scholarly journals The individual characteristics of the patients with nonspecific back pain aff ecting the dynamics of pain syndrome in the treatment with non-steroidal anti-inflammatory drugs

Author(s):  
Iryna Maslova ◽  
Natalia Mykhailovska ◽  
Oleg Devinyak ◽  
Vladyslav Moseiko ◽  
Tetiana Slobodin

The effect of nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of patients with non-specific back pain is variable, from complete ineffectiveness to the occurrence of side effects. The eff ect of NSAIDs is affected by various factors, including individual characteristics of the patient. The aim of the study was to improve the diagnostic approach to patients with non-specific back pain to identify individual indicators that can affect the efficacy and safety of NSAID therapy. The study involved 139 patients — men and women aged 30 to 60 years — with acute nonspeci fic back pain. All patients took meloxicam or celecoxib for 10 days, then observed during 90 days. On the 1st, 10th, 30th and 90th days the patients were assessed on scales — Visual Analog Scale ( VAS), Beck Depression Inventory. In the 1st and 10th days in 20 patients we determined the levels of interleukin 1 (IL-1β), interleukin 6 (IL-6), interleukin 10 (IL-10). The patients with arterial hypertension (p = 0,0053), diabetes (p = 0.04), depression (p = 0.01) had significantly worse treatment outcomes. Reduction in the levels of IL-1β and the ratio IL-6/IL-10 led to a significant reduction in pain intensity in patients with back pain. The prescription of NSAIDs for patients with back pain should be assessed from the perspective of the individual patient, including the presence of comorbidity, emotional or genetic markers, and so on, which should increase the efficiency and safety of NSAIDs treatment. Keywords: non-steroidal anti-inflammatory drugs, back pain, CYP2C9 genetic polymorphism, cytokines IL-1, IL-6/IL-10

2020 ◽  
Vol 12 (2) ◽  
pp. 42-47
Author(s):  
E. Yu. Plotnikova ◽  
V. N. Zolotukhina ◽  
L. K. Isakov ◽  
M. N. Sinkova ◽  
M. A. Sinkov

2021 ◽  
pp. 258-264
Author(s):  
K. M. Muratov ◽  
E. V. Shikh ◽  
N. I. Lapidus ◽  
Zh. I. Sizova

Non-steroidal anti-inflammatory drugs (NSAIDs) are the most common drugs in clinical practice and account for 5–10% of all drugs prescribed each year. However, the use of this group of drugs is associated with the risk of a wide range of side effects, most of which are cardiovascular complications. In addition, NSAIDs interact with other drugs, for example, their effect on antihypertensive therapy has recently been recognized as particularly important. Improvement of not only efficacy, but also safety is another important principle of rational pharmacotherapy. Adverse drug reactions (ADR) can very often result from underlying genetic factors of the human body. In this regard, a personalized approach suggesting the prescription of drugs according to the individual characteristics of patients is especially important. In such cases, pharmacogenetic testing is the most promising method that identifies the genetic factors of patients and allows to predict patients’ responses to specific drugs. This applies especially to a large range of drugs metabolised via the cytochrome P450 system in the liver. Results from numerous studies show that the effect of P450 family gene polymorphism determines the individual sensitivity to antihypertensive drugs, as it is these isozymes that are involved in the metabolism of drugs used to treat arterial hypertension (AH). In particular, the cytochrome (CYP) 450 isoenzyme is one of the basic enzymes involved in the biotransformation of losartan, an angiotensin receptor antagonist. Therefore, the CYP2C9 gene polymorphism largely determines the pharmacological response to NSAIDs and affects the effectiveness of antihypertensive therapy due to the change in the drug metabolism, as well as the structure and function of the receptors, on which they have an effect.


