"Пора лечить суставы!" Доктор Бубновский рассказал, как сделать это дома
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Почему жадные аптеки скрывали средство мощнее Экзодерила в 39 раз? Им оказался советский густой.
Даже самая убитая печень очищается этим средством!
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Международное наименование
Групповая принадлежность
Лекарственная форма
Фармакологическое действие
НПВП; оказывает противовоспалительное, анальгезирующее и жаропонижающее действие, связанное с неизбирательным торможением активности ЦОГ1 и ЦОГ2, регулирующих синтез Pg. В результате не образуются Pg, обеспечивающие формирование отека и гиперальгезии. Снижение содержания Pg (преимущественно Е1) в центре терморегуляции приводит к снижению температуры тела вследствие расширения сосудов кожи и возрастания потоотделения.
Обезболивающий эффект обусловлен как центральным, так и периферическим действием.
Уменьшает агрегацию, адгезию тромбоцитов и тромбообразование за счет подавления синтеза тромбоксана А2 в тромбоцитах. Антиагрегантный эффект сохраняется в течение 7 сут после однократного приема (больше выражен у мужчин, чем у женщин). Снижает летальность и риск развития инфаркта миокарда при нестабильной стенокардии. Эффективен при первичной профилактике заболеваний ССС, особенно инфаркта миокарда у мужчин старше 40 лет, и при вторичной профилактике инфаркта миокарда.
В суточной дозе 6 г и более подавляет синтез протромбина в печени и увеличивает протромбиновое время.
Повышает фибринолитическую активность плазмы и снижает концентрацию витамин K-зависимых факторов свертывания (II, VII, IX, X). Учащает геморрагические осложнения при проведении хирургических вмешательств, увеличивает риск развития кровотечения на фоне терапии антикоагулянтами.
Стимулирует выведение мочевой кислоты (нарушает ее реабсорбцию в почечных канальцах), но в высоких дозах.
Блокада ЦОГ1 в слизистой оболочке желудка приводит к торможению гастропротекторных Pg, что может обусловить изъязвление слизистой оболочки и последующее кровотечение. Меньшим раздражающим действием на слизистую оболочку ЖКТ обладают лекарственные формы, содержащие буферные вещества, кишечнорастворимую оболочку, а также специальные "шипучие" формы таблеток.
Показания
Ревматизм, ревматоидный артрит, инфекционно-аллергический миокардит, перикардит, ревматическая хорея – в настоящее время не применяется.
Лихорадочный синдром при инфекционно-воспалительных заболеваниях.
Болевой синдром (различного генеза): головная боль (в т.ч. связанная с алкогольным абстинентным синдромом), мигрень, зубная боль, невралгия, люмбаго, грудной корешковый синдром, миалгия, артралгия, альгодисменорея.
В качестве антиагрегантного ЛС (дозы до 300 мг/сут): ИБС, наличие нескольких факторов риска ИБС, безболевая ишемия миокарда, нестабильная стенокардия, инфаркт миокарда (для снижения риска повторного инфаркта миокарда и смерти после инфаркта миокарда), повторная преходящая ишемия мозга и ишемический инсульт у мужчин, протезирование клапанов сердца (профилактика и лечение тромбоэмболий), баллонная коронарная ангиопластика и установка стента (снижение риска повторного стеноза и лечение вторичного расслоения коронарной артерии), при неатеросклеротических поражениях коронарной артерии (болезнь Кавасаки), аортоартериит (болезнь Такаясу), клапанные митральные пороки сердца и мерцательная аритмия, пролапс митрального клапана (профилактика тромбоэмболии), рецидивирующие тромбоэмболии легочной артерии, инфаркт легкого, острый тромбофлебит, синдром Дресслера.
В клинической иммунологии и аллергологии: в постепенно нарастающих дозах для продолжительной "аспириновой" десенситизации и формирования стойкой толерантности к НПВП у больных с "аспириновой" астмой и "аспириновой триадой".
