scholarly journals Kampo Formulae for the Treatment of Neuropathic Pain ∼ Especially the Mechanism of Action of Yokukansan ∼

2021 ◽  
Vol 14 ◽  
Author(s):  
Masataka Sunagawa ◽  
Yasunori Takayama ◽  
Mami Kato ◽  
Midori Tanaka ◽  
Seiya Fukuoka ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Drug Therapy ◽  
Side Effects ◽  
Traditional Medicine ◽  
Mechanism Of Action ◽  
Pain Treatment ◽  
Kampo Medicine ◽  
Holistic Healing ◽  
Pharmacological Effects ◽  
Crude Drugs

Kampo medicine has been practiced as traditional medicine (TM) in Japan. Kampo medicine uses Kampo formulae that are composed of multiple crude drugs to make Kampo formulae. In Japan, Kampo formulae are commonly used instead of or combined with Western medicines. If drug therapy that follows the guidelines for neuropathic pain does not work or cannot be taken due to side effects, various Kampo formulae are considered as the next line of treatment. Since Kampo formulae are composed of two or more kinds of natural crude drugs, and their extracts contain many ingredients with pharmacological effects, one Kampo formula usually has multiple effects. Therefore, when selecting a formula, we consider symptoms other than pain. This review outlines the Kampo formulae that are frequently used for pain treatment and their crude drugs and the basic usage of each component. In recent years, Yokukansan (YKS) has become one of the most used Kampo formulae for pain treatment with an increasing body of baseline research available. We outline the known and possible mechanisms by which YKS exerts its pharmacologic benefits as an example of Kampo formulae’s potency and holistic healing properties.

Drugs for neuropathic pain

2021 ◽  
pp. 500-510
Author(s):  
Sachin Rastogi ◽  
Fiona Campbell
Keyword(s):  
Neuropathic Pain ◽  
Drug Therapy ◽  
Side Effects ◽  
Randomized Controlled Trials ◽  
Tissue Injury ◽  
Somatosensory System ◽  
Pain Syndrome ◽  
Direct Consequence ◽  
Controlled Trials ◽  
Pharmacological Management

Neuropathic pain is defined as “pain arising as a direct consequence of a lesion or disease affecting the somatosensory system.” It is often contrasted with nociceptive pain, which is associated with tissue injury or inflammation. Neuropathic pain conditions in children are qualitatively different from those common in adults and include complex regional pain syndrome, postoperative neuropathic pain, and autoimmune and degenerative neuropathies. Few randomized controlled trials in pediatrics means that evidence from adult studies is extrapolated to guide pharmacological management in children, which is problematic as the etiologies and mechanisms are different. An algorithm for drug therapy is proposed based on the best-available evidence, clinical experience, and the safety of these drugs in pediatric practice. A step-wise approach should be tried methodically according to effectiveness and side effects. Neuropathic pain in children, if identified and treated in a timely manner as part of an interprofessional framework, can be managed effectively.

Potential complications of nonsteroidal anti-inflammatory drug therapy

1989 ◽  
Vol 79 (12) ◽  
pp. 605-614
Author(s):  
GD Corrigan ◽  
L Pantig-Felix ◽  
IO Kanat
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Drug Therapy ◽  
Side Effects ◽  
Mechanism Of Action ◽  
Drug Class ◽  
Inflammatory Drug ◽  
The Us ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Since indomethacin was first marketed, some 40 years ago, the class of nonsteroidal anti-inflammatory drugs has grown larger than any other drug class in history. At present, there are at least 25 such drugs being used in the US and abroad, both clinically and in research. Despite their widespread use, their implications to health care are just beginning to be understood. The authors review updated theories on the mechanism of action, side effects, and drug interactions of nonsteroidal anti-inflammatory drug therapy. Proposed guidelines for monitoring their use are given. A more thorough understanding of the risks-to-benefits ratio is provided in an effort to achieve maximum patient satisfaction and safety.

scholarly journals Intracerebroventricular Pain Treatment with Analgesic Mixtures including Ziconotide for Intractable Pain

2016 ◽  
Vol 6;19 (6;7) ◽  
pp. E905-E915
Author(s):  
Hélène Staquet
Keyword(s):  
Neuropathic Pain ◽  
Side Effects ◽  
Cancer Pain ◽  
Rating Scale ◽  
Pain Treatment ◽  
Third Ventricle ◽  
High Dose ◽  
Intractable Pain ◽  
Intracerebroventricular Infusion ◽  
Intractable Cancer Pain

