摘要:

SummaryThe problem of pain and its treatment is reviewed, particularly in relation to advanced cancer and other chronic conditions in which persistent pain demands relief. The nature of pain, its assessment and treatment options are discussed briefly, as is the use of different types of analgesics to raise the patient's pain threshold. The importance of regular reassessment of the patient and his needs, and the setting of realistic analgesic treatment objectives, such as an initial target of a pain-free full night's sleep, is stressed.

ISSN:0300-7995    

DOI:10.1185/03007997809108992

出版商:Taylor&Francis    

年代:1978

数据来源: Taylor

摘要:

SummaryStudies are reviewed on diflunisal, a new analgesic agent with an improved therapeutic index, compared with acetylsalicylic acid, in animals and humans. Pharmacokinetic data indicate that a twice-daily dosage regimen of diflunisal is adequate for therapeutic purposes. Diflunisal inhibits prostaglandin E synthesis, but in humans at clinically effective doses it does not alter bleeding time or platelet aggregation. Diflunisal is uricosuric at clinically effective doses. No clinically important drug interactions with diflunisal have been found to date, although some slight alterations in blood and urine drug levels have been noted. The slight increase in prothrombin time seen when diflunisal and acenocoumarol were co-administered is not considered to be of major clinical importance.

ISSN:0300-7995    

DOI:10.1185/03007997809108993

出版商:Taylor&Francis    

年代:1978

数据来源: Taylor

摘要:

SummarySome of the difficulties encountered in investigations of long-term drug nephrotoxicity are reviewed, and the evidence for acute and chronic renal damage induced by aspirin is discussed. Two studies were carried out to investigate the acute effects of diflunisal on the kidney, and to compare its effects with those of aspirin. Measurements were made before, during and after drug intake, of epithelial cells and lysosomal enzyme (β-d-n-acetyl glucosaminidase) excretion in urine. Diflunisal caused no change in cell excretion and no increase in enzyme excretion in 6 normal volunteers. In a comparative study against aspirin, two groups of 12 patients being treated for osteoarthrosis were observed over an 8-week period. Enzyme excretion increased in both groups and appeared to be dose related. The increase, however, was relatively greater in the aspirin group. The possible significance of these findings is discussed.

ISSN:0300-7995    

DOI:10.1185/03007997809108994

出版商:Taylor&Francis    

年代:1978

数据来源: Taylor

摘要:

SummaryFaecal blood loss was measured in normal male volunteers using51Cr-labelled red cells. In a double-blind parallel study in 10 subjects, the effect of 250 mg diflunisal twice daily was compared with 750 mg aspirin 4-times daily. Drugs were taken during two 7-day periods separated by a 1-week control period. Mean daily faecal blood loss during the two treatment periods was 0.32 ml and 0.53 ml in the diflunisal group versus 6.87 ml and 3.20 ml in the aspirin group. Diflunisal did not significantly increase blood loss, while aspirin had a significant effect. In a double-blind crossover study in 12 subjects, the effect of 250 mg diflunisal twice daily was compared with 600 mg aspirin 4-times daily. Alcohol (120 ml, 40%) was added during the last 2 days of each 6-day treatment period. Faecal blood loss was not significantly affected by diflunisal and there was also no significant effect on blood loss when alcohol was co-administered. Aspirin significantly increased faecal blood loss and this effect was significantly enhanced by the addition of alcohol.

ISSN:0300-7995    

DOI:10.1185/03007997809108995

出版商:Taylor&Francis    

年代:1978

数据来源: Taylor

摘要:

SummaryA double-blind, randomized trial was carried out in 90 patients to compare the analgesic and anti-inflammatory efficacy of 500 mg diflunisal twice daily with that of 25 mg codeine phosphate 4-times daily and of placebo in relieving pain and swelling after surgical removal of impacted third molars. Diflunisal was found to be superior to codeine and placebo on the first post-operative day, but the difference in efficacy of the drugs had diminished by the third post-operative day. In the diflunisal group of 30 patients, 10 (33%) developed‘dry socket’or alveolitis sicca dolorosa. Only 2 patients in the codeine group and 1 patient in the placebo group developed this very painful condition. The possible explanation of‘dry socket’is discussed.

