The place of phenazepam in the modern use of benzodiazepine tranquilizers

Pregnancy and Phenazepam are incompatible, well almost...

During pregnancy, Phenazepam is prescribed extremely rarely. Its use is advisable only if there is a threat to vital signs.

The composition of the drug has a toxic effect on the fetus and increases the risk of having a child with congenital defects. The likelihood of pathology increases when taking Phenazepam in the early stages of pregnancy (first trimester).

In the third and last trimester, it is also dangerous to take Phenazepam, since it can cause depression of the central nervous system.

system of a newborn child, and if necessary, it is better to replace this drug with safer analogues.

If a woman takes the drug throughout her pregnancy, the baby develops a dependence syndrome. After the birth of a newborn, you will have to deal with the consequences of withdrawal. Young children have an immature central nervous system, which is sensitive to the suppressive effects of benzodiazepines.

Depressed breathing, decreased muscle tone, hypotension, hypothermia are possible consequences of taking Phenazepam in late pregnancy and just before childbirth.

Complex treatment

NSAIDs for intercostal neuralgia reduce pain and inflammation. Patients are also treated with B vitamins (B1, B6, B12), and are prescribed the combination drug milgamma. To relieve muscle spasms, muscle relaxants are used:

tizanidine;
sirdalud;
baclofen;
clonazepam.

Combination drugs are used, including an analgesic and a muscle relaxant (mialgin). If necessary, patients are prescribed sedatives. In case of severe pain, neurologists perform blockade of intercostal nerves with solutions of novocaine and lidocaine. For long-term disease, glucocorticosteroid hormones (prednisolone, hydrocortisone) are used. Applications with dimexide are also used.

As external medications for intercostal neuralgia, ointments based on bee venom (apizartron) and creams, gels and ointments with NSAIDs are used. In order to prevent the disease from becoming chronic with frequent exacerbations, patients are advised to eliminate or significantly reduce the effects of harmful factors (heavy physical activity, alcohol abuse, psycho-emotional stress).

Intercostal neuralgia can be caused by many diseases. Self-relief of pain syndrome can lead to further progression of the disease. In order to determine the cause of intercostal neuralgia and receive adequate therapy, make an appointment with a neurologist by calling the Yusupov Hospital.

L.S. Manvelov Candidate of Medical Sciences

State Institution Scientific Center of Neurology of the Russian Academy of Medical Sciences

The term “neuralgia” comes from the Greek words “neuron” - “nerve” and “algos” - pain. This pain spreads along the nerves, accompanied by other unpleasant sensations, such as crawling, burning or numbness.

The causes of neuralgia are kaleidoscopically diverse: injuries, external (heavy metals, bacterial toxins, some medications) and internal (associated with diseases of internal organs) intoxication; some diseases of the nervous system (multiple sclerosis, polyradiculoneuritis, etc.); infections (shingles, tuberculosis, brucellosis, etc.); decreased immunity; allergy; pathology of the spine (additional ribs, osteochondrosis, deforming spondylosis, disc herniation); compression of nerve trunks in the musculoskeletal and ligamentous canals. In addition, neuralgia may occur when nerves are compressed by scar tissue or tumors. Alcohol abuse, diabetes mellitus, and metabolic disorders of B vitamins, which are most often observed in gastric and duodenal ulcers, gastritis, hepatitis, and colitis, accompanied by metabolic disorders in the nervous tissue, are of significant importance.

The appearance of neuralgia due to hypoxia of the nerve trunks (insufficient oxygen flow) is caused by cardiovascular diseases: arterial hypertension, atherosclerosis, rheumatism, etc., as well as anemia (anemia).

Intercostal neuralgia can also occur with changes in the spine in menopausal women due to hormonal disorders, less often with endocrine diseases, for example, thyrotoxicosis, diseases of the adrenal glands, as well as with long-term treatment with hormonal drugs. It also occurs in other diseases accompanied by osteoporosis (loss of bone tissue).

As we see, the number of causes leading to intercostal neuralgia is extremely large, and not all of them have been listed here. Therefore, if chest pain occurs, you should not self-medicate, considering “your” diagnosis to be infallible - this threatens the development of severe complications. You should definitely seek medical help.

Neuralgia very rarely develops under the influence of only one factor. The disease is predominantly observed in older people, when all of the listed causes of its occurrence act against the background of age-related vascular changes. Neuralgia practically does not occur in children.

With neuralgia of the intercostal nerves, changes in both their function and structure may be observed. However, only disturbances in peripheral nerve fibers cannot explain attacks of pain, which can appear without any additional influence. Formations of the central nervous system take part in the formation of a painful attack, controlling the flow of impulses from the peripheral nerve trunks. Changes in the central nervous system during pain are confirmed by electroencephalography data, which makes it possible to identify characteristic “flares” of electrical activity in the brain.

The leading manifestation of intercostal neuralgia is pain along the intercostal nerves of a constant nature, sometimes intensifying in attacks, especially with movements and coughing. The intercostal spaces are painful when touched, and their sensitivity is sharply increased. Chest pain can be caused by a wide variety of reasons. We will give only a few examples that help to distinguish pain due to intercostal neuralgia from pain due to some widespread cardiovascular diseases that are life-threatening. With angina, pain occurs quickly and goes away quickly (within 3-5 minutes). Its typical location is behind the sternum, in the region of the heart; it can radiate to the shoulder, neck, left arm and shoulder blade. The patient may develop a cold sweat and fear of death. The picture of acute myocardial infarction is similar to the signs of angina pectoris, but the characteristic pain persists longer and is more difficult to relieve. The patient's condition during a heart attack is more severe; a drop in cardiac activity, blood pressure, nausea, and vomiting is possible.

Modern diagnostic methods help determine the real cause of chest pain. A truly revolutionary revolution in the diagnosis of diseases was made by X-ray computed tomography and magnetic resonance imaging, which make it possible to identify tumors, vascular, inflammatory and other signs of damage to the brain and spinal cord, spine and internal organs. Currently, these methods are widely used in practical medicine.

Treatment of intercostal neuralgia is primarily aimed at eliminating or correcting the causes that cause it. In the acute period of the disease, bed rest is recommended for 1-3 days. The patient should lie on a hard, flat surface, preferably placing a shield under the mattress. Light, dry heat helps: an electric heating pad, heated sand in bags, mustard plasters, pepper plaster on painful areas. You should avoid bending and turning the body, prolonged sitting, and even more so sudden movements and lifting heavy objects. Wearing a corset for several days works well, but not for long, so as not to develop muscle weakness.

Drug treatment includes analgesics (analgin, sedalgin, spazgan), non-steroidal anti-inflammatory drugs (ibuprofen, ketoprofen, diclofenac, Celebrex, voltaren, indomethacin, piroxicam) orally, in rectal suppositories or intramuscularly. All these drugs should be taken systematically by the hour, prophylactically, without waiting for the pain to intensify. The listed drugs are not prescribed for acute gastrointestinal diseases and with great caution for chronic lesions of the gastrointestinal tract. In this case, Flexen (ketoprofen) can be successfully used due to the characteristics of its two forms of release - capsules and solution for injection. The active substance is sealed in seamless capsules in the form of a lipophilic suspension; contact with the gastric mucosa is completely excluded, resulting in high safety and tolerability of Flexen. As for the injection form, due to the preparation of the solution immediately before administration, there is no need for stabilizers and preservatives. Two other forms of Flexen are also effective - gel and rectal suppositories.

Vitamin therapy is carried out, especially with B vitamins (B1, B6, B12), and the combined drug milgamma. To relax spasmodic muscles, muscle relaxants are prescribed (tizanidine, sirdalud, baclofen, clonazepam), as well as combination drugs that include an analgesic and a muscle relaxant (mialgin). If necessary, sedatives are prescribed.

For severe pain, blockade with solutions of novocaine and lidocaine is indicated. For long-term disease, glucocorticosteroids (prednisolone, etc.) are used. The effectiveness of treating patients with spinal lesions with tissue preparations (rumalon, chondroitin sulfate) has not been proven. Applications with dimexide are also used.

Physiotherapeutic methods of treatment are widely used: diadynamic and sinusoidally modulated currents, electrophoresis and phonophoresis of drugs, ultraviolet irradiation, etc. Reflexology is indicated: acupuncture, moxibustion, laser therapy.

