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)

The medicinal therapy of osteoarthritis is based on the use of analgesics, NSAIDs and corticosteroids to relieve pain and inflammation. In addition, "chondroprotective" agents (CPA) are used to stop the evolution of the disease. In this review the biochemical and pharmacological activities of some of the most widely used CPAs are described. All of these show more or less marked antiinflammatory activities, which for some of them are the result of an inhibition of cyclo-oxygenase and of prostaglandin biosynthesis, in which case they should be more properly classified as mild NSAIDs. Only two of the CPAs reviewed, diacerein and D-glucosamine sulfate, elicit antiinflammatory and antireactive effects without significant inhibition of the prostaglandin biosynthesis. These agents have also remarkable chondroprotective effects, and only these two agents should be classified as true CPAs. In particular glucosamine sulfate, which naturally occurs in the human body and is almost devoid of toxicity, is suitable for long-term therapeutic use. This, with its chondrometabolic, antireactive and antiarthritic properties, represents the pharmacological rationale for the use of glucosamine sulfate as a disease-modifying agent in osteoarthritis.
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PMID:Antireactive properties of "chondroprotective" drugs. 130 Mar 11

In a prospective, randomized study, continuous infusion of epidural fentanyl citrate (group E) was compared with patient-controlled intravenously administered morphine sulfate (group P) for analgesia in 66 men after radical retropubic prostatectomy. Although both methods provided satisfactory analgesia, the mean comfort level scores were lower (that is, greater comfort) in group E than in group P at all observation times. The difference in mean resting comfort level scores between groups E and P was statistically significant (P < or = 0.05) at 9 of the 11 observation times. In addition, significant differences in comfort level scores were noted at 8 of the 11 observation times during deep breathing, 5 of 11 during coughing, and 3 of 9 during ambulation. Maximal and minimal comfort level scores recorded by each patient during the course of the study were significantly lower (that is, less pain) in group E than in group P for all four categories of activity. The percentage of patients who reported no pain was significantly higher in group E than in group P at 9 of 11 observation times during resting and 5 of 11 observation times during deep breathing. No significant differences were noted in side effect profiles or duration of hospital stay. In summary, when two effective methods of analgesia used after radical retropubic prostatectomy were compared prospectively, patients who received epidural infusion of fentanyl were more comfortable than those with patient-controlled intravenous administration of morphine, as evidenced by lower mean, maximal, and minimal comfort level scores and a greater proportion of patients with complete relief of pain.
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PMID:A prospective randomized comparison of epidural infusion of fentanyl and intravenous administration of morphine by patient-controlled analgesia after radical retropubic prostatectomy. 143 73

Ketorolac tromethamine is a new injectable/oral nonsteroidal anti-inflammatory analgesic with no apparent opiate receptor activity that has been administered alone and in combination with other opiate analgesics for the treatment of postoperative pain. The drug has shown promise in analgesic comparisons with morphine sulfate; it lacks the effects of respiratory depression and nausea and vomiting usually associated with narcotic agents. Intramuscular ketorolac may be particularly useful with those patients who have respiratory disease and patients being dismissed following short ambulatory or private-office anesthetic procedures.
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PMID:Ketorolac tromethamine: an oral/injectable nonsteroidal anti-inflammatory for postoperative pain control. 144 12

Morphine sulfate (MS Contin), a proven analgesic in the treatment of cancer pain and chronic benign pain, seems to be a good analgesic for the treatment of burn pain. MS Contin is morphine sulfate incorporated in a wax cellulose matrix delivery system. This wax cellulose delivery system gives MS Contin its duration of action. Ten patients were enrolled in an open-labeled, nonrandomized study. The study was designed to examine the analgesic efficacy of MS Contin in the burn population. Each patient remained in the study for 6 days. The efficacy of the analgesic regimen was subjectively measured by the visual pain scale. The MS Contin group was retrospectively compared with a group of patients who were given continuous intravenous infusions of morphine. The two groups were matched according to age, burn size, surgical procedures, and hospital stay. The analgesic qualities of MS Contin were comparable to those of continuous intravenous morphine sulfate infusions. MS Contin is a possible candidate for the treatment of patients with burn pain because of its analgesic qualities, oral dosing, and duration of action.
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PMID:Use of morphine sulfate (MS Contin) in patients with burns: a pilot study. 145 94

