Chronic musculoskeletal pain(CMP)is a common occurrence in clinical practice and there are a variety of options for the treatment of it.However,the pharmacological therapy is still considered to be a primary treatment...Chronic musculoskeletal pain(CMP)is a common occurrence in clinical practice and there are a variety of options for the treatment of it.However,the pharmacological therapy is still considered to be a primary treatment.The recent years have witnessed the emergence of opioid crisis,yet there are no relevant guidelines on how to treat CMP with non-opioid analgesics properly.The Chinese Medical Association for the Study of Pain convened a panel meeting to develop clinical practice consensus for the treatment of CMP with non-opioid analgesics.The purpose of this consensus is to present the application of nonsteroidal antiinflammatory drugs,serotonin norepinephrine reuptake inhibitors,serotonin and norepinephrine reuptake inhibitors,muscle relaxants,ion channel drugs and topical drugs in CMP.展开更多
The analgesic effect of Semen Coicis was observed with the sequential trial in 26 cases of severe functional dysmenorrhea. The results showed that the markedly effective rate was 90%, which was much better than th... The analgesic effect of Semen Coicis was observed with the sequential trial in 26 cases of severe functional dysmenorrhea. The results showed that the markedly effective rate was 90%, which was much better than that of the control group treated by indomethacin plus subcutaneous injection of atropine (P≤0.01).展开更多
Treatment of health problems that accompany aging often includes pharmacotherapy. It is thus common for older adults—and, increasingly, younger adults—to be on multiple medications, either prescription or over-the-c...Treatment of health problems that accompany aging often includes pharmacotherapy. It is thus common for older adults—and, increasingly, younger adults—to be on multiple medications, either prescription or over-the-counter (OTC). With the consumption of multiple medications, drug-drug interactions (DDIs) are a concern. The site of drug-drug interactions is often at the level of drug metabolism. If a drug inhibits (or enhances) the metabolism of another, the blood level (therapeutic effect) can be decreased below the required level, or adverse effects can increase. Because most currently used drugs are metabolized via cytochrome P450-catalyzed pathways, drug discovers seek drugs that are metabolized by alternate pathways. Medicinal chemists have come upon a strategy—the incorporation of oxetane rings in the drug structure—that increases the likelihood that a drug will not be metabolized via CYP450. The same modification gives other desirable physical properties to the molecule. Although there are no guarantees that there will be fewer DDIs or an absence of other unexpected problems, the strategy could pave the way for new drugs that are safer and easier to use with concomitant medications.展开更多
Pain is a sensation related to potential or actual damage in some tissue of the body. The mainstay of medical pain therapy remains drugs that have been around for decades, like non-steroidal anti-inflammatory drugs (...Pain is a sensation related to potential or actual damage in some tissue of the body. The mainstay of medical pain therapy remains drugs that have been around for decades, like non-steroidal anti-inflammatory drugs (NSAIDs), or opiates. However, adverse effects of opiates, particularly tolerance, limit their clinical use. Several lines of investigations have shown that systemic (intraperitoneal) administration of NSAIDs induces antinociception with some effects of tolerance. In this review, we report that repeated microinjection of NSAIDs analgin, clodifen, ketorolac and xefocam into the central nucleus of amygdala, the midbrain periaqueductal grey matter and nucleus raphe magnus in the following 4 days result in progressively less antinociception compared to the saline control testing in the tail-flick reflex and hot plate latency tests. Hence, tolerance develops to these drugs and cross-tolerance to morphine in male rats. These findings strongly support the suggestion of endogenous opioid involvement in NSAIDs antinociception and tolerance in the descending pain-control system. Moreover, the periaqueductal grey-rostral ventro-medial part of medulla circuit should be viewed as a pain-modulation system. These data are important for human medicine. In particular, cross-tolerance between non-opioid and opioid analgesics should be important in the clinical setting.展开更多
