Antispasmodics - classification, action, instructions for use, overdose. Antispasmodics for headaches

No-shpa is effective drug antispasmodic action. Drotaverine hydrochloride, which is part of it, is very quickly absorbed into the blood and relieves spastic pain. At the same time, it is safe for the unborn child, so No-shpu is often prescribed to pregnant women with uterine hypertonicity, the threat of miscarriage, or premature birth.

Taking No-shpa during pregnancy at different times

Almost all drugs are contraindicated for expectant mothers. Because of this, many women who are expecting a baby ask the question: is it possible to take No-shpu during pregnancy? The answer is yes.

1 trimester

Even in the first trimester, when the laying occurs internal organs fetus, and the placental barrier has not yet been fully formed, gynecologists allow the use of an antispasmodic. But-shpa on early dates during pregnancy, it allows you to relieve spasm of the smooth muscles of the uterus and thereby ensures the prevention of miscarriage. In addition, the drug expands blood vessels, due to which blood circulation in the uterus increases, a larger amount begins to flow to the baby useful substances and oxygen.

2 trimester

No-shpa in the second trimester of pregnancy can also be used for medical indications. Her reception will help expectant mother get rid of discomfort lower or side of the abdomen, headache. True, a woman should not treat an antispasmodic as an absolutely harmless drug. No-shpa is a medicine, so it should be used only when absolutely necessary.

3rd trimester

In the third trimester, No-shpu is also often prescribed to pregnant women. At this time, her reception is relevant for pronounced training contractions that exhaust a woman and prevent her from fully resting (especially at night).

But it is not recommended to drink No-shpu before childbirth (unless the doctor says otherwise). It provides muscle relaxation during labor activity, which may cause uterine bleeding. Therefore, starting from 39 obstetric week, it is better to refuse the use of an antispasmodic.

Shortly before childbirth, it is better to refuse the use of tablets.

However, some women are prescribed No-shpu just before childbirth in order to speed up the process of opening the cervix (usually injections are made for this). This scheme therapy has the right to life, but it can only be compiled by a highly qualified obstetrician-gynecologist.

Why drink No-shpu during pregnancy

Indications for taking No-shpy during pregnancy are:

• strong headache;
• the threat of termination of pregnancy;
• pain in the abdomen of a pulling or cramping character;
• diseases of the biliary tract;
• intestinal colic, pathology gastrointestinal tract;
• liver disease.

How many No-shpy tablets can you drink during pregnancy

The dosage of No-shpa during pregnancy is determined by the doctor, and the expectant mother must follow his recommendations. Studies of this drug have confirmed that drotaverine does not have any toxic or teratogenic effects on the fetus.

No-shpa - the most safe drug for acute pain for pregnant women

But in the West, scientists argue that too frequent use of No-shpa in large quantities during gestation may negatively affect the development of the child's speech in the future. Special studies, which would confirm this hypothesis, has not been carried out. However, in any case, pregnant women should refrain from excessive medication.

Dosages of No-shpy during pregnancy

A single dose of No-shpa for pregnant women depends on the form of the drug used:

• tablets No-shpa 40 mg - 1-2 tablets 2-3 times a day. Maximum allowable daily dose should not exceed 240 mg (6 tablets);
• tablets No-shpa forte 80 mg - 1 tablet 2-3 times a day;
• candles 40 mg - one candle 3-6 times a day;
• ampoules 40 mg (2 ml) - up to 6 ampoules per day.

No-shpy tablets should be swallowed without chewing and washed down with water. The effect of taking the medicine is observed in about half an hour. It is also allowed to keep the tablet under the tongue until completely dissolved. Then it will work faster.

Candles with drotaverine hydrochloride are injected into the anus. Absorption of the active substance into the blood occurs after 15 minutes. This dosage form is not very convenient, so it is prescribed to expectant mothers less often than tablets. But it is better to use candles at home if there are problems with the work of the digestive tract.

No-shpy injections for a future mother should be done by a qualified specialist

No-shpy injections during pregnancy are done intravenously and intramuscularly in a hospital. In the first case maximum concentration Drotaverine in the blood is observed 5 minutes after the injection, in the second - after 15-20 minutes.

