Nonsteroidal Anti-inflammatory Drugs, Acetaminophen, and COX-2 Inhibitors

Allodynia Is Associated With Initial and Sustained Response to Acute Migraine Treatment: Results from the American Migraine Prevalence and Prevention Study

“…The absence of 5-HT 1d receptors on the second-order sensory neurons may explain the reduced efficacy of triptans once allodynia develops; triptans do not inhibit the endogenous activity (which is independent of the pain signals they receive from the meningeal nociceptors) in the sensitized neurons of the spinal trigeminal nucleus. 30,34,35 Poor central nervous system penetration of nonparenteral NSAIDs, resulting in low drug concentration in the cerebrospinal fluid and dorsal horn, 36 may explain the NSAIDs results, which are in sharp contrast to the therapeutic effects of parenteral NSAIDS, such as ketorolac. 17 Regarding the other drugs, opioids are usually excitatory, rather than inhibitory in the dorsal horn, 37,38 potentially by interfering with glutamate clearance from the synapse 39 ; barbiturates, which suppress neuronal firing by increasing chloride conductance through its binding to the GABA A receptor, 40 are thought to achieve their therapeutic effects mainly by increasing GABA level in supraspinal brain areas rather than in the spinal cord 41 ; and ergot alkaloids are thought to exert their anti-migraine effects by acting mainly on peripheral tissues (through 5-HT 1,2 receptors, a1and a2-adrenoceptors, and D 2 -like dopamine receptors) to prevent release of vasoactive neuropeptides and cause vasoconstriction of peripheral blood vessels.…”

Perbedaan Kualitas Hidup antara Berbagai Metode Manajemen Nyeri pada Pasien Nyeri Kronis

“…Pasien nyeri kronis pada kelompok ini, memiliki ketergantungan yang cukup besar terhadap obat-obatan dan adanya kombinasi obat penyakit lain yang dikonsumsi oleh pasien nyeri kronis. Selain itu, ketidakpatuhan pasien nyeri kronis dalam menjalani fisioterapi dimana program yang seharusnya dijalani 6 kali hanya dilakukan beberapa kali saja, tidak menerapkan latihan fisik yang disarankan oleh dokter rehabilitasi medik saat berada di rumah dan hanya melakukan fisioterapi saat berada di rumah sakit serta melakukan aktivitas fisik yang salah sehingga menyebabkan nyeri kambuh kembali (Buvanendran & Lipman, 2010;Feinberg et al, 2012). Hal inilah yang menyebabkan kualitas hidup pasien nyeri kronis pada kelompok ini paling rendah bila dibandingkan ketiga kelompok yang lain.…”

Stress-Induced Pain: A Target for the Development of Novel Therapeutics

“…These compounds can produce significant pain relief through a direct effect on pain pathways; however, the use of these drugs is limited by side effects, including nausea, constipation, and respiratory depression, as well as the potential for tolerance and dependence with chronic use. Nonsteroidal anti-inflammatory drugs are another therapeutic option for pain management (Buvanendran and Lipman, 2010;. Broadly, this class of compounds includes diverse agents, such as ibuprofen, naproxen sodium, celecoxib, and meloxicam.…”