Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Nonsteroidal anti-inflammatory drugs (NSAIDs) have shown efficacy in patients with osteoarthritis (OA) pain but are also associated with a dose-dependent risk of gastrointestinal, cardiovascular, hematologic, hepatic, and renal adverse events (AEs). Topical NSAIDs were developed to provide analgesia similar to their oral counterparts with less systemic exposure and fewer serious AEs. Topical NSAIDs have long been available in Europe for the management of OA, and guidelines of the European League Against Rheumatism and the Osteoarthritis Research Society International specify that topical NSAIDs are preferred over oral NSAIDs for patients with knee or hand OA of mild-to-moderate severity, few affected joints, and/or a history of sensitivity to oral NSAIDs. In contrast, the guidelines of the American Pain Society and American College of Rheumatology have in the past recommended topical methyl salicylate and topical capsaicin, but not topical NSAIDs. This reflects the fact that the American guidelines were written several years before the first topical NSAID was approved for use in the United States. Neither salicylates nor capsaicin have shown significant efficacy in the treatment of OA. In October 2007, diclofenac sodium 1% gel (Voltaren Gel) became the first topical NSAID for OA therapy approved in the United States following a long history of use internationally. Topical diclofenac sodium 1% gel delivers effective diclofenac concentrations in the affected joint with limited systemic exposure. Clinical trial data suggest that diclofenac sodium 1% gel provides clinically meaningful analgesia in OA patients with a low incidence of systemic AEs. This review discusses the pharmacology, clinical efficacy, and safety profiles of diclofenac sodium 1% gel, salicylates, and capsaicin for the management of hand and knee OA.
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PMID:Topical therapy for osteoarthritis: clinical and pharmacologic perspectives. 1933 72

In this study the effect of vehicle on in vitro diffusion of diclofenac sodium (DS) from new different formulations such as Carbopol gel (A), Sodium lauryl sulphate cream (B) and Carbopol cream (C) was evaluated with Franz diffusion cells using hydrophilic and hydrophobic synthetic membranes. The commercial formulation Voltaren Emulgel was used as reference. Furthermore, the in vivo efficacy of topical formulations was studied in the carrageenan-induced edema and hyperalgesia, whereas the antinociceptive effect was evaluated on thermal pain threshold in rat paw. The flux of DS across hydrophilic membranes showed this rank order: Control approximately equal to C > A approximately equal to B. On the other hand, the diffusion rate of DS across hydrophobic membranes resulted in the following order: Control > B > A approximately equal to C; this suggested a lower interaction between the vehicles and these membranes. The in vivo results indicated that the prepared formulations failed in the inflammatory tests to reduce the development of edema. Nevertheless, treatment with B formulation inhibited the development of acute hyperalgesia induced by carrageenan, and elicited a significant increase in paw withdrawal latencies whereas other formulations were ineffective. The results obtained in this study suggest that Sodium lauryl sulphate cream might be useful in local pain conditions and may be an effective alternative to the presently used systemic routes.
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PMID:Effect of vehicle on diclofenac sodium permeation from new topical formulations: in vitro and in vivo studies. 1941 61

The article deals with an investigation of therapeutic efficiency combined with applications of biological preparations and special medical-improving gymnastic exercises at treatment of a vertebral cervical osteochondrosis on the one hand, traditional means on the other hand. 76 patients aged 31-62 have taken part in the given research. The basic group was made by 47 patients and the control group - by 29. The patients of the basic group applied a special complex of medical-improving gymnastic exercises, and also paravertebral injections of biological preparations Traumeel S, Neuralgo-Rheum-Injeel. The patients of the control group received traditional therapy of a vertebral osteochondrosis. Injections of Voltaren (Diclofenac) intramuscularly, MIG400 (Ibuprophen) tablets, phonophorez with Indometacin ointment, a traditional complex of physiotherapy exercises. Duration of the treatment in all groups has made 28 days. Obtained data testify that by the end of treatment full knocking over of a pain syndrome in the basic group is noted at 71,2 % of patients, in control group only in 41,4 % of patients the pains have completely disappeared in a cervical spine. Thus, therapy by biological preparations in a combination to a complex of special medical-improving gymnastic exercises allows to reduce terms of knocking over of sharp clinical displays of an osteochondrosis of a cervical spine, to raise efficiency of restoration of sensitive, vascular, muscular-tonic frustration, and also allows to avoid neuro-surgical intervention at patients with hernias interspine disks.
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PMID:[The complex approach to treatment of pain syndrome of cervical vertebral osteochondrosis]. 1955 39