To prevent the disease from becoming chronic with frequent exacerbations, it is important to eliminate or significantly reduce the effect of harmful factors, such as heavy physical activity, psycho-emotional stress, alcohol abuse, diseases of the nervous system, internal organs, etc. Let us emphasize once again that it is absolutely necessary to You can consult a doctor earlier if you experience chest pain, which can be one of the symptoms not only of intercostal neuralgia, but also of a number of others, including severe, life-threatening diseases. No wonder Eastern wisdom says: “Treat a mild illness so that you don’t have to treat a severe one.”

Periodic pain in the heart and lower back, shortness of breath, inability to breathe deeply - all this is often mistaken for manifestations of a serious heart or lung disease. Fearing a terrible diagnosis, a sick person does not dare to go to the doctor, continues to endure pain and refuses his usual way of life. Meanwhile, symptoms may indicate intercostal neuralgia. This pathology is considered quickly curable, but it should not be brought to an advanced stage.

In exceptional cases they do prescribe - when?

The medicine has become widespread in the fight against diseases:

syndrome that occurs due to alcohol withdrawal (abstinence);
the presence of epileptic seizures or seizures of another nature in a pregnant woman;
diagnosed psychiatric illnesses, such as schizophrenia;
the presence of neurological diseases that caused severe irritation, anxiety or insomnia.

The drug is prescribed by a doctor, and the dose and course of treatment are selected depending on the patient’s condition. The drug can be administered intramuscularly or intravenously. Today, pharmacies also have the option of medicine in tablets.

Trigeminal neuralgia (continued...)

Many patients are helped by the broad-spectrum anticonvulsant drug morsuximide (morpholep).

Increasing the initial dose from 0.25 g per day by 0.125 g daily to the therapeutic dose (0.75 g), the effect of treatment is noted in the form of a decrease in the frequency and intensity of pain paroxysms on the 3-5th day of treatment.

Ethosuximide (Suxilep) is an anticonvulsant drug used to relieve minor epileptic seizures and also has a pronounced analgesic effect. The initial dose is 0.25 g per day (it is increased daily by 0.1 g to 0.5-1 g per day) relieves pain paroxysms.

Other antiepileptic drugs (sodium valproate, clonazepam, trimethin) are also indicated. One of the conditions for successful drug treatment of patients with trigeminal neuralgia is changing antiepileptic drugs once every 5–6 months with a gradual transition from one to another, since their disadvantage is a gradual decrease in effectiveness.

To enhance the effect of the anticonvulsant, antihistamines are prescribed from the 1st day - intramuscularly 2 ml of a 2.5% solution of diprazine (pipolfen) or 1 ml of a 1% solution of diphenhydramine at night.

Elderly people with symptoms of chronic cerebral circulatory failure (even in the stage of compensation) should be prescribed antispasmodics: aminophylline (syntophylline) - 10 ml of a 2.4% solution in 10-20 ml of isotonic sodium chloride solution, nicotinic acid - 1 ml of a 1% solution , no-shpu – 2 ml. Intravenous administration of aminophylline is contraindicated in cases of sharply low blood pressure, paroxysmal tachycardia, extrasystole, and acute heart failure.

At the same time, B vitamins are prescribed (cyanocobalamin - 500-1000 mcg intramuscularly, vitamin B1 - 2 ml of a 5% solution intramuscularly every other day), nicotinic acid - 1-2 ml of a 0.1% solution intramuscularly.

As an emergency remedy during an exacerbation of the disease, physical methods of treatment include daily diadynamic and sinusoidally modulated currents (5 - 6 procedures), diadynamic electrophoresis of novocaine, as well as ultrasound (power 0.05 - 0.1 W/cm2). For acute pain, acupuncture is indicated (1st option of the inhibitory method).

In case of frequent attacks and significant duration of the disease, to prevent conditions requiring urgent measures, repeated courses of treatment in a hospital setting with the selection of adequate doses of antiepileptic drugs are indicated.

Pentoxifylline (agapurine, trental) is prescribed - 5 ml intravenously in 100 ml of isotonic sodium chloride solution, Cavinton - 2-4 ml intravenously in 100 ml of isotonic sodium chloride solution, xanthinol nicotinate - 2 ml of 1% solution intramuscularly or nicotinic acid, aminophylline, as well as B vitamins, biostimulants (aloe, FiBS, vitreous, biosed, peloidin, peat, humisol). Along with this, tranquilizers (nozepam, sibazon, phenazepam, chlozepid, tazepam, elenium, seduxen, mebikar, napoton, etc.), antihistamines (tavegil, diazolin, fenkarol, diphenhydramine, suprastin, etc.) are used, which enhance the effect of analgesics and antiepileptics drugs. In severe forms of trigeminal neuralgia, it is recommended to prescribe antipsychotics: tizercin from 1/2 to 2 tablets (but 0.025 g per tablet) per day, droperidol - 1-2 ml of 0.25% solution, antidepressants (amitriptyline - 12.5- 25 mg 2 - 3 times a day with a gradual dose reduction after achieving a therapeutic effect) in combination with a course of treatment with baclofen, sodium hydroxybutyrate. In addition, diadynamic currents, electrophoresis of novocaine or phonophoresis of hydrocortisone and analgin are used.

Treatment of patients with bilateral trigeminal neuralgia should be carried out in a hospital setting. Preventive treatment for mild and moderate forms of the disease should be carried out once a year, for severe forms - 2 times a year.

Trigeminal neuralgia is predominantly of peripheral origin.

The main forms of trigeminal neuralgia with a predominance of the peripheral component of pathogenesis are odontogenic neuralgia of the trigeminal nerve, dental plexalgia, postherpetic neuralgia, neuralgia with damage to the semilunar ganglion, neuralgia of individual nerves of the main branches of the trigeminal nerve, etc.

Features of clinical manifestations:

Initially, pain occurs at the site of localization of the primary pathological process (focus of inflammation, injury, tumor, etc.).
Attacks of neuralgia are often preceded by painful and prolonged pain in the zone of innervation of the corresponding branch of the trigeminal nerve.
Severe pain syndrome, which intensifies in attacks, lasts a long time (hours, days), weakening gradually;
Painful manifestations may be limited to the branching zone within the main branches of the trigeminal nerve, dental plexuses and their branches, etc.
Novocaine and alcohol novocaine blockades lead to a very short-term improvement. The therapeutic effect is observed only during the period of action of novocaine, but in the future, as a rule, the pain syndrome intensifies.
Drugs of the carbamazepine group cause very little pain reduction or are completely ineffective.
A noticeable therapeutic effect is obtained by taking analgesics.
The clinical picture of this neuralgia may vary depending on the course of the underlying pathological process.
Elimination of the cause of trigeminal syndrome (removal of a diseased tooth) often does not lead to the elimination of painful paroxysms, since in the later stages of development neuralgia still has a central component.

Urgent Care. Non-narcotic analgesics (analgin, efferalgai, baralgin, tramadol) intramuscularly and intravenously are indicated.

At the same time, non-steroidal anti-inflammatory drugs are prescribed:

salicylates (acetylsalicylic acid - 0.25-0.5 g 3 - 4 times a day after meals, quversalin - 1-3 tablets 3 - 4 times a day, which can be taken before meals, etc.);
pyrazolone derivatives (butadione 0.2 g 3 times a day, rheopirin, pyrabutol, tribuzone - 0.25 g 3-4 times a day after meals);
derivatives of indoleacetic, phenylacetic, phenylpropionic and anthrapylic acids (indomethacin - 25 mg 2 - 3 times a day, bringing the daily dose to 100-150 mg, can be combined with salicylates; ibuprofen - 0.2 g in the morning before meals, washed down with tea, and 3 times a day after meals; diclofenac sodium, naproxen, mefenamic acid, chlotazol);
para-aminophenol derivatives (efferalgan - 0.5 g 2 - 3 times a day, sedalgin - 1 tablet 3 times a day).

The non-steroidal anti-inflammatory drug ketanov is used (1 ml intramuscularly or 10 mg orally 3 times a day). It has a pronounced analgesic effect. Prodeine is effective.