Objective: In order to manage the varied pathophysiological features of sickle cell disease (SCD), an array of drugs has to be used. The specific drugs used, however, depend on the locality. This study was aimed at fi...Objective: In order to manage the varied pathophysiological features of sickle cell disease (SCD), an array of drugs has to be used. The specific drugs used, however, depend on the locality. This study was aimed at finding out the drug regimen prescribed by clinicians to sickle cell disease patients who attended a Sickle Cell Clinic in Kumasi, Ghana. Method: The setting for the study is the Sickle Cell Clinic at the Komfo Anokye Teaching Hospital, Ghana, and a questionnaire was used as the study instrument. Information on drug prescription on each day of clinic visit was extracted from the medical records of the patients. Results: The drugs prescribed were “routine drugs” for SCD patients, analgesics, narcotics, anti-malarials, antibiotics, haematinics and miscellaneous drugs. The top ten commonly prescribed drugs were folic acid, diclofenac, ibuprofen, B-complex, routine drugs, artesunate/amodiaquin, paracetamol, penicillin V, amoxiclav and zincovit. Conclusion: Within the year, the drugs prescribed included those that could prevent vitamin and zinc deficiency due to continuing haemolysis, those that could mitigate the pain and inflammation from vaso-occlusion and reperfusion injury, as well as antibiotics to combat infections. Being a malarial-endemic region, prophylaxis with daraprim and symptomatic malaria fever therapy were common practices. This study has thus shown that the well-being of SCD patients in our typical tropical terrain, depends on haematinic vitamin/mineral supplements, anti-malarials, analgesics-anti-inflammatory, antipyretics and antibiotics.展开更多
胰腺癌是一种具有高度侵袭性的肿瘤,嗜神经生长是胰腺癌的重要生物学特点,其对神经的侵犯给患者带来极大的疼痛负担,严重影响患者生存质量和生存意志。世界卫生组织(World Health Organization,WHO)癌痛“三阶梯镇痛原则”是传统治疗癌...胰腺癌是一种具有高度侵袭性的肿瘤,嗜神经生长是胰腺癌的重要生物学特点,其对神经的侵犯给患者带来极大的疼痛负担,严重影响患者生存质量和生存意志。世界卫生组织(World Health Organization,WHO)癌痛“三阶梯镇痛原则”是传统治疗癌性疼痛的治疗方案,但由于其毒副作用明显、疗效差、易成瘾、易耐药以及医师临床用药不规范等因素,无法满足患者病情需要。近年来,随着介人技术的发展以及广泛的临床试验的开展,介入作为癌痛管理的“第四阶梯”,其治疗手段以及各种影像引导方式的发展与应用,如神经毁损术、^(125)I粒子植入术、患者自控镇痛泵技术、鞘内药物输注系统植入术等,临床疗效得到了有力证明,为癌痛患者提供了方便、安全、有效的治疗方式。展开更多
文摘Chronic musculoskeletal pain(CMP)is a common occurrence in clinical practice and there are a variety of options for the treatment of it.However,the pharmacological therapy is still considered to be a primary treatment.The recent years have witnessed the emergence of opioid crisis,yet there are no relevant guidelines on how to treat CMP with non-opioid analgesics properly.The Chinese Medical Association for the Study of Pain convened a panel meeting to develop clinical practice consensus for the treatment of CMP with non-opioid analgesics.The purpose of this consensus is to present the application of nonsteroidal antiinflammatory drugs,serotonin norepinephrine reuptake inhibitors,serotonin and norepinephrine reuptake inhibitors,muscle relaxants,ion channel drugs and topical drugs in CMP.
文摘 The analgesic effect of Semen Coicis was observed with the sequential trial in 26 cases of severe functional dysmenorrhea. The results showed that the markedly effective rate was 90%, which was much better than that of the control group treated by indomethacin plus subcutaneous injection of atropine (P≤0.01).
文摘Treatment of health problems that accompany aging often includes pharmacotherapy. It is thus common for older adults—and, increasingly, younger adults—to be on multiple medications, either prescription or over-the-counter (OTC). With the consumption of multiple medications, drug-drug interactions (DDIs) are a concern. The site of drug-drug interactions is often at the level of drug metabolism. If a drug inhibits (or enhances) the metabolism of another, the blood level (therapeutic effect) can be decreased below the required level, or adverse effects can increase. Because most currently used drugs are metabolized via cytochrome P450-catalyzed pathways, drug discovers seek drugs that are metabolized by alternate pathways. Medicinal chemists have come upon a strategy—the incorporation of oxetane rings in the drug structure—that increases the likelihood that a drug will not be metabolized via CYP450. The same modification gives other desirable physical properties to the molecule. Although there are no guarantees that there will be fewer DDIs or an absence of other unexpected problems, the strategy could pave the way for new drugs that are safer and easier to use with concomitant medications.
