining of the arteries of the extremities with a decrease in their lumen), Raynaud's disease (narrowing of the lumen of the vessels of the extremities), sluggishly healing wounds and ulcers.

Method of administration and dose. For mild forms of the disease, start with 2 tablets 3 times a day. The dose is selected individually. For more severe forms, 1 ampoule is administered deeply intramuscularly once a day. The drug is dissolved immediately before use. The course of treatment is 15-20 injections.

Side effects and contraindications are the same as for andecalin.

Release form. Dragees 2 units in a package of 20 pieces; ampoules (Dishinal D), containing 10 units, with the addition of a solvent, in a package of 10 pieces.

Storage conditions.

DIPROPHEN (Diprophenum)

Pharmachologic effect. It has a vasodilator and weak anticholinergic effect.

Indications for use. Spasms (involuntary muscle contractions) of blood (especially peripheral) vessels (endarteritis /inflammation of the inner lining of the artery/, Raynaud's disease /narrowing of the lumen of the vessels of the extremities/, etc.), smooth muscles of internal organs (bronchial tubes, gastrointestinal tract, urinary tract).

Method of administration and dose. Orally 0.025 g 2 times a day with a gradual increase in dose to 0.05-0.1 g 3 times a day. The course of treatment is 2-3 weeks.

Side effect. Feeling of numbness of the oral mucosa, occasional nausea, headache, slight dizziness.

Release form. Tablets of 0.05 g in a package of 10 pieces.

Storage conditions. List B. In a well-closed container.

DIPROPHYLLINE (Diprophyllinum)

Synonyms: Aristofillin, Diphyllin, Isophyllin, Astrophyllin, Coronal, Coronarin, Corfillamine-Neutral, Diprofillin, Glifillin, Neutrafillin, Solufillin, Tefilan, Teofen, etc.

Pharmachologic effect. It has a coronary dilator (dilates the blood vessels of the heart) and bronchodilator (dilates the lumen of the bronchi) and slightly increases diuresis (volume of urine output).

Indications for use. Coronary spasm (narrowing of the lumen of the heart vessels), bronchospasm (narrowing of the lumen of the bronchi), arterial hypertension (persistent rise in blood pressure), hypertension.

Method of administration and dose. Prescribed orally, intravenously, intramuscularly. Inject intravenously (slowly!) 5-10 ml (for adults) of a 2.5% solution (diluted in aseptic/sterile/1 ampoule/5 ml/10% solution in 15 ml water for injection), intramuscularly - 3-5 ml 10 % solution 1-2 times a day. Take 0.2-0.5 g orally 3-4 times a day.

They are also used in the form of rectal suppositories containing 0.5 g of diprophylline. Inject 1 suppository into the rectum 1-2 times a day (morning and evening) after a preliminary cleansing enema or spontaneous bowel movement.

The course of treatment is usually 10-20 days. If necessary, the course is repeated after a 3-5 day break.

Contraindications. The use of diprophyllin, especially intravenously, is contraindicated in cases of sharply low blood pressure, paroxysmal tachycardia, extrasystole (heart rhythm disturbance), epilepsy. The drug should also not be used for heart failure, especially associated with myocardial infarction, when there is coronary insufficiency (a discrepancy between the heart's need for oxygen and its delivery) and heart rhythm disturbances.

Release form. Powder; tablets 0.2 g; 10% solution in ampoules of 5 ml; suppositories containing 0.5 g of the drug.

Storage conditions. List B. In a cool, dark place.

ANGISVDIN (Angisedin)

A combined drug containing diprophylline, peritrol triturate, caffeine, defenin hydrochloride, valerian extract, phenobarbital.

Pharmachologic effect. It has an antispasmodic (relieving spasms) and sedative (calming) effect, dilates the coronary (heart) vessels, stimulates contractions of the myocardium (heart muscle), increasing the output and cardiac output.

