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 efficacy and tolerability of intra-arterial and intravenous PGE1 infusions in patients with occlusive arterial disease [OAD] were studied in two independent multicentre therapeutic trials. In the first study 218 patients with OAD stage III/IV were given an i.a. infusion of 1/2 to 1 ampoule of Prostavasin (10-20 micrograms PGE1) in 50 ml physiological saline solution, once a day. 211 patients took part in the second study. Patients in stage III received one i.v. infusion of 3 ampoules Prostavasin (60 micrograms PGE1) once daily, and patients in stage IV received one i.v. infusion of 2 ampoules Prostavasin (40 micrograms PGE1) twice daily, in 100-250 ml physiological saline solution. In both studies the treatment period was 4 weeks. Both i.a. and i.v. administration afforded a significant improvement in the clinical symptoms. Ulcers healed completely in 18.6% of patients under i.a. treatment (i.v.: 10.7%) and partially healed in 38.9% (i.v.: 51.1%). 50% of the patients became pain-free in the course of i.a. treatment (i.v.: 47.7%) and, at the end of the study, 61.5% no longer required analgesics (i.v.: 48.6%). Stratification of the patients into diabetics and non-diabetics showed that in the main the therapeutic response in diabetic patients was as good as in non-diabetics, allowing for the fact that the clinical pictures were usually distinctly more severe in the diabetic patients. The adverse drug reactions were, predominantly, familiar symptoms such as redness, swelling and pain in the infused extremity and phlebitis-like redness along the course of the infused vein, gastro-intestinal symptoms and headache.
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PMID:Efficacy and tolerability of intra-arterial and intravenous prostaglandin E1 infusions in occlusive arterial disease stage III/IV. 260 42

The efficacy of intracavernous autoinjection therapy with prostaglandin E1 was investigated over a period of up to six months in 187 patients with long-term erectile dysfunction. All patients had to undergo an investigation program consisting of routine laboratory tests, directional doppler sonography of the penile arteries, measurements of the BCR-latencies, as well as intracuvernum drug testing with PGE1. Six months follow-up results are available so far in 115 patients. The mean injection dose was 13.5 mcg PGE1 at the beginning of therapy and 12.8 mcg PGE1 at the end of therapy. An average of 24 prostaglandin E1 injections per patient was given. In 16.6% of the 187 patients slight to moderate pain occurred at the injection site, not influencing sexual intercourse. No priapisms lasting more than six hours were observed. A significant improvement of the blood flow in the deep and dorsal penile arteries was shown by penile doppler sonography after 6 months treatment. The efficacy and tolerability of the therapy were designated as very good to good in 91% respectively in 98% of the patients. 94% of the patients would like to continue the therapy. The results indicate that PGE1 due to its erectile potency and great tolerability will occupy an important position in the therapy of the erectile dysfunction.
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PMID:Intracavernous self-injection of prostaglandin E1 in the therapy of erectile dysfunction. 260 44

An intracavernous injection with papaverine or prostaglandin E1 (PGE1) combined with duplex ultrasonography is an objective technique to conduct a penile blood flow study (PBFS). Three hundred patients with impotence underwent papaverine (9-60 mg) induced PBFS at the University of California School of Medicine, San Francisco (UCSF), U.S.A. and another 80 patients with impotence received PGE1-induced (20 micrograms) PBFS at Veterans General Hospital-Taichung (VGH-TC), R.O.C. Preliminary evaluation of age, duration of disease and pre-injection diameter of cavernous arteries disclosed no significant difference in these 2 series. It was interesting to find that almost all parameters of vascular response to pavaverine vs PGE1 differed significantly, such as onset of response (6.5 +/- 6.5 vs 11.7 +/- 6.4 min, slower in the PGE1 group, p less than 0.001); post-injection diameter of cavernous arteries (right: 0.73 +/- 0.20 vs 0.79 +/- 0.18 mm, p = 0.03; left: 0.74 +/- 0.20 vs 0.82 +/- 0.21 mm, p = 0.005); diametral increment of cavernous arteries (right: 0.23 +/- 0.17 vs 0.33 +/- 0.17 mm, p less than 0.001; left: 0.24 +/- 0.17 vs 0.36 +/- 0.19 mm, p less than 0.001) and peak velocity (right: 27.5 +/- 16.1 vs 42.0 +/- 20.1 cm/sec, p less than 0.001; left: 28.9 +/- 15.9 vs 39.7 +/- 17.9 cm/sec, p less than 0.001). The side effects, primarily injection pain (23.8%, 19/80) in the PGE1 group and dizziness (3.0%, 9/300) in the papaverine group, were minor in these 2 series. Prolonged erection was not encountered in either series; however, immediate treatment was performed if a papaverine-induced erection lasted over 60 minutes.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comparison of penile vascular effect induced by intracavernous injection of papaverine and prostaglandin E1. 263 27

