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Journal of Orthopaedic Surgery (Hong... 2023Pharmacotherapy is the most common strategies to reduce pain for osteoarthritis (OA) patients. To analyze the trend and pattern of prescription analgesic medication use...
OBJECTIVE
Pharmacotherapy is the most common strategies to reduce pain for osteoarthritis (OA) patients. To analyze the trend and pattern of prescription analgesic medication use in American OA patients. Besides, our study also tried to figure out the demographic characteristics of opioid use among OA population which may helpful for managing the use of opioids.
METHODS
We included 2214 OA patients from 2007 to 2018. We extracted data from National Health and Nutrition Examination Survey (NHANES) database. We compared analgesics and anti-depression medications use by category between survey participants with OA and without.
RESULTS
For OA patients, NSAIDs, acetaminophen and gabapentinoid were the mostly highly used analgesics (10.2%, 9.0% and 8.9%, respectively). However, we also found that opioids use was very common in OA patients (7.7%) and the duration of opioids use was significantly long. In addition, the opioids use did not decrease from 2007 to 2018, while gabapentinoid increased rapidly from recent decade (From 5.0% to 12.1%). The common analgesic combination used by OA population was opioids with acetaminophen and gabapentinoid with selective serotonin reuptake inhibitors (SSRIs) (2.9% and 2.7%, respectively).
CONCLUSION
The use of gabapentinoid increased rapidly from recent decade, while opioids use did not decrease. The long-term excessive use of opioids was also a serious problem for OA pain control. More improvements such as focusing more on healthcare education and paying more attention on non-pharmacotherapy and the psychological situation of patients are needed.
Topics: Humans; United States; Acetaminophen; Nutrition Surveys; Analgesics; Osteoarthritis; Analgesics, Opioid; Prescriptions
PubMed: 37724650
DOI: 10.1177/10225536231202835 -
European Journal of Pharmaceutical... Jan 2022The development of new COX-2 inhibitors with analgesic and anti-inflammatory efficacy as well as minimal gastrointestinal, renal and cardiovascular toxicity, is of vital...
The development of new COX-2 inhibitors with analgesic and anti-inflammatory efficacy as well as minimal gastrointestinal, renal and cardiovascular toxicity, is of vital importance to patients suffering from chronic course pain and inflammatory conditions. This study aims at evaluating the therapeutic activity and adverse drug reactions associated with the use of the newly synthesized pyrazole derivative, compound AD732, E-4-[3-(4-methylphenyl)-5-hydroxyliminomethyl-1H-pyrazol-1-yl]benzenesulfonamide, as compared to indomethacin and celecoxib as standard agents. Anti-inflammatory activity was assessed using carrageenan-induced rat paw edema and cotton pellet granuloma tests; formalin-induced hyperalgesia and hot plate tests were done to study analgesic activity. In vitro tests to determine COX-1/COX-2 selectivity and assessment of renal and gastric toxicity upon acute exposure to AD732 were also conducted. Compound AD732 exhibited promising results; higher anti-inflammatory and analgesic effects compared to standard agents, coupled with the absence of ulcerogenic effects and minimal detrimental effects on renal function. Additionally, compound AD732 was a less potent inhibitor of COX-2 in vitro than celecoxib, which may indicate lower potential cardiovascular toxicity. It may be concluded that compound AD732 appears to be a safer and more effective molecule with promising potential for the management of pain and inflammation.
Topics: Analgesics; Animals; Anti-Inflammatory Agents; Anti-Inflammatory Agents, Non-Steroidal; Carrageenan; Cyclooxygenase 2; Cyclooxygenase 2 Inhibitors; Edema; Pyrazoles; Rats; Rats, Wistar
PubMed: 34818572
DOI: 10.1016/j.ejps.2021.106080 -
Molecules (Basel, Switzerland) Dec 2020The subject of the work was the synthesis of new derivatives of1-pyrrolo[3,4-c]pyridine-1,3(2)-dione with potential analgesic and sedative activity. Eight compounds...
