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 combination of dexamethasone and B-vitamins is widely used in Mexico to treat neuropathic pain in human beings. However, so far there is no evidence in preclinical models about the efficacy of this combination. The purpose of this study was to assess the possible synergistic interaction between dexamethasone and the B-vitamin complex in a neuropathic pain model in the rat. Neuropathic pain was induced by ligation of the left L5 and L6 spinal nerves in female Wistar rats. Tactile allodynia was determined by measuring paw withdrawal in response to probing with a series of calibrated von Frey filaments. Dexamethasone (4-32 mg/kg), B-vitamins (75-600 mg/kg), or a combination of dexamethasone and B-vitamins (100:100:1 of vitamin B1, B6 and B12, respectively) was administered subcutaneously and the antiallodynic effect was determined. Isobolographic analyses were used to define the nature of the functional interactions between dexamethasone and B-vitamins (0.5:0.5). Dexamethasone (ED30 5.4+/-1.2 mg/kg), B-vitamins (ED30 181.1+/-2.6 mg/kg), and fixed-dose ratio dexamethasone-B-vitamins combinations dose-dependently reduced tactile allodynia in the rat. Theoretical ED30 value for the combination estimated from the isobologram was 128.2+/-5.8 mg/kg. This value was significantly higher than experimental ED30 value which was 21.8+/-2.3 mg/kg. Results indicate that subcutaneous administration of dexamethasone and B-vitamins interacted synergistically to reduce tactile allodynia in the rat and suggest the use of this combination to reduce neuropathic pain in humans.
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PMID:Antinociceptive synergy between dexamethasone and the B vitamin complex in a neuropathic pain model in the rat. 1563 21

Dexamethasone is likely to play a role in the etiology of hiccups in patients receiving cisplatin-based regimens. Two hundred seventy-seven patients received three doses of ondansetron 8mg intravenously (IV) at 4hour intervals plus dexamethasone 20mg IV from the start of chemotherapy, followed by dexamethasone 5mg IV every 12hours, until chemotherapy was complete. Hiccups were observed in 114 (41.2%) patients, of whom 97.4% were men. Nausea and vomiting showed inverse correlations with hiccups (P < 0.0001 and P = 0.001, respectively). In 73 patients who experienced hiccups but lacked nausea/vomiting (H+N/V-), we discontinued dexamethasone in subsequent cycles. Sixty-six patients (90.4%) ceased hiccuping, but complete protection rates of nausea and vomiting decreased to 63% and 74%, respectively. For patients who experienced both hiccups and nausea/vomiting, the onset of nausea/vomiting usually was delayed to Day 3 or 4 and began after the cessation of hiccups. We conclude that cisplatin-related hiccups are predominant in males, dexamethasone-induced, and associated with protection against nausea/vomiting.
J Pain Symptom Manage 2005 Oct
PMID:Cisplatin-related hiccups: male predominance, induction by dexamethasone, and protection against nausea and vomiting. 1625

During pulp injury, it has been hypothesized that transforming growth factor-beta1 (TGF-beta1) is released from dentin into pulp tissue and promotes pulp tissue healing. Dexamethasone is a glucocorticoid that has been used to treat pulp injury and shown to induce differentiation of hard tissue forming cells. However, the interaction between dexamethasone and TGF-beta1 is still unknown. This study aimed to examine the effects of dexamethasone on human pulp cells in the presence of TGF-beta1. TGF-beta1 increased expression and synthesis of both fibronectin and nerve growth factor (NGF), whereas dexamethasone stimulated fibronectin synthesis but inhibited NGF expression. The application of both TGF-beta1 and dexamethasone resulted in an additional effect on fibronectin; however, dexamethasone inhibited the TGF-beta1-induced NGF expression. Dexamethasone promotes fibronectin synthesis and suppresses NGF secretion, suggesting that this reagent could be used clinically to reduce pain and promote dental pulp tissue healing.
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PMID:Different roles of dexamethasone on transforming growth factor-beta1-induced fibronectin and nerve growth factor expression in dental pulp cells. 1793 32

