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Analgesics during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Two major categories of headache are recognized, namely, (1) tension and (2) vascular (migraine). For mild to moderate headaches, aspirin, acetaminophen, ibuprofen, or naproxen usually provide satisfactory acute relief. Acetaminophen is the preferred analgesic for use during pregnancy. Aspirin in frequent and large doses should be avoided during pregnancy to maintain hemostasis, especially when headaches occur close to term. Aspirin increases the potential for bleeding because of decreased platelet activity. NSAIDs should not be used after 34 weeks gestational age because of the theoretical potential for premature closure of the ductus arteriosus and other potential adverse effects. If non-NSAID agents have failed, ibuprofen seems associated with the smallest risk for increased bleeding and premature ductus closure.
Haematological disorders
Published in Judy Bothamley, Maureen Boyle, Medical Conditions Affecting Pregnancy and Childbirth, 2020
The initial visit is key to establishing that all the elements of optimal preconception care (see Box 6.11) have been carried out and to plan antenatal care. A full and detailed medical, surgical and obstetric history will need to be recorded, and laboratory investigations undertaken (see Box 6.12). The frequency of sickle cell crisis and any organ damage needs to be established and appropriate referrals made for assessment. A review of current medications, including analgesia used for self-medication, should be made with any required adjustment regarding safe use in pregnancy. Baseline haemoglobin should be documented and any red cell alloimmunisation noted. A review of discussions regarding partner testing and prenatal diagnosis should be made and re-discussed if required21.
Pain relief in labour
Published in Michael S. Marsch, Janet M. Rennie, Phillipa A. Groves, Clinical Protocols in Labour, 2020
Michael S. Marsch, Janet M. Rennie, Phillipa A. Groves
There are various non-analgesic side effects: CNS (sedation, confusion and respiratory depression) and the GI tract (nausea, vomiting and delayed gastric emptying). Paturients receiving pethidine should also receive ranitidine and metoclopramide to counteract its GI tract side effects. There is no proven side effect of pethidine on progress of labour.
Pattern of use and awareness of side-effects of non-steroidal anti-inflammatory drugs in the Jordanian population
Published in Annals of Medicine, 2023
Randa I. Farah, Aseil E. Khatib, Hiba J. Abu Ziyad, Dareen K. Jiad, Lara R. Al Qusous, Ali Jamal Ababneh, Salma Ajarmeh
Non-steroidal anti-inflammatory drugs (NSAIDs) are a group of medications that act as painkillers and reduce fever and inflammation but have concerning side-effects [1]. These medications are used to treat different conditions, including headache, fever, acute and chronic pain, biliary and ureteric colic, rheumatologic diseases, and dysmenorrhea. Such drugs are prescribed worldwide in clinics and hospitals and can also be purchased over the counter (i.e. without a prescription), as their use is believed to be safe even over long periods [2]. Moreover, purchasing an analgesic without a prescription is considered by many members of the public to be less time-consuming, less costly, and result in faster pain relief compared to visiting an emergency room or making an appointment to be examined by a general physician [3].
First-in-human phase I studies of YJ001 spray applied to local skin in healthy subjects and patients with diabetic neuropathic pain
Published in Expert Opinion on Investigational Drugs, 2023
Xiding Yang, Ronghua Zhu, Jing Zhang, Zaihua Hou, Lingfeng Yang, Xiao Fan, Qiangyong Yan, Jingjing Li, Zhiguang Zhou, Pingfei Fang
DNP is a distressing consequence of DM and may be present in as many as one in three patients with diabetes [23]. This can have a profound impact, leading to a poor quality of life, impaired sleep, disruption of employment, and poor mental health with excessive depression and anxiety. The management of DNP is difficult and poses a significant challenge, and DNP treatments recommended by expert international consensus have remained largely unchanged over the past decade [23]. Duloxetine, pregabalin, weak opioids, and tricyclic antidepressants are widely recommended and prescribed for DNP. These oral analgesics may put patients at risk for systemic side effects. DNP is one of the most common subtypes of peripheral NP. Patients with DNP are more likely to respond to peripherally administered analgesics. The use of topical analgesics may also be associated with minimal systemic absorption in patients with DNP compared with oral agents, making the topical route of administration appealing to prescribers and patients [12]. Numerous topical analgesics have been evaluated, but only the 5% lidocaine patch or plaster [20,21,24–27] and the high dose 8% capsaicin patch [28,29] have robust evidence for the treatment of DPN. The evidence to recommend other topical agents, including amitriptyline [30,31], nutmeg extract preparation [32], ketamine [30,33], clonidine [34,35], and vasodilators [36], remains inconclusive for the treatment of DPN. Further clinical trials to assess novel topical agents are needed.
Pharmacological approaches to treat intestinal pain
Published in Expert Review of Clinical Pharmacology, 2023
Mikolaj Swierczynski, Adam Makaro, Agata Grochowska, Maciej Salaga
In IBD, intestinal pain occurs as the result of exacerbated underlying disease. When pain is observed despite adequate therapy, analgesic drugs are used. In fact, the analgesic treatment in IBD is problematic because of many limitations of NSAIDs and opioids use together with structural and anatomical changes (e.g. fistulae) within the intestine caused by the disease activity often requiring surgical intervention. These aspects emphasize the need for improvement in anti-inflammatory therapies as prevention of already mentioned anatomical changes and outbreaks of pain beyond the analgesic potential of safe drugs, such as acetaminophen [53]. In this review we highlighted a small number of studies concerning the influence of biological drugs on intestinal pain. Biologics used in IBD are the agents targeting the proteins, which play roles in inflammation and nociception. Thus, the data comparing the effect of various biologics on abdominal pain in patients would be valuable to clinicians. Moreover, similar observations from the studies on novel therapeutics acting through S1PR, ozanimod and etrasimod, are also urgently needed.