scholarly journals Dispensing patterns of drugs used for neuropathic pain and adherence to NeuPSIG guideline: an observational study

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Bahia Chahine ◽  
Farah Al Souheil
Keyword(s):  
Neuropathic Pain ◽  
Observational Study ◽  
Adult Population ◽  
Pain Disorder ◽  
Limited Data ◽  
Painful Neuropathy ◽  
Combination Treatments ◽  
Inflammatory Drugs ◽  
Underlying Mechanisms ◽  
Disorder Type

Abstract Background Neuropathic pain is a common chronic ailment that can be challenging to treat because of the heterogeneity of its etiologies, symptoms, and underlying mechanisms. Drugs to treat neuropathic pain are highly prescribed; however, limited data exist on the rates and patterns of dispensing in Lebanon. This study was conducted to assess the patterns of dispensing neuropathic pain drugs and adherence to NeuPSIG guideline in the Lebanese adult population. An observational study was conducted at 30 community pharmacies over 10 months. Adults presenting to the community pharmacy with a prescription of at least one pain medication and diagnosed with a neuropathic pain disorder were interviewed using a questionnaire that included demographic characteristics of patients, comorbidities, neuropathic pain disorder type, physicians’ specialty, and the class and number of prescribed medications. Results A total of 360 patients diagnosed with painful neuropathy were enrolled in our study. The mean patients’ age was 50.2 years. Guideline-recommended first-line agents (serotonin–norepinephrine reuptake inhibitors, tricyclic antidepressants, and gabapentinoids) were prescribed to 278 patients (77.2%), with pregabalin being the most used drug (60.5%), nonsteroidal anti‐inflammatory drugs (46.8%), opioids (15.8%), and topical agents (5.5%). Combination treatment for neuropathic pain was prescribed to 78.3% of patients. Conclusions In Lebanon, neuropathic pain management comply with the international NeuPSIG guideline. Pregabalin is the most commonly used drug, and combination treatments are usually needed to alleviate neuropathic pain.

scholarly journals Blocking Mammalian Target of Rapamycin (mTOR) Alleviates Neuropathic Pain Induced by Chemotherapeutic Bortezomib

2018 ◽  
Vol 48 (1) ◽  
pp. 54-62 ◽  
Author(s):  
Zongsheng Duan ◽  
Jing Li ◽  
Xiaochuan Pang ◽  
Hushan Wang ◽  
Zhenbo Su
Keyword(s):  
Neuropathic Pain ◽  
Substance P ◽  
Mammalian Target Of Rapamycin ◽  
Target Of Rapamycin ◽  
Cold Sensitivity ◽  
Signal Pathways ◽  
Painful Neuropathy ◽  
Systemic Injection ◽  
Underlying Mechanisms ◽  
Cold Hypersensitivity

Background/Aims: Bortezomib (BTZ) is largely used as a chemotherapeutic agent for the treatment of cancer. However, one of the significant limiting complications of BTZ is painful peripheral neuropathy during BTZ therapy. Drugs preventing and/or treating the painful symptoms induced by BTZ are lacking since the underlying mechanisms leading to neuropathic pain remain largely unclear. The purposes of this study were to examine 1) the effects of blocking mammalian target of rapamycin (mTOR) on mechanical pain and cold hypersensitivity evoked by BTZ and 2) the underlying mechanisms responsible for the role of mTOR in regulating BTZ-induced neuropathic pain. Methods: Behavioral test was performed to determine mechanical pain and cold sensitivity in a rat model. Western blot analysis and ELISA were used to examine expression of mTOR and phosphatidylinositide 3-kinase (p-PI3K) signals, and the levels of substance P and calcitonin gene-related peptide (CGRP). Results: Systemic injection of BTZ significantly increased mechanical pain and cold sensitivity as compared with control animals (P< 0.05 vs. control rats). The expression of p-mTOR, mTOR-mediated phosphorylation of p70 ribosomal S6 protein kinase 1 (p-S6K1), 4E–binding protein 4 (p-4E-BP1) as well as p-PI3K was amplified in the dorsal horn of spinal cord of BTZ rats as compared with control rats. Blocking mTOR by intrathecal infusion of rapamycin attenuated mechanical pain and cold hypersensitivity. Blocking PI3K signal also attenuated activities of mTOR, which was accompanied with decreasing neuropathic pain. Inhibition of either mTOR or PI3K blunted enhancement of the spinal substance P and CGRP in BTZ rats. Conclusions: The data for the first time revealed specific signaling pathways leading to BTZ-induced peripheral neuropathic pain, including the activation of mTOR and PI3K. Inhibition of these signal pathways alleviates pain. Targeting one or more of these signaling molecules may present new opportunities for treatment and management of peripheral painful neuropathy observed during chemotherapeutic application of BTZ.