A pregnant woman should not take No-shpu for longer than 1-3 days without a doctor's recommendation. If the pain persists even while taking the drug, their intensity increases, you should immediately call an ambulance team.

In what cases should No-shpu be drunk during pregnancy?

Like any drug, No-shpa has its contraindications. It is prohibited to take it when:

• hepatic or kidney failure;
• closed glaucoma;
• hypersensitivity to drotaverine;
• isthmic-cervical insufficiency of the cervix in a pregnant woman;
• spasm of the coronary arteries.

With vegetovascular dystonia of the hypotonic type, No-shpu can only be used under constant medical supervision. This is explained by the fact that the main active ingredient of the drug, expanding the blood vessels, can lead to a decrease blood pressure. This, in turn, is fraught with the development of collapse in the expectant mother.

Before using No-shpa, you need to consult a doctor.

Side effects that may occur in pregnant women while taking No-shpa

AT rare cases No-shpa causes the appearance of:

• constipation;
• allergic reaction(skin rash, angioedema);
• nausea;
• hyperhidrosis;
• dizziness, headaches;
• rapid heartbeat;
• hypotension.

Any of these symptoms should be a reason to seek medical advice. During a face-to-face conversation, the doctor will select a different treatment for the patient. If No-shpa is poorly tolerated, a pregnant woman should not take it.

What can replace No-shpu during pregnancy

The exact analogues of No-shpy are tablets and injections of Drotaverine and Papaverine. They are also considered safe at any stage of pregnancy. Other myotropic antispasmodics, acting similarly to No-shpa, are contraindicated for expectant mothers.

No-shpa has analogues

Thus, No-shpa is a proven and safe remedy for relieving muscle spasms. For many women, it helps to maintain pregnancy, facilitate its course with different kind complications. Therefore, it will not be superfluous to have a package of these tablets in your purse.

But it is impossible for an uncontrolled pregnant woman to take No-shpu and its analogues. It is important to first consult with your doctor and follow his instructions, strictly follow the dosage.

Everyone knows the feeling of physical pain. Usually we know how to deal with it and what antispasmodics to take. But when pain occurs in a pregnant woman, and even in the early stages, she simply can endure severe pain, not knowing how to remove it so as not to harm your baby.

There are several groups of drugs that relieve pain, the so-called antispasmodics. More often in medicine, those groups are used that include not only painkillers, but also those that have anti-inflammatory effects that relieve fever. What drug can be used during pregnancy to relieve pain? . For the reason that it does not affect the fetus, although it crosses the placenta. This drug can be used for elevated temperature, to relieve headaches, with a cold. WHO experts consider paracetamol the most harmless pain reliever at any stage of pregnancy. But you only need to remember that women who have problems with the liver, the use of this drug is prohibited.

What pain relievers are still safe during pregnancy?

You can also use analgin, but in last resort, and in small quantities. After all, its reception can affect the development of the fetus, especially in the early stages. And its frequent use can lead to the fact that the level of hemoglobin in a pregnant woman will fall. Nurofen pain reliever will be effective in the early stages and in the prescribed dosages. But not in the third trimester, because it can cause a decrease in amniotic fluid.

There are antispasmodics called spazmalgon and baralgin. They can be applied, but only from the second semester, and not in the early stages.

No-shpa and papaverine are also safe. They do not affect the unborn baby. Papaverine is administered intramuscularly or as a suppository into the rectum. But still, a greater effect can be achieved with the use of no-shpy, both with injections and tablets. It relieves pain much faster than any other painkillers. No-shpa weakens the tone of the uterus, so it cannot harm pregnancy in any way. Riabal can be just as effective. The indications are all the same as those of the no-shpy. You can use ibuprofen early, but don't risk taking it in the third trimester.

Look in the pharmacy for children's preparations, for example, panadol. It will be much safer than chemistry for adults.

Painkillers based on codeine can be taken early, but only under medical supervision. Do not take this medicine after the first trimester, it may cause problems with respiratory system child.

Do not try to drink citramon, because it contains caffeine, which adversely affects the course of pregnancy and a substance that causes fetal deformity.

