Use of Gabapentin in the Treatment of Neuropathic Pain

2000 ◽  
Vol 34 (6) ◽  
pp. 802-807 ◽  
Author(s):  
Michael A Laird ◽  
Barry E Gidal
Keyword(s):  
Neuropathic Pain ◽  
First Line ◽  
Data Synthesis ◽  
Search Terms ◽  
Clinical Literature ◽  
Limited Experience ◽  
Current Therapies ◽  
Drug Treatments ◽  
Favorable Safety

OBJECTIVE: To evaluate the role of gabapentin for the treatment of neuropathic pain. DATA SOURCES: Clinical literature was identified through MEDLINE (from 1990 to October 1999). Key search terms were gabapentin and pain. DATA SYNTHESIS: Neuropathic pain can be a problematic, chronic syndrome that is frequently refractory to current drug treatments. Gabapentin is a newer generation antiepileptic drug that is commonly used in treatment of neuropathic pain. An evaluation of clinical trials using gabapentin to treat neuropathic pain was performed. CONCLUSIONS: Gabapentin appears to be effective in treating various neuropathic pain disorders. Gabapentin may have advantages over current therapies, such as a favorable safety profile and lack of drug interactions; however, cost issues and limited experience may limit the use of gabapentin as a first-line option.

Risedronate for the Prevention and Treatment of Corticosteroid-Induced Osteoporosis

2002 ◽  
Vol 36 (3) ◽  
pp. 512-516 ◽  
Author(s):  
John A Dougherty
Keyword(s):  
Fracture Prevention ◽  
Mineral Density ◽  
Data Synthesis ◽  
Search Terms ◽  
Oral Bisphosphonate ◽  
Clinical Literature ◽  
Corticosteroid Osteoporosis ◽  
Prevention And Treatment

OBJECTIVE: To evaluate the role of risedronate in corticosteroid-induced osteoporosis. DATA SOURCES: Clinical literature was accessed through MEDLINE (1966–February 2001). Key search terms included risedronate, corticosteroid, osteoporosis, and bisphosphonate. DATA SYNTHESIS: Corticosteroid-induced osteoporosis (CIO) is clinically challenging and can lead to fractures. Risedronate, an oral bisphosphonate, has been studied for use in CIO. Trials focusing on the use of risedronate in these patients were reviewed. CONCLUSIONS: Risedronate 5 mg/d increased bone mineral density at lumbar, femoral neck, and trochanter skeletal sites in patients recently initiated on or receiving long-term corticosteroid therapy. Further investigation is needed to determine risedronate's effects on fracture prevention. The drug was well tolerated.

Safety of Selegiline with Cold Medications

2003 ◽  
Vol 37 (3) ◽  
pp. 438-441 ◽  
Author(s):  
Jeena E Jacob ◽  
Mary L Wagner ◽  
Jacob I Sage
Keyword(s):  
Adverse Events ◽  
Drug Interactions ◽  
Interaction Potential ◽  
Data Sources ◽  
Data Synthesis ◽  
Search Terms ◽  
Clinical Literature

OBJECTIVE: To evaluate the safety of the coadministration of selegiline with cold medications. DATA SOURCES: Clinical literature accessed through MEDLINE(1965–September 2002), IPA database, and Drug-Reax System. The following search terms were used: selegiline, pseudoephedrine, dextromethorphan, MAOI, and drug interactions. Somerset Pharmaceuticals, the marketers of Eldepryl (selegiline HCI), were also contacted. DATA SYNTHESIS: Despite a warning against its concomitant use with pseudoephedrine and dextromethorphan, interactions with selegiline have not been reported. However, there have been reports of patients experiencing adverse events with related agents. CONCLUSIONS: Patients taking selegiline should try to avoid pseudoephedrine and dextromethorphan or use drugs without interaction potential. If selegiline is used with these medications, watch for adverse events or replace selegiline with another drug.

Bismuth Subgallate–Epinephrine Paste in Adenotonsillectomies

2000 ◽  
Vol 34 (4) ◽  
pp. 522-525 ◽  
Author(s):  
Randy C Hatton
Keyword(s):  
Active Ingredient ◽  
Science Citation Index ◽  
Citation Index ◽  
Postoperative Bleeding ◽  
Data Sources ◽  
Data Synthesis ◽  
Search Terms ◽  
Bismuth Subgallate ◽  
Minimal Evidence

OBJECTIVE: To evaluate the role of bismuth subgallate–epinephrine (BSE) paste as a hemostatic in adenotonsillectomies. DATA SOURCES: MEDLINE (January 1966–October 1999) and Current Contents (January 1997–October 1999) were searched, using bismuth subgallate, adenoidectomy, tonsillectomy, and adenotonsillectomy as search terms. A citation search was performed using Science Citation Index (January 1977–October 1999). DATA SYNTHESIS: Adenotonsillectomies are common procedures; although there are few complications, hemorrhage is a concern. Bismuth subgallate has historically been used as an astringent and hemostatic. An evaluation of studies of bismuth subgallate and BSE paste was conducted. CONCLUSIONS: There is minimal evidence to support this practice, but data suggest that epinephrine may be the active ingredient in BSE paste. BSE paste is inexpensive, poses little risk, and may decrease postoperative bleeding; therefore, it may be a reasonable hemostatic agent.