Dexamethasone has antiemetic and analgesic effects in various types of surgery. In a randomized, double-blind, placebo-controlled trial, we evaluated the efficacy of dexamethasone for reducing postoperative nausea and vomiting (PONV) and analgesic requirement in women undergoing general anesthesia for mastectomy. Patient were allocated randomly to one of three groups (n=30 of each) to receive intravenously either placebo or dexamethasone at two different doses (4 mg, 8 mg) at the end of surgery. Postoperatively, emetic episodes and analgesic requirement were evaluated by an investigator. Patient demographics and types of surgery were not different among the treatment groups. The rate of patients experiencing PONV during 0-24 hours after anesthesia was 33% with dexamethasone 4 mg (p=0.01) and 27% with dexamethasone 8 mg (p=0.002), compared with placebo (67%). The need of indomethacin for intolerable pain was less in patients who had received dexamethasone 8 mg than in those who had received placebo (p=0.001) or dexamethasone 4 mg (p=0.034). No difference in analgesic requirement was found between the dexamethasone 4 mg and placebo groups (p=0.18). No clinically serious adverse events attributed to the study drug were observed in any of the groups. We conclude that dexamethasone 8 mg effectively decreases PONV and analgesic requirement in women undergoing general anesthesia for mastectomy.
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PMID:Reduction of postoperative nausea and vomiting and analgesic requirement with dexamethasone in women undergoing general anesthesia for mastectomy. 2805 13

This is a prospective, randomized, double blind study to evaluate the postoperative analgesia following supraclavicular brachial plexus block with Tramadol or Dexamethasone as an admixture to bupivacaine in upper extremity surgery. Total 60 patients of ASA I and II undergoing upper extremity surgery under brachial plexus block with Bupivacaine were randomly divided in to two groups; one group received Tramadol (2 mg/kg) and the other group received Dexamethasone (8 mg) as an admixture to Bupivacaine. The duration of postoperative analgesia was recorded in both groups using pain VAS score which was determined by maximum VAS score of 8-10 and when patient demands for additional analgesics. The mean duration of postoperative analgesia in the Dexamethasone group was 1028.00 minutes while in the tramadol group it was 453.17 minutes We concluded that Dexamethasone with local anaesthetic prolongs postoperative analgesia significantly than Tramadol (P<0.05) when used as admixture to local anaesthetic in brachial plexus block in upper extremity surgery.
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PMID:Comparative study between tramadol and dexamethasone as an admixture to bupivacaine in supraclavicular brachial plexus block. 1834 Mar 66

Many patients suffer from mild, moderate or severe pain during or after root canal therapy. The purpose of this study was to evaluate the efficacy of supraperiosteal injection of dexamethasone into the periapical tissues to prevent postoperative pain associated with inflammation. In a double-blind, placebo-controlled clinical trial, 100 patients with moderate or severe pain who were referred to dental school of Tehran Islamic Azad University participated in this study. All patients had a tooth with clinical diagnosis of irreversible pulpitis. After administration of local anaesthesia, access cavity was prepared. Then, the root canals were instrumented to a minimum of a No. 25 K-file. One millilitre dexamethasone (8 mg 2 mL(-1)) or placebo was injected around the tooth. The severity of pain was assessed with regard to a modified visual analogue scale after 6, 12, 24 and 48 h. The data was analysed statistically with chi-square test. Dexamethasone was considerably effective on controlling the severity of pain during the first 24 h; in contrast, there was no difference between dexamethasone and placebo groups 48 h after the first appointment. A single dose of dexamethasone infiltrated around the apex of a tooth with irreversible pulpitis could be effective in reduction or prevention of postoperative endodontic pain during the first 24 h.
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PMID:Effect of supraperiosteal injection of dexamethasone on postoperative pain. 1835

Brain edema is an important factor leading to morbidity and mortality associated with primary brain tumors. Dexamethasone, a synthetic glucocorticoid, is routinely prescribed with antineoplastic agents to alleviate pain associated with chemotherapy and reduce intracranial pressure. We investigated whether dexamethasone treatment increased the expression and activity of multidrug resistance (MDR) transporters at the blood-brain barrier. Treatment of primary rat brain microvascular endothelial cells with submicromolar concentrations of dexamethasone induced significantly higher levels of drug efflux transporters such as breast cancer resistance protein (abcg2), P-glycoprotein (P-gp; abcb1a/abcb1b), and MDR protein 2 (Mrp2; abcc2) as indicted by protein and mRNA levels as well as by functional activity. The effect of dexamethasone on transporter function was significant within 6 h of treatment, was dose dependent, and was reversible. Dexamethasone-induced upregulation of Bcrp and P-gp expression and function was partially abrogated by the glucocorticoid receptor (GR) antagonist RU486. In contrast, RU486 had no effect on the dexamethasone-induced upregulation of Mrp2, suggesting a GR-independent regulation of Mrp2, and a GR-dependent regulation of P-gp and Bcrp. In addition to the dexamethasone-induced upregulation of MDR transporters, we measured a dose-dependent and reversible increase in the expression of the nuclear transcription factor pregnane xenobiotic receptor (PXR). Administering dexamethasone to rats caused increased expression of PXR in brain microvessels within 24 h. These results suggest that adjuvant therapy with corticosteroids such as dexamethasone in the treatment of brain tumors may increase the expression of MDR transporters at the blood-brain barrier through pathways involving GR and PXR.
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PMID:Dexamethasone increases expression and activity of multidrug resistance transporters at the rat blood-brain barrier. 1852 38

