scholarly journals Corticosteroid-Sparing Effect of Chromoglycate Sodium and Nedocromil

1994 ◽  
Vol 3 (7) ◽  
pp. S25-S30 ◽  
Author(s):  
A. F. Capristo ◽  
M. Miraglia del Giudice Jr ◽  
C. Alfaro ◽  
N. Maiello
Keyword(s):  
Side Effects ◽  
Combined Treatment ◽  
Provocation Test ◽  
Double Bind ◽  
Hypertonic Solution ◽  
Inflammatory Drugs ◽  
Bronchial Hyper Responsiveness ◽  
Sparing Effect ◽  
Dose Dependent

The most appropiate management for bronchial asthma is the control of airway inflammation. Corticosteroids are the most effective anti-inflammatory drugs available, but they have a number of side effects; most of these are dose-dependent. In children, asthma control should be accomplished with low steroid doses possibly given by inhalation. In a double-bind placebo-controlled crossover study a group of children with mild to moderate asthma received NED 16 mg/day or BDP 400 μg/day. Values for FEV1, PEF, symptoms use ofbronchodilators overlapped, whereas bronchial hyper-responsiveness assessed by histamine bronchoprovocation challenge was better with BDP than NED. In another case, one boy with high bronchial hyper-reactivity assessed by provocation test with hypertonic solution, experienced a significant improvement only after 2 weeks of therapy with Deflazacort (2 mg/Kg/day) followed by 4 months on combined treatment with NED (16 mg/day) and BDP (300 μ/day). Authors conclude that NED could have a steroidsparing effect over long-term use.

Natural inhibitors against potential targets of cyclooxygenase, lipoxygenase and leukotrienes

2021 ◽  
Vol 25 ◽  
Author(s):  
Rishita Dey ◽  
Sudatta Dey ◽  
Asmita Samadder ◽  
Anil Saxena ◽  
Sisir Nandi
Keyword(s):  
Rheumatoid Arthritis ◽  
Arachidonic Acid ◽  
Side Effects ◽  
Extensive Study ◽  
Alternative Medicines ◽  
Great Acceptance ◽  
Inflammatory Drugs ◽  
Lox Inhibitors ◽  
Natural Inhibitors

Background: The cyclooxygenase (COX) and lipoxygenase (LOX) enzymes catalyze the production of pain mediators like prostaglandins (PGs) and leukotrienes (LTs) respectively from arachidonic acid. Introduction: The COX and LOX enzyme modulators are responsible for the major PGs and LTs mediated complications like asthma, osteoarthritis, rheumatoid arthritis, cancer, Alzheimer’s disease, neuropathy and cardiovascular syndromes (CVS). Many synthetic nonsteroidal anti-inflammatory drugs (NSAIDs) used in the treatment have serious side effects like nausea, vomiting, hyperacidity, gastrointestinal ulcers, CVS, etc. Methods: The natural inhibitors of pain mediators have great acceptance worldwide due to fewer side effects on long-term uses. The present review is an extensive study of the advantages of plant-based vs synthetic inhibitors. Results: These natural COX and LOX inhibitors control inflammatory response without causing side-effect-related complicacy. Conclusion: Therefore, the natural COX and LOX inhibitors may be used as alternative medicines for the management of pain and inflammation due to their less toxicity and resistivity.

Gastroprotection during long-term NSAID use – what we know after 120 years of observations?

2021 ◽  
Vol 14 (2) ◽  
pp. 132-137
Author(s):  
Michał Lipiński
Keyword(s):  
Side Effects ◽  
Risk Stratification ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Broad Spectrum ◽  
Nsaid Therapy ◽  
Gastrointestinal Complications ◽  
Gastrointestinal Side Effects ◽  
Inflammatory Drugs

Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly prescribed classes of medications. The broad spectrum of side effects following long-term NSAID therapy includes mainly, but not only, gastrointestinal complications. Risk stratification of the gastrointestinal complications events is an important element of planning NSAIDs therapy, which allows to determine the indications for the use of proton pump inhibitors. This article presents the criteria for assessment and the method of adequate prevention of gastrointestinal side effects in patients receiving long-term NSAID therapy.