Analysis of acute naproxen administration on memory in young adults: A randomized, double-blind, placebo-controlled study

2017 ◽  
Vol 31 (10) ◽  
pp. 1374-1376
Author(s):  
Jack H Wilson ◽  
Amy H Criss ◽  
Sean A Spangler ◽  
Katherine Walukevich ◽  
Sandra Hewett
Keyword(s):  
Young Adults ◽  
Healthy Adult ◽  
Adult Population ◽  
Critical Role ◽  
Random Order ◽  
Controlled Study ◽  
High Dose ◽  
Short Term ◽  
Double Blind ◽  
Inflammatory Drugs

Nonsteroidal anti-inflammatory drugs work by non-selectively inhibiting cyclooxygenase enzymes. Evidence indicates that metabolites of the cyclooxygenase pathway play a critical role in the process of learning and memory. We evaluated whether acute naproxen treatment impairs short-term working memory, episodic memory, or semantic memory in a young, healthy adult population. Participants received a single dose of placebo or naproxen (750 mg) in random order separated by 7–10 days. Two hours following administration, participants completed five memory tasks. The administration of acute high-dose naproxen had no effect on memory in healthy young adults.

scholarly journals Non-steroidal anti-inflammatory drugs and gastroprotection in primary health care users

2020 ◽  
Author(s):  
Driton Shabani ◽  
Ardiana Murtezani ◽  
Bernard Tahirbegolli ◽  
Argjira Juniku–Shkololli ◽  
Zana Ibraimi
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Urban Areas ◽  
Care Service ◽  
Adult Population ◽  
Health Care Service ◽  
Primary Health ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Gastroprotective Drugs

Objective: The aim of this study is to assess the prevalence of gastroprotection and identify the main factors that influence the taking of protective drugs among the adult population, who are treated with non-steroidal anti-inflammatory drugs (NSAID). Material and Methods: This study was cross-sectional, conducted by including a contingent of 800 users of primary health care services (n=369, 46% males and n=431, 54% females). Included in the study were individuals of both sexes aged 18+ who sought counselling or treatment during the three-month period. The data collection of this study was based on the completion of a structured questionnaire, which included questions related to the use of NSAID and the modalities for the description and application of these drugs, and simultaneous taking of gastroprotective drugs. Results: The prevalence of the gastroprotective drugs use was higher among the elderly, individuals living in urban areas, those with higher education, those with daily use of NSAID, individuals receiving prescriptions from their own doctors, and those suffering side effects from the use of NSAID, as well as subjects that had a longer duration of NSAID use. Conclusion: This paper demonstrates the need to improve the quality of primary health care service through informing and educating patients regarding the need to take gastro-protective drugs for those in high risk of adverse effects manifested by the use of NSAID.

scholarly journals Acute Myopericarditis in a Pediatric Patient after First Dose of Pfizer BioNTech COVID - 19 Vaccination: First Case Report in the Kingdom of Bahrain

