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Imet
Imet is a medicinal product that is included in the category of NSAIDs.
Indications of the imeta
The medicine is indicated for the removal of a variety of inflammations accompanied by pain. Among the pathologies that are treated with this drug:
- diseases of the ODA, having an inflammatory-degenerative character and accompanied by moderate or mild pains: such as osteoarthritis, rheumatoid arthritis, Bekhterev's disease;
- moderate or mild pain on the background of DDD diseases of other origin: exacerbated gout, articular syndrome, and in addition arthritis of psoriatic form;
- pain caused by inflammation in the soft tissue: with bursitis or tendovaginitis;
- pain in the joints or muscles in the period after injury;
- also the medicine is used to eliminate moderate or weak pains with unknown origin: with algodismenore, salpingoophoritis, and in addition headaches or dental pains;
- can be used to lower the temperature, which occurs against the background of inflammations having an infectious origin;
- it is possible to appoint in combination with other drugs that are used to eliminate inflammation in the area of ENT organs that have an infectious genesis and are accompanied by mild or moderate pain or fever;
It is possible to use the medication to reduce the elevated temperature during the post-vaccination period.
Pharmacodynamics
The active substance of the drug is ibuprofen, a derivative of phenylpropionic acid, which includes the racemic compound S-, as well as R-enantiomers. Among the properties of tablets are analgesic, anti-inflammatory and antipyretic. It helps relieve pain in joint diseases, dysmenorrhea, and with it in the period after surgical interventions. In addition, the active substance helps to eliminate dental with headaches, as well as muscle pain. Patients suffering from inflammation in the ODA, it helps to weaken the swelling in the morning with stiffness in the joints, and in addition increases the motor volume and weakens or eliminates the pain.
The drug acts by disrupting the metabolism of eicosatetraenoic acid (slows the activity of the enzyme COX). Ibuprofen is an indiscriminate NSAID, which in an equal proportion slows both isoforms of COX (COX-1 and COX-2). Because of the disruption of the process of eicosatetraenoic acid exchange, the production of proinflammatory PG (type E, and also F) - prostacyclin with thromboxane is reduced. Due to the decrease in the amount of PG within the inflammation focus, the binding of bradykinin, internal pyrogens, and other bioactive elements is weakened, which is why the activity of the inflammation process and the irritation of the painful endings decrease. The active component of the drug reduces the number of PG directly inside the thermoregulatory center in the hypothalamus, lowers the temperature and eliminates fever.
Due to a decrease in the production of thromboxane from eicosatetraenoic acid, ibuprofen, like other NSAIDs, is able to have some antiaggregatory effect.
During the study of the substance, it was found that ibuprofen affects the binding of internal interferon. Therefore, when taking Imet in patients much less irritation of the gastric mucosa (compared with salicylates) is observed.
Pharmacokinetics
With the internal administration of drugs, the active ingredient is rapidly absorbed from the digestive tract. Absorption mainly occurs in the small intestine, but a certain amount of material is absorbed through the stomach. The maximum plasma level of ibuprofen occurs 1-2 hours after ingestion. The substance has a significant synthesis with a plasma protein (about 99%). In the case of consumption with food, the peak period is extended by 0.5-1 hour, but the bioavailability level remains the same.
Metabolism of the drug occurs through the processes of hydroxylation, as well as carboxylation, and subsequently it forms inactive pharmacologically degradable products. The substance does not accumulate inside the body, but, getting inside the synovial fluid, it retains there for a long time the drug concentration.
Excretion mainly occurs through the kidneys in the form of drug-inactive decay products, and a small part of the substance is excreted through the liver also in the form of inactive decay products and with it an unchanged active substance. The half-life is approximately 2-2.5 hours, and completely the medicine is excreted from the body for 24 hours.
Use of the imeta during pregnancy
It is allowed to appoint Imet on the 1st and 2nd trimesters (exclusively by the treating doctor and if there are indications). Before the appointment, the doctor needs to carefully evaluate the likely benefits for the woman, as well as the possibility of developing complications in the fetus.
At the 3rd trimester, the drug is completely banned, because ibuprofen is capable of provoking premature closure of the botulinum duct in the fetus. In addition, delay in labor can occur, the labor period may be extended, and at the same time the risk of bleeding (both in the mother and in the newborn) may increase.
A small part of the medicine is able to penetrate the breast milk, but, according to existing information, this did not have negative consequences for children whose mothers were taking ibuprofen.
