Spasmoanalgesic Baralgin

The drug contains three active components: an analgesic, an antispasmodic and a parasympathomimetic. As is known, pathological processes occurring in the human body are often accompanied by smooth muscle spasms. Acetylcholine plays an important role in this process, especially its excess content. These processes can be controlled with the help of anticholinergic agents.

Theoretically, any substance that in a proportionate dose weakens the spasm of smooth muscles caused by acetylcholine can be used as an antispasmodic. In practice, not all anticholinergic substances are used as antispasmodics. The fact is that, in addition to the spasmolytic effect, anticholinergic substances affect the function of the heart, sweat and salivary glands, etc., which is undesirable in some cases. In addition, some of them, especially M-anticholinergics in relatively small doses cause a disorder of the central nervous system. Spasms of smooth muscles are caused not only by acetylcholine, but also by other spasmogens - histamine, serotonin, barium ions. Thus, a typical acetylcholine antagonist - atropine nevertheless manifests its spasmogenic activity in different ways. In this regard, we present a classification of antispasmodics depending on the place and mechanism of elimination of spasms of smooth muscles. All antispasmodics are divided into three main groups:

• neurotropic antispasmodics: solanaceae alkaloids - atropine; semi-synthetic homatropins, atropine derivatives - methyl bromide; synthetic paraspasmolytics - adiphenin hydrochloride;
• muscle-tropic antispasmodics: opium alkaloids - papaverine; analgesics - metamizole - sodium; nitrites - pentanolinitris;
• neuromusculotropic antispasmodics: simple - acamylophenine hydrochloride; combined (spasmoanalgesics) - baralgin.

In particular, baralgin consists of neurotropic, muscle-tropic and analgesic components. The first component acts like papaverine, and therefore it is classified as a muscle-tropic antispasmodic with a stable effect. It is absorbed directly by smooth muscle cells, which means that it stops smooth muscle spasms regardless of the innervation of the organ. In addition to the pronounced myotropic effect, this substance also has a milder neurotropic (parasympatholytic) and antihistamine effect. As a result of this property alone, it is possible to obtain a neuromusculotropic antispasmodic effect.

The second component is a typical representative of neurotropic antispasmodics, acting like atropine, but without its side effects. The parasympatholytic action of this substance is based on the displacement of acetylcholine, or, more precisely, this substance competes with acetylcholine in the fight for cholinergic receptors and thus blocks the transmission of impulses to the peripheral parasympathetic nerve branches of smooth muscles. This component also acts as a vagotropic ganglioplegic with blockade of parasympathetic ganglia.

The third component is a strong central analgesic. It relieves pain of various origins and in spastic conditions it helps to increase the effect produced by the spasmolytic components of baralgin. Due to its own myotropic action, this substance is a synergist of the first component.

Thus, the advantage of baralgin can be formulated as follows: a carefully selected combination of antispasmodics with neurotropic muscle-tropic action and a strong central analgesic opens up wide possibilities for the use of the drug in obstetric practice and other areas of clinical medicine. The synergistic action of individual components allows to reduce the dosage and thereby reduce side effects - atropine and papaverine. The drug is a strong antispasmodic and analgesic without a narcotic effect, the toxicity of the drug is minimized, since the pyrazolone component does not cause side effects. The value of the drug is also in the fact that it can be used intravenously, intramuscularly, orally and in suppositories.

The drug reduces arterial pressure (systolic) by 15-17 mm Hg and diastolic by 10-12 mm Hg. Heart rate decreases by 10-13 beats/min. The drug does not affect central venous pressure. Baralgin is widely used with a high therapeutic effect in some spastic conditions in surgical and urological practice.

In recent years, baralgin has also become more widespread in obstetric practice.

The main indications for the use of baralgin are the lack of biological readiness for childbirth, premature discharge of amniotic fluid, coordinated labor. In the presence of a post-term pregnancy, breech presentation of the fetus, as well as preparation for childbirth, the authors recommend using baralgin in the form of tablets or suppositories 3-4 times a day with a treatment duration of 3 to 10 days. Timely and correct administration of baralgin allows for a reduction in the duration of labor by 2 times.

Methods of using baralgin: 5 ml is administered intramuscularly or intravenously, repeated administration is recommended after 6-8 hours. When administered intravenously, baralgin begins to act immediately, when administered intramuscularly - after 20-30 minutes. The daily dose is 20-40 drops 3-4 times a day, or 2-3 suppositories, or 1-2 tablets 3 times a day.