Fifty patients with various musculoskeletal inflammatory conditions were treated with iontophoresis (direct current 5 milliamperes, 20 minutes). The treatment drugs were 1 cubic centimeter, 4 milligrams per milliliter of dexamethasone sodium phosphate (Decadron) combined with 2 cubic centimeters of 4% Xylocaine. Thirty-eight of the 50 patients had an excellent relief of pain and symptoms, seven reported moderate relief, and five patients had little or no change. There were no significant side effects. It was concluded that iontophoresis is an effective mode of delivering ionized antiinflammatory drugs to inflamed tissues. It is effective, painless, and safe, and provides a viable treatment. J Orthop Sports Phys Ther 1982;4(2):109-112.
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PMID:lontophoresis: Clinical Research in Musculoskeletal lnf lammatory Conditions. 1881 Jan 9

Tumors associated with the spinal cord can have devastating effects on patient function and quality of life. Most of these tumors are from metastatic disease, usually to the epidural space. Less frequently, the tumors are intrinsic to the spinal cord itself (ie, primary tumor). Regardless of the etiology, spinal cord tumors often present first with progressive local or radicular pain, or both. Other symptoms include weakness, sensory changes, or sphincter dysfunction. The timeliness of diagnosis of spinal cord tumors and promptness of treatment are important, as they directly affect outcome. Dexamethasone, a corticosteroid, is used as a temporizing measure to improve or stabilize neurologic function until definitive treatment. For nonambulatory patients with epidural metastatic tumors, surgery followed by radiation therapy maximizes neurologic function and modestly lengthens survival. However, palliative radiotherapy alone is recommended for those with neurologic deficits lasting longer than 48 hours, survival prognosis less than 3 months, inability to tolerate surgery, multiple areas of compression, or radiosensitive tumors. An ambulatory patient with a stable spine should be considered for radiation treatment only. The role of chemotherapy for epidural metastatic tumors is not well established. For intramedullary metastases, the role of surgery and chemotherapy remains controversial and radiation is the mainstay. For low-grade or benign primary spinal cord tumors, resective surgery is of benefit and can be curative. For high-grade tumors, the benefit of resection is less clear, and radiotherapy and/or chemotherapy may be helpful. The use of chemotherapy for primary spinal cord tumors has rarely been assessed. Agents reported in the literature for treatment of spinal cord gliomas include temozolomide, irinotecan, cisplatin, and carboplatin. A multidisciplinary approach is often required to maximize the therapeutic and functional outcome of patients with metastatic and primary spinal cord tumors.
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PMID:Treatment of spinal cord tumors. 1952 57

Dexamethasone causes extensive physiologic reactions including the reduction of inflammation and pain. Here, we asked whether it also affected dental or periodontal cells or dental innervation by altering voltage-gated sodium channel Na(v)1.6 immunoreactivity (IR) or neural synaptophysin. Daily dexamethasone (0.2 mg/kg) given for 1 week to rats caused 12-fold increased intensity of Na(v)1.6-IR in dendritic pulpal cells of normal molars and incisors compared with vehicle treatment. These cells also co-localized monocyte (ED-1) or dendritic cell (CD11b/Ox42) markers, and their location in molars expanded during dexamethasone treatment to include deeper pulp. Furthermore, dexamethasone caused a 10-fold decrease in the number of Na(v)1.6-immunoreactive multinucleate osteoclasts along the alveolar bone of molar root sockets. No changes occurred for neural Na(v)1.6 at axonal nodes of Ranvier, even though IR for calcitonin gene-related peptide was greatly decreased, as expected, and neural synaptophysin-IR was decreased 59% by dexamethasone. At 4 days after tooth injury, pulpal vasodilation and increased Na(v)1.6-immunoreactive pulp cells were similar for all groups. Thus, dexamethasone changes dental pulp cell and alveolar osteoclast Na(v)1.6-IR in normal teeth, but different mechanisms occur after tooth injury when tissue reactions were similar for dexamethasone- and vehicle-treated rats. Steroid-induced alterations of dental pain and inflammation coincide with altered exocytic capability in dental nerve fibers as shown by synaptophysin-IR and with altered pulp cell Na(v)1.6-IR and osteoclast number, but not with any changes in Na(v)1.6-IR for nodes of Ranvier in myelinated dental axons.
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PMID:Dexamethasone effects on Na(v)1.6 in tooth pulp, dental nerves, and alveolar osteoclasts of adult rats. 1976 26


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