Indications for use. Chronic coronary insufficiency (mismatch between the heart's need for oxygen and its delivery), prevention of angina attacks, various types of cardialgia (pain in the left half of the chest).

Method of administration and dose. Prescribe 1 tablet 3 times a day after meals.

Release form. Tablets containing diprophylline 100 mg, peritrol triturate 12.5 mg, caffeine 50 mg, odefenine hydrochloride 15 mg, valerian extract 30 mg, phenobarbital 15 mg.

Storage conditions. List B. In a place protected from light.

KATASMA

A combined preparation containing diprophylline, sodium succinic acid, sodium guaiacol glycolate, caffamine brischettini.

The pharmacological action is due to the properties of its constituent components. Diprophylline has a bronchodilator effect, sodium succinic acid improves pulmonary ventilation, stimulating the respiratory center. Guaiacole derivatives have a drying, anti-catarrhal (anti-inflammatory) effect. Caffamine Brischettini (the original caffeine derivative) has respiratory analeptic properties.

Indications for use. Asthmatic bronchitis, phenomena of bronchospasm (sharp narrowing of the lumen of the bronchi)

for various pulmonary diseases, bronchial asthma, cor pulmonale.

Method of administration and dose. Prescribe from 1 to 3 ampoules per day intramuscularly or from 2 to 4 tablets per day.

Release form. Ampoules of 3 ml in a package of 10 pieces; tablets of 20 pieces per package. 1 ampoule contains 300 mg of diprophylline, 100 mg of sodium succinic acid, 100 mg of sodium guaiacol glycolate, 50 mg of Brischettini caffamine. 1 tablet contains 150 mg of diprophylline, 50 mg of sodium succinate, 100 mg of calcium guaiacol glycolate, 100 mg of Brischettini caffamine.

Storage conditions. List B. In a dry place, protected from light.

NAFTIDROFURIL (Naftidrofuril)

Synonyms: Duzodril, Cytoxide, Dubimax, Fuxaten, Iridax, Nafronil, Natiflux, Naftifurin, Praxylene, etc.

Pharmachologic effect. Refers to 5-HT2 serotonin receptor blockers. The drug dilates peripheral vessels (arteries), improves blood supply, oxygen supply to tissues, as well as blood circulation in the vessels of the brain, retina and other organs.

Indications for use. Prescribed for circulatory disorders in peripheral vessels, especially the lower extremities (intermittent claudication, Raynaud's disease, etc.), for trophic tissue disorders (bedsores, long-term non-healing ulcers, etc.), as well as for disorders of cerebral circulation, blood supply to the fundus and etc.

Method of administration and dose. Take per os (by mouth) 200-600 mg per day after meals. For acute vascular disorders, 100 mg is administered intramuscularly, intravenously or intraarterially 2-3 times a day, and then switch to long-term administration of the drug per os.

Side effect. When taken orally, loss of appetite, nausea, vomiting, diarrhea. With rapid intravenous and intra-arterial administration, some patients experience symptoms of agitation, less often depression (depressed state).

Contraindications. Acute myocardial infarction, tendency to hypotension (low blood pressure), acute hemorrhagic stroke (acute cerebrovascular accident as a result of rupture of cerebral vessels), increased convulsive readiness, severe heart failure, severe heart rhythm disturbances.

Release form. Dragee 0.06 g in packs of 20, 50, 100 and 600 pieces. Retard dragee (long-acting) 0.1 g in packs of 20.50, 100 and 600 pieces. Capsules of 0.2 g in a package of 20 pieces. Ampoules containing 0.2 g of naftidrofuryl, in packages of 5, 10, 20 or 100 pieces.

Storage conditions. List B. In a place protected from light.

NO-SPA (No-spa)

Synonyms: Drotaverine hydrochloride, Drotaverine, Deprolene, Dihydroetaverine, Nospan, Nospazin, Tetraspazmin.

Pharmachologic effect. It has a pronounced antispasmodic (relieving spasms) effect.