Противопоказания
Побочные действия
Тошнота, снижение аппетита, гастралгия, диарея; аллергические реакции (кожная сыпь, ангионевротический отек, бронхоспазм); нарушение функции печени и/или почек; тромбоцитопения, анемия, лейкопения, синдром Рейе (энцефалопатия и острая жировая дистрофия печени с быстрым развитием печеночной недостаточности), формирование на основе гаптенового механизма "аспириновой" астмы и "аспириновой триады" (сочетание бронхиальной астмы, рецидивирующего полипоза носа и околоносовых пазух и непереносимости АСК и ЛС пиразолонового ряда).
При длительном применении – головокружение, головная боль, рвота, эрозивно-язвенные поражения ЖКТ, гипокоагуляция, кровотечения (в т.ч. в ЖКТ); нарушения зрения, снижение остроты слуха, шум в ушах, бронхоспазм, интерстициальный нефрит, преренальная азотемия с повышением содержания креатинина в крови и гиперкальциемией, папиллярный некроз, острая почечная недостаточность, нефротический синдром, асептический менингит, усиление симптомов ХСН, отеки, повышение активности "печеночных" трансаминаз.
Применение и дозировка
Таблетки растворимые: внутрь, предварительно растворив в небольшом количестве воды, – по 400-800 мг 2-3 раза в сутки (не более 6 г). При остром ревматизме – 100 мг/кг/сут в 5-6 приемов.
Таблетки, содержащие АСК в дозах свыше 325 мг (400-500 мг), рассчитаны на применение в качестве анальгезирующего и противовоспалительного ЛС; в дозах 50-75-100-300-325 мг – у взрослых, главным образом в качестве антиагрегантного ЛС.
Внутрь, при лихорадочном и болевом синдроме взрослым – 0.5-1 г/сут (до 3 г), разделенных на 3 приема. Продолжительность лечения должна не превышать 2 нед.
Шипучие таблетки растворяют в 100-200 мл воды и принимают внутрь, после еды, разовая доза – 0.25-1 г, принимают 3-4 раза в сутки. Длительность лечения – от однократного приема до многомесячного курса.
Для улучшения реологических свойств крови – 0.15-0.25 г/сут в течение нескольких месяцев.
При инфаркте миокарда, а также для вторичной профилактики у больных, перенесших инфаркт миокарда, – 40-325 мг 1 раз в сутки (чаще 160 мг). В качестве ингибитора агрегации тромбоцитов – 300-325 мг/сут длительно. При динамических нарушениях мозгового кровообращения у мужчин, церебральных тромбоэмболиях – 325 мг/сут с постепенным увеличением максимально до 1 г/сут, для профилактики рецидивов – 125-300 мг/сут. Для профилактики тромбоза или окклюзии аортального шунта – 325 мг каждые 7 ч через интраназально установленный желудочный зонд, затем перорально – 325 мг 3 раза в сутки (обычно в сочетании с дипиридамолом, который отменяют через неделю, продолжая длительное лечение АСК).
При активном ревматизме назначали (в настоящее время не назначают) в суточной дозе 5-8 г для взрослых и 100-125 мг/кг – для подростков (15-18 лет); кратность применения – 4-5 раз в сутки. После 1-2 нед лечения детям уменьшают дозу до 60-70 мг/кг/сут, лечение взрослых продолжают в той же дозе; продолжительность лечения – до 6 нед. Отмену производят постепенно в течение 1-2 нед.
Особые указания
Длительность лечения (без консультации с врачом) должна не превышать 7 дней при назначении в качестве анальгезирующего ЛС и более 3 дней в качестве жаропонижающего.
В настоящее время использование АСК в качестве противовоспалительного ЛС в суточной дозе 5-8 г ограничено в связи с высокой вероятностью развития побочных эффектов со стороны ЖКТ (НПВП-гастропатия).
Перед хирургическим вмешательством, для уменьшения кровоточивости в ходе операции и в послеоперационном периоде, следует отменить прием салицилатов за 5-7 дней и поставить в известность врача.
Во время длительной терапии необходимо проводить общий анализ крови и исследование кала на скрытую кровь.
Детям нельзя назначать ЛС, содержащие АСК, поскольку в случае вирусной инфекции они способны увеличить риск возникновения синдрома Рейе. Симптомами синдрома Рейе являются продолжительная рвота, острая энцефалопатия, увеличение печени.
