The strategy of physiological arousal of athletes in sports competition based on drug intervention / A estratégia da excitação fisiológica de atletas em competições esportivas com base em intervenção medicamentosa / Deportistas basados en intervenciones farmacéuticas, estrategia fisiológica de despertar

ABSTRACT Generally speaking, the physiological index of the human body is in a relatively stable state, which refers to the function of various organ systems with the characteristics of high-tide period, low-tide period and critical period. However, for competitive athletes, it is necessary to maintain physiological activation in both training and competition. In view of this, this study will analyze the physiological arousal degree of aspirin and acetaminophen in order to provide a reference for athletes to take analgesic drugs. In this study, the analytic hierarchy process (AHP), principal component analysis and factor analysis, were used to construct a scientific evaluation system of physiological arousal level, and the medication and non-medication status of 90 athletes were evaluated. The results showed that aspirin was better than acetaminophen in blood urea and serum creatine kinase, and the comprehensive score of some athletes was higher than 0.95. Aspirin is better in arousing athletes' physiology. The research results will provide scientific guidance for athletes to take antipyretic and analgesic drugs.

RESUMO Em termos gerais, o índice fisiológico do corpo humano encontra-se num estado relativamente estável, que se refere à função de vários sistemas de órgãos no corpo humano, com as características do período de altas, período de baixas e período crítico. No entanto, para atletas competitivos, é necessário manter a ativação fisiológica em treinamento e competição. Em vista disso, este estudo irá analisar o grau fisiológico de excitação de aspirina e acetaminofeno, a fim de fornecer referência para os atletas a tomar medicamentos analgésicos. Neste estudo, o Analytic Hierarchy Process (AHP), análise de componentes principal e análise de fatores foram usados para construir um sistema de avaliação científica de nível de excitação fisiológica, e o estado de medicação e de não medicação de 90 atletas foram avaliados. Os resultados mostraram que a aspirina foi melhor do que o acetaminofeno na ureia sanguínea e na creatina quinase sérica, e o escore abrangente de alguns atletas foi maior do que 0.95. A aspirina é melhor no despertar da fisiologia dos atletas. Os resultados da pesquisa fornecerão orientação científica para os atletas tomarem medicamentos antipiréticos e analgésicos.

RESUMEN En términos generales, el índice fisiológico del cuerpo humano se encuentra en un estado relativamente estable, que se refiere a la función de varios sistemas de órganos en el cuerpo humano, con las características del período de altas, período de bajas y período crítico. Mientras tanto, para atletas competitivos, es necesario mantener la activación fisiológica en entrenamiento y competición. En vista de eso, este estudio analizará el grado fisiológico de excitación de aspirina y acetaminofeno, a fin de proveer referencia para los atletas para tomar medicamentos analgésicos. En este estudio, el Analytic Hierarchy Process (AHP), análisis de componentes principal y análisis de fatores fueron usados para construir un sistema de evaluación científica de nivel de excitación fisiológica, y el estado de medicación y de no medicación de 90 atletas fueron evaluados. Los resultados mostraron que la aspirina fue mejor que el acetaminofeno en la urea sanguínea y en la creatina quinasa sérica, y el escore abarcador de algunos atletas fue mayor de 0.95. La aspirina es mejor en el despertar de la fisiología de los atletas. Los resultados de la investigación proveerán orientación científica para que los atletas tomen medicamentos antipiréticos y analgésicos.

Impact of post-thoracotomy analgesia with dexmedetomidine and morphine on immunocytes: a randomized clinical trial / Impacto da analgesia pós-toracotomia com dexmedetomidina e morfina em imunócitos: estudo randomizado