Analgesics are used in combination with antihistamines (fenkarol, diphenhydramine, diprazine, suprastin, diazolin, tavegil), as well as with tranquilizers and neuroleptics (aminazine, thioridazine, haloperidol).

It is advisable to prescribe drugs with an antidepressant effect in combination with the listed drugs (amitriptyline - 0.025 g 2 - 3 times a day).

In case of significantly severe pain syndrome, neuroleptanalgesia is indicated as a one-time emergency measure - intramuscular injection of 2 - 3 ml of 0.25% droperidol solution in combination with the synthetic analgesic fentanyl (2 ml of 0.005% solution).

For persistent pain that is difficult to treat, use a mixture of the following composition: 2 ml of a 50% analgin solution, 1 ml of a 2% promedol solution, 2 ml of a 0.5% novocaine solution.

Vitamins of group B (B1, B12 and their analogs) are indicated, as well as physiotherapy: dynamic or sinusoidal currents, ultrasound, moderate heat, electrophoresis of novocaine or calcium chloride, phonophoresis of hydrocortisone with analgin. In the future, mud therapy, paraffin, ozokerite, biostimulants, aloe, and acupuncture are recommended. Be sure to sanitize the oral cavity.

For trigeminal neuralgia caused by gross mechanical factors (narrowing of the infraorbital canal, cyst, tumor of the paranasal sinus, etc.), surgical treatment is indicated.

Dental plexalgia. The upper dental plexus is affected more often, the lower - less often (ratio 2:1), which is apparently due to the absence of the latter in 50% of people. Other lesions are also possible.

Most often, odontogenic factors with predominant damage to the terminal branches of the plexus lead to the development of plexalgia.

This is possible when it is difficult to remove premolars, molars and wisdom teeth, conduction anesthesia, surgical interventions on the jaws, removing filling material beyond the tops of the root canals, removing a large number of teeth within a short period of time in preparation for oral prosthetics, as well as in case of infectious lesions due to osteomyelitis of the sockets, etc. Injuries, hypothermia, intoxication can be provoking factors.

Features of clinical manifestations: characterized by the presence of pain, usually of a permanent nature. The pain is localized in the teeth and gums (sometimes it radiates to the other side of the face). Even removing the affected teeth does not relieve the pain, and in some patients it occurs in neighboring teeth.

In some patients, the pain decreases during meals, but under the influence of unfavorable meteorological factors or emotions it intensifies.

When the upper dental plexus is damaged, pain can radiate along the second branch of the trigeminal nerve and be accompanied by severe autonomic disorders.

Emergency care: prescribe non-narcotic analgesics in combination with tranquilizers and neuroleptics, anesthetic or lidocaine ointment on the gums, B vitamins, atropine alkaloids.

Specialized assistance. It is advisable to carry out a dental examination of the patient in a multidisciplinary dental clinic using radiography, electro-odontodiagnostics, etc.

If pathology of the pulp, marginal or apical periodontium, inflammatory diseases of the maxillofacial area, incorrectly manufactured dentures, as well as neoplasms are detected, appropriate treatment is carried out.

Source: //www.eurolab.ua/encyclopedia/urgent.medica.aid/2390/?page=2

But apparently in vain!

Phenazepam is quickly addictive. In order not to harm the patient, the dose is first gradually increased and then decreased. The course of treatment should not exceed two weeks, otherwise the risk of addiction increases.

The drug can cause a number of side effects; overdose and numerous side effects are possible, which must be taken into account when prescribing it to a pregnant woman.

The risk of allergies increases, manifested in the form of redness on the skin, severe itching and profuse rash. Phenazepam negatively affects the digestive system, resulting in vomiting, nausea, increased metabolism, yellowness of the skin, and abnormal bowel movements.

At the same time, the number of platelets, erythrocytes and leukocytes in the blood decreases. Cases of urinary incontinence or, conversely, delay in urine output have been recorded. The medicine can lead to hallucinations, severe drowsiness, visual disturbances and sudden changes in mood. A woman can suddenly move from depression to a euphoric state.

Expert opinion about this drug:

The place of phenazepam in the modern use of benzodiazepine tranquilizers

With the advent of benzodiazepine tranquilizers in the 60s, the psychopharmacological revolution was almost completed. To the somewhat earlier antipsychotics and antidepressants, a group of tranquilizers was added, which allowed mental health specialists to create a wide arsenal of drugs for the treatment of mental disorders. In our country, the most well-known and studied benzodiazepine tranquilizer is the domestic drug Phenazepam. The study of the properties of Phenazepam began in a number of leading clinics in the country, including the Moscow Research Institute of Psychiatry, since 1976. Already the first studies [1,2,3] conducted in our clinic involving a significant number of patients (143 patients) convincingly showed that the drug has a rapid (3-5 days) and pronounced ability to reduce anxiety, fear, various sleep disorders, vegetative disorders, senesto-hypochondriacal and obsessive syndromes. Thus, the discovery of benzodiazepine tranquilizers made it possible to significantly expand the capabilities of a psychiatrist, especially in the field of minor psychiatry (neuroses, obsessive-compulsive disorder, post-stress disorders, etc.).

However, after decades of widespread and successful use of benzodiazepines in world psychiatry, problems associated with the use of this group of drugs began to arise. Thus, the uncontrolled, often unjustified use of this group of drugs has led to their abuse and the formation of addiction.

The tragedy of the fate of benzodiazepine tranquilizers lies in the fact that in addition to their powerful and rapid pharmacotherapeutic action, these drugs also have some addictive potential. The ability of benzodiazepine derivatives to cause drug dependence is widely described in the literature [4,5,6,7,8]. However, a balanced assessment of this effect has yet to be made.

Currently, a lot of work has been done to determine the duration of benzodiazepine therapy courses, since the main problem leading to the formation of addiction is unreasonably long-term use of this group of tranquilizers. Thus, the well-known Balter MB study [9] showed that in the USA by 1979, more than 15% of patients taking benzodiazepines took them for more than 1 year, and by 1990 this number increased to a quarter of all those taking anxiolytics. A pharmacoepidemiological study of outpatients revealed that among patients taking benzodiazepine derivatives, only 5.6% took them for less than six months, while the rest took them for longer periods [10]. The data presented convincingly show that the problem of abuse of drugs in this group is associated primarily with unreasonably long courses of treatment.

Since the 90s, in connection with the described problems, most international and domestic recommendations suggest sharply limiting the duration of treatment with benzodiazepine tranquilizers to 1 month or even 1–2 weeks to relieve acute symptoms [7, 11, 12]. A number of measures were taken to limit the frequency of prescriptions, which, however, led to controversial results. Thus, a program conducted in New York State from 1988 to 1990, limiting prescriptions for tranquilizers, led to a decrease in their use by 57%, however, in parallel, the use of other psychoactive substances, primarily barbiturates and alcohol, increased [13]. At the same time, despite the emergence of new highly effective psychotropic drugs, primarily the latest generation of antidepressants (selective serotonin reuptake inhibitors - SSRIs, selective serotonin and norepinephrine reuptake inhibitors - SNRIs) and pregabalin, the range of use of benzodiazepine tranquilizers remains wide and covers almost all nosologies . In the field of minor psychiatry, benzodiazepines remain indispensable. In recent years, in the United States and the European Union, use (prescriptions for benzodiazepines) has remained fairly stable (Fig. 1), while in Russia it has been steadily declining (Fig. 2).

According to A.B. Smulevich et al. (1976) [14], benzodiazepine tranquilizers do not fundamentally differ in the spectrum of psychotropic activity, and the features of their therapeutic action depend on the power of the anxiolytic effect. Phenazepam, according to Yu.I. Vikhlyaeva, T.A. Voronina [10], in this regard, is one of the most highly potent (powerful) tranquilizers. In light of the problems associated with the abuse of benzodiazepine tranquilizers, current guidelines recommend the use of drugs of this group with a long half-life, which include Phenazepam [15]. In addition, an important factor for the possibility of flexible use of the drug is the existence of its injectable form.

The target of Phenazepam's action is GABAergic receptors. Due to the fact that GABAergic synapses are distributed in almost all parts of the brain (cortex, cerebellum, limbic system, basal ganglia, etc.), the drug affects most brain functions.

