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)

1. The evidence reviewed here indicates that pinaverium bromide (Dicetel) relaxes gastrointestinal (GI) structures primarily by inhibiting Ca2+ influx through potential-dependent channels of surface membranes of smooth muscle cells. 2. The in vivo selectivity of pinaverium bromide for the GI tract appears to be due mainly to its pharmacokinetic properties. Because of its low absorption (typical for quaternary ammonium compounds) and marked hepatobiliary excretion, most of the orally-administered dose of pinaverium bromide remains in the GI tract. 3. Orally-administered pinaverium bromide does not elicit adverse cardiovascular side-effects at doses that effectively relieve GI spasm, pain, transit disturbances and other symptoms related to motility disorders. 4. Pinaverium bromide is the only Ca2(+)-antagonist with known therapeutic efficacy in the treatment of irritable bowel syndrome and certain other functional intestinal disorders.
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PMID:Action of pinaverium bromide, a calcium-antagonist, on gastrointestinal motility disorders. 217 9

The aim of this study was to evaluate the efficacy of cimetropium bromide, a new antimuscarinic compound, in relieving symptoms of patients with irritable bowel syndrome over a three month period. Seventy consecutive outpatients were given cimetropium (50 mg tid) or placebo according to a double blind, randomised, parallel groups design. Symptoms were evaluated initially and at monthly intervals up to the end of the study period. One patient receiving placebo withdrew because of treatment failure. Pain score decreased by 40, 66, 85% in the cimetropium group, at the end of the first, second and third months respectively, compared with 26, 32 and 52% reductions among controls (p = 0.0005). At the end of treatment there was a 86% reduction in the number of abdominal pain episodes per day in the cimetropium group compared with 50% in the placebo group (p = 0.001). Constipation and diarrhoea scores decreased by 59 and 49% in the cimetropium treated patients, compared with 37 and 39% in controls, the differences between being not significant. At the end of the study 89% of the patients treated with cimetropium considered themselves as globally improved as opposed to 69% in the placebo group (p = 0.039). The corresponding 95% confidence intervals for the differences between the proportion of improved patients in the two groups were from 11% to 29%. Six patients taking cimetropium complained of slight dry mouth. The results of this study showed that cimetropium bromide is effective in relieving pain in patients with irritable bowel syndrome.
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PMID:Longterm treatment of irritable bowel syndrome with cimetropium bromide: a double blind placebo controlled clinical trial. 218 1

The purpose of this study is an investigation of two protocols using propofol as induction and maintenance agent in 100 children scheduled for strabismus surgery (4-8 year, ASA I, NYHA I). Protocol I; Propofol 6 mg.kg-1 in 60 s with fentanyl 2 micrograms.kg-1 and vecuronium bromide 0.08 mg.kg-1 for induction, followed by propofol 11 mg.kg-1 for maintenance; Protocol II; Propofol 3 mg.kg-1 in 20 s with fentanyl 3 micrograms.kg-1 for induction, followed by propofol 12 mg.kg-1.h-1 for maintenance. It appears that the use of protocol I offers significant advantages compared with protocol II: a better quality of induction with a lesser incidence of pain during injection of propofol; a better quality of maintenance with very infrequent bradycardia from oculocardiac reflectivity; and a better recovery with a greatly reduced frequency of nausea and vomiting.
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PMID:[Anesthesia using propofol during surgery of strabismus in children. A comparison of two different protocols of induction and maintenance]. 225 60

