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FDA-Approved Drugs with Potent in Vitro Antiviral Activity Against Severe Acute Respiratory Syndrome Coronavirus 2
pharmaceuticals Article FDA-Approved Drugs with Potent In Vitro Antiviral Activity against Severe Acute Respiratory Syndrome Coronavirus 2 1, , 1, 2 1 Ahmed Mostafa * y , Ahmed Kandeil y , Yaseen A. M. M. Elshaier , Omnia Kutkat , Yassmin Moatasim 1, Adel A. Rashad 3 , Mahmoud Shehata 1 , Mokhtar R. Gomaa 1, Noura Mahrous 1, Sara H. Mahmoud 1, Mohamed GabAllah 1, Hisham Abbas 4 , Ahmed El Taweel 1, Ahmed E. Kayed 1, Mina Nabil Kamel 1, Mohamed El Sayes 1, Dina B. Mahmoud 5 , Rabeh El-Shesheny 1 , Ghazi Kayali 6,7,* and Mohamed A. Ali 1,* 1 Center of Scientific Excellence for Influenza Viruses, National Research Centre, Giza 12622, Egypt; [email protected] (A.K.); [email protected] (O.K.); [email protected] (Y.M.); [email protected] (M.S.); [email protected] (M.R.G.); [email protected] (N.M.); [email protected] (S.H.M.); [email protected] (M.G.); [email protected] (A.E.T.); [email protected] (A.E.K.); [email protected] (M.N.K.); [email protected] (M.E.S.); [email protected] (R.E.-S.) 2 Organic & Medicinal Chemistry Department, Faculty of Pharmacy, University of Sadat City, Menoufia 32897, Egypt; [email protected] 3 Department of Biochemistry & Molecular Biology, Drexel University College of Medicine, Philadelphia, PA 19102, USA; [email protected] 4 Department of Microbiology and Immunology, Zagazig University, Zagazig 44519, Egypt; [email protected] 5 Pharmaceutics Department, National Organization for Drug Control and Research, Giza 12654, Egypt; [email protected] 6 Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas, Houston, TX 77030, USA 7 Human Link, Baabda 1109, Lebanon * Correspondence: [email protected] (A.M.); [email protected] (G.K.); [email protected] (M.A.A.) Contributed equally to this work. -
Dentistry and Basic Non- Opioid Prescribing in Pain Dmitry M
Dentistry and Basic Non- Opioid Prescribing in Pain Dmitry M. Arbuck, MD President, Indiana Polyclinic Clinical Associate Professor of Psychiatry and Pain Management, Marian University College of Osteopathic Medicine Clinical Assistant Professor of Psychiatry and Medicine, IU School of Medicine www.IndianaPolyclinic.com Version May 2020 1 Disclosures No disclosures currently (May 7, 2020) 2 Disclaimer ISDH Oral Health Program Disclaimer for courses or presentations: The information provided in this course or presentation does not, and is not intended to, constitute dental, medical, or legal advice; instead, all information, content, and materials available in this course or presentation are for general informational purposes only. You should contact an outside dentist, physician, or attorney to obtain dental, medical, or legal advice and prior to acting, or refraining from acting, on the basis of information contained in this course or presentation. All liability with respect to actions taken or not taken based on the contents of this course or presentation are hereby expressly disclaimed. 3 Goals of Pain Management • Decrease pain • Increase function • Utilize medications that limit unacceptable side effects, including addiction 4 Goals of This Presentation • Gain knowledge of appropriate use of NSAIDs and acetaminophen for pain management in dentistry • Improve insight into benefits and adverse effects of various NSAIDs • Learn appropriate alternatives to opioid use for pain management 5 Opioids: Use with Caution • Use of opioids for -
Piroxicam 10Mg and 20Mg Capsules Celecoxib Or Acetylsalicylic Acid (Aspirin), a Not Known (Frequency Cannot Be Estimated No Longer Use
