Проблемные лекарства

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Дипирон запрещено импортировать в Австралию и Сингапур; он изъят или запрещен в Дании, Норвегии и Швеции; строго ограничен в Бангладеш, Египте, Германии, Греции, Израиле, Италии, Перу, на Филиппинах и в Венесуэле; в Мексике он не разрешен для использования в педиатрической практике [104].

Пропифеназон был запрещен или изъят в Ирландии и Турции [105]. Все пиразолоны строго ограничены в Германии, Греции, Японии и Саудовской Аравии [106].

Дополнительная информация дается в главах:

Время действовать

Ненадлежащее использование анальгетиков может вызывать серьезные и иногда летальные побочные эффекты. Проблемой во всем мире является почечные заболевания или почечная недостаточность, вызванные анальгетиками. Там, где проводились хорошо поставленные исследования, можно было провести связь между значительной частью пациентов, которым была заменена почка или которые находились на диализе, и использованием анальгетиков. В 1987 г. в Австралии эта цифра составляла 13%; в 1986 г. в Германии она была равна 16.8%; в 1988 г. в Бельгии - 18% [107]. Будет серьезной ошибкой считать, что продукт "безопасен" только потому, что он отпускается без рецепта.

Дело еще более осложняет озадачивающая масса анальгетиков на рынке многих стран; причем все они рекламируются как более эффективные, более быстродействующие, или более безопасные в купировании боли. Как уже отмечалось, для многих из них эти утверждения научно не подтверждаются. В отношении некоторых продуктов данные ясно говорят о том, что риск перевешивает любую предполагаемую пользу. Настало время рационализировать подход к лечению боли.

Рекомендации к действию

  1. Все анальгетики следует ограничить препаратами с одним ингредиентом (за исключением буферного аспирина, или комбинации парацетамола с антидотом метонином).
  2. Все анальгетики, содержащие декстропропоксифен, глафенин, фенацетин или производные пиразолона, должны быть немедленно изъяты с рынка.
  3. У всех анальгетиков на упаковке должно указываться воспроизведенное (непатентованное) наименование продукта, а также максимальные пределы дозировки, особенно в случае с парацетамолом.

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