What medications should I take to relieve muscle spasms? Myotropic antispasmodic drugs: mechanism of action Antispasmodics act.

Muscle spasm can be either an independent phenomenon or a symptom of a disease. Anti-muscle spasm medications help relieve tension in skeletal muscles, smooth muscles of the digestive tract, and relieve neurotransmitter-induced dystonia.

Causes of the disease

Cramps, pain, dizziness, nausea, tachycardia are symptoms of muscle spasm. This painful condition can be caused by a number of reasons:

• stress, overwork;
• osteochondrosis of the cervical and other parts of the spine;
• structural features of the spinal column;
• pregnancy;
• response to pain;
• intense sports activities;
• vitamin deficiency, lack of micro- and macroelements;
• dehydration;
• hypocarbohydrate diets.

Drug relief of symptoms

A symptom that is associated with certain diseases. Various drugs are used in medicine to treat it.

Use of muscle relaxants

They relieve tension from skeletal muscles and help slow down the conduction of nerve impulses:

1. Mydocalm (tolperisone) is prescribed for osteochondrosis, arthrosis, sclerosis, after surgical interventions, for myalgia and to remove spasms; helps slow down the conduction of nerve impulses, thereby relieving muscle pain, cramps, tension, and dizziness.
2. Sirdalud (tinadizine) is a centrally acting muscle relaxant: it can not only relieve muscle spasms, but also has a pronounced analgesic effect.
3. Baclofen is a muscle relaxant that has virtually no effect on neuromuscular tension and does not cause such weakness as Mydocalm and Sirdalud.
4. Sibazon is a drug that has a pronounced calming effect on the central nervous system, it is classified as a tranquilizer, a benzodiazepine derivative, but it also has muscle relaxant properties: it is used for complex injuries, arthrosis, and myositis.

Use of antispasmodics

Antispasmodic drugs (No-shpa, Papaverine, Mebeverine), which remove spasms from the muscles gastrointestinal tract, hepatic and renal colic.

NSAIDs and sedatives

Non-steroidal anti-inflammatory drugs. The following list of drugs is used in pharmacy:

• Xefocam (lornoxicam);
• Celebrex (celecoxib);
• Nise, Nimesil (nimesulide);
• Movalis, Movasin (meloxicam).

NSAID drugs block the enzymes COX1 and COX2, which are responsible for the production of inflammatory mediators. Due to this, they relieve inflammation, spasm, reduce pain and swelling.

On the pharmaceutical market, drugs in this group are represented by a wide range: Ibuprofen, Ketonal, Piroxicam, Indomethacin, Diclofenac. But they are used less frequently, as they are aggressive towards the gastrointestinal tract.

Sedatives promote relaxation, relieve nervous tension and reduce the conduction of nerve impulses along the fibers. They are divided into the following groups:

• plant origin (Novo-passit, Persen);
• chemical nature (Afobazole);
• combined (Corvalol, Valoserdin, Valemidin).

Vitamins, micro- and macroelements help normalize blood circulation, hematopoiesis, improve tissue trophism, support water-electrolyte balance. The following drugs are used in neurology:

1. Group B vitamins (Kombilipen, Milgamma, Neuromultivit) in injections and tablets: improve blood circulation, hematopoiesis, and impulse transmission along nerve fibers.
2. Magnesium preparations (Magnelis B6, Magne B6, Magnerot, Magnesium Plus) are necessarily used to relieve muscle spasms: they relieve cramps, muscle spasms, improve myocardial contractility, improve mood and performance, and relieve flatulence (bloating).
3. Multivitamins (Supradin, Multi-tabs, Centrum, Complivit, Vitrum) improve the body's metabolic processes.

special instructions

For the treatment of neuralgia, osteochondrosis and other neurological diseases, a complex of the above drugs is used, but they all have contraindications and side effects:

1. Muscle relaxants cause bradycardia and a decrease in blood pressure, dizziness, and reduce the speed of reactions. Therefore, they are prescribed with caution for work that requires increased attention, or prescribed at night.
2. Antispasmodics can cause a decrease in blood pressure. Hypotension and bradycardia are absolute contraindications for use.
3. NSAIDs have an ulcerogenic effect on the gastrointestinal tract. They are prescribed with caution for gastrointestinal diseases. NSAIDs must be taken after meals, preferably with milk.

Features of prescribing drugs for the treatment of muscle spasms

1. For mild pain, local medications are prescribed in the form of ointments (Nurofen, Nise, Ketonal, Voltaren), or patches (Nanoplast, Voltaren, Dorsaplast, Versatis)
2. For osteochondrosis, muscle relaxants are prescribed in combination with NSAIDs and vitamins.
3. For pain that is not relieved by oral and local medications, injections of muscle relaxants, NSAIDs and vitamins are used. Drug provocation leads to pain relief.
4. Often muscle spasms require the prescription of drugs that help normalize blood circulation (Actovegin, Cerebrolysin, Cavinton).

Conclusion

Muscle spasms may be sporadic, especially after physical activity. Then it is enough to take an analgesic or NSAID, and the problem is solved. But often muscle spasm is a symptom of a disease. Then complex therapy is required.

How to relieve pain in this case must be decided by a neurologist. And after removal acute pain It is necessary to undergo a course of massage and physical therapy. To prevent muscle spasms from recurring, you need a proper, balanced diet and physical activity.