The subject of the work was the synthesis of new derivatives of1-pyrrolo[3,4-c]pyridine-1,3(2)-dione with potential analgesic and sedative activity. Eight compounds werereceived. The analgesic activity of the new compounds was confirmed in the "hot plate" test and in the "writhing" test. All tested imides - were more active in the "writhing" test than aspirin, and two of them, and , were similar to morphine. In addition, all of the new imides inhibited the locomotor activity in mice to a statistically significant extent, and two of them also prolonged the duration of thiopental sleep.On the basis of the results obtained for the previously synthesized imides and the results presented in this paper, an attempt was madeto determine the relationship between thechemical structure of imides and their analgesic and sedativeproperties.
Topics: Analgesics; Animals; Hypnotics and Sedatives; Locomotion; Male; Mice; Pyridines; Pyrroles; Structure-Activity Relationship
PubMed: 33322767
DOI: 10.3390/molecules25245883 -
Analgesic and Opioid Use for Patients Discharged from the Emergency Department with Ureteral Stones.Journal of Endourology Jul 2021The aim of this study was to describe and characterize the analgesic and opioid use for patients discharged from the emergency department (ED) with renal colic due to...
The aim of this study was to describe and characterize the analgesic and opioid use for patients discharged from the emergency department (ED) with renal colic due to ureteral stone. This is a secondary analysis of a multicenter prospective trial of ED patients diagnosed by CT scan as having a symptomatic ureteral stone <9 mm in diameter. Participants were contacted after randomization on days 2, 7, 15, 20, and 29 and reported opioid and nonopioid analgesic use and stone passage. CT scan was repeated on day 29 to 36 to confirm passage. Of 403 participants, 314 (77.9%) took an analgesic after discharge and 199 (49.4%) took opioids. Opioids were more commonly used by younger patients ( = 0.04) and those with a family history of stones ( = 0.003). Stone size and tamsulosin use were not associated with analgesic utilization. Shorter time to passage and more distal stone location were associated with less analgesic and opioid use. For those who did not expel a stone, 55.0% took opioids at any time, and for those who did expel a stone, 31.9% took opioids before the stone was expelled and 15.7% took opioids at any time after the stone was expelled. Factors associated with increased use of analgesics in patients discharged from the ED include a longer time to stone passage, no spontaneous passage, and proximal position of the stone in the ureter. Some patients continued to use analgesics after the stone had passed, but most stopped using analgesics by day 29. The study has been registered at https://clinicaltrials.gov (NCT00382265).
Topics: Analgesics; Analgesics, Opioid; Emergency Service, Hospital; Humans; Patient Discharge; Prospective Studies; Ureteral Calculi
PubMed: 33213185
DOI: 10.1089/end.2020.0835 -
Journal of Medicinal Chemistry Aug 2023The design and synthesis of a series of 2,7-diazaspiro[4.4]nonane derivatives as potent sigma receptor (SR) ligands, associated with analgesic activity, are the focus of...
The design and synthesis of a series of 2,7-diazaspiro[4.4]nonane derivatives as potent sigma receptor (SR) ligands, associated with analgesic activity, are the focus of this work. In this study, affinities at S1R and S2R were measured, and molecular modeling studies were performed to investigate the binding pose characteristics. The most promising compounds were subjected to toxicity testing and subsequently screened for analgesic properties. Compound () exhibited negligible cellular toxicity and a high binding affinity to both SRs (S1R = 3.5 nM, S2R = 2.6 nM), but not for other pain-related targets, and exerted high potency in a model of capsaicin-induced allodynia, reaching the maximum antiallodynic effect at very low doses (0.6-1.25 mg/kg). Functional activity experiments showed that S1R antagonism is needed for the effects of and that it did not induce motor impairment. In addition, exhibited a favorable pharmacokinetic profile.
Topics: Humans; Ligands; Receptors, sigma; Protein Binding; Pain; Analgesics
PubMed: 37535861
DOI: 10.1021/acs.jmedchem.3c00959 -
The Journal of Pain Feb 2023The 0 to 10 numeric rating scale of pain intensity is a standard outcome in randomized controlled trials (RCTs) of pain treatments. For individuals taking analgesics,...