Назначение таблеток после еды, тщательное их измельчение, использование таблеток с буферными добавками или покрытых специальной кишечнорастворимой оболочкой, а также одновременное использование ЛС, нейтрализующих кислотность желудочного сока, снижают раздражающее действие на ЖКТ.
Обладает тератогенным влиянием; при применении в I триместре приводит к развитию расщепления верхнего неба; в III триместре вызывает торможение родовой деятельности (ингибирование синтеза Pg), преждевременное закрытие артериального протока у плода, гиперплазию легочных сосудов и гипертензию в "малом" круге кровообращения. Выделяется с грудным молоком, что повышает риск возникновения кровотечений у ребенка вследствие нарушения функции тромбоцитов.
АСК даже в небольших дозах уменьшает выведение мочевой кислоты из организма, что может стать причиной развития острого приступа подагры у предрасположенных пациентов.
В период лечения следует воздерживаться от приема этанола.
Взаимодействие
Усиливает токсичность метотрексата, снижая его почечный клиренс, эффекты др. НПВП, наркотических анальгетиков, пероральных гипогликемических ЛС, резерпина, гепарина, непрямых антикоагулянтов, тромболитиков и ингибиторов агрегации тромбоцитов, сульфаниламидов (в т.ч. ко-тримоксазола), Т3; снижает эффект урикозурических ЛС (бензбромарон, сульфинпиразон), гипотензивных ЛС, диуретиков (спиронолактон, фуросемид).
ГКС, этанол и этанолсодержащие ЛС увеличивают повреждающее действие на слизистую оболочку ЖКТ, повышают риск развития желудочно-кишечных кровотечений.
Повышает концентрацию дигоксина, барбитуратов, солей Li+ в плазме.
Антациды, содержащие Mg2+ и/или Al3+, замедляют и ухудшают всасывание АСК.
Миелотоксические ЛС усиливают проявления гематотоксичности препарата.
Отзывов о лекарстве Тромбо АСС: 1
Лора , 16.06.2016 , возраст: 33
Принимаю Тромбо Асс уже около полугода. Врач его назначил взамен Кардиомагнила, от которого у меня стал болеть желудок. Тромбо Асс меня целиком и полностью устраивает, специальная оболочка таблеток щадяще действует на желудок — никаких проблем с ним нет теперь. Со своей задачей — разжижение крови — справляется на ура (я после инсульта, врач назначил эти препараты для снижения риска возникновения повторного инсульта)
Большинство людей подвержены развитию тяжелых патологий сердечной мышцы, головного мозга и сосудов. Особенно это касается тех, кто входит в зону риска возникновения подобных недугов. На помощь к ним придет препарат Тромбоасс. Это действенный нестероидный, противовоспалительный медикамент на основе ацетилсалициловой кислоты.
Фармакологический эффект
Представляет собой нестероидное противовоспалительное средство для снижения агрегированности тромбоцитов ввиду развития в них тромбоксана. Помимо указанных благоприятных воздействий обеспечивает анальгезирующее и жаропонижающее.
Активный компонент, а именно ацетилсалициловая кислота быстро всасывается в желудочно-кишечный тракт. После чего, происходит небольшой метаболизм. Далее происходит процесс биотрансформирования главного вещества и его расщепление в печени и их преобразование в различные салицилаты, выходящие через ткани и мочу. У женщин метаболический период более медленный.
Время полувыведения действующего вещества изучаемого медпродукта составляет до 20 минут. Выводится через почечную систему полностью через трое суток.
Показания к использованию
- Предупреждение острых инфарктов, инсульта, проблем с кровообращением головного мозга у лиц, которые входят в зону риска – курящие, пожилые или полные люди, диабетики, гипертоники;
- Наличие нестабильной стенокардии;
- Недопущение тромбоэмболии, тромбоза вен, в том числе после соответствующих хирургических операций.
