Is it necessary to take an antispasmodic for inflammation of the pancreas?

What are antispasmodics

Antispasmodics are medications with a special mechanism of action aimed at relaxing muscle microfibers in the walls of blood vessels and any internal organs with a smooth muscle structure. Antispasmodics used in gastroenterology are intended to relieve spasm of the smooth muscles of the abdominal organs, including the pancreas, as well as the walls of blood vessels in areas of spasm.

The therapeutic properties of these pharmacological agents include:

• relaxation of the muscles of the digestive system, including the ducts of the pancreas and bile ducts;
• elimination of pain caused by convulsive contraction of muscle fibers of the digestive system;
• reduction in the excretory activity of the pancreas; decreased secretion of hydrochloric acid;
• dilatation of blood vessels, bronchi, stimulation of the heart, reduction of pressure.

Antispasmodics not only relieve pain, but also activate blood supply to organs. In addition, the use of these medications does not directly affect the mechanism of pain sensitivity and therefore does not complicate the diagnosis in any way.

What helps and why do you start?

This medication is considered a universal remedy. It is used for:

• stomach ulcer;
• intestinal colic;
• gastrointestinal diseases;
• spastic constipation.

The drug is also effective for relieving cramps during menstruation in women and cystitis.

The drug allows you to quickly get rid of toothache and headaches. This medicine is allowed to be taken by expectant mothers in the early and late stages, because it relieves the tone of the uterus, thereby preventing miscarriage and premature labor. The drug can be used for pain and spasms of various natures.

Drotaverine for pancreatitis

The medication has worked well for inflammation of the pancreas. It is prescribed to patients with exacerbation of the inflammatory process in the pancreas, as well as with chronic pancreatitis and severe pain.

The active ingredients begin to act half an hour after consuming the tablets.

Drotaverine is prescribed for chronic pancreatitis and in case of exacerbation of the inflammatory process in the pancreas.

How do antispasmodics act in illness?

The leading syndrome in acute pancreatitis is, of course, pain.
If this is the first time an attack has occurred, it can be very difficult to immediately determine the source of pain. For such cases, there is a diagnosis of “acute abdomen” and a standard of care for it - until the causes of this condition are clarified. In order not to miss a catastrophe in the abdominal cavity, such as a perforated stomach ulcer, acute appendicitis, or, worse, developing peritonitis, there are drugs from the group of antispasmodics that will help relieve pain and not blur the picture of the disease. One of the most common causes of pancreatitis is swelling or blockage of the excretory duct. The purpose of the drug is to eliminate this spasm, after which the normal outflow of pancreatic and bile juices is normalized. In case of chronic uncomplicated pancreatitis, Duspatalin, which is available in tablet form, can be used for these purposes. With long-term use of this medicine in patients with chronic pancreatitis, stable remission can be achieved.

In acute pancreatitis, preference is given to the injection of antispasmodic drugs. In an acute process, the pain syndrome is so intense that minutes count. Each additional second of acute pain causes severe suffering to the patient and can lead to painful shock. In these cases, injectable forms of antispasmodics are used, which quickly relieve spasms and partially eliminate pain.

During pregnancy and lactation

Medications from the group of antispasmodics are allowed to be taken during early pregnancy. The dose is prescribed only by the doctor after examining the woman. It is not recommended to take the medicine in the later stages, as the active substances lead to softening of the cervix. While breastfeeding, you cannot take pills or give injections. There is no data on exposure to milk. In case of strict indications, lactation is interrupted for the period of treatment.

Taking Drotaverine is allowed in the early stages of pregnancy. The dose of the medicine is prescribed by the doctor.

The source of pain impulses in pancreatitis, or “what hurts”

The mechanism of pain development in acute pancreatitis has many components. This is swelling of the gland and overstretching of its capsule, this is a spasm of the sphincter of Oddi, this is a reflex spasm of the bile ducts and gallbladder, this is spastic pain in the small intestine. This is an autonomic reaction in response to a powerful release of cortisol and adrenaline - the hormones of fear and stress - that accompany an attack. Almost everywhere there is a spasm of the smooth muscles of the abdominal organs, which means that by acting on it with the help of specific drugs (antispasmodics), you can significantly alleviate the patient’s condition.

