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Piroxicam as a single dose in treating acute postoperative pain

There is insufficient evidence that single doses of piroxicam provide effective analgesia in adults with acute postoperative pain. This review assessed the efficacy of oral single‐dose piroxicam in adults with moderate/severe postoperative pain using information from randomised placebo controlled trials. The results were based on few data and were not robust. The results suggested that piroxicam (20 mg or 40 mg) was more effective than placebo and comparable to other non‐steroidal anti‐inflammatory drugs and intramuscular morphine 10 mg. Adverse effects were uncommon. The most frequently reported adverse effects were dizziness, nausea and vomiting.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Single dose oral tenoxicam for acute postoperative pain in adults

Pain is commonly experienced after surgical procedures. Acute postoperative pain of moderate or severe intensity is often used (as a model) to test whether or not drugs are effective painkillers. In this case we could find no studies that tested oral tenoxicam against placebo. It is possible that the studies were done, but not reported, because they were used only to register tenoxicam with licensing authorities throughout the world. However, this leaves an important gap in our knowledge, and it means that we cannot be confident about using oral tenoxicam for acute painful conditions.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Single dose lornoxicam (trade names Xefo, Xafon, Lorcam, Acabel) for acute postoperative pain in adults

Lornoxicam is a non‐steroidal anti‐inflammatory drug (NSAID) that is used as a painkiller (analgesic). A high level of pain relief is experienced by about 45% of those with moderate to severe postoperative dental pain after a single dose of lornoxicam 8 mg, compared to about 10% with placebo. This is comparable to the proportion experiencing the same level of pain relief with ibuprofen 200 to 400 mg. Adverse events were generally mild and did not differ from placebo in these singe dose studies. There were insufficient data to assess duration of action, but it is likely to be similar to ibuprofen 200 mg.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Recompression therapy and adjunctive drug therapy for decompression illness (the bends)

Decompression illness (DCI) is due to the presence of bubbles in the tissues or blood vessels following the reduction of surrounding pressure (decompression). It is most commonly associated with breathing compressed gas while diving underwater. The effects of DCI may vary from the trivial to life‐threatening and treatment is usually administered urgently. Recompression is applied while breathing 100% oxygen or a mixture of oxygen and helium (heliox), based on the reduction in bubble size with pressure and more rapid elimination of nitrogen from the bubbles when breathing nitrogen poor mixtures. Recovery without recompression can be slow and incomplete and DCI is responsible for significant health problems in geographical areas where recompression is unavailable. Recompression with 100% oxygen has become universally accepted as the appropriate therapy despite the lack of high quality clinical evidence of effectiveness. This review found only two randomized trials enrolling a total of 268 patients. One trial compared standard oxygen recompression to helium and oxygen recompression, while the other compared oxygen recompression alone to recompression and an adjunctive non‐steroidal anti‐inflammatory drug (NSAID). Both trials suggested that these additional interventions may shorten the course of recompression required. For example, the use of an NSAID reduced the median number of recompression sessions required from three to two. We conclude that there is little evidence for using one recompression strategy over another in the treatment of decompression illness and that the addition of an anti‐inflammatory drug may shorten the course of recompression required. More research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Nonsteroidal anti‐inflammatory drugs are effective treatment for acute renal colic

Acute renal colic is the pain caused by the blockage of urine flow secondary to urinary stones. The prevalence of kidney stone is thought to be between 2% to 3%, and the incidence has been increasing in recent years due to changes in diet and lifestyle. The renal colic pain is usually a sudden intense pain located in the flank or abdominal areas. This usually happens when a urinary stone blocks the ureter (the tube connecting the kidneys to the bladder). Different types of pain killers are used to ease the discomfort. Nonsteroidal anti‐inflammatory drugs (NSAIDs) and antispasmodics (treatment that suppresses muscle spasms) are used commonly to relieve pain and discomfort. This review aimed to assess the effectiveness of commonly used non‐opioid pain killers in adult patients with acute renal colic pain. Fifty studies enrolling 5734 participants were included in this review. Treatments varied greatly and combining of studies was difficult. We found that overall NSAIDs were more effective than other non‐opioid pain killers including antispasmodics for pain reduction and need for additional medication. We also found that the combining NSAIDs with antispasmodics did not increase the efficacy. No serious adverse effects were reported by any of the included studies.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Aspirin, steroid and non‐steroidal anti‐inflammatory drugs use for treating Alzheimer's disease

Inflammation may play an important role in the development of Alzheimer’s disease. There is also some evidence from community surveys that people receiving anti‐inflammatory drugs for various medical conditions may be less likely to develop Alzheimer's disease. Fourteen studies met our inclusion criteria for this review and none of the exclusion criteria. Aspirin, steroid and non‐steroidal anti‐inflammatory drugs (NSAIDs) (traditional and the selective cyclooxygenase‐2 (COX‐2) inhibitors) showed no significant benefit in the treatment of Alzheimer's disease. Therefore, the use of these drugs cannot be recommended for the treatment of Alzheimer's disease.         

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Non‐steroidal anti‐inflammatory drugs, including aspirin and paracetamol (acetaminophen) in people taking methotrexate for inflammatory arthritis

This summary of a Cochrane review describes what we know from research about any safety issues from using non‐steroidal anti‐inflammatory drugs, or NSAIDs, including aspirin, or paracetamol (acetaminophen), or both, along with methotrexate in people with inflammatory arthritis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Topical non‐steroidal anti‐inflammatory drugs for acute musculoskeletal pain in adults

Acute musculoskeletal pain describes conditions like a sprained ankle or a muscle pull. These usually get better over two or three weeks without treatment, but can be very painful while they last.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Treatment with oral drugs other than steroids to reduce lung inflammation and deterioration in lung function in people with cystic fibrosis

Inflammation contributes to lung damage. In the long term this is the most common reason for early death in cystic fibrosis. In high doses, non‐steroidal anti‐inflammatory drugs, particularly ibuprofen, may work against inflammation, but in low doses there is some evidence that they may cause inflammation. The use of high doses has also raised concerns about the potential for unwanted effects, which has limited the use of these drugs in cystic fibrosis. We looked for trials comparing oral non‐steroidal anti‐inflammatory drugs to placebo, at any dose for at least two months in people with cystic fibrosis.This updated review includes twice as many participants as the original review. We found evidence showing that high‐dose non‐steroidal anti‐inflammatory drugs, most notably ibuprofen, can slow the progression of lung damage in people with cystic fibrosis, especially in younger people. There are limited long‐term safety data; however, there are enough data to recommend that non‐steroidal anti‐inflammatory drugs be temporarily stopped when patients are receiving intravenous aminoglycosides or other agents toxic to the kidneys.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Comparing NSAIDs

How do NSAIDs compare in reducing pain?

PubMed Clinical Q&A [Internet] - National Center for Biotechnology Information (US).

Version: May 1, 2011

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