Нестероидные противовоспалительные препараты в практике терапевта


DOI: https://dx.doi.org/10.18565/therapy.2024.1.138-148

А.Е. Каратеев

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой», г. Москва
Аннотация. Нестероидные противовоспалительные препараты (НПВП) занимают центральную позицию в современной системе мультимодальной анальгетической терапии, основанной на комплексном применении немедикаментозных методов и фармакологических средств с различным механизмом действия. Многоплановое действие НПВП определяет их высокий терапевтический потенциал при таких распространенных болезнях скелетно-мышечной системы, как остеоартрит, неспецифическая боль в спине и патология околосуставных мягких тканей. По своей эффективности НПВП превосходят максимальные дозы парацетамола и не уступают опиоидам. При использовании противовоспалительных доз НПВП в течение 7–14 дней уменьшение боли ≥ 50% отмечается у 40–50% пациентов. Однако НПВП могут вызывать серьезные осложнения со стороны желудочно-кишечного тракта (ЖКТ), почек и, главное, сердечно-сосудистой системы. Поэтому при их назначении следует учитывать наличие коморбидных заболеваний и факторов риска, использовать препараты с наилучшим профилем безопасности (для конкретной ситуации) и при необходимости назначать препараты для предупреждения ЖКТ-осложнений (ингибиторы протонной помпы, ребамипид).
Ключевые слова: осложнения НПВП-терапии, эффективность НПВП, болезни костно­мышечной системы, скелетно-мышечная боль, нестероидные противовоспалительные препараты (НПВП), сердечно-сосудистая система, желудочно-кишечный тракт
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Об авторах / Для корреспонденции

Андрей Евгеньевич Каратеев, д. м. н., начальник отдела воспалительных заболеваний суставов ФГБНУ «Научно-исследовательский институт ревматологии имени В.А. Насоновой». Адрес: 115522, г. Москва, Каширское шоссе, д. 34а.
E-mail: aekarat@yandex.ru
ORCID: https://orcid.org/0000-0002-1391-0711


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