2021 ◽  
Vol 14 (3) ◽  
pp. 274-278
Author(s):  
Robert Rupiński ◽  
Jarosław Woroń

Non-steroidal anti-inflammatory drugs (NSAIDs) are drugs that are difficult to replace in the treatment of inflammatory pain. Both the mechanisms involved in the development of inflammatory pain and the individual characteristics of each non-steroidal anti-inflammatory drugs currently allow for personalized drug selection in such a way as to escalate its effectiveness while minimizing the risk of side effects. Diclofenac is a non-steroidal anti-inflammatory drug with one of the longest clinical experience. Since the beginning of the 70s of the last century, it has become an important element of everyday rheumatological practice, used in both degenerative and autoimmune diseases.


2017 ◽  
pp. 9-14
Author(s):  
L. Nazarenko ◽  

The article discusses the pathogenetic basis for the use of non-steroidal anti-inflammatory drugs (NSPVP) in obstetric practice for the treatment of pain syndrome in women with threatened abortion and pathological preliminary period. Provided with modern views on the mechanisms of analgesic clinical efficacy, side effects NSPVP. Provides information about the place of NSPVP during pregnancy, the risks to the fetus, the positive aspects in the conduct of women at risk of preterm birth, the pathological preliminary period. Key words: nonsteroidal anti-inflammatory drug, pain, premature birth, preliminary period.


2016 ◽  
Vol 97 (2) ◽  
pp. 217-221
Author(s):  
V N Shilenok ◽  
E V Nikitina

Aim. To conduct a comparative analysis of used anesthesia methods in patients with acute pancreatitis in intensive care units settings using pain scales.Methods. Depending on the anesthesia type, 44 patients with acute pancreatitis were divided into three groups: the first group received intramuscular injections of nonsteroidal anti-inflammatory drugs and spasmolytics, the second group - intramuscular injections of non-steroidal anti-inflammatory drugs and opioid analgesics, the third group - epidural anesthesia with local anesthetics. Comparative analysis of pain character, intensity was conducted, its dynamics in patients of all groups amid anesthesia was evaluated using a visual analogue scale, verbal rating scale, verbal descriptor scale, McGill pain questionnaire.Results. Baseline pain intensity in patients of all groups was high. Patients estimated this pain as «very strong». The time and the level of pain intensity reduction for various anesthesia types had differences. Pain syndrome was eliminated slower in patients of the second group. By the end of the 1st day, patients of this group continued to complain of «strong» pain. Pain intensity decreased only on the 2nd day - patients reported «moderate» pain. Pain syndrome was not completely eliminated in these patients for 2 days of anesthesia. 97.7% of patients reported that the visual analogue scale is the most acceptable pain assessment scale for them.Conclusion. In patients with acute pancreatitis, the most optimal anesthesia types are intramuscular nonsteroidal anti-inflammatory drugs with spasmolytics and prolonged epidural anesthesia with local anesthetics; intramuscular administration of opioid analgesics with non-steroidal anti-inflammatory drugs is less effective in relieving pain.


2021 ◽  
Vol 5 (2) ◽  
pp. 96-101
Author(s):  
V.B. Vasilyuk ◽  
◽  
G.I. Syraeva ◽  
M.V. Faraponova ◽  
◽  
...  

Gout is one of the most common forms of inflammatory arthritis. Medical care for gout includes non-steroidal anti-inflammatory drugs (NSAIDs). This paper reviews the efficacy and safety of NSAIDs prescribed for the acute attack of gout, in particular, AMBENIUM® parenteral. It was demonstrated that phenylbutazone is a powerful NSAID that provides significant analgesic and anti-inflammatory effects. Considering a broad spectrum of adverse reactions of NSAIDs, these agents should be prescribed and used under in-depth analysis of patient’s condition, comorbidities and the level of their decompensation, and potential drug interactions. In addition, optimal dosages and duration of NSAID treatment are of particular importance. The authors conclude that AMBENIUM® parenteral is an effective and safe therapeutic modality for gout. Its profile and risk/benefit ratio are regarded as “favorable” compared to other NSAIDs. KEYWORDS: gout, arthritis, pain, non-steroidal anti-inflammatory drugs, parenteral, efficacy, safety. FOR CITATION: Vasilyuk V.B., Syraeva G.I., Faraponova M.V. Efficacy and safety of non-steroidal anti-inflammatory drugs for acute attack of gout. Russian Medical Inquiry. 2021;5(2):96–101. DOI: 10.32364/2587-6821-2021-5-2-96-101.


