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Topical Pain Medications and Their Role in Pain Management
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
Chemotherapy-induced peripheral neuropathy (CIPN) is extremely debilitating, and patients have limited options for relief. Dose reduction or the discontinuation of chemotherapy regimens may result from severe CIPN. A pilot study done by Rossignol et al.10 investigated the application of amitriptyline 10% cream on neuropathic pain. Patients who had hematological or solid tumors with CIPN of the hands and feet were given amitriptyline 10% cream twice a day. Pain intensity scores were assessed by the VAS at 1, 2, and 4 weeks, followed by monthly for up to 1 year. A total of 44 patients were enrolled in the study. The median pain score was 7 at baseline which decreased to a median of 2 after 4 weeks of topical treatment. This led to 11/44 patients with reduced initial chemotherapy doses, as well as 5 patients who discontinued chemotherapy, to resume chemotherapy after treatment with topical amitriptyline 10%.
Swarm Intelligence and Evolutionary Algorithms for Drug Design and Development
Published in Sandeep Kumar, Anand Nayyar, Anand Paul, Swarm Intelligence and Evolutionary Algorithms in Healthcare and Drug Development, 2019
One of the commonly caused side effects from the cancer chemotherapy is chemotherapy-induced peripheral neuropathy (CIPN), which is quite a life debilitating causing enormous pain. The multifactorial as well as the poorly understood mechanisms of toxicity have paved way for the identification of novel treatment methods. The computational models of drug neurotoxicity can be implemented in the case of early drug discovery in order to screen, in case of a high-risk compounds which chases the safe drug candidates for further development methods.
Metabolic Therapies in the Management of Heel Pain
Published in Kohlstadt Ingrid, Cintron Kenneth, Metabolic Therapies in Orthopedics, Second Edition, 2018
Another common medication that causes complications in foot health are chemotherapeutic agents, including platinum drugs, taxanes, epothilones and vinca alkaloids.8 Chemotherapy-induced peripheral neuropathy is the most common podiatric side effect that is not only painful and uncomfortable for the patient but can lead to overuse of the plantar fascia and weakness in the intrinsic foot muscles. This can be quite distressing for patients; however, recent evidence from several small pilot studies has shown that the use of vitamin E might help prevent or lessen the side effects of chemotherapy-induced peripheral neuropathy and thus the risk of plantar fasciitis. Other agents that look promising in preliminary studies include glutamine, glutathione, N-acetylcysteine, oxcarbazepine and xaliproden.8
Using Xenopus oocytes in neurological disease drug discovery
Published in Expert Opinion on Drug Discovery, 2020
Steven L. Zeng, Leland C. Sudlow, Mikhail Y. Berezin
In addition, a new type of pain caused by common by chemotherapy drugs leads to the condition known as chemotherapy induced peripheral neuropathy (CIPN). CIPN occurs in nearly 10 – 60% of patients treated with first-line chemotherapy drugs. Patients with acute neurotoxicity appear to be at increased risk for chronic neuropathy in which painful symptoms persist long after cessation of chemotherapy. Deterioration of sensory neurons and their axons leads to the loss of nerve fibre density and nociception, and this also puts the patient at greater risk of serious damage to the hands or feet. CIPN can be debilitating and is frequently the primary reason for patients choosing to discontinue chemotherapy. To date, most of the CIPN prevention trials have not demonstrated benefits compared to treatment with a placebo, and therefore novel targets are critically needed. A number of recent studies used Xenopus oocytes to test new targets and identify new active drug candidates. Thus, Romero et al. developed a novel peptide RgIA4 that exhibits high potency for both human and rodent α9α10 nAChR [116], a recently discovered ion channel that has been implicated in the neuropathic pain, including CIPN [117].
Incidence of vincristine induced neurotoxicity in children with acute lymphoblastic leukemia and its correlation with nutritional deficiencies
Published in Pediatric Hematology and Oncology, 2019
Sankalp Dudeja, Shreya Gupta, Sunita Sharma, Anju Jain, Suvasini Sharma, Puneet Jain, Satinder Aneja, Jagdish Chandra
Treatment of childhood ALL involves a minimum of 2 years of chemotherapy with multiple administrations of vincristine, a neurotoxic drug. Chemotherapy-induced peripheral neuropathy is the most important dose-limiting toxicity of vincristine. Chemotherapy-induced peripheral neuropathy manifests as tingling, numbness, difficulty in walking, jaw pain, constipation, urinary retention, or paralytic ileus.3 Patients with preexisting neuropathy can develop life-threatening paralysis, even with low doses of vincristine.4 In western countries, the pattern of vincristine-induced neuropathy varied from no dose-limiting toxicity, mild axonal neuropathy (on nerve conduction study), or isolated fine motor abnormalities.5,6. However, there is a paucity of data on the incidence of vincristine-induced neuropathy in India. Given the high incidence of undernutrition in India and possible concomitant micronutrient deficiencies, the incidence of vincristine-induced neuropathy could be higher than in the western countries. The present study is a prospective study to determine the incidence of neuropathy in patients with Acute Lymphoblastic Leukemia (ALL) after completion of induction of remission phase and to correlate its incidence with undernutrition, vitamin B12, folate and iron deficiency.
Rapamycin alleviates proinflammatory cytokines and nociceptive behavior induced by chemotherapeutic paclitaxel
Published in Neurological Research, 2019
Xiaoli Zhang, Nan Jiang, Jing Li, Dongyan Zhang, Xiaohong Lv
Paclitaxel is a widely prescribed chemotherapeutic agent for the treatment of breast, lung, and other cancers, but causes a variety of serious side effects, including peripheral neuropathy, leukopenia, joint or muscle pain, vomiting, and alopecia [5]. Chemotherapy-induced peripheral neuropathy causes severe sensory disturbances that range from mild tingling to spontaneous painful burning paresthesia affecting the sensory nerves to the hands and feet [6] and can persist long after treatment cessation [7] in up to 68% of chemotherapy cancer patients [8]. As traditional analgesics generally lack efficacy in treating this condition [9], a pressing need exists for novel analgesic strategies. In another word, treatment options for these abnormal sensations have been restricted, partly due to a poor understanding of the underlying mechanisms responsible for neuropathic pain induced by chemotherapeutic paclitaxel.