scholarly journals Safe use of meloxicam in clinical practice

2019 ◽  
pp. 46-50
Author(s):  
E. I. Sas ◽  
V. B. Grinevich
Keyword(s):  
Chronic Pain ◽  
Clinical Practice ◽  
Gastrointestinal Tract ◽  
High Efficiency ◽  
Controlled Trials ◽  
High Efficacy ◽  
Selective Inhibitors ◽  
Good Tolerability ◽  
Inflammatory Drugs ◽  
Inflammatory Changes

Non-steroidal anti-inflammatory drugs (NSAIDs) – means of treatment of acute and chronic pain associated primarily with inflammatory changes, so this group of drugs is widely used in neurology, rheumatology, traumatology, etc. The mechanism of action of the drugs is associated with the effect on cyclooxygenase-2 (COG-2) and blockade of proinflammatory prostaglandins (PG) synthesis, as well as the effect on COG-1 and suppression of cytoprotective PG synthesis, which determines the possibility of side effects from the gastrointestinal tract (GIT). Now application of NPVP is focused not so much on increase of efficiency, as on their big safety. Creation of COG-2-selective inhibitors (meloxicam) and COG-2-high selective inhibitors (coxybes) allowed to reduce significantly the risk of complications from gastrointestinal tract while maintaining high efficiency. Thus, the safety profile of meloxicam, mainly inhibiting COG-2, is estimated in a whole series of studies. In particular, two large prospective controlled trials - MELISSA and SELECT - proved that meloxicam is less toxic to gastrointestinal tract than traditional NSAIDs. Thus, a reasonable conclusion can be made about the high efficacy of meloxicam, which is not inferior to that of non-selective NSAIDs, with good tolerability and safety of the drug against gastrointestinal tract.

Features of NSAIDs' use in pandemic. Gastroenterologist's view

2021 ◽  
Vol 1 (6) ◽  
pp. 32-34
Author(s):  
E. I. Sas
Keyword(s):  
Chronic Pain ◽  
Gastrointestinal Tract ◽  
Side Effects ◽  
Viral Infection ◽  
Mechanism Of Action ◽  
Clinical Course ◽  
Inflammatory Drugs ◽  
Cox 2 ◽  
Inflammatory Changes ◽  
Cox 1

Non-steroidal anti-inflammatory drugs (NSAIDs) are drugs used to treat acute and chronic pain associated primarily with inflammatory changes. This group of drugs is widely used in neurology, rheumatology, traumatology, etc. The main mechanism of action of the drugs is associated with the effect on cyclooxygenase-2 (COX-2) and blockade of the synthesis of pro-inflammatory prostaglandins (PG), as well as the effect on COX-1 and suppression of the synthesis of cytoprotective PG, which determines the possibility of side effects from the gastrointestinal tract. In the pandemic, the use of this group of drugs has increased many times over. Features of the clinical course of both the viral infection itself and the use of other drugs leads to a significant change in the pharmacodynamics and pharmacokinetics of NSAIDs, which may lead to the development of undesirable side effects.

scholarly journals A survey on the experience of 136 Italian urologists in the treatment of erectile dysfunction with PDE5 inhibitors and recommendations for the use of Avanafil in the clinical practice

2016 ◽  
Vol 88 (2) ◽  
pp. 128 ◽  
Author(s):  
Vincenzo Mirone ◽  
Ferdinando Fusco ◽  
Fabio Parazzini ◽  
Alessandro Zucchi
Keyword(s):  
Erectile Dysfunction ◽  
Clinical Practice ◽  
Scientific Literature ◽  
Therapeutic Option ◽  
Tolerability Profile ◽  
High Efficacy ◽  
Pde5 Inhibitors ◽  
Good Tolerability ◽  
Duration Of Action ◽  
Different Characteristics

