ABSTRACT
The symptomatic treatment of pain associated with spasm of gastrointestinal or genitourinary origin can include the use of spasmolytic agents and/or non-steroidal anti-inflammatory drugs. However, the evidence of a superior effectiveness of combination in comparison with individual drugs is scarce and controversial. A double-blind, randomised, clinical trial study was designed to characterize the analgesic effect and safety of ketorolac and hyoscine butylbromide against hyoscine butylbromide alone in patients with ambulatory acute cramping pain of gastrointestinal and genitourinary origin. 160 patients with a pain level ≥4 in a 1-10 cm visual analogue scale were allocated to receive a fixed dose of ketorolac/hyoscine butylbromide (10 mg/20 mg) or hyoscine butylbromide (20 mg) alone at 6 h intervals, during a 48 h period. Both treatments were similarly effective when compared as a whole or when groups were classified by pain origin. Conversely, when treatments were grouped by pain intensity, ketorolac/hyoscine butylbromide combination showed a significant better pain relief profile than hyoscine butylbromide alone in pain intensity ≥7, but not <7. Data indicate that the oral ketorolac/hyoscine butylbromide mixture could be a better option than hyoscine butylbromide alone in the treatment of some acute intense cramping painful conditions.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Cholinergic Antagonists/therapeutic use , Colic/drug therapy , Female Urogenital Diseases/drug therapy , Gastrointestinal Diseases/drug therapy , Ketorolac Tromethamine/therapeutic use , Pain/drug therapy , Scopolamine/therapeutic use , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Chemistry, Pharmaceutical , Cholinergic Antagonists/adverse effects , Colic/etiology , Double-Blind Method , Drug Combinations , Female , Female Urogenital Diseases/complications , Gastrointestinal Diseases/complications , Humans , Ketorolac Tromethamine/adverse effects , Male , Middle Aged , Pain/etiology , Pain Measurement , Scopolamine/adverse effectsSubject(s)
Diabetes Mellitus, Type 2/drug therapy , Glyburide/therapeutic use , Hypoglycemic Agents/therapeutic use , Metformin/therapeutic use , Adult , Aged , Blood Glucose/metabolism , Combined Modality Therapy , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/diet therapy , Drug Combinations , Exercise Therapy , Female , Follow-Up Studies , Humans , Male , Middle AgedSubject(s)
Diabetes Mellitus, Type 2/drug therapy , Glyburide/therapeutic use , Hypoglycemic Agents/therapeutic use , Metformin/therapeutic use , Adult , Aged , Blood Glucose/metabolism , Combined Modality Therapy , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/diet therapy , Drug Combinations , Exercise Therapy , Female , Follow-Up Studies , Humans , Male , Middle AgedSubject(s)
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Diclofenac/therapeutic use , Hyperalgesia/drug therapy , Vitamin B Complex/therapeutic use , Animals , Behavior, Animal/drug effects , Carrageenan , Female , Hot Temperature , Hyperalgesia/chemically induced , Pain Measurement/drug effects , Rats , Rats, WistarSubject(s)
Formaldehyde , Inflammation/prevention & control , Pain Measurement/drug effects , Pain/prevention & control , Vitamin B Complex/pharmacology , Animals , Behavior, Animal/drug effects , Female , Inflammation/chemically induced , Naloxone/pharmacology , Narcotic Antagonists/pharmacology , Pain/chemically induced , Rats , Rats, WistarSubject(s)
Cefaclor/pharmacokinetics , Cephalosporins/pharmacokinetics , Adult , Area Under Curve , Cefaclor/blood , Cephalosporins/blood , Half-Life , Humans , Male , MexicoSubject(s)
Cefixime/therapeutic use , Cephalosporins/therapeutic use , Typhoid Fever/drug therapy , Adolescent , Adult , Anti-Bacterial Agents/pharmacology , Child , Child, Preschool , Feces/microbiology , Female , Humans , Male , Microbial Sensitivity Tests , Salmonella typhi/drug effects , Typhoid Fever/microbiologySubject(s)
Anti-Inflammatory Agents/therapeutic use , Dexamethasone/therapeutic use , Low Back Pain/drug therapy , Vitamin B Complex/therapeutic use , Adolescent , Adult , Anti-Inflammatory Agents/adverse effects , Dexamethasone/adverse effects , Female , Humans , Male , Pain Measurement , Spasm/drug therapy , Vitamin B Complex/adverse effectsSubject(s)
Anti-Inflammatory Agents, Non-Steroidal/antagonists & inhibitors , Anti-Inflammatory Agents, Non-Steroidal/toxicity , Anti-Ulcer Agents/therapeutic use , Duodenal Ulcer/prevention & control , Misoprostol/therapeutic use , Stomach Ulcer/prevention & control , Adult , Anti-Ulcer Agents/adverse effects , Diclofenac/toxicity , Double-Blind Method , Duodenal Ulcer/chemically induced , Duodenal Ulcer/pathology , Female , Humans , Male , Middle Aged , Misoprostol/adverse effects , Stomach Ulcer/chemically induced , Stomach Ulcer/pathologyABSTRACT
The role of vitamin B complex preparations as an analgesic adjuvant is controversial. Therefore, the purpose of the present study was to characterize the potentiation of the antinociceptive effect of diclofenac by a vitamin B complex preparation and its individual components by using the pain-induced functional-impairment model in the rat (PIFIR). Pain was produced by the intraarticular injection of uric acid in the right hind limb. Oral administration of diclofenac resulted in a dose-dependent antinociceptive effect. Oral administration of a vitamin B complex preparation containing thiamine (vitamin B(1)), pyridoxine (vitamin B(6)), and cyanocobalamin (vitamin B(12)) in a 1:1:0.01 proportion did not produce any antinociception by itself, but it significantly potentiated the effect of diclofenac. Coadministration of diclofenac with either thiamine or pyridoxine resulted in an antinociceptive effect similar to that of diclofenac alone. On the other hand, coadministration of cyanocobalamin significantly increased diclofenac-induced antinociception. It is concluded that the potentiation of diclofenac-induced antinociception in the PIFIR model is due to cyanocobalamin.
