Browsing by Subject "Gabapentin"

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  • Männistö, Ville; Åberg, Fredrik (2020)
    Kipulääkityksen valinta maksasairauden yhteydessä on vaativaa. Moni kipulääke metaboloituu maksan kautta ja saattaa aiheuttaa merkittäviä haittavaikutuksia. Jos potilaalla ei kuitenkaan ole akuuttia maksavauriota ja maksasairaus on kompensaatiossa, voidaan valtaosaa kipulääkkeistä käyttää ainakin lyhytaikaisesti. Parasetamolin käyttöä varotaan monesti turhaan, sillä sen käyttö pienennettyinä annoksina on yleensä turvallista, mikäli maksasairaus ei ole merkittävää eikä potilas käytä liikaa alkoholia tai kärsi aliravitsemuksesta. Sen sijaan tulehduskipulääkkeitä tulisi välttää muun muassa munuaisvaurion uhan ja verenvuotoriskin takia. Myös opioideja tulisi välttää tai käyttää pieninä annoksina harvoin annosvälein enkefalopatiariskin takia. Neuropaattisen kivun hyviä hoitovaihtoehtoja ovat trisykliset masennuslääkkeet, pregabaliini ja gabapentiini.
  • Wei, Hong; Wu, Hai-Yun; Chen, Zuyue; Ma, Ai-Niu; Mao, Xiao-Fang; Li, Teng-Fei; Li, Xin-Yan; Wang, Yong-Xiang; Pertovaara, Antti (2016)
    Spinal transient receptor potential ankyrin 1 (TRPA1) channel is associated with various pain hypersensitivity conditions. Spinally, TRPA1 is expressed by central terminals of nociceptive nerve fibers and astrocytes. Among potential endogenous agonists of TRPA1 is H2O2 generated by D-amino acid oxidase (DAAO) in astrocytes. Here we studied whether prolonged block of the spinal TRPA1 or astrocytes starting at time of injury attenuates development and/or maintenance of neuropathic hypersensitivity. Additionally, TRPA1 and DAAO mRNA were determined in the dorsal root ganglion (DRG) and spinal dorsal horn (SDH). Experiments were performed in rats with spared nerve injury (SNI) and chronic intrathecal catheter. Drugs were administered twice daily for the first seven injury days or only once seven days after injury. Mechanical hypersensitivity was assessed with monofilaments. Acute and prolonged treatment with Chembridge-5861528 (a TRPA1 antagonist), carbenoxolone (an inhibitor of activated astrocytes), or gabapentin (a comparison drug) attenuated tactile allodynia-like responses evoked by low (2 g) stimulus. However, antihypersensitivity effect of these compounds was short of significance at a high (15 g) stimulus intensity. No preemptive effects were observed. In healthy controls, carbenoxolone failed to prevent hypersensitivity induced by spinal cinnamaldehyde, a TRPA1 agonist TRPA1 and DAAO mRNA in the DRG but not SDH were slightly increased in SNI, independent of drug treatment The results indicate that prolonged peri-injury block of spinal TRPA1 or inhibition of spinal astrocyte activation attenuates maintenance but not development of mechanical (tactile allodynia-like) hypersensitivity after nerve injury. (C) 2016 Elsevier Inc. All rights reserved.