Cyclooxygenase
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Non-Steroidal Anti-Inflammatory Agents – Benefits and New Developments for Cancer Pain
Carr_subbed.qxp 22/5/09 09:49 Page 18 Supportive Oncology Non-steroidal Anti-inflammatory Agents – Benefits and New Developments for Cancer Pain a report by Daniel B Carr1 and Marie Belle D Francia2 1. Saltonstall Professor of Pain Research; 2. Special Scientific Staff, Department of Anesthesiology, Tufts Medical Center DOI: 10.17925/EOH.2008.04.2.18 Pain is one of the complications of cancer that patients most fear, and This article surveys the current role of NSAIDs in the management of its multifactorial aetiology makes it one of the most challenging cancer pain and elucidates newly recognised mechanisms that may conditions to treat.1 A systematic review of epidemiological studies on provide a foundation for the next generation of NSAIDs for analgesia cancer pain published between 1982 and 2001 revealed cancer pain for cancer patients. prevalence rates of at least 14%.2 A more recent systematic review identified prevalence rates of cancer pain in as many as one-third of Mechanism of Analgesic Effects patients after curative treatment and two-thirds of patients NSAIDs are a structurally diverse group of compounds known to undergoing treatment regardless of the stage of disease. The wide prevent the formation of prostanoids (prostaglandins and variation in published prevalence rates is due to heterogeneity of the thromboxane) from arachidonic acid through the inhibition of the populations studied, diverse settings, site of primary cancer and stage enzyme cyclo-oxygenase (COX; see Table 1). COX has two isoenzymes: and methodology used to ascertain prevalence.1 COX-1 is found ubiquitously in most tissues and produces prostaglandins and thromboxane, while COX-2 is located in certain A multimodal approach to the treatment of cancer pain that deploys tissues (brain, blood vessels and so on) and its expression increases both pharmacological and non-pharmacological methods may be during inflammation or fever. -
United States Patent [19] [11] Patent Number: 6,149,923 Shirahase Et Al
US006149923A United States Patent [19] [11] Patent Number: 6,149,923 Shirahase et al. [45] Date of Patent: Nov. 21, 2000 [54] ANTIRHEUMATIC AGENT OTHER PUBLICATIONS [75] Inventors: Hiroaki Shirahase, Nagaokakyo; Yoshimi et al Importance of Hydrolysis of Amino Acid Akihisa Yoshimi, Takatsuki; Fumio Moiety in Water—Soluble Prodrugs of Disodium Cromogly Fukata, Osaka; Hideki Okunishi; Yuta cate for Increased Oral Bioavailability 1992 J. Pharmaco Kobayashi, both of IZumo, all of Japan bio—Dyn 15:339—345. Mori et al Pro—drugs for the Oral Deliver of Disodium [73] Assignee: Kyoto Pharmaceutical Industries, Cromoglycate 1988 Chem. Pharm. Bull. 36:338—344. Ltd., Kyoto, Japan Primary Examiner—Thurman K. Page Appl. N0.: Assistant Examiner—Todd D. Ware 09/202,368 Attorney, Agent, or Firm—Leydig, Voit & Mayer, Ltd. PCT Filed: Jun. 6, 1997 [57] ABSTRACT PCT No.: PCT/JP97/01974 An antirheumatic agent comprising diethyl § 371 Date: Dec. 10, 1998 L-lysylcromoglycate of the following formula § 102(e) Date: Dec. 10, 1998 NH; PCT Pub. No.: WO97/47297 [87] OCOCH(CH2)4NH2 PCT Pub. Date: Dec. 18, 1997 o OCHZCHCHZO o [30] Foreign Application Priority Data Jun. 11, 1996 [JP] Japan .................................. .. 