Abstract Objective This study aimed to investigate the impact of post-thoracotomy analgesia with dexmedetomidine and morphine on immunocytes. Methods A total of 118 patients with post-thoracotomy Patient-Controlled Intravenous Analgesia (PCIA) in our hospital from March 2016 to July 2018 were randomly selected and divided into the Composite (COM) Group (57 patients administered with dexmedetomidine [1.0 µg.kg-1 body weight] and morphine [0.48 mg.kg-1 body weight]) and the Morphine (MOR) group (61 patients administered with morphine [0.48 mg.kg-1]). The values of lymphocyte subsets (CD3+, CD4+, and CD8+) and Natural Killer cells in the peripheral blood of these two groups were detected by FACSCalibur flow cytometry at different time points (before anesthesia induction [T0], immediately after tracheal extubation [T1], 12 hours after surgery [T2], 24 hours after surgery [T3], 48 hours after surgery [T4], 72 hours after surgery [T5], and 7 days after surgery [T6]). The doses of morphine at T3 to T5 and the adverse reactions between the two groups were also recorded and compared. Results The CD3+ level and the CD4+/CD8+ ratio at T2 to T5 and the CD4+ level and NK cells at T3 to T5 were significantly higher in the COM Group than in the MOR Group (p< 0.05). The postoperative morphine dose and the incidence of postoperative itching, nausea, and vomiting were significantly lower in the COM Group than in the MOR Group (p< 0.05). Conclusions Dexmedetomidine combined with morphine for post-thoracotomy PCIA can improve the function of immunocytes, reduce morphine consumption, and reduce the adverse reactions during analgesia induction.

Resumo Objetivo Estudar o impacto em linfócitos causado pelo uso da dexmedetomidina associada à morfina para analgesia pós-toracotomia. Método Um total de 118 pacientes utilizando Analgesia Intravenosa Controlada pelo Paciente (AICP) pós-toracotomia em nosso hospital, de março de 2016 a julho de 2018, foram selecionados aleatoriamente e divididos em dois grupos: o Grupo Combinado [COM, 57 pacientes que receberam dexmedetomidina (1,0 µg.kg-1 de peso corpóreo) associada à morfina (0,48 mg.kg-1 de peso corpóreo)] e o Grupo Morfina [MOR, 61 pacientes, que receberam somente morfina (0,48 mg.kg-)]. Os valores dos subconjuntos de linfócitos (CD3+, CD4+ e CD8+) e das células NK no sangue periférico desses dois grupos foram medidos por citometria de fluxo FACSCalibur em diferentes momentos do estudo [antes da indução anestésica (T0), imediatamente após extubação traqueal (T1), 12 horas após a cirurgia (T2), 24 horas após a cirurgia (T3), 48 horas após a cirurgia (T4), 72 horas após a cirurgia (T5) e 7 dias após a cirurgia (T6)]. As doses de morfina do momento T3 ao T5 e as reações adversas entre os dois grupos também foram registradas e comparadas. Resultados O nível de CD3+ e a razão CD4+/CD8+ de T2 a T5, e o nível de CD4+ e as células NK de T3 a T5 do Grupo COM foram significantemente maiores (p< 0,05) quando comparados ao Grupo MOR. A dose de morfina no pós-operatório e a incidência de prurido, náusea e vômito no pós-operatório foram significantemente menores no grupo MOR (p< 0,05). Conclusões Dexmedetomidina combinada com morfina para AICP no período pós-toracotomia pode melhorar a função dos linfócitos, reduzir o consumo de morfina e diminuir reações adversas durante a analgesia.

The influence of non-steroidal anti-inflammatory drugs and paracetamol used for pain control of orthodontic tooth movement: a systematic review

ABSTRACT The present study aimed to perform a systematic literature review to determine if there is a non-steroidal anti-inflammatory drug (NSAID) that interferes less within tooth movement. This research was performed according to the PRISMA statement. Articles were searched in eight electronic databases (PubMed, Scopus, Embase, Web of Science, LILACS, SciELO, Google Scholar, and Open Grey). Only experimental studies on male Wistar rats were selected, which included experiments related to the influence of NSAIDs on orthodontic movement. Studies in animals with pathological conditions, literature review articles, letters to the editor and/or editorials, case reports, abstracts, books, and book chapters were excluded. Each of the steps of this systematic literature review was performed by two examiners independently. Results: the total sample consisted of 505 articles, from which 6 studies were eligible after a qualitative analysis. From the drugs assessed, paracetamol was unanimous for not interfering within orthodontic movement when compared to the control group. However, drugs such as aspirin, ibuprofen, sodium diclofenac, and selective cyclooxygenase-2 inhibitors caused a reduction in tooth movement when compared to the control group. Conclusion: paracetamol could be considered the drug of choice for pain relief because it interferes less within tooth movement.