Antispasmodics are medical supplies, which are used to relieve pain and muscle spasms in the intestines or to stimulate the passage of food through the digestive tract.

How do antispasmodics work?

Food moves through the digestive tract because muscles tense and then relax along the entire length of the intestine. These muscle contractions are not consciously controlled and are caused by various chemicals that interact with muscle cell receptors. However, in cases like irritable bowel syndrome, the frequency of contractions (peristaltic waves) may occur too frequently and cause symptoms such as abdominal pain, cramping, colic and bloating.

The active substances that make up antispasmodics affect muscle contractions through which food moves through the digestive tract. Therefore, they are used to treat conditions caused by abnormal bowel movements, including irritable bowel syndrome and gastrointestinal diverticulum. In some cases, antispasmodics may be used to relieve symptoms of nonulcer dyspepsia. Antispasmodics that stimulate motility are also used in the treatment of gastroesophageal reflux disease, in which stomach contents enter the esophagus and injure it.

When does a doctor prescribe antispasmodics?

As a rule, if a patient complains of discomfort in the abdomen and pelvis, bloating, or intestinal dysfunction, before prescribing antispasmodic medications, the doctor may recommend that he change his diet, for example, reduce the amount of fiber. This may help normalize muscle contractions in the digestive tract in people with irritable bowel syndrome. Your doctor may also advise you to reduce your consumption of alcohol and tobacco and take a sedative (because stress can also cause disturbances in the digestive tract). If the above measures do not help, the doctor prescribes antispasmodics.

What types of antispasmodics are there?

Antispasmodics can be divided into three groups: drugs that regulate contractions of the smooth muscles of the esophagus (myotropic), anticholinergic drugs (antihistamines and drugs for the treatment of extrapyramidal disorders) and substances that stimulate gastrointestinal motility. All three types of antispasmodics can be used to relieve abdominal pain that occurs with irritable bowel syndrome or esophageal diverticula. Sometimes antispasmodics are used to relieve symptoms caused by disruption of the normal functioning of the stomach and reflux esophagitis.

Drugs that directly affect the smooth muscles of the digestive tract, or myotropic antispasmodics

They have a direct effect on the smooth muscles of the stomach and intestines, causing them to relax and thereby relieving pain. As a rule, myotropic antispasmodic drugs are taken orally. Medications containing small doses of agents that regulate contractions of the esophageal muscles may be available without a prescription.

Some antispasmodics may additionally contain agents that increase the volume of intestinal contents. When taking them, you must drink plenty of fluids, otherwise intestinal blockage may occur. In addition, it is not recommended to take such antispasmodic drugs

Drugs that regulate contractions of the esophageal muscles, sometimes as side effects may cause headache or nausea.

• Mebeverine (contained in two drugs currently presented on the Russian market - Duspatalin and Niaspam);
• Papaverine (drug of the same name);
• Drotaverine (everyone knows "").

Peppermint (oil, tablets). Peppermint oil is thought to work by reducing the entry of calcium into muscle cells, leading to muscle relaxation. Enteric-coated capsules are preferable to pure oil because they deliver the substance directly to the colon. True, some doctors believe that medicinal effect peppermint oil is unconvincing. Peppermint capsules can sometimes irritate the mouth or esophagus, so take them with plenty of water.

Anticholinergic antispasmodics

The active substances contained in antispasmodics of this type work by blocking the flow of chemicals that cause contraction of the walls of the esophagus to the receptors of muscle cells. This type of antispasmodic can reduce muscle spasms by reducing the transmission of nerve signals to the intestinal wall. They are usually taken orally and sold with or without a prescription.

Side effects of anticholinergic antispasmodics may include headache, constipation, dry mouth, redness of the skin, and blurred vision. They may also make it difficult to urinate. Children and older adults are especially at risk of developing side effects.

This group includes active substances:

• Dicycloin (dicyclomine, dicycloverine) in its pure form, as a rule, is not presented, but is included in the following drugs: “Trigan”, “Trigan D”, “Dolospa Tabs”;
• Atropine sulfate is contained in the drug "Spasmoveralgin";
• Propantheline is contained in the medicine “Pro-bantin”;
• Drugs that stimulate gastrointestinal motility

Antispasmodics belonging to this group help food pass through the stomach and intestines, relieving patients of attacks of non-ulcer dyspepsia. Motility stimulants also have a positive effect on the tone of the lower esophageal sphincter, which prevents the discharge of excess stomach contents into the esophagus. It may also help prevent the onset of gastroesophageal reflux disease.

Typically, motor stimulants are taken orally and are available only by prescription. Side effects may cause diarrhea and drowsiness. Sometimes metoclopramide and, in exceptional cases, domperidone can cause uncontrollable muscle spasms, especially of the face, tongue, mouth and neck. This complication is more common in children and young adults, in whom the barrier between the blood and nerve tissue (the so-called blood-brain barrier) is more permeable. Therefore, metoclopramide is not recommended for people under twenty years of age. Both of these drugs can also be used to relieve nausea and vomiting.

Domperidone is part of Motoricum, Domstal, Motilak, Motilium. Metoclopramide. His trade names– “Cerukal”, “Raglan”, etc.

Which antispasmodic drug is the best?