Indications for use. Spasm of the stomach and intestines, spastic constipation, attacks of cholelithiasis and urolithiasis, angina pectoris, spasm (sharp narrowing of the lumen) of peripheral vessels.

Method of administration and dose. Orally 0.04-0.08 g 2-3 times a day; intramuscularly 2-4 ml of 2% solution; intravenously (slowly) 2-4 ml of a 2% solution, if necessary intra-arterially (obliterating endarteritis /inflammation of the inner lining of the arteries of the extremities with a decrease in their lumen/).

Side effect. Dizziness, palpitations, sweating, feeling hot, allergic dermatitis (skin inflammation).

Contraindications. Hypertrophy (increase in volume) of the prostate gland and glaucoma (increased intraocular pressure), especially the angle-closure form.

Release form. Tablets of 0.04 g in a package of 100 pieces; ampoules with a capacity of 2 ml, containing 0.04 g, in a package of 50 pieces.

Storage conditions. List B. In a dry place, protected from light.

BISPAN

A combined drug containing no-shpu and the anticholinergic drug isopropamide.

Indications for use. Used for intestinal spasms, spastic colitis (inflammation of the colon, characterized by sharp contractions), acute and chronic hyperacid gastritis (inflammation of the stomach due to a persistent increase in acidity), peptic ulcer of the stomach and duodenum, cholecystopathy (gallbladder disease), spasms of the ureters and others diseases accompanied by spasms of smooth muscles of internal organs.

Method of administration and dose. Prescribed orally for adults in acute cases, 1-2 tablets 2-3 times a day; in chronic cases - 1 tablet 2-3 times a day for 3-4 weeks.

Side effects and contraindications are the same as for no-shpa

Storage conditions. List B. In a dry place, protected from light.

NICOSPAN (Nicospan)

A combined preparation containing no-shpa and nicotinic acid.

Pharmachologic effect. Has a pronounced vasodilating effect.

Indications for use. Spasms (sharp narrowing of the lumen) of cerebral and peripheral vessels.

Method of administration and dose. Orally after meals, 1 tablet 1-3 times a day or 1-2 ml ("/2-1 ampoule) subcutaneously or intramuscularly 1-2 times a day. If necessary, inject 1 ml of solution slowly into a vein. For peripheral disorders blood circulation (thromboangiitis obliterans), 1-2 ml of solution is injected (slowly!) into the femoral artery.

Side effects and contraindications are the same as for no-shpa.

Release form. Tablets of 0.1 g composition: no-shpy - 0.078 g, nicotinic acid - 0.0022 g; ampoules of 2 ml of the composition: no-shpa - 0.0642 g (64.2 mg) and nicotinic acid - 0.0176 g (17.6 mg), in a package of 10 pieces.

Storage conditions. List B - In a dry place, protected from light.

PAPAVERINA HYDROCHLORIDE (Papaverini hidrochloriduin)

Pharmachologic effect. Myotropic antispasmodic (relieving spasms of smooth muscles) drug. Reduces the tone and reduces the contractile activity of smooth muscles and therefore has a vasodilator and antispasmodic (relieving spasms) effect. In large doses, it reduces the excitability of the heart muscle and slows down intracardiac conduction.

Indications for use. Spasms (sharp narrowing of the lumen) of cerebral vessels, angina pectoris, endarteritis (inflammation of the inner lining of the arteries), cholecystitis (inflammation of the gallbladder), pylorospasm (spasm of the muscles of the pylorus), spastic colitis, spasm of the urinary tract, bronchospasm (narrowing of the lumen of the bronchi).

