Вісник проблем біології і медицини (Nov 2019)
PATHOGENETICALLY REASONED USAGE OF DRUGS, DEPENDING ON THE SEVERITY OF PAIN SYNDROME OR MANIFESTATION OF AN INFLAMMATORY REACTION IN DENTAL PRACTICE
Abstract
Pain of varying intensity and duration is one of the most common symptoms of various diseases. Treatment of pain syndromes is rather challenging task. Modern medicine has the ability of focused influence on complex mechanisms of pain perceptions in order to protect the patient from acute pain associated with trauma or surgery. However, the sustainable practice of usage of unified schemas and specific generally accepted algorithms has not yet been observed. According to modern estimations severe pain affects from 30% to 75% of patients. Therefore, fast and complete pain relief is one of the priority tasks of pharmacotherapy. Severe and prolonged pain significantly disrupts the regulation of homeostasis and the activity of the autonomic nervous system, depresses the psychic, causes stress, depression, immune deficiency, depletes physiological and emotional resources, turns into a damaging factor, contributing to the development of new pathological processes, often induces generalized processes that represent danger to the body, and acquiring the status of an independent disease has a negative impact on the quality of life of the patient, leads to material, social and moral losses. In dental practice pain is most often caused by the presence of inflammatory processes (pulpitis, periodontitis, parodontitis, alveolitis, periostitis, osteomyelitis, acute herpetic gingivostomatitis, etc.) or tissue injuries, as well as during surgical, numerous therapeutic, prothetic and orthodontic interventions in the maxillofacial region. Taking into account the pathogenesis of inflammatory and traumatic pain syndromes it is reasonable to use drugs that suppress the synthesis and secretion of endogenous algogens and mediators that act on different parts of the inflammatory process and therefore, nonsteroidal anti-inflammatory drugs are the first choice for pharmacotherapy of this pathology (NSAIDs) for its prevention and treatment. Despite the fact that all NSAIDs have similar pharmacodynamics, they differ in the strength of action, the severity of individual effects, their onset and duration, as well as the ability to cause side effects. The analgesic effect of these drugs is manifested to a greater extent with pain of mild to moderate intensity, especially due to the inflammatory process. In order to reduce the intensity the duration of pain symptom (short-term course of pain treatment) the usage of Ketorol is effective and safe. When conducting anti-inflammatory therapy, it is recommended to use NSAIDs that have a pronounced anti-inflammatory effect, which are safe for long-term use (“Nise”). The proper choice of NSAIDs can adequately eliminate pain and inflammation, reduce the risk of postoperative complications, improve the quality of life of patients, their performance and psychological state.
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