In general, medical research has not shown one type of antispasmodic to be demonstrably superior to another. However, some people may respond better to one type of antispasmodic. Therefore, if one medicine does not help as quickly as we would like, you should change it to one with a similar effect, but with a different composition. Myotropic antispasmodics tend to have the least side effects, so they are usually prescribed first.

How to take antispasmodics?

Medicines should be taken as prescribed by a doctor. The doctor must provide all the required information, including how often this should be done and when exactly (before meals, after meals). Some are advised to take antispasmodic drugs before meals if pain begins after eating.

It is generally recommended to take antispasmodics only when needed (for example, when symptoms worsen and stop taking them when they stop). Note: an antispasmodic drug will relieve pain, but does not promise complete relief from it.

How quickly do antispasmodics work?

They usually take effect within an hour. The effectiveness of an antispasmodic may depend on the dose and frequency of use.

How long should they be taken?

Antispasmodics are usually used to relieve symptoms. You should consult your doctor about this.

Who can't take antispasmodics?

For most people they do not cause side effects. Full list Contraindications are indicated in the instructions that are included in the package with the medicine. In particular, antispasmodics may not be suitable for people with intestinal obstruction, myasthenia gravis, pyloric stenosis (narrowing of the gastric outlet), or prostate adenoma (enlarged prostate gland). Pregnant and breastfeeding women should additionally consult a doctor.

Additional Information

Patients suffering from irritable bowel syndrome tend to attribute any deterioration in their condition to this disease. However, this opinion may be wrong. Therefore, if any changes, especially negative ones, occur in the usual pattern of symptoms, you should consult your doctor. Particular attention should be paid to: weight loss, bleeding from the rectum, blood in the stool.

Antispasmodics mean medicinal substances that eliminate attacks of spastic pain - the main symptom of diseases of the gastrointestinal tract and injuries of mechanical origin (fractures, cuts, burns, etc.). Spastic pain occurs as a result of spasms of the smooth muscles of internal organs, disease of the urinary tract and biliary system. The greatest likelihood of its manifestation occurs with an unhealthy lifestyle, poor diet, diseases of the gastrointestinal tract and in women with PMS. In such cases, antispasmodics relieve tension from the walls of internal organs, thereby removing pain and discomfort.

Antispasmodics are used for acute spasms of the smooth muscles of the gastrointestinal tract, diseases of the bile and urinary tract, colic and acute pain in different parts of the body. In pharmacology, the most effective are antispasmodics, a list of which is provided in accordance with their types and mode of action on the body and general state patient:

Neurotropic antispasmodics: list

Neurotropic antispasmodics stop nerve impulses coming from the smooth muscles of internal organs:

• Category M-anticholinergics.

They stop m-cholinergic receptors and destroy all connections between them and acetylcholine. Helps suppress colic in gastrointestinal disorders:

• "Atropine sulfate" - has antispasmodic and antisecretory effects. After oral administration, it begins to act most effectively after 30 minutes, and injection into a vein gives results within a few minutes;
• "Platyphylline hydrotartrate" - has similar action with atropine;
• "Pirenzipine" is an antiulcer gastroprotective drug that reduces the activity of gastric juice.

Category of anticholinergics

They block the work of acetylcholine, a conductor involved in the transmission of nerve impulses:

• “Methacin” is an antispasmodic, interacts with m-anticholinergic blockers, shielding them from acetylcholine;
• "Homatropin" - acts primarily in the field of m-cholithiasis systems;
• "Scopolamine" - on the principle of atropine, affects the peripheral cholinoreactive systems.

Myolytic category

Relaxes bronchial smooth muscles, used to suppress spasm in the bronchi:

• "Teopek" is a bronchodilator, phosphodiesterase inhibitor;
• "Ventax" - stimulates the work of the respiratory center, normalizes working processes in the lungs, promotes the release of adrenaline and improved blood circulation in the kidneys;
• "Theotard" - has antispasmodic and anti-inflammatory effects. Relaxes the smooth muscles of the bronchus, thereby improving breathing.

Vasodilator category

These drugs have a neurotropic antispasmodic effect, as a result of which vascular tone is removed by suppressing nerve impulses:

• “No-shpa”, or “Drotaverine” - used for chronic diseases Gastrointestinal tract, cholecystitis, gastric ulcer, cerebral vasospasm, kidney disease, urinary tract and biliary tract;
• "Papaverine" - for spasms of peripheral arteries, smooth muscles of internal organs, cerebral vessels and kidney diseases.

Nitrite category

Created to eliminate spasms of the heart muscle, have a myotropic effect, which consists of relieving pain by reducing blood flow to the heart:

• “Sustak” has antianginal, hypotensive, vasodilating and vasodilating effects. Daily dose should not exceed 80 mg in 3-4 doses;
• “Nitroglycerin” is a drug that has peripheral vasodilating properties. Reduces the load on the myocardium, which consequently requires less oxygen, after which its smooth muscles relax and pain decreases.

Myotropic antispasmodics: list of medications

The action of drugs from this category is aimed at influencing the structure of cells in the muscles, changing their biomechanics, resulting in the removal and complete elimination of spasmodic pain. They are divided into two groups: selective and non-selective antispasmodics.

Selective antispasmodics

They have a selective effect and are most often prescribed for problems with the gastrointestinal tract:

• "Mebeverine";
• "Loperamide";
• "Neobutin" is a selective gastrointestinal antispasmodic agent with prokinetic activity;
• "Duspatalin."