• drowsiness Reporting of side effects • ringing in ears (tinnitus) If you get any side effects, talk to your doctor, • abdominal pain/discomfort pharmacist or nurse. This includes any possible • constipation side effects not listed in this leaflet. • diarrhoea Package leaflet: Information for the patient • wind You can also report side effects directly via the • feeling sick (nausea) Yellow Card Scheme at: Piroxicam 10mg and 20mg • being sick (vomiting) www.mhra.gov.uk/yellowcard or search for • indigestion MHRA Yellow Card in the Google Play or Apple Capsules • itching App Store. Read all of this leaflet carefully before 2 What you need to know before • skin rash By reporting side effects you can help provide • swelling of the feet, hands or other parts of you start taking this medicine because it you take Piroxicam capsules more information on the safety of this contains important information for you. the body (oedema) medicine. • weight increase. • Keep this leaflet. You may need to read Do not take Piroxicam capsules if you: it again. • are allergic to piroxicam or any of the other 5 How to store Piroxicam capsules Uncommon (may affect up to • If you have any further questions, ask ingredients of this medicine (listed in section 1 in 100 people): Keep this medicine out of the sight and reach 6); an allergic reaction to other NSAIDs or • blurred vision your doctor or pharmacist. of children. • This medicine has been prescribed for any other medications, especially serious • fast or pounding heartbeat Store below 25°C in a dry place. Protect from skin reactions (regardless of severity) such as • sore mouth and/or lips you only. -
The Challenge of Drug-Induced Aseptic Meningitis Revisited
Letters cardioverter-defibrillator generator replacements and upgrade procedures: brospinal fluid (CSF) findings and reviews added to the litera- results from the REPLACE registry. Circulation. 2010;122(16):1553-1561. ture from 1999 to date. Tables have been assembled from 6. Kramer DB, Buxton AE, Zimetbaum PJ. Time for a change: a new approach to information derived from 192 studies (these data are avail- ICD replacement. N Engl J Med. 2012;366(4):291-293. able from the authors on request). The Challenge of Drug-Induced Aseptic Results | Four groups of drugs continue to be associated Meningitis Revisited with DIAM (Table 1): nonsteroidal anti-inflammatory Cases of drug-induced aseptic meningitis (DIAM) are likely drugs (NSAIDs), antibiotics, immunosuppressive- underreported, and only a few reviews of the literature have immunomodulatory (IS-IM), and antiepileptic drugs.1 Prior been performed. We have updated (to February 2014) a pre- exposure to the associated drug was present in 26% to 35% vious review (1999)1 to identify newer agents associated with of cases (Table 1). The interval between exposure and men- DIAM, as well as distinctive new features. ingitis ranged from minutes to 5 months (Table 1). Most patients presented with headache, fever, meningismus, and Methods | Using the MEDLINE database, we searched the lit- mental status changes (Table 2). Underlying systemic disor- erature to February 2014 and included those cases with cere- ders were often present, particularly systemic lupus ery- Table 1. Drugs Involved in Drug-Induced -
FELDENE (Piroxicam) in Pregnant Women
FELDENE® (piroxicam) CAPSULES 10 mg and 20 mg For Oral Use Cardiovascular Risk • NSAIDs may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk (see WARNINGS). • FELDENE is contraindicated for the treatment of peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery (see WARNINGS). Gastrointestinal Risk • NSAIDs cause an increased risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk for serious gastrointestinal events (see WARNINGS). DESCRIPTION FELDENE® contains piroxicam which is a member of the oxicam group of nonsteroidal anti-inflammatory drugs (NSAIDs). Each maroon and blue capsule contains 10 mg piroxicam, each maroon capsule contains 20 mg piroxicam for oral administration. The chemical name for piroxicam is 4-hydroxyl-2-methyl-N-2-pyridinyl-2H-1,2,-benzothiazine-3-carboxamide 1,1-dioxide. Piroxicam occurs as a white crystalline solid, sparingly soluble in water, dilute acid, and most organic solvents. It is slightly soluble in alcohol and in aqueous solutions. It exhibits a weakly acidic 4-hydroxy proton (pKa 5.1) and a weakly basic pyridyl nitrogen (pKa 1.8). The molecular weight of piroxicam is 331.35. Its molecular formula is C15H13N3O4S and it has the following structural formula: 4′ 3′ 5′ OH O 5 C NH 6′ 6 4 2′ 3 N 2 7 1 N S CH3 8 O 2 Reference ID: 3708816 The inactive ingredients in FELDENE capsules include: Blue 1, Red 3, lactose, magnesium stearate, sodium lauryl sulfate, starch. -
