Patients'attitudes to rectal drug administration

One hundred adult patients attending for day case surgery were surveyed by anonymous questionnaire in order to determine their attitudes to rectal drug administration. Fifty four patients did not want an analgesic drug (diclofenac sodium) administered rectally whilst under anaesthesia, all preferring to take it orally if available. Ninety eight patients thought that drugs administered per rectum should always be discussed with them beforehand and a few had very strong feelings about this route of administration. We suggest that prescribers of rectal diclofenac should always discuss it with patients pre-operatively. Whilst many are happy to have suppositories, some young patients are sensitive about this and prefer to take such medication by mouth.     

The effect of diclofenac and nefopam on postoperative dental pain

Eighty-two outpatients who received general anaesthesia for surgical removal of maxillary or mandibular third molars were given either diclofenac 75 mg or nefopam 20 mg intramuscularly for postoperative pain control. They and the control group were also allowed oral paracetamol as required. The results showed that there was no significant pain relief from these single intramuscular injections.     

Diclofenac and post-tonsillectomy haemorrhage

The authors noticed a marked increase in the incidence of reactionary post-operative haemorrhage after tonsillectomy during the course of 1992. This increase appeared to be related to the introduction of diclofenac as a post-operative analgesic. A retrospective review of casenotes of patients having tonsillectomy under the care of the senior author (P. M. R.) in 1992 revealed that four of the 73 patients (5.5%) receiving diclofenac at induction of anaesthesia suffered reactionary haemorrhage requiring operative control, as compared with two of 293 (0.7%) receiving other analgesics.     

Comparison of the effect of intravenous ketoprofen, ketorolac and diclofenac on platelet function in volunteers

Background : Nonsteroidal anti–inflammatory drugs (NSAIDs) inhibit prostaglandin synthesis which may result in impaired platelet function. Because NSAIDs have different abilities to inhibit cyclo–oxygenases we compared the effect of intravenous ketoprofen, ketorolac and diclofenac on platelet function in volunteers. Methods : Ten healthy male volunteers were given ketoprofen 1.4 mg kg^-1, ketorolac 0.4 mg kg^-1 and diclofenac 1.1 mg kg^-1 in saline i.v. on three different occasions, at more than one–week intervals, in a randomized double–blind crossover study. Platelet function was evaluated before (sample 0), 2 (sample 2) and 24 h (sample 3) after the beginning of the infusion. Results : Two of the volunteers had no secondary platelet aggregation in their aggregation curves before the experiment (sample 0, studied three times) and their results were excluded from the final analysis. Diclofenac inhibited adrenaline (0.9 μg–ml^-1) induced platelet aggregation less (median maximal aggregation 22.5%) than ketoprofen (18.3%) and ketorolac (15.7%) (P<0.05) in sample 2. In the ketorolac group in sample 3 an impairment of adrenaline (0.9 ng ml^-1) induced platelet aggregation was still seen (26.7%) (P<0.05) but not in the other groups. Diclofenac did not affect adenosine diphosphate (ADP) induced platelet aggregation. However, ketorolac caused an impairment in ADP (3 μM and 6 μM) induced platelet aggregation and ketoprofen in ADP (6 μM) induced platelet aggregation in sample 2. Bleeding time was prolonged (P<0.05) after ketoprofen and ketorolac (sample 2) but not after diclofenac. Platelet retention on glass beads was unaffected by the tested drugs. Conclusion : Ketoprofen, ketorolac and diclofenac caused a reversible platelet dysfunction. Diclofenac had the mildest effect, while platelet dysfunction was still seen 24 h after the beginning of ketorolac.     

Correlation of antiinflammatory and hormonal activity of derivatives of the 8,16-diazasteroid series

Antiinflammatory activity and mechanism of action are studied for seven compounds of the 8,16-diazasteroid series. It is established that the antiinflammatory activity of the compounds is increased on the whole due to the reduced ketofunction in the 12 position of 8,16-diazasteroid as well as for the introduction of methoxy groups in the 2 and 3 position or phenol substitute in the 16 position. The activity of compounds VI and VII also depends on the inflammation model or on the pain reaction and differs significantly from the effectiveness of diclofenac sodium and prednisolone. Unlike the latter, the compounds under study are virtually devoid of hormonal activity. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 119, N ^o 2, pp. 168–171, February, 1995 Presented by P. V. Sergeev, Member of the Russian Academy of Medical Sciences     

呋咱氮氧化物偶联的双氯芬酸衍生物的药理活性筛选

目的 考察呋咱氮氧化物偶联的双氯芬酸衍生物的抗炎活性与胃肠道副作用的关系以及其NO的释放情况。方法 采用小鼠耳二甲苯致炎和角叉菜胶致大鼠足跖肿胀两种实验模型对系列化合物进行了抗炎活性初步筛选,并对抗炎活性较好的化合物进行了胃肠道副作用的观察及NO体内外释放量的测定。结果 抗炎活性较好的化合物其胃肠道副作用明显轻于双氯芬酸,也轻于已知的非甾体抗炎药,且3h体内均有明显的NO释放。结论 NO的引入能有效对抗非甾体抗炎药所致的胃肠道副作用。     

双氯芬酸钠微乳的家兔体内药代动力学考察

目的 :考察双氯芬酸钠微乳在家兔体内的药代动力学过程。方法 :家兔单次口服双氯芬酸钠微乳和双氯芬酸钠混悬液后 ,用 HPL C法测定血中双氯芬酸钠浓度。 结果 :双氯芬酸钠微乳和混悬液的 AU C0 -∞ 分别为 13.45 6和 10 .5 84μg· h· m l- 1 ,cmax 1 为 2 .85 2和 3.145 μg/m l,tmax1 为 1.438和 0 .75 0 h。 结论 :双氯芬酸钠微乳在家兔体内吸收过程较为平缓 ,可在较长时间内维持一定的血药浓度。     

双氯芬酸钠脉冲控释微丸的制备与体外释放影响因素的研究

 目的制备双氯芬酸钠脉冲控释微丸并考察体外释放影响因素。方法采用挤出滚圆法制备载药丸芯，以水溶胀性材料低取代羟丙基纤维素为内包衣溶胀层，乙基纤维素水分散体为外包衣作为控释层制备脉冲控释微丸，并考察溶胀层材料类型、溶胀层和控释层包衣增重、介质pH值和微丸粒径等对药物释放的影响。结果药物通过控释层衣膜破裂释放，溶胀层材料类型、溶胀层和控释层包衣增重和微丸粒径等对脉冲控释微丸的释药时滞和释放速率均具有显著影响，药物释放情况不受介质pH值的影响。结论采用水溶胀性材料低取代羟丙基纤维素为内包衣层，制备的脉冲控释微丸，当内包衣层增重为11%和外包衣层增重胀层为17%时，达到了时滞为4h，时滞后1.5h累积释药80%以上的脉冲释药效果。