scholarly journals Steroid-induced Glaucoma: An Avoidable Irreversible Blindness

2017 ◽  
Vol 11 (2) ◽  
pp. 67-72 ◽  
Author(s):  
SS Pandav ◽  
Savleen Kaur ◽  
Sushmita Kaushik ◽  
Sonia Phulke
Keyword(s):  
Intraocular Pressure ◽  
Side Effects ◽  
Ocular Hypertension ◽  
Chronic Administration ◽  
Systemic Steroid ◽  
Over The Counter ◽  
Ocular Side ◽  
Inflammatory Drugs ◽  
Irreversible Blindness

ABSTRACT Steroids are a group of anti-inflammatory drugs, commonly used to treat ocular and systemic conditions. Unmonitored use of steroids especially in eye drop formulations is common in situations when it is easily available over-the-counter, resulting in undesirable side effects. Among the ocular side effects, cataract and glaucoma are common. Steroid-induced ocular hypertension was reported in 1950, when long-term use of systemic steroid was shown to increase the intraocular pressure (IOP). Chronic administration of steroids in any form with raised IOP can cause optic neuropathy resulting in steroid-induced glaucoma. This review describes the pathophysiology and epidemio­logy of steroid-induced glaucoma, recognition of side effects, and principles of management. The purpose is to familiarize all clinicians with the potential dangers of administering steroids without monitoring the eye and the dangers of irreversible blindness in some instances of habitual self-prescription by patients. How to cite this article Phulke S, Kaushik S, Kaur S, Pandav SS. Steroid-induced Glaucoma: An Avoidable Irreversible Blindness. J Curr Glaucoma Pract 2017;11(2):67-72.

scholarly journals The use of hyaluronic acid preparations for the treatment of osteoarthritis of the major joints

2021 ◽  
Vol 4 (2) ◽  
pp. 11-16
Author(s):  
O Kalashnikov ◽  
O Sulyma ◽  
T Osadchuk ◽  
V Zayets ◽  
T Nizalov ◽  
...  
Keyword(s):  
Side Effects ◽  
Adverse Side Effects ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
High Level ◽  
Time Of Administration ◽  
Inflammatory Effect ◽  
The Ideal

The authors of the article analyzed the experience of domestic and foreign experts in the effectiveness of the use of HA preparations in the treatment of osteoarthritis of major joints. Background  and  Objective. To analyze the literature sources in order to determine the effectiveness of the use of HA preparations in the treatment of osteoarthritis of major ligaments. Materials and methods. Articles in specialized scientific journals and collections, Internet resource.Results. The analysis of literature sources determined the important role of HA preparations in the supplying and functioning of the articular cartilage. Researchers are inclined to believe that the ideal HA preparation should be as close as possible to the physiological HA of the synovial fluid of the joint. The developed domestic drug Artro-Patch fully corresponds to these parameters. Conclusions. The use of modern injectable HA preparations is advisable at stages 1–3 of OA. Anti-inflammatory effect of HA preparations makes it possible to reduce the dose and time of administration of non-steroidal anti-inflammatory drugs and, as a consequence, reduce the risk of developing many adverse side effects of NSAIDs. The high level of safety of HA preparations, the absence of serious side effects during their long-term use determine their widespread use in the clinical practice of modern orthopedists.

scholarly journals Tolerability and Efficacy of Long-Term Medical Therapy in Primary Aldosteronism

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A301-A302
Author(s):  
Troy Puar ◽  
Fengjie Tang ◽  
Lih-Ming Loh ◽  
Roger Foo ◽  
Wann Jia Loh ◽  
...  
Keyword(s):  
Side Effects ◽  
Medical Therapy ◽  
Primary Aldosteronism ◽  
Male Gender ◽  
Monitoring Strategy ◽  
Biochemical Control ◽  
Duration Of Treatment ◽  
Limited Efficacy ◽  
Dose Dependent