基金supported by the grant from Georgian National Science Foundation,No.GNSF/ST07/6-234
文摘Pain is a sensation related to potential or actual damage in some tissue of the body. The mainstay of medical pain therapy remains drugs that have been around for decades, like non-steroidal anti-inflammatory drugs (NSAIDs), or opiates. However, adverse effects of opiates, particularly tolerance, limit their clinical use. Several lines of investigations have shown that systemic (intraperitoneal) administration of NSAIDs induces antinociception with some effects of tolerance. In this review, we report that repeated microinjection of NSAIDs analgin, clodifen, ketorolac and xefocam into the central nucleus of amygdala, the midbrain periaqueductal grey matter and nucleus raphe magnus in the following 4 days result in progressively less antinociception compared to the saline control testing in the tail-flick reflex and hot plate latency tests. Hence, tolerance develops to these drugs and cross-tolerance to morphine in male rats. These findings strongly support the suggestion of endogenous opioid involvement in NSAIDs antinociception and tolerance in the descending pain-control system. Moreover, the periaqueductal grey-rostral ventro-medial part of medulla circuit should be viewed as a pain-modulation system. These data are important for human medicine. In particular, cross-tolerance between non-opioid and opioid analgesics should be important in the clinical setting.
文摘Objective: In order to manage the varied pathophysiological features of sickle cell disease (SCD), an array of drugs has to be used. The specific drugs used, however, depend on the locality. This study was aimed at finding out the drug regimen prescribed by clinicians to sickle cell disease patients who attended a Sickle Cell Clinic in Kumasi, Ghana. Method: The setting for the study is the Sickle Cell Clinic at the Komfo Anokye Teaching Hospital, Ghana, and a questionnaire was used as the study instrument. Information on drug prescription on each day of clinic visit was extracted from the medical records of the patients. Results: The drugs prescribed were “routine drugs” for SCD patients, analgesics, narcotics, anti-malarials, antibiotics, haematinics and miscellaneous drugs. The top ten commonly prescribed drugs were folic acid, diclofenac, ibuprofen, B-complex, routine drugs, artesunate/amodiaquin, paracetamol, penicillin V, amoxiclav and zincovit. Conclusion: Within the year, the drugs prescribed included those that could prevent vitamin and zinc deficiency due to continuing haemolysis, those that could mitigate the pain and inflammation from vaso-occlusion and reperfusion injury, as well as antibiotics to combat infections. Being a malarial-endemic region, prophylaxis with daraprim and symptomatic malaria fever therapy were common practices. This study has thus shown that the well-being of SCD patients in our typical tropical terrain, depends on haematinic vitamin/mineral supplements, anti-malarials, analgesics-anti-inflammatory, antipyretics and antibiotics.
文摘胰腺癌是一种具有高度侵袭性的肿瘤,嗜神经生长是胰腺癌的重要生物学特点,其对神经的侵犯给患者带来极大的疼痛负担,严重影响患者生存质量和生存意志。世界卫生组织(World Health Organization,WHO)癌痛“三阶梯镇痛原则”是传统治疗癌性疼痛的治疗方案,但由于其毒副作用明显、疗效差、易成瘾、易耐药以及医师临床用药不规范等因素,无法满足患者病情需要。近年来,随着介人技术的发展以及广泛的临床试验的开展,介入作为癌痛管理的“第四阶梯”,其治疗手段以及各种影像引导方式的发展与应用,如神经毁损术、^(125)I粒子植入术、患者自控镇痛泵技术、鞘内药物输注系统植入术等,临床疗效得到了有力证明,为癌痛患者提供了方便、安全、有效的治疗方式。