scholarly journals Conolidine: A Novel Plant Extract for Chronic Pain

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Amber N. Edinoff ◽  
Akash S. Patel ◽  
Mitchell W. Baker ◽  
Jesse Lawson ◽  
Christopher Wolcott ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Care Setting ◽  
Primary Care Setting ◽  
Indole Alkaloid ◽  
Opiate Receptor ◽  
Common Symptom ◽  
Onset Of Action ◽  
New Era ◽  
Alternative Medications ◽  
Opioid Diversion

: Pain, the most common symptom reported among patients in the primary care setting, is complex to manage. Opioids are among the most potent analgesics agents for managing pain. Since the mid-1990s, the number of opioid prescriptions for the management of chronic non-cancer pain (CNCP) has increased by more than 400%, and this increased availability has significantly contributed to opioid diversion, overdose, tolerance, dependence, and addiction. Despite the questionable effectiveness of opioids in managing CNCP and their high rates of side effects, the absence of available alternative medications and their clinical limitations and slower onset of action has led to an overreliance on opioids. Conolidine is an indole alkaloid derived from the bark of the tropical flowering shrub Tabernaemontana divaricate used in traditional Chinese, Ayurvedic, and Thai medicine. Conolidine could represent the beginning of a new era of chronic pain management. It is now being investigated for its effects on the atypical chemokine receptor (ACK3). In a rat model, it was found that a competitor molecule binding to ACKR3 resulted in inhibition of ACKR3’s inhibitory activity, causing an overall increase in opiate receptor activity. Although the identification of conolidine as a potential novel analgesic agent provides an additional avenue to address the opioid crisis and manage CNCP, further studies are necessary to understand its mechanism of action and utility and efficacy in managing CNCP.

Psychological/Behavioral Therapies

2021 ◽  
pp. 211-230
Author(s):  
Daniel M. Doleys ◽  
Nicholas D. Doleys
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Adverse Events ◽  
Cell Phone ◽  
Care Setting ◽  
Primary Care Setting ◽  
Complex Nature ◽  
Self Help ◽  
Behavioral Therapies

The sole use of medically (somatic)-based therapies when treating a patient is rarely sufficient to address the complex nature of chronic pain. The risk of iatrogenic dependence, and compromising adverse events, encourages the use of a more comprehensive and patient-involved process. There are a number of psychologically based therapies applicable to the treatment of chronic pain. The most researched and commonly used are the behavioral-based therapies. They range from simple to complex and from brief to prolonged. While it may be preferable to have these treatments applied by a trained behavioral specialist with a background in chronic pain, many can be adapted for use in the primary care setting. Furthermore, a variety of cell phone apps, self-help books, and YouTube presentations are available for patient and family use.

scholarly journals The Dyspepsia Alphabet: DU, GU, GERD, NERD, NUD/FD and UD

2001 ◽  
Vol 15 (1) ◽  
pp. 49-55
Author(s):  
ABR Thomson
Keyword(s):  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Common Symptom ◽  
Treatment Algorithms ◽  
New Treatment ◽  
The Many

The care of patients with dyspepsia may be almost as confusing as the many terms that are used to describe this very common symptom. A symptom-based approach may prove to be ideal for the patient with undiagnosed dyspepsia. This brief overview describes some of the many terms used to describe dyspepsia. Clearly, new treatment algorithms are needed for the care of patients with undiagnosed dyspepsia seen in a primary care setting.

Functional self-efficacy and pain-related disability among older veterans with chronic pain in a primary care setting

Pain ◽  
2003 ◽  
Vol 104 (1) ◽  
pp. 131-137 ◽  
Author(s):  
Lisa C Barry ◽  
Zhenchao Guo ◽  
Robert D Kerns ◽  
Bao D Duong ◽  
Carrington M. Reid
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Self Efficacy ◽  
Care Setting ◽  
Primary Care Setting

scholarly journals Clinicoepidemiological profile and practices to manage dizziness in primary care setting: results from an Indian registry

2021 ◽  
Vol 7 (2) ◽  
pp. 320
Author(s):  
Divya Prabhat ◽  
Ganga Kiran
Keyword(s):  
Primary Care ◽  
Management Practices ◽  
Care Setting ◽  
Primary Care Setting ◽  
Treatment Approach ◽  
Study Data ◽  
Common Symptom ◽  
Primary Care Settings ◽  
Concomitant Medications

<p class="abstract"><strong>Background:</strong> Dizziness is a common symptom encountered in primary care settings by general physicians and specialists. This study evaluated the clinicoepidemiological profile and management practices in patients with dizziness in an Indian primary care setting.</p><p class="abstract"><strong>Methods:</strong> This prospective, multicentric, observational study was conducted between November 2018 and June 2019. Patients aged≥18 years presenting with clinical features of dizziness were eligible. The study data included demographics and socioeconomic details, complete medical history, medication and concomitant medication use, and the cause and pattern of dizziness. Patients had a baseline visit and two follow-up visits at weeks 1 and 4.   </p><p class="abstract"><strong>Results:</strong> Overall, 1000 patients with a mean age of 45.1 years were included (women: 51.5%; men: 48.5%). Of these, 762 reported dizziness as a primary complaint; whereas, 238 reported it as a complaint associated with nausea, vomiting and light-headedness on visit 1, which reduced on subsequent visits. Around 34% of the patients were unemployed and 59% belonged to the upper-middle class. The most common co-morbidities were hypertension and diabetes mellitus (n=132, each). More than 50% of the patients presented with vestibular cause (n=577), followed by neurologic (n=179), metabolic (n=84) and psychiatric (n=61) etiologies. Betahistine (n=581) and prochlorperazine (n=312) were the commonly prescribed medicines for primary and associated complaints. The most commonly used concomitant medications were telmisartan (n=53), glimepiride plus metformin (n=40), metformin (n=32) and ondansetron (n=29).  </p><p class="abstract"><strong>Conclusions:</strong> Dizziness has a multifactorial origin necessitating a multifactorial treatment approach. Betahistine and prochlorperazine were the most commonly prescribed drugs in the primary care setting (CTRI/2018/11/016408).  </p>

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