Instructions for use

All antispasmodics must be used strictly in accordance with the doctor’s instructions, subject to an accurately established diagnosis.

Antispasmodics for children

Each manufacturer indicates the specifics of taking its form of the drug in children. For example, in some forms drotaverine is not used in children under 2 years of age, in others the recommended daily dose for children aged 1-6 years is 40-120 mg (in 2-3 doses), for children over 6 years of age - 80-200 mg (in 2-5 doses). Hyoscine butyl bromide is prohibited for children under 6 years of age. Pinaveria bromide is not recommended for people under 18 years of age. Natural antispasmodics (infusions and decoctions, as a rule) are prepared from individual plants or from collections containing flowers, roots, leaves, stems. They are prescribed to children for various diseases accompanied by spasms or convulsions.

Antispasmodics for newborns

Antispasmodics for newborns are very limited for use; there are only a few names that pediatricians allow to give to children. The M-anticholinergic drug priphinium bromide in certain forms relieves spasms and relieves pain. Infants up to 3 months. it is prescribed orally in the form of syrup, 1 ml every 6–8 hours; from 3 to six months - 1-2 ml every 6-8 hours, from 6 months. up to one year - 2 ml every 6-8 hours; from 1 to 2 years - 5 ml every 6-8 hours. Children are also prescribed herbal preparations containing natural antispasmodics - peppermint, fennel oil, anise, dill.

Antispasmodics for pregnant women

Antispasmodics should be prescribed to pregnant women with caution, only if the expected benefit from therapy outweighs the potential risk to the fetus. For many drugs there is no clinical data for pregnant women; for some, pregnancy is a contraindication (bencyclane, dicycloverine, hyoscine butyl bromide).

Antispasmodics during lactation

In general, it is not recommended to prescribe antispasmodics during lactation, or drotaverine and bendazole are prescribed with caution (in some forms, only if the potential benefit is greater than the harm to the child). Breastfeeding should be discontinued while taking oxybutynin.

Interaction with other drugs

If an antispasmodic is used simultaneously with sedatives and antihypertensive drugs, then an increase in the therapeutic effect of both drugs is observed. You cannot combine the medication with other types of antispasmodic drugs. This process increases the risk of side effects and overdose. Medicines based on phenobarbital enhance the effect of Drotaverine. Not compatible with alcohol. Does not affect concentration.

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How does an antispasmodic work for chronic pancreatitis?

As is known, the cause of the development of pancreatitis is most often a blockage of the main pancreatic duct due to spasm of the sphincter of Oddi - the opening through which pancreatic juice and bile enter the duodenum. Relieving spasm and further normalizing sphincter tone - this problem is successfully solved by duspatalin in chronic pancreatitis. This drug is used only in oral forms - tablets and capsules, and is therefore not suitable for emergency care. However, its long-term use (up to 24 weeks) for chronic pancreatitis allows achieving stable remission.

Duspatalin

Duspatalin for pancreatitis is used for the chronic course of such a disorder.

The drug has several positive features, in particular:

• minimal likelihood of serious side effects with long-term use;
• easy to take - you need to take one 200-gram capsule twice a day - morning and evening before eating;
• constantly maintains optimal tone of the large pancreatic duct;
• normalizes the functioning of the sphincter;
• prevention of stagnation of pancreatic juice;
• promoting the establishment of stable remission of the chronic course of the disease;
• improving the functioning of the pancreas.

Duspatalin should be taken with caution when driving a car, as well as during pregnancy.

Basic painkillers for acute pancreatitis

With pain in the pancreas, inflammatory mediators are released that have a destructive effect on other organs of the digestive system: the symptom increases and can last for several days if emergency assistance is not provided. Painkillers are prescribed as quickly as possible, since not only the patient’s physical health suffers, but also his psychological state.

If pain relief is necessary, in order to quickly alleviate the patient’s condition, any drug from the following groups is used:

• myotropic antispasmodic;
• non-steroidal anti-inflammatory drugs (NSAIDs);
• non-narcotic or narcotic analgesic;
• anesthetic.