ISSN:0300-7995    

DOI:10.1185/03007997809108996

出版商:Taylor&Francis    

年代:1978

数据来源: Taylor

摘要:

SummaryA series of double-blind randomized trials was carried out in patients suffering from moderate to severe pain after meniscectomy to assess the analgesic effectiveness of diflunisal. In a single-dose study, 150 patients received either diflunisal (125 mg, 250 mg or 500 mg), aspirin (600 mg), or placebo, and hourly assessments were made of pain severity over an 8-hour period. The results showed that 500 mg diflunisal produced comparable relief to aspirin within 3 to 4 hours, but the analgesic effect continued for longer and was still very marked after 8 hours. A multi-dose study in 120 patients receiving doses of diflunisal (375 mg or 500 mg) or placebo confirmed the overall effectiveness of twice daily treatment with diflunisal. In a comparative study against oxyphenbutazone (200 mg t.i.d.), hourly pain scores made on the first postoperative day showed that a single dose of 500 mg diflunisal produced comparable relief over a 12-hour period to that with 2 doses of 200 mg oxyphenbutazone. Overall response to multiple doses was assessed as excellent or good by all the patients receiving diflunisal. Preliminary results are reported on the use of diflunisal in other painful conditions.

ISSN:0300-7995    

DOI:10.1185/03007997809108997

出版商:Taylor&Francis    

年代:1978

数据来源: Taylor

摘要:

SummaryA double-blind randomized trial was carried out in 161 primiparous women suffering from moderate to severe post-episiotomy pain to compare the analgesic efficacy of single doses of diflunisal (125 mg, 250 mg, or 500 mg), aspirin (600 mg), and placebo. The results of pain rating assessments made before and at hourly intervals after drug administration showed that both the active drugs were more effective than placebo and produced similar pain relief over the first 4 hours. The analgesic efficacy of aspirin tailed off after 4 hours but pain relief with 500 mg diflunisal was still evident after 8 hours. Over 65% of patients in the diflunisal group had effective relief of pain at 8 hours whereas there was no significant difference between the aspirin and placebo-treated groups by the seventh and eighth hour.

ISSN:0300-7995    

DOI:10.1185/03007997809108998

出版商:Taylor&Francis    

年代:1978

数据来源: Taylor

摘要:

SummaryAn on-going double-blind study was carried out in women requiring pain relief after episiotomy to compare the efficacy of 500 mg diflunisal twice daily, 65 mg dextro-propoxyphene plus 650 mg paracetamol 3-times daily, and placebo. Fifty-seven patients, allocated at random to receive 2-days' treatment with one or other of the trial drugs, have been studied to date. The preliminary results, as assessed by descriptive rating scales, showed that all three treatments were equally effective in relieving spontaneous pain and pain at night. Patients' overall opinion showed no difference between treatments although the investigator assessed diflunisal to be better than the combined preparation and both to be better than placebo. A visual analogue scale of assessment is to be used for the remainder of the trial.

ISSN:0300-7995    

DOI:10.1185/03007997809108999

出版商:Taylor&Francis    

年代:1978

数据来源: Taylor

摘要:

SummaryA double-blind randomized trial was carried out in 60 patients with osteoarthrosis of the hip or knee to assess the relative efficacy and tolerance of treatment with diflunisal twice daily (maximum 750 mg per day) or with aspirin given 4-times daily (maximum 3 g per day) over a period of 12 weeks. Clinical assessments were made on entry and at regular intervals of weight-bearing pain, night pain, specific function pain, inactivity stiffness, and range of joint movement. A considerable proportion of patients in both groups showed improvement in all parameters except for limitation of movement. The difference in response between the two groups was not statistically significant, neither was the patients' overall opinion of response to or clinician's assessment of therapeutic efficacy of either drug treatment at the end of the trial. Ten of the 29 patients in the aspirin group had to withdraw because of adverse reactions, mainly gastro-intestinal, compared with 4 of the 31 patients in the diflunisal group. The overall incidence of side-effects in all patients was lower in the diflunisal group, and those that were reported were less disturbing. At the end of the double-blind study, patients were given the option to continue with the particular drug treatment for a further two 13-week periods. More patients chose to remain on diflunisal than on aspirin at the end of each of the three periods and the difference was statistically significant.

ISSN:0300-7995    

DOI:10.1185/03007997809109000

出版商:Taylor&Francis    

年代:1978

数据来源: Taylor

摘要:

SummaryA double-blind trial was carried out in 37 patients with osteoarthrosis to compare the efficacy and tolerance of 250 mg diflunisal twice daily with that of 400 mg ibuprofen 3-times daily over an 8-week period. Rating scale assessments were made, at the end of a preceding 1-week wash-out period on placebo and at regular fixed intervals, of weight-bearing pain, night pain, a specific functional activity, and of the duration of inactivity stiffness. Patients' and physician's overall evaluations of response, taking side-effects into account, were made on completion of the study. The data collected indicated that in 30 patients completing the trial both treatments produced similar overall results and, with the exception of weight-bearing pain which appeared to be improved more in the ibuprofen group, diflunisal provided equal therapeutic benefit with fewer side-effects.

ISSN:0300-7995    

DOI:10.1185/03007997809109001

出版商:Taylor&Francis    

年代:1978

数据来源: Taylor