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)

In a double-blind corss-over trial, 30 patients experiencing primary dysmenorrhea were treated with 2 prostaglandin inhibitors, mefenamic acid (250mg) and flufenamic acid (100 mg), and an analgesia, dexhropropoxyphene (32.5 mg)/paracetamol (325 mg) (D.H. and P.). The patients took each drug for 3 consecutive cycles and were subjectively assessed. Results indicate that there was no significant difference between mefenamic acid and flufenamic acid nor flufenamic acid and D.H. and P.; however, mefenamic acid was significantly better than D.H. and P. The total number of mefenamic acid capsules taken was significantly less than either flufenamic acid or D.H. and P. In rating side effects, mefenamic acid was significantly better in reducing the effects of faintness, nausea, and constipation and flufenamic acid was statistically significant in reducing nausea. There were possible side effects in 3 women taking mefenamic acid and in 2 women taking D.H. and P.
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PMID:Trial of prostaglandin-synthetase inhibitors in primary dysmenorrhoea. 7 91

Studies with azidomorphine derivatives have revealed that some of them, particularly N-cyclopropylmethylnorazidomorphine (CAM), stimulate some opiate receptors, while inhibit the others. The opiate receptors stimulated by CAM are called opiate A receptors, while those antagonized by CAM are called opiate B receptors. Opiate receptors are located at nerve terminals and upon stimulation decrease the release of a neurotransmitter. Opiate A receptors are most probably located at cholinergic nerve terminals, are present in the guinea pig ileum, mouse vas deferens and in the brain. Their stimulation leads to constipation and mental clouding. Opiate B receptors located on adrenergic nerve terminals are present in the cat nictitating membrane and in the brain. Their stimulation produces analgesia, depression of coughing and respiration, catalepsy, and mental clouding.
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PMID:Two kinds of opiate receptor. 19 68

A study of 50 patients undergoing haemorrhoidectomy under general anaesthesia in Reading was undertaken. Half the patients received, in addition, a caudal anaesthetic given by the surgeon at the beginning of the operation with the patient in the lithotomy position. The rest of the patients had no form of local anaesthetic. The amount of analgesia needed, general comfort after the operation, and the number of days after surgery of the first bowel movement were recorded. The use of caudal anaesthesia resulted in a 79% reduction in the number of doses of papaveretum needed by the patients after the operation and a reduction by half in the period of postoperative constipation. Possible reasons for the latter finding are discussed. The possible risks of caudal anaesthesia are considered, but it is concluded that they are far outweighed by the benefits obtained.
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PMID:Haemorrhoidectomy without tears. 42 Apr 95

Pain management, nutritional support, and psychosocial support are fundamental services that enhance patients' ability to cope with their cancer and its therapy. The common goal of symptom prevention mandates that each of these supportive services be provided to all patients throughout their cancer experience. Comprehensive cancer pain management begins with identifying the origin of all of the patient's pains and treating each one specifically. Pain prevention can be achieved through around-the-clock opioid administration with as-needed supplements for breakthrough pain and dose titration. Common narcotic side effects such as constipation and nausea also must be prevented. Successful opioid analgesia requires that patient and family concerns regarding addiction and tolerance be dispelled at the outset. Cancer pain prevention can be further optimized with the use of appropriate coanalgesics in response to the pathophysiology of the patient's pains. Cognitive and behavioral therapies may also be useful adjuncts to reduce both pain and suffering. Procedure-oriented pain control should be considered when systemic pharmacologic therapy does not provide adequate pain relief or is associated with intolerable side effects. The only absolute contraindications for pain-relieving procedures are untreatable coagulopathy and a decrease in mental status not related to medical pain management. Useful neurodestructive techniques include radiofrequency lesioning, cryoanalgesia, and chemical neurolysis with agents such as phenol, alcohol, and hypertonic saline. The most beneficial pain-relieving procedures and percutaneous cordotomy, spinal narcotics, celiac and hypogastric plexus ablation, spinal neurolysis, and epidural injection of steroids and hypertonic saline. Procedure selection depends on the cause of the pain and the patient's prognosis. Common indications for pain-relieving procedures include unilateral pain below the shoulder, upper abdominal visceral pains, pelvic visceral pain, perineal pain, vertebral body metastasis, discogenic pain, and spinal stenosis. As results of well-conducted scientific trials begin to appear in the literature, the indications for these procedures will be better understood, resulting in their more appropriate use. Principles of nutritional support in patients with cancer include an awareness of the problem of malnutrition and its impact on performance status, quality of life, prognosis, and treatment; identification of those patients at risk; prophylactic versus therapeutic intervention; and analysis and management of the specific impediment(s) to adequate nutrient intake and absorption. The primary goals for nutritional support in cancer patients are prevention of weight loss and maintenance of adequate protein status. Appreciation of practical issues of nutritional support will enable the practicing physician to achieve these goals using primarily oral nutrition options.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Supportive care in oncology. 128 50

