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)

Recently, caffeine consumption in Japan is thought to have increased. Although caffeine had been considered to be harmless, there have been studies which suggests an association between caffeine and health and give rise to vigorous discussion. However, in Japan, there have been few epidemiological studies on caffeine consumption among a general population. A questionnaire survey was conducted among medical students and the results were as follows: 1) High dose users (estimated daily caffeine use is 250 mg or more) were observed in 15.2% and the proportion was higher in males than in females. 2) The respondents gave sleepiness, dry mouth and so on, as reasons for taking caffeine beverages, and gave, as the effects of caffeine, becoming clear-headed, shaking off sleepiness, and epigastric discomfort or pain. 3) A third of respondents have experienced taking caffeine tablets and ampules to shake off sleepiness and, in males, the more caffeine they had daily, the more who reported the experience. 4) Caffeine consumption has an association with alcohol use and smoking habit among males.
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PMID:Caffeine consumption among medical students. 208 88

Carbamazepine (CBZ), an anticonvulsant with psychotropic and anti-pain properties, has been reported to displace ligands at adenosine binding sites. This paper describes biochemical and behavioural studies in rodents comparing CBZ to the adenosine agonists L-phenylisopropyl-adenosine (L-PIA) and N-ethylcarboxamido-adenosine (NECA), the new antagonists PD116,948 and PD115,199 which are also relatively A1 and A2 specific respectively, and the mixed antagonists theophylline and caffeine, attempting to determine functional correlates of the binding studies. Changes in cAMP synthesis and behavioural syndromes produced by the drugs, alone and in combination, were monitored. Classification of the observed effects in terms of A1 and A2 activity was complex, probably due to functional interactions between A1 and A2 subtypes. Nevertheless, it was found that chronic CBZ administration (0.25% in food for 3 days, followed by 0.5% for 11 days) produced a pattern of interaction identical to that of PD115,199 (10-100 mg/kg IP). Thus, both treatments attenuated the behavioural syndrome produced by L-PIA (0.1 or 0.5 mg/kg SC), but did not affect that produced by NECA (0.03 mg/kg SC). CBZ mildly increased hypoactivity after clonidine (0.2 mg/kg IP) which was used as a control. By contrast, the A1 antagonist PD116,948 (0.1-10 mg/kg IP) antagonised both behavioural syndromes. Similarly in the biochemical experiments both chronic CBZ and PD115,199 (10-100 microM) reduced stimulation of cAMP synthesis by L-PIA (confirming that this is mediated by A2 receptors), while only basal cAMP synthesis was affected by PD116,948 (10 microM) and theophylline (60 microM).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Chronic carbamazepine down-regulates adenosine A2 receptors: studies with the putative selective adenosine antagonists PD115,199 and PD116,948. 215 32

Post-lumbar puncture headache (PLPHA) and spontaneous hypoliquorrheic headache are both associated with low spinal fluid pressure. A dull or throbbing occipital ache characteristically worsened by sitting or standing and eased by lying down is peculiar to both. Additional symptoms and signs may accompany the headache. In PLPHA the pain is triggered by leakage of cerebrospinal fluid through the dural rent, but the cause of the pain is probably due to intracranial arterial and venous dilatation. The same mechanism probably applies to spontaneous hypoliquorrheic headache in which the site of leakage is rarely found. The majority of cases subside without treatment over several days. Those that persist may be treated with epidural blood patch or saline infusion with good results. A simple, innocuous, yet underutilized form of treatment is caffeine sodium benzoate. This review will discuss the incidence, pathogenesis, prevention and treatment of these headaches.
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PMID:Headaches associated with low spinal fluid pressure. 218 67

Thanks to recent biochemical and neuroendocrine findings, migraine belonging to the group of primary headaches appears as a pathology of the antinociceptive system with evolutive character. It has been demonstrated, in fact, that right at the early stage of migraine, there is a significant reduction in liquoral concentrations of beta-endorphin (beta-E), endogenous opioid peptide followed by a similar change in the plasma opioid system. The opioid system deficiency is even more evident after stimulation tests that point to reduced reactivity of the hypothalamo-hypophyseal system with respect to stimuli that in normal subjects trigger hypophyseal beta-E incretion. Caffeine, a member of the methyl-xanthine group, is an interesting molecule in the study of migraine patients because the chronic intake of this substance, contained in numerous analgesics, has been related to the chronic nature of the pain. The purpose of the present study is to assess the relationship between caffeine consumption and plasma opioid system. With the administration of a single oral dose of caffeine, normal subjects present an increase in plasma concentrations of beta-E, while in patients with chronic migraine, the response is significantly lower. These data confirm the poor reactivity of the plasma opioid system to pharmacological stimuli in migraine. Average daily consumption of caffeine has also been determined. It was not possible to establish a correlation between consumption of caffeine and plasma concentrations of beta-E whether basal or after stimulus with caffeine.
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PMID:[Plasma beta-endorphin and caffeine consumption in chronic hemicrania]. 223 63

