The combination of diclofenac and B vitamins – effectiveness and safety in clinical practice

2021 ◽  
Vol 14 (1) ◽  
pp. 44-51
Author(s):  
Marek Postuła ◽  
Pamela Czajka ◽  
Alex Fitas
Keyword(s):  
Cardiovascular Risk ◽  
Side Effects ◽  
B Vitamins ◽  
Nervous System Activity ◽  
Risk Patients ◽  
Inflammatory Drugs ◽  
Effective Pain Relief ◽  
Pain Stimuli ◽  
Positive Effect ◽  
Low Cardiovascular Risk

Diclofenac is one of the most commonly used non-steroidal anti-inflammatory drugs in the World, eagerly chosen for the therapy of skeletal, joint and muscle pain. However, the use of diclofenac is associated with side effects common for the entire class of drugs, including enhancement of cardiovascular risk. It has been shown that B vitamins are involved in many processes essential for the nervous system activity, as well as in the mechanism of initiating and transmitting pain stimuli. Besides, they have a synergistic analgesic effect when combined with diclofenac. Application of both drugs in analgesic therapy resulted in more effective pain relief, but also allowed for the reduction of diclofenac doses, leading to minimize the risk of side effects. The combination of B vitamins has a positive effect on the efficacy and safety of the therapy, which is important especially for low cardiovascular risk patients.

The MASP activity and the thrombosis risk in low cardiovascular risk patients

2017 ◽  
Vol 263 ◽  
pp. e163
Author(s):  
Sofia Eliashevich ◽  
Oxana Drapkina ◽  
Batogab Shoibonov
Keyword(s):  
Cardiovascular Risk ◽  
Thrombosis Risk ◽  
Risk Patients ◽  
Low Cardiovascular Risk

Pharmacological management: Pain relief

2020 ◽  
pp. 429-444
Keyword(s):  
Side Effects ◽  
Pain Relief ◽  
Patient Information ◽  
Patient Assessment ◽  
Oral Drugs ◽  
Pharmacological Management ◽  
Analgesic Ladder ◽  
Gastric Cytoprotection ◽  
Inflammatory Drugs ◽  
Effective Pain Relief

This chapter examines the pharmacological management of pain relief in musculoskeletal conditions. It reviews the analgesic ladder and oral drugs used in analgesia, including tricyclics and other antidepressants and non-steroidal anti-inflammatory drugs (NSAIDs). In addition, topical therapies are discussed. The benefits, common side effects, cautions, and contraindications of drugs used to manage pain are included. There is also reference to the medications used in gastric cytoprotection as these are required to be co-prescribed with NSAIDs. Also included are aspects of patient assessment prior to treatment together with relevant patient information to ensure safe and effective pain relief.

High cardiovascular risk patients benefit more from bariatric surgery than low cardiovascular risk patients

2018 ◽  
Vol 33 (5) ◽  
pp. 1626-1631 ◽  
Author(s):  
David Gutierrez Blanco ◽  
David Romero Funes ◽  
Giulio Giambartolomei ◽  
Emanuele Lo Menzo ◽  
Samuel Szomstein ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Cardiovascular Risk ◽  
High Cardiovascular Risk ◽  
Risk Patients ◽  
Low Cardiovascular Risk

The effect of PCSK9 Inhibitor EVOLOCUMAB on aldosterone among high cardiovascular risk patients

2020 ◽  
Author(s):  
Elena Lzkhakov ◽  
Yakov Shacham ◽  
Mariana Yaron ◽  
Merav Serebro ◽  
Karen Tordjman ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
High Cardiovascular Risk ◽  
Pcsk9 Inhibitor ◽  
Risk Patients

Telmisartan in High Cardiovascular Risk Patients

2012 ◽  
Vol 8 (1) ◽  
pp. 10 ◽  
Author(s):  
Roland Asmar ◽  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Ace Inhibitors ◽  
Angiotensin Receptor Blockers ◽  
High Cardiovascular Risk ◽  
Raas Blockade ◽  
Risk Patients ◽  
Receptor Blockers ◽  
Current Guidelines

The worldwide morbidity and mortality burden of cardiovascular disease (CVD) is overwhelming and caused by increasing life expectancy and an epidemic of risk factors, including hypertension. Therapeutic options targeting different areas of the renin–angiotensin–aldosterone system (RAAS) to disrupt pathophysiological processes along the cardiovascular continuum are available. Angiotensin-converting enzyme (ACE) inhibitors are first-line treatments for CVD and angiotensin receptor blockers (ARBs) are suitable alternatives. Both ACE inhibitors and ARBs prevent CVD by lowering blood pressure (BP). Additionally, several studies have demonstrated that RAAS blockade can reduce cardiovascular risk beyond what might be expected from BP lowering alone. However, the ARBs are not all equally effective. Telmisartan is a long-lasting ARB that effectively controls BP over the full 24-hour period. Recently, the Ongoing telmisartan alone and in combination with ramipril global endpoint trial (ONTARGET) study showed that telmisartan reduces cardiovascular events in high cardiovascular risk patients similarly to the gold standard ACE inhibitor ramipril beyond BP lowering alone, but with a better tolerability. Based on the results of the ONTARGET and Telmisartan randomized assessment study in ACE intolerant subjects with cardiovascular disease (TRANSCEND) studies, telmisartan is indicated for the reduction of cardiovascular morbidity. This article aims to review current guidelines for the management of CVD and consider key data from clinical trials and clinical practice evaluating the role of telmisartan in CVD.

Cardiovascular Disease in Spondyloarthritides

2020 ◽  
Vol 18 (5) ◽  
pp. 473-487 ◽  
Author(s):  
Charalampos Papagoras ◽  
Paraskevi V. Voulgari ◽  
Alexandros A. Drosos
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Healthcare Providers ◽  
Cardiovascular Death ◽  
Point Of View ◽  
Treat To Target ◽  
Inflammatory Joint Diseases ◽  
Scientific Organizations ◽  
Increased Risk ◽  
Risk Patients

The spondyloarthritides are a group of chronic systemic inflammatory joint diseases, the main types being ankylosing spondylitis (AS) and psoriatic arthritis (PsA). Evidence accumulating during the last decades suggests that patients with AS or PsA carry an increased risk for cardiovascular disease and cardiovascular death. This risk appears to be mediated by systemic inflammation over and above classical cardiovascular risk factors. The excess cardiovascular risk in those patients has been formally acknowledged by scientific organizations, which have called physicians’ attention to the matter. The application by Rheumatologists of new effective anti-rheumatic treatments and treat-to-target strategies seems to benefit patients from a cardiovascular point of view, as well. However, more data are needed in order to verify whether anti-rheumatic treatments do have an effect on cardiovascular risk and whether there are differences among them in this regard. Most importantly, a higher level of awareness of the cardiovascular risk is needed among patients and healthcare providers, better tools to recognize at-risk patients and, ultimately, commitment to address in parallel both the musculoskeletal and the cardiovascular aspect of the disease.

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