8-149549 [51] Int. Cl.7 .......................... .. A61K 9/00; A61K 31/35; A01N 43/16 H5c2ooc o o cooczns US. Cl. ......................... .. 424/400; 514/825; 514/456 Field of Search ........................... .. 424/400; 514/825, or a nontoxic salt thereof as an active ingredient. This 514/456 compound has an anti-in?ammatory action and immuno modulating action, is absorbed by oral administration to be References Cited delivered efficiently to local sites, and is associated With feWer side effects, so that it serves Well as an antirheumatic U.S. -
Pain Management in Companion Animals
CONTINUING EDUCATION TAP OUR APP Pain Management in Companion Animals Download “NCPA Mobile” Today! by Ann Philbrick, PharmD, BCPS Don’t be left out of the latest news affecting community pharmacy—download our new app, NCPA Mobile! Receive real-time updates, join the conversation on Twitter with a built-in feed, Jul. 1, 2015 (expires Jul. 1, 2018) and never miss out on breaking news affecting community pharmacy. Keep the Activity Type: Application-based app on your phone year-round for updates, news, alerts, and more from NCPA. To earn continuing education credit: ACPE Program 0207-0000-15-007-H01-P; 0207-0000-15-007-H01-T Upon successful completion of this article, the pharmacist should be able to: 1. Describe the process of pain in the dog and cat including identification of ways they express pain. 2. Describe the appropriate use, mechanism of action, and precautions for use of analgesics in the treatment of pain in dogs and cats. 3. Explain the key issues that impair the prevention of diversion in compan- ion animal owners. Upon successful completion of this article, the pharmacist should be able to: 1. Describe the process of pain in the dog and cat including identification of ways they express pain. To get the free NCPA Mobile app: 2. Describe the appropriate use, mechanism of action, and precautions for FREE ONLINE CE. To take advantage use of analgesics in the treatment of pain in dogs and cats. of free continuing pharmacy educa- iPhone and iPad users—search “NCPA 3. Explain the key issues that impair the prevention of diversion in compan- tion (CPE) for this program, pharma- ion animal owners. -
Comparing the Effects of Salts of Diclofenac and Almioprofen with Aspirin on Serum Electrolytes, Creatinine and Urea Levels in Rabbits
Comparing the effects of salts of diclofenac and almioprofen with aspirin on serum electrolytes, creatinine and urea levels in rabbits Nawazish-i-Husain Syed*, Farnaz Zehra, Amir Ali Rizvi Syed, Sabiha Karim and Farrakh Zia Khan University College of Pharmacy, University of the Punjab, Lahore, Pakistan Abstract: The effects of diclofenac sodium, diclofenac potassium, alminoprofen and aspirin on serum electrolytes (serum Na+ and K+), urea and creatinine were compared in rabbits in acute and chronic phases of treatment. The data suggested that all the four drugs markedly increased the serum electrolytes, urea and creatinine levels in both post- treatment phases. In conclusion, present study does not