International journal of clinical practice. Supplement最新文献_第3页

Population impact of strategies designed to reduce peptic ulcer risks associated with NSAID use. 减少与使用非甾体抗炎药相关的消化性溃疡风险策略的人群影响

International journal of clinical practice. Supplement Pub Date : 2003-04-01

Michael Langman

{"title":"Population impact of strategies designed to reduce peptic ulcer risks associated with NSAID use.","authors":"Michael Langman","doi":"","DOIUrl":"","url":null,"abstract":"The risk of ulcer complications rises steeply with dose for aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) but estimates of the overall incidence of bleeding ulcer are unreliable. Drug utilisation data, epidemiological data on the frequency of bleeding ulcer and death, and the relative risks associated with different NSAIDs, indicate that the number of cases of bleeding ulcer attributable to NSAIDs in the United Kingdom is approximately 2,400. Substitution of ibuprofen at a dose of 2.4 g/day for all other NSAIDs would reduce the number of events attributable to NSAIDs from 2,431 to 695 annually. At a dose of 1200 mg/day, substituting ibuprofen or another safe NSAID would be likely to reduce events to zero. Similarly, substitution of ibuprofen 2.4 g/day for all other NSAIDs would reduce attributable ulcer mortality to 80. The total number of excess cases attributable to aspirin is 753 annually. If prophylactic aspirin was prescribed solely at a dose of 75 mg/day, the number of cases would fall to 445 annually and the number of related deaths from 87 to 51 annually. NSAIDs and aspirin account for approximately one-third and previous ulcer for about one-fifth of the overall risk of bleeding ulcer and its complications.","PeriodicalId":73436,"journal":{"name":"International journal of clinical practice. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22364812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Review of the analgesic efficacy of ibuprofen. 布洛芬镇痛疗效综述。

International journal of clinical practice. Supplement Pub Date : 2003-04-01

William T Beaver

引用次数: 0

Epidemiology overview of gastrointestinal and renal toxicity of NSAIDs. 非甾体抗炎药胃肠道和肾脏毒性的流行病学综述。

International journal of clinical practice. Supplement Pub Date : 2003-04-01

David Henry, Patricia McGettigan

{"title":"Epidemiology overview of gastrointestinal and renal toxicity of NSAIDs.","authors":"David Henry, Patricia McGettigan","doi":"","DOIUrl":"","url":null,"abstract":"This review updates previous systematic reviews to explore the overall levels of risk of serious upper gastrointestinal complications of treatment with non-steroidal anti-inflammatory drugs (NSAIDs) and to investigate the importance of dose in explaining variations in risk. Thirty-six eligible case control studies were published between 1985 and 2000 and involved 19,648 cases and 105,373 controls. Eight eligible cohort studies included around 400,000 exposed subjects and 1 million non-exposed controls. The pooled unadjusted odds ratio from case control studies (compared with non-use of NSAIDs) for serious gastrointestinal complications is 4.06 (CI95% 3.47, 4.75); the pooled odds ratio from cohort studies is 2.29 (CI95% 1.50, 3.51). Unadjusted odds ratios range from 1.81 for ibuprofen to 7.46 for piroxicam. These data require careful interpretation because the statistical power of analyses of individual NSAIDs is lower than that for the class as a whole. There is a rank order of risk for different NSAIDs at low doses but at higher doses the odds ratios tend to converge. Ibuprofen is associated with a lower risk of serious gastrointestinal complications than other NSAIDs; this advantage is probably lost at higher doses (>1800 mg/day).","PeriodicalId":73436,"journal":{"name":"International journal of clinical practice. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22365475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The safety of ibuprofen suspension in children. 布洛芬混悬剂在儿童中的安全性。

International journal of clinical practice. Supplement Pub Date : 2003-04-01

Samuel M Lesko

{"title":"The safety of ibuprofen suspension in children.","authors":"Samuel M Lesko","doi":"","DOIUrl":"","url":null,"abstract":"This paper describes two studies in children with fever in which the safety of ibuprofen was compared with that of paracetamol. The Boston University Fever Study aimed to assess the risk of rare but serious adverse events in febrile children. There were 795 admissions among 84,192 children during the study. There were no significant differences between the drugs in the risk of admission or the risk of secondary endpoints (admissions for asthma or cellulitis, or physician visits for abdominal pain or dyspepsia) and no evidence of clinically significant impairment of renal function. However, ibuprofen was associated with a significantly lower risk of physician visits for asthma: the incidence associated with ibuprofen was 3.0% (CI95% 2.1, 4.1) compared with 5.1% (CI95% 3.5, 7.1) for paracetamol (P = 0.02). The second study was a case control study to investigate a possible association between antipyretic medication, varicella infection and necrotising fasciitis. We identified 52 children aged under 19 years who were admitted to hospital with varicella and Group A streptococcal infection and 172 matched controls with uncomplicated varicella. The risk of invasive Group A streptococcal infection was associated with demographic and environmental factors and persistent high fever. There was no association with the use of ibuprofen or paracetamol alone, but the use of both agents was significantly associated with streptococcal infection. These studies demonstrate that children with fever tolerate treatment with ibuprofen as well as treatment with paracetamol. Neither agent is associated with an increased risk of necrotising soft tissue infections.","PeriodicalId":73436,"journal":{"name":"International journal of clinical practice. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22365476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Relative efficacy of selective COX-2 inhibitors compared with over-the-counter ibuprofen. 选择性COX-2抑制剂与非处方布洛芬的相对疗效比较。