Like all 1,4-benzodiazepine derivatives, Phenazepam has the following effects: anxiolytic, anti-obsessive, sedative, hypnotic, vegetotropic, anticonvulsant, muscle relaxant. When taken orally, the drug is well absorbed from the gastrointestinal tract, the time to reach the maximum concentration of Phenazepam in the blood is from 1 to 2 hours, the half-life from the body is from 6 to 10 hours, excretion of the drug is mainly carried out through the kidneys.

The main clinical target of Phenazepam is anxiety syndrome of any origin (neurosis, depression, generalized anxiety disorder, post-traumatic stress disorder, panic disorder, social phobia, obsessive-compulsive disorder, psychosis). In terms of anxiolytic action, Phenazepam is one of the most powerful tranquilizers, comparable in activity to lorazepam, favorably differing from it in the duration of the effect, more than 2 times greater than diazepam, 5 times greater than clonazepam and nitrazepam [11]. In 1988, a review was made of 15 clinical studies that included more than one and a half thousand patients [16]. In most cases (60%), Phenazepam was used as monotherapy, in 40% it was combined with drugs from other groups (neuroleptics, antidepressants, mood stabilizers). Daily doses averaged 3–5 mg/day. As a result of the treatment, significant improvement was recorded in 63.3%, in 28.8% the effect was insignificant and only in 7.9% there was no effect. Phenazepam turned out to be the most effective in the treatment of mental disorders of the neurotic level, in the structure of which anxiety predominated. Already in the first days after the administration of Phenazepam, a significant decrease in anxiety tension, irritability, sleep disturbances, and somatovegetative disorders was observed. It was also noted that the effect achieved after one month of therapy was persistent. In addition, it was found that the use of the drug for affective disorders turned out to be effective in the case of predominance of depressive anxiety syndrome in the structure and, conversely, the least effective - when manifestations of vital depression and adynamic disorders predominated in the clinical picture. Based on the generalized data, it was found that the use of the drug as monotherapy for psychotic disorders was ineffective. Thus, the effectiveness of the drug decreased if the level of disorder shifted from neurotic to psychotic level.

A study of the vegetotropic effect of Phenazepam in neurotic patients at a daily dose of 3 mg in comparison with diazepam at a dose of 40 mg/day showed that the effect of Phenazepam appeared on days 4–5, coinciding with the anxiolytic effect. A pronounced vegetotropic effect occurred on the 10–12th day. The use of Phenazepam turned out to be more effective in the sympathoadrenal structure of the autonomic crisis than in the vagoinsular one. In terms of its therapeutic effect on autonomic symptoms, Phenazepam was more effective than diazepam [17].

A study of the effect of Phenazepam in agripnic disorders showed a clear positive effect on all types of sleep disorders (disturbances in falling asleep, night awakenings, early insomnia), superior in severity and speed of onset to all other tranquilizers, including diazepam. The effect of the drug, as a rule, was not accompanied by morning drowsiness and lethargy [18]. Phenazepam is also effective for sleep disorders of alcohol origin [19]. It must be emphasized that the prescription of Phenazepam as a hypnotic drug should take into account the periods currently recommended by WHO and domestic guidelines, that is, no more than 1 month [7, 11, 12].

A review summarizing the use of benzodiazepine tranquilizers in epilepsy notes that Phenazepam has been successfully used in combination therapy with anticonvulsants to treat various types of seizures [19, 20]. The introduction of Phenazepam into the regimen for the treatment of resistant polymorphic seizures led to a complete cessation or halving of their frequency in 60% of patients [21, 22].

Benzodiazepine tranquilizers play an important role in the treatment of somatic and psychosomatic diseases. Thus, in the review work of V.A. Raisky [21] noted the high effectiveness of benzodiazepines in anxiety, anxiety-phobic and accompanying vegetative disorders in cardiovascular, gastrointestinal, pulmonary and other diseases. At the same time, depending on the task, the drug had both the main anxiolytic and hypno-sedative, anticonvulsant and muscle relaxant effects. It was noted that Phenazepam in doses of 1.5–2 mg/day was superior to diazepam and nitrazepam in all types of action and showed equal results with lorazepam. Its moderate analgesic effect was also noted [23].

Phenazepam is widely used in cardiology. The main indication for treatment with Phenazepam is neurohumoral disorders of the cardiovascular system in the form of vegetative paroxysms of the sympathetic-adrenal type with cardialgia, hyperhidrosis, tachycardia, accompanied by fear of death and psychomotor agitation. The use of Phenazepam at a dose of 1–3 mg/day relieves vegetative paroxysms, sleep disturbances, and cardialgia [24]. There is evidence that Phenazepam at a dose of 1.5 mg/day has an antiarrhythmic effect on various heart rhythm disorders - atrial, ventricular, supraventricular extrasystole, paroxysms of atrial fibrillation. Phenazepam is most effective (69%) in patients with an association of heart rhythm disturbances with neurotic disorders [14].

Phenazepam is successfully used in complex therapy for coronary heart disease (CHD). Thus, already in the first days of taking the drug, night sleep is normalized, anxiety and fear for one’s life and health, irritability, and fixation on various manifestations of the disease are reduced. Phenazepam has a significant positive effect on autonomic-vascular dysfunctions - headache, sweating, respiratory arrhythmia. It was found that Phenazepam is more effective for neurosis-like disorders in patients with coronary artery disease (70%) compared to diazepam (62%) and chlordiazepoxide (49%) [25].

Benzodiazepines are widely used in anesthesiology and resuscitation. They are used for preoperative sedation, as an introductory drug for general anesthesia and potentiation of its effect.

Phenazepam is used for sedation of seriously ill patients on mechanical ventilation. The drug has the ability to block the mechanisms of psychogenic provocation of bronchial asthma attacks, which is observed in 19–51% of patients [26].

Phenazepam is used in gynecological practice in the treatment of premenstrual tension syndrome. It has been shown to be more effective than traditionally used hormonal therapy [27].

The presence of a muscle relaxant effect in Phenazepam allows its use in neurological disorders: extrapyramidal disorders, increased muscle tone (tardive dyskinesia, essential tremor, restless legs syndrome) [28]. There is successful experience in using the drug for headaches (tension headache, migraine, post-traumatic encephalopathy) [29]. The presence of sedative and vegetative-stabilizing effects in benzodiazepines, the ability to reduce spastic phenomena, and reduce the content of pepsins and hydrochloric acid in gastric juice justifies their use in gastroenterological practice in the treatment of gastric ulcers, dyskinesia of the gastrointestinal tract, ulcerative colitis, etc. [9]. At a daily dose of 2–3 mg, Phenazepam was effective for cardio- and angioneurosis, hyperventilation syndrome, “irritable stomach”, “irritable colon”, “irritable bladder” [30].

Thus, the data presented indicate the widespread use of Phenazepam in general somatic practice. The breadth and diversity of the clinical profile of Phenazepam makes it possible to use it in many areas of medicine.

At the same time, it is necessary to take into account the most important issues of tolerability, adverse events, as well as the dosage regimen and criteria for the duration of benzodiazepine therapy courses. 1,4 benzodiazepine derivatives are one of the safest groups of drugs in medicine, due to the “wide corridor” between therapeutic and toxic doses. There are no data on deaths as a consequence of treatment with Phenazepam and other tranquilizers in therapeutic doses [12], and deaths from overdose with benzodiazepines are extremely rare [31]. The drugs do not have a significant effect on the cardiovascular, hepatic, endocrine and urinary systems [32]. However, when prescribing Phenazepam, it is worth considering the possibility of its interaction with certain drugs used in both psychiatric and somatic practice. It is necessary to mention the ability of benzodiazepine tranquilizers in combination with barbiturates and opiates to depress the respiratory center. It is worth considering this possible complication when prescribing Phenazepam in patients with chronic obstructive pulmonary diseases [3, 18].