present any advantage of diclofenac sodium over diclofenac potassium at electrolyte levels on short and long term treatment. Nevertheless, current data support the evidence of renal function impairment by all the four drug therapies used in the present study, which is generally caused by NSAIDS. Keywords: NSAIDs, renal function, serum electrolytes. INTRODUCTION were given fodder twice daily, while water was available ad libitum. Throughout the study, environmental Inflammatory diseases including rheumatoid arthritis and conditions remained constant. Rabbits were divided into osteoarthritis are initially treated with non-steroidal anti- five groups, each of six animals. Same group of animals inflammatory drugs (NSAIDS) (Patrono and Rocca, were used for acute and chronic phases of the study. In 2009). Previously, steroids were prescribed to manage the both studies, rabbits of each group were orally chronic inflammatory diseases, however, due to their administered diclofenac Na+, diclofenac K+, severe adverse effects, NSAIDS has become the first alminoprofen, acetyl salicylic acid in a doses of 2.5mg, choice to treat these diseases. -
Table S1: Sensitivity, Specificity, PPV, NPV, and F1 Score of NLP Vs. ICD for Identification of Symptoms for (A) Biome Developm
Table S1: Sensitivity, specificity, PPV, NPV, and F1 score of NLP vs. ICD for identification of symptoms for (A) BioMe development cohort; (B) BioMe validation cohort; (C) MIMIC-III; (D) 1 year of notes from patients in BioMe calculated using manual chart review. A) Fatigue Nausea and/or vomiting Anxiety Depression NLP (95% ICD (95% CI) P NLP (95% CI) ICD (95% CI) P NLP (95% CI) ICD (95% CI) P NLP (95% CI) ICD (95% CI) P CI) 0.99 (0.93- 0.59 (0.43- <0.00 0.25 (0.12- <0.00 <0.00 0.54 (0.33- Sensitivity 0.99 (0.9 – 1) 0.98 (0.88 -1) 0.3 (0.15-0.5) 0.85 (0.65-96) 0.02 1) 0.73) 1 0.42) 1 1 0.73) 0.57 (0.29- 0.9 (0.68- Specificity 0.89 (0.4-1) 0.75 (0.19-1) 0.68 0.97 (0.77-1) 0.03 0.98 (0.83-1) 0.22 0.81 (0.53-0.9) 0.96 (0.79-1) 0.06 0.82) 0.99) 0.99 (0.92- 0.86 (0.71- 0.94 (0.79- 0.79 (0.59- PPV 0.96 (0.82-1) 0.3 0.95 (0.66-1) 0.02 0.95 (0.66-1) 0.16 0.93 (0.68-1) 0.12 1) 0.95) 0.99) 0.92) 0.13 (0.03- <0.00 0.49 (0.33- <0.00 0.66 (0.48- NPV 0.89 (0.4-1) 0.007 0.94 (0.63-1) 0.34 (0.2-0.51) 0.97 (0.81-1) 0.86 (0.6-0.95) 0.04 0.35) 1 0.65) 1 0.81) <0.00 <0.00 <0.00 F1 Score 0.99 0.83 0.88 0.57 0.95 0.63 0.82 0.79 0.002 1 1 1 Itching Cramp Pain NLP (95% ICD (95% CI) P NLP (95% CI) ICD (95% CI) P NLP (95% CI) ICD (95% CI) P CI) 0.98 (0.86- 0.24 (0.09- <0.00 0.09 (0.01- <0.00 0.52 (0.37- <0.00 Sensitivity 0.98 (0.85-1) 0.99 (0.93-1) 1) 0.45) 1 0.29) 1 0.66) 1 0.89 (0.72- 0.5 (0.37- Specificity 0.96 (0.8-1) 0.98 (0.86-1) 0.68 0.98 (0.88-1) 0.18 0.5 (0-1) 1 0.98) 0.66) 0.88 (0.69- PPV 0.96 (0.8-1) 0.8 (0.54-1) 0.32 0.8 (0.16-1) 0.22 0.99 (0.93-1) 0.98 (0.87-1) NA* 0.97) 0.98 (0.85- 0.57 (0.41- <0.00 0.58 (0.43- <0.00 NPV 0.98 (0.86-1) 0.5 (0-1) 0.02 (0-0.08) NA* 1) 0.72) 1 0.72) 1 <0.00 <0.00 <0.00 F1 Score 0.97 0.56 0.91 0.28 0.99 0.68 1 1 1 *Denotes 95% confidence intervals and P values that could not be calculated due to insufficient cells in 2x2 tables. -
What Are the Acute Treatments for Migraine and How Are They Used?