Intracerebroventricular (ICV) administration of opioids for control of intractable cancer pain has been used since 1982. We present here our experience of intracerebroventricular administration of pain treatments including ziconotide associated with morphine and ropivacaine for patients resistant to a conventional approach, with nociceptive, neuropathic, or mixed pain. These clinical cases were conducted with patients suffering from refractory pain, more than 6/10 on a numerical pain rating scale (NPRS) while on high-dose medical treatment and/ or intolerance with significant side effects from oral medication. The baseline study visit included a physical examination and an assessment of pain intensity on a NPRS. Under general anesthesia, a neuronavigation device was used to place the catheter on the floor of the third ventricle, supported by an endoscope. Then, drugs were injected in the cerebroventricular system, through a pump (external or subcutaneous). The primary objective was to measure pain evaluation with ICV treatment after a complete withdrawal of other medications. Four patients were enrolled: 3 with intractable cancer pain and one with central neuropathic pain. The median NPRS at baseline was 9.5 [8.5; 19]. The mean NPRS after one month was 3.5 [3; 4.5]. Ziconotide was initiated at 0.48 µg/dy and up to a median of 1.2 µg/dy [1.0; 1.56]. The median dose of morphine and ropivacaine used initially was respectively 0.36 mg/dy [0.24; 0.66] up to 0.6 mg/dy [0.45; 4.63] and 1.2 mg/dy [0; 2.4] up to 2.23 mg/dy [1.2; 3.35]. Minor side effects were initially observed but transiently. One psychiatric agitation required discontinuation of ziconotide infusion. For intractable pain, using ziconotide by intracerebroventricular infusion seems safe and efficient, specifically for chronic neoplastic pain of cervicocephalic, thoracic, or diffuse origin and also for pain arising from a central neuropathic mechanism. Key words: Intracerebroventricular infusion, ziconotide, intractable pain, nociceptive and neuropathic pain

Analgesics

2013 ◽  
pp. 600-606
Author(s):  
Joanne Foo ◽  
Benazir Saleem ◽  
Philip G. Conaghan
Keyword(s):  
Neuropathic Pain ◽  
Monoclonal Antibodies ◽  
Nerve Growth Factor ◽  
Growth Factor ◽  
Side Effects ◽  
Mechanism Of Action ◽  
New Agents ◽  
Presenting Symptoms ◽  
Target Action

Pain is one of the commonest presenting symptoms of musculoskeletal disorders and may be one the hardest to treat successfully. The available analgesic options provide different modes of action and their ranks continue to expand with new agents, some with multiple target action. This chapter reviews currently available analgesics (paracetamol and opioids) used for managing musculoskeletal pain and the agents used for neuropathic pain, including their mechanism of action, pharmacokinetics and side effects. The role of neuroleptic agents is reviewed, and a brief outline of some newer therapies for the treatment of pain such as tapentadol, and a potential therapy, anti-nerve growth factor monoclonal antibodies.

scholarly journals Activation of Peripheral μ-opioid Receptors by Dermorphin [d-Arg2, Lys4] (1–4) Amide Leads to Modality-preferred Inhibition of Neuropathic Pain

2016 ◽  
Vol 124 (3) ◽  
pp. 706-720 ◽  
Author(s):  
Vinod Tiwari ◽  
Fei Yang ◽  
Shao-Qiu He ◽  
Ronen Shechter ◽  
Chen Zhang ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Side Effects ◽  
Opioid Receptor ◽  
Opioid Receptors ◽  
Dynamic Range ◽  
Pain Treatment ◽  
Female Rats ◽  
Male Rats ◽  
Μ Opioid Receptor ◽  
Μ Opioid Receptors

Abstract Background Opioids have long been regarded as the most effective drugs for the treatment of severe acute and chronic pain. Unfortunately, their therapeutic efficacy and clinical utility have been limited because of central and peripheral side effects. Methods To determine the therapeutic value of peripheral μ-opioid receptors as a target for neuropathic pain treatment, the authors examined the effects of dermorphin [d-Arg2, Lys4] (1–4) amide (DALDA), a hydrophilic, peripherally acting μ-opioid receptor agonist, in male and female rats with spinal nerve ligation–induced neuropathic pain. The authors also utilized behavioral, pharmacologic, electrophysiologic, and molecular biologic tools to characterize DALDA’s possible mechanisms of action in male rats. Results DALDA, administered subcutaneously, had 70 times greater efficacy for inhibiting thermal (n = 8 to 11/group) than mechanical hypersensitivity (n = 6 to 8/group) in male rats. The pain inhibitory effects of DALDA on mechanical and heat hypersensitivity were abolished in animals pretreated with systemic methylnaltrexone (n = 7 to 9/group), a peripheral μ-opioid receptor antagonist. In the spinal wide-dynamic range neurons, systemic DALDA inhibited C-fiber–mediated, but not A-fiber–mediated, response in neuropathic male rats (n = 13). In primary sensory neurons, DALDA inhibited the capsaicin-induced [Ca2+] increase more than the β-alanine–induced [Ca2+] increase (n = 300); capsaicin and β-alanine activate subpopulations of neurons involved in the signaling of heat and mechanical pain, respectively. DALDA-treated rats (n = 5 to 8/group) did not exhibit motor deficits and locomotor impairment suggesting that it does not induce central side effects. Conclusions These findings suggest that DALDA may represent a potential alternative to current opioid therapy for the treatment of neuropathic pain and is likely to be associated with minimal adverse effects.