On the Internet you can find instructions and reviews for each of the drugs. For example, on this page you can read about a modern medicine for pain http://neobutin.ru/ or on any other resource at your discretion.

Non-selective antispasmodics

They have no selectivity, eliminating painful spasms and thereby excluding any painful sensations:

• "Ketanov";
• "Solpadeine";
• "Nurofen".

The most commonly used antispasmodics: list of drugs for pain

• "Dicicloverin" - eliminates the problem of spasm of the smooth muscles of internal organs.
• "Hyoscine butylbromide" - for diseases of the gallbladder and bile ducts, cholecystitis, hepatic, biliary, intestinal colic and pylorospasm.
• "Papaverine" - for spasm of peripheral vessels, smooth muscles of internal organs, cerebral vessels and renal colic.
• "Benziclan" - for impaired blood flow in the brain, vascular eye diseases, stomach ulcers and other gastrointestinal diseases.
• "Oxybutynin" - for problems with urinary incontinence and nocturnal enuresis.
• “Pinaveria bromide” – for intestinal obstructions, diarrhea, and biliary tract diseases.

Thus, you can choose a medicine for pain of various effects and directions that suits your body. However, it should be remembered that all antispasmodic drugs, the list of which is given above, must be taken only with a doctor’s prescription after an examination and all necessary tests, and then you will forever forget about the very concept of pain.

Antispasmodics - list of drugs

The majority of all pain that occurs is associated with spastic contraction of the smooth muscles of the internal organs. To eliminate this unpleasant symptom antispasmodics are intended - the list of drugs in this group includes about one and a half thousand medications. Some of them are based on natural ingredients, while others are based on artificial chemical compounds.

Classification of the list of antispasmodic drugs

Usually considered medicines are divided into 2 large subgroups according to their mechanism of action:

1. Myotropic. Such antispasmodics change the course of biochemical processes in the tissues and cells of the smooth muscles themselves.
2. Neurotropic. This type of medication acts on the nerves that stimulate the smooth muscles of the internal organs, interrupting or stopping the process of transmitting impulses, irritation, and excitement.

Myotropic antispasmodics

The presented group of drugs, as a rule, includes as active ingredients:

• bencyclane;
• halidor;
• Otilonium bromide;
• drotaverine;
• hymecromone;
• papaverine;
• nitroglycerine;
• isosorbide dinitrate;
• pinaveria bromide;
• bendazole;
• hymecromone;
• mebeverine.

Based on the listed active ingredients The following names of medications are produced:

• Demidov syrup;
• Spasmocystenal;
• Avisan;
• Halidor;
• Driptan;
• Enablex;
• Kellyn;
• Novitropan;
• Bendazole;
• Vero-Drotaverine;
• Demidovsky elixir;
• madder extract;
• Dibazol solution for injection;
• Dicetel;
• Spazoverine;
• drotaverine hydrochloride;
• Plantex;
• Duspatalin;
• Altalex;
• No-shpa;
• Spasmoveralgin Neo;
• Librax;
• Marelin;
• Droverin;
• Papaverine;
• bencyclane fumarate;
• Cistrin;
• mebeverine hydrochloride;
• Trimedat;
• mint tablets;
• Spasmonet;
• peppermint leaves;
• Drotaverine;
• Nyaspam;
• Cystenal;
• Platyfillin;
• peppermint oil;
• Spasmomen;
• peppermint tincture;
• Nosh-Bra;
• Oxybutin;
• pinaveria bromide;
• Ple-Spa;
• Spasmol;
• Nikoshpan;
• Spakovin;
• Dibazol;
• Sparex;
• Trigan;
• fennel fruits.

The given list of antispasmodic drugs helps with pain in the gall bladder, liver, stomach, renal and intestinal colic, premenstrual syndrome and other spastic contractions of internal organs.

The most effective base ingredient of the subgroup of antispasmodics under consideration is atropine sulfate. It is a toxin that blocks the transmission of impulses in nervous system, therefore it has a pronounced and rapid effect on pain syndrome.

Also, as active components for the production of neurotropic antispasmodics, substances similar in their mechanism of action to atropine sulfate are used - M-anticholinergics:

• buscopan;
• hyoscylamine;
• prifinium bromide;
• Arpenal Scopolamine;
• hyoscine butyl bromide;
• platiphylline;
• aprofen methocinium;
• difacil;
• ganglefen.

• Piregexal;
• Vagos;
• Buscopan;
• Gastril;
• Pyrene;
• Metacin;
• Gastromen;
• Pirenzepine;
• Detrusitol;
• Gastrozem;
• Mydriacyl;
• Gastropin;
• Ipravent;
• Pirenzepin;
• Gastrocepin;
• Midroom;
• Hyoscine;
• Platyfillin;
• Oxyvent;
• hyoscyamine sulfate;
• Itrop;
• No-Spasm;
• Platyphylline hydrotartrate.

Combination medications are also produced that eliminate spasm not only of smooth muscles, but also of blood vessels, and also exhibit analgesic properties - Spazmalgon, Baralgin. These antispasmodics are included in the list of drugs for headaches, migraines and other similar pathologies.

