PROSPECTS OF USING A COMBINATION OF LOCALLY INJECTED NON-STEROIDAL ANTI-INFLAMMATORY DRUGS AND OPIOIDS IN PERIPHERAL PAIN MANAGEMENT
https://doi.org/10.21292/2078-5658-2019-16-3-41-47
Abstract
The article reviews scientific literature on serious side effects of non-steroidal anti-inflammatory drugs (NSAIDs) and opioid analgesics widely used to treat acute and chronic pain. In order to reduce the incidence of side effects in clinical practice, oral combinations of NSAIDs and opioids are used. Unfortunately, the efficacy and safety of these combinations also do not meet contemporary requirements for analgesics. Local use of NSAIDs and opioids is one of the alternatives, which will reduce the dose of systemically administered drugs. Peripheral mechanisms play a key role in systemic mu-opioid analgesia. The use of these mechanisms when developing medication for pain relief offers promising prospects in the treatment of acute and chronic pain.
About the Author
YU. А. KOLESNIKOV
Kordamed AS
Estonia
Estonia
Yury A. Kolesnikov Kordamed AS, Candidate of Medical Sciences, Anesthesiologist and Emergency Physician, Alcohologist.
Pärnu mnt 80, 10131 Tallinn
References
1. Armstrong C.P., Blower A.L. Non-steroidal anti-inflammatory drugs and life threatening complications of peptic ulceration. Gut., 1987, vol. 28, no. 5, pp. 527-532.
2. Brown M.B., Hanpanitcharoen M.N., Martin G.P. An in vitro investigation into the effect of glycosaminoglycans on the skin partitioning and deposition of NSAIDs. Int. J. Pharm., 2001, vol. 28, no. 225, pp. 113-121.
3. Brown M.B., Martin G.P., Jones S.A. Dermal and transdermal drug delivery systems: current and future prospects. Drug Delivery, 2006, vol. 13, no. 3, pp. 175-187.
4. Cryer B., Feldman M. Cyclooxygenase-1 and cyclooxygenase-2 selectivity of widely used nonsteroidal anti-inflammatory drugs. Am. J. Med., 1998, vol. 104, no. 5, pp. 413-421.
5. Cryer B., Kimmey M.B. Gastrointestinal side effects of nonsteroidal anti– inflammatory drugs. Am. J. Med., 1998, vol. 105, no. 1, pp. 20-30.
6. Dogrul A., Gülmez S.E., Deveci M.S. et al. The local antinociceptive actions of nonsteroidal antiinflammatory drugs in the mouse radiant heat tail-flick test. Anesth. Analg., 2007, vol. 104, no. 4, pp. 927-932.
7. Gallagher R.E., Arndt D.R., Hunt K.L. Analgesic effects of topical methadone: a report of four cases. Clin. J. Pain, 2005, vol. 21, no. 2, pp. 190-192.
8. https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates
9. Karlsson P.I., Moller A.T., Jensen T.S. et al. Epidermal nerve fiber length density estimation using global spatial sampling in healthy subjects and neuropathy patients. J. Neuropathol. Exp. Neurol., 2013, vol. 72, no. 3, pp. 186-192.
10. Kolesnikov Y. A., Sõritsa D. Analgesic synergy between topical opioids and topical non-steroidal anti-inflammatory drugs in the mouse model of thermal pain. Eur. J. Pharmacol., 2008, vol. 28, no. 1-3, pp. 126-133.
11. Kolesnikov Y.A., Wilson R.S., Pasternak G.W. The synergistic analgesic interactions between hydrocodone and ibuprofen. Anesth. Analg., 2003, vol. 97, no. 6, pp. 1721-1723.
12. Laine L. Approaches to nonsteroidal anti-inflammatory drug use in the high-risk patient. Gastroenterology, 2001, vol. 120, no. 3, pp. 594-606.
13. Laine L., Yang H., Chang S.C. et al. Trends for incidence of hospitalization and death due to GI complications in the United States from 2001 to 2009. Am. J. Gastroenterol., 2012, vol. 107, no. 8, pp. 1190-1195.
14. LaMotte R.H., Lundberg L.E., Torebjörk H.E. Pain, hyperalgesia and activity in nociceptive C units in humans after intradermal injection of capsaicin. J. Physiol., 1992, vol. 448, pp. 749-764.
15. Larsen I.M., Drewes A.M., Olesen A. The effect of a combination of diclofenac and methadone applied as gel in a human experimental pain model – a randomized, placebo-controlled trial. Basic Clin. Pharmacol. Toxicol., 2018, vol. 123, no. 2, pp. 188-192.
16. Martins S.S., Segura L.E., Santaella-Tenorio J. et al. Prescription opioid use disorder and heroin use among 12‒34 year-olds in the United States from 2002 to 2014. Addict Behav., 2017, vol. 65, pp. 236-241.
17. Masclee G.M., Valkhoff V.E., Coloma P.M. et al. Risk of upper gastrointestinal bleeding from different drug combinations. Gastroenterology, 2014, vol. 147, no. 4, pp. 784-792.
18. McCarthy B.G., Hsieh S.T., Stocks A. et al. Cutaneous innervation in sensory neuropathies: evaluation by skin biopsy. Neurology, 1995, vol. 45, pp. 1848-1855.
19. Nozadze I., Tsiklauri N., Gurtskaia G. et al. NSAIDs attenuate hyperalgesia induced by TRP channel activation. Data Brief, 2016, vol. 13, no. 6, pp. 668-673.