Low density lipoprotein (LDL) apheresis was carried out in 28 atherosclerotic patients with clinical signs of poor peripheral circulation and abnormally high LDL levels. The LDL apheresis using extracorporeal adsorption with a dextran sulfate cellulose column (Liposorber, Kaneka, Japan) was done 10 times over 3 months. Hyperlipidemia was rapidly corrected after the initial two aphereses, whereas clinical signs of arteriosclerosis obliterans (ASO), such as coldness of the legs in 17 of 19 patients (89.5%), intermittent claudication in 14 of 17 patients (82.4%), foot pain at rest in 15 of 18 patients (83.3%), poor arterial pulsation in 12 of 16 patients (75.0%), and diminution of ulcer/necrosis in 3 of 5 patients (60.0%), improved in parallel. Improvement in plethysmographic and thermographic findings were observed in 10 of 10 patients (100.0%) and 13 of 14 patients (92.9%), respectively. Our tentative conclusion is that LDL apheresis using the Liposorber system was very effective in removing LDL from blood, and clinical symptoms rapidly improved in all patients concomitant with a reduction in plasma LDL levels. Hyperlipidemia may be a risk factor for symptomatic ASO in the lower extremities, and its active correction may be worth trying.
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PMID:LDL apheresis in atherosclerotic disease with hyperlipidemia. 145 97

The effects of pentazocine, diazepam and midazolam in 100 patients to reduce the uncomfortable feeling during epidural block procedure were studied. All patients (ASA I-II) were premedicated with intramuscular atropine sulfate 0.5 mg and hydroxyzine 50 mg. To relieve pain and anxiety during epidural block procedure, pentazocine (15 mg; 20 Cases or 30 mg; 20 Cases), diazepam (5 mg; 20 Cases) or midazolam (2.5 mg; 20 Cases) was given intravenously in the operating room before epidural procedure. After the epidural block, patients were anesthetized with nitrous oxide-oxygen-isoflurane or nitrous oxide-oxygen-sevoflurane. The following day, patients' self-assessments of pain during epidural block procedure were categorized as good and fair. The effects of drugs were compared between patients with im premedication only with patients with further iv administration. Patients with pentazocine 15 mg were similar to the patients given only im premedication. Pentazocine 30 mg and diazepam 5 mg tended to allay the patients' pain feeling. Midazolam 2.5 mg was effective producing anterograde amnesia and antianxiety effects. Small doses of midazolam were effective to relief patients' uncomfortable feeling.
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PMID:[The effects of pentazocine, diazepam and midazolam in patients to reduce the uncomfortable feeling during epidural block procedure]. 146 Jul 60

Cachexia occurs in the majority of cancer patients before death. It is the result of major metabolic changes produced by tumor-released substances as well as by cytokines and some endogenous peptides. The most significant clinical manifestation is profound anorexia. Aggressive parenteral nutrition has not been able to increase patient survival or produce any significant symptomatic improvement. Recent research, therefore, has focused on drugs that might result in symptomatic improvement, even if no significant nutritional changes are detected. Corticosteroids have been shown to increase appetite for a brief period of time, but they do not appear to improve caloric intake or nutritional status. In addition to appetite stimulation, corticosteroids also improve a number of other symptoms transiently. Progestational drugs have been found in a number of studies to increase appetite, caloric intake, and nutritional status. The most effective type and dose of progestational drugs have not been clearly established. Cyproheptadine, hydrazine sulfate, and cannabinoids have all been suggested to have beneficial effects on appetite; their effectiveness, however, needs to be confirmed in prospective, controlled trials. Some of these trials are currently under way. Current data suggest that megestrol acetate or other progestational agents could be useful--because of effects on not only appetite but also overall nutritional status--in patients who have profound anorexia as the main manifestation of cachexia, provided expected survival can be measured in weeks or months. In patients with shorter expected survival or those who have problems tolerating progestational drugs, a brief course of corticosteroids may provide short-term symptomatic effects. Future studies should focus on (1) improving understanding of both the pathophysiology of cancer cachexia and the interaction of some of the major syndromes of terminal cancer--e.g., pain, cachexia, and cognitive failure--and (2) characterizing the symptomatic effects of different drugs more completely.
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PMID:Clinical management of anorexia and cachexia in patients with advanced cancer. 146 26

