PATHOGENETICALLY REASONED USAGE OF DRUGS, DEPENDING ON THE SEVERITY OF PAIN SYNDROME OR MANIFESTATION OF AN INFLAMMATORY REACTION IN DENTAL PRACTICE

Shundrik M. A., Tkachenko I. M., Marchenko I. Y., Vodoriz Y. Y

LITERATURE REVIEWS

Scentific article

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.

pain syndrome, inflammation, oral cavity, non-steroidal anti-inflammatory drugs

1. Zhuravlev VN, Nikolaeva AA. Terapiya litsevoi boli: vzglyad stomatologa. Problemy stomatologiі. 2012;3:36-8. [in Russiаn].
2. Kostina IN. Terapiya posleoperatsionnoi boli v ambulatornoi praktike stomatologa. Problemy stomatologii. 2011;2:27-9. [in Russiаn].
3. Ovechkin AM, Gorobets ES, Shifman EM. Izbrannye lektsii po regional’noi anestezii i lecheniyu posleoperatsionnoi boli. Petrozavodsk: IntelTek; 2009. 20 s. [in Russiаn].
4. Verlan NV. Perspektivy kupirovaniya posleoperatsionnogo bolevogo sindroma: primenenie ketorolaka. Statsionarnozameshchayushchie tekhnologii. 2016;3-4:63-4. [in Russiаn].
5. Timofeev AA, Ushko NA, Dakal AV. Sravnitel’naya kharakteristika nenarkoticheskikh anal’getikov, ispol’zuemykh v chelyustno-litsevoi khirurgii. Stomatolog-praktik. 2010;3:22-4. [in Russiаn].
6.  Alekseeva LI. Mesto lokal’noi terapii v lechenii osteoartroza. RMZh. 2011;32:2048-52. [in Russiаn].
7. Vertkin AL, Prokhorovich EA, Goruleva EA, Girel’ OI. Effektivnost’ i bezopasnost’ primeneniya Ketorola dlya kupirovaniya bolevogo sindroma na dogospital’nom etape. 2010. 32 s. [in Russiаn].
8. Shostak NA. Kompleksnye bolevye sindromy v praktike vracha-internista: diagnostika. Lechenie. Sovremennaya revmatologiya. 2009;1:8-3. [in Russiаn].
9. Viktorov AP. Farmakoterapiya khronicheskoi boli: problemy effektivnosti i bezopasnosti. Nesteroidnye protivovospalitel’nye lekarstvennye sredstva (NPVLS). Chast ‘3. Ratsional’naya Farmakoterapiya. 2011;2:22-7. [in Russiаn].
10. Voznesenskii AG. Klinicheskaya farmakologiya nesteroidnykh protivovospalitel’nykh sredstv. 2010. 110 s. [in Russiаn].
11. Zoryan EV, Rabinovich SA. Effektivnost’ i bezopasnost’ nesteroidnykh protivovospalitel’nykh sredstv. Stomatologiya dlya vsekh. 2012;1:36-40. [in Russiаn].
12. Galanova TA, Tsepov LM, Nikolaev AM. Algoritm lecheniya khronicheskogo apikal’nogo periodontita. Endodontiya Today. 2009;3:74-8. [in Russiаn].
13. Grechenkov AS, Kondrashenko EN, Butrov AV. Nimesulid kak preparat vybora pri lechenii boli v ambulatornoi praktike. Statsionarozameshchayushchie technologií. 2016;3-4:63-4. [in Russiаn].
14. Egorova OA. Effektivnost’ i bezopasnost’ ketorola pri bolevom sindrome v klinike ambulatornoi khirurgicheskoi stomatologie. Stomatologiya. 2009;6:53-4. [in Russiаn].
15. Karateev AE, Alekseeva LI, Bratygina EA Otsenka chastoty razvitiya pobochnykh effektov pri dlitel’nom ispol’zovanii nimesulida v real’noi klinicheskoi praktike. RMZh. 2009;21:1466-72. [in Russiаn].
16. Zorina OA, Abaev ZM, Boriskina OA, Berkutova IS. Spektr primeneniya preparata nimesil v parodontologii. Rossiiskaya stomatologiya. 2012;5(3):30-6. [in Russiаn].
17. Sidel’nikova LF, Kolenko YuG. Primenenie nesteroidnykh protivovospalitel’nykh sredstv v kompleksnom lechenii erozivno-yazvennykh porazhenii slizistoi obolochki polosti rta. Sovremennaya stomatologiya. 2013;1:54-6. [in Russiаn].
18. Sokhov ST, Aksamit LA, Vikha GV. Primenenie nesteroidnykh protivovospalitel’nykh sredstv dlya lecheniya stomatologicheskikh zabolevanii. M.: Med-press; 2011. 96 s. [in Russiаn].
19. Bystrov NK, Bystrova EL. Effektivnost’ primeneniya preparata Ketorol® v stomatologicheskoi praktické. Stomatolog praktik. 2014;3:26-8. [in Russiаn].
20.  Belovol AN, Knyaz’kova II. Terapevticheskaya effektivnost’ Nimesulida. Zdorov’ya Ukraуni. Revmatologiya. Farmakoterapiya. 2012. 89 s. [in Russiаn].
21. Karateev AE. Nimesulid: dostoinstva prevyshayut nedostatki. Trudnyi patient. 2012;4:42-9. [in Russiаn].
22. Mattia C, Ciarcia S, Muhindo A, Coluzzi F. Nimesulide: 25 years later. Minerva Med. 2010 Aug;101(4):285-93.
23. Fleisher GM. Anal’geticheskoe deistvie Ketorola® pri bolevom sindrome v stomatologicheskoi praktické. Stomatolog praktik. 2014;2:40-2. [in Russiаn].
24. Belovol AN, Knyaz’kova II. K voprosu o bezopasnosti primeneniya nimesulida v klinicheskoi praktické. Novosti meditsiny i farmatsii. Klinicheskaya farmakologiya. 2012;6:6-8. [in Russiаn].
25. Fleisher GM, Fomichev IV. Primenenie Ketorola® pri endodonticheskom lechenii oslozhnenii kariesa. Stomatolog praktik. 2014;4:12-3. [in Russiаn].
26. Fleisher GM. Anal’geticheskoe deistvie Ketorola® pri bolevom sindrome v stomatologicheskoi praktické. Stomatolog praktik. 2014;2:40-2. [in Russiаn].
27. Zhuravlev VP, Nikolaeva AA. Klinicheskoe obosnovanie ispol’zovaniya preparata Ketorol® dlya simptomaticheskoi terapii litsevoi bolí. Problemy stomatologii. 2012;5:30-2. [in Russiаn].
28. Fleisher GM. Primenenie preparata ketorol v ambulatornoi stomatologii Stomatolog-praktik. 2015;4:46-8. [in Russiаn].
29. Sidel’nikova LF, Kolenko YuG, Grig NI. Obosnovanie vybora optimal’noi terapii pri lechenii boli i vospaleniya v stomatologicheskoi praktické. Sovremennaya stomatologia. 2013;4:17-21. [in Russiаn].

«Bulletin of problems biology and medicine» Issue 4 Part 1 (153), 2019 year, 52-56 pages, index UDK 616.31:616- 002./-009.7-039-085:615:616-092

10.29254/2077-4214-2019-4-1-153-52-56