Treatment of any disease is a whole complex of procedures and medications. Sometimes you look at the list and think that the doctor probably played it safe! After all, gastritis and ulcers are such studied diseases! Maybe you don’t need to take everything that is prescribed? What if we treat one thing and cripple the other?
Gastric ulcers and gastritis, although they affect the same system of the body, are different diseases. Therefore, both the principles of treatment and medications may differ, but at the same time overlap with each other. Consider tablets for gastritis and ulcers.
Composition of the drug Ketorol
The active substance in tablet form is ketorolac tromethamine, and the main auxiliary elements are: lactose, microcrystalline cellulose, corn starch.
The solution in ampoules is also based on ketorolac. But the excipients here are different: sodium chloride, ethyl alcohol, propylene glycol and octoxynol. About 1 ml is purified water for injection.
Gel for external use relieves pain thanks to the same main substance that is used in other dosage forms - ketorolac. Additional elements in the composition are: dimethyl sulfoxide, sodium methyl parahydroxybenzoate, carbomer, tromethamine and water.
Absorbents and antihistamines
Enterosgel - used to treat acute gastritis.
Adsorbents are prescribed for acute gastritis. These substances collect toxins on their surface and remove them from the body. The treatment protocol includes the following drugs:
- Activated carbon
- Enterosgel
- Polysorb
- Polyphepan
For allergic gastritis, the use of antihistamines is indicated. For acute or chronic inflammation, these drugs are prescribed as a preventive measure. Some drugs are taken 3 times a day - suprastin, others - loratadine, cetrin, elcet - once a day is enough.
Pharmacological group
Ketorol belongs to the group of non-steroidal anti-inflammatory drugs, which includes many drugs of different compositions, differing in their mechanisms of action, but with similar pharmacological effects. The main difference between this group is the lack of effect on the adrenal glands, that is, this group of medications is not hormonal.
There are three main areas in which non-steroidal anti-inflammatory drugs act:
- relieving pain;
- relieving inflammation;
- normalization of body temperature.
Ketorol, being a representative of NVPS, performs all three functions.
Antacids for gastritis
Phosphalugel - used in the treatment of acute and chronic gastritis.
These drugs must meet the following criteria: neutralize hydrochloric acid, effectively remove toxins, reduce irritation of the stomach walls, and produce an analgesic effect.
Absorbed antacids - Rennie, Bourget's mixture - enter into a chemical reaction with gastric juice.
After the effect of the drug ends, hydrochloric acid begins to be produced in greater quantities than before taking the antacid. Therefore, these drugs are not used in the treatment of gastritis.
In acute and chronic cases, non-absorbable antacids are indicated. The choice of these drugs is wide - Almagel, Maalox, Phosphalugel, Taltsid, Vikalin.
When is Ketorol prescribed?
Three main directions of the drug form the indications that become the reason for prescribing Ketorol:
- soft tissue bruises;
- bursitis;
- ligament damage;
- synovitis;
- myalgia of any etiology;
- neuralgia;
- radiculitis;
- rheumatism.
It should be remembered that taking Ketorol is predominantly symptomatic. When pain appears from the list of indications, take the drug. If there is no pain, you do not need to drink Ketorol or use it as a course of injections.
The choice between tablets and injections is made after analyzing several factors:
- if you have stomach diseases, the tablets are contraindicated;
- for persistent vomiting or difficulty swallowing, Ketorol is administered intramuscularly;
- a broken jaw is a reason to make a choice not in favor of pills;
- acute pain from radiculitis is relieved faster after injection;
- menstrual pain is relieved after taking Ketorol tablets;
- in the postoperative period, they also often opt for tablets, especially if intramuscular administration is complicated by the consequences of the operation.
Despite the fact that Ketorol is prescribed as a NSAID, the main indication is pain. When body temperature rises, preference is given to other active ingredients.
Antibiotics and antibacterial drugs, pyrokinetics and antacids
Antibiotics are medications aimed at suppressing Helicobacter pylori.
Among the antibiotics chosen are broad-spectrum agents - clarithromycin, tetracycline, amoxicillin.
In case of infection by a resistant strain of Helicobacter, medications are selected individually after testing for sensitivity to antibiotics.
This group of drugs is aimed at suppressing Helicobacter. Trichopolum or metronidazole is traditionally used as an antibacterial drug.
If Helicobacter is not detected, and the ulcer is caused by other reasons, then antibiotics are not used for treatment. Pyrokinetics improve the movement of food through the gastrointestinal tract, relieve dyspepsia, heartburn, and a feeling of heaviness in the stomach. Traditionally, cerucal, metoclopramide, and motilium are prescribed. These drugs are not used to treat ulcers on their own.
Antacids are prescribed to relieve heartburn. The choice of these drugs is huge - Maalox, Gastral, Almagel. The course of taking antacids should not exceed 14 days. Additionally, patients are prescribed vitamin complexes, antispasmodics – no-spa, drotaverine, baralgin.
In case of a mild condition, treatment is carried out on an outpatient basis. In severe cases - bleeding, suspected perforation - only in a medical institution.
Contraindications
Any non-steroidal drugs, including Ketorol, are not prescribed for lesions of the gastrointestinal tract. This is due to the fact that NSAIDs increase the risk of gastric bleeding, especially in people aged 60+.
