Tag Archives: medication

IV APAP of Little Benefit for Cardiothoracic Post-op Pain

IV APAP of Little Benefit for Cardiothoracic Post-op Pain – Pain Medicine Newsby Kenneth Bender – Aug 2019

This is an amazingly honest negative evaluation of IV Tylenol, which some people claimed was just as effective as opioids. But this study is a reality check and brings more science and less hype to the overcrowded field of opioid/pain studies.

Intravenous acetaminophen provided little benefit in multimodal analgesia regimens for cardiothoracic postoperative pain and posed a risk for hypotension, according to a study of outcomes in a real-world population.

I’m thrilled to hear it stated so definitively after so many years of hearing how great of a pain killer Tylenol is.  Continue reading

Long-term opioid therapy for chronic pain

Long-term opioid therapy in chronic noncancer pain. NIH – Feb 2015 – a systematic review and meta-analysis of efficacy, tolerability, and safety in open-label extension trials with a study duration of at least 26 weeks (that’s 1/2 year).

This study confirms what pain patients all know: long-term opioids are effective for long-term pain, require few increases, and only rarely result in “opioid use disorder”. 

The efficacy and safety of long-term (≥ 6 months) opioid therapy (LtOT) in chronic noncancer pain (CNCP) is under debate.A systematic review with meta-analysis of the efficacy and harms of opioids in open-label extension studies of randomized controlled trials (RCTs) has not been conducted until now.   Continue reading

OTC Pain Medications: The Pros and Cons

OTC Pain Medications: The Pros and Cons – Pharmacy Times – by Kathleen Kenny, PharmD, RPH – Aug 2017

OTC pain medications are, by far, the most widely used of the OTC medications.

Two types of OTC pain medications are available.

  1. The first is acetaminophen (N-acetyl-p-aminophenol, or APAP), and
  2. the second is nonsteroidal anti-inflammatory drugs (NSAIDs), which include ibuprofen, naproxen, and aspirin.

Continue reading

NGF Inhibitor leads to rapid joint destruction

NGF Inhibitor Reduces Joint Pain but Raises Risk for Deterioration – Pain Medicine News – Oct 2019

Tanezumab, an investigational monoclonal antibody that inhibits nerve growth factor, improved joint pain and physical function in patients with osteoarthritis, in a placebo-controlled clinical trial.

Although the agent demonstrated efficacy relative to placebo in study participants who had not obtained relief with conventional agents, the investigators characterized the improvement with tanezumab as modest, and found that it was associated with an increased incidence of rapidly progressive osteoarthritis (OA) and a requirement for total joint arthroplasty.

Such adverse effects would doom any other medication, but this one keeps getting promoted only because it’s not an opioid.  Continue reading

The absurd trashing of antidepressants

Why the constant trashing of antidepressants is absurd – Vasco M Barreto | Aeon Essays

I was first prescribed antidepressants in 2000. Ever since, I have been on and off these drugs, mostly because the idea of taking them made me uncomfortable.

It was a mixture of guilt, probably not unlike the guilt some athletes must feel for taking a prohibited doping substance; shame for needing a pill that had such a profound impact on my behaviour; and frustration with the recurrent episodes of depression that would bring me back to the antidepressants I would then quickly abandon.

I broke this cycle when my daughters were born and I realised that it would be irresponsible to stop treatment because being a good father meant having a stable mood.   Continue reading

Indian industry in denial over drug-quality charges

Indian pharmaceutical industry in denial over drug-quality charges – STAT

Katherine Eban’s new book, “Bottle of Lies,” has focused a very intense spotlight on the mostly ignored transgressions of the Indian generic pharmaceutical industry in the processes they follow — or all too often don’t follow — to make quality products.

This industry, which has rarely been subjected to such rigorous journalistic scrutiny, has lashed back at Eban, attacking her integrity and her work.

The latest salvo comes from Kiran Mazumdar Shaw, who calls Eban’s exposé anecdotal, biased, unfair, and unbalanced, and accuses the author of playing up to the poor perceptions of the Indian pharmaceutical industry and the country.   Continue reading

Non-Opioid Medication May Reduce Pain

Novel, ‘Non-Habit Forming’ Medication May Reduce Low Back PainNancy A. Melville – Apr 2019

A novel, “non-habit-forming” neurosteroidappears to be effective and well tolerated in the treatment of chronic low back pain, new research suggests.

In a double-blind, randomized controlled trial of almost 100 Iraq/Afghanistan-era veterans, those treated with a pharmaceutical-grade tablet formulation of pregnenolone showed “significant and meaningful reductions” in low back pain intensity ratings at 6 weeks compared with their peers who received matching placebo, investigators report.

I’m excited about this because pregnenolone is an over-the-counter supplement available to us all.
Continue reading

Pregabalin (Lyrica) for Anxiety

Because I’m plagued by anxiety, I’m always interested in any unorthodox methods of dealing with it. While “benzos” would work for the immediate problem, I can’t (and am not allowed to with my opioids) take them all the times I’m anxious.

With all my researching, I’m surprised to discover that I missed a solution that seems obvious in retrospect: the Lyrica I’m prescribed, which I take on an “as needed” basis for a certain kind of pain, can also act as an anti-anxiety medication.

Here are a couple of PubMed abstracts showing that Lyrica (pregabalin) has been evaluated for anxiety for years already: Continue reading

Generic Drugs Are Poisoning Us

A New Book Argues That Generic Drugs Are Poisoning Us – New York Times  – By David Dobbs – May 13, 2019

This is a review of a recently published book exposing the seamy side of the “profit above all else” generic drug industry:

The Inside Story of the Generic Drug Boom
By Katherine Eban

I’ve always been suspicious of generic drugs because I’ve noticed that my body sometimes reacts slightly differently to a new batch, and often reacts very differently to a switch from brand-name medications to generic. This book validates my concerns and even adds new ones.  Continue reading

Pregabalin Rectifies Aberrant Brain Chemistryń

Brain imaging reveals dynamic changes caused by pain medicines | University of Michigan Health System – University of Michigan – 2013 (no longer available online in 2019. This is a repost with new relevance)

…the implication is that at least one factor in chronic pain can now be visualized by computer imaging.  Pregabalin (Lyrica) soothes the insula, and the changes in insula activity and corresponding decreasing pain levels were made visible for the first time.

So far, we’ve only had static images of brains to compare those of people with chronic pain to those who are pain-free, but now we can compare the changes as they happen in a single individual.  Continue reading