Drug and method of prophylactic treatment of primary dysmenorrhea
The invention relates to medicine, gynecology, and can be used for the treatment of primary dysmenorrhea. Assign instenon 1 tablet 3 times a day for 4 days before and on the first day of menstruation. This invention contributes to the complete relief of pain, all autonomic disorders, as well as to reduce the volume of lost blood during menstruation. 2 S. p. f-crystals.
The invention relates to medicine, gynecology, specifically to medicines used for the treatment of primary dysmenorrhea. Primary dysmenorrhea - cyclical pain syndrome, which is caused by a complex autonomic, metabolic and behavioral impairments that accompany the menstrual shedding of the endometrium. Dysmenorrhea is marked at 31-52% of women[1, 2, 3, 4].
Known use for the treatment of primary dysmenorrhea following groups of medicines[1, 2, 3, 4, 5, 6]:
1. Non-steroidal anti-inflammatory drugs (NSAIDs).
- indomethacin 25 mg 3 times a day after meal with milk, 3 days before your period is due in just 6 days.
- mefenamovaya acid 250 mg 3-4 times daily, after a meal, a course of 6 days starting C the alley as needed but not more than 32 mg
- ibuprofen 300 mg 3 times a day, the first dose before eating, the rest to be taken after meals.
is naproxen 250 mg, in the first 3 days two doses of 250 mg, the last 3 days - one 250 mg.
- Raven rapid (diclofenac) 50 mg 2 times a day, 1-5 days depending on the clinical effect.
2. Antileukotriene drugs (in the event of failure NSAIDs) adalat 60 mg daily, singulair 30 mg per day.
3. The combined oral contraceptive pill (marvelon, mercilon, regulon, novinet, LOGEST, femoden).
4. The progestogen. Duphaston 5-25 day or 15-25 day of the menstrual cycle at 10 mg 1-2 times a day for 3-6 months.
5. Auxiliary tools. Antispasmodic and analgesic funds (no-Spa, baralgin, spazmatron, donalyn, sevadal, dipyrone), sedatives (Valerian, motherwort, hops, oregano, peony), blockers, CA-channel, vitamins E, E6. However, all tools have a number of disadvantages [1,2,3,5]. So, unfortunately, NSAIDs can have some side effects, as extragenital (dyspepsia, diarrhea, skin rash, renal dysfunction, and thrombocytopenia), and antifertility that may limit their prelude rarely, and most women tolerate the drugs. The use of NSAIDs is contraindicated in gastric ulcer and duodenal ulcer, gastritis and other diseases of the gastrointestinal tract, as they may exacerbate the process[1, 2, 3].
Welcome antileukotriene drugs may cause allergic reactions, toxic hepatitis, headache, disorders gastrointestinal disorders, their safety during pregnancy has not been established .
The combined oral contraceptives (COCS) raises a number of positive non-contraceptive effects - reduction of blood loss, recovery of a regular cycle, lowering the risk of developing iron deficiency anemia and inflammatory diseases of the pelvic organs, reduction in the incidence of endometrial cancer and ovarian cancer. The most serious complications COCS include increased risk of thromboembolism, cardiovascular diseases, disorders of fat, carbohydrate and vitamin exchanges[1, 2, 3].
Closest to the proposed purpose is gestagen Duphaston , the reception of which has no androgenic, estrogenic, anabolic effects. Duphaston no effect on liver function, lipid spectrum is t influence on the processes of ovulation, causes a full circular secretory transformation of the endometrium and thereby provides a complete rejection during menstruation. However, the treatment appears after taking the drug for a long time. Can be used in women who want to get pregnant[1, 2, 3, 6].
The auxiliaries is symptomatic, they are often ineffective. Thus, all used today for the treatment of primary dysmenorrhea drugs have side effects that affect quality of life.
Preference at this point you can give Duphaston or taking oral contraceptives[1, 2, 3, 4, 6], however, many patients do not want to use hormonal drugs.
A new technical challenge: expanding Arsenal of drugs used for the treatment of primary dysmenorrhoea, and the expansion of the scope of the drug by reducing the number of complications.
The set task is solved by the use as a drug for the prophylactic treatment of primary dysmenorrhea drug instenon, which is administered 1 tablet 3 times a day for 4 days before and on the first day of menstruation. Ven is coated tablets of white color. Known indications for use:
Diseases of the brain vascular and age of the character.
Insufficient blood supply to the brain.
Dizziness caused by a functional disorder of the brain.
