Given the very frequent prescription of non-opiod analgesics (NOA), their dependence potential has been a subject of research. Increased use of NOA in the last decade has led authors to publish case reports to describe the dependence potential of these agents. Metamizole (dipyrone) has become one of the most popular NOA agents, in being easily accessible and inexpensive. Its analgesic effect depends on the central inhibition of cyclo-oxigenase (COX-3) and activation of the opiodergic and cannabinoid systems. Recent research has also stressed its possible anxiolytic effects. Our Literature search indicated no previous reports regarding metamizole misuse. Case of a 41 year old female patient is presented. She had self administered increasing doses of i.v. metamizole reaching up to 10 ampules per day. Considering the risk of mortality due to the metamizole's side effect of agranulocytosis, we thought that it could be a significant contribution to the literature to present a case of a possible metamizole abuse.

2014-06-27·The Ukrainian Biochemical Journal

Biophysical parameters of erythrocyte membranes and mechanisms

Article

作者: Goriushko, H. G. ; Velychko, O. N. ; Kurapova, T. N. ; Babenko, L. P. ; Paramonova, G. I. ; Buhtiarova, T. A. ; Litvinova, N. V. ; Gubskyi, Yu. I.

Methods of fluorescent probing, spectrophotometry and microcalorimetry were applied to investigate the alterations in biophysical parameters of erythrocytes membranes, and specifically microviscosity, surface charge, molecular organization of lipid bilayer and lipid-protein interactions under conditions of acute pain syndrome produced by experimental chemical lesion. The distinctive features of non-opiod analgesics interactions and binding to the erythrocytes membranes of rats subjected to acute nociceptive pain accompanied with oxidative stress development were investigated. The abilities of analgesics under research, and namely paracetamol, aspirin, phenazone, ketorolac, pyrodazole, ketoprofenum, natrium mefenaminate, indometacin, nimesulide to make up physico-chemical complexes with lipoperoxidation modified erythrocytes surface and protein-lipid bilayer showed marked changes. The significance of oxidative damage of biophase under conditions of acute pain syndrome for analgesics effective pharmacodynamics and pharmacokinetics realization is under consideration.

2013-04-01·Minerva anestesiologica3区 · 医学

Long-lasting beneficial effects of periradicular injection of meloxicam for treating chronic low back pain and sciatica.

3区 · 医学

Article

作者: Borghi, B ; Martignani, M ; Greggi, T ; White, P F ; Mordenti, A ; Borghi, R ; Aurini, L ; Lolli, F

BACKGROUNDChronic low back pain (LBP) and sciatica can occur without obvious structural causes and are often resistant to conventional analgesic drugs. The effect of periradicular injection of meloxicam on LBP with or without a radicular component was assessed. A secondary objective of this prospective observational study was to assess the effect of meloxicam on functional recovery.METHODSSeventy-two patients (30 men, 42 women) with LBP and/or sciatica were followed for 90 days to six years after injecting 10 mg meloxicam in 10 mL saline at each of the involved dermatomal levels. A standard verbal rating scale (VRS) from 0=no pain to 10=severe pain was used for assessing LBP before the injection of meloxicam (at baseline) and at 1, 5, 10, 30 and 60 min, and 1, 5, 15, 30 and 90 days intervals after the injection. The meloxicam injection was repeated only if the VRS score remained >3. Rescue analgesic requirements and functional activity levels were also assessed from 30-90 days after the last injection of meloxicam.RESULTSThe mean baseline LBP score was 8.60 ± 1.50 (SD) despite the use of multi-modal analgesic regimens (NSAIDs, glucocorticosteroids, paracetamol, oral opioids, gabapentanoid compounds, epidural or periradicular steroid and/or local anesthetics) as well as laser treatments and physical therapy. The majority of patients reported that their pain intensity decreased by ~50% 1-2 min after the meloxicam injection was completed. Thirty-six patients (50%) required no further injections, 25 patients (35%) required a second injection after seven days, and 11 patients (15%) required a total of three injections. After the meloxicam treatment(s), only 10 patients (14%) required "rescue" analgesia with oral NSAIDs. All patients were able to increase their level of functional activity after the meloxicam treatment(s).CONCLUSIONPeriradicular injections of meloxicam (10 mg) appear to be a useful alternative to opioid and non-opiod analgesics for patients with intractable LBP due to nerve root inflammation.

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