A much more serious aspect of inappropriate use of benzodiazepine anxiolytics is withdrawal syndrome. Most often, this phenomenon occurs when the drug is abruptly discontinued or discontinued after an unreasonably long (more than 1 month) course of therapy. Typical withdrawal symptoms are anxiety, irritability, sleep disturbances, headaches, muscle twitching, tremors, increased sweating, and dizziness [33]. In the vast majority of cases, to relieve withdrawal symptoms, it is enough to use the discontinued drug. Thus, in a survey of general practitioners and psychiatrists in Moscow, of the cases assessed as withdrawal syndrome, 83% had a mild form of the disorder that did not require drug treatment. There are polar opinions on this issue in the literature. The number of patients with withdrawal syndrome ranges from 0.1 to 100% [34]. It is often extremely difficult to distinguish the manifestations of this phenomenon from the manifestations of the underlying disease, which occurs predominantly with alarming symptoms [35]. To avoid the development of withdrawal syndrome and the formation of dependence when using benzodiazepine tranquilizers, in addition to limiting the course duration, you can use several simple recommendations given in Table 1.

Thus, Phenazepam is effective for various conditions and has a scope of application in almost any field of medicine, being a highly effective, fast-acting and safe remedy for solving a huge number of tactical problems that clinicians often encounter in their practice. At the same time, it is not recommended to prescribe Phenazepam (like all benzodiazepine derivatives) as long-term therapy. The course of treatment with the drug should not exceed 1 month [11, 12]. It is obvious that the combination of the wide therapeutic profile of the drug, the power and safety of its action still determine the high demand for Phenazepam in the treatment of patients with anxiety (neurotic) and psychosomatic disorders.

LITERATURE

1. Avedisova A.S. On the issue of addiction to benzodiazepines // Psychiatry and psychopharmacotherapy. 1999; 1:12–15. 2. Avedisova A.S., Yastrebov D.V., Kostacheva E.A. and others. Pharmacoepidemiological analysis of outpatient prescription of benzodiazepine tranquilizers in psychiatric institutions // Russian Psychiatric Journal. 2005; 4:10–12. 3. Avrutsky G.Ya., Vovin R.Ya., Lichko A.E., Smulevich A.B. Biological therapy of mental illnesses. L.: Medicine, 1975; 311. 4. Avrutsky G.Ya., Aleksandrovsky Yu.A., Berezova N.Yu. and others. Use of the new tranquilizer Phenazepam in psychiatric practice // Journal of Neuropathology and Psychiatry named after. Korsakov. 1979; 3: 344–350. 5. Avrutsky G.Ya., Neduva A.A. Treatment of mental patients. Guide for doctors. M.: 1988; 528. 6. Aleksandrovsky Yu.A. Clinical pharmacology of tranquilizers. M.: Medicine, 1973. 7. Aleksandrovsky Yu.A., Benkovich B.I. and others. The place of psychopharmacotherapy in the treatment of autonomic dysfunctions in patients with borderline forms of neuropsychiatric disorders. Paroxysmal autonomic disorders. M.: 1979. 8. Andronati S.A., Avrutsky G.Ya., Bogatsky A.V. and others. Phenazepam. Kyiv. 1982; 288. 9. Balter MB, Uhlenhuth EH The beneficial and adverse effects of hypnotics // J Clin Psychiatry, vol.52 (Suppl.), 1991, 16-23 10. Vikhlyaev Yu.I., Voronina T.A. Pharmacology of Phenazepam // Express information: new drugs. M.: VNIIMI, 1978; 3: 265–279. 11. Voronina T.A. Position of Phenazepam among benzodiazepine drugs. New psychotropic drugs. Proceedings of the symposium. Lvov, 1978; 100. 12. Holmgren P., Jones AWJ Forensic Sci. 2003; 48:6:1416–1421. 13. Drobizhev M.Yu. Psychopharmacotherapy in the general somatic network (somatotropic effects, compatibility with somatotropic drugs) //Psychiatry and psychopharmacotherapy. 2000; 2: 2. 14. Smulevich A.B., Mazaeva N.A., Golovanova L.A. and others. Differentiated pharmacotherapy of neurotic conditions (comparative effectiveness of benzodiazepine derivatives) // Journal. neuropathology and psychiatry named after. Korsakov. 1976; 2: 255–262. 15. Kaplan G.I., Sadok B.D. Clinical psychiatry. 1994; 2: 412. 16. Kostovski V. Benzodiazepines: mechanisms of action and application. 1988. pp. 28–37 17. Mezhevitinova A.E. Premenstrual syndrome (to help the practitioner) // Gynecology. 2002; 4: 23. 18. Mosolov S.N. Basics of psychopharmacotherapy. M.: 1996; 288. 19. Mosolov S.N. Psychopharmacological and antiepileptic drugs approved for use in Russia, Ed. 2nd, revised, M.: 2004; 301. 20. Patsernyak S.A. Stress. Vegetoses. Psychosomatics. St. Petersburg ABC. 2002; 384. 21. Raisky V.A. Psychotropic drugs in the clinic of internal diseases. M.: Medicine. 1988; 256. 22. Rudenko G.M., Shatrova N.G., Lepakhin V.K. Features of psychotropic activity and effectiveness in the treatment of various conditions of the original domestic tranquilizer Phenazepam. Express information: New drugs. M.: VNIIMI. 1978; 3:7–29. 23. Rudenko G.M., Shatrova N.G., Lepakhin V.K. Psychotropic activity and effectiveness of Phenazepam in the treatment of various conditions. Phenazepam. Kyiv. 1982; 228–245. 24. Seredenin S.B., Voronina T.A., Neznamov G.G., et al. Phenazepam: 25 years in medical practice. The science. 2007; 222. 25. Smulevich A.B., Drobizhev M.Yu., Ivanov S.V. Clinical effects of benzodiazepine tranquilizers in psychiatry and general medicine. M.: 2005; 56. 26. Smulevich A.B., Drobizhev M.Yu., Ivanov S.V. Clinical effects of benzodiazepine tranquilizers in psychiatry and general medicine. M.: Media Sphere. 2005; 88. 27. Smulevich A.B., Drobizhev M.Yu., Ivanov S.V. Clinical effects of benzodiazepine tranquilizers in psychiatry and general medicine. M.: Media Sphere. 2005; 68. 28. Smulevich A.B., Drobizhev M.Yu., Ivanov S.V. Clinical effects of benzodiazepine tranquilizers in psychiatry and general medicine. M.: 2005; 51. 29. Ashton H. Benzodiazepine withdrawal: an unfinished story // Brit Med J 1984; 288:1135–1140. 30. British national formulary No. 31, 1996. 31. Karobath M. Molecular basis of benzodiazepine action // Trends Neurosci. 1979; 2: 166. 32. Reidenberger MM Effect of requirement for triplicate prescription for benzodiazepines in New York state // Clin Pharmac and Terap. 1991; 50: 129–131. 33. Roy-Byrne PP, Hommer D. Benzodiazepine withdrawal: overview and implications for the treatment of anxiety // Am J Med. 1988; 84:1041–1052. 34. WHO. Program on substance abuse. Rational use of benzodiazepines. 1996. 35. Laughren TP, Baltey Y., Greenblat DJ Chronic diazepam treatment in psychiatric outpatients // Aсta Psychiat Scand. 1982; 65:171–179

Emergency or caesarean section to be delivered

On the recommendation of the anesthesiologist, depending on the health and emotional state of the woman, Phenazepam is prescribed before the CS. As prescribed, it should be administered the night or immediately before surgery.

Pre-medication is often used as a relaxation before general anesthesia. Thanks to taking the drug, a woman’s anxiety and gland secretion are reduced.

Also, after the medicine, the effect of drugs used for anesthesia is enhanced. In this case, the combination of drugs may be different. It includes analgesics, sedatives and antihistamines.

Pharmacological action of the drug

The drug "Phenazepam" is classified as a benzodiazepine tranquilizer. The medication has sedative, anti-anxiety, hypnotic, muscle relaxant and anticonvulsant properties. Its use allows you to eliminate sleep problems caused by a long period of falling asleep and frequent awakenings due to nervous tension.

The medicine relieves obsessive fears, emotional outbursts, mood swings, panic attacks and inexplicable anxiety.

Sometimes it is used in the complex treatment of phobias, mental disorders, and withdrawal syndrome due to alcohol dependence. The composition is able to prevent the spread of convulsive activity, enhance the effect of anesthesia, and facilitate the process of preparing for surgery.