The 0 to 10 numeric rating scale of pain intensity is a standard outcome in randomized controlled trials (RCTs) of pain treatments. For individuals taking analgesics, there may be a disparity between "observed" pain intensity (pain intensity with concurrent analgesic use) and pain intensity without concurrent analgesic use (what the numeric rating scale would be had analgesics not been taken). Using a contemporary causal inference framework, we compare analytic methods that can potentially account for concurrent analgesic use, first in statistical simulations, and second in analyses of real (non-simulated) data from an RCT of lumbar epidural steroid injections. The default analytic method was ignoring analgesic use, which is the most common approach in pain RCTs. Compared to ignoring analgesic use and other analytic methods, simulations showed that a quantitative pain and analgesia composite outcome based on adding 1.5 points to pain intensity for those who were taking an analgesic (the QPAC) optimized power and minimized bias. Analyses of real RCT data supported the results of the simulations, showing greater power with analysis of the QPAC as compared to ignoring analgesic use and most other methods examined. We propose alternative methods that should be considered in the analysis of pain RCTs. PERSPECTIVE: This article presents the conceptual framework behind a new quantitative pain and analgesia composite outcome, the QPAC, and the results of statistical simulations and analyses of trial data supporting improvements in power and bias using the QPAC. Methods of this type should be considered in the analysis of pain RCTs.
Topics: Humans; Analgesics, Opioid; Randomized Controlled Trials as Topic; Analgesics; Pain Management; Pain; Pain, Postoperative
PubMed: 36220482
DOI: 10.1016/j.jpain.2022.09.017 -
Journal of Pharmacy & Pharmaceutical... 2018Many clinical diseases are accompanied by the symptoms of pain, and the degree of pain is closely related to the patients' suffering. Therefore, effectively relieving... (Review)
Review
Many clinical diseases are accompanied by the symptoms of pain, and the degree of pain is closely related to the patients' suffering. Therefore, effectively relieving pain has become one of the vital concerns of clinical treatment and analgesic drug research. Non-opioid drugs are mainly used for the clinical treatment of mild to moderate pain, whereas opioid drugs are mainly used for treating moderate to severe pain. However, opioid drugs easily elicit adverse reactions, such as gastrointestinal discomfort, addiction, dependence, and so on. Traditional Chinese medicine and its active ingredients have unique advantages in the treatment of pain for quite a long time, and many analgesic drugs directly or indirectly were isolatiedfrom Chinese medicine or natural products, such as Liu Suan Yan Hu Suo Yi Su Pian and aspirin. With the development and modernization of research on herbal medicine more and more studies have been conducted on the active ingredients and mechanisms of traditional Chinese medicine analgesics. However, no review has been done on analgesic active components and their mechanisms. In this paper, 81 active components with clear chemical structure and definite analgesic effects in vivo and in vitro of traditional Chinese medicine and mechanisms of action reported in recent literatures are reviewed and summarized to provide reference for clinical analgesia and analgesics research.
Topics: Analgesics; Animals; Drugs, Chinese Herbal; Humans; Medicine, Chinese Traditional; Molecular Structure; Pain
PubMed: 30465707
DOI: 10.18433/jpps30212 -
Current Protocols in Pharmacology Dec 2017MicroRNA(miRNA)-mediated gene regulation underlies cellular processes, playing an important role in homeostasis and diseases. The expression and function of miRNAs are... (Review)
Review
MicroRNA(miRNA)-mediated gene regulation underlies cellular processes, playing an important role in homeostasis and diseases. The expression and function of miRNAs are altered by various pharmacological agents, with differences in the endogenous levels of miRNAs influencing drug efficacy and toxicity. Thus, miRNA levels could be a biomarker for predicting treatment response, efficacy, and safety. In addition, elucidating the mechanistic significance of miRNA alterations can aid in the identification of therapeutic targets and patient selection, and guide personalized therapy. Discussed in this overview are the properties of miRNA, their modulation, and the ways to measure them. The effects of different classes of analgesics, including opioid and non-opioid, are described as examples of drug-induced modifications of miRNA, with a discussion on how measurement of miRNA levels in patients receiving analgesic therapy can assist in maximizing effectiveness while minimizing the untoward responses to this drug class. © 2017 by John Wiley & Sons, Inc.