Perineural dexmedetomidine effects on sciatic nerve in rat / Efeitos de dexmedetomidina perineural no nervo ciático em ratos

Abstract The present study was designed to test the hypothesis that high dose dexmedetomidine would increase the duration of antinociception to a thermal stimulus in a rat model of sciatic nerve blockade without causing nerve damage. The rats were anesthetized with isoflurane. After electromyography (EMG) recordings, right sciatic nerves were explored and perineural injections were delivered: Group D (n = 7), 40 µg µg kg-1 dexmedetomidine administration, Group II (n = 6), (0.2 mL) saline administration, Group III (n = 2), only surgically exploration of the right sciatic nevre. Time to paw withdrawal latency (PAW) to a thermal stimulus for both paws and an assessment of motor function were measured every 30 min after the nerve block until a return to baseline. The compound muscle action potential (CMAP) of right and left sciatic nerves were recorded 10 times per each nerve once more after perineural injections at 14 day. After EMG recordings, right and the part of left sciatic nerve were excised at a length of at minimum 15 mm for histopathological examination. Comparison of right/left CMAP amplitude ratios before and 14 days after the procedure showed a statistically significant difference (p = 0.000). There were no differences in perineural inflammation between the Group D, Group S, and Group E at 14 days.

Resumo O presente estudo foi desenvolvido para testar a hipótese de que dexmedetomidina em dose alta aumentaria a duração da antinocicepção a um estímulo térmico em modelo de rato de bloqueio do nervo ciático sem causar danos ao nervo. Os ratos foram anestesiados com isoflurano. Após os registros da eletromiografia (EMG), os nervos ciáticos direitos foram explorados e injeções perineurais foram administradas: Grupo D (n = 7) recebeu 40 µg/kg-1 de dexmedetomidina, Grupo II (n = 6) recebeu 0,2 mL de solução salina, Grupo III (n = 2) recebeu apenas exploração cirúrgica do nervo ciático direito. O tempo de latência de retirada da pata (LRP) a um estímulo térmico para ambas as patas e uma avaliação da função motora foram avaliados a cada 30 minutos após o bloqueio do nervo até o retorno à fase basal. O potencial de ação muscular composto (PAMC) dos nervos ciático direito e esquerdo foi registrado 10 vezes para cada nervo, mais uma vez, após as injeções perineurais no 14º dia. Após os registros da EMG, o nervo ciático direito e parte do esquerdo foram excisados com um comprimento de no mínimo 15 mm para exame histopatológico. A comparação das proporções da amplitude do PAMC direito/esquerdo antes e 14 dias após o procedimento mostrou uma diferença estatisticamente significativa (p = 0,000). Não houve diferenças em inflamação perineural entre os grupos D, S e E aos 14 dias.

Effectiveness of hip muscle strengthening in patellofemoral pain syndrome patients: a systematic review

Introduction: Patellofemoral pain syndrome (PFPS) is characterized by anterior knee pain, which may limit the performance of functional activities. The influence of hip joint motion on the development of this syndrome has already been documented in the literature. In this regard, studies have investigated the effectiveness of hip muscle strengthening in patients with PFPS. Objectives: The aims of this systematic review were (1) to summarize the literature related to the effects of hip muscle strengthening on pain intensity, muscle strength, and function in individuals with PFPS and (2) to evaluate the methodological quality of the selected studies. Method: A search for randomized controlled clinical trials was conducted using the following databases: Google Scholar, MEDLINE, PEDro, LILACS, and SciELO. The selected studies had to distinguish the effects of hip muscle strengthening in a group of patients with PFPS, as compared to non-intervention or other kinds of intervention, and had to investigate the following outcomes: pain, muscle strength, and function. The methodological quality of the selected studies was analyzed by means of the PEDro scale. Results: Seven studies were selected. These studies demonstrated that hip muscle strengthening was effective in reducing pain. However, the studies disagreed regarding the treatments' ability to improve muscle strength. Improvement in functional capabilities after hip muscle strengthening was found in five studies. Conclusion: Hip muscle strengthening is effective in reducing the intensity of pain and improving functional capabilities in patients with PFPS, despite the lack of evidence for its ability to increase muscle strength. .