Four common oral analgesics were tested in a single-blind trial to determine their relative efficacy in the management of postsurgical pain in 103 patients who had their impacted third molars surgically removed under general anesthesia. The analgesics tested were acetylsalicylic acid (26 patients), ibuprofen (26 patients), a paracetamol/codeine/caffeine combination (Solpadeine) (25 patients), and dihydrocodeine (26 patients). The paracetamol/codeine/caffeine combination, ibuprofen, and acetylsalicylic acid preparations produced equally effective analgesia. Dihydrocodeine was found to be a poor analgesic in this pain model. There were no adverse reactions to any of the preparations.
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PMID:A study of the comparative efficacy of four common analgesics in the control of postsurgical dental pain. 223 74

Three hundred fifty outpatients with postoperative pain after the surgical removal of impacted third molars were randomly assigned, on a double-blind basis, to receive a single oral dose of aspirin 650 or 1000 mg, caffeine 65 mg, a combination of aspirin 650 mg with caffeine 65 mg, or placebo. Using a self-rating record, subjects rated their pain and its relief hourly for 6 hours after medicating. Estimates of summed pain intensity difference, peak pain intensity difference, total relief, peak relief, and hours of 50% relief were derived from these subjective reports. All active treatments except caffeine were significantly superior to placebo. Pairwise comparisons indicated the aspirin-caffeine combination was statistically superior to aspirin 650 mg alone for hours of 50% relief among patients who had severe baseline pain. Adverse effects were transitory and none were serious.
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PMID:Evaluation of aspirin, caffeine, and their combination in postoperative oral surgery pain. 228 58

Forty postpartum patients with postdural puncture headache (PDPH) were randomly assigned to receive oral caffeine (300 mg) or a placebo. Intensity of headache, quantitated using a visual analogue pain scale (VAS), was assessed immediately before drug administration and 4 and 24 h later. Relief of PDPH measured as delta VAS (initial VAS - VAS at 4 h) was significantly better in the caffeine than in the placebo group (P = 0.014). Six patients (30%) whose PDPH was relieved by caffeine at 4 h had recurrence of symptoms the following day. Our study demonstrates that caffeine administered orally provides relief, albeit if sometimes transient, from PDPH with minimal side effects.
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PMID:Effects of oral caffeine on postdural puncture headache. A double-blind, placebo-controlled trial. 240 33

A significant percentage of chronic headache sufferers use excessive quantities of substances for relief. Drug dependency is frequent in these patients. Patients have an impaired lifestyle, sustain organ system damage, may suffer a withdrawal syndrome, and continue to have headaches. Drug abuse must cease before a satisfactory remission occurs. Particular attention is directed to ergotamine, butalbital, analgesics, and caffeine. The mechanism of substance abuse may be related to repeated use of substances that reinforce behavior and stimulate brain reward systems. Treatment includes comprehensive diagnostic workup, withdrawal of the agent, and use of headache preventives. beta-Adrenergic blockers, tricyclic antidepressants, monoamine oxidase (MAO) inhibitors, and nonsteroidal anti-inflammatory agents may be of value. Behavior modification and dietary counseling are also helpful.
Clin J Pain 1989
PMID:Drug abuse in headache patients. 252 Mar 77

The intrathecal administration of strychnine in rats yields a prominent touch-evoked allodynia. The effects of an intrathecally administered A1 adenosine agonist: N6-(L-2-phenylisopropyl)-adenosine (LPIA) or an A2 adenosine agonist: 5'-(N-ethyl carboxamido)-adenosine (NECA), on this touch-evoked hyperesthesia were examined. Over the range of 0.3-1.0 nmol these agents produced a dose-dependent inhibition of the strychnine-evoked hyperesthesia. This inhibition was reversed following intraperitoneal injection of caffeine, an adenosine receptor antagonist. No statistical differences between LPIA and NECA were recorded. The powerful effect of adenosine analogues on strychnine hyperesthesia occur at doses that have only a mild analgesic effect on the thermally evoked hot-plate response. This effect is in contrast to opioids, which have been reported to be only minimally effective against strychnine-evoked hyperesthesia. The characteristics of the strychnine hyperesthesia appear to mimic the clinical phenomenon observed in patients suffering from sensory dysesthesia following nerve injury and suggest a possible role for the adenosine receptor in certain pain states.
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PMID:Role of spinal adenosine receptors in modulating the hyperesthesia produced by spinal glycine receptor antagonism. 255 66

The analgesic effect of caffeine used alone and in combination with dipyrone and butalbital was evaluated after oral administration in mice, using two different pain tests: the hot plate test and the phenylbenzoquinone-induced writhing test. Neither caffeine (5 to 200 mg/kg) nor butalbital (10 and 20 mg/kg) (20 mg/kg was the highest dose that did not induce sleep) produced a significant antinociceptive effect, whereas dipyrone was active from 400 mg/kg in the hot plate test and from 50 mg/kg in the writhing test. The scores obtained with the combinations were not different from those of the dipyrone-treated group, except for the butalbital-dipyrone combination. Thus caffeine is not an analgesic adjuvant in mice; its presence in the combination studied appears to be justifiable only insofar as it inhibited the sedative effect of butalbital.
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PMID:Lack of importance of caffeine as an analgesic adjuvant of dipyrone in mice. 263 28


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