Other contraindications include:
- bronchial asthma;
- renal failure;
- lactation;
- pregnancy;
- hyperkalemia;
- patient age under 16 years;
- liver diseases;
- cerebral hemorrhage.
In addition, simultaneous use with the following drugs is prohibited:
- pentoxifylline;
- acetylsalicylic acid;
- lithium salts;
- probenecid;
- anticoagulants.
Take Ketorol with caution in case of thyroid diseases, diabetes mellitus and severe somatic diseases.
Ketorol®
Often - more than 3%; less often - 1–3%; rarely - less than 1%.
From the digestive system:
often (especially in elderly patients over 65 years of age with a history of erosive and ulcerative lesions of the gastrointestinal tract) - gastralgia, diarrhea; less often - stomatitis, flatulence, constipation, vomiting, feeling of fullness in the stomach; rarely - nausea, erosive and ulcerative lesions of the gastrointestinal tract (including with perforation and/or bleeding - abdominal pain, spasm or burning in the epigastric region, melena, vomiting like “coffee grounds”, nausea, heartburn), cholestatic jaundice, hepatitis, hepatomegaly, acute pancreatitis.
From the urinary system:
rarely - acute renal failure, lower back pain with or without hematuria and/or azotemia, hemolytic uremic syndrome (hemolytic anemia, renal failure, thrombocytopenia, purpura), frequent urination, increased or decreased urine volume, nephritis, edema of renal origin.
From the senses:
rarely - hearing loss, ringing in the ears, visual impairment (including blurred vision).
From the respiratory system:
rarely - bronchospasm, shortness of breath, rhinitis, laryngeal edema.
From the side of the central nervous system:
often - headache, dizziness, drowsiness; rarely - aseptic meningitis (fever, severe headache, convulsions, stiffness of the neck and/or back muscles), hyperactivity (mood changes, anxiety), hallucinations, depression, psychosis.
From the cardiovascular system:
less often - increased blood pressure; rarely - pulmonary edema, fainting.
From the hematopoietic organs:
rarely - anemia, eosinophilia, leukopenia.
From the hemostasis system:
rarely - bleeding from a postoperative wound, nosebleeds, rectal bleeding.
From the skin:
less often - skin rash (including maculopapular rash), purpura; rarely - exfoliative dermatitis (fever with or without chills, redness, thickening or flaking of the skin, swelling and/or tenderness of the tonsils), urticaria, Stevens-Johnson syndrome, Lyell's syndrome.
Allergic reactions:
rarely - anaphylaxis or anaphylactoid reactions (change in facial skin color, skin rash, urticaria, skin itching, tachypnea or dyspnea, swelling of the eyelids, periorbital edema, shortness of breath, difficulty breathing, heaviness in the chest, wheezing).
Other:
often - swelling (face, legs, ankles, fingers, feet, weight gain); less often - increased sweating; rarely - swelling of the tongue, fever.
How to take Ketorol
Regarding the oral form, two schemes are used, differing in the type of tablets:
- for resorption;
- To be swallowed with water.
Lozenges contain 10 mg of active substance. If moderate pain occurs, place 1 tablet on the tongue until it is completely dissolved. No need to drink water. If the pain returns after a while, you can repeat the dose. The maximum daily dose is 4 tablets (40 mg ketorolac).
Tablets, intended to be swallowed with water, contain 10 mg of ketorolac. Daily intake should not exceed 40 mg of the drug. Adults can take Ketorol tablets every 4-6 hours. For elderly patients aged 60+, it is necessary to increase the interval between doses to 6-8 hours.
Injections for intramuscular administration can be repeated no more often than after 4 hours. The first analgesic effect is noted within half an hour after administration of the solution. The maximum analgesic effect occurs after 1.5 hours.
Method of treating the disease
An ulcer is a violation of the integrity of the gastric mucosa.
An ulcer is a violation of the integrity of the mucous membrane of the stomach or duodenum.
There are many reasons for this disease, but the main one is infection by the microorganism Helicobacter pylori. Ulcer treatment tactics include the use of the following groups of drugs:
- Antisecretory agents
- Bismuth preparations
- Antibiotics and antibacterial agents
- Drugs that improve gastrointestinal motility
- Antacids
- Antisecretory drugs
These substances reduce the production of gastric juice and its aggressive effect on the mucous membranes. This group of drugs includes proton pump inhibitors, H2-histamine receptor blockers, M1 anticholinergics.
Proton pump inhibitors are prescribed for confirmed lesions of Helicobarker pylori. These substances reduce the aggressiveness of hydrochloric acid by up to 80%. Doctors prescribe the following drugs:
- Omez or omeprazole, zerocid – 1–2 capsules per day
- Pariet or rabeprozole – 1–2 tablets per day
- Nexium or ecomeprazole – 1–2 capsules per day
When taking drugs of this group, the effect of antibiotics and antibacterial substances increases. Take them 1 hour before meals. H2-histamine receptor blockers have a similar effect to proton pump inhibitors. You can drink them at any time, regardless of meals. Doctors prescribe:
- Ranitidine, Rantak, Zoran 150 mg 2 times a day
- Famotidine, also known as gastrosidine, blockacid, 1 capsule 2 times a day
M1 anticholinergics reduce the production of hydrochloric acid and the enzyme pepsin. Currently, the drug "Pirenzepine" is prescribed at a dose of 50 mg 2 times a day. The tablets should be taken before meals.