Comparison Between Preoperative Use of Sublingual Piroxicam With
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 17, Issue 10 Ver. 9 (October. 2018), PP 80-84 www.iosrjournals.org Comparison Between Preoperative Use of Sublingual Piroxicam with that of Oral Ketorolac on Postoperative Pain Following Single Visit Root Canal Therapy –A Double Blind Randomized Control Study Akilan Balasubramanian1, Unnikrishna K2 1(Assistant professor, Department of conservative dentistry and endodontics, IRT medical college and hospital, The Tamilnadu Dr MGR medical university, India). 2(Senior resident, Department of conservative dentistry and endodontics, Government dental college, Kerala university of health sciences, India.) Corresponding Author: Akilan Balasubramanian Abstract: The purpose of this study was to determine if preoperative use of single dose of 20mg sublingual piroxicam and 20mg dispersible ketorolac would significantly reduce postendodontic pain, when compared with 600mg ibuprofen following single visit root canal treatment An additional objective was to compare the efficacy of sublingual piroxicam and dispersible ketorolac on post endodontic pain following single visit root canal treatment. A total of 70 adult patients consented to a double-blind, single-dose oral administration of 20mg of ketorolac, 20mg of piroxicam, 600 mg of ibuprofen, before single visit root canal therapy. Each Patient-reported visual analog scale ratings of pain intensity were conducted upon initial clinical presentation and at 6, 12, 24 and 48 hours and 72 h after completion of single visit root canal treatment. The results showed that at 6hrs period after single visit root canal treatment, all the three drugs Ketorolac, Piroxicam, Ibuprofen are equally effective in reducing post operative pain. -
STUDIES with NON-STEROIDAL ANTI-INFLAMMATORY DRUGS By
STUDIES WITH NON-STEROIDAL ANTI-INFLAMMATORY DRUGS by Elizabeth Ann Galbraith M.Sc., C.Biol., M.I.Biol. A thesis submitted for the degree of Doctor of Philosophy in the Faculty of Veterinary Medicine of the University of Glasgow Department of Veterinary Pharmacology M ay 1994 ProQuest Number: 11007888 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a com plete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. uest ProQuest 11007888 Published by ProQuest LLC(2018). Copyright of the Dissertation is held by the Author. All rights reserved. This work is protected against unauthorized copying under Title 17, United States C ode Microform Edition © ProQuest LLC. ProQuest LLC. 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106- 1346 4kh! TUT GLASGOW UNIVERSITY ) LIBRARY i To Ian ii TABLE OF CONTENTS Acknowledgements v Declaration vi Summary vii List of tables xi List of figures xv Abbreviations xvii Chapter 1 - General Introduction 1 Chapter 2 - General Material and Methods 29 Chapter 3 - Studies with Flunixin 3.1 Introduction 43 3.2 Experimental Objectives 44 3.3 Materials and Methods 45 3.4 Experiments with Flunixin 48 3.5 Results of Oral Experiments with Flunixin 49 3.6 Results of Intravenous Experiments with Flunixin 53 3.7 Results of Subcutaneous Experiments with Flunixin 55 3.8 Discussion 57 3.9 Tables and Figures -
2 Inhibitors and Non-Steroidal Anti-Inflammatory Drugs (Nsaids)