Farmakologicheskie properties: instenon is a combination drug for improvement of brain blood circulation and metabolism. It contains three drug substances that support each other in their interaction:
geksobendin - increases the energy status of the neuron due to the activation of the utilization of glucose and oxygen, which gives an energy substrate for the synthesis and metabolism of neurotransmitters, neurotransmitter and recovery of synaptic transmission, stabilize physiological mechanisms of autoregulation of cerebral and cardiac blood flow;
etamivan - improves integrative brain activity due to the activation of the ascending departments of the reticular formation, normalizes the functional state of the neural complexes of the cortex and subcortical-stem structures;
etofillin - improves the microcirculation of the brain by increasing perfusion of the blood pressure, has a stimulating effect on the nervous system through stimulation of the subcortical structures, the middle brain stem centers and nuclei (respiratory, and vasomotor centers of the autonomic regulation).
Protivopokazaniya: increased intracranial pressure, cerebral hemorrhage, seizures, hypersensitivity to the drug components.
During pregnancy and nursing instenon accepted only on the individual doctor's orders.
Usage and dosage: 1-2 tablets 3 times a day, without chewing, during or after eating, drinking small amounts of liquid.
Clinical trials showed that the use of instenon useful in the prophylactic treatment of primary dysmenorrhea. Patients prescribed the drug for 2 days before and on the first day of menstruation, but the desired effect has not been noticed. Taking the drug for 4 days before and on the first day of menstruation was marked by a pronounced clinical effect. The study included 63 patients with primary dysmenorrhea (33 patients with adrenergic types of flow, 4 patients with serotoninergicheskim types of flow, 26 patients with mixed type of preparations, in the form of headache, nausea, dizziness, which demanded the abolition of instenon and transfer of patients on conventional treatment methods.
Clinical example: patient N. 14 years old, a student of the 9th grade. Menstruation from the age of 11, was installed immediately, with painful menarche, 7 days 26-27 days. Sex life not lived. Pain occurs 1-2 hours before the arrival of menstruation that lasts for days. Strongly expressed the pain lasts for 6-7 hours, and therefore missing classes. The pain combined with nausea, fever, chills, internal trembling, sweating, palpitations, weakness, anxiety, uncertainty, vomiting, sensitivity to cold and pale skin, sleepiness, decreased performance. As treatment repeated attempts reception shpy, no effect was noted. In the survey exhibited clinical diagnosis: primary dysmenorrhea, mixed flow, 3 severity. Assigned instenon 1 tablet 3 times a day for 4 days before menstruation and during the first day during 3 menstrual cycles. In the first menstrual cycle - monthly with a weak pain, was not observed in the vegetative symptoms, no absences. In the second and third menstrual cycles - full kopiowanie from 7 to 5-4 days the decrease in the volume of lost blood.
Thus, the proposed method, which is to assign up to 4 days before and on the first day of menstruation drug instenon 1 tablet 3 times a day, allows you to spend preventive treatment of primary dysmenorrhea by reducing the number of complications associated with the appointment of traditional therapy. The drug instenon well tolerated by patients, does not provide some side antifertility and extragenital effects (dyspepsia, diarrhea, skin rash, renal dysfunction, and thrombocytopenia), allergic reactions, will not increase the risk of thromboembolism, vascular diseases, does not violate fat, carbohydrate and vitamin exchanges, does not affect the processes of ovulation, reduces krovopoterju during menstruation and reduces the risk of developing iron deficiency anemia.
Sources of information
1. Practical gynecology (clinical lectures). Edited by Acad. The RAMS C. I. Kulakov and Professor C. I. Prilenskoe. M: Medpress-inform, 2001, S. 253-259.
2. Gurkin Y. A. adolescent Gynecology. A guide for physicians. SPb: Folio, 2000, S. 250-260.
3. The second all-Russian forum “Mother and child”. Dysmenorrhea. Questions diagnostics is their disease. Vol. 3, I. XLIX, 2000, S. 50-54.
5. On The Main Page. Drugs in Russia. Handbook, 2000, C. B 11-13, B 198, 199.
6. Obstetrics and gynecology. International Bulletin, 2003, vol. 1, S. 4.
1. The drug instenon as a drug for the prophylactic treatment of primary dysmenorrhea.
2. A method of prophylactic treatment of primary dysmenorrhea by pharmacotherapy, characterized in that designate instenon 1 tablet 3 times a day for 4 days before and on the first day of menstruation.