Expert opinion on pharmacotherapy
-
Expert Opin Pharmacother · Dec 2007
Randomized Controlled Trial Comparative StudyPatient-controlled intravenous analgesia with remifentanil in nulliparous subjects in labor.
in this study we controlled the efficiency and safety of using remifentanil combined with two different supplementary background infusions for labor analgesia in nulliparous patients. ⋯ it was determined that remifentanil with a 15-mug demand dose and 0.15 mug/kg/min supplementary continuous infusion is an effective choice for patient-controlled analgesia during labor in nulliparous subjects.
-
Expert Opin Pharmacother · Dec 2007
ReviewRecent advances, trends and economic considerations in the risk assessment, prevention and treatment of postoperative nausea and vomiting.
During the last two decades there have been considerable achievements regarding the management of postoperative nausea and vomiting (PONV). Due to the importance of these symptoms in the aim to streamline clinical processes and to improve patient satisfaction, the debate on the best strategies and also research that focuses on PONV continues. This review summarises the recent developments with respect to the management of PONV. ⋯ The new neurokinin-1 receptor antagonist, aprepitant, and the long lasting 5-HT(3) receptor antagonist palonosetron are the latest developments in this context. Treatment is most important and can also be regarded as a secondary prevention. Due to limited efficacy of single treatment interventions, combination therapy may gain more widespread use in the future.
-
Expert Opin Pharmacother · Dec 2007
ReviewFentanyl buccal tablet: rapid relief from breakthrough pain.
Breakthrough pain--a transient increase in pain occurring over a baseline of controlled persistent pain--represents an important clinical challenge in the management of cancer and other chronic pain conditions. The fentanyl buccal tablet is a new sugar-free, easily-administered formulation that uses an effervescent drug delivery system to enhance the rate and extent of fentanyl absorption across the buccal mucosa. ⋯ Fentanyl buccal tablets are generally well tolerated, with the most commonly observed adverse events being typical opioid side effects. Fentanyl buccal tablets represent a convenient and effective treatment for the control of breakthrough pain.
-
Expert Opin Pharmacother · Dec 2007
ReviewPregabalin in the management of central neuropathic pain.
Central neuropathic pain is a painful condition, often severe, that occurs in a person who is already affected by an injury or disease of the brain or spinal cord. This dual insult is especially threatening to the quality of life of a person and their ability to perform even the most basic of tasks. ⋯ However, two randomised placebo-controlled studies have recently emerged demonstrating efficacy of pregabalin in reducing central neuropathic pain due to spinal cord injury and central poststroke pain. Pregabalin, an anticonvulsant, has been shown to be efficacious in the management of peripheral neuropathic pain of various causes and now may have a role to play in central neuropathic pain.
-
Frovatriptan belongs to the triptan compounds used for the acute treatment of migraine. Its affinity for the migraine-specific serotonin 5HT1B-receptors is highest in the class. Its long half-life in plasma (26 h) and metabolism by multiple pathways are unique characteristics among the triptans. ⋯ Frovatriptan was better tolerated than sumatriptan in a head-to-head comparison study. Frovatriptan could make its mark especially in slowly progressing migraine attacks and in attacks that are highly predictable. For example, for the short-term prophylaxis of menstrual migraine, frovatriptan is the triptan of first choice.