Source: https://womanadvice.ru/spazmolitiki-spisok-preparatov

Painkiller tablets of the NSAID group

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a large group of drugs that differ in their chemical structure, mechanism of action, and strength of analgesic and anti-inflammatory effect. The drugs help reduce pain and stop inflammatory processes in various acute and chronic diseases.

Advantages

The main advantage of non-steroidal drugs is their wide range of applications. The drugs help eliminate pain syndrome after injuries and operations, for joint diseases (arthritis, gout, osteochondrosis), cope with migraines and headaches, help with algodismenorrhea (pain during menstruation). In addition to the analgesic effect, NSAIDs inhibit the development of inflammatory processes and lower the temperature during acute viral and bacterial infections.

Flaws

Painkillers from the NSAID group are contraindicated for use by pregnant and lactating women and children (under 6, 12 or 16 years of age). They have an extensive list of contraindications and side effects, among which damage to the digestive tract (the mucous membrane of the stomach and intestines, up to the formation of ulcers and bleeding) and kidneys is most often noted. Often development adverse reactions caused by taking large doses of drugs or their long-term use. To avoid irritating effects on the stomach, they should be taken only after meals.

Antispasmodics

Antispasmodics eliminate attacks of spastic pain that arise from various diseases of the internal organs. The antispasmodic effect is achieved by acting directly on smooth muscle cells or by blocking the transmission of nerve impulses.

Advantages

Drugs help reduce pain in organ diseases digestive system, biliary tract, kidneys and Bladder, pelvic organs. Effectively eliminate colic and pain due to irritable bowel syndrome. With caution, under medical supervision, drugs can be prescribed to pregnant and lactating women and children.

Flaws

The drugs have a fairly wide list of contraindications, including tuberculosis, severe forms of renal, liver and heart failure, and some types of colitis.

Rating of the best antispasmodics

No-shpa

An effective pain reliever based on drotaverine belongs to the group of myotropic antispasmodics. The drug reduces the tone and motor activity of smooth muscles of internal organs, moderately expands blood vessels. Like other painkillers of the antispasmodic group, No-shpa helps relieve pain from spasms of the smooth muscles of the bladder, spastic colitis, diseases of the biliary tract and gallbladder, and peptic ulcers. No-shpa also helps with headaches caused by spasm of blood vessels.

Severe renal and liver failure, intolerance to drotaverine are contraindications for use. No-spa almost never has side effects. However, it must be borne in mind that taking pills can cause a severe decrease in blood pressure, headaches and dizziness, increased heart rate, and insomnia. Long-term use may cause constipation and nausea. The maximum single dose of the drug is 2 tablets, the daily dose is 6 tablets. The duration of treatment without consulting a doctor is no longer than 2 days.

Analogs - Spasmol, Drotaverine, Spasmonet.

• Eliminates spasms of various origins.
• It does not mask appendicitis and other surgical pathologies and does not complicate diagnosis (unlike Analgin and many other painkillers, it can be used for abdominal pain).
• The product is relatively safe, but No-shpa can be taken with caution by pregnant women and children.

• Helps only with spasms. No-spa will not help with dental, joint, muscle pain, pain syndrome after injuries and burns.
• The pain goes away no earlier than half an hour after taking the pill.
• Weak effect, does not always relieve pain completely.
• High cost - about 60 rubles, 6 tablets per package.

Spasmol

The domestic antispasmodic based on drotaverine has a wide range of applications: gastroduodenitis, peptic ulcer, kidney and gallstones, spastic colitis and proctitis, vasospasm (peripheral and cerebral), threatened abortion and postpartum contractions.

In some cases, taking Spasmol provokes a decrease in blood pressure, dizziness, feeling hot and sweating, increased heart rate, and sleep disorders.

Analogs - Drotaverine, No-shpa, Spasmonet.

• Helps with any pain.
• Much cheaper than the similar No-shpa - about 40 rubles for 20 tablets per package.

• A large number of contraindications.
• It only eliminates spasms, but does not always relieve pain.

Combination pain pills

Combined painkillers contain both an analgesic and an antispasmodic as the main components.

Advantages

Thanks to the combination of antispasmodic and analgesic, the drugs act on any type of pain.

Flaws

Due to the combined composition, the safety profile of the drugs decreases, the number of contraindications and side effects increases.

Rating of the best combination painkillers

Rating	#1	#2	#3
Name
Points
Gentle effect on the body
Effectively eliminates painful sensations	Ease of use	Duration of action	Availability in the pharmacy network

A combined drug based on paracetamol, acetylsalicylic acid and caffeine eliminates pain and has a moderate anti-inflammatory and antipyretic effect. Caffeine has a stimulating effect on the central nervous system. But Citramon contains it in low concentration (30 or 40 mg), so it has virtually no stimulating effect on the nervous system, but only improves vascular tone and enhances blood circulation. In addition, caffeine enhances the analgesic and antipyretic effect of paracetamol and acetylsalicylic acid. Citramon eliminates pain in algodismenorrhea, neuralgia, relieves pain in muscles and joints, helps with toothache, headaches, and migraines. The product has a very wide list of contraindications, which is due to the combined composition. Among them are polyposis, bronchial asthma, erosions and ulcers of the gastrointestinal tract, severe course coronary disease heart, arterial hypertension, renal failure, glaucoma, vitamin K deficiency in the body, hemorrhagic diathesis, sleep disorders, increased nervous excitability, age under 15 years, pregnancy, period breastfeeding and others.

