Clinical and experimental pharmacology & physiology
-
Clin. Exp. Pharmacol. Physiol. · Jun 2021
Meta AnalysisColchicine treatment can improve outcomes of coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis.
Currently, there is no widely acceptable and proven effective treatment for coronavirus disease 2019 (COVID-19). Colchicine has been shown to offer a benefit in reducing the inflammation in several inflammatory diseases. This study aims to analyze the efficacy of colchicine administration and outcomes of COVID-19. ⋯ This meta-analysis showed that the administration of colchicine was associated with improvement of outcomes of COVID-19 [OR 0.43 (95% CI 0.34-0.55), p < 0.00001, I2 = 0%, fixed-effect modelling] and its subgroup which comprised of reduction from severe COVID-19 [OR 0.44 (95% CI 0.31-0.63), p < 0.00001, I2 = 0%, fixed-effect modelling] and reduction of mortality rate from COVID-19 [OR 0.43 (95% CI 0.32-0.58), p < 0.00001, I2 = 0%, fixed-effect modelling]. Our study suggests the routine use of colchicine for treatment modalities of COVID-19 patients. More randomized clinical trial studies are still needed to confirm the results from this study.
-
Clin. Exp. Pharmacol. Physiol. · Aug 2020
Meta AnalysisDexmedetomidine in the prevention of postoperative delirium in elderly patients following non-cardiac surgery: A systematic review and meta-analysis.
The efficacy of dexmedetomidine in the prevention of postoperative delirium (POD) remains ambiguous, however, it has been used to reduce the incidence of delirium in elderly patients. Here, we conducted a meta-analysis study for assessing the effects of dexmedetomidine on POD among elderly patients following non-cardiac surgery. A systematic literature search was performed against the PubMed, EMBASE, Cochrane Library, and Web of Science databases, and all relevant literature published till November 30, 2019, were considered. ⋯ However, patients who received dexmedetomidine had a higher incidence of bradycardia and hypotension. In conclusion, the meta-analysis revealed that dexmedetomidine appears to decrease the risk of POD in elderly patients following non-cardiac surgery. However, as some of the studies were heterogeneous and of low quality, high-quality trials are necessary for drawing more definitive conclusions.
-
Clin. Exp. Pharmacol. Physiol. · Jan 2016
ReviewNefopam analgesia and its role in multimodal analgesia: A review of preclinical and clinical studies.
Nefopam is a non-opioid, non-steroidal, centrally acting analgesic drug used to prevent postoperative pain, primarily in the context of multimodal analgesia. This paper reviews preclinical and clinical studies in which nefopam has been combined with opioids, non-steroidal anti-inflammatory compounds, and paracetamol. This report focuses on the literature during the last decade and discusses the translational efforts between animal and clinical studies in the context of multimodal or balanced analgesia. ⋯ Nefopam combinations including NSAIDs (ketoprofen or tenoxicam) or paracetamol also demonstrated a synergic interaction or an enhancement of the analgesic effect of the associated compound. In conclusion, this review of nefopam combinations including various analgesic drugs (opioids, NSAIDs and paracetamol) reveals that enhanced analgesia was demonstrated in most preclinical and clinical studies, suggesting a role for nefopam in multimodal analgesia based on its distinct characteristics as an analgesic. Further clinical studies are needed to evaluate the analgesic effects of nefopam combinations including NSAIDs or paracetamol.
-
Clin. Exp. Pharmacol. Physiol. · Jan 2014
ReviewIs there a role for ambulatory blood pressure monitoring in pregnancy?
1. Ambulatory blood pressure monitoring (ABPM) has been used in pregnancy for just over 20 years now and is generally well tolerated. Normal values have been established for different gestations; these are slightly higher than conventional blood pressure (BP) in normal pregnancy, presumably reflecting greater activity during the 24 h of ABPM recordings. 2. ⋯ The best role for ABPM is to determine whether women with office hypertension in early pregnancy have true (usually essential) hypertension or white-coat hypertension. The latter can be managed without antihypertensives and pregnancy outcomes appear good, although possibly with a slightly increased incidence of pre-eclampsia. 6. Women who have had pre-eclampsia are at greater life-time risk for cardiovascular diseases; several years postpartum these women have slightly higher ABPM-measured BP than women who had normal pregnancies and a greater propensity to metabolic syndrome.
-
Clin. Exp. Pharmacol. Physiol. · Nov 2013
ReviewImpact of preterm birth and bronchopulmonary dysplasia on the developing lung: long-term consequences for respiratory health.
Preterm birth affects 8-10% of human pregnancies and is a major cause of long-term disability. Individuals who are born very preterm, especially if they develop bronchopulmonary dysplasia (BPD), have an increased risk of impaired lung function in infancy, childhood and adulthood, as well as an increased risk of respiratory illness. Our aim is to briefly review current understanding of the basis for long-term impairments in lung function and respiratory health following preterm birth and BPD. ⋯ Long-term lung injury apparently relates to the use of mechanical ventilation and the use of supplemental oxygen in infancy. Impaired lung function in later life is due to airway hyper-reactivity and fewer alveoli, resulting in reductions in the surface area for gas exchange and physical support for bronchioles. Because the incidence of preterm birth is not declining, it will continue to be a major cause of respiratory ill-health in adults.