Drug Class Review on Cyclo-oxygenase (COX)-2 Inhibitors and Non-steroidal Anti-inflammatory Drugs (NSAIDs) Final Report Update 3 Evidence Tables November 2006 Original Report Date: May 2002 Update 1 Report Date: September 2003 Update 2 Report Date: May 2004 A literature scan of this topic is done periodically The purpose of this report is to make available information regarding the comparative effectiveness and safety profiles of different drugs within pharmaceutical classes. Reports are not usage guidelines, nor should they be read as an endorsement of, or recommendation for, any particular drug, use or approach. Oregon Health & Science University does not recommend or endorse any guideline or recommendation developed by users of these reports. Roger Chou, MD Mark Helfand, MD, MPH Kim Peterson, MS Tracy Dana, MLS Carol Roberts, BS Produced by Oregon Evidence-based Practice Center Oregon Health & Science University Mark Helfand, Director Copyright © 2006 by Oregon Health & Science University Portland, Oregon 97201. All rights reserved. Note: A scan of the medical literature relating to the topic is done periodically(see http://www.ohsu.edu/ohsuedu/research/policycenter/DERP/about/methods.cfm for scanning process description). Upon review of the last scan, the Drug Effectiveness Review Project governance group elected not to proceed with another full update of this report. Some portions of the report may not be up to date. Prior versions of this report can be accessed at the DERP website. Final Report Update 3 Drug Effectiveness Review Project TABLE OF CONTENTS Evidence Table 1. Systematic reviews…………………………………………………………………3 Evidence Table 2. Randomized-controlled trials………………………………………………………9 Evidence Table 3. -
Annrheumd00427-0020.Pdf
Annals of the Rheumatic Diseases, 1989; 48, 372-381 Evaluation of the effects of antiarthritic drugs on the secretion of proteoglycans by lapine chondrocytes using a novel assay procedure SIMON COLLIER AND PETER GHOSH From the Raymond Purves Research Laboratories (The University of Sydney) at the Royal North Shore Hospital of Sydney, St Leonards, NSW 2065, Australia SUMMARY A new method is described for separating free 35SO4- from 35SO4 labelled groteoglycans synthesised by rabbit articular chondrocytes cultured in the presence of excess 4 The procedure uses the low solubility product of barium sulphate to remove, by precipitation, free 35SO4- from culture medium. Optimum recovery of 35so4 labelled proteoglycans was achieved after papain digestion to release 35SO4-glycosaminoglycans, and addition of chondroitin sulphate before the precipitation step. Using this assay, we studied the effect of six drugs-indomethacin, diclofenac, sodium pentosan polysulphate, glycosaminoglycan polysulphate ester, tiaprofenic acid, and ketoprofen-on the secretion into the medium of labelled proteoglycans by lapine chondrocytes. The six drugs were tested at 0< 1, 1, 10, 50, and 100 I.g/ml over four consecutive 48 hour culture periods. A consistent concentration-response pattern was found for the four non-steroidal anti-inflammatory drugs (NSAIDs) studied. Generally they inhibited proteoglycan secretion at 50 and 100 [ig/ml but had no effect at lower concentrations. Inhibition of secretion was strongest with indomethacin and diclofenac at 50 and 100 ig/ml. In contrast with the NSAIDs studied, the two sulphated polysaccharides (sodium pentosan polysulphate and glycosaminoglycan polysulphate ester) at low concentrations increased proteoglycan secretion by chondrocytes, with maximal stimulation occurring at 1 [ig/ml. -
Inflammatory Drugs (Nsaids) for People with Or at Risk of COVID-19
Evidence review Acute use of non-steroidal anti- inflammatory drugs (NSAIDs) for people with or at risk of COVID-19 Publication date: April 2020 This evidence review sets out the best available evidence on acute use of non- steroidal anti-inflammatory drugs (NSAIDs) for people with or at risk of COVID-19. It should be read in conjunction with the evidence summary, which gives the key messages. Evidence review commissioned by NHS England Disclaimer The content of this evidence review was up-to-date on 24 March 2020. See summaries of product characteristics (SPCs), British national formulary (BNF) or the MHRA or NICE websites for up-to-date information. For details on the date the searches for evidence were conducted see the search strategy. Copyright © NICE 2020. