Antispasmodics - classification, action, instructions for use and reviews. Therapeutic properties of antispasmodics in urology, indications and contraindications for use

One of the main symptoms of gastrointestinal dysfunction is pain. Antispasmodics for pain in the intestines eliminate muscle spasms, are also used in gynecology (premenstrual syndrome), in the pathology of the urinary tract and other painful manifestations associated with smooth muscles. Myotropic antispasmodics are the most popular drugs that act on smooth muscle cells.

Drugs have side effects and contraindications

Drotaverine

It differs from papaverine in a longer and stronger effect. It is used in case of contraindications to anticholinergics. Reduces intestinal peristalsis, muscle tone, dilates blood vessels. Does not penetrate the brain. Has high bioavailability. Contraindications: hypersensitivity, cardiogenic shock, hypotension, cardiac, renal and hepatic insufficiency. Caution during pregnancy and lactation, glaucoma, atherosclerosis coronary arteries. Side effects: hypotension, headache, insomnia, tachycardia, constipation, nausea. Advantages - low price.

Produced under the names Drotaverine(45 rubles for 20 tablets), No-shpa(more expensive - 132 rubles), Spazmol, Spazoverin.

Drug Drotaverine

papaverine hydrochloride

Reduces the tone of the muscles of organs and blood vessels. Increases blood flow, including in the brain. In large doses, a sedative effect, a decrease in cardiac excitability and conduction. Used to remove muscle spasms and as a premedication. It is produced in the form of tablets (price from 40 rubles), suppositories, injection solution (10 rubles per ampoule).

mebeverine

Reduces contraction of smooth muscles and their tone. Indicated for the treatment of IBS. Side effects(less compared to drotaverine and papaverine): dizziness, allergies, nausea, diarrhea. Contraindicated in pregnancy. Refrain from activities that require concentration of attention during the treatment period.

Trade names: Meverin, Sparex(from 257 rubles), Niaspam(from 313 rubles), Duspatalin(from 470 rubles).

The drug Duspatalin

Hyoscine butyl bromide

A group of neurotropic antispasmodics that disrupt the transmission of nerve impulses in smooth muscle cells. In addition to the antispasmodic effect, it normalizes (reduces) the secretion of the digestive glands. Does not affect the CNS. Eliminates pain and discomfort in the abdomen associated with cramps. Contraindications: angle-closure glaucoma, pregnancy, pulmonary edema, myasthenia gravis, cerebral atherosclerosis. Caution in the first trimester of pregnancy. The maximum concentration of the drug after 2 hours. Small doses are required to achieve the effect. An effective antispasmodic for the intestines, has no atropine-like action. The minimum likelihood of side effects (less than that of no-shpy): tachycardia, shortness of breath, urinary retention, dry skin, dry mouth.

Tradename - Buscopan: tablets (315 rubles) and rectal suppositories (377 rubles).

Spazmalgon

A combination drug that contains: metamizole sodium (NSAIDs with analgesic, anti-inflammatory, antipyretic properties), pitofenone hydrochloride (antispasmodic, similar to papaverine), fenpiverinium bromide (relaxes muscles, M-cholinergic blocker). The active substances reinforce each other. Contraindications: angina pectoris, CHF, pregnancy and lactation, up to 6 years, intestinal obstruction, high sensitivity. During the treatment period, control the content of leukocytes and liver function, exclude alcohol, drive vehicles. Release form: tablets (from 136 rubles), ampoules (32 rubles per 1 pc.).

Meteospasmil

Combined remedy. Contains alverin - antispasmodic myotropic action, simethicone - reduces flatulence. Indications: disorders of the gastrointestinal tract, preparation for the study abdominal cavity(US, instrumental, X-ray). The cost of capsules is 416 rubles.

Myotropic antispasmodics in tablets are easy to carry, they are easy to use in the right situation.

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Antispasmodics - medicines belonging to the group of pharmaceuticals intended for for efficient and fast removal pain syndrome with a strong negative effect on the body. The considered group of medications actively copes with severe pain having a diverse "nature" of origin, ranging from trauma to menstrual pain.

Mechanism of action

Using antispasmodics, can relieve almost any pain associated with gastrointestinal problems, mechanical injuries (blows, ailments during the rehabilitation period after fractures), menstruation.

Expert opinion

Prikhodko Arkady Arkadievich

Rheumatologist - city polyclinic, Moscow.

Ask your question to a neurologist for free

Irina Martynova. Graduated from the Voronezh State medical University them. N.N. Burdenko. Clinical intern and neurologist of BUZ VO \"Moscow Polyclinic\".

Education: V.A. Nasonova NIIR, Astrakhan State medical Academy.

After taking the medicine, muscle relaxation occurs in the zone of pain formation, as well as blocking of nerve irritating impulses. Thus, the pain spasm is removed. As a result, the pain subsides.

