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By Joe Weatherly FM/Hospitalist-CoFounder of QuestioningMedicine and PCRAP contributor.
Anne-Marie Schjerning Olsen, Gunnar H Gislason, Patricia McGettigan, Emil Fosbøl, Rikke Sørensen, Morten Lock Hansen, Lars Køber, Christian Torp-Pedersen, Morten Lamberts
IMPORTANCE: Antithrombotic treatment is indicated for use in patients after myocardial infarction (MI); however, concomitant use of nonsteroidal anti-inflammatory drugs (NSAIDs) could pose safety concerns. OBJECTIVE: To examine the risk of bleeding and cardiovascular events among patients with prior MI taking antithrombotic drugs and for whom NSAID therapy was then prescribed. DESIGN, SETTING, AND PARTICIPANTS: Using nationwide administrative registries in Denmark (2002-2011), we studied patients 30 years or older admitted with first-time MI and alive 30 days after discharge...
February 24, 2015: JAMA: the Journal of the American Medical Association
O Mathiesen, J Wetterslev, V K Kontinen, H-C Pommergaard, L Nikolajsen, J Rosenberg, M S Hansen, K Hamunen, J J Kjer, J B Dahl
Post-operative pain affects millions of patients worldwide and the post-operative period has high rates of morbidity and mortality. Some of this morbidity may be related to analgesics. The aim of this review was to provide an update of current knowledge of adverse events (AE) associated with the most common perioperative non-opioid analgesics: paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), glucocorticoids (GCCs), gabapentinoids and their combinations. The review is based on data from systematic reviews with meta-analyses of analgesic efficacy and/or adverse effects of perioperative non-opioid analgesics, and randomised trials and cohort/retrospective studies...
November 2014: Acta Anaesthesiologica Scandinavica
J B Dahl, R V Nielsen, J Wetterslev, L Nikolajsen, K Hamunen, V K Kontinen, M S Hansen, J J Kjer, O Mathiesen
In contemporary post-operative pain management, patients are most often treated with combinations of non-opioid analgesics, to enhance pain relief and to reduce opioid requirements and opioid-related adverse effects. A diversity of combinations is currently employed in clinical practice, and no well-documented 'gold standards' exist. The aim of the present topical, narrative review is to provide an update of the evidence for post-operative analgesic efficacy with the most commonly used, systemic non-opioid drugs, paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs)/COX-2 antagonists, glucocorticoids, gabapentinoids, and combinations of these...
November 2014: Acta Anaesthesiologica Scandinavica
Irene van Echteld, Mihir D Wechalekar, Naomi Schlesinger, Rachelle Buchbinder, Daniel Aletaha
BACKGROUND: This is an update of a Cochrane review first published in 2006. Gout is one of the most common rheumatic diseases worldwide. Despite the use of colchicine as one of the first-line therapies for the treatment of acute gout, evidence for its benefits and harms is relatively limited. OBJECTIVES: To evaluate the benefits and harms of colchicine for the treatment of acute gout. SEARCH METHODS: We searched the following electronic databases from inception to April 2014: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE...
August 15, 2014: Cochrane Database of Systematic Reviews
Laura W Bowers, Ilane X F Maximo, Andrew J Brenner, Muralidhar Beeram, Stephen D Hursting, Ramona S Price, Rajeshwar R Tekmal, Christopher A Jolly, Linda A deGraffenried
Obesity is associated with a worse breast cancer prognosis and elevated levels of inflammation, including greater cyclooxygenase-2 (COX-2) expression and activity in adipose-infiltrating macrophages. The product of this enzyme, the proinflammatory eicosanoid prostaglandin E2 (PGE2), stimulates adipose tissue aromatase expression and subsequent estrogen production, which could promote breast cancer progression. This study demonstrates that daily use of a nonsteroidal anti-inflammatory drug (NSAID), which inhibits COX-2 activity, is associated with reduced estrogen receptor α (ERα)-positive breast cancer recurrence in obese and overweight women...
August 15, 2014: Cancer Research
Ana Sofia Carvalho, Helena Ribeiro, Paula Voabil, Deborah Penque, Ole N Jensen, Henrik Molina, Rune Matthiesen
We investigated the molecular effects of glucosamine supplements, a popular and safe alternative to nonsteroidal anti-inflammatory drugs, for decreasing pain, inflammation, and maintaining healthy joints. Numerous studies have reported an array of molecular effects after glucosamine treatment. We questioned whether the differences in the effects observed in previous studies were associated with the focus on a specific subproteome or with the use of specific cell lines or tissues. To address this question, global mass spectrometry- and transcription array-based glucosamine drug profiling was performed on malignant cell lines from different stages of lymphocyte development...