The listed results are achieved by inhibiting the activity of the central nervous system and suppressing reflexes. The main component of the drug "Phenazepam" acts quite aggressively. Systematic use of medication or exceeding permissible dosages can cause drug dependence and withdrawal syndrome. For these reasons, pregnancy is one of the contraindications to the use of the product, but in practice this prohibition sometimes has to be circumvented. It happens that the potential risks of taking a tranquilizer during pregnancy turn out to be less dangerous than the consequences of refusing such a step.

The active substance of the drug can enhance the effect of anesthesia and facilitate the process of preparing for surgery.

Survey of women in labor

We checked a survey of women in labor who took Phenazepam during pregnancy, and here are their reviews.

I was prescribed one Phenazepam tablet the night before my upcoming planned Caesarean section. The fact is that I was very worried and worried about the outcome of the upcoming operation.

I asked my husband to read reviews about the drug on the Internet. They were quite contradictory, however, the purpose of the appointment (keeping calm and healthy sleep) made me agree to the appointment. Sleep came in about 20 minutes.

I slept well all night and woke up fresh and rested in the morning. Operation was successfully completed. A daughter was born (9 out of 10 on the Apgar scale). After anesthesia, I recovered quickly and easily. In my case, the drug deserves only positive reviews.

Victoria, 28 years old

Considering my age and great desire to have a second child, I had to be in confinement 4 times during the entire pregnancy. The fact is that 1.5 years before that I lost my baby at an impressive age. For me, every move, pill, and prescription mattered.

Now I understand that I took everything to heart. I should add that I have problems with blood pressure and excess weight, so my second pregnancy was a challenge for me.

Lying on guard in the same ward with a woman much younger than me in age, I had to see how she lost her baby. At that moment I literally experienced shock. She was much younger and healthier than me. I started getting hysterical. As doctors later explained, the risk of fetal loss has increased.

In order to calm me down, they injected me with Phenazepam. Later I found out that during pregnancy it is used extremely rarely. The drug helped, I quickly calmed down and slept. Subsequently, I gave birth to a healthy girl, however, and today I believe that you should not drink anything stronger than valerian during pregnancy.

Valentina, 40 years old

Phenazepam for intercostal neuralgia

Have you been trying to heal your JOINTS for many years?

Head of the Institute for Joint Treatment: “You will be amazed at how easy it is to heal your joints by taking every day...

Recommendations

If severe pain occurs in the intercostal area, you should immediately contact an experienced neurologist.

Why? Only an experienced doctor can make a differential diagnosis with other diseases. The thing is that under the guise of intercostal neuralgia, completely different diseases can be hidden.

For example, renal colic or cardiac pathologies can occur with similar symptoms.

OUR READERS RECOMMEND!

Our readers successfully use SustaLife to treat joints. Seeing how popular this product is, we decided to bring it to your attention. Read more here...

If intercostal neuralgia is detected, there is no need to panic, because a professional doctor can prescribe the correct treatment, which will facilitate a return to work and a healthy normal life.

Why is self-medication dangerous for health? The thing is that almost all medications have their contraindications and side effects.

In addition, not all drugs will be effective for a given disease in every individual case.

That is why only a qualified doctor can determine which medications, in what dosage and form are suitable for a particular patient, as well as prescribe the correct duration of medication treatment.

There are simple recommendations that promote effective treatment of pathology. It is worth remembering that in the first days of the disease, and it is during this period that the pain is incredibly strong, you need to adhere to bed rest and take sick leave.

Painkillers are effective in treating the disease in its various forms.

You can read about how to treat intercostal neuralgia with folk remedies in this article.

Naturally, first of all, patients need to be prescribed medications that can eliminate pain. Treatment must be comprehensive. Next, let's talk about the main remedies used for intercostal neuralgia.

Medicines

The pathology must be treated with the following drugs:

analgesics (painkillers). The main mechanism of action of this group is the effective elimination of pain - the main symptom of this disease. Experts recommend taking tablets no more than 4 times a day, otherwise you cannot avoid the development of side effects, including the following: impaired renal function, hypotension, allergic reactions. An overdose can cause the following undesirable symptoms: nausea, vomiting, drowsiness, etc. Popular analgesic drugs are: analgin, sedalgin, spasmalgon;
anti-inflammatory drugs. The peculiarity of this group of drugs is that they not only relieve the inflammatory process, but also effectively combat pain in the intercostal space. The most well-known representatives are the following drugs: diclofenac, ibuprofen. Treatment with non-steroidal anti-inflammatory drugs must be carried out competently, and medications should be taken only after the recommendation of a specialist, as they can cause such unpleasant consequences: headache, nausea, kidney inflammation, etc. The drugs are prescribed by injections or they are used as an ointment. For example, Nimid ointment is popular due to its effectiveness in combating pain and inflammation. Another effective drug is Movalis. The medicine is available in different forms: solution, tablets, suppositories. It copes well with pain;
muscle relaxants. These medications are capable of relieving muscle spasms, and spasms are the main cause of the development of the disease;
B vitamins. A lack of vitamins of this group can also cause the development of pathology;
local anesthetics. The use of blockades based on novocaine or lidocaine is effective even with intense pain;
sedatives. Drugs like Relanium or Elanium help the brain not react so violently to severe pain;
sanitization of the oral cavity and nose. This includes the treatment of chronic tonsillitis, sinusitis, caries, etc.;
physiotherapeutic treatment (electrophoresis, ultrasound, reflexology).

It is important to start treatment in a timely manner, otherwise serious complications may appear, including chronic pain syndrome and limited range of motion.

Additional treatments

If conservative treatment does not bring relief, surgical methods are used, among which are the following:

neurolysis This procedure involves promptly releasing a nerve compressed by surrounding tissues;
neurotomy. Neurotomy is the name given to cutting a nerve, which has a good effect on pain;
tractotomy. The purpose of this procedure is to combat the conduction of pathological impulses by crossing the conduction pathways. Tractotomy is used exclusively for diseases that are refractory to other treatment methods.

Ointments for the treatment of intercostal neuralgia

Consider the most popular ointments.

Voltaren

The ointment can be applied up to 4 times a day. Due to the presence of diclofenac in the composition, an analgesic and anti-inflammatory effect is provided.

Available in the form of creams or gels. The drug has a remarkable analgesic effect.

Apizartron

The appearance of redness and a feeling of warmth after applying the ointment should not be alarming; this is a normal reaction. This German ointment is based on bee venom. Thanks to this, nerve endings are irritated, blood flow increases, pain is eliminated, and biologically active substances, which are mediators of the inflammatory process, are eliminated faster.

The ointment has a combined composition: viper venom, turpentine ointment, camphor. This unique composition provides a warming effect and reduces pain.

Menovazin

Menthol, which is part of the drug, helps to irritate nerve endings, dilate subcutaneous blood vessels, enhance the analgesic effect, and create a feeling of coolness.

Turpentine ointment

The main component of the ointment, turpentine, has an antiseptic effect. In addition, it relieves intense pain.

Finalgon

The drug helps dilate blood vessels, which has a warming effect. The ointment effectively fights inflammation and relieves pain.

Considering all of the above, we can conclude that intercostal neuralgia is a fairly serious disease that should not be “joked” with. If signs indicating the presence of pathology appear, contact a specialist immediately!

Source: //taginoschool.ru/sustavy/fenazepam-pri-mezhrebernoj-nevralgii/

Conclusions and facts

The sedative drug Phenazepam should be taken with caution in all patients. To do this, you must first obtain

doctor's prescription and under no circumstances begin treatment on your own.

During pregnancy, the drug is prescribed only if absolutely necessary and there is a threat to the life of the child or mother.

Before a planned CS, Phenazepam is used as a preparatory drug that helps a woman relax and not be in a state of anxiety before the upcoming operation.

The prescription is made depending on the psycho-emotional state of the woman and is authorized by the anesthesiologist.

This drug is prescribed by doctors as an anticonvulsant. It can relax the muscular system as much as possible and suppress reflexes. You can buy it at any pharmacy if you have a prescription from your doctor.

In fact, this medicine is prescribed to pregnant women extremely rarely. It is recommended to be used only in cases where there is a threat to the life of the expectant mother.

List of medications for intercostal neuralgia

Severe pain in the ribs prompts a person to go to the doctor to find out how to treat intercostal neuralgia and what medications to suppress the symptoms of the disease.
Intercostal neuralgia does not belong to the category of dangerous diseases. But it develops against the background of serious pathologies and develops into serious complications. Neuralgia is caused by intervertebral protrusions and hernias, tuberculosis, diabetes mellitus, multiple sclerosis, and tumors.