It is possible to relieve pain before the ambulance arrives by taking an antispasmodic. This drug will partially relieve pain and will not blur the overall clinical picture of the disease.

A suitable painkiller for the pancreas is No-shpa (Drotaverine): an adult can give the injection themselves. There is no point in taking a pill in this state, since severe pain is accompanied by nausea and vomiting.

Narcotic analgesics and anesthetics are prescribed exclusively in hospital settings under the supervision of a physician. They are used in an unsuccessful attempt to relieve pain with antispasmodics and NSAIDs, which are non-narcotic painkillers.

Fentamil or Promedol are prescribed in case of severe complications (for example, necrosis) and increased pain. The presence of indications and hospital conditions allow for pain relief with narcotic painkillers.

Anesthesia involves the use of novocaine medications (Novocaine, Lidocaine). This is carried out by medical specialists; the condition for this is that the patient is in the surgical department or in the intensive care ward. Sometimes novocaine blockades of the solar plexus are carried out in gastroenterology conditions.

Acute inflammation with severe pain must be relieved by parenteral administration of drugs: with this method of administration, they act almost immediately. Painkillers for pancreatic pain are used for mild exacerbation or for chronic disease.

The effect of antispasmodics in acute pancreatitis

Acute pancreatitis is sometimes accompanied by a pain syndrome of such intensity that it can cause the development of painful shock and lead to the death of the patient. Therefore, you cannot hesitate here: only injection antispasmodics bring quick relief. These are well-proven no-spa, platyphylline and papaverine. If the patient does not vomit, no-shpa can also be used in tablets, but when administered intravenously, its effect begins already from the second minute. Which is important for the patient’s psychological state - after all, every minute filled with pain becomes an hour for him.

Papaverine is similar in its effect to no-shpa; it is a drug with a minimum number of side effects and a selective effect on the smooth muscles of the abdominal organs. Its disadvantages, perhaps, include a relatively short period of action - about four hours, after which the injection must be repeated.

The most powerful remedy that permanently eliminates spasms of smooth muscles of internal organs is platiphylline; it is administered every 12 hours in a dose of 1-2 mg, subcutaneously or intramuscularly. However, symptoms of side effects with platyphylline are more frequent and more serious than with other antispasmodics. Therefore, the use of the drug is recommended only under medical supervision.

No-spa in the complex treatment of pancreatitis

In addition to no-shpa, a different number of drugs are used in the treatment of pancreatitis. It is important that the interaction of the drugs does not cause harm to the human body. It is necessary to take into account possible concomitant diseases and medications taken in parallel by the patient.

Sometimes, in severe cases of the disease, they resort to prescribing two antispasmodics at the same time. Similar tactics are used in the acute phase of the disease to quickly relieve pain. The simultaneous administration of no-shpa and opioid drugs reduces the effectiveness of the latter.

Features of taking no-shpa for pancreatitis

Since vomiting is a common symptom of acute pancreatitis, prescribing the drug in tablets may not be advisable. It is better to prescribe no-shpa intramuscularly or intravenously.

The standard single dose of no-shpa is 2 ml. The drug must be injected deep into the gluteal muscle. When delivering the medicine intravenously, the drug must be diluted with 10 ml of saline or water for injection. The medicine will need to be administered slowly. It is better to inject the drug in a lying position, avoiding provoking collapse.

The drug can be administered intravenously. This form of administration is especially effective for persistent vomiting and associated severe dehydration of the patient. It is allowed to administer the drug by drip by dissolving the drug in 200 ml of physiological solution. The rate of administration should not exceed 60-80 drops per minute.

Painkillers for chronic pancreatitis

Chronic pancreatitis is also characterized by pain. But in most cases it depends on how severe the inflammatory process is. The intensity of the attack of pain is inferior to that that accompanies acute pancreatitis. There may be no high temperature, and vomiting does not always occur. Therefore, in some cases it is possible to take any drug in tablet form:

1. No-spa, papaverine, Duspatalin (Meteospasmil) - pain relief with these antispasmodics is effective, even if other nearby digestive organs are involved - the stomach, gall bladder, liver, and gastritis and cholecystitis are aggravated.
2. Analgin, Baralgin are analgesics, the use of which is permissible if the disease is chronic, with moderate pain symptoms.
3. Indomethacin, Movalis, Ketanov are NSAID drugs; taking them at home allows for good pain relief, even if you do not give an injection, but take a pill.