Forty-five patients undergoing total abdominal hysterectomy were randomly divided into three groups. An epidural tube was inserted into one of the following three sites, Th11-12, L2-3, and caudal region. General anesthesia was then maintained with nitrous oxide-oxygen-enflurane, and pancuronium bromide. Morphine hydrochloride 2 mg in 8 ml of normal saline was administered into one of the designated epidural spaces one to two hours before the assumed end of surgery. Postoperative pain was assessed every four hours after the end of the operation until the next morning. Morphine exerted a relatively profound and prolonged analgesic effect in 40% of the Th11-12 group of patients, as well as in 6.7% of the L2-3 and caudal groups. But, supplementary analgesics were necessary in the other patients. No significant differences were found in the degree and extension of postoperative pain, as well as the doses of supplementary analgesics among the three groups. Adverse effects, such as nausea, vomiting and itching, occurred in 30 to 40% of each of the morphine administered groups. Though morphine was applied into different spinal levels, this clinical study did not show any difference in extension of analgesia. The epidurally applied morphine may be distributed widely in the spinal arachnoid space after some time, and may exert an effect on the brain as well as on the spinal nerves. When morphine is administered epidurally one to two hours before the end of a surgical operation, selection of an injection site according to the dermatome level of the skin incision may be unnecessary.
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PMID:[Degree and extension of analgesic effect of morphine applied at three different spinal levels of epidural space]. 227 45

This study was designed to assess whether intra- and postoperative epidural analgesia would diminish the overall rate of postoperative complications after major abdominal operations when compared to a standard anesthetic and postoperative analgesic regimen. A total of 214 patients undergoing infrarenal aortic bypass operations, gastric resection, gastrectomy, Whipple's operation, or duodenum-preserving pancreatic resection were randomly divided into two groups. Patients in the epidural group (n = 98) were operated on under light general anesthesia (midazolam, low-dose fentanyl, N2O/O2, pancuronium bromide). In addition, a mixture of bupivacaine (0.25%) and fentanyl (2 micrograms/ml) was infused (6-10 ml/h) via a thoracic epidural catheter intra- and postoperatively for 76:1.45 h (logarithmic normal distribution). Patients in the control group (n = 116) were operated on under a standard general anesthesia (midazolam, fentanyl, N2O/O2, isoflurane, pancuronium-bromide). Piritramid was injected for postoperative pain relief, either i.v. (recovery room, intensive care unit) or i.m. (surgical ward). In the epidural group the quality of analgesia and ability to cough were significantly better (2 P less than 0.0071) than in the control group (four observations each on the 1st and 2nd postoperative days). Heart rate and mean arterial pressure were lower in the epidural group at the same points of observation (2 P less than 0.01), as was the plasma glucose on the 1st postoperative day. The time up to the first postoperative defecation was shorter in the epidural group (79:1.51 h) as compared to the control group (93:1.38 h; 2 P less than 0.0167). The time to hospital discharge was equal in both groups (epidural group 19:1.6 days, control group 18:1.6 days).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[No reduction in postoperative complications by the use of catheterized epidural analgesia following major abdominal surgery]. 240 44

The lectin Ricinus communis agglutinin I (RCAI) was topically applied to transected mouse sciatic nerve or to neuromas formed 2 months after a nerve transection. Fluorochrome-labelled ricin was transferred to the corresponding dorsal root ganglia where it accumulated selectively in the nerve cells, apparently as a consequence of retrograde axonal transport. The ricin caused an almost total loss of the dorsal root ganglionic neurons and, consequently, could prevent formation of neuromas or eliminate an already existing neuroma. The hybrid toxin wheat germ agglutinin (WGA)-ricin-A chain caused no apparent increased sensitivity for neuronal destruction. The drugs doxorubicin and ethidium bromide, similarly applied, labelled satellite and other cells in addition to neurons in the ganglia, and caused only a moderate neuronal loss. The presented method to eliminate neuromas by selectively destroying sensory neurons may provide a means to study pain mechanisms in neuromas.
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PMID:Effects of retrograde axonal transport of Ricinus communis agglutinin I on neuroma formation. 242 94