Do not take aspirin, as it can cause bleeding.

How to relieve toothache during pregnancy?

Women who have gone through pregnancy know how painful toothache can be during this time. Since calcium, which is part of their structure, is washed out of the teeth.

Be careful, you will not suffer as much from pain as from an infection that may occur. Often pregnant women, without consulting a doctor, take drugs that can adversely affect the health of the child. For example, a decoction of sage, which is rinsed with teeth, really removes pain, but for a pregnant woman it can be dangerous topics which can cause miscarriage. Therefore, do not self-medicate, but immediately contact a dentist who knows what is best to do in such a situation and which drug to take.

Can pain relievers be used during pregnancy?

Nowadays there is huge selection pain-relieving ointments. But not all of them can be taken by women in position. Dangerous at any stage of pregnancy will be preparations containing poisons of bees and snakes, dimexide and other active substances.

If you have any kidney or liver disease, you should not take painkillers at all. It also happens when antispasmodics not only do not give the expected effect, but even cause side effects. In such cases, you should definitely consult a doctor.

But still remember that no matter what means you take, first of all you need the advice of a doctor and a special selection. medicines.

It is impossible to imagine a person who has never experienced a headache. According to statistics, women experience this type of pain 20% more often than men. Experts advise not to endure a headache, as it worsens the quality of life and reduces performance.

On the this moment exists big choice drugs that can effectively relieve headaches. But what about pregnant women if most medicines cannot be used during the period of bearing a child? It has been proven that many drugs can cause certain developmental disorders of the child, especially in the first trimester of pregnancy (up to 13 weeks).

Let's try to figure out which drugs can be taken by pregnant women in order to effectively get rid of a headache and not adversely affect the development of the fetus.

Headache medications to take during pregnancy

Antispasmodics

Often the cause of pain can be a spasm of cerebral vessels.

In such cases, effective means that contain substances in their composition that relax the walls of blood vessels. Due to this, an increase in the diameter of blood vessels occurs, blood circulation normalizes.

It's important to know that this group drugs are effective for tension headaches.

Antispasmodics are the most safe group painkillers during pregnancy.

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PAPAVERIN and NO-ShPA belong to the class of so-called myotropic antispasmodics, that is, they lower the tone smooth muscles internal organs, reduce them motor activity, moderately dilate blood vessels and thus eliminate the increased tone of the muscular organ.

It must be said that in terms of the severity and duration of the antispasmodic (relaxing smooth muscles) action of NO-ShPA, it is superior to PAPAVERIN.

Many characteristics of NO-SHPY are superior to those of PAPAVERINE, and it is for this reason that most companies (after the expiration of the patent protection of the original drug) today produce drotaverine hydrochloride under their own names. But not everyone managed to create a complete analogue of NO-ShPE.

NO-SHPA is 3-4 times more effective than PAPAVERIN, moreover, it is characterized by a higher bioavailability, which is about 100%, i.e. "Work" almost all 100% of the drug. When taken orally, NO-ShPA is rapidly absorbed. The PAPAVERINE compound is poorly soluble in the aquatic environment, it is used mainly intravenously (intramuscularly) or rectally in suppositories (this is how the drug is prescribed to pregnant women for direct entry into the bloodstream through the vessels of the rectum). Thus, the possibility of taking a pill of the drug, and not the inconvenient rectal administration (into the rectum) is another big plus of HO-SHPY. Still, the pill is always at hand, and it is easier to take it.

Many pregnant women carry NO-SHPY tablets with them everywhere and take them at the slightest discomfort. These actions are justified when there is a feeling of uterine tension, pain in the lower abdomen, however self-administration tablets should in no case replace a visit to a doctor: a tablet acts as a means of "ambulance" before contacting a doctor.

The action of NO-SHPY begins very quickly - already 10-12 minutes after taking the pill and 3-5 minutes after intramuscular injection. Also, when administered intravenously, the action of NO-SHPY manifests itself somewhat faster - after 2-4 minutes, and maximum effect develops in 30 minutes. The effect of PAPAVERINE is more delayed (when administered intravenously, the effect develops in 5-10 minutes).