Contraindications
Among the contraindications of drugs:
- intolerance of certain elements of the drug or other drugs from the category of NSAIDs;
- The presence in the anamnesis of an aspirin triad (it consists of spasms of bronchi, hypersensitivity to aspirin, and in addition to this allergic rhinitis caused by taking aspirin);
- It is forbidden to use the drug in combination with other drugs that are included in the category of NSAIDs (among them are selective inhibitors of the element COX-2);
- disorders in the hematopoietic system, which have an unknown origin, and in addition a tendency to bleeding in the gastrointestinal tract and the presence of active hemorrhage in the patient (among them cerebrovascular);
- hemorrhagic syndrome or peptic ulcer (also their presence in the anamnesis);
- It is forbidden to use tablets in severe stages of disorders of renal or hepatic function, and in addition, with a severe stage of heart failure;
- it is contraindicated in the age of 12 years.
Caution is required when appointing the elderly, because the risk of bleeding in them is higher (including with subsequent fatalities). For this category of patients, therapy begins with a minimal single dose, and then it is gradually increased if necessary until the desired medication effect is achieved.
Caution should be prescribed for people with SLE, elevated blood pressure, Sharpe's syndrome, heart failure, and kidney or liver disorders. In addition, it is taken with caution in the period immediately after surgery.
Side effects of the imeta
Due to the use of the medicine, such side effects may appear:
- organs of the cardiovascular system: development of heart failure, arrhythmia or increased blood pressure. Single (in the case of drug use in a large dose) develops a myocardial infarction;
- organs of the hematopoietic system: the development of pancito-, thrombocyto- or leukopenia, and in addition agranulocytosis or anemia. Due to a disorder in the blood-forming system, pains in the throat, erosion in the oral mucosa, muscle pains, temperature increase and depression may develop. In addition, bleeding of unknown origin (among such hemorrhages in the skin) may occur, as well as bleeding from the nose and bruises. If prolonged drug use is required, it is recommended that hemograms are regularly monitored;
- organs of PNS and CNS: development of dizziness and headaches, problems with wakefulness and sleep regimes, a feeling of irritability, severe fatigue. However, there may be psychotic reactions, a sense of emotional lability or unreasonable anxiety, and also develop depression. Single convulsions or psychomotor agitation are observed;
- sensory organs: due to prolonged use of tablets, vision may be impaired (clarity reduced, dryness of the eye mucous membranes developed, and colors perception also disrupted). In addition, hearing disorders and tinnitus can occur;
- Gastrointestinal organs: vomiting, epigastric pain, heartburn, nausea, stool disorders (both constipation and diarrhea) and digestion, swelling, dryness of oral mucous membranes. In some situations, bleeding in the gastrointestinal tract, the development of gastric ulcers (or ulcers of the duodenum gut), sometimes accompanied by bleeding and perforation, and in addition ulcerative form of stomatitis. In addition, occasionally exacerbation of regional enteritis and colitis, as well as the emergence of pancreatitis, gastritis or esophagitis. Single as a result of treatment evolved duodenitis. If bleeding started in the digestive tract (symptoms - black stools, vomiting that resembles the coffee grounds in color, and severe pain in the epigastrium), the medicine needs to be canceled, and then consult a doctor;
- liver: acute stage of liver failure, liver intoxication, hepatic function disorder, and in addition hepatitis and hepatorenal syndrome;
- organs of the urinary system: development of swelling (usually appear in people with kidney failure or elevated blood pressure), tubulointerstitial nephritis, cystitis, oliguria, nephrotic syndrome, polyuria, and in addition hyperuricemia and medullary necrosis. Single glomerular nephritis or hematuria is observed. If you need a long course of therapy with Imato, you need to regularly monitor the kidneys;
- skin reactions: the development of Lyell's syndrome or Stevens-Johnson, dry skin, hair loss, as well as photophobia;
- parasitic diseases and infections: infection processes (for example, necrotizing fasciitis) develop sporadically or worsen, the cause of which can be the use of NSAIDs. If the development of a new infectious process has begun or the old infection has aggravated, it is necessary to consult with the treating doctor for the abolition of drugs and the appointment of antibacterial treatment. Single after taking the tablets, there were signs of serous meningitis (such as headaches, vomiting, hyperthermia, mental disorders, nausea, and neck muscle tension). Similar symptoms often developed in people with autoimmune pathologies (such as Sharpe's syndrome or SLE);
- allergic manifestations: itching, rashes on the skin, urticaria, runny nose, erythema multiforme, and in addition anaphylactoid manifestations (such as a decrease in blood pressure and laryngeal edema with the tongue), reaching anaphylaxis. People with hypersensitivity may experience bronchial spasms, as well as attacks of bronchial asthma. If the patient has allergic manifestations, it is necessary to cancel the medication and immediately consult a doctor, because in some cases a person may need urgent medical help;
- Other: prolonged use of drugs in large doses can increase the likelihood of a stroke or ATE.
