Treatment of neuropathic pain , Pregabalin in comparison with Gabapentin
Neuropathic pain is a current problem of modern life, difficult responding to treatment. The purpose of the present overview comes down to assessment of efficiency of Pregabalin and Gabapentin at treatment of peripheral and central neuropathic pain. In clinical trials of high level. Materials and methods. The present overview included randomized controlled studies.
Pregabalin is a medicine with anti-epileptic effect which allows to reduce severity of spasms of cross-striped skeletal muscles. Pregabalin is an analog of the main brake mediator of structures of central nervous system. Pregabalin is an analog of piperidic acid ((S)-3 (aminomethyl)-5-methylhexane acid).
While Gabapentin on the chemical structure practically does not differ from piperidic acid. It is acid which is a brake neurotransmitter of central nervous system. The symptomatic anticonvulsant interferes with development of epileptic attacks. Also stops neuropathic pains. These pains arise because of pathological excitement of the central nervous system or neurons.
Gabapentin does not influence radioligand linking of GAMK with receptors. This drug is not metabolized in not proteinogenic acid. Also does not inhibit capture of a brake neurotransmitter. In concentration up to 100-110 microns the operating components do not show affinity to:
- and to other specific receptors.
Pregabalin is effective at patients with diabetic neuropathy and post-herpetic neuralgia. Clinical trials showed. Reduction of the index of pain by 50%, approximately at 35% of patients against the background of use of Pregabalin and for 18% of the patients receiving placebo was noted. The patients receiving Pregabalin and not noting drowsiness. Reduction of the index of pain by 50% was noted in 33% of cases. The patients accepting placebo at them this indicator was 18%. Drowsiness was noted at 48% of patients who received Pregabalin medicine. And at 16% of patients the receiving placebos. In addition at patients with neuropathic pain of Pregabalin reduced a sleep disorder. Improved the general condition and quality of life. The severity of allodynia at post-herpetic neuralgia decreased. Uneasiness at the central neuropathic pain. The need for morphine at neuropathic pain owing to cancer decreased. The severity of the constipations caused by it decreased. Effects of non-steroidal anti-inflammatory drugs (amplified at chronic lower back pain).
Mechanism of action Gabapentin. It is ability of medicinal metabolites, to activate additional ion channels. In used of Neurontin the new formed peptide receptors were found. In a limbic system and a neocortex. These receptors carry out successful antiepileptic activity of active ingredients. At use of Gabapentin side effects arise considerably less than at reception of other anticonvulsants. If undesirable reactions are shown, then they are shown at patients at the very beginning of pharmacotherapy. It considerably facilitates life both to patients, and their treating to doctors.
Research of mechanical properties in molecular crystals in the field of a crystal engineering. Qualitative mechanical properties are necessary for production of pharmaceutical important substances in drugs, suitable for use. Monocrystals help to correlate microscopic structure to macroscopic properties for potential design. Hydrate forms of two anticonvulsant zwitterionic drugs, Pregabalin and Gabapentin are examples of crystal materials which show macroscopic plasticity. Direct comparison of these structures with their waterless analogs which are brittle allows to assume that presence of water is crucial for plasticity. On the contrary, structural features, such as molecular packing and anisotropic distribution of strong and weak interactions, seem less important.
In recent years abuse cases gabapentinoid became frequent (gabapentin or pregabalin). Data on pharmacovigilance from Reporting system on side effects of the Food and Drug Administration (FAERS) provide useful information about messages about side effects (ADE) for detection of a signal save gabapentin damit.
Though it is traditional was not considered as abuse drugs, for the analyzed terms more than 600 cases of abuse were registered that causes the necessity of further studying and standard investigation.
Each drug has pluses and minuses, in too time these drugs are similar in properties and origin.