1. Recent work has demonstrated artificial penile erection after intracavernous injection of prostaglandin E1 (PGE1). A possible dose-response relationship between PGE1 and its erectile action was examined in a double-blind, cross-over designed, placebo-controlled study. 2. Twenty patients aged (mean +/- s.d.) 45 +/- 10.5 years suffering from psychogenic erectile dysfunction were tested on four occasions. Subjects received four intracavernous injections of saline containing either no other substance, preservative, 5 micrograms or 10 micrograms PGE1. 3. Investigations revealed clear dose-dependency of PGE1 in the grade and duration of erection achieved as well as in the latency between injection and achievement of erection (P less than 0.001). Saline and preservative did not induce erection. 4. Some local pain of varying grades did occur in 11/20 patients after 5 micrograms PGE1 and in 14/20 patients after 10 micrograms PGE1 injected intracavernously. This side-effect was caused by PGE1 itself and also showed a clear dose-relation (P = 0.0035). 5. Prostaglandin E1 appears to be a promising substance for diagnostic and therapeutic purposes in erectile dysfunction. Despite the discomfort observed in some patients, PGE1 is very effective even in low doses. PGE1 10 micrograms is suggested as the appropriate initial diagnostic dose for intracavernous injection to differentiate between the normal and pathological cavernous-vascular system.
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PMID:Dose-dependent effect and side-effect of prostaglandin E1 in erectile dysfunction. 268 40

In a controlled multicenter study 70 patients with chronic arterial occlusive disease stage IV according to Fontaine's classification were randomised to treatment with prostaglandin E1 (PGE1) or pentoxifylline (PX), administered over 4 weeks. Parameters of effectiveness were the reduction of analgesics, the relief of rest pain according to an analogue scale, the improvement of the ulceration according to an ulcer score and the healing of necrotic area. The results show that both forms of treatment produced a significant reduction in analgesic consumption and rest pain. Moreover in both groups a significant reduction of the ulcer score and healing of the necrotic area were observed. Side effects occurred in six patients of the PGE1-group and in ten patients of the PX-group, which required premature discontinuation of treatment in four patients of the PX-group. The study also demonstrated that PGE1 is more effective in the treatment of severe arterial occlusive disease than PX. With respect to the analgesic consumption, the reduction of ulcer score and the healing of necrotic area a significant difference was found in favour of PGE1. In accordance the six months follow-up examinations showed a marked deterioration in the PX-group opposed to the PGE1-group. The intravenous application of PGE1 over a period of 4 weeks in patients with severe arterial occlusive disease seems to be an effective therapeutical principle.
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PMID:Intravenous prostaglandin E1 versus pentoxifylline therapy in chronic arterial occlusive disease--a controlled randomised multicenter study. 269

We screened 80 patients at our hospital for the differential diagnosis of impotence using intracavernous injection of prostaglandin E1 (20 micrograms). The rate of positive response was 78.8 per cent (63 patients). Neither systemic reactions nor priapism occurred. However, a considerable incidence (23.8 per cent, 19 of 80 patients) of tolerable injection pain was encountered. The 133xenon penile washout study was conducted routinely in impotent men for hemodynamic evaluation of penile vascularity. In 80 patients a positive correlation between the response of intracavernous prostaglandin E1 injection and the result of the washout study was found (r equals 0.381, p less than 0.0002). We selected 14 subjects randomly to receive additional intravenous infusions of prostaglandin E1 (6 ampules, 120 micrograms total) for 3 days, after which another 133xenon washout study was done. The washout studies before and after intravenous prostaglandin E1 infusion were compared, and 10 patients (71.4 per cent) appeared to obtain improvement in half-time clearance and penile blood flow. However, only 3 patients noticed improvement subjectively. We suggest that prostaglandin E1 could be a desirable alternative for the diagnosis and treatment of impotence.
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PMID:Impotence evaluated by the use of prostaglandin E1. 272 34

Our physical, chemical and clinical findings - especially lactate, night pain and peripheral blood flow - have shown that in most cases of AOD stages III and IV, intraarterial infusions with prostaglandine E1 largely improved the peripheral situation. PGE1 seems to meliorate the blood flow - causing better oxygen supply - and to inhibit thrombocyte aggregation. An improvement of the clinical situation will be the result. In most cases a differentiation between responders and non-responders is possible but, on the other hand, it is not possible, however, to give a safe forecast of the success of this treatment in the individual patient.
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PMID:Intraarterial prostaglandine E1 in arterial occlusive disease (AOD) stages III and IV. 295 66

