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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/2079-701X-2020-9-146-154</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-5718</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ПОДДЕРЖИВАЮЩАЯ ТЕРАПИЯ В ОНКОЛОГИИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>SUPPORTIVE THERAPY IN ONCOLOGY</subject></subj-group></article-categories><title-group><article-title>Болевой синдром в онкологии. Возможности применения декскетопрофена</article-title><trans-title-group xml:lang="en"><trans-title>Pain syndrome in oncology. Possibilities of dexketoprofen administration</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2582-3957</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Пчелинцев</surname><given-names>М. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Pchelintsev</surname><given-names>M. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Пчелинцев Михаил Владимирович, к.м.н., доцент кафедры клинической фармакологии и доказательной медицины </p><p>197022, Санкт-Петербург, ул. Льва Толстого, д. 6–8</p></bio><bio xml:lang="en"><p>Mikhail V. Pchelintsev, Cand. of Sci. (Med.), Associate Professor of the Department of Clinical Pharmacology and Evidence Based Medicine </p><p>6–8, Lev Tolstoy St., St Petersburg, 197022 </p></bio><email xlink:type="simple">mvpchelintsev@inbox.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Первый Санкт-Петербургский государственный медицинский университет им. академика И.П. Павлова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Pavlov First St Petersburg State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2020</year></pub-date><pub-date pub-type="epub"><day>28</day><month>07</month><year>2020</year></pub-date><volume>0</volume><issue>9</issue><fpage>146</fpage><lpage>154</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Пчелинцев М.В., 2020</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="ru">Пчелинцев М.В.</copyright-holder><copyright-holder xml:lang="en">Pchelintsev M.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/5718">https://www.med-sovet.pro/jour/article/view/5718</self-uri><abstract><p>Боль является, несомненно, очень важной проблемой при ведении онкологических больных. В зависимости от интенсивности боли для ее лечения используются анальгетики из разных фармакологических групп. Согласно рекомендациям ВОЗ, основными средствами, применяемыми при ноцицептивной боли у онкологических больных, являются нестероидные противовоспалительные препараты (НПВП), слабые и сильные опиоиды. При участии в формировании боли наряду с ноцицептивным нейропатического компонента к ним добавляются противоэпилептические препараты (карбамазепин, габапентин, прегабалин), трициклические антидепрессанты (амитриптилин), местные анестетики (лидокаин). Кроме этих препаратов применяются адъюванты. Эти лекарственные средства потенцируют анальгетический эффект НПВП и опиоидов, корректируют нежелательные реакции на них. Часто развитие интенсивной боли у пациентов обусловлено костными метастазами, которые формируются при онкологических процессах различной первичной локализации. При этом пациенты могут испытывать как постоянную, так и приступообразную, прорывную боль. Эффективность НПВП у онкологических пациентов обусловлена не только анальгетическим эффектом, но и воздействием на процессы воспаления в местах формирования и роста опухоли, а также в метастатических очагах. Декскетопрофена трометамол (ДКПТ) – эффективный и безопасный НПВП, представляющий собой водорастворимую соль правовращающего стереоизомера кетопрофена. Препарат обладает хорошей жирорастворимостью и растворимостью в воде. За счет этого ДКПТ может быстро всасываться, создавать терапевтические концентрации в плазме крови, преодолевать гематоэнцефалический барьер. Он оказывает выраженное и быстрое анальгетическое действие при различных заболеваниях, что связано как с центральными анальгетическими механизмами, так и с противовоспалительным действием в периферических тканях. Доказана эффективность ДКПТ при болях в костях, связанных с онкологическим процессом. Наличие раствора для внутривенного введения и быстрое действие при приеме внутрь позволяют применять препарат при прорывной боли. Препарат значительно потенцирует действие слабых и сильных опиоидов при комбинированной терапии, что дает возможность использовать опиоидные анальгетики в меньших дозах.</p></abstract><trans-abstract xml:lang="en"><p>Pain is an important problem in oncology patients. Depending on its intensity, for pain treatment, analgesics of different pharmacological classes are used. According to WHO recommendations, for nociceptive pain treatment in oncology patients, non-steroidal antiinflammatory drugs (NSAIDs), mild and potent opioids are the essential medications. If in pain formation along with the nociceptive pain component, a neuropathic one is present, antiepilepsy drugs, tricyclic antidepressants, local anesthetics are added. Apart from these medicines, adjuvants are used. These agents potentiate the analgesic endpoint of NSAIDs and opioids, correct their adverse effects. Often, intensive pain development is driven by bone metastases, which form in oncologic processes of different primary localization. Herewith, patients could suffer from constant as well as from paroxysmal, “breakthrough” pain. The efficacy of NSAIDs in oncology patients is due not only to analgesic effect but also to their action on inflammatory processes in areas of tumor formation and growth as well as in metastatic foci. Dexketoprofen trometamol is an effective and safe NSAID, a water-soluble salt of a dexketoprofen dextrorotatory stereoisomer. The preparation has a good lipid and water solubility. Thus, dexketoprofen trometamol can rapidly absorb, create therapeutic concentrations in blood serum, and penetrate through brain-blood barrier. It produces a significant and fast analgesic action in different diseases, which is related both to central analgesic mechanisms and to anti-inflammatory effect in peripheral tissues. Dexketoprofen trometamol efficacy is proven in bone pain related to oncological disease. The availability of intravenous solution and the prompt action at oral administration allow using the medicine for “breakthrough” pain. The medication significantly potentiates the action of mild and potent opioids at combined therapy, which allows to use opioid analgesics in lower doses.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>онкология</kwd><kwd>боль</kwd><kwd>анальгезия</kwd><kwd>НПВП</kwd><kwd>декскетопрофен</kwd><kwd>дексалгин</kwd></kwd-group><kwd-group xml:lang="en"><kwd>oncology</kwd><kwd>pain</kwd><kwd>analgesia</kwd><kwd>NSAID</kwd><kwd>dexketoprofen</kwd><kwd>dexalgin</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Сарманаева Р.Р., Абузарова Г.Р., Бычкова Н.В., Алексеева Г.С. Лечение вариативного болевого синдрома при лучевой терапии костных метастазов рака молочной железы. Медицинский совет. 2019;(19):165–168. doi: 10.21518/2079-701X-2019-19-165-168.</mixed-citation><mixed-citation xml:lang="en">Sarmanayeva R.R., Abuzarova G.R., Bychkova N.M., Alexeeva G.S. 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