Pharmacological group

The drugs in question belong to the group of "antispasmodics", which includes, among others, herbal (natural) origin.

Types of antispasmodics

In pharmaceuticals, there are several types of antispasmodics. Based on the mechanism of action, antispasmodics are divided into:

• Myotropic.
• Neurotropic.

Neurotropic antispasmodics

The use of drugs in this category contributes to the arrest of nerve impulses coming from smooth muscles internal organs.

In turn, neurotropic antispasmodics are divided into numerous types.

M-anticholinergics
Pharmaceuticals are aimed at stopping m-cholinergic receptors, as well as destroying the connection between acetylcholine and m-cholinergic receptors. Drugs are used mainly in the suppression of gastrointestinal colic.

Examples of M-anticholinergics:

• "Adefinin".
• "Atropine".
• "Scopolamine".
• "Pirenzepine".
• "Platyphylline hydrotartrate".

Cholinolytics
Means of this type block the action of acetylcholine, which is a conductor in the transmission of nerve impulses.

Expert opinion

Filimoshin Oleg Alexandrovich

Doctor - neurologist, city polyclinic of Orenburg. Education: Orenburg State Medical Academy, Orenburg.

Drugs are used for acute pain spasms caused by asthma, gastrointestinal problems.

Examples of anticholinergics:

• "Scopolamine".
• "Homatropin".
• "Metacin".
• "Saracen".

Myolytics
Facilities have a relaxing effect on the smooth muscles of the bronchi. Medications are used to suppress bronchial spasms.

Examples of myolytics:

• "Theodur".
• "Ventax Euphylong".
• "Theotard".
• "Teopak".

Vasodilators
They have a neurotropic antispasmodic effect, in which the tone is removed from the vessels by suppressing the nervous structures.

Examples of antispasmodics with vasodilating action:

• "Papaverine hydrochloride".
• Eufillin.
• "No-Shpa".
• "Theobromine".
• "Nikospan".

Nitrites
Apply with pain spasms in the region of the heart. Preparations of this type have a myotropic effect, i.e. relieve pain against the background of a decrease in blood flow to the heart.

Examples of nitrites:

• "Sustak".
• "Erinit".
• "Nitroglycerine".

Myotropic antispasmodics

The action of the funds of this subgroup directed at the cellular structure of muscles, changes biomechanics, which leads to the removal of painful spasms.

Medications of this subgroup are divided into the following types:

• Selective.
• Non-selective.

Selective antispasmodics
The drugs of the considered subgroup differ in the selectivity of action.

They are mainly used to solve problems with pain syndromes of the gastrointestinal tract.

Examples of selective antispasmodics:

• "Mebeverine".
• "Loperamide".
• "Duspatalin".

Non-selective antispasmodics
Medications of this subspecies do not have selectivity in their action in the elimination of pain.

Examples of non-selective antispasmodics:

• Solpadein.

Antispasmodics: natural and artificial

By nature of origin, the drugs in question are divided into:

• Artificial. Medications produced on the basis of artificial chemical compounds (Bendazol, Driptan, Avisan, Enablex, Plantex, etc.).
• Natural. Means produced on the basis of herbs (marsh calamus, common tansy, mint, lovage, chernobyl).

Indications

Despite the variety of antispasmodics, they have the following list of common effective actions for the sudden onset of painful spasms:

• Withdrawal acute pain in the gastrointestinal tract. A couple of tablets are enough to relieve pain in the abdomen, side, etc.
• Cupping painful syndromes with irritable bowel.
• smooth muscles of internal organs.

Contraindications

To antispasmodics should be approached with caution. Each drug has its own contraindications. However, they have some general contraindications that you need to familiarize yourself with before using them.

Only the attending physician can determine exactly which medications can be prescribed to the patient, based on his associated pathologies, so as not to harm the body.

To similar general contraindications include the following items:

• When a megacolon is found (enlarged colon).
• Crohn's disease.
• When establishing colitis (separate subspecies).
• The presence of tuberculosis (regardless of stage).
• In intestinal pathologies associated with active development microbes.

The patient should use antispasmodic drugs only after a medical examination, or be aware of their comorbidities.

special instructions

Both types of antispasmodics (neurotropic, myotropic) have general guidelines for their use. This is important for every patient to know before taking them.

• Pregnancy. Using antispasmodics during pregnancy, women risk the fetus, as some components can affect the development of the unborn child. It is possible to take drugs such as "Papaverine", "", "Riabal".
• Coordination. Such medications, like Drotaverine, can cause some state of inhibition in actions, drowsiness. For this reason, injections or tablets of antispasmodic drugs should be excluded for professional drivers and people who often drive a car. This also applies to Solifenacin.
• The vast majority of antispasmodics are prohibited for use in childhood although there are some exceptions. "Drotaverin" - from 2 years old, "Hyoscin butyl bromide" - from 8 years old, "Pinaverium bromide" - from 14 years old. It is advisable to use products of natural origin. By making a decoction of special herbs that bring an analgesic effect, you can protect the child from serious side effects.
• Aged people. It should be prescribed with caution, taking into account the advanced age of patients in this group. This is due to the presence of possible comorbidities that can cause a serious condition in the body.