Effect of paracetamol on pharmacokinetics of isoniazid in Teddy goats

In this study the effect of paracetamol on pharmacokinetics [PK] of isoniazid [INH] in Teddy goats was investigated. INH was administered as a single oral dose at 10 mg/kg body weight to every experimental goat. After a wash out period of 7 days, INH and paracetamol [at the rate of 15 mg/kg body weight] were given simultaneously through oral route for investigation of drug interactions. Both times, following drug administration, blood samples were collected at predetermined time intervals from the jugular vein of each animal and analyzed for INH by spectrophotometric analysis. PK parameters were calculated using two compartment open model. When used with paracetamol, the value of biological half life [t1/2beta] of INH was significantly decreased [p<0.05] from 2.391 +/- 0.216 to 2.17 +/- 3.46 hours. The value for apparent volume of distribution [Vd] was also significantly decreased [p<0.05] from 0.905 +/- 0.327 to 0.786 +/- 0.161 L/kg and total body clearance [CL] was increased insignificantly [p>0.05] from 3.59 +/- 2.03 to 4.04 +/- 2.61 mL/min/kg. Based on these results, it was concluded that dose of isoniazid should be increased when concomitantly used with paracetamol

Treatment with paracetamol, ketorolac or etoricoxib did not hinder alveolar bone healing: a histometric study in rats

Prostaglandins control osteoblastic and osteoclastic function under physiological or pathological conditions and are important modulators of the bone healing process. The non-steroidal anti-inflammatory drugs (NSAIDs) inhibit cyclooxygenase (COX) activity and consequently prostaglandins synthesis. Experimental and clinical evidence has indicated a risk for reparative bone formation related to the use of non-selective (COX-1 and COX-2) and COX-2 selective NSAIDs. Ketorolac is a non-selective NSAID which, at low doses, has a preferential COX-1 inhibitory effect and etoricoxib is a new selective COX-2 inhibitor. Although literature data have suggested that ketorolac can interfere negatively with long bone fracture healing, there seems to be no study associating etoricoxib with reparative bone formation. Paracetamol/acetaminophen, one of the first choices for pain control in clinical dentistry, has been considered a weak anti-inflammatory drug, although supposedly capable of inhibiting COX-2 activity in inflammatory sites. OBJECTIVE: The purpose of the present study was to investigate whether paracetamol, ketorolac and etoricoxib can hinder alveolar bone formation, taking the filling of rat extraction socket with newly formed bone as experimental model. MATERIAL AND METHODS: The degree of new bone formation inside the alveolar socket was estimated two weeks after tooth extraction by a differential point-counting method, using an optical microscopy with a digital camera for image capture and histometry software. Differences between groups were analyzed by ANOVA after confirming a normal distribution of sample data. RESULTS AND CONCLUSIONS: Histometric results confirmed that none of the tested drugs had a detrimental effect in the volume fraction of bone trabeculae formed inside the alveolar socket.

Antinociceptive effect of amitriptyline in mice of acute pain models.

Tricyclic antidepressant drugs induce antinociceptive effect and suggest that their analgesic action could be related to the monoaminergic activity of the drugs. The analgesic activity of amitriptyline was observed in mouse models of acute pain. Mice were divided into different groups and were given amitriptyline in different doses alone and in combination with morphine. Reaction time in Hot-Plate and Tail-Flick tests was observed. Results showed that amitriptyline had antinociceptive effect in acute pain state in experimental models. Amitriptyline in combination with morphine had better analgesic effect than the morphine alone in Hot-Plate test.

Parametric evaluation of methotrimeprazine-midazolam-ketamine and methotrimeprazine-midazolam-ketamine-xylazine combination in dogs / Avaliação paramétrica das associações levomepromazinamidazolam-cetamina e levomepromazinamidazolamcetamina-xilazina em cães