The symptoms of neuralgia are such that they can easily be confused with signs of renal colic, cholecystitis, and angina. Only a doctor can make a correct diagnosis and prescribe treatment based on diagnostic studies.

Methods of drug therapy

The use of medications is the main way to treat intercostal neuralgia. To treat the disease and the cause that caused it, the following is prescribed:

pills;
injections for intramuscular and intravenous administration;
ointments, gels or creams.

The form of medication for intercostal neuralgia is chosen by the doctor. Medicines are prescribed taking into account the severity of the disease, the patient’s well-being and contraindications.

Tablets are considered an ineffective treatment for intercostal neuralgia. In addition, they irritate the mucous membranes of the gastrointestinal tract and cause adverse reactions. Erosive gastritis and stomach ulcers are possible harm from uncontrolled use of tablets.

Pain relievers

The primary goal of drug therapy is to relieve pain – the main symptom of the disease. Pills and injections help get rid of prolonged debilitating pain. For pain relief the following is usually prescribed:

Spasmalgon;
Spazgan;
Analgin;
Baralgin;
I took it.

To relieve unbearable pain that occurs with swelling of nerve fibers and root compression syndrome, the following is used:

Ketoprofen;
Ibuprofen;
Nise;
Celebrex;
Diclofenac.

Analgesics are used to relieve pain and prevent new attacks:

Sedalgin;
Panadol;
Tylenone;
Pentalgin.

These drugs are available in tablets, injection solutions, ointments and gels. They are taken in tablets. To quickly relieve pain, injections are given and IVs are placed.

The course of treatment with anesthetics is short, it does not exceed 4-5 days. They disrupt the normal functioning of the gastrointestinal tract.

Local painkillers

Local anesthetics relieve swelling and pain of a neuralgic nature. They are prescribed for temporary relief of acute pain. Reduce pain and eliminate muscle tension with ointments, gels, and injection solutions.

The drugs are applied or injected directly into the lesion. They are used to make blockades. Pain is suppressed with injections of Lidocaine, Novocaine or Xylocaine. The use of local anesthetics is limited in time. They are highly toxic agents that can cause great harm to the body. Unbearable pain is relieved with one-time blockades.

Anti-inflammatory medications

Inflammatory processes occurring in nerve fibers lead to swelling and pain. The swollen tissue puts pressure on the nerves. Pinched nerve roots are accompanied by pain. Relieving inflammation, eliminating pain.

Inflammatory processes are suppressed with non-steroidal anti-inflammatory drugs:

Ortofen;
Diclofenac;
Nimesulide;
Ketoprofen;
Voltaren;
Movalis.

The products effectively relieve inflammation. If you use them correctly, according to the regimen given by the doctor, you can get a long-term stable remission. To eliminate inflammation, take a tablet 2 times a day, give an injection, or use rectal suppositories.

The body's susceptibility to drugs is almost the same. But they are best absorbed through the mucous membranes. Long-term treatment with anti-inflammatory drugs causes exacerbation of certain ailments (for example, gastritis or ulcers). They should not be used without a doctor's prescription.

Muscle relaxants

Drug treatment for intercostal neuralgia includes muscle relaxants - drugs with a calming effect. They eliminate pain, relax muscles, and improve the patient’s well-being. Which of them can be used for treatment:

Sirdalud;
Tizanidine;
Tolperisone.

The taken muscle relaxant eliminates congestion in muscle tissue and swelling. For treatment, use a drug prescribed by a doctor.

Vitamin therapy

To suppress inflammatory processes, replenish vitamins and minerals, and strengthen the immune system, it is necessary to take special complexes. Medicines with B vitamins are involved in blocking acute inflammatory processes that erupt in nerve tissues. Vitamin complexes relieve muscle spasms and neutralize the negative effects of medications used.

Sedatives

Painful sensations worsen the well-being of patients, plunge them into a state of prolonged stress, create a feeling of discomfort, and reduce the quality of life. Taking sedatives for intercostal neuralgia helps relieve nervous tension, relax skeletal muscles, and normalize the condition of the sick person.

For this purpose, drug therapy can include a remedy with an extract of a soothing medicinal plant. Suitable for treatment:

Chamomile;
Mint;
Motherwort.

Herbs with a sedative effect are used separately or preparations are made from them. It is worth drinking infusions and decoctions from them. Pharmaceutical preparations have an effective effect: syrups, tinctures.

They drink a sedative at night. It promotes good sleep, proper rest, and relieves nervous and muscle tension. Essential oils: lavender and peppermint have an excellent relaxing effect.

Medicines with bee and snake venom

Eliminate intercostal neuralgia with medications based on snake and bee venom. The effectiveness of ointments and gels with these poisons is quite high. They warm up the skin, accelerate blood circulation, remove metabolic products, and saturate tissues with bioactive substances. The drugs regenerate damaged nerve tissue.

The product with poison is used externally, it is rubbed into the lesions with soft massaging movements, bypassing the heart area. For treatment use:

Apisatron. Ointment with bee venom suppresses pain and inflammation, restores blood flow.
Viprosal. Ointment with viper venom eliminates pain and improves blood circulation. Camphor and fir, which the drug contains, have an analgesic effect.

These ointments are used as prescribed by a doctor. They are not always used for treatment of:

lactation;
pregnancy;
allergies;
heart diseases.

Antiviral agents

Problem: how to treat intercostal neuralgia of a viral nature is easily solved. Antiviral medications are used to suppress it. Effectively fight pathology:

Ointments and gels

Remedies for neuralgia in the form of ointments and gels quickly relieve pain. They instantly penetrate through the skin pores into the deep tissues, to the lesion, reduce the severity of the pain syndrome and eliminate swelling.

External agents stimulate blood circulation, distract from pain, and relieve nervous tension. Thanks to them, blood supply to the sore spot improves, nutrition of damaged tissues, and pain goes away.

To treat intercostal neuralgia use:

Fastum-gel. The product relieves pain, stimulates blood flow, and eliminates swelling.
Capsicam. The ointment, due to its effective warming effect, accelerates the supply of blood to tissues. It restores tissue trophism and helps replenish nutrients.
Finalgon. The ointment warms up. Thanks to it, blood vessels dilate. Blood flow increases. Oxygen and nutrients enter the tissues.
Indomethacin, Ortofen, Naklofen, Ibuprofen. Ointments fight inflammation, swelling and pain.
Menovazin. The ointment has a pronounced analgesic effect.
Chondroxyl. The chondroprotector restores mobility to the spine.

Preference is given to ointments. Their rate of penetration into tissue is higher than that of gels. In the early stages and for severe pain, ointments are used that can relieve muscle spasms and relax muscles.

You will also find it useful: What other ointments help with intercostal neuralgia

For patients suffering from severe pain, try not to prescribe ointments with a burning effect. By increasing stimulation at the site of the lesion, it is possible to provoke the development of an ischemic crisis or heart attack due to excessive outflow of blood from the coronary vessels.

Antispasmodics

With neuralgia, the muscle tissue surrounding the damaged nerve fibers spasms, their tone is excessively high. Without eliminating muscle spasms, you cannot get rid of pain. Increased tone is relieved with antispasmodics:

Besalol;
Halidor;
No-spy;
Papazol.

To eliminate spasms, they take pills and give injections.

Intercostal neuralgia requires complex therapeutic treatment. Thanks to it, pain is quickly relieved, the patient’s well-being is improved, and the inflammatory processes that cause the disease are blocked. Prescription of treatment by a doctor is a prerequisite. The prescribed medications will give the maximum therapeutic effect and will not allow complications to develop.

Source: //hondrozz.ru/lechenie/lekarstva/chem-lechit-mezhrebernuyu-nevralgiyu-kakimi-lekarstvami.html

When is the drug prescribed?

- diseases of a neurological nature associated with insomnia, nervous irritation and constant anxiety;

— the medicine shows itself well in eliminating the withdrawal syndrome that occurs after stopping alcohol;

— it is also recommended to use the product when a disease such as schizophrenia is detected;

- if a pregnant woman has epileptic and other seizures.