In addition, there are special instructions and storage of antispasmodic drugs. Leaving funds within the reach of children is not acceptable.

A cool and dark place of storage has a positive effect on the shelf life of antispasmodics.

Overdose

In the event of an overdose, antispasmodics can give the following negative reactions on the body:

• Disorders of a dyspeptic nature, including vomiting, nausea.
• The patient may feel very dizzy.
• Severe lethargy, loss of physical tone.

Side effects

Care should be taken in choosing one or another antispasmodic, based on possible side effects. Possible side effects are as follows:

• Seizures are excluded.
• allergic reactions in the form of urticaria, rash, erythema, itching.
• The course of taking a medication may be accompanied by flatulence.

Complex preparations

Funds of this type have a wide spectrum of action that can help with almost any pain that has arisen, regardless of the nature of its origin. Such funds help with pain (relieve angiospasms) of vascular diseases, with pain disturbances in the lower back, with problems of cerebral circulation.

Thus, combined agents combine the ability to eliminate spasms, both smooth muscles and blood vessels.

The following complex medications are most in demand:

• Spazmalgon.
• "Spazgan".

What antispasmodic to use?

With the elimination of pain spasm results will be faster if you use certain tools.

Use for osteochondrosis

Recipes to get rid of headaches cervical osteochondrosis a bunch of. However, the most effective of all is the use of "Baralgin".

With osteochondrosis of the cervical region, tablets "Drotaverine" and "Papaverine" are effective.

These medications not only improve blood circulation in the cervical spine, but also successfully relieve muscle tension, which leads to a long-awaited relief of the patient's condition.

If the main pain zone for osteochondrosis is the lower back, then specialized injections should be used. With osteochondrosis lumbar Mydocalm injections have confirmed their effectiveness. The medication has a general effect, so it can help with osteochondrosis in various parts of the spine. After a couple of Mydocalm injections, the patient will feel a noticeable relief, as well as an improvement when walking and turning his arms. This is due to the presence of lidocaine in injections, which creates a powerful anesthetic effect. In the vast majority of cases, if it becomes especially severe, doctors without fail resort to the help of "".

Use for headache

Medications-antispasmodics easily solve the problem with sudden severe headaches. Doctors recommend taking "Benziklan", "Drotaverin", "Papaverin" for spasms of cerebral vessels.

These funds normalize blood circulation in the neck, which brings additional oxygen to the brain, and also relieve muscle stiffness.

Conclusion on the topic

Sudden surging pain does not make sense to endure if it is of a prolonged nature. It is advisable to use antispasmodics in case of helplessness of analgesics. It is important to remember that the use of antispasmodics should be agreed with your doctor. Only a specialist can give optimal recommendations on the use of a particular drug of the group of painkillers under consideration. Otherwise, it may cause collateral damage to the health of the patient.

For this reason, it is advisable to familiarize yourself with the instructions for the antispasmodic, or visit the therapist's office.

Smooth muscles and used to prevent or eliminate spasms of smooth muscle organs. Examples of clinically significant effects of these drugs are: elimination of pain caused by muscle spasms of the abdominal organs, improvement of lung ventilation due to bronchial expansion during bronchospasm, decrease and increase in blood flow in peripheral vessels as a result of a decrease in the tone of the vascular wall.

According to the mechanism of action, myotropic and neurotropic antispasmodics are distinguished. Myotropic S. with. reduce the tone of smooth muscle organs by directly influencing the biochemical processes occurring in smooth muscle cells. In experiments on isolated organs, they lower the tone of smooth muscles, blood vessels, bronchi, intestines, urinary and biliary tracts, etc. Under conditions of the whole organism individual groups myotropic S. with. show unequal to different smooth muscle organs and therefore are used mainly for certain indications, for example, as bronchodilators (bronchodilators), antihypertensives (antihypertensives), as well as for pain caused by spasms of smooth muscles of organs gastrointestinal tract.

Myotropic antispasmodics belong to different classes of chemical compounds. Among them are distinguished: nitrites and nitrates - amyl nitrite, nitroglycerin, nitrosorbide, etc.; isoquinoline derivatives - papaverine, no-shpa; purine derivatives - theobromine, theophylline, xanthinol nicotinate, etc.; benzimidazole derivatives - dibazol; esters of carboxylic acids - gangleron, diprofen, etc. To myotropic S. with. different chemical structures with a pronounced vasodilating effect include diazoxide, apressin and sodium nitroprusside, which are usually considered as the main focus of action. As S. page, effective at coronary disease hearts and arterial hypertension, use calcium channel blockers - fenigidin, verapamil and diltiazem. Captopril, an angiotensin-converting enzyme, is also used as an antihypertensive agent, which proved effective not only in renin-dependent, but also in other forms of arterial hypertension.