20. Olesen A.E., Andresen T., Staahl C. et al. Human experimental pain models for assessing the therapeutic efficacy of analgesic drugs. Pharmacol. Rev., 2012, vol. 64, no. 3, pp. 722-729.
21. Ortiz M.I., Granados-Soto V., Castañeda-Hernández G. The NO-cGMP-K+ channel pathway participates in the antinociceptive effect of diclofenac, but not of indomethacin. Pharmacol. Biochem. Behav., 2003, vol. 76, no. 1, pp. 187-195.
22. Papworth J., Colville-Nash P., Alam C. et al. The depletion of substance P by diclofenac in the mouse. Eur. J. Pharmacol., 1997, vol. 325, no. 2-3, pp. R1–R2.
23. Schmidt M., Sоrensen H.T., Pedersen L. Diclofenac use and cardiovascular risks: series of nationwide cohort studies. BMJ, 2018, vol. 4, pp. 362-372.
24. Schnitzer T. The new analgesic combination tramadol/acetaminophen. Eur. J. Anaesthesiol., suppl. 2003, vol. 28, pp. 13-17.
25. Singh G. Gastrointestinal complications of prescription and over-the-counter nonsteroidal anti-inflammatory drugs: a view from the ARAMIS database. Arthritis, Rheumatism, and Aging Medical Information System. Am. J. Ther., 2000, vol. 7, no. 2, pp. 115-121.
26. Singh G., Rosen R.D. NSAID induced gastrointestinal complications: the ARAMIS perspective – 1997. Arthritis, Rheumatism, and Aging Medical Information System. J. Rheumatol., 1998, vol. 51, no. 3, pp. 8-16.
27. Smalley W.E., Griffin M.R. The risks and costs of upper gastrointestinal disease attributable to NSAIDs. Gastroenterol. Clin. North Am., 1996, vol. 25, no. 2, pp. 373-396.
28. Southall M.D., Li T., Gharibova L.S. et al. Activation of epidermal vanilloid receptor-1 induces release of proinflammatory mediators in human keratinocytes. J. Pharmacol. Exp. Ther., 2003, vol. 304, no. 1, pp. 217-222.
29. Stevens J.P., Wall M.J., Novack L. et al. The Critical Care Crisis of Opioid Overdoses in the United States. Ann. Am. Thorac. Soc., 2017, vol. 14, no. 12, pp. 1803-1809.
30. Tonussi C.R., Ferreira S.H. Mechanism of diclofenac analgesia: direct blockade of inflammatory sensitization. Eur. J. Pharmacol., 1994, vol. 14, no. 251 (2-3), pp. 173-179.
31. Torebjörk H.E., Lundberg L.E., LaMotte R.H. Central changes in processing of mechanoreceptive input in capsaicin-induced secondary hyperalgesia in humans. J. Physiol., 1992, vol. 448, pp. 765-780.
32. Tsai J.C., Lin C.Y., Sheu H.M. et al. Noninvasive characterization of regional variation in drug transport into human stratum corneum in vivo. Pharm. Res., 2003, vol. 20, no. 4, pp. 632-638.
33. Wang L., Hilliges M., Jernberg T. et al. Protein gene product 9.5–immunoreactive nerve fibres and cells in human skin. Cell Tissue Res., 1990, vol. 261, no. 1, pp. 25-33.
34. Warner T.D., Mitchell J.A. Cyclooxygenases: new forms, new inhibitors, and lessons from the clinic. FASEB J., 2004, vol. 18, no. 7, pp. 790-804.
35. Wenk H.N., Brederson J.D., Honda C.N. Morphine directly inhibits nociceptors in inflamed skin. J. Neurophysiol., 2006, vol. 95, no. 5, pp. 2083-2097.
36. Wenk H.N., Honda C.N. Immunohistochemical localization of delta opioid receptors in peripheral tissues. J. Comp. Neurol., 1999, vol. 408, no. 4, pp. 567-579.
37. Wolfe M.M., Lichtenstein D.R., Singh G. Gastrointestinal toxicity of nonsteroidal antiinflammatory drugs. N. Engl. J. Med., 1999, vol. 17, no. 24, pp. 1888-1899.
38. Wright J.M. The double-edged sword of COX-2 selective NSAIDs. CMAJ, 2002, vol. 12, no. 10, pp. 1131-1137.
39. www.accessdata.fda.gov/drugsatfda_docs/label/2009/022122s006lbl.pdf
40. Zelcer S., Kolesnikov Y., Kovalyshyn I. et al. Selective potentiation of opioid analgesia by nonsteroidal anti-inflammatory drugs. Brain. Res., 2005, vol. 8, no. 1-2, pp. 151-156.
41. Zhang W.Y., Li Wan P.A. Analgesic efficacy of paracetamol and its combination with codeine and caffeine in surgical pain – a meta-analysis. J. Clin. Pharm. Ther., 1996, vol. 21, no. 4, pp. 261-282.
Review
For citations:
KOLESNIKOV Yu.А. PROSPECTS OF USING A COMBINATION OF LOCALLY INJECTED NON-STEROIDAL ANTI-INFLAMMATORY DRUGS AND OPIOIDS IN PERIPHERAL PAIN MANAGEMENT. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2019;16(3):41-47. (In Russ.) https://doi.org/10.21292/2078-5658-2019-16-3-41-47
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