Do not take this medicine on your own under any circumstances! The consequences can be sad not only for you, but also for your baby. The regimen, dosage and duration of treatment can only be determined by your attending physician. The drug is usually administered intravenously or intramuscularly. Sometimes it is prescribed in tablet form.

Phenazepam for neuralgia

Have you been trying to heal your JOINTS for many years?

Head of the Institute for Joint Treatment: “You will be amazed at how easy it is to heal your joints by taking every day...

Reasons for the development of intercostal neuralgia in pregnant women

In medicine, the term “intercostal neuralgia” refers to a pain syndrome that suddenly appears in the area where a large number of nerve endings are located due to their compression, prolonged irritation and the development of inflammation.

Dynamically developing intercostal neuralgia in a pregnant woman is most often observed in the 2nd or 3rd trimesters. This fact is due to the presence of certain processes that occur in the body of the expectant mother carrying a child.

Due to serious hormonal changes in the female body, the volume of fluid gradually increases, and this tends to provoke in the future the appearance of very severe edema, which is the main cause of compression of the nerves.

OUR READERS RECOMMEND!

Our readers successfully use SustaLife to treat joints. Seeing how popular this product is, we decided to bring it to your attention. Read more here...

Due to the gradual enlargement of the uterus, a pregnant woman’s diaphragm rises, which reduces the volume of the chest during inhalation/exhalation. At the same time, the intercostal spaces are slightly reduced, which leads to very painful compression of the nerves that are located directly between the ribs.

In some cases, such a serious disease in pregnant women develops against the background of a number of joint ailments due to severe infringement of the nerve endings in the spine.

The development of the disease is also possible with serious violations of posture and the development of spinal curvature.

Neuralgia can be triggered by a lack of vitamins that belong to group B, since in this case a fairly significant metabolic disorder occurs in the body and in the nervous tissue.

In addition, the causes of neuralgia in pregnant women are infectious diseases such as herpes zoster and ARVI. The causative agents of these diseases become most active against the background of a sharp decrease in immunity.

Bacteria tend to produce large amounts of harmful toxins, which gradually spread throughout the body and cause serious damage to the nerves. Severe hypothermia can also cause the development of a neurological disease.

Most common symptoms

If we consider the most common symptoms of such an unpleasant disease, then we need to highlight the pain that occurs in the intercostal nerves. This pain syndrome has very different intensities.

It appears in the form of not too long attacks. Since a pregnant woman can feel pain in the chest area, it is very often considered cardiac.

In addition, the expectant mother may experience unpleasant sensations in the area of the spleen, liver, shoulder blades or stomach.

The most common sign of the development of intercostal neuralgia is the effect of chest movement on the intensity of the pain that occurs. In this case, unpleasant sensations appear not only when moving, but also in a state of complete rest. When moving your arms, turning your body sharply, sneezing and coughing, the pain intensifies.

Uncontrollable pain attacks are accompanied by sweating, frequent muscle twitching, numbness of the skin areas located in the area of the affected nerve, and convulsions.

When pressing on the intercostal spaces, the pain intensifies.

It is impossible to relieve the painful condition of neuralgia with nitroglycerin, but the condition of a pregnant woman will improve after taking properly selected sedatives.

A woman who is preparing to become a mother can be diagnosed with intercostal neuralgia by a physician based on previously performed laboratory tests and examination of the abdominal and chest organs, since their pathology is the most important cause of the development of the disease. In order to completely eliminate deviations in the functioning of certain organs of a pregnant woman, a woman may be prescribed an ultrasound examination.

Side effects

Please note that this product can cause allergic reactions, manifested in the form of itching, redness and rash on the skin.

Also, the active components of the drug negatively affect the circulatory system. The number of platelets, leukocytes and red blood cells in the blood may significantly decrease.

There have also been cases of urinary incontinence or, conversely, retention.

Some women experienced very frequent mood swings - from depressive to enchanting.

Emergency cases

This preliminary preparation will promote good relaxation before the introduction of general anesthesia. Thanks to this, a pregnant woman can calm down. The feeling of anxiety will disappear without a trace, and the functioning of the endocrine glands will normalize.

The use of this drug before anesthesia will enhance the effect of the latter.

During pregnancy, this drug is used, as you might understand, only in the most extreme cases. Its use in the early stages may increase the risk of birth defects. In the later stages of pregnancy, there is a possibility of depression of the nervous system of the unborn baby.

The dosage will be selected by the doctor purely individually. However, most often, experienced specialists replace this drug with safer analogues.

Indications and contraindications for treatment with Phenazepam

Instructions for use indicate various pathological conditions for which the drug is effective:

for neuroses, psychopathy, accompanied by sudden changes in mood, anxiety, irritation, fear, tension;
reactive psychoses, sleep disorders;
hypochondria, autonomic dysfunction syndrome;
epilepsy, panic attacks, dyskinesias, nervous tics;
to prevent phobias and similar conditions;
with increased muscle tone and rigidity;
lability of the autonomic nervous system;
alcohol withdrawal.

The drug is used in preliminary preparation before surgery and general anesthesia.

Phenazepam is included in the list of potent medications, has many contraindications for use and is changed for certain categories of patients. The drug is not prescribed to patients:

in coma or shock;
with myasthenia gravis, angle-closure glaucoma - in case of an acute attack or hereditary predisposition;
with COPD, acute respiratory failure;
minors, pregnant and lactating women;
with individual intolerance to the component composition.

Supervision by a specialist during therapy is necessary for patients with renal or hepatic dysfunction. Increased caution is required when treating people with drug addiction syndrome, psychological dependence on medications, and in old age.

Reviews from patients and doctors

Of course, doctors prescribe this remedy to their pregnant patients extremely rarely. Most often, this is done with the aim of calming and relieving anxiety before the birth itself. Patients who experienced the effect of this medicine were generally satisfied. The anxiety really disappeared, and quality healthy sleep began.

When using the product during a cesarean section, the operation was successful. After anesthesia, the women quickly recovered and felt great. However, adverse reactions such as allergies, nausea, vomiting and dizziness were also observed.

During pregnancy, the product should be used very carefully and only under the strict supervision of a doctor.

Cautions

Particular caution should be taken when taking the drug during severe depression, as the drug can be used to carry out suicidal intentions. The product should be used very carefully in weakened patients.

The frequency of side effects, as well as their intensity, depend on the general condition of the patient, as well as on his sensitivity to the components of the drug included in the composition. Usually, when the dosage is reduced or the medication is completely discontinued, all side effects completely disappear.

Please note that if used for too long, this drug can cause addiction. Therefore, you need to start taking it and stop taking it very smoothly and carefully. If you stop treatment very abruptly, withdrawal syndrome may occur, since the body has already become accustomed to the active components.

Adverse reactions during therapy with Phenazepam

Non-standard reactions of the body arise against the background of the above contraindications or as an individual reaction of the body. The problem is related to the influence of the components on the functionality of the nervous system.

The majority of those undergoing the procedure experience increased drowsiness, chronic fatigue, lethargy, and attacks of dizziness. Patients complain of impaired concentration, problems with orientation in space, symptoms of ataxia, confusion, and slow psychomotor reactions.

A list of rarer side effects from Phenazepam is presented:

cephalgia, euphoria;
depression, tremor;
problems with memory, coordination of movements;
asthenia, myasthenia, dysarthria.

Occasionally, therapeutic manipulations provoke attacks of aggression, phobias, and hallucinations. Patients develop suicidal tendencies, insomnia, and muscle spasticity.

When the digestive tract is damaged, the following occurs:

dryness of the oral mucosa;
involuntary secretion of saliva;
refusal to eat, constipation with diarrhea;
heartburn, nausea, yellowing of the skin;
increased activity of liver enzymes.

Therapy with Phenazepam can cause increased or decreased sexual desire and symptoms of dysmenorrhea. Some patients experience allergies with skin rashes and obsessive itching. A list of other adverse reactions is presented:

addiction and development of drug dependence;
drop in blood pressure level;
impaired vision clarity with doubling of objects;
weight loss, heart rhythm disturbances.

With a sharp reduction in dosage or stopping treatment, withdrawal syndrome occurs. Clinical signs of the pathology resemble the symptoms that led to the need for Phenazepam procedures.