December 2014: Molecular & Cellular Proteomics: MCP
Tatsuya Fujii, Koshi Takana, Sumihisa Orita, Gen Inoue, Nobuyasu Ochiai, Kazuki Kuniyoshi, Yasuchika Aoki, Tetsuhiro Ishikawa, Masayuki Miyagi, Hiroto Kamoda, Miyako Suzuki, Yoshihiro Sakuma, Gou Kubota, Yasuhiro Oikawa, Kazuhide Inage, Takeshi Sainoh, Jun Sato, Kazuyo Yamauchi, Tomoaki Toyone, Junichi Nakamura, Shunji Kishida, Kazuhisa Takahashi, Seiji Ohtori
PURPOSE: Opioids improve pain from knee and hip osteoarthritis (OA) and decrease the functional impairment of patients. However, there is a possibility that opioids induce analgesia and suppress the physiological pain of OA in patients, thereby inducing the progression of OA changes in these patients. The purpose of the current study was to investigate the possibility of progressive changes in OA among patients using opioids. MATERIALS AND METHODS: Two hundred knee or hip OA patients were evaluated in the current prospective, randomized, active-controlled study...
September 2014: Yonsei Medical Journal
Natàlia Corcoll, Vicenç Acuña, Damià Barceló, Maria Casellas, Helena Guasch, Belinda Huerta, Mira Petrovic, Lidia Ponsatí, Sara Rodríguez-Mozaz, Sergi Sabater
We assessed the tolerance acquired by stream biofilms to two non-steroidal anti-inflammatory-drugs (NSAIDs), ibuprofen and diclofenac. Biofilms came from a stream system receiving the effluent of a wastewater treatment plant (WWTP). The response of biofilms from a non-polluted site (upstream the WWTP) was compared to that of others downstream with relevant and decreasing levels of NSAIDs. Experiments performed in the laboratory following the pollution-induced community tolerance (PICT) approach determined that both algae and microbial communities from biofilms of the sites exposed at the highest concentrations of ibuprofen and diclofenac acquired tolerance to the mixture of these NSAIDs occurring at the sites...
October 2014: Chemosphere
G I Stepaniuk, A A Stoliarchuk
Experiments on intact cats were made to study the effect of intravenous injection of voltaren (4 mg/kg) and intraventricular injection of indomethacin (4 mg/kg), ibuprophen (5 mg/kg), and butadion (22 mg/kg) on the coronary circulation and oxygen consumption by the myocardium. Indomethacin and butadion decreased the volumetric velocity of the coronary circulation and to a lesser degree oxygen consumption by the myocardium in all the experiments, whereas voltaren in 8 of 15 experiments. Ibuprophen and voltaren (in part of experiments) led to an increase in the coronary circulation and to greater oxygen utilization by the myocardium...
March 1985: Farmakologiia i Toksikologiia
O M Laudanno, J A Cesolari, J Esnarriaga, P Flaherty, J Vada, G Guastalli, P San Miguel, O A Bedini
UNLABELLED: This work was aimed to study COX-1 and COX-2 selectivity in 16 non-steroidal anti-inflammatory drugs (NSAIDs), at ulcerogenic doses in 2 experimental models: 1) provided subcutaneously (sc), after solid food(SF), (antrum ulcers and intestinal erosions); and 2) orally (O) (fundic and intestinal erosions). METHODS: 17 groups of female Wistar rats (n = 7 each group), weighing 200 g, 36 h fasting with water ad libitum, were submitted to the following experiments: 1...
1998: Acta Gastroenterologica Latinoamericana
Hazem Khalaf, Lotta Salste, Patrik Karlsson, Per Ivarsson, Jana Jass, Per-Erik Olsson
Pharmaceuticals are regularly released into the environment; in particular non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics. Erythromycin, naproxen, furosemide and atenolol are reported to be stable for up to 1 year in the environment, which increases the risk for accumulation. In the present study we have measured the occurrence and concentration of pharmaceuticals in river Viskan (Jössabron) downstream of a sewage treatment plant in Borås, Sweden. Pharmaceuticals and water samples were tested for potential human risk by evaluating inflammatory responses (NF-kappaB and AP-1) using human T24 bladder epithelial cells and Jurkat T-cells...
February 1, 2009: Science of the Total Environment
E E Morse
Numerous drugs and chemicals affect the function of human blood platelets. The mechanism of action of some medications is partly understood. Aspirin is the most frequently involved drug. It appears to interfere with the platelet release reaction by acetylation of a platelet membrane protein which may be involved in the synthesis of prostaglandins. Other anti-inflammatory drugs, including indomethacin, phenylbutazone, ibuprophen (Motrin) and clonixin, also interfere with the release reaction but have a shorter acting course than aspirin...
