抗炎镇痛的布洛芬（Anti-inflammatory and analgesic ibuprofen）

抗炎镇痛的布洛芬（Anti-inflammatory and analgesic ibuprofen） 抗炎镇痛的布洛芬(Anti-inflammatory and analgesic ibuprofen) [universal name] Ibuprofen Tablets [English name] Ibuprofen Tablets [main ingredient] ibuprofen [property] this product is icing or film coating, white after removing coating. [indications] This product is non steroidal anti-inflammatory drugs. Apply to: 1. relieve rheumatoid arthritis, osteoarthritis, spinal arthritis, gouty arthritis, rheumatoid arthritis and other chronic arthritis or acute persistent joint pain symptoms, etiology, treatment and control of the disease without effect. 2. in the treatment of non pain soft tissue rheumatic arthritis, such as shoulder pain, tenosynovitis, bursitis, myalgia and exercise injury pain etc.. 3. acute mild and moderate pain, such as postoperative, post-traumatic, strain, primary dysmenorrhea, toothache, headache, etc.. 4. antipyretic effects on fever in adults and children. [Specification] [1) 0.1g; (2) 0.2g [usage and dosage] 1. adults commonly used oral dosage. (1) rheumatism, once 0.4g to 0.6g, 3~4 times a day rheumatoid arthritis, osteoarthritis than the amount of consumption should be greater. (2) mild or moderate pain and dysmenorrhea pain, once 0.2g to 0.4g, once every 4~6 hours. The maximum dosage for adults is usually 2.4G per day. 2. commonly used oral dose of children. Weight 5 to 10mg/kg each time, 3 times a day. [adverse effects] 1. digestive symptoms include indigestion, stomach burning, stomach pain, nausea and vomiting, which occur in 16% of the long-term users. These symptoms disappear and most of them are tolerated. A small number (<1%) of gastric ulcers and gastrointestinal bleeding were also caused by perforated ulcers. 2. nervous system symptoms such as headache, drowsiness, dizziness and tinnitus are rare, and appear in 1% ~ 3% patients. 3., renal dysfunction is rare, mostly in patients with underlying nephrotic syndrome, but a small number of patients may have lower extremity edema. 4. other rare symptoms include rash, bronchial asthma, elevated liver enzymes, and decreased white blood cells. 5. during the treatment period, such as gastrointestinal bleeding, liver and kidney function impairment, visual disturbance, abnormal blood picture and allergic reactions, the drug should be discontinued. [contraindications] allergic reactions to aspirin or other non steroidal anti-inflammatory drugs can cause cross allergic reactions and can cause bronchospasm in people who are allergic to aspirin. For this type of patient, disable this product. [matters needing attention] 1. for late pregnancy women can prolong pregnancy, resulting in dystocia and extension of labor. Pregnant women and lactating women should not be used. 2. inhibit platelet aggregation, which can prolong bleeding time, but disappear after 24 hours. 3. can increase the blood urea nitrogen and serum creatinine, and decrease the creatinine clearance rate. 4., the following circumstances should be used with caution (1) the original bronchial asthma patients can be aggravated after medication. (2) cardiac dysfunction, hypertension, water retention and edema after drug use. (3) hemophilia or other hemorrhagic diseases (including coagulation disorders and platelet dysfunction), prolonged bleeding after treatment, increased bleeding tendency. (4) those with a history of peptic ulcer disease are prone to gastrointestinal side effects, including new ulcers. (5) renal dysfunction increases in patients with renal failure, and even leads to renal failure. (6) the blood, liver and kidney function should be checked regularly for long term use. [pregnant women and lactating women] Disable. [drug interaction] 1., drinking or with other non steroidal anti-inflammatory drugs, increase the side effects of gastrointestinal tract, and there is the risk of ulceration. Long term with acetaminophen can increase the toxic side effects on the kidney. 2. with aspirin or other salicylic acid drugs, the efficacy is not increased, and the incidence of gastrointestinal adverse reactions and bleeding tendency increased. Three With heparin, coumarin and other anticoagulant drugs and platelet aggregation inhibitors, there is a risk of increased bleeding. 4. and furosemide with sodium, and the antihypertensive effect of weakening the latter row. 5. when Vera Pammy and nifedipine were used, the serum concentration of this product increased. 6. this product can increase the blood concentration of digoxin, with adjusted dose of digoxin should be noted. 7., this product can enhance the anti diabetic drugs (including oral hypoglycemic agents) role. 8., this product and antihypertensive drugs with the use of the latter may affect the antihypertensive effect. 