International journal of clinical practice. Supplement Pub Date : 2003-04-01

Raymond Dionne

{"title":"Relative efficacy of selective COX-2 inhibitors compared with over-the-counter ibuprofen.","authors":"Raymond Dionne","doi":"","DOIUrl":"","url":null,"abstract":"Non-steroidal anti-inflammatory drugs (NSAIDs) suppress the activity of both isoforms of cyclo-oxygenase (COX). Inhibition of COX-1, the constitutive isoform, is primarily responsible for the adverse gastrointestinal effects of the NSAIDs whereas inhibition of COX-2, the inducible isoform, accounts for their therapeutic effects. COX-2 inhibitors such as celecoxib and rofecoxib appear to be as effective as non-selective NSAIDs in the treatment of chronic inflammatory disease but their analgesic efficacy and their safety at the higher doses required for analgesia are less certain. There is consistent evidence that COX-1 plays a major role in the early pain response following injury and that analgesia is increased when both COX-1 and COX-2 are inhibited simultaneously. Early postoperative nociception may cause hyperalgesia at a later time by a process of central plasticity. In an experimental model of pain, ibuprofen promptly suppresses prostaglandin E2 concentrations whereas celecoxib has no discernible effect until 90-120 minutes postoperatively, when COX-2 activity is induced. Both drugs significantly reduce pain compared with placebo but celecoxib appears to have a slower onset of action. The analgesic effect of ibuprofen is well characterised for acute pain and short-term treatment is well tolerated.","PeriodicalId":73436,"journal":{"name":"International journal of clinical practice. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22364808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The use of ibuprofen in neonates in the treatment of patent ductus arteriosus. 布洛芬在新生儿动脉导管未闭治疗中的应用。

International journal of clinical practice. Supplement Pub Date : 2003-04-01

Bart Van Overmeire

{"title":"The use of ibuprofen in neonates in the treatment of patent ductus arteriosus.","authors":"Bart Van Overmeire","doi":"","DOIUrl":"","url":null,"abstract":"Indomethacin has long been used to treat patent ductus arteriosus but it is associated with a relatively high risk of adverse effects; recent evidence suggests that ibuprofen is effective and may be safer. In a randomised trial to compare the efficacy and safety of ibuprofen and indomethacin in the treatment of patent ductus arteriosus, 144 infants received three doses of ibuprofen lysine (10, 5 and 5 mg/kg) at 24-hour intervals or indomethacin 0.2 mg/kg at 12-hour intervals. Ductal closure occurred in 70% of children treated with ibuprofen and 66% of those given indomethacin on the first treatment (P = 0.41). Nineteen children underwent surgical ligation, equally distributed between the treatment groups (P = 0.81). Urine production was significantly greater than in children given indomethacin from day 3 to day 7 and the serum creatinine concentration was significantly lower from day 7. Ductal closure was associated with higher serum concentrations of ibuprofen and a concentration of 10-12 mg/l appears to be the minimum level for efficacy. In a randomised, placebo-controlled, double-blind trial of prophylaxis with ibuprofen, the rate of patent ductus arteriosus associated with ibuprofen was 19% compared with 42% with placebo. Urine output was comparable in the two groups except on day 1, when it was significantly lower among infants given ibuprofen. Ibuprofen is therefore as effective as indomethacin in the treatment of patent ductus arteriosus, and effective as prophylaxis, in premature infants.","PeriodicalId":73436,"journal":{"name":"International journal of clinical practice. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22364809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Forty years of ibuprofen use. 用了40年布洛芬。

International journal of clinical practice. Supplement Pub Date : 2003-04-01

Nicholas Moore

{"title":"Forty years of ibuprofen use.","authors":"Nicholas Moore","doi":"","DOIUrl":"","url":null,"abstract":"Low-dose ibuprofen is as effective as aspirin and paracetamol for the indications normally treated with over-the-counter (OTC) medications and is associated with the lowest risk of gastrointestinal toxicity of any non-steroidal anti-inflammatory drug. By contrast, even low-dose aspirin is associated with an appreciable risk of gastrointestinal toxicity. Paracetamol is well tolerated and effective in treating mild to moderate pain but there is growing concern about a possible risk of gastrointestinal toxicity and a possible link with asthma in children. The PAIN (Paracetamol, Aspirin, Ibuprofen New tolerability) study was a blinded randomised comparison of the tolerability of OTC analgesics in the treatment of common types of acute pain encountered in the community. A total of 8,677 adults were randomised to treatment with ibuprofen 1200 mg/day, paracetamol 3 g/day or aspirin 3 g/day for 1-7 days. The most common indications for treatment were musculoskeletal conditions (31-33%), colds or flu (19-20%), backache (15-17%), sore throat (11-12%) and headache (10-11%). Significant adverse events were more common with aspirin (10.1%) than ibuprofen (7.0%) (P<0.001) or paracetamol (7.8%). Significant gastrointestinal events were less frequent with ibuprofen (4.0%) than with aspirin (7.1%, P<0.001) or paracetamol (5.3%) (P=0.025). For every 100 patients treated, five more will experience significant adverse events if they are taking aspirin rather than ibuprofen, and four more than if they were taking paracetamol.","PeriodicalId":73436,"journal":{"name":"International journal of clinical practice. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22364810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Discovery, mechanisms of action and safety of ibuprofen. 布洛芬的发现、作用机制和安全性。

International journal of clinical practice. Supplement Pub Date : 2003-04-01

K D Rainsford

引用次数: 0

Risk factors associated with the development of gastroduodenal ulcers due to the use of NSAIDs. 非甾体抗炎药引起胃十二指肠溃疡的相关危险因素

International journal of clinical practice. Supplement Pub Date : 2003-04-01

M Michael Wolfe

引用次数: 0

The mechanism of action of anti-inflammatory drugs. 抗炎药的作用机制。

International journal of clinical practice. Supplement Pub Date : 2003-04-01

John Vane

引用次数: 0