2. Acute Treatment CQ II-2-1 What are the acute treatments for migraine and how are they used? Recommendation The mainstay of acute treatment for migraine is pharmacotherapy. The drugs used include (1) acetaminophen, (2) non-steroidal anti-inflammatory drugs (NSAIDs), (3) ergotamines, (4) triptans and (5) antiemetics. Stratified treatment according to the severity of migraine is recommended: use NSAIDs such as aspirin and naproxen for mild to moderate headache, and use triptans for moderate to severe headache, or even mild to moderate headache when NSAIDs were ineffective in the past. It is necessary to give guidance and cautions to patients having acute attacks, and explain the methods of using medications (timing, dose, frequency of use) and medication use during pregnancy and breast-feeding. Grade A Background and Objective The objective of acute treatment is to resolve the migraine attack completely and rapidly and restore the patient’s normal functions. An ideal treatment should have the following characteristics: (1) resolves pain and associated symptoms rapidly; (2) is consistently effective; (3) no recurrence; (4) no need for additional use of medication; (5) no adverse effects; (6) can be administered by the patients themselves; and (7) low cost. Literature was searched to identify acute treatments that satisfy the above conditions. Comments and Evidence The acute treatment drugs for migraine generally include (1) acetaminophens, (2) non-steroidal anti-inflammatory drugs (NSAIDs), (3) ergotamines, (4) triptans, and (5) antiemetics. For severe migraines including status migrainosus and migraine attacks refractory to treatment, (6) anesthetics, and (7) corticosteroids (dexamethasone) are used (Tables 1 and 2).1)-9) There are two approaches to the selection and sequencing of these medications: “step care” and “stratified care”. -
Use of Aspirin and Nsaids to Prevent Colorectal Cancer
Evidence Synthesis Number 45 Use of Aspirin and NSAIDs to Prevent Colorectal Cancer Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 540 Gaither Road Rockville, MD 20850 www.ahrq.gov Contract No. 290-02-0021 Prepared by: University of Ottawa Evidence-based Practice Center at The University of Ottawa, Ottawa Canada David Moher, PhD Director Investigators Alaa Rostom, MD, MSc, FRCPC Catherine Dube, MD, MSc, FRCPC Gabriela Lewin, MD Alexander Tsertsvadze, MD Msc Nicholas Barrowman, PhD Catherine Code, MD, FRCPC Margaret Sampson, MILS David Moher, PhD AHRQ Publication No. 07-0596-EF-1 March 2007 This report is based on research conducted by the University of Ottawa Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-02-0021). Funding was provided by the Centers for Disease Control and Prevention. The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. The information in this report is intended to help clinicians, employers, policymakers, and others make informed decisions about the provision of health care services. This report is intended as a reference and not as a substitute for clinical judgment. This document is in the public domain and may be used and reprinted without permission except those copyrighted materials noted for which further reproduction is prohibited without the specific permission of copyright holders. -
Comparative Efficacy and Safety of Mavacoxib and Carprofen in The
Paper Paper Comparative efficacy and safety of mavacoxib and carprofen in the treatment of canine osteoarthritis M Payne-Johnson, C Becskei, Y Chaudhry, M R Stegemann A multi-site, masked, randomised parallel group study employing a double dummy treatment design was performed in canine veterinary patients to determine the comparative efficacy and safety of mavacoxib and carprofen in the treatment of pain and inflammation associated with osteoarthritis for a period of 134 days. Treatments were administered according to their respective summaries of product characteristics. Of 139 dogs screened, 124 were suitable for study participation: 62 of which were dosed with mavacoxib and 62 with carprofen. Both treatments resulted in a very similar pattern of considerable