Abstract Introduction: Patients with primary aldosteronism (PA) have increased cardiovascular risk and studies have found that medical therapy fails to ameliorate this. This may be due to side effects and limited efficacy of medications at tolerable doses. Methods: We conducted a retrospective study on 201 patients with PA treated with medical therapy (spironolactone, eplerenone or amiloride) for PA from 2000–2020 at two tertiary centres. Patients were assessed for efficacy to achieve clinical and biochemical control, and for side effects. Results: 53.7% of patients achieved blood pressure <140/90mmHg, 44.6% achieved serum potassium ≥4.3mmol/L, and 63.2% achieved renin levels >1ng/ml/hr. Concordance between biochemical control as assessed by potassium and renin levels was 49%. 45.3% of patients experienced side effects, with 8.5% switching to another medication, 18.9% decreasing dose, and 10.0% stopping medications altogether. Risk factors for side effects were spironolactone use, dose ≥50mg, duration of treatment ≥1 year, male gender and unilateral PA. Patients with unilateral PA, compared to bilateral PA, used higher median doses of spironolactone, 75mg vs 50mg, P<0.001, but more had persistent hypokalemia, 20.5% versus 6.4%, P=0.007. 44 patients with unilateral PA underwent surgery after initial medical therapy, which further improved systolic and diastolic BP, from 142 to 134mmHg, P<0.001, and from 85 to 79mmHg, P<0.001, respectively. Conclusion: Dose-dependent side effects limit the efficacy of medical therapy in PA. Future prospective studies should assess the best monitoring strategy for biochemical control during long-term medical therapy. In patients with unilateral PA, surgery remains a better option compared to life-long medications.

scholarly journals A review study of targeting of AAK1 and JAK1/2 using baricitinib in COVID-19 infected human cells

2020 ◽  
Vol 16 (supplement) ◽  
pp. 9-15
Author(s):  
Abeer M Al-Humaidhi
Keyword(s):  
Side Effects ◽  
Inhibitory Effect ◽  
Term Treatment ◽  
Long Term Treatment ◽  
Pros And Cons ◽  
Experimental Trials ◽  
Pharmaceutical Agents ◽  
Dose Dependent ◽  
A Current

     The outbreak of a current public health coronavirus 2019 disease is a causative agent of a serious acute respiratory syndrome and even death. COVID-19 has exposed to multi-suggested pharmaceutical agents to control this global disease. Baricitinib, a well-known antirheumatic agent, was one of them. This article reviews the likely pros and cons of baricitinib in attenuation of COVID-19 based on the mechanism of drug action as well as its pharmacokinetics. The inhibitory effect of baricitinib on receptor mediated endocytosis promoter, AKK1, and on JAK-STAT signaling pathway is benefacial in inhibition of both viral assembling and inflammation. Also, its pharmacokinetic has encouraged the physicians toward the drug selection for COVID-19 treatment. On the other hand, most of baricitinib side effects are dose-dependent. In conclusion, targeting of AAK1 and JAK1/2 using baricitinib has predicted to be potential and effective with minimal side effects in management COVID-19 infected patients for a short therapeutic dosing period. Laboratory monitoring should be considered for some parameters. However, experimental trials are mandatory for a long-term treatment with a lower dose of baricitinib to evaluate its effectiveness and safety in patients with moderate COVID-19 infection.

Side effects of nonsteroidal anti-inflammatory drugs: mechanisms and possibilities of drug correction

1997 ◽  
Vol 78 (3) ◽  
pp. 213-217
Author(s):  
L. E. Ziganshina ◽  
A. U. Ziganshin
Keyword(s):  
Side Effects ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

The problem of complications during therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) is extremely relevant due to the need for long-term (often lifelong) use of these drugs, as well as due to their uncontrolled use by many patients.

scholarly journals HYALURONIC ACID PREPARATIONS IN BIG JOINT OSTEOARTHRITIS MANAGEMENT

2021 ◽  
pp. 80-96
Author(s):  
O. V. Kalashnikov ◽  
O. M. Sulyma ◽  
T. I. Osadchuk ◽  
А. V. Kalashnikov ◽  
V. B. Zayets ◽  
...  
Keyword(s):  
Side Effects ◽  
Term Treatment ◽  
Safety Level ◽  
Orthopedic Surgeons ◽  
Effi Ciency ◽  
Long Term Treatment ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
And Function

Abstract. The authors of the paper analyzed the experience of domestic and foreign experts on the effi-ciency of HA preparation in big joint osteoarthritis management. Task of the study is to analyze literature sources to identify the efficiency of HA preparations in big joints osteoarthritis management. Materials and methods: articles published by specialized scientific journals, paper collections, internet sources. Results: The analysis of literature sources determined the essential role of HA in joint cartilage nutrition and function. The researches tend to believe that an ideal HA preparation must be as close as possible to the physiological HA of joint’s synovial fluid. The HA preparation elaborated in our state, Artropatch meets these demands completely. Conclusions. Modern HA injectable preparations are expedient on the 1-3 stage of OA. Anti-inflammatory effect of HA preparations predetermines the possibility to decrease the intake dose and period of non-steroid anti-inflammatory drugs, consequently decreasing the risk of many unfavorable side effects of NSAIPs. The high safety level of HA preparations and no significant side effects after long-term treatment make them widely used in clinical practice of modern orthopedic surgeons.