January 1977: Annals of Clinical and Laboratory Science
Jennifer Y Xie, Chaoling Qu, Amol Patwardhan, Michael H Ossipov, Edita Navratilova, Lino Becerra, David Borsook, Frank Porreca
Preclinical assessment of pain has increasingly explored operant methods that may allow behavioral assessment of ongoing pain. In animals with incisional injury, peripheral nerve block produces conditioned place preference (CPP) and activates the mesolimbic dopaminergic reward pathway. We hypothesized that activation of this circuit could serve as a neurochemical output measure of relief of ongoing pain. Medications commonly used clinically, including gabapentin and nonsteroidal anti-inflammatory drugs (NSAIDs), were evaluated in models of post-surgical (1 day after incision) or neuropathic (14 days after spinal nerve ligation [SNL]) pain to determine whether the clinical efficacy profile of these drugs in these pain conditions was reflected by extracellular dopamine (DA) release in the nucleus accumbens (NAc) shell...
August 2014: Pain
Li Wei, Thomas M MacDonald, Claudine Jennings, Xia Sheng, Robert W Flynn, Michael J Murphy
Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used; however, they are also nephrotoxic with both acute and chronic effects on kidney function. Here we determined NSAID prescribing before and after estimated GFR (eGFR) reporting and evaluate renal function in patients who used NSAIDs but stopped these after their first eGFR report. A population-based longitudinal analysis using a record-linkage database was conducted with the GFR estimated using the four-variable equation from the MDRD study and analyzed by trend test, paired t-test, and logistic regression modeling...
July 2013: Kidney International
C J Menkes
Adverse drug reactions are more common in patients over sixty-five years of age. There is no significant change of absorption with aging but oxidations reactions are, usually, decreased. The most important change is in the renal elimination of drugs. The renal insufficiency related to the use of NSAIDs is prostaglandin dependent. It is characterized by a fall in urine output, body weight gain, rising of blood urea nitrogen, creatinine and, sometimes, potassium. This situation is usually rapidly reversible after discontinuation of the therapy but an acute renal failure may occur...
1989: Scandinavian Journal of Rheumatology. Supplement
C Stöllberger, J Finsterer
Nonsteroidal anti-inflammatory drugs (NSAIDs) are a frequently prescribed group of highly effective drugs of which the most well-known side effect is gastrointestinal peptic ulcer. However, NSAIDs have additional renal, cardiovascular, hematological, dermatological, and neurological side effects. Although the spectrum of side effects is slightly different between the conventional NSAIDs and the recently developed cyclooxygenase 2 (COX-2) inhibitors, their overall spectrum is quite similar. Aim of this review is to summarize the current knowledge about NSAIDs and their effects on patients with cardio- or cerebrovascular disorders...
September 2003: Zeitschrift Für Kardiologie
Thierry Schaeverbeke, François Héloire, Gilbert Deray
Despite the cardiovascular risk attributable to the NSAIDs, these drugs are among the most prescribed treatments in the world. Recently to manage this risk during chronic inflammatory rheumatisms a surveillance plan has been developed based on a decision algorithm. Given that the arterial thrombotic risks (myocardial or cerebral) are observed essentially during long-term treatments, two types of situation have been envisaged, short-term treatments and long-term treatments. Before any short-term NSAID prescription (less than one month), the cardio-renal risk should be evaluated...
September 2006: La Presse Médicale
Koji Takeuchi
Prostaglandin E2 not only prevents NSAID-generated small intestinal lesions, but also promotes their healing. The protective effects of prostaglandin E2 are mediated by the activation of EP4 receptors and functionally associated with the stimulation of mucus/fluid secretions and inhibition of intestinal hypermotility, resulting in the suppression of enterobacterial invasion and iNOS up-regulation, which consequently prevents intestinal lesions. Prostaglandin E2 also promotes the healing of intestinal damage by stimulating angiogenesis through the up-regulation of VEGF expression via the activation of EP4 receptors...
December 2014: Current Opinion in Pharmacology
Luiz Miguel Santiago, Carolina Pereira, Philippe Botas, Ana Rita Simões, Rosa Carvalho, Gonçalo Pimenta, Glória Neto
OBJECTIVE: To study the differences between controlled and uncontrolled hypertensive patients. METHODS: This was a cross-sectional observational study of the hypertensive population on the lists of three general practitioners in the district of Coimbra in central Portugal in 2013, with a margin of error of 6% and 95% confidence interval in each sample, organized in ascending order of health care user numbers. Data were gathered electronically by the investigators after approval by the Regional Health Authority's ethics committee...
July 2014: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Amit M Algotar, Roxanna Behnejad, M Suzanne Stratton, Steven P Stratton
BACKGROUND: PSA and PSA velocity (PSAV, rate of PSA change over time) are biomarkers for diagnosis and prognosis of prostate cancer. Men who are at high risk for prostate cancer also have associated comorbidities for which they are taking NSAIDs and statins for long periods; therefore, it is important to understand the effect of these medications on markers used to assess prostate cancer risk. METHODS: Using a population of 699 men, multiple linear regressions were used to investigate the associations between PSA and concomitant medications, and mixed-effects models were used to investigate these associations with PSAV...
October 2014: Cancer Epidemiology, Biomarkers & Prevention
2014-08-01 12:54:39
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