2021 ◽  
Vol 33 (4) ◽  
pp. 29-32
Author(s):  
Ghada Al Qassim ◽  
Vimalarani Arulselvam ◽  
Suad R Al Amer ◽  
Salah Al Ghanem ◽  
Neale Nicola Kalis
Keyword(s):  
Case Report ◽  
Adverse Events ◽  
Pediatric Patient ◽  
Task Force ◽  
Limited Data ◽  
First Case ◽  
National Task ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Coronavirus disease 201 9 (COVID - 1 9 ) vaccination for children over 12 years of age began on May 2021 in the kingdom of Bahrain. Very limited data is available regarding the adverse events related to COVID -19 vaccination in children. This is a case report of a 12-year-old previously healthy boy with acute myopericarditis who presented on day 5 after the first dose of Pfizer COVID - 19 vaccination. Other causes of acute myopericarditis were ruled out. He was treated with non - steroidal anti-inflammatory drugs and recovered fully. This case of vaccine-induced myocarditis was reported to the national task force of Bahrain for combating COVID - 19.

scholarly journals An observational study of Atyambupan as Hetu (nidan) in diabetes mellitus (Madhumeha) and its preventive treatment

2021 ◽  
Vol 9 (02) ◽  
Author(s):  
Dr. Priyanka Kandikattiwar
Keyword(s):  
Diabetes Mellitus ◽  
Drinking Water ◽  
Observational Study ◽  
Water Intake ◽  
Adult Population ◽  
Preventive Treatment ◽  
Excessive Drinking ◽  
Dietary Factor ◽  
The World ◽  
Excessive Water

ABSTRACT:- It is common lifelong health disease. India had more diabetics than any other country in the world, according to the International Diabetes Foundation, although the country has now been surpassed in the top spot by China. Diabetes currently affects more than 62 million Indians, which is more than 7.1% of the adult population. The average age on onset is 42.5 years. Nearly 1 million Indians die due to diabetes every year1. According to WHO Diabetes is a Life style disorder. The main cause of diabetes is there is restless lifestyle, stress, unnatural dietary factor. It has turned out biggest silent killer today’s in world. In Ayurveda diabetes can be correlated with Madhumeh which is a Vata predominant disease. Causes of Madhumeh are Diwaswap, Atyaambupan(excessive water intake), Guru, Madhur, Shita, Snighatdh, Ahara Sevan2 etc. Now a day most of people think drinking large amounts of water is helpful for proper skin health, Digestion, and Health, etc? Claims have been made that excessive drinking water gives you a radiant skin, and healthy while others people say it has no effect and it causes many disease and side effect .so here is effort to highlight the Atyambupan (Excessive water intake) as Nidan of Diabetes given in Ayurvedic text as well as occurring at present and make aware the society to prevent the disease through Nidanparivarjan.

FEATURES OF PERICARDIAL DISEASES IN ELDERLY PERSONS (LITERATURE REVIEW)

2021 ◽  
pp. 245-250
Author(s):  
Н.Ю. Шимохина ◽  
М.М. Петрова
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Elderly Patients ◽  
Elderly People ◽  
Malignant Neoplasms ◽  
Elderly Persons ◽  
Limited Data ◽  
Pericardial Diseases ◽  
Inflammatory Drugs ◽  
European Society Of Cardiology

В рекомендациях Европейского общества кардиологов (ESC), выпущенных в 2015 г., представлены ограниченные данные о ведении пожилых пациентов с перикардитом. У лиц пожилого возраста высока вероятность наличия таких факторов риска перикардита, как злокачественные новообразования или почечная недостаточность. Трудности диагностики заболеваний перикарда могут возникнуть в группе пожилых пациентов с сопутствующей ИБС и развитием острого инфаркта миокарда. В терапии перикардита у пожилых пациентов в первую очередь используют нестероидные противовоспалительные препараты, предпочтительно аспирин. Лицам пожилого возраста не рекомендован прием индометацина. Сложности медикаментозного лечения могут быть связаны с полипрагмазией и когнитивными нарушениями у пожилых пациентов с коморбидными заболеваниями. Прогноз в группе пациентов старше 60 лет, перенесших перикардит, менее благоприятен в сравнении с более молодыми лицами. The recommendations of the European Society of Cardiology (ESC), released in 2015, provide limited data on the management of elderly patients with pericarditis. Elderly people are more likely to have pericarditis risk factors such as malignant neoplasms or renal failure. Difficulties in diagnosing pericardial diseases may occur in a group of elderly patients with concomitant coronary heart disease and the development of acute myocardial infarction. In the treatment of pericarditis in elderly patients, non-steroidal anti-inflammatory drugs, preferably aspirin, are primarily used. Elderly people are not recommended taking indomethacin. Difficulties of drug treatment may be associated with polypharmacy and cognitive impairment in elderly patients with comorbid diseases. The prognosis in the group of patients older than 60 who have undergone pericarditis is less favorable in comparison with younger persons.