This pilot study evaluated the efficacy and side effects of a combination of initial patient-controlled analgesia (PCA) for dose-finding with transdermal fentanyl administration. Twenty inpatients, requiring strong opioids for severe cancer pain, received intravenous fentanyl on an on-demand basis over a 24-h period. The amount of fentanyl administered was then used as a guideline for selecting a suitable transdermal therapeutic system (TTS) on the 2nd day, which remained in place for 3 days. The size of a 2nd TTS, being used from day 5 to 7, was adjusted according to the amount of supplementary intravenous fentanyl doses on day 3. From day 4 to 7 intravenous fentanyl was stopped, and subcutaneous morphine was made available as a rescue medication. A standardized adjuvant medication was allowed. Pain intensity, pain relief, quality of sleep, mood, general state of health, activity, mobility, rescue morphine consumption and side effects were assessed using a diary after baseline pain and symptoms were recorded. Vital functions were monitored and fentanyl plasma levels were measured daily in 15 patients. The use of TTS fentanyl in combination with initial dose titration using PCA gave rapid and statistically significant pain relief. Patient compliance and acceptance were excellent. In the absence of severe side effects the main complaints were dryness of the mouth and constipation. Increasing pain intensity and increasing supplementary morphine requirements as well as decreasing plasma fentanyl levels on day 7 may indicate that conversion ratios from intravenous to transdermal administration should be increased or that TTS should be changed earlier.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Transdermal fentanyl and initial dose-finding with patient-controlled analgesia in cancer pain. A pilot study with 20 terminally ill cancer patients. 145 86

A double-blind, parallel group study was undertaken in general practice to compare the efficacy of and tolerability to controlled-release (CR) dihydrocodeine tablets and combination dextropropoxyphene/paracetamol tablets in patients with severe osteoarthritis of the hip(s). Eighty-six patients were randomly allocated to receive either CR dihydrocodeine (60 mg) tablets (1 tablet twice daily to 2 tablets daily) or combination dextropropoxyphene (32.5 mg)/paracetamol (325 mg) tablets (2 tablets 3-times daily to 2 tablets 4-times daily) for a period of 2 weeks. Patients recorded in a diary card 4 times a day the severity of their pain and each morning whether or not they woke during the night due to pain in their hip(s). On entry to the study, after the first week's treatment and at the final visit another week later, the investigator assessed the patient's severity of pain on passive movement of the hip and also noted the severity of any volunteered symptoms or side-effects. After 2-weeks' treatment, pain on passive movement of the hip joint was statistically significantly less severe on CR dihydrocodeine than on dextropropoxyphene/paracetamol (p = 0.02). Nausea and vomiting were more pronounced in the dihydrocodeine than in the dextropropoxyphene/paracetamol group after the first week's treatment but by the end of the study there was no significant treatment difference in any of the volunteered side-effects. Patients on CR dihydrocodeine developed some constipation as expected and the dextropropoxyphene/paracetamol patients suffered from impaired concentration. More patients withdrew on CR dihydrocodeine than on dextropropoxyphene/paracetamol but these withdrawals tended to occur early in the trial just after initiating therapy. Tolerance in terms of withdrawals or side-effect profile did not appear to the dosage of each preparation administered. It is concluded that after 2-weeks' treatment CR dihydrocodeine provided superior analgesia to dextropropoxyphene/paracetamol with no difference in side-effects. Furthermore, CR dihydrocodeine has the advantage of twice rather than 3 or 4-times daily dosing.
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PMID:The efficacy and tolerability of controlled-release dihydrocodeine tablets and combination dextropropoxyphene/paracetamol tablets in patients with severe osteoarthritis of the hips. 146 44

An 18-month-old boy was admitted to our hospital with sudden onset of paraplegia, analgesia of the lower limbs, dysuria and constipation. His gestational and birth histories were unremarkable. Past history revealed he had lymphangioma in his left inguinal region, and had been treated in another hospital. Neurological examination revealed flaccid paraplegia, analgesia below Th12 dermatome and dysuria. MRI revealed an intramedullary high intensity lesion surrounded by round low intensity areas located from TH11 to L2 vertebral levels, suggesting the existence of vascular tumor or spinal AVM. Spinal angiogram revealed arteriovenous fistula with large intramedullary aneurysmal vascular dilatation from T12 to L2 vertebral level. The feeder was the Adamkiewicz artery which branched from the left Th12 intercostal artery. First, artificial embolization with thrombin gelfoam was performed successfully. However, follow-up MRI showed an image of flow void in the aneurysm again, indicating recanalization of the AVF. Therefore, an operation was undertaken on October 24th, 1988. The patient was placed in prone position and osteoplastic laminotomy from Th10-L2 was performed. The thrombus and wall of the aneurysm were mostly removed through the lumbosacral midline myelotomy for decompression. Then, the feeder and drainers were ligated. Postoperative course was uneventful. 2.5 years after the operation, he still had flaccid paralysis at the ankle joints bilaterally, analgesia below L4 dermatome, neurogenic bladder and constipation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[An infant case of spinal arteriovenous malformation with a large venous aneurysm]. 157 80