Role of SIRT1 in Neuropathic Pain from the Viewpoint of Neuroimmunity

2021 ◽  
Vol 27 ◽  
Author(s):  
Youjia Fan ◽  
Rong Dong ◽  
Honghai Zhang ◽  
Buwei Yu ◽  
Han Lu
Keyword(s):  
Nervous System ◽  
Neuropathic Pain ◽  
Immune System ◽  
Noxious Stimulation ◽  
First Line ◽  
Physiological Conditions ◽  
Combined Action ◽  
Sensory Nervous System ◽  
First Line Treatment

: The current clinical first-line treatment of neuropathic pain still considers only the nervous system as the target, and its therapeutic effect is limited. An increasing number of studies support the opinion that neuropathic pain is a result of the combined action of the sensory nervous system and the related immune system. Under physiological conditions, both the nervous system and the immune system can maintain homeostasis by adjusting the mitochondrial function when sensing noxious stimulation. However, in the case of neuropathic pain, mitochondrial regulatory dysfunction occurs, which may result from the decreased expression of SIRT1. In this study, we review the role of SIRT1 in neuropathic pain from the viewpoint of neuroimmunity.

Glucose-Insulin-Potassium Solution for Acute Myocardial Infarction

2002 ◽  
Vol 36 (6) ◽  
pp. 1080-1084 ◽  
Author(s):  
Jeffrey L Janiger ◽  
Judy WM Cheng
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
English Language ◽  
Duration Of Treatment ◽  
Data Synthesis ◽  
Mortality And Morbidity ◽  
Search Terms ◽  
Study Selection ◽  
Meta Analyses

OBJECTIVE: To review the role of glucose-insulin-potassium (GIK) solution in the management of acute myocardial infarction (AMI). DATA SOURCES: MEDLINE (1966–October 2001) database, using the search terms glucose, insulin, potassium, and myocardial infarction. STUDY SELECTION: Relevant English-language human studies and meta-analyses. DATA SYNTHESIS: Most studies that have investigated the use of GIK in AMI have been from the prethrombolytic era. Although most data trended toward favoring GIK in improving mortality and morbidity of AMI, the Polish GIK study was terminated prematurely because of an increase in mortality in patients treated with GIK. Dosage, duration of treatment, and route of administration of GIK varied among studies. CONCLUSIONS: Until results from larger-scale studies become available, the routine use of GIK infusion in AMI patients is not recommended.

Treatment of Listeriosis

2000 ◽  
Vol 34 (5) ◽  
pp. 656-661 ◽  
Author(s):  
Mary E Temple ◽  
Milap C Nahata
Keyword(s):  
Treatment Options ◽  
Alternative Therapies ◽  
Second Line ◽  
Data Synthesis ◽  
Disease States ◽  
Drug Of Choice ◽  
Search Terms ◽  
Food Borne ◽  
Clinical Literature ◽  
Food Borne Illness

OBJECTIVE: To review the most currently accepted treatment options for the treatment of listeriosis. DATA SOURCES: Clinical literature was accessed through MEDLINE (1966–October 1999). Key search terms included Li steria monocytogenes, food-borne illness, penicillins, fluoroquinolones, cephalosporins, and vancomycin. DATA SYNTHESIS: Listeriosis is mainly a food-borne illness caused by L. monocytogenes;people most prone to the disease are pregnant women, newborns, elderly, and those with HIV or other diseases compromising immunity. Listeria infections are associated with a high mortality rate, and thus effective antibiotic treatment is essential. Although a variety of antibiotics have activity against the organism, ampicillin alone or in combination with gentamicin remains the treatment of choice. Some patients may require alternative therapies due to allergies or certain disease states. Second-line agents for these cases include trimethoprim/ sulfamethoxazole, erythromycin, vancomycin, and the fluoroquinolones. Cephalosporins are not active against Listeria. CONCLUSIONS: Ampicillin is currently the drug of choice for treating L. monocytogenes infections. Many antibiotics have been shown to be effective and are used as second-line agents. However, further study is required for some of the most recently introduced antibiotics, such as the fluoroquinolones, to determine their place in the treatment of Listeriainfections.