Introduction: PDE5 inhibitors are the firstline treatment for erectile dysfunction. Although all these drugs share the same mechanism of action, each agent could have different characteristics in terms of selectivity, pharmacokinetics and tolerability profile. Materials and Methods: This manuscript illustrates a project, undertaken by the Italian Society of Urology in order to obtain a “snapshot” of the experience of Italian urologists with the use of PDE5 inhibitors in the clinical practice. This project included a survey, targeting a sample of 136 Italian urologists experienced in the treatment of ED, and the organization of a conference of experts who, based on the findings of the survey, the scientific literature and the clinical experience, would define some recommendations for the use of PDE5 inhibitors in clinical practice with a particular focus on Avanafil, the most recent drug in this class. Results: The following recommendations on the use of Avanafil were issued: 1) In patients who are candidates for the use of Avanafil, it is advisable to use the 200-mg dose from the first administration; 2) When used at the highest dose (200 mg), Avanafil shows a favourable tolerability profile with an efficacy similar to that of other agents; 3) The patient should be instructed to take Avanafil on an empty stomach, i.e., 30-45 minutes before or 2 hours after a meal; 4) The efficacy window of Avanafil is between 30 minutes and 6 hours after dosing, which qualifies this molecule as a new drug with an intermediate duration of action; 5) Avanafil at a dose of 50-100 mg/day may be a therapeutic option in chronic rehabilitation. Conclusions: Among PDE5 inhibitors, Avanafil is a new agent with an intermediate duration of action, characterized by high efficacy and good tolerability even at the highest dose (200 mg).

scholarly journals Topical nonsteroidal anti-inflammatory drugs for management of pain syndrome

2021 ◽  
pp. 74-80
Author(s):  
O. A. Shavlovskaya ◽  
I. A. Bokova ◽  
N. I. Shavlovskiy
Keyword(s):  
Chronic Pain ◽  
Musculoskeletal Pain ◽  
Clinical Efficacy ◽  
Adult Population ◽  
Pain Syndrome ◽  
Cardiovascular Risks ◽  
Good Tolerability ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Topical Nsaids

Chronic pain continues to remain one of the urgent problems of modern medicine. From 15 to 25% of the adult population suffers from chronic pain. Medical treatment includes the appointment of non-steroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants. The greatestform for the appointment of NSAIDs is the topical form. According to the recommendations of International and National societies for the treatment of pain syndrome, osteoarthritis (OA) therapy are recommended to start with topical NSAIDs, as drugs with less systemic adverse side effects (NSAIDs).Topical NSAIDs have proven analgesic and antiinflammatory efficacy in the treatment of diseases of the musculoskeletal system, musculoskeletal pain, but have a low risk of developing systemic NSAIDs in comparison with oral forms, which expands the possibilities of their appointment in patients with comorbid pathology (diseases of the gastrointestinal tract, cardiovascular risks).Among NSAIDs, diclofenac is the "gold standard" of analgesia. After topical application, diclofenac penetrates through the skin and further into the deeper underlying tissues while maintaining sufficient concentration to provide a therapeutic effect. The topical form of diclofenac – diclofenac diethylamine 2%, when used correctly, can cause an analgesic effect comparable to the oral form. This topical form has a high clinical efficacy in the treatment of acute musculoskeletal pain (sprains), the course of therapy takes 1 week, for chronic pain syndromes (knee OA or hand) the course of therapy is from 2 to less than 6 weeks. The clinical efficacy of diclofenac diethylamine monotherapy is comparable to that for complex therapy in combination with oral forms of NSAIDs, while having good tolerability.

The consequences of using widely available non-steroidal anti-inflammatory drugs (NSAIDs)