PURPOSE: To evaluate the parameters of dogs anesthetized by different dissociative drugs protocols through continuous intravenous infusion. METHODS: Thirty healthy dogs of both sexes were assigned randomly to three groups (G1, G2, and G3). G1 was administered with methotrimeprazine as a pre-anesthetic medication, intravenously midazolam-ketamine as bolus for induction and midazolam-ketamine by continuous intravenous infusion for a 60 minute-period of maintenance. G2: the same as for G1. plus an increase in the midazolam dose during maintenance. G3: the same treatment as for G2, plus the addition of xylazine during maintenance. Immediately after induction the anesthetic maintenance started, and measures were taken 15 minutes after pre-medication, at 10 minutes intervals, during maintenance (M0 to M7). RESULTS: Bradycardia, atrioventricular blockage, bradypnea and hypoxemia were shown in G3. G1 and G2 showed a slight hypotension only. CONCLUSION: There were some advantages by using the continuous intravenous via: no parameters oscillation and reduction in the anesthetic recovery period. The increase in midazolam dose brought about little parametric variations which were greater when xylazine was used, with a consequent hypoxemia, bradyarrhytmia, and decrease in respiratory frequency and minute volume.

OBJETIVO: Avaliar os parâmetros de cães anestesiados com diferentes protocolos de fármacos dissociativos por infusão intravenosa contínua. MÉTODOS: Foram utilizados 30 cães, machos e fêmeas, clinicamente sadios, distribuídos aleatoriamente em três grupos (G1,G2 e G3) (*)). Em G1 utilizou-se levomepromazina como medicação pré-anestésica (MPA), midazolam-cetamina pela via intravenosa em bolus para indução e midazolam-cetamina em infusão intravenosa contínua por 60 minutos para manutenção. Em G2 procedeu-se da mesma forma que em G1 elevando-se, porém, a dose de midazolam durante a manutenção. Em G3 repetiu-se o tratamento empregado em G2, acrescentando-se a xilazina à manutenção. Após a indução, iniciou-se imediatamente a manutenção anestésica, realizando-se aferições, 15 minutos depois da MPA, em intervalos de 10 minutos, durante a manutenção (M0 a M7). RESULTADOS: Em G3 ocorreu bradicardia, bloqueio átrio-ventricular, bradipnéia e hipoxemia e em G1 e G2, discreta hipotensão. CONCLUSÃO: A via intravenosa contínua apresentou vantagens quanto a: não oscilação dos parâmetros e redução no período de recuperação anestésica. A elevação da dose de midazolam resultou em discretas variações paramétricas, estas, acentuadas pelo uso da xilazina, que causou hipoxemia, bradiarritmia, diminuição da freqüência respiratória e volume minuto.

Analgésicos no opioides en dolor postoperatorio pediátrico / Analgesic not opioids in pediatric postoperative pain

El dolor postoperatorio es todavía subvalorado en la población pediátrica. Por otro lado, entre las publicaciones que abordan el tema del dolor postoperatorio solo un 10 por ciento de ellas incluye a la población menor de 15 años. Las alternativas terapéuticas en base a analgésicos no opiaceos es restringida en niños, ya que sólo un 20 por ciento del total de las drogas disponibles en el mercado ha probado su eficacia y seguridad en esta población. un analgésico antiguo es el acetaminofeno, acumulando la mayor cantidad de estudios. Los antinflamatorios no esteriodales (AINEs) han ganado popularidad en el manejo del dolor postoperatorio pediátrico. El objetivo de esta revision es determinar cuáles son las indicaciones y las dosis mas racionales y seguras para el tratamiento del dolor agudo en niños.

Postoperatory pain is still subvaluated in pediatric population. On the other hand, only 10 percent of publications discussing postoperatory pain subjects includes a population under age 15. Therapeutic alternatives based on nonopiate analgesics are restrained for children as only 20 percent of the total available drugs in the market has proven their efficacy and safety in children. An old analgesic is acetaminophen, which accumulates most part of studies. Nonsteroidal antinflammarory drugs (NSAI) are gaining popularity to manage postoperatory pain in children. The objective of this revision is to determine the most rational and safest indications and dosages when treating acute pain in children.

Antinociceptive activity of Vitex-negundo Linn leaf extract.

