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Assessing and managing pain
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
Lindsey Pollard, Harriet Barker
Non-steroidal anti-inflammatory drugs (NSAIDs) reduce inflammation and are effective for mild to moderate pain. They are available in oral, transdermal, rectal (PR) and topical preparations. They are commonly used postoperatively in combination with other analgesics and are also the drug of choice in conditions such as arthritis and some other chronic pain conditions.
Selected topics
Published in Henry J. Woodford, Essential Geriatrics, 2022
Non-pharmacological interventions include physiotherapy, weight reduction and increased exercise.24 Non-steroidal anti-inflammatory drugs (NSAIDs) are often used in younger patients, but carry a high risk of toxicity in older adults (including gastric bleeding, renal impairment, hypertension and heart failure). Cyclooxygenase 2 (COX-2) inhibitors may be less prone to cause gastric bleeding, but have all the other risks of harm plus a possible increase in cardiac ischaemic events. For these reasons all NSAIDs should be avoided in older adults unless absolutely necessary. Paracetamol (acetaminophen) and weak opioids are safer options for analgesia. Joint replacement surgery may be considered in those who have significant disability despite other therapeutic measures. In a cohort of older adults (mean age 75) with severe OA who underwent hip or knee replacement, post-operative complications occurred in 17% (none fatal), median time to independent walking was 12 days, and surgery was associated with significant symptomatic benefits at 12 months.25
Phytoconstituent-Loaded Nanomedicines for Arthritis Management
Published in Mahfoozur Rahman, Sarwar Beg, Mazin A. Zamzami, Hani Choudhry, Aftab Ahmad, Khalid S. Alharbi, Biomarkers as Targeted Herbal Drug Discovery, 2022
Syed Salman Ali, Snigdha Bhardwaj, Najam Ali Khan, Syed Sarim Imam, Chandra Kala
There are various medicines such as steroids, nonsteroidal anti-inflammatory drugs (NSAIDs), and immunosuppressant and widely used for controlling and suppressing inflammatory response but are associated with adverse effects. So, Herbal therapy is best suited as an alternate or complementary therapy to achieve increased pharmacological response with no or minimal side effects (Mona et al., 2016).
Xiaojianzhong decoction attenuates aspirin-induced gastric mucosal injury via the PI3K/AKT/mTOR/ULK1 and AMPK/ULK1 pathways
Published in Pharmaceutical Biology, 2023
Ting Chen, Shengchuan Bao, Juan Chen, Jiaxiang Zhang, Hailiang Wei, Xin Hu, Yan Liang, Jingtao Li, Shuguang Yan
In recent years, with the widespread clinical use of non-steroidal anti-inflammatory drugs (NSAIDs), there has been an increase in the incidence of gastric ulcers caused by them. The most intuitive manifestation of gastric ulcers is gastric mucosal injury. A common gastrointestinal disease, gastric mucosal injury is the first link in a variety of gastric diseases (Kwon et al. 2019). NSAIDs commonly used in clinical practice include aspirin, paracetamol, diclofenac and ibuprofen (Eccleston et al. 2017), among which aspirin is used for the prevention of cardiovascular and cerebrovascular diseases because of its anti-platelet aggregation and anti-thrombotic properties (Fiala and Pasic 2020). However, even low doses of aspirin can lead to the occurrence of gastric mucosal injury with long-term use (Tseng et al. 2021), causing secondary damage to the patient’s body and seriously affecting their quality of life. At present, the treatment of aspirin-induced gastric mucosal injury mostly uses proton pump inhibitors, H2 receptor antagonists and gastric mucosal protectors. However, there are disadvantages to these treatments, such as unsustainable efficacy and numerous side effects (Oncel et al. 2021), and these disadvantages greatly limit the application of aspirin in clinics. Therefore, it is important to find a drug that can effectively protect against aspirin-induced gastric mucosal injury.
Preparation and in vitro–in vivo evaluation of QbD based acemetacin loaded transdermal patch formulations for rheumatic diseases
Published in Pharmaceutical Development and Technology, 2022
Ece Özcan Bülbül, Hasan Ali Husseın, Gizem Yeğen, Mehmet Evren Okur, Neslihan Üstündağ Okur, Neşe Buket Aksu
Acemetacin is an anti-inflammatory and non-steroidal drug (NSAID) used for rheumatic diseases. The daily dosage of acemetacin is 120 mg p.o. (can be increased to 180 mg) and plasma half-life of 1–2 h. The most common adverse effects are peptic ulceration or gastrointestinal bleeding (Chandrasekharan 2007). Orally administered anti-inflammatory non-steroidal drugs also cause side effects like vomiting, nausea, abdominal pain, dizziness, heartburn, and headache (Amodwala et al. 2017). The most frequent indications are chronic articular rheumatism, psoriatic arthritis, and acute inflammatory events in degenerative arthropathies. Nowadays, capsule (extended-release, delayed-release, and coated) dosage form is available. However, a transdermal system can help overcome the adverse effects (Li et al. 2005). By preparing the transdermal system of acetametacin, it is aimed at circulating at a certain speed and delivering the drug through the skin in a controlled manner. In addition, TDDS was preferred over the oral route because it has advantages, including increased patient compliance and avoidance of first-pass metabolism (Sabbagh and Kim 2022).
Spirulina supplements: an approach moderating aspirin persuaded histological and ultra-structural alterations in albino rats gastric mucosa
Published in Ultrastructural Pathology, 2022
Sherif A. Kamar, Ahmed H. Bayoumi, Hagar Yousry Rady
The incidence of stroke and other coagulopathies reported an increase of about 5% since the start of the worldwide pandemic caused (SARS-CoV-2).1 Increasing numbers of patients younger than 50 years showed large-vessel ischemic stroke.2 Owing to its wide range and variety of use, aspirin, and other non-steroidal anti-inflammatory drugs (NSAIDs) were prescribed to different acute situations (e.g., pain, fever, and inflammation). NSAIDs are the most commonly preventive agents against the development and progression of cardiovascular diseases (CVDs) and coagulopathies.3 Not only on the cardiovascular domain but also on the field of cancer treatment NSAIDs has provided preventive way for chronic diseases, and acute pain management.4 It was reported two years ago during the quarantine period that ibuprofen disappeared from the pharmacy shelves leading to global shortage. Further studies proved later that ibuprofen and other NSAIDs should be avoided in all positive COVID-19 patients as it may worsen the symptoms.5