From the history of medicinal preparations

PAPAVERIN (its full name is papaverine hydrochloride) was developed and obtained earlier than NO-ShPA - in the 50s. At the same time, several global companies began to produce it, each using its own pharmaceutical raw materials.

The creator of NO-SHPY is the Hinoin plant (Hungary). The history of the creation of the drug began with the development of a method for the industrial production of PAPAVERINE by the research group of the Khinoin plant. A new compound - drotaverine hydrochloride (trade name NO-ShPA) - was synthesized in the laboratory of the plant in 1961. In the future, the pharmacologists of this pharmaceutical company constantly improved the raw materials from which the drug was prepared, and today NO-ShPA has some advantages over PAPaverine. Now the plant "Hinoin", which produces NO-ShPA, is part of the pharmaceutical company "Sanofi-Sintelabo". Thus, NO-ShPA is the original trademark of this company.

According to other indicators, PAPAVERIN and NO-ShPA are similar. Both of these drugs do not affect the nervous system. They are well combined with analgesics - painkillers, which, if necessary, allows for combination therapy, complementing the antispasmodic effect with the analgesic effect of the analgesic. In combination with them, the following analgesics are used: PARACETAMOL, acetylsalicylic acid, IBUPROFEN, DICLOFENAC.

In some cases, PAPA-VERIN and NO-SHPU are prescribed together: in the morning and afternoon, a woman takes NO-SHPY tablets, and at night she injects suppositories with PAPAVERIN. Other prescription options are possible, depending on the situation and the preferences of the doctor, based on his professional experience.

During pregnancy and during breastfeeding The safety and efficacy of papaverine hydrochloride has not been established. But there are no clear data against him either. Therefore, it continues to be applied (including from Russia). NO-ShPA has a slightly higher safety profile, so it can be taken even during pregnancy. Thus, according to the Hungarian Committee for the Control of Accidental Developmental Anomalies, out of 30,663 women who participated in the study (1980 - 1991), 9.5% took HO-SHPU during pregnancy (due to the threat of its interruption for 2 -th and 3rd months or due to the threat of premature birth in last month pregnancy). According to the results of the study, no teratogenic (unfavorable for the fetus) effect of the drug was noted. But these studies have been conducted in a limited number, and therefore it is believed that it is possible to take HO-ShPU, but only on the recommendation of the attending physician and under his supervision. We must not forget that even such proven drugs have contraindications and side effects.

Do not use PAPAVERIN and NO-ShPU in case of hypersensitivity or allergy to the drug. For some lung diseases ( bronchial asthma, severe bronchitis) and disorders heart rate they should be taken with caution and under medical supervision.

Of the side effects are possible: drowsiness, nausea, dizziness, palpitations, a feeling of heat, increased sweating, constipation. With rapid intravenous administration, as well as when used in high doses, cardiac arrhythmias may develop. True, these side effects quite rare (especially in NO-SHPY).

Concluding the conversation about antispasmodics, it is necessary to warn expectant mothers against self-medication with these two drugs, which can be found in any pharmacy (and first aid kit), when the symptoms described at the beginning of the article appear. Be sure to consult your doctor: he will select the optimal dosage and timing of treatment. Moreover, most often, treatment is not limited to taking PAPAVERINE or NO-SHPY, remember that if you have uterine hypertonicity, you must not only take medication, but also follow a certain lifestyle. You should provide yourself (and your baby) with a sparing regimen, reduce physical and mental stress, master the relaxation techniques that are vital for a pregnant woman, and at the slightest sign of an increase in uterine tone, consult a doctor. Physical exercise with the appearance of discomfort in the lower abdomen are contraindicated; I would like to lie down and relax. Sex is also undesirable, since the contraction of the uterus occurs during orgasm, which (with increased tone) can cause miscarriage. Usually these simple measures are enough to reduce the tone of the uterus. And PAPAVERIN or NO-SHPA will help you complete your pregnancy with its long-awaited finale - delivery on time.

No-shpa is an antispasmodic drug often prescribed to women during pregnancy with uterine tone. It quickly enters the bloodstream, relieving spastic pain in hollow organs, and rarely causes side effects. No-shpa lies in the purse of every pregnant woman. safe remedy, effectively helping with the threat of miscarriage.