improvement as indicated in all parameters assessed by both owner and veterinarian. The primary efficacy endpoint ‘overall improvement’ was a composite score of owner assessments after approximately six weeks of treatment. Both drugs were remarkably effective, with 57/61 (93.4 per cent) of mavacoxib-treated dogs and 49/55 (89.1 per cent) of carprofen-treated dogs demonstrating overall improvement and with mavacoxib’sefficacy being non-inferior to carprofen. The treatments had a similar safety profile as evidenced by documented adverse events and summaries of clinical pathology parameters. The positive clinical response to treatment along with the safety and dosing regimen of mavacoxib makes it an attractive therapy for canine osteoarthritis. Introduction convert arachidonic acid into prostaglandin H2, from which a Osteoarthritis (OA) is characterised by a degenerative, progres- series of prostanoids is derived; this can result in sensitisation of sive and irreversible deterioration of joints resulting in a nociceptive neurone terminals and with repeated stimulation decreased range of motion, pain, joint swelling and crepitus. -
Licofelone-DPPC Interactions: Putting Membrane Lipids on the Radar of Drug Development
molecules Article Licofelone-DPPC Interactions: Putting Membrane Lipids on the Radar of Drug Development Catarina Pereira-Leite 1,2 , Daniela Lopes-de-Campos 1, Philippe Fontaine 3 , Iolanda M. Cuccovia 2, Cláudia Nunes 1 and Salette Reis 1,* 1 LAQV, REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal; [email protected] (C.P.-L.); [email protected] (D.L.-d.-C.); [email protected] (C.N.) 2 Departamento de Bioquímica, Instituto de Química, Universidade de São Paulo, Av. Prof. Lineu Prestes, 748, 05508-000 São Paulo, Brazil; [email protected] 3 Synchrotron SOLEIL, L’Orme des Merisiers, Saint Aubin, BP48, 91192 Gif-sur-Yvette, France; [email protected] * Correspondence: [email protected]; Tel.: +351-220-428-672 Academic Editors: Maria Emília De Sousa, Honorina Cidade and Carlos Manuel Afonso Received: 19 December 2018; Accepted: 30 January 2019; Published: 31 January 2019 Abstract: (1) Background: Membrane lipids have been disregarded in drug development throughout the years. Recently, they gained attention in drug design as targets, but they are still disregarded in the latter stages. Thus, this study aims to highlight the relevance of considering membrane lipids in the preclinical phase of drug development. (2) Methods: The interactions of a drug candidate for clinical use (licofelone) with a membrane model system made of 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC) were evaluated by combining Langmuir isotherms, Brewster angle microscopy (BAM), polarization-modulation infrared reflection-absorption spectroscopy (PM-IRRAS), and grazing-incidence X-ray diffraction (GIXD) measurements. -
Non-Steroidal Anti-Inflammatory Drugs Inhibit Bone Healing: a Review S
Review Article © Schattauer 2010 385 Non-steroidal anti-inflammatory drugs inhibit bone healing: A review S. Barry Washington State University, Department of Veterinary Clinical Sciences, Veterinary Teaching Hospital, Pullman, Wash- ington, USA crine and autocrine activity, have since Keywords stems from prostaglandin inhibition and is been shown to regulate constitutive and in- Non-steroidal anti-inflammatory drugs, likely multifactorial. In human medicine ducible functions throughout the body, in- NSAID, bone healing NSAID are known to prevent heterotopic ossi- cluding bone healing (5–9). The mech- fication, however the clinical importance of anism of NSAID inhibition to bone healing Summary their effects on bone healing remains contro- is unknown, but is likely multifactorial. Re- The ability of non-steroidal anti-inflammatory versial. Although a small handful of reports searchers have suggested that NSAID affect drugs (NSAID) to inhibit bone healing has suggest that NSAID suppress bone healing in normal bone healing in multiple ways, with been established in experimental animal dogs and horses, there is little published infor- emphasis often (but not