2021 ◽  
pp. 67-72
Author(s):  
V. A. Parfenov ◽  
I. A. Lamkova

Introduction. Kinesitherapy (KT) – one of the leading areas of patient care with chronic nonspecific (musculoskeletal pain) low back pain. For chronic lumbar pain, a standard KT is commonly used, that includes group sessions with a medical specialist. Often not taking into account the individual characteristics of patients, their attitude to KT, does not use a backpain education program in combination with KT (extended KT). Physical activity and hypodynamia are compared in patients with chronic nonspecificlow back pain in standard KT and extended KT.Aim of study is to assess the effectiveness of the standard and extended KT in the enhancement of physical activity.Materials and methods. 71 patients were observed (17 men and 54 women, average age 55.09 ± 13 years) with chronic nonspecific low back pain. Patients received non-steroidal anti-inflammatory drugs (NSAIDs) as painkillers. 34 patients received a standard KT, 37 patients – an extended KT. Patients were asked to complete the Numeric Pain Rating Scale (NPRS), the Oswestry Low Back Pain Disability Questionnaire, and the International Physical Activity Questionnaire (IPAQ) at baseline, after 7 days and 90 days.Results and discussion. In the extended KT group, physical activity increased from 11 (7–16) points to 16 (13–19) points after 7 days (p = 0.001) and up to 23 (15–26) points after 3 months (p = 0.0002). There has been a statistically significant decrease in the proportion of patients with hypodynamy (p = 0.0015). There is no statistically significant increase in physical activity in the standard therapy group. The use of NSAIDs in non-specific low back pain is discussed, the effectiveness of the use of dexketoprofen (Dexalgin) during lumbar pain is noted.Conclusion. In the case of nonspecific low back pain, the extended KTimprovesphysical activity and reduce hypodynamy.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Małgorzata Chmielewska-Krzesińska ◽  
Krzysztof Wąsowicz

Abstract Introduction Ozone is not harmful itself; however, it directly oxidises biomolecules and produces radical-dependent cytotoxicity. Exposure to ozone is by inhalation and therefore the lungs develop the main anti-inflammatory response, while ozone has an indirect impact on the other organs. This study investigated the local and systemic effects of the ozone-associated inflammatory response. Material and Methods Three groups each of 5 Wistar Han rats aged 6 months were exposed for 2h to airborne ozone at 0.5 ppm and a fourth identical group were unexposed controls. Sacrifice was at 3h after exposure for control rats and one experimental group and at 24 h and 48 h for the others. Lung and liver samples were evaluated for changes in expression of transforming growth factor beta 1, anti-inflammatory interleukin 10, pro-inflammatory tumour necrosis factor alpha and interleukin 1 beta and two nuclear factor kappa-light-chain-enhancer of B cells subunit genes. Total RNA was isolated from the samples in spin columns and cDNA was synthesised in an RT-PCR. Expression levels were compared to those of glyceraldehyde-3-phosphate dehydrogenase (GAPDH) and analysed statistically. Results All variables changed non-linearly over time comparing experimental groups to the control. Conspicuous expression changes in the subunit genes and cytokines were observed in both evaluated organs. Conclusion Locally and systemically, inflammation responses to ozone inhalation include regulation of certain genes’ expression. The mechanisms are unalike in lungs and liver but ozone exerts a similar effect in both organs. A broader range of variables influential on ozone response should be studied in the future.


Sign in / Sign up

Export Citation Format

Share Document