При каких ситуациях препарат запрещен
- Эрозийных явлениях в органах желудочно-кишечного тракта, включая с наличием кровотечений;
- Бронхиальной астме (даже с полипозами носа) спровоцированной данным НПВС;
- Предрасположенности к обильным кровоизлияниям;
- Первых и последних периодах вынашивания будущего младенца;
- Несовершеннолетнем возрасте;
- Чрезмерной чувствительности к действующему и дополнительным компонентам.
Особо внимательным нужно быть тем, кто имеет подагру, проблемы с почками и печенью, насморк любого происхождения, аллергии на медпрепараты.
Встречаемые побочные явления
В зоне риска все системы организма. В первую могут начаться дисфункции органов пищеварения, а именно рвота, изжога, боли в эпигастральной области. Кроме того, не исключены бронхоспазмы, нарушения кроветворческой сферы, в частности кровотечения. Также возможны аллергии и дестабилизация центральной нервной системы – головокружение.
Разрешено ли лечение в период беременности и лактации?
Прием лекарства на протяжении первых трех месяцев вынашивания плода подвергает риску возникновения дефектов в ходе развития будущего ребенка, в частности волчья пасть и кардиологические патологии. Во время второго триместра беременности, препарат употребляют в условиях серьезного контроля медиков. На последних месяцах таблетки тоже запрещены ввиду безусловного пагубного влияния.
Небольшое количество медсредства неминуемо попадает в молоко матери, при долгом терапевтическом процессе. Но такое явление никак не скажется на здоровье младенца, соответственно лечение не приостанавливается.
Оптимальные правила приема
Пилюли принимаются перорально, перед употреблением еды, запивая достаточным количеством воды.
В сутки достаточно от 50 до 100 мг по одной таблетке. Срок лечения устанавливается в больнице, в индивидуальном порядке. Более точная лечебная схема устанавливается врачом в каждом отдельном случае, в зависимости от диагноза.
Последствия превышения установленных доз
Наименее безобидные реакции возникают при небольшой передозировке – подташнивание, спутанное сознание, вестибулярные нарушения, общее недомогание. Большие дозы способствуют серьезным проблемам – удушение, отек легких, отсутствие дыхания, нестабильный сердечный ритм, отказ почек и прочие тяжелейшие последствия.
В такой ситуации, в качестве экстренной помощи, вызывается рвота, пьются слабительные. Уже в стационарных условиях производится промывание желудка и прием активированного угля.
Лекарственная совместимость
Усиливает действие ряда лечебных веществ:
- Гепарин и прочие антикоагулянты непрямого действия. Обуславливает угнетение функций тромбоцитов;
- Метотрексат. Снижает почечный клиренс;
- Антитромбоцитарные и тромболитические вещества;
- Дигоксин. Почечная экскреция – минимальна;
- Гипогликемические медпродукты. Вытесняют производные сульфонилмочевины в ходе белкового метаболизма;
- Вальпроевая кислота.
Ослабляет действенность лишь при приеме урикозурических фармпродуктов и различных глюкокортикостероидов. Также пагубно на здоровье влияет попутное задействование ибупрофена.
Ключевые эпизоды терапевтического периода
- Лекарство способно провоцировать приступ астмы бронхиального типа у лиц, имеющих повышенную чувствительность к определенному компоненту медпрепарата;
- Низкая дозировка может привести к подагре;
- Люди, имеющие сахарный диабет должны осторожно принимать лекарство ввиду гипогликемического эффекта;
- Терапия должна проходить без употребления спиртных напитков. В такой ситуации пациент подвергается к сильному раздражению слизистой внутренних органов и более долгому кровотечению, при их возникновении;
- От управления автомобилями и занятия потенциально опасной деятельностью, требующей ответственного отношения и повышенного внимания, медики настоятельно советуют отказаться на время приема лекарства.
Хранение и срок годности
Препарат нужно определить в темное, недоступное для детей и сухое место. Температура должная составлять не выше 25 градусов по Цельсию. Сохраняет свои свойства на протяжении трех лет.
Сколько стоит ТромбоАсс – цена в аптеке
Реализация – без рецепта из медицинского учреждения. Стоимость продажи (по информации интернет-ресурса apteka.ru в г. Москва) варьируется от 53 до 163 рублей (0,05 г, 28 штук в упаковке и 100 мг, 100 таблеток соответственно). В других регионах ценник колеблется несущественно.