Effect of Cyclooxygenase-2 Inhibitors on Blood Pressure

2003 ◽  
Vol 37 (3) ◽  
pp. 442-446 ◽  
Author(s):  
Deanna L Johnson ◽  
Tina M Hisel ◽  
Beth Bryles Phillips
Keyword(s):  
Blood Pressure ◽  
Cyclooxygenase 2 ◽  
Data Sources ◽  
Selective Inhibitors ◽  
Data Synthesis ◽  
Hypertensive Patients ◽  
Search Terms ◽  
Clinical Literature ◽  
Cox 2 ◽  
Cyclooxygenase 2 Inhibitors

OBJECTIVE: To evaluate the effect of cyclooxygenase-2 selective inhibitors (CSIs) on blood pressure. DATA SOURCES: Clinical literature accessed through MEDLINE (1966–May 2002). Key search terms included COX-2 selective inhibitors; anti-inflammatory agents, nonsteroidal; celecoxib; rofecoxib; and hypertension. DATA SYNTHESIS: Data from prospective studies on the effects of CSIs on blood pressure are conflicting. Several studies have reported increased blood pressure as an adverse effect of CSIs. CONCLUSIONS: Additional studies are needed to evaluate the effects of CSIs on blood pressure. CSIs should be used with caution in hypertensive patients and blood pressure monitored closely if a CSI is indicated.

The Use of Topiramate in Mood Stabilization

2002 ◽  
Vol 36 (7-8) ◽  
pp. 1277-1281 ◽  
Author(s):  
Ian D Maidment
Keyword(s):  
Bipolar Disorder ◽  
Bipolar Disorders ◽  
Mood Stabilizer ◽  
Mood Stabilizers ◽  
Double Blind ◽  
Data Synthesis ◽  
Complex Disorder ◽  
Search Terms ◽  
Clinical Literature ◽  
Mood Stabilization

OBJECTIVE: To review data on the effectiveness of topiramate as a mood stabilizer. DATA SOURCES: Clinical literature accessed through MEDLINE (1985–September 2001) and the manufacturer. Key search terms included topiramate, mania, mood stabilizer, and bipolar disorder. DATA SYNTHESIS: The traditional standard therapy for bipolar disorder has been lithium. Other mood stabilizers are increasingly being used to manage this complex disorder. Studies that used topiramate in bipolar disorders were evaluated. CONCLUSIONS: The present data from open trials suggest that topiramate may possibly possess antimanic properties. Controlled, double-blind studies are required to confirm this efficacy.

Leukotriene Modifiers to Prevent Aspirin-Provoked Respiratory Reactions in Asthmatics

2002 ◽  
Vol 36 (9) ◽  
pp. 1457-1461 ◽  
Author(s):  
Julie A Volkman ◽  
Pamala J Pontikes
Keyword(s):  
Nasal Polyps ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Complete Inhibition ◽  
Data Sources ◽  
Antiinflammatory Drugs ◽  
Data Synthesis ◽  
Search Terms ◽  
Clinical Literature ◽  
Life Threatening ◽  
The Relationship

OBJECTIVE: To evaluate the use of leukotriene modifiers in preventing aspirin-provoked respiratory reactions in asthmatics. DATA SOURCES: Clinical literature accessed through MEDLINE (1965–February 2001). Key search terms included aspirin, asthma, leukotriene, and treatment. DATA SYNTHESIS: Aspirin-sensitive asthmatics experience a wide variety of symptoms, ranging from rhinitis to life-threatening bronchospasms, after the ingestion of aspirin or nonsteroidal antiinflammatory drugs (NSAIDs). The relationship between aspirin sensitivity, asthma, and nasal polyps was first reported in 1922. The exact mechanism of these reactions is not clearly understood. Four studies investigated the use of leukotriene modifiers to prevent aspirin-provoked respiratory reactions. The efficacy of these agents ranged from complete inhibition to no blockade. CONCLUSIONS: Patients who experience aspirin-sensitive asthma should be cautious when taking aspirin and NSAIDs, despite treatment with leukotriene inhibitors.

Sialorrhea — Therapeutic Drug Options

2002 ◽  
Vol 36 (11) ◽  
pp. 1785-1790 ◽  
Author(s):  
Dorothy Z Tscheng
Keyword(s):  
Small Sample Size ◽  
Symptom Relief ◽  
Small Sample ◽  
The Other ◽  
Therapeutic Drug ◽  
Efficacy And Safety ◽  
Drug Induced ◽  
Data Synthesis ◽  
Search Terms ◽  
Drug Treatments

OBJECTIVE: To review the efficacy and safety of various drug treatments for sialorrhea. Pharmacotherapy for drug-induced sialorrhea is not addressed. DATA SOURCES: Clinical studies were identified using PubMed (1966–October 2001). Key search terms included sialorrhea and drug therapy. DATA SYNTHESIS: Sialorrhea is a social and physical detriment to patients. Drug treatment, although not necessarily the treatment of choice for all patients, can offer some symptom relief. CONCLUSIONS: Literature has documented that benztropine, glycopyrrolate, and scopolamine can reduce the incidence of sialorrhea. Although the literature evaluating the therapeutic options has limitations (e.g., small sample size, inconsistent outcome measurements), glycopyrrolate may have an advantage over the other agents due to fewer adverse effects.

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