Myotropic S. with. from among the purine derivatives, they relax the smooth muscles of the bronchi, dilate the coronary vessels of the heart, the vessels of the brain, reduce the tone of peripheral vessels and lower blood pressure, pressure in the pulmonary vessels and stimulate the heart, increasing its need for oxygen. However, the bronchodilator effect of this group of drugs is of greatest practical importance.

The neurotropic S. pages, which have a predominantly bronchodilator effect, include isadrin, orciprenaline, salbutamol, fenoterol, and others (see Adrenomimetic agents), as well as the sympathomimetic ephedrine. They are used to stop and prevent attacks of bronchial asthma. The bronchodilator effect of these drugs is due to their stimulating effect on β 2 -adrenergic receptors. However, all these drugs to a greater or lesser extent also stimulate β 1 -adrenoreceptors of the myocardium, which is the cause of a number of side effects (tachycardia, extrasystoles, etc.) when they are used as bronchodilators. These properties are least pronounced in the so-called selective β 2 -blockers (salbutamol, fenoterol, etc.). Of practical importance is the antispasmodic effect of β-adrenergic agonists in relation to the myometrium, because, by stimulating β 2 -adrenergic receptors of the uterus, adrenomimetics lower its tone and contractile activity and, therefore, are used as tocolytic agents (Tocolytic agents).

II Antispasmodics (spasmolytica; .:, antispasmodics)

drugs that relieve spasm of smooth muscles of internal organs (atropine, papaverine, theophylline, etc.).

1. Small medical encyclopedia. - M.: Medical Encyclopedia. 1991-96 2. First health care. - M.: Great Russian Encyclopedia. 1994 3. Encyclopedic dictionary of medical terms. - M.: Soviet Encyclopedia. - 1982-1984.

See what "Anspasmodics" are in other dictionaries:

- (from spasm and Greek lysis relaxation) medicinal substances that relieve spasms of smooth muscles of internal organs, etc. Used for bronchial asthma, renal colic, etc ... Big Encyclopedic Dictionary

- (from spasm and Greek lýsis relaxation), medicinal substances that relieve spasms of the smooth muscles of the internal organs. It is used for bronchial asthma, renal colic, etc. * * * encyclopedic Dictionary

- (antispasmodics), lek. in va, causing a decrease in tone or elimination of spasm of smooth muscles of blood vessels and ext. organs (gastrointestinal tract, bronchi, uterus, biliary and urinary tract, etc.). Spasmolytic. they possess you ... ... Chemical Encyclopedia

Antispasmodics- (Spasmolytica) group medicinal substances, relaxing the smooth muscles of all internal organs, especially blood vessels, intestines and uterus. An important place in this group is occupied by vasodilators, including antihypertensives, ... ... Veterinary Encyclopedic Dictionary

- (from Spasm and Lysis) pharmacological substances of various chemical structures that cause relaxation of the smooth muscles of the internal organs: blood vessels (see. Vasodilators), bronchi, gastrointestinal tract, ... ... Great Soviet Encyclopedia

- (spasmolytica; synonym: antispasmodics, antispasmodics) drugs that relieve spasm of smooth muscles of internal organs (atropine, papaverine, theophylline, etc.) ... Big Medical Dictionary

Antispasmodics- [from Greek. spasma lysis dissolution, weakening] drugs that relieve spasms of smooth muscles of blood vessels, bronchi, internal organs ... Psychomotor: a dictionary-reference - affect the contractile activity and tone of the myometrium (smooth muscles of the uterus). To M. pages that enhance the motility of the myometrium include oxytocin, its semi-synthetic. an analogue of deaminooxytocin (the NH2 group of cysteine ​​and the H atom are replaced), some others ... ... Chemical Encyclopedia

Antispasmodics - drugs to eliminate pain caused by spasms of smooth muscles. These pharmacological preparations not only reduce the severity of symptoms, but are also used in complex therapy various diseases. Most often, antispasmodics are used in the treatment of pathologies of the urinary and cardiovascular systems, as well as the gastrointestinal tract. Manufacturers produce drugs in the form of injection solutions, tablets, capsules, dragees, rectal suppositories. In recipes traditional medicine herbs, flowers and roots are mentioned, which have antispasmodic properties.

By acting on the smooth muscle muscles of the internal organs, antispasmodics eliminate the cause of pain

Characteristic features of medicines

The human musculature consists of smooth and striated muscles. The contractions of the latter are controlled by the central nervous system. With the help of striated muscles, a person maintains balance, moves, changes the position of the body in space. They are mainly located in the limbs, torso, neck and head. Smooth muscle is found in the walls of:

• lymphatic vessels;
• arteries;
• capillaries.