Список недорогих аналогов
Сравнительная таблица позволяет в полной мере раскрыть список недорогих дженериков. Их выпускают импортные и отечественные фармацевтические фирмы. В перечне представлены средства таблетированной формы производства. Каждое из них имеет свои особенности. Для сравнения были выбраны две наиболее известные интернет-аптеки, где можно купить препарат.
| Наименование аналога подешевле препарата Тромбоасс | Apteka.ru (цена в руб.) | Piluli.ru (цена в руб.) | ||
| Москва | СПб | Москва | СПб | |
| Тромбопол | 50 | 49 | 51 | 50 |
| Ацекардол | 23 | 23 | 29 | – |
| Ацетилсалициловая кислота | 13 | 14 | 3 | 4 |
Тромбопол – (Польша)
Зарубежный дженерик, компетентный в предостережении человека от инфаркта и инсульта. Используется в почтенном возрасте, при повышенном давлении и сахарном диабете. Касается и тех людей, которые ведут неблагоприятный образ жизни – курят, неправильно питаются, много выпивают. Еще одна задача препарата – преодоление стенокардии нестабильного характера, сведение к минимуму нарушений насыщения мозга кровью и тромбозов.
Не разрешается людям с язвой желудка, эрозийными явлениями кишечной среды и внутренним кровотечением. Также в список противопоказаний включены «аспириновая астма», 1-ый и 3-ий триместры вынашивания плода, грудное кормление, несовершеннолетний возраст и непереносимость подобных нестероидных противовоспалительных медикаментов.
Побочно не исключены неприятности в виде рвоты, изжоги, болезненности в эпигастральной области, бронхоспазмы, вестибулярные дисфункции, повышение кровоточивости и легкие аллергические ситуации – обширные высыпания по телесным покровам и отечности.
Ацекардол – (Россия)
Российская замена, позволяющая не допустить у людей с чрезмерной массой тела, сахарным диабетом, артериальной гипертензией, а также пожилым и курящим развиться инфаркту либо инсульту. В целях проведения профилактических мероприятий задействуется против возникновения тромбоза, тромбоэмоблии, в том числе после проведения оперативных вмешательств на сосудах. Еще одна положительная сторона медикамента – улучшение кровообращения головного мозга и борьба с нестабильной стенокардией.
В первую очередь Ацекардол запрещается заболевшим с неусвоением его составляющих компонентов. В данную группу входят лица с внутренними кровоизлияниями, геморрагическим диатезом, астматики, беременные (первый и последний триместр), кормящие грудным молоком ребенка и не достигшие совершеннолетия.
Попутно с терапией, больной подвержен некоторым негативным явлениям. Встречаются аллергии – от безобидной сыпи и до анафилактического шока. В этой связи, лицам, склонным к развитию данных явлений и неусвоения отдельных элементов нужно отказаться от этого фармацевтического продукта. Еще больше опасны проблемы с ЖКТ – перфорация кишечника и желудка, кровотечения из-за открытия язв.
Ацетилсалициловая кислота – (наиболее дешевый препарат отечественного производства)
Известное, универсальное медицинское средство в таблетках. В его задачи входит борьба с целой массой заболеваний, в частности с инфекционными и аллергическими миокардитами, ревматической болезненностью и артритом, повышенной температурой тела из-за имеющегося воспалительного либо инфекционного недуга. Снимает боли невыраженной интенсивности различных происхождений – головы, сфер миалгии и невралгии. Не допускает возникать тромбозам, эмболиям, инфарктам и кровоизлияниям в мозг, улучшая ишемическое кровообращение.
Избегать это медсредство нужно людям с обострением имеющихся язвенных процессов в органах, ответственных за стабильное переваривание еды. Не допускается прием лицами до 15-ти лет, на первых и последних месяцах беременности, в ходе грудного вскармливания и непереносимости состава.
