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Minerva Anestesiologica Jan 2021
Topics: Antipyretics; Body Temperature; COVID-19; Fever; Hospitalization; Humans
PubMed: 33231411
DOI: 10.23736/S0375-9393.20.15195-2 -
European Journal of Pediatrics Dec 2022Children are the future of the world, but their health and future are facing great uncertainty because of the coronavirus disease 2019 (COVID-19) pandemic. In order to...
UNLABELLED
Children are the future of the world, but their health and future are facing great uncertainty because of the coronavirus disease 2019 (COVID-19) pandemic. In order to improve the management of children with COVID-19, an international, multidisciplinary panel of experts developed a rapid advice guideline at the beginning of the outbreak of COVID-19 in 2020. After publishing the first version of the rapid advice guideline, the panel has updated the guideline by including additional stakeholders in the panel and a comprehensive search of the latest evidence. All recommendations were supported by systematic reviews and graded using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Expert judgment was used to develop good practice statements supplementary to the graded evidence-based recommendations. The updated guideline comprises nine recommendations and one good practice statement. It focuses on the key recommendations pertinent to the following issues: identification of prognostic factors for death or pediatric intensive care unit admission; the use of remdesivir, systemic glucocorticoids and antipyretics, intravenous immunoglobulin (IVIG) for multisystem inflammatory syndrome in children, and high-flow oxygen by nasal cannula or non-invasive ventilation for acute hypoxemic respiratory failure; breastfeeding; vaccination; and the management of pediatric mental health.
CONCLUSION
This updated evidence-based guideline intends to provide clinicians, pediatricians, patients and other stakeholders with evidence-based recommendations for the prevention and management of COVID-19 in children and adolescents. Larger studies with longer follow-up to determine the effectiveness and safety of systemic glucocorticoids, IVIG, noninvasive ventilation, and the vaccines for COVID-19 in children and adolescents are encouraged.
WHAT IS KNOWN
• Several clinical practice guidelines for children with COVID-19 have been developed, but only few of them have been recently updated. • We developed an evidence-based guideline at the beginning of the COVID-19 outbreak and have now updated it based on the results of a comprehensive search of the latest evidence.
WHAT IS NEW
• The updated guideline provides key recommendations pertinent to the following issues: identification of prognostic factors for death or pediatric intensive care unit admission; the use of remdesivir, systemic glucocorticoids and antipyretics, intravenous immunoglobulin for multisystem inflammatory syndrome in children, and high-flow oxygen by nasal cannula or non-invasive ventilation for acute hypoxemic respiratory failure; breastfeeding; vaccination; and the management of pediatric mental health.
Topics: Adolescent; Child; Humans; Antipyretics; COVID-19; COVID-19 Vaccines; Immunoglobulins, Intravenous; Oxygen; Respiratory Insufficiency
PubMed: 36109390
DOI: 10.1007/s00431-022-04615-4 -
Experimental Biology and Medicine... May 2023Acetaminophen (APAP), a widely used antipyretic and analgesic drug in clinics, is relatively safe at therapeutic doses; however, APAP overdose may lead to fatal acute... (Review)
Review
Acetaminophen (APAP), a widely used antipyretic and analgesic drug in clinics, is relatively safe at therapeutic doses; however, APAP overdose may lead to fatal acute liver injury. Currently, -acetylcysteine (NAC) is clinically used as the main antidote for APAP poisoning, but its therapeutic effect remains limited owing to rapid disease progression and the general diagnosis of advanced poisoning. As is well known, APAP-induced hepatotoxicity (AIH) is mainly caused by the toxic metabolite -acetyl--benzoquinone imine (NAPQI), and the toxic mechanisms of AIH are complicated. Several cellular processes are involved in the pathogenesis of AIH, including liver metabolism, mitochondrial oxidative stress and dysfunction, sterile inflammation, endoplasmic reticulum stress, autophagy, and microcirculation dysfunction. Mitochondrial oxidative stress and dysfunction are the major cellular events associated with APAP-induced liver injury. Many biomolecules involved in these biological processes are potential therapeutic targets for AIH. Therefore, there is an urgent need to comprehensively clarify the molecular mechanisms underlying AIH and to explore novel therapeutic strategies. This review summarizes the various cellular events involved in AIH and discusses their potential therapeutic targets, with the aim of providing new ideas for the treatment of AIH.
