Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

On February 21st, 2020 the first case of severe acute respiratory syndrome due to the coronavirus 2 (SARS-CoV-2) causing the CoViD-19 disease, was identified in Italy. In the following days, despite the restrictive public health measures aimed to avoid the infection's spread, the number of cases increased. As of March 8th, 2020, Italy is the 2nd most affected country in the world. As of March 6th, 2020, the Italian Society of Anesthesia Analgesia Resuscitation and Intensive Care (SIAARTI) published operational recommendations and ethical considerations to support the clinicians involved in the care of critically-ill CoViD-19 patients, in regard a probable scenario where an imbalance between supply and demand of ICU beds, is put in place by a steadily rising number of these patients.
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PMID:[Clinical ethics recommendations for the allocation of intensive care treatments, in exceptional, resource-limited circumstances.] 3320 75

The rapid spread of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has led to a global pandemic. The 2019 coronavirus disease (COVID-19) presents with a spectrum of symptoms ranging from mild to critical illness requiring intensive care unit (ICU) admission. Acute respiratory distress syndrome is a major complication in patients with severe COVID-19 disease. Currently, there are no recognized pharmacological therapies for COVID-19. However, a large number of COVID-19 patients require respiratory support, with a high percentage requiring invasive ventilation. The rapid spread of the infection has led to a surge in the rate of hospitalizations and ICU admissions, which created a challenge to public health, research, and medical communities. The high demand for several therapies, including sedatives, analgesics, and paralytics, that are often utilized in the care of COVID-19 patients requiring mechanical ventilation, has created pressure on the supply chain resulting in shortages in these critical medications. This has led clinicians to develop conservation strategies and explore alternative therapies for sedation, analgesia, and paralysis in COVID-19 patients. Several of these alternative approaches have demonstrated acceptable levels of sedation, analgesia, and paralysis in different settings but they are not commonly used in the ICU. Additionally, they have unique pharmaceutical properties, limitations, and adverse effects. This narrative review summarizes the literature on alternative drug therapies for the management of sedation, analgesia, and paralysis in COVID-19 patients. Also, this document serves as a resource for clinicians in current and future respiratory illness pandemics in the setting of drug shortages.
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PMID:Sedation, Analgesia, and Paralysis in COVID-19 Patients in the Setting of Drug Shortages. 3284 30

The Severe Acute Respiratory Syndrome-related Coronavirus-2 (SARS-CoV2) pandemic has sparked controversy regarding the use of certain routine and investigational pharmacologic interventions during pregnancy and the postpartum period. In this review, we critically appraise guidance in regard to pharmacologic considerations unique to pregnant and lactating women with coronavirus disease (COVID-19). We summarize the evidence, which supports the routine use of antenatal corticosteroids, magnesium sulfate and low-dose aspirin where clinically indicated, and if not contraindicated for medical reasons. We highlight that decision-making about initiation, dose and duration of prophylactic anticoagulation for pregnant patients with COVID-19 should be made by a multidisciplinary team and must consider disease severity, timing of delivery in relation to disease onset, inpatient versus outpatient status, underlying comorbidities, and contraindications to the use of anticoagulation. We discuss the rationale behind suggested modifications to the use of peripartum analgesia and anaesthesia at the time of the pandemic, as well as considerations specific to mechanically-ventilated pregnant patients. Finally, we discuss emerging evidence supporting the reduction in mortality in patients with COVID-19 with the use of corticosteroids, while tabulating up-to-date information on the safety of various investigational therapies for COVID-19. It is hoped that this comprehensive review while providing guidance to clinicians caring for pregnant and postpartum women during the COVID-19 pandemic will also encourage researchers to consider their inclusion in clinical trials of therapeutic interventions for COVID-19. This article is protected by copyright. All rights reserved.
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PMID:Pregnancy and COVID-19: Pharmacologic Considerations. 3295 55