• Quickly eliminates severe headaches, including those that occur when the weather changes.
• Cheap - 10–15 rubles for 10 tablets.

• There are a lot of contraindications and side effects.
• May cause nausea.
• Increases blood pressure.
• Relieves mild to moderate pain, but will not help with severe pain.
• If you take it frequently over a long period, the pills stop helping.
• It is best for eliminating headaches, but for joint and muscle pain, after injuries, it has a weak effect.
• It interacts with many drugs (barbiturates, sulfonamides, including biseptol, anticoagulants and others), increasing their toxicity when used simultaneously. Before use, be sure to read the instructions.
• The tablets taste bitter and are hard to swallow.

A combined drug based on metamizole, pitofenone and fenpiverinium bromide has a pronounced antispasmodic and analgesic effect. Used to relieve pain caused by spasm of smooth muscles of internal organs. The main indications are intestinal, renal and biliary colic, biliary dyskinesia, chronic colitis, diseases of the pelvic organs. As an adjuvant it is prescribed for arthralgia, myalgia, neuralgia, for pain caused by diagnostic procedures.

• The drug quickly eliminates abdominal pain and headaches.
• Helps with pancreatitis, urolithiasis.

• A large list of contraindications.
• Significantly lowers blood pressure and is not suitable for hypotensive patients.

The drug based on ibuprofen, fenpiverinium bromide and pitofenone has anti-inflammatory, analgesic and antispasmodic effects. Prescribed for intestinal, renal and biliary colic, biliary dyskinesia. Helps with headaches (including migraines). Used for short term symptomatic treatment for joint pain, myalgia, ischalgia, neuralgia.

• It has a complex effect, helps with any pain, including girls during menstruation.
• It acts quickly – 10–20 minutes after taking the tablet.

• Some patients have to wait a long time, about an hour, for the effect.
• A very large list of contraindications.
• In some cases, after taking the pill, nagging pain occurs in the heart area.

conclusions

It is impossible to unequivocally answer the question of which painkiller is better. The effectiveness of the drug depends not only on its composition, raw materials and technologies used in production. Of considerable importance is the nature and intensity of the pain syndrome, the individual susceptibility of the body to a particular remedy.

The pharmaceutical market offers a large list of modern painkillers. But you shouldn’t get carried away with analgesics by taking them constantly. All drugs in this group have sufficient wide range contraindications, may cause serious side effects, mask clinical picture and can make it difficult to make a diagnosis for pain in the abdomen and heart. Pain syndrome is a manifestation of a particular disease, and it is important not just to relieve pain, but to establish its cause and carry out appropriate targeted treatment.

Classification

Depending on the mechanism of action, all antispasmodics that affect the smooth muscles of the gastrointestinal tract are divided into 2 large groups: neurotropic and myotropic.

Neurotropic antispasmodics inhibit the transmission of nerve impulses to smooth muscle cells. These include:

• m-anticholinergic blockers of central and peripheral action (they are also called atropine-like) - atropine, platyphylline, belladonna preparations (belladonna);
• Peripheral m-anticholinergic blockers – prifinium bromide, hyoscine butylbromide, methocynium bromide;
• centrally acting anticholinergics (difacil, aprofen, ganglefen and others).

Myotropic antispasmodics act on the smooth muscle cells themselves without affecting nerve synapses and impulse conduction. These include the following drugs:

• non-selective Ca2+ channel antagonists – pinaveria and otilonium bromide;
• blockers of Na+ channels coupled to the acetylcholine receptor - mebeverine;
• analogues of cholecystokinin - hymecromone;
• nitric oxide donors (nitrates) – isosorbide dinitrate and nitroglycerin;
• phosphodiesterase inhibitors – drotaverine, papaverine, bencyclane.

The mechanism of contraction of smooth muscle cells: basic physiology

This and the next sections are intended for inquisitive readers who are interested not only in the name and dose of the drug for a specific disease, but also in the mechanisms that occur in our body under its influence. The rest, in principle, can skip them and immediately proceed to the “Indications” section.

Any process in our body is determined by a number of physiological reactions following each other. The same applies to the process of reducing the mining and metals industry.

The main role in stimulating the contraction of smooth muscle cells is played by a substance called “acetylcholine”. On the surface of smooth muscle cells there are several types of receptors, each of which performs a strictly defined function. Thus, acetylcholine interacts with type 3 muscarinic receptors, which leads to the opening of calcium channels located in the cell membrane and the influx of Ca2+ ions into the cell, into the cytoplasm. These ions interact with a special protein, which is also present in the cytoplasm - calmodulin (its function is calcium binding) and activate the enzyme - myosin light chain kinase (the protein that forms the basis of smooth muscle cells). The latter activates myosin, making it possible to interact with the protein actin (it is also found in the smooth muscle cell). These 2 proteins form bonds with each other and seem to shift, approach each other - the cell contracts.

This is exactly how the process of muscle contraction occurs normally.

Mechanism of action and effects of antispasmodics

The main effect of drugs in this group - antispasmodic - is based on the intervention of their components in the mechanisms of contraction of smooth muscle cells, which, as a rule, make up middle layer walls of the digestive tract.