If the tablet does not produce the desired result, the drug is prescribed in the form of intramuscular, intravenous injections or infusions. This method of administration has advantages: it quickly and effectively relieves pain of any intensity.

Features of action for pancreatitis

One of the basic symptoms of pancreatic inflammation is pain. The reasons for its occurrence are several main factors:

• obstruction of the main excretory duct of the gland due to spasm of the so-called sphincter of Oddi - a muscular ring with an opening through which pancreatic juice and bile flow into the duodenum;
• abnormal stretching of the capsule of the inflamed organ;
• reflex spasm of the bile ducts and gallbladder;
• spasmodic contractions in the small intestine.

In acute attacks of pancreatitis, cutting, often unbearable, girdle pain can lead the patient to a state of painful shock and death. To relieve the intensity of pain and prevent shock, antispasmodics are immediately used to relax the muscle ring of Oddi, eliminate obstruction of the excretory ducts and open the way for juice and bile into the small intestine.

An acute attack of pancreatitis requires injection of medicinal solutions that have a powerful and accelerated therapeutic effect. Antispasmodics are intended to relax the smooth muscle organs of the gastrointestinal tract, spasmed in the local area of ​​the abdominal cavity, head, heart, etc. For mild dull pain and the absence of vomiting, medications to relax the smooth muscles of the abdominal organs and eliminate pain syndrome are prescribed antispasmodics in the form of tablets.

Side effects

During oral administration, side symptoms may occur in the form of:

• nausea;
• arrhythmias;
• constipation;
• shortness of breath.

One of the side effects from taking Drotaverine is constipation.

With intravenous and intramuscular administration the following is observed:

• dizziness;
• increased heart rate;
• lowering blood pressure;
• feeling hot and sweating.

Rashes, redness, swelling, and hematoma may appear at the injection site.

How do antispasmodics work?

Pain caused by pancreatitis can be caused by many factors, for example:

• swelling of the pancreas;
• gallbladder spasm;
• spasm in the small intestine;
• almost always - a spasm of smooth muscles.

The main purpose of antispasmodics (in gastroenterology) is to reduce spasm of smooth muscles in the complex treatment of abdominal pain of varying intensity. Once in the body, the active substance dilates blood vessels and has a myotropic effect.

All antispasmodic drugs must be prescribed by a doctor; self-treatment can lead to a worsening of the condition and erase the clinical picture of the disease, which will make it very difficult to make a correct diagnosis.

In the complex treatment of pancreatitis, several types of drugs are used to help relieve pain from smooth muscle spasms. These include:

• Nosh-pa (or Drotaverine);
• Papaverine;
• Atropine;
• Nyaspam;
• Duspatalin.

pharmachologic effect

The drug is considered a myotropic antispasmodic. In its composition and action it is similar to Papaverine. It is only generally accepted that he copes with the task better. After taking the pills, there is a decrease in smooth muscle tone. Under the influence of the active components, the blood vessels begin to dilate, but this does not affect the nervous system. The medicine is prescribed to patients as an analgesic and antispasmodic agent if there are restrictions on the use of medications from the category of anticholinergic drugs.

Drotaverine is a myotropic antispasmodic.

Effective antispasmodic drugs

The degree of therapeutic effect of antispasmodics is largely determined by the severity of the manifestations of pancreatitis, the course of the disease (acute or chronic), the dosage form of the drug (tablets or injections), age and other internal diseases that complicate inflammation in the pancreas. Let's look at the list of the main antispasmodic drugs prescribed for pancreatitis.

Popular Nosh-pa

A very common medicine for abdominal pain, which has proven itself to be an effective remedy. The active ingredient of Nosh-pa is drotaverine - it is a myotropic substance with antispasmodic action. This drug exists in tablets and ampoules for injection. To relieve pain during an attack of pancreatitis, both forms of medication are used. Injections are used to relieve intense pain, since the effect occurs faster (almost immediately after administration of the substance) than after taking pills. The tablets begin to act 20–30 minutes after administration. The maximum daily dose of the drug is 240 mg.