Hollow internal organs contract due to the presence of precisely smooth muscle membranes. They maintain the tone of all blood vessels, thanks to them food moves through the gastrointestinal tract. If a person could control smooth muscles, then there would be no problems in various systems of his life. But this type of muscle is under the control of the autonomic system, so innervation disorders and other disorders lead to spasms.

Medicines help to restore the functional activity of the stomach, intestines, gallbladder or bladder. These include antispasmodics that relax the smooth muscles of the hollow internal organs. As a result of a decrease in the tone of muscle fibers, discomfort caused by spasms is quickly stopped.

Classification

Spasmodic pain is an integral part clinical picture many diseases. Their treatment begins with the use of antispasmodics, which alleviate the symptoms, allow for a full-fledged etiotropic and pathogenetic therapy. Some of these drugs (for example,) affect only the smooth muscle muscles of certain internal organs. This selectivity helps to avoid complications and undesirable consequences. Other antispasmodics () affect all smooth muscles in the human body. This significantly limits the range of patients in whose treatment such drugs can be used.

Warning: “Broad-spectrum antispasmodics are used with caution in the treatment of pregnant women. The drugs affect the uterus, which can cause premature birth. Women who are carrying a child should be serious about choosing pills, even for a banal headache.

Antispasmodics are available in various dosage forms, including rectal suppositories.

Myotropic drugs

Under the action of myotropic antispasmodics, the ionic balance in cell membranes changes as a result of a direct effect on smooth muscle muscles. The contractile activity of cells decreases after the launch of complex biochemical reactions. Antispasmodics of this group are able to relax the smooth muscles of certain internal organs, reducing the severity of pain and discomfort. These medicines include:

• Benziklan;
• Halidor;
• Drotaverine;
• Hymecromon;
• Nitroglycerine;
• Isosorbide dinitrate;
• Bendazole;
• Hymecromon;
• Mebeverine.

Myotropic antispasmodics are used for disorders of the gastrointestinal tract, menstrual pain, digestive disorders of neurogenic etiology. They quickly reduce the tone of the smooth muscle of the organs. Papaverine hydrochloride normalizes the internal conductivity of the heart muscle.

Warning: Antispasmodics various kinds should not be taken without a doctor's prescription. The drugs have various contraindications, including intestinal infections, Crohn's disease, childhood.

Neurotropic drugs

Neurotropic antispasmodics are drugs that can affect the conduction of impulses in the autonomic nervous system. Such drugs do not have a direct, but an indirect effect on the smooth muscle muscles of the internal organs. They are used in the treatment of diseases of the respiratory and biliary tract, organs of the urinary system and the digestive tract. In addition to therapeutic, neurotropic drugs also exhibit antispasmodic properties. The following drugs have the greatest therapeutic efficacy:

• Difacil;
• Buscopan;
• scopolamine arpenal;
• Hyoscyamine;
• Platifillin;
• Aprofen;
• Atropine sulfate;
• Ganglefen.

Neurotropic antispasmodics may differ in the mechanism of action on smooth muscle muscles. Some drugs normalize the innervation of impulses to the central nervous system due to its ability to influence receptors located in blood vessels. Due to this mechanism, the activity of the endocrine glands decreases, the heart rate increases, and the secretion of gastric juice increases.

The second group of neurotropic antispasmodics acts more selectively. They affect directly the receptors of the bladder, urethra, stomach, intestines. The active substances of these drugs do not penetrate into the smooth muscle fibers of the internal organs of other vital systems.

No-shpa is one of the most commonly used antispasmodics for pain relief.

neuromyotropic drugs

This type of antispasmodics exhibits myotropic and neurotropic properties. Medicines are included in this group not only chemical composition, but also by the complex effect on the smooth muscle muscles of internal organs and blood vessels. Camylofin has a neuromyotropic effect due to its structure, and other preparations contain several ingredients with certain antispasmodic properties.

Combined drugs

For combined, or complex, antispasmodics, the manifestation of several therapeutic effects. Baralgin, Spazgan, Spazmalgon have analgesic and antispasmodic effects. Some medicines help to stop inflammatory process and even reduce elevated temperature body. As a result, the human condition improves by eliminating the cause of the pathology and the symptoms provoked by it.

Therapeutic properties

There is another classification of antispasmodics, which takes into account the overall therapeutic effect of drugs on the human body. Also, tablets and injection solutions exhibit side effects that do not allow their use in the treatment of patients with chronic diseases. For example, some antispasmodics can reduce arterial pressure. They can not be taken to normalize the work of the gastrointestinal tract for hypotensive patients.

Painkillers

Doctors recommend these drugs to patients diagnosed with cholecystitis, pancreatitis, biliary colic. They are effective for painful cramps during menstruation. Due to the ability to dilate blood vessels, painkillers are used in such pathologies:

• migraines;
• arterial hypertension;
• disorders of the blood supply to the brain.