We have evaluated objectively pain tolerance in transrectal ultrasound-guided prostate biopsy (TRUS) using local periprostatic per rectal anesthesia as compared to the conventional method. From November 2008 to May 2009, 90 patients underwent transrectal ultrasound-guided prostate biopsy at Department of Urology, Clinical Center University Sarajevo. 90 patients who fulfilled the inclusion criteria were randomized into 3 groups of 30 patients each. Group 1 received periprostatic local anesthesia with 2% lidocaine, group 2 received Voltaren supp placed in rectum an hour before biopsy while group 3 received no local anesthesia. Pain scale responses were analyzed for each aspect of the biopsy procedure with a visual analog scale of 0-none to 10-maximal. There was no difference between the 3 groups in pain scores during digital rectal examination, intrarectal injection and probe insertion. The mean pain scores during needle insertion in group 1 receiving periprostatic nerve block and in group 2 receiving Voltaren supp were 3,10 +/- 2,32 and 5,15 +/- 2,01 respectively. In group 3 (no local anesthesia), mean pain scores were 6,06 +/- 2,95 which was found to be significantly different (p < 0,001). However, morbidity after the biopsy was not statistically different between all 3 groups. TRUS-guided prostate biopsy is a traumatic and painful experience, but the periprostatic blockage use is clearly associated with more tolerance and patient comfort during the exam. It is an easy, safe, acceptable and reproducible technique and should be considered for all patients undergoing TRUS biopsy regardless of age or number of biopsies.
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PMID:Transrectal ultrasound-guided prostate biopsy, periprostatic local anesthesia and pain tolerance. 2019 35

Non-steroidal anti-inflammatory drugs are commonly prescribed in dental practice after minor oral surgical procedures such as tooth extraction. Diclofenac sodium is one of the non-steroidal anti-inflammatory drugs widely used for pain relief in dentistry. Although adverse reactions to these drugs are rare, at times they can cause a life-threatening phenomenon. Stevens-Johnson syndrome is one such potentially lethal adverse drug reaction. Most reported cases of analgesic-induced Stevens-Johnson syndrome were due to oxicams or propionic acid derivatives. There are very few detailed reports of Stevens-Johnson syndrome due to use of diclofenac. We report here a case of Stevens-Johnson syndrome which occurred due to use of diclofenac sodium. The clinical features of this condition and multidisciplinary management of the patient are described in brief.
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PMID:Stevens-Johnson syndrome: a case report. 2058 64

We examined 140 patients, aged from 23 to 47 years, with headache of tension type (HAT). Patients were stratified into two groups: HAT with trigger zones in pericranial muscles (HAT-1) and HAT without those (HAT-2). The study included the detection of pain threshold and pain tolerability in pericranial muscles using pressure algometer, quantitative assessment with the McGill Pain Questionnaire, evaluation of depression and anxiety. Loci of primary and secondary hyperalgesia, signs of anxiety disorder were observed in patients with HAT-1. Diclofenac sodium had a temporary effect and tizanidine had a stable positive effect. In patients with HAT-2, we found loci with signs of secondary hyperalgesia in pericranial muscles and symptoms of depression. There was no effect of diclofenac sodium, tizanidine had a subtle positive effect and venlafaxine exerted a good stable effect. In conclusion, there are different pathophysiological mechanisms of HAT with the presence of trigger zones in pericranial muscles and HAT without trigger zones.
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PMID:[Clinical features of headache of tension type and principles of treatment]. 2118 2