Dosing and administration
The medicine is taken orally, you can not grind or chew the pill - it should be swallowed whole, washed down with water. If required, the tablet may be divided in half. To reduce the likelihood, as well as the severity of adverse reactions, the drug should be consumed with food or after eating.
The size of dosages, as well as the duration of therapy are prescribed by the doctor - each patient separately (depending on the individual characteristics of the organism and the nature of the disease).
For children aged 12+ years, with the elimination of mild and moderate pain, 200-400 mg of the drug (or 0.5-1 tablet) is often prescribed twice or thrice a day. You should take medicines at intervals of at least 4 hours. A day is allowed to take no more than 1000 mg (or 2.5 tablets).
For children 12+ years, a one-time intake of 200-400 mg LS (or 0.5-1 tablet) is prescribed to lower the high temperature. If necessary, you can drink the pill again, after 4 hours. For the day allowed to consume a maximum of 1000 mg of the drug (or 2.5 tablets).
For children aged 15+ years with adults, in the treatment of moderate and mild pain, a 2-3-fold use of 200-400 mg of LS per day is usually prescribed. It is required to adhere to the reception mode with intervals of at least 4 hours. For a day you can drink no more than 3 tablets of medicine (dosage 1200 mg).
Adolescents from 15 years and adults are prescribed a one-time intake of 200-400 mg of medication per day to reduce high fever. If necessary, you can drink another dose in 4 hours. For a day is allowed to take no more than 3 tablets (or 1200 mg of the drug).
Overdose
Due to the use of tablets in high doses develop disorders in the central nervous system (headaches, slowing of psychomotor reactions, dizziness, a feeling of drowsiness, and besides it rings in the ears, children may experience myoclonic cramps). Along with this, because of an overdose, there may be: vomiting (sometimes a shade of coffee grounds, due to bleeding in the gastrointestinal tract), nausea, epigastric pain, asthma attacks, as well as disorders in the liver or kidneys. If the dosage continues to increase, respiratory depression, cyanosis, a drop in blood pressure, nystagmus, the development of an acute form of kidney failure, metabolic acidosis, and also fainting and a coma will begin.
There is no specific antidote, therefore, in order to remove the overdose, it is necessary to rinse the stomach, take enterosorbents and use symptomatic treatment. If breathing has stopped, resuscitation procedures should be started immediately.
Interactions with other drugs
As a result of the combination of the drug with ACE inhibitors and β-adrenergic blockers, the hypotensive properties of the latter decrease.
Combined use with hypothiazide, furosemide and other diuretic drugs weakens their pharmacological properties.
Ibuprofen increases the properties of anticoagulants, so in the case of simultaneous use of these drugs increases the likelihood of bleeding in the gastrointestinal tract.
In case of use together with SCS, the likelihood of developing negative reactions from the digestive tract may increase.
The active component of the drug displaces from the process of synthesis with plasma protein the following drugs (when combined with them): anticoagulants of indirect action, antidiabetic drugs (oral), hydantoin derivatives and sulfonylureas.
Combined use with hydrochlorothiazide, amlodipine and captopril slightly weakens their hypotensive properties.
The combination with ibuprofen increases the toxic effect of methotrexate, as well as baclofen.
Aspirin reduces the plasma indices of ibuprofen.
Simultaneous use with the substance warfarin increases the duration of bleeding, and with it the development of hematomas and microhematuria.
Combination with colestyramin weakens the absorption of the active substance inside the digestive tract.
Combined reception with lithium drugs provokes an increase in lithium indices in plasma. Along with this, the drug, when used concomitantly, increases the concentration of digoxin with phenytoin inside the plasma.
Magnesium hydroxide enhances the initial absorption of ibuprofen inside the gastrointestinal tract.