Using evidence from different sources: an example using paracetamol 1000 mg plus codeine 60 mg

Smith, L. A.; Moore, R Andrew; McQuay, Henry J; Gavaghan, David

doi:10.1186/1471-2288-1-1

Cited by 37 publications

(19 citation statements)

References 55 publications

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“…Currently, many different classes of drugs serve as an effective complement to non-steroidal anti-inflammatory drugs (NSAIDs) or opioids in the management of pain. Opioids have frequently been used in combination with NSAIDs for the clinical management of both acute and chronic pain (Cooper et al, 1982;Minotti et al, 1989;Sun et al, 1993;Collins et al, 2000;Smith et al, 2001;Schnitzer, 2003;Oldfield and Perry, 2005); this limits the doses of medication that a patient can receive.…”

Section: Introductionmentioning

confidence: 96%

The combination of naproxen and citral reduces nociception and gastric damage in rats

et al. 2010

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It has been shown that the association of non-steroidal anti-inflammatory drugs with plant extracts can increase their antinociceptive activity, allowing the use of lower doses and, thus, limiting side effects. Therefore, the aim of this study was to examine the effects of the interaction between naproxen and citral on nociception and gastric injury in rats. Naproxen, citral, or combinations of naproxen and citral produced an antinociceptive effect. The administration of naproxen produced significant gastric damage, but this effect was not obtained with either citral or the naproxen-citral combination. The ED(50) value was estimated for the individual drugs and an isobologram was constructed. The derived theoretical ED(50) for the antinociceptive effect (423.8 mg/kg) was not significantly different from the observed experimental value (359.0 mg/kg); hence, the interaction between naproxen and citral mediating the antinociceptive effect is additive. These data suggest that the naproxen-citral combination interacts at the systemic level, produces minor gastric damage, and potentially has therapeutic advantages for the clinical treatment of inflammatory pain.

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Section: Introductionmentioning

confidence: 96%

The combination of naproxen and citral reduces nociception and gastric damage in rats

et al. 2010

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“…The purpose is to associate two or more drugs with different mechanisms of action in order to achieve a synergistic interaction, yielding a sufficient antinociceptive effect with low doses, and therefore reducing the intensity and incidence of untoward effects (Curatolo and Sveticic, 2002). Predominantly, most of opioids are clinically associated with acetaminophen or the NSAIDs acetylsalicylic acid, diclofenac or ibuprofen (Cooper et al, 1982;Minotti et al, 1989;Sun et al, 1993;Collins et al, 2000;Smith et al, 2001;Schnitzer, 2003;Oldfield and Perry, 2005), thus limiting the dosages of medication that a patient can receive. In this respect, opioids have been frequently used in combination with non-steroidal anti-inflammatory drugs (NSAIDs) in the clinical management of acute and chronic pain.…”

Section: Introductionmentioning

confidence: 99%

Examination of the interaction between peripheral lumiracoxib and opioids on the 1% formalin test in rats

Ortiz

Castañeda‐Hernández

2008

European Journal of Pain

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It has been shown that the association of non-steroidal anti-inflammatory drugs (NSAIDs) with opioid analgesic agents can increase their antinociceptive activity, allowing the use of lower doses and thus limiting side effects. Therefore, the aim of the present study was to examine the possible pharmacological interaction between lumiracoxib and codeine or nalbuphine at the local peripheral level in the rat using the 1% formalin test and isobolographic analysis. Lumiracoxib, codeine, nalbuphine or fixed-dose ratios lumiracoxib-codeine or lumiracoxib-nalbuphine combinations were administrated locally in the formalin-injured paw and the antinociceptive effect was evaluated using the 1% formalin test. All treatments produced a dose-dependent antinociceptive effect. ED(40) values were estimated for the individual drugs and an isobologram was constructed. The derived theoretical ED(40)'s for the lumiracoxib-codeine and lumiracoxib-nalbuphine combinations were 423.4+/-31.3 microg/paw and 310.9+/-24.2 microg/paw, respectively, being significantly higher than the actually observed experimental ED(40) values, 233.2+/-30.9 microg/paw and 132.7+/-11.6 microg/paw, respectively. These results correspond to a synergistic interaction between lumiracoxib and opioids at the local peripheral level, potency being about two times higher with regard to that expected from the addition of the effects of the individual drugs. Data suggest that low doses of the lumiracoxib-opioids combination can interact synergistically at the peripheral level and therefore this drug association may represent a therapeutic advantage for the clinical treatment of inflammatory pain.

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“…Literature search using this hierarchy ensured that high quality evidence was preferentially sought and included; at the same time, it allowed different study designs to be included; without resorting to data likely to be biased [5]. Table V summarizes the Methodology process.…”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

“…com/view/0/index.html). It has been shown that a brief RCT search strategy comprising these databases is generally sufficient to locate trials for systematic reviews in most cases and exhaustive searching is no longer regarded cost-effective, if the most important databases have been covered [5].…”

Section: Sources Of Literaturementioning

confidence: 99%

UNICEF-PHFI series on newborn and child health, India: Methodology for systematic reviews on child health priorities for advocacy and action

et al. 2011

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India is committed to reducing childhood mortality and morbidity. This requires evidence-based policy and practice in the realm of public health. This in turn necessitates advocacy and action (among all stakeholders), focused on locally relevant issues. A collaboration to work towards this goal was forged between the Public Health Foundation of India (PHFI), United Nations International Childrens Emergency Fund (UNICEF), India; and a team of independent researchers. As a first step, a systematic review of literature on four priority areas of newborn care (community based interventions) and child health (acute respiratory infection, diarrheal disease, anemia), was undertaken to address important issues including epidemiology, interventions for management, and operational issues of planning, implementing, and measuring actions at a programmatic level. This paper describes the development of the methodology for undertaking these systematic reviews including the process for framing of research questions, building a research team, and executing the systematic review (literature search strategy, data extraction, analysis, and reporting). The challenges associated with ensuring robust methodology, are also described.

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Using evidence from different sources: an example using paracetamol 1000 mg plus codeine 60 mg

Cited by 37 publications

References 55 publications

The combination of naproxen and citral reduces nociception and gastric damage in rats

The combination of naproxen and citral reduces nociception and gastric damage in rats

Examination of the interaction between peripheral lumiracoxib and opioids on the 1% formalin test in rats

UNICEF-PHFI series on newborn and child health, India: Methodology for systematic reviews on child health priorities for advocacy and action

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