Tail flick test in rats and acetic acid induced writhing in mice were employed to study the antinociceptive activity of ethanolic leaf extract of Vitex-negundo (VN) (100, 250 and 500 mg/kg, p.o). The effect was compared with meperidine (40 mg/kg, sc) in tail flick method and aspirin (50 mg/kg, p.o) in writhing test as a standard control respectively. An interaction with naloxone hydrochloride was also studied in tail flick method for its mechanism of central analgesic action. The test drug showed significant analgesic activity in dose dependant manner in both the experimental models. In comparison to standard drug (meperidine), more than ten times dose of VN extract was required to produce comparable significant antinociceptive activity. The sub-effective dose (5 mg/kg, po) of VN potentiated the analgesic activity of meperidine (4 mg/kg, sc) and aspirin (25 mg/kg, po). Naloxone (1 mg/kg, sc) did not reverse the analgesic effect of VN extract. Our observations suggest that VN possesses both central and peripheral analgesic activity. The central analgesic action does not seem to be mediated through opioid receptors. It, may prove to be a useful adjuvant therapy along with standard analgesic drug.

Automedicación en individuos de la Región de la Araucanía con problemas musculoesqueléticos / Self medication among patients with musculoskeletal symptoms in Región de la Araucanía

Background Self-medication is a common behavior in the general population, specially among those suffering from chronic pain. Aim: To study the prevalence and characteristics of self medication. Subjects and Methods: Aiming to know the prevalence and features of self medication, a structured interview was applied to 272 out of 419 individuals from the general population, that reported musculoskeletal symptoms. Results: Sixty five percent of those interviewed recognised self medication. No gender differences were observed and there was a trend towards a higher frequency of self medication among older individuals. The frequency of self-medication was higher in low socioeconomic groups, subjects with long lasting pain, those with more severe pain and among subjects with a previous prescription. The drugs more frequently used were dipyrone, piroxicam and aspirin. The average daily piroxicam dose reported was 27 mg. Self medication was not associated with the labor condition of the subjects or the time of occurrence of symptoms. Conclusions: Self medication is a frequent behavior, particularly among low socio-economic groups and those with long lasting and more severe pain

Synergistic Effects Between Intrathecal Clonidine and Neostigmine in the Formalin Test

Spinal alpha-2 adrenoceptors and cholinergic receptors are involved in the regulation of acute nociception and the facilitated processing. The aim of this study was to examine the pharmacological effect of an intrathecal alpha-2 agonist and a cholinesterase inhibitor on the facilitated pain model induced by formalin injection and to determine the nature of drug interaction using an isobolographic analysis. Both intrathecal clonidine and neostigmine dose-dependently suppressed the flinching during phase 1 and phase 2. Intrathecal pretreatment with atropine reversed the antinociceptive effects of clonidine and neostigmine in both phases. Pretreatment with intrathecal yohimbine attenuated the effect of clonidine. The antinociception of clonidine and neostigmine was not reversed by mecamylamine. Isobolographic analysis showed that intrathecal clonidine and neostigmine acted synergistically in both phase 1 and 2. Intrathecal pretreatment with atropine and yohimbine antagonized the effect of the mixture of clonidine and neostigmine in both phases, but no antagonism was observed with mecamylamine pretreatment. These data indicate that spinal clonidine and neostigmine are effective to counteract the facilitated state evoked formalin stimulus, and these two drugs interact in a synergistic fashion. In addition, the analgesic action of intrathecal clonidine is mediated by spinal muscarinic receptors as well as alpha-2 adrenoceptors.

Impacto de las clínicas del dolor en la práctica de la reumatología / Influence of pain clinics in rheumatology practice

El dolor, considerado universalmente como señal de algún padecimiento es el síntoma más frecuente por el que un paciente busca ayuda médica. El objetivo de la medicina es preservar o, en su caso, devolver la salud o aliviar el dolor y el sufrimiento. Un adecuado entendimiento del dolor es fundamental para lograr esta metas. El reumatólogo "trabaja con el dolor". El colegio Americano de Reumatología incluye aproximadamente unos 170 padecimientos que constituyen el campo de la reumatología. En muchos de ellos el dolor es su connotativo. El tratamiento ideal de cualquier dolor es resolver su causa; en ocasiones es factible lograrlo, en otras el dolor persiste por algún tiempo después de iniciado su tratamiento. Algunos padecimientos son extremadamente dolorosos (como casos de dolor agudo), que requieren analgésicos de inmediato (por ejemplo: gota, hernia de disco intervertebral, cólico renal, posoperatorio, quemaduras, trauma o cáncer). Fármacos analgésicos como acetaminofeno, aspirina y otros antiinflamatorios no esteroides son ampliamente empleados por los reumatólogos, pero los opioides pocas veces son utilizados, siendo los fármacos, actualmente disponibles, más poderosos para aliviar el dolor. El médico no debe titubear en emplear analgésicos opioides en casos de dolor agudo severo ni en pacientes con dolor crónico maligno (por cáncer) o en casos de dolor crónico no maligno, por ejemplo algunos padecimiento dolorosos crónicos, como los reumatológicos o neurológicos