Method of administration and dose. Orally, adults take 0.04-0.08 g (40-80 mg) 3-4 times a day; children - also 3-4 times a day: from 6 months of age. up to 2 years - 0.005 g (5 mg) per dose, 3-4 years - 0.005-0.01 g, 5-6 years - 0.01 g, 7-9 years - 0.01-0.015 g , 10-14 years - 0.015-0.02 g per dose. In case of vomiting or difficulty swallowing, it is prescribed in the form of suppositories (suppositories) rectally (into the rectum) 0.02-0.04 g 2-3 times a day (for adults). Adults are administered 1-2 ml (usually 2 ml) of a 2% solution subcutaneously and intramuscularly, and intravenously in the same dose (very slowly!), diluting a 2% solution of papaverine hydrochloride in 10-20 ml of isotonic sodium chloride solution. Children are given in smaller doses according to their age. Higher doses for adults orally: single - 0.2 g, daily - 0.6 g; under the skin, intramuscularly and into a vein: single dose - 0.1 g, daily - 0.3 g. Higher doses for children orally from 6 months of age. up to 1 year: one-time - 0.005 g, daily - 0.01 g; at the age of 2 years - one-time 0.01 g, daily 0.02 g; 3-4 years - one-time 0.015 g, daily 0.03 g; 5-6 years - one-time 0.02 g, daily 0.04 g; 7-9 years - one-time 0.03 g, daily 0.06 g; 10-14 years - one-time 0.05-0.06 g, daily 0.1-0.2 g. Children under 6 months. not prescribed.

Side effect. Atrioventricular block (impaired conduction of excitation through the conduction system of the heart), ventricular extrasystole (disturbance of heart rhythm), with intravenous administration, decreased blood pressure, constipation.

Contraindications. Atrioventricular conduction disorders (impaired conduction of excitation through the conduction system of the heart).

Release form. Powder; tablets of 0.01 g for children in a package of 10 pieces; tablets of 0.04 g in a package of 10 pieces; ampoules of 2 ml of 2% solution in a package of 10 pieces; rectal suppositories (suppositories for insertion into the rectum) 0.02 g in a package of 10 pieces.

Storage conditions. List B. In a well-closed container in a protected place.

NIKOVERIN (Nicoverinum)

A combined preparation containing papaverine hydrochloride and nicotinic acid.

Indications for use. As an antispasmodic (relieving spasms) and vasodilator for hypertension (persistent rise in blood pressure), angina pectoris, migraine, endarteritis (inflammation of the inner lining of the arteries).

Method of administration and dose. 1 tablet 2-3 times a day.

Side effect. Hyperemia (redness) of the skin, feeling of heat.

Release form. Tablets in a package of 10 pieces containing papaverine hydrochloride 0.02 g, nicotinic acid 0.05 g.

Storage conditions. List B. In a dry place, protected from light.

PAPAZOL (Papazohim)

A combined drug containing papaverine hydrochloride and dibazole.

Indications for use. For hypertension (persistent increase in blood pressure) and angina pectoris.

Method of administration and dose. 1-2 tablets 2-3 times a day.

Side effect. Decreased cardiac output.

Contraindications. Hypertension in old age.

Release form. Tablets containing papaverine hydrochloride and dibazole 0.03 g each, in a package of 10 pieces.

Storage conditions. List B. In a dry place, protected from light.

Spasmoveralginuni

Pharmachologic effect. Combined drug. It is a combination of drugs with antispasmodic (relieving spasms), analgesic (painkillers) and sedative (calming) properties. Ephedrine counteracts the inhibitory effects of phenobarbital.

Indications for use. Spasms (sharp contraction) of the muscles of the gastrointestinal tract; biliary colic; renal colic; bladder spasms; migraine; algodismenorrhea (painful menstruation).

Method of administration and dose. Doses are set individually. Typically, adults are prescribed 1 tablet 1-3 times a day. Children aged 6 to 15 years are prescribed "/2-3A tablets 1-3 times a day.

Possible development of addiction (reduction or absence of effect with prolonged repeated use).

With long-term administration of spasmoveralgin, blood counts should be regularly monitored.