9. this product can reduce the excretion of probenecid, increase blood concentration, thereby increasing the toxicity, so with the use of this product should reduce the dose. 10., this product can reduce the excretion of methotrexate, increase its blood concentration, and even up to the level of poisoning, so this product should not be used with or large doses of methotrexate. [drug overdose] Adverse drug reactions, and dose taking medication should be so excessive as emergency treatment including vomiting, gastric lavage, oral activated charcoal, antacids or (and) diuretics, and give support and other monitoring methods. [pharmacology and toxicology] Pharmacodynamics: This product has analgesic, anti-inflammatory and antipyretic effects. The mechanism of action is to reduce prostaglandin synthesis by inhibiting cyclooxygenase, thereby reducing the sensitivity of prostaglandin to tissue congestion, swelling, and reducing pain in peripheral nerves. It acts as a antipyretic through the hypothalamic thermoregulation center. [pharmacokinetics] Oral absorption, and food with the absorption of slow down, but the amount of absorption is not reduced. In combination with antacids containing aluminum and magnesium, this does not affect absorption. The binding rate of plasma protein was 99%. After 1.2 to 2.1 hours, the serum concentration reaches the peak value. When the dosage is 200mg, the serum concentration is 22~27 g/ml, the dosage is 400mg, 23~45 g/ml, and the dosage is 600mg, 43~57 g/ml. After one dose, the t1/2 was usually 1.8 to 2 hours. After 5 hours of administration, the concentration of the joint fluid was equal to that of the serum, and the concentration of the joint fluid was higher than that of the plasma within the next 12 hours. This product is metabolized in the liver, 60% to 90% by the kidneys, excreted by urine, and 100% excreted within 24 hours, of which about 1% of the prototype, and part of the excretion with feces. [storage] airtight preservation. A brief introduction to Bloven's pharmacodynamics In 1968, ibuprofen began in the UK market, because of its both anti-inflammatory and anti rheumatism effect, and the curative effect and adverse reactions with aspirin and acetaminophen, and soon become the pillar products on the market. However, as the antipyretic, analgesic and anti-inflammatory drugs, the adverse reactions such as gastrointestinal tract, the key is how to take scientifically. Antipyretic, analgesic and anti-inflammatory drugs are indispensable in our daily life, but the data show that long-term use of such drugs in patients, about 10% to 25% people may have peptic ulcer, less than 1% of them had serious complications such as gastrointestinal bleeding or perforation; and the US data also showed that oral antipyretic analgesic anti-inflammatory drugs after the mortality, AIDS, diabetes, leukemia, malignant melanoma. As one of the mainstay drugs in the antipyretic analgesics market, Bloven has this compound in anti-inflammatory, analgesic, cold and other compound preparations. Seeing the above data, some people may worry: can they still be eaten? In fact, this fear is unnecessary. Experiments have shown that the OTC dose of ibuprofen is relatively safe. Bloven's 3 advantages 1, relatively safe, WHO recommended for children to use In the antipyretic analgesic and anti-inflammatory drugs in all, WHO only recommend acetaminophen (paracetamol) and Bloven as a safe and effective application of antipyretic drugs in pediatrics, visible in the premise of the normal rational drug use, it can be assured to take the. 2, control the effect of persistent high fever, more often for high fever Acetaminophen is more effective than acetaminophen at the same temperature as the body temperature is above 39.2, And the fever time is more lasting than that. Because of this special effect, ibuprofen is mostly used for persistent high fever. 3, strong analgesic effect, 16-32 times stronger than aspirin It has the advantage of a superior analgesic effect, 16~32 times stronger than aspirin, and is commonly used in various forms of arthritis, toothache, postoperative pain and cancer pain. TIPS1-- why is ibuprofen good for pain relief? Because it inhibits prostaglandins that amplify pain. Prostaglandin and body pain, heat, inflammation, can cause local tissue hyperemia, swelling, fever, the "pain" signal amplification, Cox and Bloven and other non steroidal anti-inflammatory drugs can inhibit the body (COX), and the inhibition of prostaglandin synthesis, in order to stop the pain. In addition to inhibiting prostaglandin synthesis, ibuprofen also inhibits leukocyte activity and release of lysosomes, thereby reducing the pain sensitivity of local peripheral nerves to bradykinin and other pain causing substances, and also helping to relieve pain. TIPS2-- what is prostaglandin? Prostaglandin is a kind of