Topical nonsteroidal anti-inflammatory drugs (NSAIDs) may offer a safer alternative to their oral counterparts for the management of osteoarthritis. Diclofenac sodium topical solution with dimethyl sulfoxide (TDiclo) was evaluated in five randomized, controlled trials and is indicated for treatment of the signs and symptoms associated with osteoarthritis of the knee. Three studies showed that TDiclo is superior to placebo and vehicle control with respect to pain, physical function, and perception of osteoarthritis symptoms. Two studies showed that benefits are similar to those of oral diclofenac, with one study demonstrating statistical equivalence. The most common adverse event associated with TDiclo in these studies was dry skin. Incidences of gastrointestinal adverse events and abnormal levels of liver enzymes were lower with TDiclo compared with oral diclofenac in active-controlled studies. Based on these studies, TDiclo represents a practical, evidence-based option for the management of osteoarthritis of the knee.
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PMID:Diclofenac sodium topical solution with dimethyl sulfoxide, a viable alternative to oral nonsteroidal anti-inflammatories in osteoarthritis: review of current evidence. 2181 89

Withaniasomnifera (Ashwaganda) belonging to the family solanaceae is the subject of our present study. Withanoloides which are the major chemical constituents have been proved of interest because of their structural variations in the hybrids of different races. Docking is the process which brings the two structures together. In the present study we focus the extensive use of tool and graphical software for the identification of the binding energy of selected Withanolides like Withaferin -A, Withanolide-D from Withaniasomnifera and to screen the phytoconstituents that will dock/bind to the active sites of COX-2 enzyme. The relief from the symptoms of inflammation and pain can be by the Pharmacological inhibition of COX which involves the prediction of potential ligand for the treatment of inflammation. The energy value of docking between the target and the phytoconstituents under investigation and comparison with Diclofenac sodium was taken into consideration for coming into conclusion regarding the best pose and the binding ability.
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PMID:Molecular docking studies of withanolides against Cox-2 enzyme. 2271 47

Previously it was reported elsewhere that Lawsonia inermis have anti-inflammatory and analgesic effect in experimental animals. The in vitro porcine alpha amylase inhibitory effect was investigated of this plant methanolic extracts and consequently hypoglycemic effect by quantitatively determining the maltose from the maltose standard curve while the anti-inflammatory effect by acetic acid induced writhing test in mice. Acarbose (10 microg mL(-1)) and Diclofenac sodium (20 mg kg(-1)) were used as reference hypoglycemic and anti-inflammatory drugs, respectively, for this study. The methanolic leaves extract of the plant significantly inhibited (60.97% compared to untreated) enzymatic activity of the amylase at 10 microg mL(-1) dose (p < 0.05) also reduced the chemically induced nociceptive pain stimuli significantly at all doses (p < 0.01). Carbohydrates, glycosides, flavonoids, saponins and tannins were found to have in phytochemical screening of the extract which are thought to bring these effects. For the conclusive purpose, it is suggesting from the result that the pharmacological properties of this Lawsonia inermis can elicit hypoglycemic effect by inhibiting alpha-amylase enzyme and can reduce neurogenic pain stimulus. It gives the notion that how this group of patient would be therapeutically benefitted by decreasing both these effects by the same agent which is easy available.
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PMID:Alpha amylase enzyme inhibitory and anti-inflammatory effect of Lawsonia inermis. 2450 51

Diclofenac sodium is a 2-arylacetic acid, nonsteroidal anti-inflammatory drug. It is widely used in pain management. Side effects such as urticaria, asthmatic attack, vasospastic angina, ischemic stroke, and Kounis syndrome may be seen after the use of diclofenac sodium. However, anaphylactic shock is rare. Anaphylactic shock secondary to injection of diclofenac sodium can be treated successfully with intramuscular injection of adrenaline. Because diclofenac sodium is commonly used in analgesic treatment in emergency departments, we present this case report to emphasize that anaphylactic shock may be seen after the use of that drug.
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PMID:Anaphylaxis after intramuscular injection of diclofenac sodium. 2458 86


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