No-shpa at different stages of pregnancy

Reception of No-shpy during pregnancy is permissible at any time. Despite the fact that in the 1st trimester the laying of the child's organs occurs, and there is still no placental barrier, the first trimester is still not a contraindication for treatment with the drug. On the contrary, the remedy helps prevent miscarriage in the early stages, relieving spasms of the smooth muscles of the uterus.

With the threat of a miscarriage, a pregnant woman begins to feel long-lasting pains in the lower abdomen. The first steps in this case are:

1. Telephone consultation with the doctor in charge of the pregnancy. It is very good if you have his phone number, otherwise you should seek help by calling the ambulance service.

In any case, visit your gynecologist as soon as possible.

2. Taking 2 No-shpa tablets. If you have No-shpa Forte, then drink 1 tablet, as the drug is stronger.

The active substance of the drug is drotaverine. When it enters the body, the contractile activity of muscle fibers, including the uterus, decreases. She relaxes, hypertonicity no longer threatens, and the risk of miscarriage disappears.

In addition, the drug promotes vasodilation, which increases the blood supply to the uterus. Thus, the provision of oxygen and nutrients to the baby is improved, which only benefits him.

Drotaverine is considered more effective than papaverine, the medicinal effect of which is less pronounced and not so long.

During the 2nd trimester, the drug should be taken strictly according to indications. Despite the fact that no threat to the fetus has been identified, No-shpa should not be abused. Do not exceed the maximum daily dose and do not increase the course of treatment on your own.

In the 3rd trimester, you can also take No-shpu without fear for the health of the child. Drotaverine is excellent for coping with pain during training contractions. Feeling the contractions of the uterus, drink 1-2 tablets of No-shpa, and the pain will recede.

If, within an hour after taking the No-shpa tablet, the contractions ended, then they were training. If their frequency begins to increase, and pain increase, this indicates the onset of labor. Call an ambulance or go to the hospital on your own.

On the later dates refrain from taking the medicine. It turns out that when muscles relax during labor, the risk of bleeding increases. Therefore, at the 39th week of pregnancy, try not to use No-shpu to eliminate spastic pain.

However, the opening of the cervix is ​​often prevented by spasms of the muscles of the uterus itself. Then the use of the remedy is justified, but the decision on its appointment is made only by the doctor. He also determines the dosage and method of application, most often this is intravenous administration of the drug.

When to take No-shpu?

The drug is used in the event of spastic pain. Indications for drug treatment are:

• cholecystitis and other diseases of the biliary tract (outside the stage of exacerbation);
• diseases of the inflammatory nature of the urinary system (pyelitis, cystitis, urolithiasis, and others), accompanied by spasms;
• intestinal colic (regardless of the nature of origin);
• disease digestive system(local ulcers of the duodenum and / or stomach, gastritis, colitis and others);
• spastic headache (so-called tension pain).

During pregnancy, No-shpa is usually prescribed for hypertension, because the drug helps to relieve uterine tension and maintain pregnancy, it also helps to eliminate intestinal spasms and pain in the liver area. But self-medication does not eliminate the need to visit a doctor with a complaint about the occurrence of certain pains.

How does No-shpa affect the fetus?

Drotaverine, which is the active substance of the drug, was administered to pregnant animals to study its effect on the fetus. Studies have shown that it does not have a teratogenic and toxic effect on the cub. Therefore, this medication is widely used in domestic practice for the treatment of pregnant women.

In the West, scientists believe that excessive intake of drotaverine during pregnancy can negatively affect the child in the future, namely, slow down the development of the baby's speech. Special studies to prove this hypothesis have not been conducted. However, doctors recommend refraining from taking No-shpa excessively during the period of bearing a baby.

Therefore, follow the dosage prescribed by the instructions and other features of taking the drug.

Instructions for use No-shpy: dosage and contraindications

During pregnancy, one of the three dosage forms of the drug No-shpa is prescribed. It can be:

• tablets 40 mg (or 80 mg for No-shpa Forte);

1 tablet of No-shpa Forte is equal in content to 2 regular tablets of drotaverine

• candles 40 mg;
• solution in ampoules of 40 mg.