Some antispasmodics eliminate pain in the heart, others affect the smooth muscles located in the bronchi. This group includes drugs (Duspatalin), which are used in the treatment of diseases of the digestive system. They not only reduce the severity of pain after eating, but also help to normalize the work of the gastrointestinal tract.

Vasodilators

The group of myotropic antispasmodics includes drugs with a vasodilating effect, which occurs due to the relaxation of the smooth muscles of the hollow internal organs and blood vessels. Drugs are used primarily to eliminate pain. Myotropic antispasmodics are used not only for the treatment of organs various systems life, but also as a prophylactic to prevent recurrence of chronic pathologies.

Eufillin exhibits not only the properties of an antispasmodic, but is also able to dilate blood vessels. This drug is often used in injection dosage form to reduce persistent venous or intracranial pressure. Eufillin is not used to treat patients with coronary insufficiency, as one of its side effects is tachycardia.

Hypotensive

Nicotinic acid, Phenobarbital and Papaverine hydrochloride are used in combination to relieve spasms of blood vessels located in the brain and lower blood pressure. The use of antispasmodics in the treatment of hypertension is most relevant in atherosclerosis. Drotaverine, although slightly, lowers blood pressure. This drug does not affect the cause of the pathology, but it well eliminates its main symptom - a headache.

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Antispasmodics- group medicines that eliminate attacks of spastic pain, which is one of the most unpleasant symptoms in the pathology of internal organs.

Spasmodic pain is a spasm of the smooth muscles of the internal organs, including the gastrointestinal tract, urinary tract, and biliary system. Spasmodic pain most often appears with premenstrual syndrome (PMS), nutritional errors, chronic diseases of the gastrointestinal tract (gastric ulcer, duodenum, biliary system, etc.). Antispasmodics in such situations relax the muscles, relieve spasm and, accordingly, significantly reduce pain.

classification

Antispasmodics can be classified according to their mechanism of action into:
1. Neurotropic antispasmodics - affect the process of transmission of nerve impulses to the nerves that stimulate the smooth muscles of one or another internal organ. Basically, these are M-anticholinergics - atropine sulfate and the like: platifillin, scopolamine, hyoscilamine, belladonna preparations, metocinium, prifinium bromide, arpenal, difacil, aprofen, ganglefen, hyoscine butyl bromide, buscopan;
2. Myotropic antispasmodics - have an effect directly on smooth muscle cells, changing the biochemical processes occurring inside them. Their basis is drotaverine (No-shpa), benziklan, papaverine, bendazol, hymecromon, isosorbide dinitrate, nitroglycerin, mebeverine, otilonium bromide, pinaverium bromide, halidor, hymecromon.

Antispasmodics are also classified by origin:
1. Natural antispasmodics - lovage pharmacy, belladonna, chamomile, oregano, calamus marsh, orthosiphon (kidney tea), May lily of the valley, black henbane, common tansy, Chernobyl herb, mint;
2. artificial medications.

Release form

• Antispasmodic tablets - Buscopan, Galidor, No-Shpa, Drotaverin, Drotaverin-Ellada, Nosh-Bra, No-Shpa Forte, Spazmonet, Spazmol, Spazmonet-Forte, No-Shpalgin, Driptan, Spazoverin, Dicetel, Vezikar, Nikoshpan, Trimedat, Papazol, Bekarbon, Besalol, Papaverine, Platifillin;
• Tincture - peppermint tincture;
• Antispasmodic suppositories (rectally) - Buscopan, belladonna extract, Papaverine;
• Granules for the preparation of the solution - Plantaglucid, Plantacid;
• Whole fruits - cumin fruits;
• Drops for oral administration - Valoserdin, Zelenin drops;
• Capsules - Sparex, Duspatalin;
• Antispasmodics in ampoules - solutions for intravenous and intramuscular injections - Dibazol, Trigan, Droverin, No-Shpa, Spakovin, Papaverin, Platifillin (subcutaneously).

Pharmacological group

Antispasmodics (including herbal or combined).

pharmachologic effect

The antispasmodic effect is provided by interference in the mechanism of muscle contraction. Antispasmodics stop an attack of spastic pain due to the effect either directly on smooth muscle cells, or by blocking the ones going to them. nerve impulses.

Indications for use

TO general indications include: elimination of spasms of smooth muscles of the gastrointestinal tract, biliary and urinary tract, removal of colic, elimination of pain in irritable bowel syndrome, hypertonicity, treatment of diseases of the cardiovascular system.

Dicycloverine- eliminates spasms of smooth muscles of internal organs (intestinal, hepatic, renal colic, algomenorrhea).