• M-anticholinergics block type 3 muscarinic receptors, which are localized on the surface of smooth muscle cells, and type 1, located in the autonomic nerve ganglia. The conduction of a nerve impulse through these receptors is blocked, an action potential does not occur, and the smooth muscle cells relax. The effect on m1-cholinergic receptors is also accompanied by an antisecretory effect.
• Centrally acting anticholinergics, in addition to the main ones mentioned above, also have a sedative effect.
• For a smooth muscle cell to contract, it must contain sufficient amounts of sodium and calcium ions. The blockade of sodium channels, which is carried out by mebeverine, leads to the fact that the interaction of acetylcholine with the muscarinic cholinergic receptor type 3 is not accompanied by the entry of sodium ions into the cell, and then calcium - the contraction process is disrupted.
• Calcium channel blockers lead to disruption of the processes of calcium ions entering the cytoplasm of SMCs, which disrupts the chain of reactions necessary for its reduction.
• Phosphodiesterase inhibitors act on the enzyme of the same name, which again leads to a decrease in the level of calcium ions in the cytoplasm and a decrease in the contractility of this cell. In addition, these drugs affect calmodulin, reducing its activity.
• Nitrates (nitric oxide donors) interact with special receptors, forming substances that synthesize cyclic guanosine monophosphate (cGMP) inside the SMC. The latter leads to a decrease in the level of calcium ions in the cytoplasm of the cell and, as a consequence, to its relaxation.
• Cholecystokinin analogues act selectively on the sphincters of the gallbladder and Oddi, relaxing them, and thereby ensuring the outflow of bile from the bladder into duodenum, decreased pressure in the bile ducts. These drugs do not affect other parts of the digestive tract.

Indications

The main purpose of taking medications in this group is to eliminate visceral abdominal pain - that which is caused by spasm (sharp contraction) of smooth muscle cells of the hollow organs of the digestive tract.

This same spasm is considered a universal reaction that occurs in response to pathological process(often inflammatory) in the organ. In addition, it develops when the lumen of an organ is blocked - mechanical obstruction.

Relaxation of the smooth muscle cell leads to a decrease in the tone of the wall of the affected organ and pressure in its lumen, which is accompanied by a decrease in pain, normalization of the outflow of contents from the organ (for example, bile from the biliary tract), and improved blood supply to its wall.

For almost any kind of abdominal pain, antispasmodics are used as first-line treatment drugs (of course, not alone, but in combination with other drugs, in particular with enveloping drugs).

If the use of drugs from the NSAID group (analgin, diclofenac) is fraught with, so to speak, “erasing” the symptoms of acute surgical pathology (they should absolutely not be taken if there are symptoms acute abdomen), then antispasmodics do not pose such a threat, therefore they are used in these situations.

Neurotropic antispasmodics affect not only M3-, but also M1-cholinergic receptors, which leads to a decrease in the secretion of digestive enzymes by cells. Their use is preferable in clinical situations in which the antisecretory effect is necessary to improve the patient's condition (for example, in acute pancreatitis).

In addition to gastroenterology, antispasmodics are widely used in other branches of medicine, especially in urology and gynecology - they are successfully used to eliminate spasms of the smooth muscles of the bladder and other parts of the urinary tract, as well as the uterus.

Contraindications

In some cases, the use of antispasmodics is undesirable and even threatens to worsen the person’s condition. Contraindications are:

• individual hypersensitivity to the components of the drug;
• megacolon of any nature;
• severe acute intestinal infections, with severe intoxication syndrome;
• chronic inflammatory diseases intestines (in particular, UC and Crohn's disease) in the active stage;
• pseudomembranous colitis.

The last 3 diseases are dangerous because with moderate and severe cases, fever, pronounced syndrome intoxication and so on, the use of antispasmodics significantly increases the risk of developing colon hypertrophy - a pathology called “megacolon”. This is a serious complication that sharply reduces the patient’s quality of life, in some cases threatening it, requiring surgical intervention.

Conclusion

Antispasmodics are a group of drugs that are widely used in gastroenterology as first-line drugs for the treatment of abdominal pain (stomach pain). There are 2 groups of these drugs - neurotropic and myotropic antispasmodics, each of which includes subgroups that differ in their mechanism of action, but lead to the same result - relaxation of smooth muscle cells and pain relief. In this article we briefly examined these mechanisms, and also talked about general indications and contraindications to the use of antispasmodics, and in the second part we will briefly consider the main representatives of this pharmacological group.

How do antispasmodics work?

The pharmacological action of antispasmodics is considered to be the effect on nerve impulses and muscle cells. Thanks to this property of the drugs, pain is relieved.

Antispasmodics are available in tablet form. Their composition, regardless of the manufacturer, in most cases has few differences. The effects of drugs with different names can be combined into a single list.

Action of antispasmodics:

• reduction in the intensity of pain symptoms;
• decreased muscle tone;
• blocking M-cholinergic receptors;
• choleretic properties (not all antispasmodics);
• direct impact on biochemical intracellular processes;
• elimination of smooth muscle spasm;
• sedative properties.

Types of antispasmodics

The range of modern antispasmodics has expanded significantly. The two main groups of drugs of this type have been supplemented by complex drugs that combine the properties of neurotropic and myotropic antispasmodics.

All types of antispasmodic medications differ in their own properties and have their own indications for use. With cholecystitis, it is not recommended to make a choice on your own.