Recent studies have shown that, in the presence of inflammation, the local administration of opioids results in analgesia. The analgesic efficacy of local anesthetics and morphine administered intraarticularly was compared in patients undergoing arthroscopic knee surgery under epidural anesthesia. We compared postoperative pain scores (VAS) and opioid requirements among 47 patients receiving, in a randomized, double-blinded fashion, one of three intraarticular medications (20 ml): normal saline with 100 micrograms epinephrine (group 1, n = 16); 0.25% bupivacaine with 100 micrograms epinephrine (group 2, n = 15); and 3 mg morphine sulfate and 100 micrograms epinephrine in normal saline (group 3, n = 16). VAS scores were similar in the groups preoperatively and on arrival in the recovery room. At the end of the first postoperative hour, the residual sensory blockade was minimal in all three groups (mean = 3.8-4.1 segments) and almost total recovery occurred in all three groups before the second postoperative hour. The VAS in group 3 was not significantly different than group 1 at any time interval. Intraarticular bupivacaine (group 2) provided significantly better analgesia than did saline or morphine (group 1 or 3) in the first 2 postoperative hours (ANOVA, P < .05). Subsequent VAS scores were not significantly different in the three groups. While no patient in group 2 requested analgesics during the first postoperative hour, nine patients in group 3 required systemic analgesics (P < .01). We conclude that no evidence for a peripheral opiate-receptor mediated analgesia could be demonstrated in patients undergoing arthroscopic knee surgery under epidural anesthesia.
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PMID:Comparison of postoperative analgesic effects of intraarticular bupivacaine and morphine following arthroscopic knee surgery. 146 65

The objectives of the study were to compare the efficacy and safety of a continuous infusion (CIV) of morphine and intermittent parenteral opioids (IPO) in children with sickle cell vaso-occlusive crises (VOCs); to determine whether 50% oxygen administration through a face mask can reduce the duration of severe pain in patients receiving CIV morphine; and to measure morphine concentration at steady state for pharmacokinetic and pharmacodynamic analysis in patients receiving CIV morphine. The study was designed as a prospective, controlled, "before-and-after" evaluation of two different analgesic regimens. For patients receiving CIV morphine, there was a randomized, double-blind, placebo-controlled study of O2 vs. air. The patients were 66 children with sickle cell disease, 3-18 years old, requiring opioid therapy for severe VOC (32 patients in phase A, 34 in phase B). The analgesic regimens were as follows: phase A: meperidine, morphine, or codeine IM or IV bolus every 3 or 4 hours; phase B: morphine sulfate, loading dose 0.15 mg followed by CIV 0.04 mg/kg/hr. The infusion rate was adjusted every 8 hours according to pain and/or symptoms of opioid toxicity. Pain assessment was by behavioral observation (BPS). In terms of results, the mean opioid dose (morphine equivalent) was similar in both groups (0.032 +/- 0.020 mg/kg/hr in phase A and 0.035 +/- 0.011 in phase B). However, the duration of severe pain was significantly shorter in phase B (0.9 +/- 1.0 days) than in phase A (2.0 +/- 1.8 days). No severe opioid toxicity was observed in either group. Oxygen did not shorten the duration of severe pain compared to the placebo group (0.94 +/- 1.08 and 0.95 +/- 1.19 days, respectively) nor did it prevent the appearance of new pain sites. Pharmacokinetic analysis was performed in 24 patients of phase B. Total body clearance (TBC) of morphine was greater in children before puberty than after (40.4 +/- 10 vs. 28 +/- 11 mL/kg/min; p < 0.05). In conclusion, in children with severe VOCs, continuous infusion of morphine provides better analgesia than intermittent opioid therapy. Fifty percent oxygen inhalation had no effect on the duration of pain.
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PMID:Analgesia in children with sickle cell crisis: comparison of intermittent opioids vs. continuous intravenous infusion of morphine and placebo-controlled study of oxygen inhalation. 146 65

An experimental clinical study was performed using heparan sulfate in order to ascertain the effects of the drug in the treatment of 2nd or 3rd degree varicose dilatation of the hemorrhoid plexus. Forty female patients, mean age 37 years and suffering from varicose dilatation of the hemorrhoid plexus, were enrolled in the study. The study was carried out in an open comparison with oxerutin using parallel groups with random access. After a run-in period of 3 days, 20 patients commenced treatment with 1 50 mg tablet of heparin sulfate 3 times daily, whereas the other 20 patients were given 1,500 mg oxerutin tablet again 3 times daily. Subsequently, treatment was continued at the following doses: 1 50 mg tablet of heparin sulfate twice a day, and 1,500 mg tablet of oxerutin twice a day, for a duration of two weeks. At pre-established times (before treatment, after 1 week, after 2 weeks), a standard questionnaire was filled in relating to each patient in order to evaluate the efficacy and tolerability of treatment. No adverse or undesirable effects were reported. Each participant was also put on a personalized and computerised diet with the same fibre intake. 55% of patients treated with oxerutin reported persistent moderate or intense pain caused by defecation compared to 45% of the group treated with heparan sulfate. Both drugs induced the remission of skin rash and itching. Compared to the control drug, heparan sulfate was more efficacious in relation to the normalisation of hyperemia and mucoid secretion.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Effects of administration of 50 mg heparan sulfate tablets to patients with varicose dilatation of the hemorrhoid plexus (hemorrhoids)]. 148 Mar 10


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