This medicine is sold without a doctor's prescription, but since it has a number of contraindications, it is recommended to consult a specialist before purchasing Nosh-pa.

Contraindications to the use of the drug:

• individual intolerance to components;
• renal failure;
• heart failure;
• lactation period;
• severe forms of liver failure;
• children under 6 years of age.

This drug also has serious side effects:

• cardiopalmus;
• dizziness;
• decreased blood pressure;
• allergic reactions (itching, redness and rashes on the skin);
• injections in rare cases can cause paralysis of the respiratory center.

Considering possible side effects, it is better to use the drug after a complete medical examination of the body.

Drotaverine

Drotaverine for pancreatitis is one of the most common, effective and affordable antispasmodics. The medicine has a long-lasting and pronounced relaxing effect on the smooth muscles of internal organs and blood vessels. It is on the basis of drotaverine that such a well-known drug as No-shpa has been developed, which eliminates spastic contractions of the muscles of the abdominal organs, including the pancreatic ducts.

Drotaverine tablets begin to act 25-40 minutes after administration, so they are used in the absence of severe pain and vomiting in the patient. An intramuscular injection of Drotaverine or No-shpa has a therapeutic effect within 5-7 minutes. Contraindications for prescribing drugs based on drotaverine include:

• serious cardiac pathologies, including cardiogenic shock;
• low blood pressure;
• severe kidney and liver dysfunction;
• admission for children under 7 years of age;
• individual intolerance.

During pregnancy and breastfeeding, use with caution.

Papaverine

Papaverine relieves pain in pancreatitis by reducing pressure in the organ caused by spasm of the glandular ducts and restoring the outflow of bile and pancreatic juice. The medication is used in the form of suppositories, tablets and 2% injection solution. Papaverine works most effectively when administered subcutaneously or by drip intravenous infusion. In pediatrics, Papaverine is also prescribed to children. In tablets and suppositories - starting from the age of 6 months, in the form of injections - from 1 year. The dosage is selected by the doctor in accordance with the age and severity of pancreatitis.

There are several forms of release of Papaverine:

• solutions for injections;
• suppositories;
• pills.

Contraindications for Papaverine are the same as for Drotaverine and No-shpa. But Papaverine is also not used in patients with glaucoma and hypothyroidism.

Experts do not prescribe Papaverine in the following cases:

• with some types of arrhythmia, for example, with atrioventricular block;
• severe liver failure;
• for glaucoma;
• decreased blood pressure levels;
• intolerance.

In addition, there is no data on the safety of the use of this substance by children, as well as women during pregnancy or breastfeeding.

Atropine

Atropine for pancreatitis is prescribed as an antispasmodic, which relieves increased tone and spastic contractions in the pancreas. In practice, Atropine is used only in the acute phase of the pathology. Due to the universal mechanism of action and the rapid onset of the therapeutic effect, antispasmodics are often prescribed to eliminate pain due to pancreatitis.

In case of an acute attack of pancreatitis, Atropine is prescribed in the form of injections to block pain only under strict indications and with mandatory medical supervision. The peculiarity of the therapeutic effect of Atropine is due to its ability to enhance the analgesic effect of analgesics - Analgin, Baralgin. Therefore, for spastic pain against the background of pancreatitis, Atropine solution is often administered in combination with painkillers. This can significantly reduce the duration of an acute attack.

Atropine reduces the severity of adverse reactions from drugs, for example, morphine, which must be resorted to in case of painful shock. It should be borne in mind that the medicinal substance in Atropine is an alkaloid that is found in the fibers of poisonous plants - henbane, belladonna, and datura. Therefore, the medicine has serious contraindications and pronounced undesirable effects. In this regard, in pediatrics they avoid prescribing Atropine to children or use it, calculating the dosage strictly in accordance with the child’s body weight.