Antispasmodics are divided into three groups:

• neurotropic drugs (medicines stimulate smooth muscles, disrupt the transmission of nerve impulses in ganglia of the autonomic type and in the endings of the autonomic nerves, stopping a pain attack);
• myotropic drugs (pain sensations are eliminated by such drugs due to their effect on the biochemical processes occurring inside smooth muscle cells);

Exists separate group antispasmodics, which combine the properties of not only blocking pain, but also perform the functions of choleretic drugs. This nuance affects the demand for such medications in the treatment of any type of cholecystitis.

Examples of antispasmodic drugs

The main difference between myotropic antispasmodics and neurotropic drugs of the same group is the principle of action. In the first case, the components included in the medications affect smooth muscles, and in the second - on nerve endings cells.

Examples of myotropic antispasmodics:

• “No-spa” (tablets with the active substance drotaverine hydrochloride, the drug quickly penetrates smooth muscle cells, evenly distributed throughout the tissues, the drug is one of the most popular medications for eliminating pain during the development and exacerbation of cholecystitis);
• “Drotaverine” (the drug has antispasmodic activity, the ability to change the permeability of cells and the potential of their membranes, by improving the lumen of blood vessels, the supply of oxygen to tissues improves, smooth muscles relax, and pain attacks are stopped);
• “Halidor” (the drug reduces the motor activity of smooth muscles, additionally has a sedative effect and a vasodilator effect, restores the patient’s condition in a short period of time and eliminates pain attacks);
• “Papaverine” (the medication is quickly absorbed regardless of the form of release, is used when painful attacks or spasms occur, and significantly relaxes the smooth muscles of the internal organs);

Examples of neurotropic antispasmodics:

• "Difacil" (antispasmodic with choleretic properties, relieves all types of spasms, including smooth muscles of internal organs, this drug is especially recommended for pain attacks at night and their combination with a disturbance in the patient’s emotional state, as well as insomnia);
• "Aprofen" (the drug has the ability to dilate blood vessels, eliminate spasms of smooth muscles, the drug is one of the medications of synthetic origin, has a beneficial effect on gallbladder and urinary tract, easing the patient’s condition during attacks of cholecystitis);
• “Buscopan” (in addition to eliminating spasms of the smooth muscles of internal organs, the drug normalizes the secretion of the digestive glands, this remedy is especially recommended when bitter belching occurs during an exacerbation of cholecystitis and pain accompanying the development of this disease);
• “Atropine” (the drug is recommended for pain attacks of any intensity, in addition to relaxing smooth muscles, the drug normalizes the functioning of numerous glands in the human body, the drug belongs to the category of antispasmodics with the longest possible period of action).

Contraindications

The list of contraindications is always indicated in the instructions for the drugs. Depending on the composition of the medications, the list of prohibitions on their use differs, but some restrictions apply to the entire group of antispasmodics.

In the presence of serious diseases of the vital systems of the body, antispasmodics are prescribed in special dosages or replaced with other drugs.

• colitis (most varieties of this disease);
• tuberculosis (at any stage of development);
• Crohn's disease;
• pathological enlargement of the colon;
• microbial intestinal diseases;
• some congenital pathologies of internal organs;
• individual intolerance to the components included in antispasmodics.

The nuances of taking antispasmodics

With the development of cholecystitis, antispasmodics are included in the main course of treatment. Drugs in this category should be taken not only in accordance with the instructions, but also by following some important rules.

An overdose of such drugs can cause serious health consequences and lack of effectiveness.

Important information about antispasmodics:

• antispasmodics are prohibited for use during pregnancy and lactation (the effect of smooth muscle relaxation can cause serious problems with pregnancy, drugs can provoke premature birth);
• in case of heart or kidney failure, antispasmodics should never be taken without the prescription of specialists (if such deviations are present, antispasmodics are replaced by other means);
• an overdose of antispasmodics causes headaches, blurred vision, nausea, and general weakness, allergic reaction, excitation of the central nervous system and dyspeptic abnormalities;
• independent increase in dosage or uncontrolled use of antispasmodic drugs can cause heart rhythm disturbances, symptoms of tachycardia, arrhythmia, arterial pressure decreases and can create an extremely unfavorable situation for the patient;
• Antispasmodics should be taken with caution by elderly people or patients with an initially weakened condition (the course of treatment for cholecystitis should be carried out not only under the supervision of a doctor, but also preferably in a hospital).

Conventional painkillers do not have the required effectiveness for the development of cholecystitis. There is no point in trying to relieve pain with Aspirin or Paracetamol.

1. Firstly, other groups of drugs affect other internal systems of the body.
2. Secondly, they do not have the property of blocking the nerve endings of cells.

In addition, treatment of cholecystitis should be carried out under the supervision of a doctor, so self-medication can cause complications of the inflammatory process.

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:

1. Neurotropic antispasmodics (M-anticholinergics) . They do not allow transmission nerve impulse on 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.
2. 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.
3. 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.
4. Often used as antispasmodics infusions and decoctions 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 herbs modern man cannot be used as monotherapy, exclusively 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, 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 affect mainly the gallbladder, as well as 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

Thanks to its fast and long-lasting effect, as well as complex mechanism actions, 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 . Helps relieve spastic contractions 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 while taking antispasmodics may vary depending on the nature of the drug itself. medicinal product, 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.