active substance composed of unsaturated fatty acids in human and animal body, which has many physiological functions. It can stimulate smooth muscle and reduce blood pressure. Because it was discovered in semen, it was thought to have been secreted by the prostate gland, so it became prostaglandin. But in fact, the prostatic secretion "is a misnomer, now that prostaglandins in semen mainly from the seminal vesicle, and prostaglandin is a kind of endocrine. For Bloven, refer to age and weight As antipyretic, analgesic, and anti-inflammatory drugs, the risk of adverse reactions is associated with a dose that is relatively more closely related. In the small dose, short-term medication premise, adverse reactions are relatively less, but long term and large number of applications, the incidence of gastrointestinal and other adverse reactions will increase. Therefore, in the use of ibuprofen, more attention should be given to age, weight and other indicators. For children with fever, each kilogram weight of about 10 to 20mg, every 6 hours 1 times, within 24 hours shall not exceed 4 times; For adults with fever, each about 200mg, usually a maximum of 800mg per day; Arthritis patients with long-term pain use more than 2.4 grams per week, while under the guidance of doctors or licensed pharmacists. Special note: ibuprofen is generally not used for ordinary fever In some countries and regions of Europe and America, the high fever caused by viral infection in children is more likely to occur with ibuprofen. Therefore, the most commonly used antipyretic is acetaminophen (paracetamol). But in China, Bloven is seldom used in children, so the children who have high fever can choose Bloven. Renal toxicity that can not be ignored Compared with other similar antipyretic analgesics and anti-inflammatory drugs, ibuprofen has a lower adverse reaction, but it can not be ignored in large amounts and long-term use. The latest US medical Yearbook claims that 1% of people who use ibuprofen can suffer from kidney failure. In particular, patients suffering from osteoarthritis and rheumatoid arthritis are routinely examined for kidney function when ibuprofen is used for years. Thankfully, kidney damage caused by ibuprofen is largely restored after withdrawal. 4 types of ibuprofen should not be used Patients with allergic rhinitis, asthma, and nasal polyps should be careful with their initial use of ibuprofen. Ibuprofen may increase or induce asthma. Long service of ibuprofen in patients with digestive tract ulcer activity period, clinical about 15% will lead to indigestion, stomach pain, nausea, vomiting and other symptoms, although most people can tolerate and withdrawal symptoms may disappear, but there are still a few people who have stomach ulcers, gastrointestinal bleeding and other reactions, because of this, there are patients peptic ulcer should be disabled or with caution. Kidney failure is used with caution, and the drug has a risk of kidney failure, even if the kidney is healthy enough for long-term use of ibuprofen, so caution is needed before medication. The sick and elderly especially patients with heart disease or other diseases have caused due to decreased renal blood flow, in the use of ibuprofen, should be cautious. In addition, elderly patients tend to have liver and kidney dysfunction, especially for long periods of time. Grams of the drug or food and ibuprofen Aminoglycoside antibiotics aminoglycoside antibiotics (e.g. tobramycin and gentamicin), is known to have drug toxicity to kidney, may cause acute renal failure associated with ibuprofen and aminoglycoside antibiotics. Children or adolescents, in particular, suffer kidney damage in the short term (in some cases, for only one day). When two drugs are combined, the onset is very rapid, the longer the use, the more serious the disease, and even may develop irreversible renal failure, be extra careful. Aspirin, ibuprofen, and aspirin may reduce the cardiovascular protective effects of aspirin. Oral antidiabetic drugs, ibuprofen and oral antidiabetic drugs can increase the plasma concentration of oral antidiabetic drugs, equivalent to an increase in the dose of hypoglycemic agents, and can cause hypoglycemia coma in severe cases. Glucocorticoids, glucocorticoids (such as prednisone) can cause gastrointestinal ulcers in themselves, and ibuprofen can increase the risk of intestinal ulcers. Wine, coffee, ibuprofen on the gastric mucosa is more irritating, and coffee with the use of stimulating gastric acid secretion, will increase the stimulation of the gastric mucosa, and even induce gastric bleeding, gastric perforation. Drinking with wine increases the side effects of the gastrointestinal tract and increases the risk of ulcers. Editor / Jin Tingwen / Huang Jiqiu (Doctor of pharmacy, Union Medical College)