Cimetropium bromide is a new antimuscarinic compound with strong antispasmodic activity. The aim of this study was to evaluate the effects of oral cimetropium bromide on total gut transit time in patients with irritable bowel syndrome. Forty patients, divided according to their initial total gastrointestinal transit times and presenting symptoms, were treated with cimetropium bromide 50 mg t.d.s. or placebo for 1 month according to a double-blind, parallel group design. Before and after treatment all subjects ingested 24 radio-opaque markers. The total intestinal transit time was determined by evaluating the rate of disappearance of markers from plain X-ray films of the abdomen taken every 24 h for 4 days. Pain and bowel habits were also monitored. Seven patients did not complete the study. Cimetropium bromide significantly (P less than 0.01) shortened the whole gut transit time in patients with prolonged transit time (80.8 +/- 4.0 h before vs 60.8 +/- 6.7 h after treatment) and improved the global clinical condition significantly compared with placebo (P = 0.029). In patients with a short total intestinal transit time, cimetropium bromide had no effect on whole gut transit time and did not significantly improve symptoms. The results of this study indicate that oral cimetropium bromide is effective both objectively and subjectively in a subgroup of irritable bowel syndrome patients with constipation.
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PMID:Effects of cimetropium bromide on gastrointestinal transit time in patients with irritable bowel syndrome. 252 Jun 22

Forty outpatients with endoscopically confirmed duodenal ulcers were entered in a double blind trial. They were randomly allocated to octatropine-methyl-bromide and sulglycotide salt (GVP) or placebo. The results show that the combination of the two drugs is less efficacious than the two constituent substances taken separately, is not more efficacious than placebo in ulcer healing, and is ineffective with regard to ulcer pain.
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PMID:Octatropine-methyl-bromide and sulglycotide salt in the short-term treatment of active duodenal ulcer. A double blind endoscopic study of 40 outpatients. 269 31

The clinical efficacy and safety of HSR-902 (tiquidium bromide, Thiaton) in patients with spastic pain caused by ureteral stones were evaluated in a double blind comparative trial. A daily dose of 30 mg HSR-902 or 60 mg butylscopolamine bromide as a control drug was orally administered for 7 days. With either drug marked improvement of spastic pain was observed. The time to obtain relief from spastic pain and utility rating were significantly more excellent with HSR-902 than with butylscopolamine bromide. With all other parameters used no significant difference was observed between the two drugs. Mild adverse effects such as abdominal discomfort and constipation were observed in 2 of the 87 cases in the butylscopolamine bromide group but none of the 83 cases in the HSR-902 group. Taking efficacy and safety of the treatment into consideration, no significant difference was observed in usefulness between the two drugs, and we were able to confirm the usefulness of HSR-902 for relief from spastic pain caused by ureteral stones.
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PMID:[A comparative double-blind trial of HSR-902 and butylscopolamine bromide for relieving colic in ureteral stone patients]. 288 61

The sphincter of Oddi is the smooth muscle connection between the bile duct and the duodenum. Its physiological function is associated with a regular motility characterized by phasic contractions superimposed on the sphincter of Oddi baseline pressure. Recently introduced ERCP-manometry permits further studies of sphincter of Oddi pharmacology. A number of drugs have so far been studied. Sedatives of the diazepam type had no effect on the sphincter, while butylscopolaminium bromide, a typical neurotropic agent, brings about cessation of the sphincter motility for 3-8 minutes. Hymecromon lowered the sphincter baseline pressure from 9.8 to 7.8 mmHg. A 1.2 mg sublingual dose of nitroglycerin, a typical musculotropic agent, caused significant relaxation of the sphincter, and decreased baseline pressure from 8.9 mmHg to 2.9 mmHg; Sphincter motility was not affected. Morphine-like analgetics, in particular pentazocine, elevated sphincter baseline pressure, but buprenorphine and tramadol did not. Pharmacological doses of gastrointestinal hormones also affect the sphincter; CCK octapeptide, glucagon and secretin are able to decrease sphincter of Oddi baseline pressure, and CCK octapeptide abolishes sphincter motility. Sphincter of Oddi pharmacology is of clinical interest. The administration of sphincter-relaxing agents, in particular nitroglycerin and butylscopolaminium bromide, enables the endoscopist to extract small common bile duct stones without previous papillotomy. Analgetics that induce sphincter contraction and thus hinder the flow of bile and pancreatic juice, may be helpful for the treatment of pain in patients with pancreatico-biliary disease. Investigations into the effect of CCK on the healthy and diseased sphincter permit us to identify patients with sphincter dysfunction using a special CCK-provocation test.
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PMID:Pharmacology of the sphincter of Oddi. 304 55


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