scholarly journals Nonsteroidal Anti-Inflammatory Drugs and Opioids in Postsurgical Dental Pain

2020 ◽  
Vol 99 (7) ◽  
pp. 777-786 ◽  
Author(s):  
E.V. Hersh ◽  
P.A. Moore ◽  
T. Grosser ◽  
R.C. Polomano ◽  
J.T. Farrar ◽  
...  
Keyword(s):  
Naproxen Sodium ◽  
Analgesic Efficacy ◽  
Optimal Dose ◽  
Dental Pain ◽  
Third Molars ◽  
Short Course ◽  
Surgical Extraction ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Versus Risk

Postsurgical dental pain is mainly driven by inflammation, particularly through the generation of prostaglandins via the cyclooxygenase system. Thus, it is no surprise that numerous randomized placebo-controlled trials studying acute pain following the surgical extraction of impacted third molars have demonstrated the remarkable efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen sodium, etodolac, diclofenac, and ketorolac in this prototypic condition of acute inflammatory pain. Combining an optimal dose of an NSAID with an appropriate dose of acetaminophen appears to further enhance analgesic efficacy and potentially reduce the need for opioids. In addition to being on average inferior to NSAIDs as analgesics in postsurgical dental pain, opioids produce a higher incidence of side effects in dental outpatients, including dizziness, drowsiness, psychomotor impairment, nausea/vomiting, and constipation. Unused opioids are also subject to misuse and diversion, and they may cause addiction. Despite these risks, some dental surgical outpatients may benefit from a 1- or 2-d course of opioids added to their NSAID regimen. NSAID use may carry significant risks in certain patient populations, in which a short course of an acetaminophen/opioid combination may provide a more favorable benefit versus risk ratio than an NSAID regimen.

scholarly journals O USO DE ANTIINFLAMATÓRIOS ESTEROIDAIS E NÃO ESTERIODAIS NO CONTROLE DA DOR E DO EDEMA EM CIRURGIA DE TERCEIROS MOLARES

2016 ◽  
Vol 7 (1) ◽  
Author(s):  
Ricardo Natã Fonseca Silva ◽  
Lúcia Coelho Garcia Pereira
Keyword(s):  
Literature Review ◽  
Oral Cavity ◽  
Postoperative Period ◽  
Dental Arch ◽  
Third Molars ◽  
Drug Classes ◽  
Surgical Extraction ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Congenitally Missing

Introduction: Third molars are the last teeth to erupt through the oral cavity and in some cases they are congenitally missing, display impaction or remain included. There are many reasons for their removal: decay, lack of space in the dental arch or problems during its eruption. During surgical extraction, oral tissues may be injured, which causes painful symptoms and edema. To combat these surgical complications, it is necessary the use of drugs that fight inflammation, non-steroidal anti-inflammatory drug (NSAIDs) and corticosteroids. To obtain best results, the combination of NSAIDs and steroidal anti-inflammatory drugs are used in patients, either as preemptive medication and as postoperative medication. Objective: Performing a literature review in order to determine which drug classes have better postoperative outcomes for pain and swelling in of third molars extraction. Materials and methods: Studies present in SciELO, Lilacs and Pubmed databases published between 2000-2014 were included. Final considerations: Corticosteroids are used preemptively in order to reduce swelling frame, while NSAIDs have greater use in the postoperative period, in an attempt to reduce the pain.

Short-Course Systemic and Topical Non-Steroidal Anti-Inflammatory Drugs: Impact on Adverse Renal Events in Older Adults with Co-Morbid Disease

Drugs & Aging ◽  
2020 ◽  
Author(s):  
Cynthia Ciwei Lim ◽  
Andrew Teck Wee Ang ◽  
Hanis Bte Abdul Kadir ◽  
Puay Hoon Lee ◽  
Bandy Qiuling Goh ◽  
...  
Keyword(s):  
Older Adults ◽  
Short Course ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

scholarly journals USO DE ANALGÉSICOS Y ANTIINFLAMATORIOS EN UN SERVICIO DE CIRUGÍA BUCAL EN MEDELLÍN, 2013-2015

2019 ◽  
Vol 30 (2) ◽  
Author(s):  
Stefanía Hernández Viana ◽  
Natalia Silva Gómez ◽  
David Andrés Gálvis Pareja ◽  
María Cecilia Martínez Pabón
Keyword(s):  
Oral Surgery ◽  
Descriptive Study ◽  
Third Molars ◽  
Prescription Pattern ◽  
Drug Of Choice ◽  
Dental Practitioners ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
School Of Dentistry ◽  
Clinical Records

Introduction: dental surgical procedures trigger an inflammatory response, for which dental practitioners prescribe analgesic and anti-inflammatory medications using pharmacological guidelines that require knowledge on the use of medicines in a given environment. The aim of the present study was to identify the analgesics and anti-inflammatory drugs most commonly prescribed at the oral surgery service of the Universidad de Antioquia School of Dentistry. Methods: this retrospective descriptive study reviewed the clinical records of the oral surgery service in the period January 2013-August 2015. A total of 1,177 records were reviewed, and 709 were selected for analysis. Results: 53.1% of the drugs prescribed were non-selective Nonsteroidal Anti-Inflammatory Drugs (NSAIDs). Ibuprofen was formulated in 26.7% of all cases, followed by nimesulide with 24.1% and the combination of acetaminophen plus meloxicam with 10.2%. This same prescription pattern was observed in patients reporting no additional relevant medical history. In the case of gastric history, nimesulide was the drug of choice. 84% of all procedures were surgical extractions of third molars, with ibuprofen 600 mg postoperative for three days as the main therapeutic scheme. Conclusion: ibuprofen, nimesulide, and the combination acetaminophen plus meloxicam were the main analgesics and anti-inflammatory drugs prescribed in this study, according to medical and surgical records.

scholarly journals Analgesic efficacy of non-steroidal anti-inflammatory drugs in experimental pain in humans

1993 ◽  
Vol 36 (5) ◽  
pp. 417-425 ◽  
Author(s):  
JUDITH S. WALKER ◽  
JESUS F. ARROYO ◽  
TUAN NGUYEN ◽  
RICHARD O. DAY
Keyword(s):  
Analgesic Efficacy ◽  
Experimental Pain ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

THREE CARDINAL LESSONS FROM ADAPT – 10 YEARS ON

2014 ◽  
pp. 1-5
Author(s):  
J.C.S. Breitner ◽  
C.G. Lyketsos
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Trial Design ◽  
Naproxen Sodium ◽  
Prevention Trial ◽  
Phase Iii ◽  
Increased Risk ◽  
Phase Iii Trials ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

The Alzheimer’s Disease Anti-inflammatory Prevention Trial was a placebo-controlled three-arm pharmaco-prevention trial of the non-steroidal anti-inflammatory drugs naproxen sodium and celecoxib for prevention of incident Alzheimer’s disease (AD) dementia in older (aged 70 and over) adults. Although subjects were at increased risk of symptoms because of a firstdegree family history, they were meant to be cognitively healthy at enrollment. ADAPT encountered several problems that resulted in the termination of its treatments after only two years on average. Interim results were complex but potentially interesting. In the end, however, the results were null. We describe the complications that prevented ADAPT from achieving conclusive results, and suggest that these could have been avoided if the trial design and execution had been better guided by preliminary data. We believe such data should be available before beginning further ambitious phase III trials of this sort, and we suggest a broad method by which such data can be accumulated with reasonable economy.

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