Effect of nonsteroidal anti-inflammatory drugs on colorectal distension-induced visceral pain

Abstract

Objectives:To investigate nonsteroidal anti-inflammatory drugs effectiveness in colorectal distension (CRD)-induced visceral pain model.Materials and Methods:Male Sprague–Dawley (250–300 g) rats were anesthetized with ketamine (50 mg/kg, intraperitoneally [i.p.]) and chlorpromazine (25 mg/kg, i.p.). Two bipolar Teflon-coated Ni/Cr wire electrodes (80-M diameter) were placed in the abdominal external oblique muscle for the recording of electromyography. Jugular vein catheter was placed for the administration of drugs. CRD method was applied to evaluate of visceral pain. All drugs (paracetamol, meloxicam, metamizole, and dexketoprofen) administered intravenously.Results:Paracetamol 200, 400, and 600 mg/kg did not change the visceromotor response (VMR) when compare with the control group. Meloxicam 2 and 4 mg/kg showed no effect but at doses of 6 mg/kg meloxicam significantly ([51.9 ± 6.4%] [P < 0.001]) decreased VMR compared with the control group. Metamizole 200 mg/kg did not change responses but dose of 400 and 600 mg/kg metamizole reduced VMR. Dexketoprofen 2 and 4 mg/kg did not cause a change in VMR but 6 mg/kg dose significantly reduced response compared with the control group ([43.9 ± 3.9%, 36.8 ± 2.8%, 34.8 ± 2.5%, 42.1 ± 4.8%, 40.7 ± 3.5%, 36.4 ± 2.7%, and 26.1 ± 2.2%]; from 10 min to 70 min, respectively, [P < 0.05]).Conclusion:Metamizole, dexketoprofen and meloxicam show antinociceptive effect with different duration of action on CRD-induced visceral pain model. This condition can be explained due to different chemical structures and different mechanisms which play a role in modulation of pain.

Educational Interventions for Medical Students to Improve Pharmacological Knowledge and Prescribing Skills: A Scoping Review

“…Over the last two decades, the WHO GGP was widely reported as one of the cornerstones of prescribing education, and this is consistent with the findings of this review [10][11][12]. Thirty-five studies included in the current review aimed to improve prescribing skills, and six of these explicitly reported designing their educational interventions based on the WHO GGP six-step approach [20,36,53,64,80,89]. All six studies reported positive Kirkpatrick level 1 outcomes and four of these also reported positive Kirkpatrick level 2 findings [20,36,53,64].…”

“…Eleven studies used multicomponent interventions [42,52,53,67,71,[89][90][91][92][93][94], and of these, seven focused on prescribing skills and four on clinical pharmacology knowledge. Among all seven studies on prescribing skills, the most common components included prescription writing exercises (4 studies) [42,53,71,89], case-based learning (3 studies) [90,91,94], and group discussions (3 studies) [42,53,71].…”

“…Eleven studies used multicomponent interventions [42,52,53,67,71,[89][90][91][92][93][94], and of these, seven focused on prescribing skills and four on clinical pharmacology knowledge. Among all seven studies on prescribing skills, the most common components included prescription writing exercises (4 studies) [42,53,71,89], case-based learning (3 studies) [90,91,94], and group discussions (3 studies) [42,53,71]. Three studies reported positive Kirkpatrick level 2c outcomes -statistically significant improvement in prescription writing and medication communication skills [53,71,94] and another reported retention of prescribing skills four years after the intervention (42).…”