Drotaverine- used for chronic gastroduodenitis and cholecystitis, postcholecystectomy syndrome, cholelithiasis, peptic ulcer stomach and duodenum, spastic colitis, cardio - and pylorospasm; with spasm of cerebral vessels, as well as spasms of arterial peripheral vessels; renal colic, algomenorrhea, to reduce the intensity of uterine contractions and eliminate cervical spasms in childbirth, as well as when performing a number of instrumental studies. In diseases of the biliary tract: cholangiolithiasis, cholecystitis, cholecystolithiasis, pericholecystitis, cholangitis, papillitis. With spasms of smooth muscles of the urinary tract: urethrolithiasis, nephrolithiasis, cystitis, pyelitis, bladder tenesmus.

Hyoscine butyl bromide- with spastic dyskinesia of the gallbladder (including the biliary tract), cholecystitis, hepatic, biliary, intestinal colic, peptic ulcer of the duodenum and stomach, algomenorrhea, pylorospasm.

Papaverine - with spasms of peripheral vessels, smooth muscles of internal organs, cerebral vessels, with renal colic.

Benziklan- with disorders of cerebral circulation, atherosclerotic genesis or angiospastic (in complex therapy), cerebrovascular diseases. In vascular eye diseases (including diabetic angiopathy, occlusion of the central retinal artery). With obliterating diseases of peripheral arteries of any origin, angiodystonia, postoperative and post-traumatic circulatory disorders. With peptic ulcer of the stomach and duodenum, other diseases of the gastrointestinal tract, accompanied by hypermotor or spastic dyskinesia of the esophagus, biliary tract, intestines (enteritis, gastritis, colitis, cholecystopathy, tenesmus, cholelithiasis, postcholecystectomy syndrome). In urology - with spasms of the urinary tract, and also as an adjuvant therapy for nephrolithiasis.

oxybutynin- with urinary incontinenceassociated with instability of the bladder function, impaired or as a result of disorders of a neurogenic nature (detrusor hyperreflexia - a muscle that contracts bladder, for example, with spina bifida, common sclerosis) or with idiopathic disorders of the detrusor function (motor incontinence). This drug is also prescribed for nocturnal enuresis (in children older than 5 years).

Pinaverium bromide- with violations of the transit of intestinal contents and discomfort caused by functional disorders from the intestines, as well as for the treatment of pain associated with functional disorders of the biliary tract and in preparation for an X-ray examination of the gastrointestinal tract using barium sulfate.

Instructions for use

All antispasmodics must be used strictly in accordance with the instructions of the doctor, subject to an accurately established diagnosis.

Antispasmodics for children

Each manufacturer indicates the features of taking their form of the drug in children. For example, in some forms, drotaverine is not used in children under 2 years of age, in others it is recommended daily dose for children aged 1-6 years is 40-120 mg (in 2-3 doses), over the age of 6 years - 80-200 mg (in 2-5 doses). Hyoscine butylbromide is prohibited for children under 6 years of age. Pinaverium bromide is not recommended for under 18s. Natural antispasmodics (infusions and decoctions, as a rule) are prepared from individual plants or from collections containing flowers, roots, leaves, stems. They are given to children various diseases accompanied by spasms or convulsions.

Antispasmodics for newborns

Spasmolytics for newborns are very limited for use, there are only a few items that pediatricians are allowed to give to children. M-anticholinergic prifinium bromide in certain forms relieves spasms and relieves pain. Infants up to 3 months it is administered orally as a syrup, 1 ml every 6-8 hours; from 3 to six months - 1-2 ml every 6-8 hours, from 6 months. up to a year - 2 ml every 6-8 hours; from 1 year to 2 years - 5 ml every 6–8 hours. Children are also prescribed herbal preparations containing natural antispasmodics - peppermint, fennel oil, anise, dill.

Antispasmodics for pregnant women

Antispasmodics should be prescribed to pregnant women with caution only if the expected benefit from therapy outweighs the potential risk to the fetus. For many drugs, there are no clinical data for pregnant women; for some, pregnancy is a contraindication (bencyclane, dicycloverine, hyoscine butylbromide).

Antispasmodics during lactation

Basically, the appointment of antispasmodics during lactation is not recommended, or drotaverine, bendazole are prescribed with caution (in some forms, only if the potential benefit is greater than the harm to the child). When taking oxybutynin, breastfeeding should be discontinued.

Antispasmodics for headaches

Drotaverine, papaverine, benziklan, mainly in tablet form, contribute to a decrease in the intensity of headache caused by spasms of cerebral vessels or cerebrovascular accident. Also good effect and relief of seizures are given by complex preparations, which, in addition to antispasmodics, also contain anti-inflammatory and analgesic components.

Antispasmodics for menstruation

With menstruation, antispasmodics based on drotaverine are effective (but are prescribed with caution to women with low blood pressure), herbal antispasmodics (herbal infusions), dicycloverine, hyoscine butylbromide, or combined drugs. Since the pain symptom can be expressed very clearly, even bedridden some women, their use gives a good result, alleviating spasmodic attacks and improving blood circulation.

