hrvatski

Principi farmakoterapije temporomandibularnih poremećaja

Temporomandibularni poremećaji su naziv za poremećaje temporomandibularnih zglobova i/ili žvačnog mišičja nedovoljno razjašnjene etiologije. Od kliničkih znakova i simptoma temporomandibularnih poremećaja za pacijenta je najtegobnija temporomandibularna bol, a zatim ograničenost pokreta pokreta mandibule. Farmakološka terapija je najčešće dovoljna komplementarna terapija u stomatološkom ili po potrebi multidisciplinarnom liječenju temporomandibularne boli. Pravilan izbor lijekova u liječenju akutne i kronične temporomandibularne boli važan je za uspjeh liječenja bez obzira na prethodne simptome i radiološki nalaz temporomandibularnih zglobova. Najčešće se propisuju nesteroidni antireumatici (NSAR), a tek po potrebi kortikosteroidi, anksiolitici, triciklički antidepresivi i lokalni anestetici. NSAR su najčešće rabljeni lijekovi uopće te je potrebno nadzirati njihovu upotrebu s obzirom na postignuti analgetski učinak i njihove potencijalne ozbiljne gastrointenstinalne, kardiovaskularne i bubrežne nuspojave te reakcije preosjetljivosti. Ipak, samo lijekovi nisu dostatni u uklanjanju bolova te se trebaju kombinirati s ostalim oblicima terapije, kao što je: okluzijska udlaga, fizioterapija i kognitivno-bihevioralno liječenje. Temporomandibular disorders (TMD) designate a cluster of diagnoses of the temporomandibular joint (TMJ) and/or masticatory muscle disorders from the musculoskeletal disorders group with insufficiently explained etiology. As far as the diagnostically important clinical signs and symptoms of TMDs are concerned, the most uncomfortable for the patient is the temporomandibular pain, followed by the limitation of the mandible. Pharmacological therapy is usually a competent complementary therapy used in dental or multidisciplinary treatment of temporomandibular pain. The right choice of drugs in treatment of acute and chronic temporomandibular pain can prove to be successful regardless of the previous symptoms and radiological results regarding temporomandibular joints. Non-steroidal anti-inflammatory drugs (NSAIDs) are most often prescribed while corticosteroids, short relaxing and tranquilizer drugs, tricyclic antidepressants and local anesthetics are only prescribed when necessary. NSADs are the most commonly used medications in general and therefore it is necessary to supervise their usage with respect to the achieved analgesic effect and their potential serious adverse drug reactions (gastrointenstinal, cardiovascular, renal and hypersensitivity reactions). However, drugs are not sufficient in pain relief and should be combined with other methods of treatment such as: occlusal splint, physiotherapy and cognitive-behavioral therapy.

temporomandibularni poremećaji; farmakoterapija; analgezija; nesteroidni antireumatici

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