Antispasmodic Niaspam

Antispasmodic myotropic action - Niaspam. Like other drugs, it affects smooth muscle fibers and does not have an anticholinergic effect. The main substance is mebeverine, available in the form of capsules in a dosage of 200 mg.

The drug is dispensed in pharmacies according to a doctor's prescription. This antispasmodic agent has a number of serious side effects, such as:

• Quincke's edema;
• hives;
• exanthema;
• itching and redness of the skin;
• swelling of the face.

These signs are very dangerous for human health, so before taking the drug it is necessary to take tests and undergo a full examination of the body in order to prevent their occurrence.

The drug is contraindicated for children under 12 years of age, with individual intolerance to the main substance; it is prescribed with caution to pregnant women and women during breastfeeding.

Platyfillin

Platiphylline is a medicine from the group of atropine-like substances, which, in addition to its antispasmodic effect on the smooth muscle tissue of the gland, has a weak sedative effect. A 0.2% solution is used for subcutaneous injection as an emergency treatment to relieve acute attacks of pain. The medicine has an extended list of serious side effects, therefore, like Atropine, it is used only under medical supervision, especially in children.

In cases of exceeding the dosage of Platiphylline for pancreatitis causes the following consequences:

• rapid heartbeat against the background of low blood pressure;
• dry mouth;
• hoarseness of voice;
• intestinal atony;
• disruption of the process of urine emission;
• attacks of severe headache and dizziness;
• seizures;
• photophobia.

Also, when prescribing such a medicine, gastroenterologists take into account such contraindications for use as:

• glaucoma;
• intestinal atony;
• muscle weakness;
• heartbeat disturbance;
• renal and liver failure;
• colitis of ulcerative nature.

The course of treatment of the disease with this drug is from ten to twenty days.

Duspatalin

Antispasmodic, produced in tablets and capsules with the active ingredient mebeverine.

The drug has several positive features for exacerbation of pancreatitis:

• reduces spasm of the main pancreatic duct;
• affects the tone of the muscular sphincter of Oddi;
• improves the functioning of the pancreas, preventing stagnation of pancreatic juice;
• with long-term use shows a minimum of serious undesirable effects.

Duspatalin is not used for emergency care during an acute attack of pain. But long-term treatment (up to 6 months) with a chronic process allows it to achieve a persistent weakening of the manifestations of pancreatitis. Duspatalin relieves only pathologically increased motility, without reducing normal one, and does not cause one of the common complications when using antispasmodic therapy - intestinal atony.

Other drugs used for pathologies of the pancreas, which are accompanied by spasm of smooth muscle cells: Niaspam, Sparex. Effective products based on mebeverine, but less expensive than Duspatalin. Riabal (prifinium bromide). An antispasmodic in the form of a syrup, which is used in pediatrics for infants from 3 months of age. Eliminates pain due to inflammation of the gland, intestinal spasms (colic), and bloating in infants.

Dicetel (pinaverine bromide). Halidor (in tablets and injections). Buskopan. It is one of the effective means for relieving spastic pain in chronic pancreatitis. Prevents the development of an acute attack, relaxes the sphincter and eliminates stagnation of bile and pancreatic juice. At the same time, it eliminates pain from spasms of smooth muscles of all organs of the gastrointestinal tract, nausea, bloating, and diarrhea.

Spasmoanalgesic Spazmalgon (in tablets and injections).

Thanks to the interaction of three active components, it has a pronounced therapeutic effect for pancreatitis. Spazmalgon contains two types of antispasmodics (fenpiverinium bromide, pitofenone) and the analgesic metamizole sodium (analgin), which enhance each other’s effects. It is used in tablets for moderate spastic pain. When injected, it has a stronger effect for acute pain. Additionally acts as an anti-inflammatory and antipyretic agent.

Other combination drugs: Bral, Revalgin (in injections), Spazgan (in tablets and injections), Maxigan, Spazmalin.

How long does it take for Drotaverine to work?

After taking the tablets, the effect is observed within 20-30 minutes. Maximum concentration is achieved after 45-60 minutes. If the medicine is administered intravenously or intramuscularly, a positive result is observed after 5-10 minutes.

The action of Drotaverine begins 20-30 minutes after taking the tablets.