Одновременно у больного возможны проявления побочных действий. В их числе – боли в животе, понос, тяга к рвоте, резкое снижение массы тела, ненормальная работа печени. Под негативным влиянием и центральная нервная система. В ряде случаев проблемы с ней бывают при затянувшейся терапии – мигрень, временное ухудшение зрения и менингит асептической формы. Самые редкие вредные моменты – cнижение количества тромбоцитов в крови, дисфункции мочевыделительной системы, почек, а также аллергия – сыпи, отеки.
Выводы по недорогим синонимам
В любой ближайшей аптеке можно приобрести не только изучаемый фармпродукт, но и его заменители по более доступной цене. Некоторые из них позволяют существенно сэкономить денежные средства. Производят их, в основном, в России. Но перед их приобретением важно обратиться к компетентным специалистам, которые грамотно установят диагноз и порекомендуют конкретное лекарство, оптимальную схему, способную противостоять имеющемуся заболеванию.
Чем заменить тромбоАСС?
Противовоспалительное лекарственное нестероидное средство Тромбо Асс относится к большой группе препаратов, в которых активным действующим веществом выступает ацетилсалициловая кислота.
Лекарство Тромбо Асс ― таблетки для приёма внутрь, содержащие всем знакомую кислоту ацетилсалициловую.
Их оболочка предохраняет внутреннюю оболочку желудка от повреждающего воздействия этого реагента, в этом преимущество этой лекарственной формы перед обычным аспирином.
Принимают их 1 раз в день после приёма пищи, не допуская передозировки.
Основные свойства таблеток Тромбо Асс
Лекарству присущи все особенности фармакологического воздействия на организм, которыми обладает аспирин:
- Противовоспалительное действие, связанное с уменьшением проницаемости капиллярных стенок.
- Жаропонижающее действие ― подавление синтеза простагландинов (веществ, провоцирующих болевые ощущения и температурную реакцию).
- Обезболивающее действие, связанное с воздействием вещества на мозговые центры.
- Антикоагуляционное свойство (препятствующее свёртыванию крови) за счёт воздействия на тромбоциты.
Для воздействия на свёртывающую систему при профилактическом приёме достаточно принять 1 таблетку Тромбо Асс в неделю.
Согласно сведениям из Оксфордского университета, употребление ацетилсалициловой кислоты на протяжении нескольких лет снижает риск:
- рака горла и пищевода ― на 60%,
- злокачественной опухоли лёгкого ― на 30%;
- рака прямой кишки ― на 40%,
- рака простаты ― на 10%.
Хорошим терапевтическим эффектом можно объяснить такую статистику, что в мире ежегодно употребляется 80 млрд. таблеток, содержащих ацетилсалициловую кислоту.
Аналоги
В аптечной сети предлагается более восьми десятков препаратов, которые могут заменить Тромбо Асс.Это, например:
Аналоги ТромбоАСС
Все заменители имеют оболочку для уменьшения раздражающего действия салицилата, все имеют положительные отзывы, есть и побочные эффекты. Без помощи врача трудно определиться с выбором подходящего лекарства для конкретного случая.
Если для сравнения рассмотреть два таких признанных средства как Тромбо Асс и Кардиомагнил, то можно отметить разную дозировку основного компонента: в Кардиомагниле кислоты ацетилсалициловой ― 75 мг, а в таблетках Тромбо Асс ― 100 и 50 мг.
Кроме этого, таблетки Кардиомагнила содержат ещё соединение магния для дополнительной защиты желудочной стенки и воздействия на сердечную мышцу.
Можно сделать вывод, что в каждом препарате есть только ему присущая особенность, позволяющая достичь оптимальной эффективности при различных сочетаниях заболеваний у пациентов.
Цена одной упаковки этой группы препаратов зависит от дозировки и числа таблеток в блистерах, она составляет 40-80 рублей. Традиционный аспирин стоит
Показания к применению
Препараты с ацетилсалициловой кислотой назначаются при:
а также в пожилом возрасте.
Противопоказания
Существуют обстоятельства, которые надо учитывать при выборе лекарственного средства:
Принимать лекарство надо строго по инструкции, не превышая указанной максимальной дозы. Перед приёмом препарата нужна консультация врача.
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