Is Burning Mouth Syndrome a Neuropathic Pain Disorder? A Systematic Review

2021 ◽  
Vol 35 (3) ◽  
pp. 218-229
Author(s):  
Isabel Carreño-Hernández ◽  
Juliana Cassol-Spanemberg ◽  
Eugenia de Rivera-Campillo ◽  
Albert Estrugo-Devesa ◽  
José López-López
Keyword(s):  
Systematic Review ◽  
Neuropathic Pain ◽  
Burning Mouth Syndrome ◽  
Pain Disorder ◽  
Burning Mouth

Rationalized Approach for The Treatment of Neuropathic Pain

2021 ◽  
pp. 2887-2895
Author(s):  
Srishti Chaudhary ◽  
Pankaj Kumar Prashar ◽  
Anamika Gautam ◽  
Ankita Sood ◽  
Sachin Kumar Singh ◽  
...  
Keyword(s):  
Nervous System ◽  
Neuropathic Pain ◽  
Good Choice ◽  
Opioid Agonist ◽  
Painful Condition ◽  
Inflammatory Drugs ◽  
Topical Glyceryl Trinitrate ◽  
Multiple Drugs ◽  
Somatosensory Nervous System ◽  
Global Population

Injury to the nerves causes alteration in normal neurobiological sequences lead to disease of somatosensory nervous system called as neuropathic pain (NP). It affects both central as well as peripheral nervous system. It is a chronic painful condition occurs due to various diseases like HIV, diabetes, lesions, infection, trauma, and metabolic insults. NP affects 7-10% of global population, hence subsequently is a major concern. Pharmacotherapy for NP remains a major clinical challenge due to its complex pathophysiology. Current treatments like Analgesics, anticonvulsants, non-steroidal anti-inflammatory drugs, tri-cyclic antidepressants, sodium channel blocker and opioid agonist administrated individually to patients of NP are providing only meager and partial relief. Furthermore, these drugs have limited efficacy as well as adverse effects. Hence instead of monotherapy, pathophysiology of NP suggests that administering multiple drugs (polypharmacy) show quick and sufficient effect in the treatment of NP. Recent updates indicate that combination of Morphine and gabapentin, Pregabalin and duloxetine, Gabapentin and nortriptyline, Amitriptyline and ketamine (topical), Doxepin and capsaicin (topical), Glyceryl trinitrate (topical) and valproate are also a good choice for the treatment of NP. Several clinical trials also established that combination pharmacotherapy showed greater efficacy than monotherapy in treating NP. Physicians, scientists working in the area of NP are not only looking for its treatment but also in resolving the issues of co-morbidities associated with it. Hence the present review focuses on rationalized approach of combination therapy for the treatment of various aspects of NP.

Topical anesthetics and analgesics

2021 ◽  
pp. 494-500
Author(s):  
William T. Zempsky
Keyword(s):  
Neuropathic Pain ◽  
Side Effects ◽  
Oral Administration ◽  
Topical Administration ◽  
Venous Access ◽  
Clinical Situation ◽  
Chronic Musculoskeletal Pain ◽  
Topical Anesthetics ◽  
Systemic Side Effects ◽  
Inflammatory Drugs

Topical administration of anesthetics and analgesics can allow for the efficient, painless delivery of medications that may reduce systemic side effects associated with the medication, whilst providing clinical advantages over injected or oral administration for the same clinical situation. Topical anesthetics have become widely used prior to a variety of painful procedures in children, including venous access, laceration repair, and injections. Topical administration of nonsteroidal anti-inflammatory drugs, lidocaine, capsaicin, and other agents also are useful for a range of conditions, including acute and chronic musculoskeletal pain, and neuropathic pain.

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