Drugs used for improvement or stabilization of peripheral circulation include antiaggregants or anticoagulants for secondary prevention of arteriosclerosis, vasoactive substances and fibrinolytic agents. -Two prospective trials document that aspirin or the combination of aspirin and dipyridamole reduce progression of arterial occlusive disease significantly in comparison to placebo. Aspirin is best suited for secondary prevention of recurrent stenoses or occlusions after carotid or femoral endarterectomy, whereas anticoagulants are preferred in patients with embolism and after peripheral implantation of venous bypasses. -Significant improvement of walking distance is achieved by several compounds influencing blood rheology. The effect does not exceed that obtained by physical training. If reconstructive arterial surgery or percutaneous transluminal angioplasty are not possible, some patients with rest pain or gangrene may be successfully treated by intraarterial administration of prostaglandin E1.
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PMID:[Drug therapy in peripheral arterial occlusive disease]. 305 39

Misoprostol is an analogue of prostaglandin E1 and is the first synthetic prostaglandin analogue to be made available for the treatment of peptic ulcer disease. It inhibits gastric acid secretion in man, and there is also some evidence that it limits the extent of gastrointestinal damage induced by ulcerogenic agents in animals and healthy volunteers at doses lower than those required to inhibit acid secretion. This 'cytoprotective' activity has been explained by several mechanisms, but its contribution to the clinical efficacy of misoprostol in healing established ulcers is doubtful since the drug does not appear to be effective in healing peptic ulcers at non-antisecretory dosages. In clinical trials, ulcer healing has been reported in 60 to 85% of patients with duodenal ulcers and 32 to 54% with gastric ulcers receiving misoprostol 200 micrograms 4 times daily for 4 weeks--the recommended dosage. In comparative studies, the percentage of patients with healed ulcers after misoprostol (800 micrograms daily) was not significantly different from that with cimetidine (1200 mg daily), although there was greater pain relief with cimetidine. No study has yet been published concerning the use of misoprostol as maintenance therapy for the prevention of ulcer recurrence, and no long term tolerability data are available. However, in acute ulcer healing studies (2 to 12 weeks in duration) misoprostol has been well tolerated. Diarrhoea was the most commonly reported symptom, and this was only rarely of sufficient severity to interfere with treatment. No evidence of histopathological changes in the gastric mucosa induced by misoprostol have been reported in man. Evidence of uterine stimulant effects in women receiving misoprostol during the first trimester of pregnancy has resulted in the drug being contraindicated during pregnancy. Thus, misoprostol is a new type of antiulcer drug, providing an alternative approach to the therapy of peptic ulcer disease. It has been shown to be effective and well tolerated in the healing of both gastric and duodenal ulcers. Future studies need to identify the specific types of patients likely to obtain most benefit from treatment, in order to define more clearly the place of misoprostol in the treatment of these indications, as well as addressing the possibility of ulcer prevention with lower doses of misoprostol.
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PMID:Misoprostol. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in the treatment of peptic ulcer disease. 310 5

Hypochlorhydria induced by potent antisecretory drugs is followed by a marked elevation of serum gastrin levels which leads to changes in ECL cell density in rats. "Soft" antiulcer drugs like prostaglandins do not increase gastrin levels. Their use in peptic ulcer disease seems to be mainly limited by a relatively high incidence of diarrhea and abdominal cramps. Rioprostil is a new prostaglandin E1 analogue. We compared the potency and duration of action of rioprosil 600 micrograms nocte with 300 micrograms bid on human gastric secretion in a placebo-controlled double-blind study. We further evaluated the clinical effectiveness of rioprostil 600 micrograms nocte in the acute treatment of duodenal ulcer. Nocturnal gastric acidity (24:00 to 08:00) was inhibited from 54.5 +/- 1.7 mmol H+/L (placebo experiments; n =9) to 26.7 +/- 3.5 mmol H+/L (52%) by rioprostil 300 micrograms bid (p less than 0.05) and to 14.4 +/- 3.8 mmol H+/L (74%) by rioprostil 600 micrograms nocte (p less than 0.05). During the daytime (09:00 to 18:00), H+ activity was reduced by 33% and 15% respectively (n.s.). Two hundred and three patients with endoscopically proven duodenal ulcers were randomly allocated to treatment with either rioprostil 600 micrograms nocte or ranitidine 300 mg nocte for 4 weeks in a prospective double-blind study. The two groups were similar. After 2 and 4 weeks treatment respectively, about 55% and 85% of patients healed on rioprostil 600 micrograms nocte and 55% and 90% on ranitidine 300 mg nocte. There were no differences between the treatment groups in ulcer pain relief.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Prostaglandins and peptic ulcer disease: nocturnal administration of rioprostil vs ranitidine in duodenal ulcer healing. 310 57


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