Side effect. Leukopenia (a decrease in the level of leukocytes in the blood) up to agranulocytosis (a sharp decrease in the number of granulocytes in the blood) is possible. Allergic reactions in the form of skin rash. Symptoms caused by the anticholinergic effect (due to atropine): dry mouth, impaired accommodation (visual perception), tachycardia (rapid heartbeat), atony (loss of tone) of the intestines, difficulty urinating.

Contraindications. Hypersensitivity to the components of the drug; lactation; leukopenia; porphyria (hereditary disorder of porphyrin metabolism); constipation; mechanical stenosis (narrowing) of the gastrointestinal tract; megacolon (significant dilation of part or all of the colon); arterial hypertension (high blood pressure); severe heart failure; heart rhythm disturbances, including tachycardia; cardiac ischemia; acute myocardial infarction; thyrotoxicosis (thyroid disease); hypertrophy (increase in volume) of the prostate gland; glaucoma (increased intraocular pressure); treatment with MAO inhibitors. The drug is not prescribed to children under 6 years of age. You should not drink alcohol during treatment.

The drug may reduce the ability to concentrate, so care should be taken when driving vehicles and servicing machinery.

Release form. Tablets containing propyphenazone 150 mg, phenobarbital 20 mg, papaverine chloride 30 mg, codeine dihydrogen phosphate 15 mg, ephedrine chloride 5 mg, atropine methobromide 0.5 mg, in a package of 10 pieces.

Storage conditions. List B. In a dry place, protected from light.

Papaverine hydrochloride is also included in the preparations astfillin, pagluferal, Sereysky mixture, Andipal tablets, Besalol tablets, Pa-lufine tablets, Tepafillin tablets, Theoverine tablets, Teodibaverine tablets.

Antispasmodic (Spasmolytimim)

Synonyms: Adifenin, Difacil, Vagospasmil, Vegantin, Trazentin.

Pharmachologic effect. It has M-cholinolytic activity, suppresses N-cholinoreactive systems of the body and has an antispasmodic (relieving spasms) effect.

Indications for use. Endarteritis (inflammation of the inner lining of the arteries), pylorospasm (spasm of the pylorus muscles), spastic colic, peptic ulcer of the stomach and duodenum.

Method of administration and dose. Orally after meals, 0.05-0.1 g 2-4 times a day, intramuscularly 5-10 ml of a 1% solution.

Side effect. In case of overdose, dry mouth, dizziness, headache, feeling of intoxication, pain in the epigastric region, local anesthesia.

Contraindications. Glaucoma (increased intraocular pressure), a job that requires quick mental and physical reactions.

Release form. Powder.

Storage conditions. List B. In a dry place, protected from light.

Phenicaberanum

Pharmachologic effect. Antispasmodic (relieving spasms) agent.

Indications for use. Used for chronic coronary insufficiency (discrepancy between the heart's need for oxygen and its delivery) with attacks of angina pectoris; for diseases of the digestive tract, accompanied by spasms of smooth muscle organs, chronic cholecystitis (inflammation of the gallbladder).

Method of administration and dose. Orally (regardless of food intake) is prescribed 0.02 g 3-6 times a day, intramuscularly - 2 ml of a 0.25% solution (0.005 g) 2-3 times a day. The duration of treatment is 4-6 weeks.

The drug is more effective when administered parenterally (intramuscularly) than when taken orally.

To relieve (relieve) an attack of angina, phenicaberan is administered only intramuscularly (2 ml of 0.25% solution).

Side effect. Dizziness, headache, general weakness, loss of appetite; in these cases, reduce the dose or temporarily stop taking the drug.

Contraindications. Chronic nephritis (inflammation of the kidneys) with edema and impaired nitrogen excretory function of the kidneys, bleeding ulcers of the stomach and duodenum, diabetes mellitus, pregnancy. Caution is needed in case of myocardial infarction (in the acute period). If blood pressure increases, the drug is discontinued.

Release form. Film-coated tablets, 0.02 g in a package of 20 pieces; 0.25% solution in ampoules of 2 ml in a package of 10 pieces.

Storage conditions. List B. In a place protected from light.