exclusively) placed models using mice, rats, and rabbits. The mation to direct veterinary practice in do- on processes related to the inflammatory mechanism of action is largely unknown but mestic species. stage. Deciphering the mechanism of NSAID inhibition requires an understanding of Correspondence to: Vet Comp Orthop Traumatol 2010; 23: 385–392 Sabrina Barry, DVM doi:10.3415/VCOT-10-01-0017 fracture healing. Fracture healing presents Washington State University Received: January 31, 2010 an exquisitely orchestrated series of coor- Department of Veterinary Clinical Sciences Accepted: June 23, 2010 dinated molecular and cellular events. -
Latest Administration Hour Prior to Competition Max Dosage Per Pound of Body Weight Medication Trade Name Medication Generic Name
MEDICATION MEDICATION MAX DOSAGE PER POUND LATEST ADMINISTRATION HOUR ADMINISTRATION METHOD GENERIC NAME TRADE NAME OF BODY WEIGHT PRIOR TO COMPETITION (single dose per 24 hours unless specified otherwise) Dexamethasone Azium® 2.0 mg/100Lb >12 hours IV, IM (20 mg/1000Lb) or 0.5 mg/100Lb >6 hours IV (5.0 mg/1000Lb) or 1.0 mg/100LB >6 hours Oral (10 mg/1000Lb) Diclofenac Surpass® 5 inch ribbon, 1⁄2 inch thick, >12 hours Topical, 2 doses each day 12 hours apart one site Firocoxib Equioxx® 0.1 mg/kg >12 hours Oral (0.0455 mg/Lb) (45.5 mg/1000Lb) Phenylbutazone (“bute”) * Butazolidin® 2.0 mg/Lb >12 hours Oral, IV (2.0 grams/1000Lb) or 1.0 mg/Lb AM & PM feed Oral, 2 doses each day, 12 hours apart (1.0 grams/1000Lb) Flunixin meglumine * Banamine® 0.5 mg/Lb >12 hours Oral, IV (500 mg/1000Lb) Ketoprofen Ketofen® 1.0 mg/Lb >4 hours, but IV (1.0 gram/1000Lb) >6 hours is recommended Meclofenamic acid Arquel® 0.5 mg/Lb Oral, 2 doses each day, 12 hours apart (500 mg/1000Lb) Naproxen Naprosyn® 4.0 mg/Lb >12 hours Oral (4.0 grams/1000Lb) Eltenac Not yet approved Telzenac® 0.25 mg/Lb (250 mg/1000Lb) 12 hours IV Methocarbamol Robaxin® 5.0 mg/Lb >6 hours Oral, IV, 2 doses each day, 12 hours apart (5.0 grams/1000Lb) * Do not administer phenylbutazone and flunixin at the same time (Unless used according to The maximum treatment time for any of the above permitted medication is five days, with the Section 8). -
Cyclooxygenase-1 (COX-1) and COX-1 Inhibitors in Cancer: a Review of Oncology and Medicinal Chemistry Literature
pharmaceuticals Review Cyclooxygenase-1 (COX-1) and COX-1 Inhibitors in Cancer: A Review of Oncology and Medicinal Chemistry Literature Alessandra Pannunzio and Mauro Coluccia * Department of Pharmacy-Drug Sciences, University of Bari “Aldo Moro”, Via E. Orabona 4, I-70125 Bari, Italy; [email protected] * Correspondence: [email protected]; Tel.: +39-080-544-2788 Received: 4 September 2018; Accepted: 9 October 2018; Published: 11 October 2018 Abstract: Prostaglandins and thromboxane are lipid signaling molecules deriving from arachidonic acid by the action of the cyclooxygenase isoenzymes COX-1 and COX-2. The role of cyclooxygenases (particularly COX-2) and prostaglandins (particularly PGE2) in cancer-related inflammation has been extensively investigated. In contrast, COX-1 has received less attention, although its expression increases in several human cancers and a pathogenetic role emerges from experimental models. COX-1 and COX-2 isoforms seem to operate in a coordinate manner in cancer pathophysiology, especially in the tumorigenesis process. However, in some cases, exemplified by the serous ovarian carcinoma, COX-1 plays a pivotal role, suggesting that other histopathological and molecular subtypes of cancer disease could share this feature. Importantly, the analysis of functional implications of COX-1-signaling, as well as of pharmacological action of COX-1-selective inhibitors, should not be restricted to the COX pathway and to the effects of prostaglandins already known for their ability of affecting the tumor phenotype. A knowledge-based choice of the most appropriate tumor cell models, and a major effort in investigating the COX-1 issue in the more general context of arachidonic acid metabolic network by using the systems biology approaches, should be strongly encouraged.