2018 ◽  
Vol 21 (3) ◽  
Author(s):  
Joanna Synoweć ◽  
Katarzyna Pogorzelczyk ◽  
Marlena Robakowska ◽  
Daniel Ślęzak ◽  
Przemysław Żuratyński ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Chronic Pain ◽  
Gastrointestinal Tract ◽  
Adverse Effects ◽  
Respiratory Diseases ◽  
Easy Access ◽  
The World ◽  
Wide Availability ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used throughout the world due to their wide availability and a broad range of effects. Patients have easy access to these drugs in pharmacies and cosmetic shops, with the latter ones rarely having personnel qualified to provide advice on dosage. NSAIDs are usually administered to manage pain, fever and inflammation. They are used for conditions such as rheumatoid arthritis, oropharyngeal inflammations or in the treatment of chronic pain. Nevertheless, they are most often used for home treatment of common conditions, such as cold. However, NSAIDs can cause multiple adverse effects. They adversely affect the gastrointestinal tract, contribute to hypertension, show hepatotoxic properties, exacerbate respiratory diseases, induce allergies and haematological complications. Adverse effects may occur both due to overdose, as well as independently of the dose. The aim of this review is to present adverse effects of nonsteroidal anti-inflammatory drugs, the awareness of Poles concerning the use of NSAIDs, as well as measures to be taken in order to limit the adverse health consequences of the use of these drugs.

Non-steroidal anti-inflammatory drugs in practice of cardiologist: choice of drug

2020 ◽  
pp. 22-26
Author(s):  
M. Yu. Omelchenko
Keyword(s):  
Conservative Treatment ◽  
Severe Pain ◽  
Pain Syndrome ◽  
Original Study ◽  
Lumbosacral Spine ◽  
Efficacy And Safety ◽  
High Efficacy ◽  
Good Tolerability ◽  
Daily Dose ◽  
Inflammatory Drugs

Data from an original study evaluating the efficacy and safety of dexketoprofen in the conservative treatment of pain syndrome in patients are presented. This paper presents three clinical cases of successful conservative treatment of pain in patients. Patients, depending on the therapy they received, were divided into three groups: patient S., 50 years old, (pain in the joints) received Dexketoprofen-SZ at a dose of 25 mg twice a day for 5 days; a patient, 50 years old, (severe pain in the lumbosacral spine) received Dexketoprofen-SZ 25 mg every 8 hours (daily dose not more than 75 mg) for 5 days; the patient, 20 years old, (painful heavy periods) received Dexketoprofen-SZ, depending on the intensity of pain, 25 mg every 8 hours. Conclusions. The drug Dexketoprofen-SZ at a dosage of 25 mg 2–3 times a day has shown high efficacy and good tolerability in various patients in the practice of an outpatient cardiologist.

scholarly journals Nonsteroidal anti-inflammatory drugs in chronic pain: implications of new data for clinical practice

2018 ◽  
Vol Volume 11 ◽  
pp. 1937-1948 ◽  
Author(s):  
Kok Yuen Ho ◽  
Kok Ann Gwee ◽  
Yew Kuang Cheng ◽  
Kam Hon Yoon ◽  
Hwan Tak Hee ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Clinical Practice ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

scholarly journals Ethical examination of sham surgeries for relief of chronic pain in clinical practice

2018 ◽  
Vol 87 (1) ◽  
pp. 52-54
Author(s):  
Katherine Fleshner ◽  
Jacek Orzylowski
Keyword(s):  
Chronic Pain ◽  
Clinical Practice ◽  
Placebo Effect ◽  
Clinical Benefit ◽  
Placebo Response ◽  
Ethical Framework ◽  
Controlled Trials ◽  
Evidence Based ◽  
Randomized Controlled ◽  
Sham Surgery

Treatment of chronic pain is challenging for both patients and physicians alike. Interventional management of pain is often indicated for patients who are not helped by pharmacotherapy, and can include procedures such as neurectomy and vertebroplasty. However, randomized controlled trials of these procedures often demonstrate a significant improvement in symptomology among patients in the control arm who have instead undergone a sham surgery, which eliminates the perceived surgical steps required for benefit but mimics the surgery in every other way. We examine whether an ethical framework might exist for sham surgeries to hypothetically be performed for clinical benefit of chronic pain. Once all evidence-based options are exhausted, performing sham surgeries may be justified under beneficence and non-maleficence since sham procedures are often equally efficacious but considerably safer than their true intervention counterparts. Physicians must only recommend such procedures with the intent of ameliorating patient suffering. Some degree of disclosure of a possible placebo effect prior to a sham surgery may satisfy the principle of autonomy while still maintaining the placebo response.

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