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3763-9 Contents Contents ...................................................................................................... 1 Background ................................................................................................. 2 Intervention .................................................................................................. 2 Clinical problem ........................................................................................... 3 Objective ...................................................................................................... 3 Methodology ................................................................................................ 4 Summary of included studies -
Indocin® (Indomethacin) Oral Suspension
INDOCIN® (INDOMETHACIN) ORAL SUSPENSION Cardiovascular Risk • NSAIDs may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at a greater risk. (See WARNINGS.) • INDOCIN is contraindicated for the treatment of peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery (see WARNINGS). Gastrointestinal Risk • NSAIDs cause an increased risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk for serious gastrointestinal events. (See WARNINGS.) DESCRIPTION Suspension INDOCIN1 for oral use contains 25 mg of indomethacin per 5 mL, alcohol 1%, and sorbic acid 0.1% added as a preservative and the following inactive ingredients: antifoam AF emulsion, flavors, purified water, sodium hydroxide or hydrochloric acid to adjust pH, sorbitol solution, and tragacanth. Indomethacin is a non-steroidal anti-inflammatory indole derivative designated chemically as 1-(4-chlorobenzoyl)-5-methoxy-2-methyl-1H-indole-3-acetic acid. 1 Indomethacin is practically insoluble in water and sparingly soluble in alcohol. It has a pKa of 4.5 and is stable in neutral or slightly acidic media and decomposes in strong alkali. The suspension has a pH of 4.0-5.0. The structural formula is: 1 Registered trademark of MERCK & CO., Inc., Whitehouse Station, NJ U.S.A. and licensed to Iroko Pharmaceuticals, LLC, Philadelphia, PA, U.S.A. -
Toxic Effects of Non-Steroidal Anti- Inflammatory Agents in Rats
African Journal of Biomedical Research, Vol. 9 (2006); 219 - 223 ISSN 1119 – 5096 © Ibadan Biomedical Communications Group Full Length Research Article Toxic Effects of Non-Steroidal Anti- Inflammatory Agents in Rats 1*Abatan, M. O, Lateef I. and 2Taiwo V.O. 1 Full-text available at Department of Veterinary Physiology & Pharmacology 2 http://www.ajbrui.com Department of Veterinary Pathology, & Faculty of Veterinary Medicine, University of Ibadan, Ibadan http://www.bioline.br/md Ibadan, Nigeria ABSTRACT The toxicosis of some non-steroidal anti-inflammatory drugs, piroxicam, indomethacin, phenylbutazone, and aspirin, which occasionally are locally used in Nigeria as rodenticides have been evaluated in rats using changes in the serum biochemical and haematological parameters as indices of toxicity. In the study, no clinical symptoms were observed in all the treatment groups except in the group of animals exposed to indomethacin which showed decreased feed intake, sluggishness, diarrhoea and some mortality were also recorded in the group. On the serum biochemical parameters, indomethacin and piroxicam caused increases in the level of total bilirubin and decreases blood urea nitrogen. Aspirin, indomethacin, and phenylbutazone produced increases in serum Received: aspartate aminotransferase and this increase is significant (P<0.05) with February, 2005 Accepted: the group treated with indomethacin compared to the control group. November, 2005 Indomethacin also caused significant (P<0.05) increase in the level of Published serum alanine aminotransferase. None of the treatment groups produced September, 2006 significant changes in haematological parameters except that indomethacin produced significant increase (P<0.05) in the total white blood cell count. Histological studies revealed that indomethacin also caused mild periportal hepatic necrosis and kupffer cell proliferation.