Topics: Humans; Acetaminophen; Oxidative Stress; Chemical and Drug Induced Liver Injury; Acetylcysteine
PubMed: 36670547
DOI: 10.1177/15353702221147563 -
Stroke Sep 2019
Topics: Aneurysm, Ruptured; Animals; Aspirin; Female; Humans; Intracranial Aneurysm; Male; Subarachnoid Hemorrhage
PubMed: 31409272
DOI: 10.1161/STROKEAHA.119.026094 -
Zhonghua Gan Zang Bing Za Zhi =... Mar 2021Acetaminophen (APAP) is a widely used antipyretic and analgesic drug that is safe and effective in the therapeutic doses, but overdose may cause hepatotoxicity and even... (Review)
Review
Acetaminophen (APAP) is a widely used antipyretic and analgesic drug that is safe and effective in the therapeutic doses, but overdose may cause hepatotoxicity and even acute liver failure (ALF). Finding reliable biomarkers for APAP toxicity is not only a hot spot of current research, but also a problem that needs to be solved urgently. Clinicians should consider the existence of APAP hepatotoxicity when using APAP treatment, and explain that APAP may have a certain degree of dose dependence. This paper reviews the most promising biomarkers currently being evaluated, and expounds their application in the field of APAP hepatotoxicity, as well as the mechanism of mitochondrial damage and mitochondrial autophagy, thereby contributing to the diagnosis, prognosis, mechanism and research progress of therapeutic targets of APAP hepatotoxicity.
Topics: Acetaminophen; Analgesics, Non-Narcotic; Chemical and Drug Induced Liver Injury; Drug Overdose; Humans; Liver; Liver Failure, Acute
PubMed: 33902198
DOI: 10.3760/cma.j.cn501113-20191206-00450 -
British Journal of Clinical Pharmacology Jul 2022Understanding how pharmaceutical opioids and antipyretic analgesics interact with the immune system potentially has major clinical implications for management of... (Review)
Review
Understanding how pharmaceutical opioids and antipyretic analgesics interact with the immune system potentially has major clinical implications for management of patients with infectious diseases and surgical and critical care patients. An electronic search was carried out on MEDLINE, EMBASE, PsycINFO, CENTRAL and the Cochrane library to identify reports describing the immunomodulatory effects of opioid analgesics and antipyretic analgesics, and their effects in infectious diseases. In adaptive immunity, nonsteroidal anti-inflammatory drugs have divergent effects: augmenting cell-mediated immunity but inhibiting humoral immunity. Nonsteroidal anti-inflammatory drugs have demonstrated a beneficial role in Mycobacterium tuberculosis infection and histoplasmosis in animals, and may be plausible adjuvants to antimicrobial agents in these diseases. There is a need to evaluate these findings rigorously in human clinical trials. There is preliminary evidence demonstrating antiviral effects of indomethacin in SARS CoV-2 in vitro; however, uncertainty regarding its clinical benefit in humans needs to be resolved in large clinical trials. Certain opioid analgesics are associated with immunosuppressive effects, with a developing understanding that fentanyl, morphine, methadone and buprenorphine suppress innate immunity, whilst having diverse effects on adaptive immunity. Morphine suppresses key cells of the innate immunity and is associated with greater risk of infection in the postsurgical setting. Efforts are needed to achieve adequate analgesia whilst avoiding suppression of the innate immunity in the immediate postoperative period caused by certain opioids, particularly in cancer surgery.
Topics: Analgesics; Analgesics, Opioid; Animals; Anti-Inflammatory Agents, Non-Steroidal; Antipyretics; Communicable Diseases; Humans; Morphine; Pharmaceutical Preparations; COVID-19 Drug Treatment
PubMed: 35229890
DOI: 10.1111/bcp.15281 -
Computational and Mathematical Methods... 2022NOSH-Aspirin, which is generated from NO, HS, and aspirin, affects a variety of essential pathophysiological processes, including anti-inflammatory, analgesic,... (Review)
Review
NOSH-Aspirin, which is generated from NO, HS, and aspirin, affects a variety of essential pathophysiological processes, including anti-inflammatory, analgesic, antipyretic, antiplatelet, and anticancer properties. Although many people acknowledge the biological significance of NOSH-Aspirin and its therapeutic effects, the mechanism of action of NOSH-Aspirin and its regulation of tissue levels remains obscure. This is in part due to its chemical and physical features, which make processing and analysis difficult. This review focuses on the biological effects of NOSH-Aspirin and provides a comprehensive analysis to elucidate the mechanism underlying its disease-protective benefits.