Tablets are taken orally (swallowed). The effectiveness of the drug when using this form begins after half an hour. To speed up the advance therapeutic effect, you should dissolve the tablet, holding it under the tongue.

Candles are administered rectally (in anus). They are absorbed into the blood in 10-15 minutes. But they are rarely prescribed to pregnant women because of the inconvenient dosage form.

No-shpy injections begin to act: with intramuscular injection - after 20 minutes, and with intravenous injection - after 5 minutes.

Dosage and duration of treatment

The maximum dose of No-shpa is 6 tablets (40 mg) per day or 3 tablets (80 mg) per day.

If the drug is used in injections, then the maximum daily dose remains the same: 6 ampoules of 40 mg. But the exact dosage and method of taking No-shpa is determined by the attending physician.

Without consulting a doctor, a pregnant woman should not drink No-shpa tablets for more than 1-2 days in a row. If the pain in the lower abdomen does not disappear, then you need to consult a doctor to clarify the causes of their occurrence and change the tactics of treatment. If No-shpa is prescribed as an auxiliary, and not the main drug, then without consultation it can be taken for 2-3 days.

Contraindications

No-shpa treatment is excluded if:

• severe forms of heart, kidney or liver failure;
• hypersensitivity to the components of the drug;
• hypersensitivity to sodium disulfide, which is part of the medicinal solution for intramuscular or intravenous administration;
• intolerance to galactose, transmitted in a hereditary way. And also with a deficiency of lactase (a special enzyme) and glucose-galactose malabsorption syndrome. This contraindication applies only to dosage form No-shpy in tablets. Their excipient is lactose.

No-shpa should be taken with caution by patients with vegetovascular dystonia by the type of hypotension. If a pregnant woman has low blood pressure, then during the injection, the patient should take a horizontal position. This is associated with an increased risk of collapse.

When taking the hypotensive tablet form of the drug, you need to be vigilant, systematically measuring the pressure.

When taking No-shpy tablets by women with lactose intolerance, a pregnant woman may complain of an upset digestive system.

With a lack of an enzyme involved in the hydrolysis of lactose, treatment with tablets is unacceptable.

In these two cases, when the process of assimilation of galactose and glucose is impaired, it is recommended to use the rectal, intravenous or intramuscular route of administration of the drug.

If to sodium disulfide in a pregnant woman hypersensitivity, then an allergic reaction in the form of bronchial spasm is possible. For this reason, it is not allowed to take No-shpa in injections if there is a history of allergies. An indirect contraindication is also the presence of bronchial asthma in the patient.

Overdose

An overdose occurs when the drug is taken excessively. If the maximum allowable dose is exceeded, a heart rhythm disturbance is possible. In exceptional cases, even fatal cardiac arrest is possible.

If the patient has taken too many pills at one time, then he needs constant monitoring. medical worker. If necessary, assigned symptomatic treatment, and the main functions of the body are supported. The patient is artificially induced to vomit and the stomach is washed.

Interaction with other drugs

If another antispasmodic medication was taken along with drotaverine, then they enhance each other's action.

If blood pressure was lowered as a result of treatment with tricyclic antidepressants, procainamide or quinidine, then drotaverine in injections enhances this effect.

Side effects

After taking No-shpa in rare cases, there are:

• failures from of cardio-vascular system(decrease in blood pressure and increased heart rate);
• malfunctions nervous system, manifested in the form of dizziness, headache, sleep disturbances;
• disruption of the gastrointestinal tract (may cause nausea and constipation);
• allergic reactions (urticaria, rash with itching, Quincke's edema).

No-shpa is a harmless drug if you follow the rules for taking it. It helps to keep the pregnancy and get rid of the pain of a spastic nature. Side effects appear very rarely. But if they occur, you should still refuse to take this drug, and together with your doctor, choose another antispasmodic.

Analogues of No-shpa are Spazmol, Spazoverin, Spakovin, Spazmonet, Drotaverin, Nosh-bra and others.