Topics: Analgesics; Animals; Humans; MicroRNAs; Pain
PubMed: 29261227
DOI: 10.1002/cpph.29 -
British Journal of Anaesthesia Mar 2022Treating pain in the context of chronic kidney disease (CKD) is challenging because of altered pharmacokinetics and pharmacodynamics, with an increased risk of toxicity... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Treating pain in the context of chronic kidney disease (CKD) is challenging because of altered pharmacokinetics and pharmacodynamics, with an increased risk of toxicity and drug adverse events in this population. The aims of this systematic review and meta-analysis were to assess the prevalence of analgesic use and establish the risk of analgesics-related adverse events, in patients with CKD.
METHODS
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Medline, Embase, CINAHL, and CENTRAL were searched until January 2021. Random-effects meta-analyses and meta-regression were conducted to pool and summarise prevalence data and measures of association between analgesic use and adverse events.
RESULTS
Sixty-two studies relevant to the prevalence of analgesic use and 33 to analgesic-related adverse events were included, combining data on 2.3 and 3 million individuals, respectively. Pooled analyses found that 41% (95% confidence interval [CI], 35-48) of the CKD population regularly use analgesia. The annual period prevalence was estimated at 50% for opioids and 21% for nonsteroidal anti-inflammatory drugs (NSAID). Overall, 20% and 7% of patients with CKD are on chronic opioid or NSAID therapy, respectively. Opioid use was associated with an increased risk of death (1.61; 95% CI, 1.12-2.31; n= 7, I= 91%), hospitalisation (1.38; 95% CI, 1.32-1.45; n=2, I=0%), and fractures (1.51; 95% CI, 1.16-1.96; n=3, I=54%).
CONCLUSION
High levels of analgesic consumption and related serious adverse outcomes were found in patients with CKD. Consideration needs to be given to how these patients are assessed and managed in order to minimise harms and improve outcomes.
CLINICAL TRIAL REGISTRATION
CRD42019156491 (PROSPERO).
Topics: Analgesics; Animals; Drug-Related Side Effects and Adverse Reactions; Humans; Pain; Renal Insufficiency, Chronic
PubMed: 34763813
DOI: 10.1016/j.bja.2021.08.035 -
Scientific Reports Apr 202110-Alkylthiocolchicines have been obtained and characterized by spectroscopic methods and their biological activities as: cytotoxic, anti-inflammatory and analgesic...
10-Alkylthiocolchicines have been obtained and characterized by spectroscopic methods and their biological activities as: cytotoxic, anti-inflammatory and analgesic activities have been tested. Cytotoxic activity against SKOV-3 ovarian cell line for 10-alkylthiocolchicine analogues was reported and tested compounds showed to be more active than commonly used doxorubicin. Some of tested C-10 alkylthiolated colchicines have been found to exhibit cytotoxicity at levels comparable to that of the natural product-colchicine. 10-Methylthiocolchicine has IC = 8 nM and 10-ethylthiocolchicine has IC = 47 nM in comparison to colchicine IC = 37 nM. Moreover for 10-alkylthioderivatives apoptosis test, cyclin B1 and cell cycle tests were performed. 10-n-Butylthiocolchicine was tested for anti-inflammatory and analgesic activities it showed to produce analgesic rather than anti-inflammatory effect.
Topics: Analgesics; Animals; Anti-Inflammatory Agents, Non-Steroidal; Antineoplastic Agents, Phytogenic; Cell Line, Tumor; Colchicine; Drug Screening Assays, Antitumor; Humans; Male; Rats; Rats, Wistar; Sulfur Compounds
PubMed: 33907227
DOI: 10.1038/s41598-021-88260-1