ABSTRACT
Cancer is one of the leading causes of morbidity and mortality worldwide & cancer pain is experienced by patients with advanced, metastatic and terminal disease. Buprenorphine, a partial µ-receptor agonist and antagonist at the kopioid receptor, shows no clinically relevant accumulation of active metabolites, and pharmacokinetics remain unchanged in renal insufficiency. In elderly cancer patients, the use of opioids for control of cancer pain is a therapeutic challenge, as these group of patients often associated with renal and hepatic comorbidity that limited the use of strong opioids like morphine. Methods : A retrospective observational study was conducted in elderly patients to estimate the efficacy of transdermal buprenorphine patch for controlling of cancer pain as well as to assess the safety of the patch. For pain control Numerical Rating Score (NRS) was used & for safety assessment Grade 3 or 4 toxicity were recorded.Hepatic & renal toxicity were measured at baseline, at 1st month & at 3rd month of treatment & lastly at 6th month of treatment. Results : Majority of the patients showing good to excellent global satisfaction with Buprenorphine patch and 57% of patients suffered from constipation along with 38% nausea & vomiting. It was found that there was a significant reduction in pain intensity from baseline with a p value of <0.05. There was no significant hepatic or renal toxicity found in the study. Conclusion : Transdermal buprenorphine patch is effective and safe in elderly cancer patients for pain control. Further studies should be performed in order to find safe and effective opioid methods necessary to give greater insight into the difficult balance between analgesia and toxicity
ABSTRACT
There is a dearth of chemico-analytical or instrumental methods for standardization and quality control of higher dilutions of homeopathic drugs. Aim: This review highlights the challenges in standardization of anti-inflammatory homeopathic drugs and suggests a battery of biological assays for their standardization. Methods: We retrieved a total 57 scientific reports from the experimental studies and scientific reviews published between January 1999 and June 2014 related to anti-inflammatory homeopathic drugs and their high dilutions. These comprised of 18 reports on preclinical evaluation, 15 on source materials, 9 on isolated constituents and 15 studies on in-vitro experiments. Few recent citations which supported the initial studies were added later during the compilation of the manuscript. Conclusion: Standardization and quality control of homeopathic mother tinctures and high dilutions warrants an urgent attention. As biological activities are observed to be attributed to the high dilutions which are practically devoid of active ingredients, their standardization may be done through the suggested battery of biological investigations. It is suggested that the current methods of standardization of homeopathic drugs need to be upgraded to include sensitive, reproducible and relevant biological assays so that the end users are assured of the quality, efficacy, and safety of homeopathic dilutions...