Antispasmodics for cystitis

The appointment of antispasmodics for cystitis will help relieve painful spasm, reduce tone, reduce the urge to urinate and facilitate unpleasant symptoms. In this disease, drugs based on drotaverine are effective: No-Shpa tablets, papaverine, platyfillin - in the form of injections, bencilan (as a component of complex treatment).

Antispasmodics for the elderly

Antispasmodics for the elderly should be prescribed with extreme caution, taking into account concomitant diseases and pathologies, as well as taking other medications, the effect of which may affect the effectiveness of antispasmodics and vice versa.

Antispasmodics for pancreatitis

The appointment of antispasmodics in pancreatitis is primarily aimed at reducing the pain syndrome, which is quite pronounced and manifests itself in acute, lingering, constant or periodic pain. Together with others medicines they ease the course of the disease. The most commonly used for this disease are papaverine and its derivatives, drotaverine (No-Shpa and its other commercial names), platyfillin (1-2 mg every 12 hours), atropine. In acute pancreatitis, drotaverine begins to act within a few minutes, giving relief, and the maximum effect occurs after 30 minutes. Papaverine relieves spasm of the muscles of internal organs, reduces the tone of smooth muscles and relieves pain.

Antispasmodics for renal colic

Renal colic is characterized by very pronounced pain, so pain relief is the first task during an attack. The patient is prescribed platifillin in injections of 1 mg or 5 mg tablets (for children by age it is prescribed in a dose of 0.002 (0.2 mg) to 0.003 g (3 mg) per dose, drotaverine tablets, atropine (its relaxing effect is used to treat colic of various localization, including strong renal).

Antispasmodics for the intestines

Since the intake can cause constipation, especially in the elderly, whose bowel function is already weakened, it is important to take into account such points when prescribing. With all kinds of intestinal diseases, pinaverium bromide has an excellent antispasmodic effect, which should be taken with meals, drinking plenty of water, without dissolving and chewing 50 mg 3-4 times a day. Children are not recommended. Mebeverine lowers the tone and reduces the contractile activity of the smooth muscles of the gastrointestinal tract (large intestine mainly) - it is used to treat abdominal pain, in violation of the chair, secondary spasms and irritable bowel syndrome: tablets 3 times a day, capsules - 2 times in 20 minutes before meals (daily dose of 400 mg). Side effects and low efficiency limit the use of anticholinergics in intestinal diseases.

Antispasmodics for cholecystitis

With cholecystitis, antispasmodics help reduce pain symptoms, in particular, anticholinergics (atropine, platifillin) and papaverine, drotaverine are prescribed. The most effective is the appointment of mebeverine hydrochloride 2 times a day, 200 mg, and pinaverium bromide 3 times, 100 mg. With hypotonic dyskinesia, tonic drugs are used; antispasmodics should be avoided. With cholecystitis, it is recommended to drink an infusion of natural antispasmodic peppermint, 3 times a day for half a glass after meals.

Antispasmodics for osteochondrosis

Antispasmodics for osteochondrosis assist in the removal muscle tension, reduce tension and improve blood circulation in the local area, which has a positive effect on the patient's well-being and reduces the severity pain. In this disease, mainly papaverine and drotaverine are prescribed.

Electrophoresis with antispasmodics

Electrophoresis with antispasmodics is indicated in the acute period of spinal injury in children. With papaverine 0.5%, electrophoresis can be performed from 5-10 days of life. Electrophoresis treatment with papaverine is also used for spinal enuresis. According to the recommendations of neurologists, such treatment is carried out for hypertonicity in children. This procedure with drotaverine and papaverine is indicated for hyperkinetic disorders of the biliary tract and spastic constipation. The technique is transverse, the current density is 0.03-0.05 mA/cm2, for 8-12 minutes, daily; course 8-10 procedures.

Antispasmodics for gastritis

Antispasmodics for gastritis are one of the most effective drugs relieving discomfort and pain. It should be noted that when taking anticholinergics, an additional effect is observed - a decrease in acidity, so they must be taken with excessive secretion.

Antispasmodics for urolithiasis

Renal colic is one of the main manifestations in this disease, characterized by changes in urinary tract and kidneys with the formation of urinary stones in them. With colic, pain is aching, dull, constant, sometimes acute, so the use of antispasmodic drugs, including combined ones, alleviates the patient's condition by relieving spasm of the smooth muscles of the ureters. Drotaverine and benziklan, as well as complex antispasmodics, are combined with drugs that promote the destruction and discharge of stones.

Antispasmodics for colitis

In chronic and ischemic colitis, papaverine and drotaverine (1-2 tablets 2-3 times a day), platyfillin are prescribed to reduce pain, relieve spasms and weaken violent intestinal motility. With diarrhea, astringents and enveloping agents are combined with atropine sulfate.