Actualización en el uso racional de los antipiréticos en pediatría / Update of rational use of antipiretics in pediatrics

El proceso febril en el niño es el resultado de alteraciones en el centro termorregulador secundarias a la elevación del punto fijo por encima del parámetro normal. Sus causas pueden ser infecciosas o no. El tratamiento de la fiebre debe estar enfocado básicamente a resolver la causa que la originó. Históricamente el ácido acetil salicílico (ASA) ha sido el más usado por sus propiedades antipiréticas, antiinflamatorias y analgésicas, pero por su asociación al síndrome de Reyes se ha dejado de usar en menores de 14 años. La mayoría de los fármacos antipiréticos son analgésicos y antiinflamatorios. Los medicamentos que regresan el punto fijo a la normalidad son los inhibidores de la síntesis de la prostaglandina como: paracetamol, diclofenaco, tolmetina, naproxeno, ibuprofeno, etc. para realizar una buena selección de un antipirético se debe tener en cuenta los siguientes aspectos: edad, causa del proceso febril, vida media del antipirético, sabor del medicamento, efectos adversos y costos

Levomepromazina e atropina como medicaçöes pré-anestésicas na anestesia pela associaçäo tiletamina/zolazepam, em cäes / Comparison between levomepromazine and atropine as premedication agents before anesthesia using tiletamine/zolazepam in dogs

O objetivo desta pesquisa foi avaliar o emprego da atropina e da levomepromazina como medicaçöes pré-anestésicas para a anestesia pela associaçäo tiletamina/zolazepam. Foram empregados 30 cäes, distribuídos em três grupos iguais. O grupo 1 (controle) foi tratado com 0,2ml/kl de soluçäo fisiológica (placebo) por via intravenosa; o grupo 2 com 0,044mg/kg de sulfato de atropina por via subcutânea e o grupo 3 com 1mg/kg de cloridrato de levomepromazina por via intravenosa. Quinze minutos após, todos os grupos receberam a associaçäo tiletamina/zolazepam na dose de 10mg/kg por via intramuscular. Antes da medicaçäo pré-anestésica, 15 minutos após a mesma e aos 15, 30, 60 e 105 minutos após a administraçäo da associaçäo tiletamina/zolazepam foram registrados: ECG, temperatura, freqüência respiratória, volume corrente, volume minuto, freqüência cardíaca, pressäo arterial, valores hemogasométricos arteriais, graus de analgesia e miorrelaxamento e reflexos protetores. Outros dados como: secreçäo salivar, período de latência, período anestésico hábil e período de recuperaçäo foram igualmente mensurados para efeito comparativo. De acordo com os resultados obtidos concluiu-se que o sulfato de atropina näo deve ser administrado como medicaçäo pré-anestésica, por potencializar a taquicardia induzida pela associaçäo tiletamina/zolazepam. A levomepromazina, além de inibir a sialorréia, mantém a estabilidade cardiorrespiratória e apresenta açäo potencializadora dos efeitos anestésicos da associaçäo.

Uma análise crítica sobre benefícios e riscos da dipirono / Critical analysis of the risks and benefits of the dipyrone

Os analgésicos antipiréticos säo drogas maciçamente consumidas em nível mundial e, por serem fármacos relativamente antigos, pouco se tem publicado a esse respeito. Este estudo visa fazer uma análise crítica e objetiva sobre os benefícios e riscos na utilizaçäo de analgésicos, bem como sobre a coerência de alternativas terapêuticas. Foi realizada extensa análise de literatura científica internacional sobre o assunto, com particular atençäo ao estado de Boston e aos dados atuais de estudos recentes em farmacoepidemiologia. Conclui-se que o uso de analgésicos é bastante seguro, sendo que a dipiron é um dos farmacos mais bem avaliados quanto ao seu perfil de segurnaça