Nonsteroidal Anti-Inflammatory Drugs, Alone or Combined With Opioids, for Cancer Pain

2004 ◽  
Vol 22 (10) ◽  
pp. 1975-1992 ◽  
Author(s):  
Ewan McNicol ◽  
Scott Strassels ◽  
Leonidas Goudas ◽  
Joseph Lau ◽  
Daniel Carr
Keyword(s):  
Side Effects ◽  
Cancer Pain ◽  
Limited Data ◽  
Inclusion Criteria ◽  
Clinical Difference ◽  
Significant Difference ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Meta Analyses ◽  
Dose Dependent

Purpose To assess the safety and efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs), alone or combined with opioids, for the treatment of cancer pain. Patients and Methods Forty-two trials involving 3,084 patients met inclusion criteria: eight compared NSAID with placebo; 13 compared one NSAID with another; 23 compared NSAID with opioid, NSAID or opioid versus NSAID plus opioid combinations, or NSAID plus opioid combinations versus NSAID plus opioid combinations; and nine studies assessed the effect of increasing NSAID dose. Results Sixteen studies lasted 1 week or longer and 11 evaluated a single dose. Seven of eight trials demonstrated superior efficacy of single doses of NSAID compared with placebo. Only four of 13 studies reported increased efficacy of one NSAID compared with another; four other studies found that one NSAID had fewer side effects than one or more others. Thirteen of 14 studies found no difference, or minimal clinical difference, when comparing an NSAID plus opioid combination versus either drug alone. Comparisons between various NSAID plus opioid combinations were inconclusive. Four studies demonstrated increased efficacy with increased NSAID dose, without dose-dependent increases in side effects. Conclusion Heterogeneity of study methods and outcomes precluded meta-analyses. Short duration of studies undermines generalization of findings on efficacy and safety. On the basis of limited data, NSAIDs appear to be more effective than placebo for cancer pain; clear evidence to support superior safety or efficacy of one NSAID compared with another is lacking; and trials of combinations of an NSAID with an opioid have disclosed either no significant difference, or at most a slight but statistically significant advantage, compared with either single entity.

scholarly journals Steroid Sparing Effect of Omalizumab in Seropositive Allergic Bronchopulmonary Aspergillosis

2015 ◽  
Vol 6 (2) ◽  
pp. ar.2015.6.0128 ◽  
Author(s):  
Keith T. Beam ◽  
Christopher A. Coop
Keyword(s):  
Cystic Fibrosis ◽  
Side Effects ◽  
Respiratory Symptoms ◽  
Immunoglobulin E ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Steroid Use ◽  
Sparing Effect ◽  
Airway Colonization ◽  
Steroid Sparing

Background Allergic bronchopulmonary aspergillosis (ABPA) is a common serious hypersensitivity reaction to airway colonization with Aspergillus in patients with asthma or cystic fibrosis. While steroids are effective in controlling the respiratory symptoms of ABPA, they have many side effects that make them undesirable for long term use. Antifungals have been used to reduce dependency on systemic steroids but long term use can be limited by side effects and there is the possibility of developing resistance to azoles. Some clinicians have successfully used anti-immunoglobulin E (anti-IgE) therapy in various populations, though it is frequently added to antifungals. Objective Further describe the utility of anti-IgE therapy for ABPA for patients unable to tolerate antifungals. Methods We describe the case of a patient with serologic ABPA who did not tolerate therapy with antifungals but was able to significantly reduce her average daily steroid use while receiving anti-IgE therapy with omalizumab added to her other respiratory medications. Results After therapy with omalizumab, our patient was able to reduce her need for daily corticosteroids by nearly 80%. Conclusions Omalizumab may reduce corticosteroid dependence in patients with allergic bronchopulmonary aspergillosis for patients unable to tolerate antifungals, though use may be limited by cost. Additional studies are needed. ClinicalTrial.gov identifier NCT00787917.

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