The in vitro binding profile and some in vivo pharmacological properties of (+/-)trans-N-Methyl-N-[2-(1-pyrrolidinyl)-cyclohexyl]benzo[b]-thiophene- 4-acetamide (PD 117302) were tested in rats. In rat brain membrane preparation, PD 117302 was selective for the k-binding sites, its KI (3.51 nM) being respectively about 200 and 1300 times lower at k- than at mu- and delta-sites. In vivo, PD 117302 injected intravenously (i.v.) showed dose-related analgesic effects in the 55 degrees C hot-plate test (peak-time 5 min) and in the paw pressure test. In both tests high doses of naloxone were required for full antagonism. PD 117302, injected i.v., produced dose-related diuresis in normally hydrated rats, which was prevented by 2 mg/kg of subcutaneous naloxone or diprenorphine. PD 117302 at doses between 0.125 and 2 mg/kg i.v. did not delay the gastrointestinal transit of a charcoal meal and did not antagonize morphine-induced constipation. Thus PD 117302 has good selectivity for k-binding sites in vitro and induces analgesia and diuresis, but does not slow gastrointestinal transit in vivo, supporting its k-agonist activity.
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PMID:In vitro binding profile and in vivo pharmacological properties of the K-opioid compound PD 117302. 165 87

The postoperative care of patients usually is characterized by the fact that the individual need of pain killers is not sufficiently recognized. An opioid given only when asked for, results in an underdosage as the patient does not receive the analgesic in time, so that he suffers pain. As there is insufficient knowledge with regard to the pharmacology of opioids which can be used for postoperative pain therapy, physicians and nurses usually tend to give a lower dose in order to avoid any possible side-effects. Considerations which lead to opioid underdosage include: the development of addiction and possible side-effects such as respiratory depression, heavy sedation, possible constipation and urinary retention. The aim in postoperative pain therapy is a time-contingent dosing after careful intravenous titration of the compound in the lower dose range during continuous supervision. Thus, the individual need in the recovery room can be estimated. Only such a procedure helps to keep the patient pain-free over a long period of time, reduces the workload of nurses during the night, results in the reduction of complications and finally may even reduce the hospital stay. Piritramide is a compound which has a number of potential advantages with regard to efficacy and side-effects in postoperative pain therapy. It has the highest analgesic potency among those compounds suitable for postoperative pain therapy; when compared with pethidine, pentazocine or nalbuphine it shows remarkable cardiovascular stability. In comparison to morphine, pethidine and pentazocine, piritramide has a lower incidence of nausea and vomiting. With a mean duration of action of up to six hours, piritramide has an advantage over pentazocine (3 hours), pethidine (2-3 hours) and morphine (5-6 hours). Compared to other mixed narcotic analgesics, piritramide does not induce dysphoric side-effects when given in the higher dose range and does not lead to addiction. It is derived from the same group of agents such as fentanyl or alfentanil which are used in neuroleptanaesthesia so that there is an increase in analgesia one to the interaction with the same receptor site. Piritramide has a fast onset of action, 2-5 minutes after intravenous injection and a peak action after 10 minutes. In comparison to pethidine it has no cardiovascular effects, in particular no myocardial depression or increased myocardial oxygen demand (MVO2). Last but not least, the cost-effectiveness is a financial factor of increasing importance to the institution that runs the hospital.
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PMID:[Postoperative pain treatment]. 168 69

Conditions in which antidepressants have been used include diabetic neuropathy, postherpetic neuralgia, headaches, arthritis, chronic back pain, cancer, thalamic pain, facial pain, and phantom limb pain. Although much of the available information is derived from inadequately controlled trials, it seems that antidepressants provide analgesia in many of these disorders. The analgesic effects tend to be independent of antidepressant effects, and doses of heterocyclic antidepressants used for analgesia seem to be lower than those considered effective in the treatment of depression. Doses should be started low and gradually increased until the patient reaches the highest tolerable dose. Onset of analgesia is variable, ranging from 1 day to 10 weeks. Common side effects include dry mouth, drowsiness, urinary retention, orthostatic hypotension, and constipation. Optimum dosages and schedules have not been established.
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PMID:Antidepressants in the management of chronic pain syndromes. 214 20


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