Topics: Anti-Inflammatory Agents; Anti-Inflammatory Agents, Non-Steroidal; Aspirin; Disulfides; Humans; Nitrates
PubMed: 36035295
DOI: 10.1155/2022/4463294 -
Frontiers in Pharmacology 2021The coronavirus disease, 2019 (COVID-19), has spread rapidly around the world and become a major public health problem facing the world. Traditional Chinese medicine... (Review)
Review
The coronavirus disease, 2019 (COVID-19), has spread rapidly around the world and become a major public health problem facing the world. Traditional Chinese medicine (TCM) has been fully committed to treat COVID-19 in China. It improved the clinical symptoms of patients and reduced the mortality rate. In light of the fever was identified as one of leading clinical features of COVID-19, this paper will first analyze the material basis of fever, including pyrogenic cytokines and a variety of the mediators of fever. Then the humoral and neural pathways of fever signal transmission will be described. The scattered evidences about fever recorded in recent years are connected in series. On this basis, the understanding of fever is further deepened from the aspects of pathology and physiology. Finally, combining with the chemical composition and pharmacological action of available TCM, we analyzed the mechanisms of TCMs to play the antipyretic effect through multiple ways. So as to further provide the basis for the research of antipyretic compound preparations of TCMs and explore the potential medicines for the prevention and treatment of COVID-19.
PubMed: 33828481
DOI: 10.3389/fphar.2021.583279 -
Molecular Biology Reports Aug 2022Acetaminophen (APAP) is commonly prescribed as an antipyretic and analgesic agent in the practical field. Like every other drug(s), APAP also undergo metabolism by... (Review)
Review
Acetaminophen (APAP) is commonly prescribed as an antipyretic and analgesic agent in the practical field. Like every other drug(s), APAP also undergo metabolism by oxidation or conjugation by glucuronate and sulphate to form the toxic metabolite N-acetyl-p-benzoquinone imine (NAPQI). Moreover, the NAPQI is detoxified by conjugation with reduced glutathione (GSH). Interestingly, APAP is also metabolized in the kidney by deacetylation reaction in the presence of N-deacetylase enzyme into another severely toxic but minor metabolite, p-aminophenol. Both NAPQI and p-aminophenol shows nephrotoxicity as well as hepatotoxicity. Hence, the long-term therapeutic dose use and unnecessary overdose of APAP are of great concern as prolonged negligence may cost the nephrotoxicity that may lead to uremia and finally to kidney failure. It has recently been investigated that probiotic supplementation inhibits the sequential events associated with APAP-induced nephrotoxicity. This review emphasizes the role of different probiotics that have already been investigated in nephrotoxicity or uremia caused by APAP overdose.
Topics: Acetaminophen; Glutathione; Humans; Probiotics; Renal Insufficiency; Uremia
PubMed: 35661049
DOI: 10.1007/s11033-022-07534-7 -
Critical Reviews in Analytical Chemistry 2022Paracetamol (PAR) is an effective antipyretic and analgesic drug utilized worldwide, safer at therapeutic levels but over-dosing and the chronic usage of PAR results in... (Review)
Review
Paracetamol (PAR) is an effective antipyretic and analgesic drug utilized worldwide, safer at therapeutic levels but over-dosing and the chronic usage of PAR results in accumulation of toxic metabolites, which leads to kidney and liver damages. Hence, a simple, rapid, cost-effective, and sensitive analytical technique is needed for the accurate determination of PAR in pharmaceutical and biological samples. Though numerous techniques have been reported for PAR detection, electrochemical methods are being receiving more interest due to their advantages. Moreover, in the past few decades, room temperature ionic liquids (RTILs) have been utilized in electrochemical sensors due to their attractive properties. In this present review, authors gathered research findings available for the determination of PAR using RTIL-based electrochemical sensors and discussed. The advantages and limitations in these systems as well as the future research directions are summarized.
Topics: Acetaminophen; Carbon; Electrochemical Techniques; Electrodes; Ionic Liquids; Temperature
PubMed: 33622098
DOI: 10.1080/10408347.2021.1882834