COMBINATION OF POTASSIUM PERCHLORATE AND PROPYLTHIOURACIL IN THE TREATMENT OF THYROTOXICOSIS

1968 ◽  
Vol 57 (4) ◽  
pp. 565-577 ◽  
Author(s):  
K. E. Røkke ◽  
J. H. Vogt
Keyword(s):  
Drug Therapy ◽  
Side Effects ◽  
Metabolic Rate ◽  
Total Cholesterol ◽  
Basal Metabolic Rate ◽  
Combined Therapy ◽  
Combined Treatment ◽  
Control Measures ◽  
Potassium Perchlorate ◽  
Plasma Total Cholesterol

ABSTRACT A report is given on 95 thyrotoxic patients treated with a combination of 400 mg propylthiouracil and 400 mg of potassium perchlorate. Perchlorate was stopped when a marked remission of symptoms was obtained, on an average after less than 7 weeks. Euthyroidism was found on an average after 7.2 weeks. The basal metabolic rate, PBI, plasma total cholesterol and weight showed a fairly rapid normalization. Thirteen of the 95 patients were given radio-iodine therapy shortly before drug therapy was started. The remaining 82 cases were grouped together with the 23 cases previously reported. Of the total of 105 cases, 96 became euthyroid on combined therapy. For the frequency of side-effects, the thirteen cases mentioned above were included, giving a total of 118 cases. Eight cases showed an increase in goitre size and 15 cases had other side-effects, of which three were granulocytopenia due to propylthiouracil. The possibility of a higher frequency of mainly minor side-effects on combined therapy has to be balanced against the seemingly rapid and reliable therapeutic effect. Combined treatment, perhaps with even smaller doses than reported here, can be recommended in selected cases of thyrotoxicosis where a shortening of the thyrotoxic state seems of importance, or possibly where difficulties due to iodine exposure may be anticipated, provided adequate control measures are taken.

Sending out Biased Signals: an Appropriate Proposition for Pain?

2019 ◽  
Vol 32 (2) ◽  
pp. 108-110 ◽  
Author(s):  
E. Besserer-Offroy ◽  
P. Sarret
Keyword(s):  
Side Effects ◽  
Acute Pain ◽  
Gold Standard ◽  
Pain Treatment ◽  
Opioid Analgesics ◽  
Mu Opioid Receptor ◽  
Clinical Development ◽  
Mu Opioid ◽  
Development Stages ◽  
The Past

In the past few years, several biased ligands acting at the mu-opioid receptor were reported in the literature. These agonists are aimed at reducing pain while having fewer side effects than morphine, the gold standard of opioid analgesics. In this mini-review, we describe and discuss the recent advances in mu-biased ligands actually in preclinical and clinical development stages, including the latest U.S. Food and Drug Administration review of oliceridine, a biased mu-agonist for moderate to severe acute pain treatment developed by the company Trevena.

EVALUATION OF THE EFFECTIVENESS OF NECK SHOULDER PAIN TREAMENT BY ACUPUNCTURE, MASSAGE AND TRADITIONAL MEDICINE REMEDY

2013 ◽  
pp. 110-117
Author(s):  
Thi Tan Nguyen
Keyword(s):  
Traditional Medicine ◽  
Shoulder Pain ◽  
Research Methodology ◽  
Pain Treatment ◽  
Central Hospital ◽  
Treatment Results ◽  
Good Account ◽  
Before And After ◽  
The City ◽  
Pain Patients

Objectives: To assess the effectiveness neck shoulder pain treatment by acupuncture, massage and traditional medicine remedy. Materials and Methods: 42 patients included in the inpatient and outpatient at the Department of Traditional Medicine, Hue Central Hospital and Traditional Medicine Hospital of Thua Thien Hue, was diagnosed as neck shoulder pain. Patients were treated with acupuncture, massage and medicine, according to the research methodology, assessing the results before and after treatment. Results: The age accounted for the highest proportion of 31-45 (42.49%), the second is between the ages of 46-60 (26.18%) and> 60 (26.18%). Incidence in the city (66.67%) than rural (33.33%) (p <0:05). Patients presented with neck shoulder pain (100%), together with the head pain, pain in the shoulder, arm numbness, movement restrictions tilted head bowed. Conclusion: good variety and accounted for 71.42% of which are quite good account of 14.28%, only 2.38% is poor. Results of good, high aged 31-45 (35.72%) and in patients with a course of treatment (66.66%). Key words: neck shoulder pain, acupuncture, massage, traditional medicine remedy.

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