Cataflam & Flu Symptoms

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Cataflam as NSAID

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Cataflam & Flu Symptoms

  1. 1. Upper Respiratory Tract Infection URTI
  2. 2. Precautions <ul><ul><li>History of GIT ulceration. </li></ul></ul><ul><ul><li>Sever impairment functions of </li></ul></ul><ul><ul><ul><li>Hepatic. </li></ul></ul></ul><ul><ul><ul><li>Renal. </li></ul></ul></ul><ul><ul><ul><li>Cardiac. </li></ul></ul></ul><ul><ul><li>Porphyria. </li></ul></ul><ul><ul><li>Blood count in long term use. </li></ul></ul><ul><ul><li>Pregnancy. </li></ul></ul><ul><ul><li>Lactation . </li></ul></ul>
  3. 3. Respiratory Tract Anatomy
  4. 4. Challenges ?! <ul><li>The Upper Respiratory Tract Infection (URI) is one of the most common complaints in all primary care and emergency care practices. </li></ul><ul><li>Even though it is considered a &quot;self-limited&quot; disease and relatively benign in terms of some critical illnesses that are seen in any medical practice it has a tremendous impact on the health care system and society. </li></ul><ul><li>The URI is estimated to cost $3.5 BILLION a year in the US alone, and accounts for 40 percent of the time lost from jobs and as many as 23 million lost school days. </li></ul><ul><li>It is an easily acquired illness that sweeps through communities and families causing mild to moderate misery and sending many to their doctor for care and advice. </li></ul>
  5. 5. Challenges ?! <ul><li>We know that greater than 90 percent of upper respiratory tract infections are viral. Viruses are sophisticated infectious agents that are self limited - meaning they resolve on their own. </li></ul><ul><li>There are over 100 different types of viruses that infect the upper respiratory tract. </li></ul><ul><li>First and foremost, antibiotics DON'T work . </li></ul><ul><li>In the past it was common knowledge that if you were blowing out or coughing up discolored (green) mucous that you had a bacterial infection and needed antibiotics. </li></ul><ul><li>More recent research indicates that the color of mucous is not necessarily related to bacterial infection. </li></ul>
  6. 6. URTI ?! <ul><li>Upper respiratory infections are common infections and include </li></ul><ul><ul><ul><li>Pharyngitis </li></ul></ul></ul><ul><ul><ul><li>Sinusitis </li></ul></ul></ul><ul><ul><ul><li>Epiglottitis </li></ul></ul></ul><ul><ul><ul><li>Laryngotracheitis </li></ul></ul></ul><ul><ul><ul><li>Common cold </li></ul></ul></ul><ul><li>Viruses play a significant role in the pathogenesis of many of these infections. </li></ul><ul><li>Bacteria and other organisms also are responsible. </li></ul>
  7. 7. Distribution of Diagnostic Categories for Patient Encounters *Nonspecific Viral URTI includes Colds, Croup, Laryngitis and Influenza
  8. 8. Symptoms <ul><li>It usually starts with a tickle in the throat and perhaps mild fatigue Just plain tired when you don't expect to be tired. </li></ul><ul><li>Congestion and runny nose, sore throat and sometimes a fever and body aches follow. </li></ul><ul><li>Next may come a cough that keeps you awake at night. </li></ul><ul><li>With these symptoms comes the recognition and dismay that you have a &quot;cold.&quot; </li></ul><ul><li>This constellation of symptoms adds up to general inconvenience and misery. </li></ul><ul><li>NSAIDs are thought to enhance the efficacy of the antibacterial agents by better penetration to the site of infection </li></ul>
  9. 9. Management <ul><li>Rest and fluid intake are critical to recovering from a viral upper respiratory illness. </li></ul><ul><li>Over-the-counter medication is for symptom relief </li></ul>
  10. 10. Phospholipid Membrane Arachidonic Acid Prostacycline Leukotrines Cyclo-Oxygenase Pathway Lipoxygenase Pathway PG Thromboxane Phosphlipase Prostaglandins are released from injured cells and cause erythema, vasodilation and hyperalgesia
  11. 11. Why NSAIDs ?! <ul><li>NSAIDs (including aspirin) act primarily by inhibiting the synthesis of prostaglandins from arachidonic acid. </li></ul><ul><li>This anti-prostaglandin effect is thought to be the major mechanism of action of NSAIDs; it may produce analgesia by blocking prostaglandin-related pain impulse generation, or through inhibition of other pain mediators, such as bradykinin or histamine. </li></ul><ul><li>Higher doses (typically prescription level) of NSAIDs also produce anti-inflammatory effects. </li></ul>
  12. 12. Mainstay Therapy <ul><ul><li>In the common cold, symptomatic therapy remains the mainstay of treatment. </li></ul></ul><ul><ul><li>A number of agents have been investigated in an effort to shorten the course of illness or prevent disease. </li></ul></ul><ul><ul><ul><li>These agents are antihistamines, zinc, vitamin C, and herbal therapy. </li></ul></ul></ul><ul><ul><ul><li>Patients who use zinc have been demonstrated to experience significantly fewer days with coughing, headache, nasal congestion, nasal drainage, and sore throat. </li></ul></ul></ul>
  13. 13. Others Add on Therapy <ul><li>Nasal and systemic decongestants -- The goal of uncomplicated sinusitis is to relieve the obstruction. </li></ul><ul><ul><ul><li>Antihistamines should be avoided because they thicken secretions. These drugs can be used for this purpose. </li></ul></ul></ul><ul><li>Antibiotics -- The chosen antibiotic ideally should be </li></ul><ul><ul><ul><li>Easy to take </li></ul></ul></ul><ul><ul><ul><li>Free of adverse effects </li></ul></ul></ul><ul><ul><ul><li>Affordable </li></ul></ul></ul><ul><ul><ul><li>Penicillins and cephalosporins; no isolates have been identified that demonstrate in vitro resistance to these drugs. </li></ul></ul></ul>
  14. 14. When to Seek Medical Help <ul><li>Fever In general, a fever of 38 C is expected during the initial 2 days of a viral illness. if: </li></ul><ul><ul><ul><li>The fever is exceptionally high. </li></ul></ul></ul><ul><ul><ul><li>The fever is prolonged or not controlled </li></ul></ul></ul><ul><ul><ul><li>The fever returns during the course of the illness, especially with new symptoms. </li></ul></ul></ul>
  15. 15. When to Seek Medical Help <ul><li>Prolonged Course </li></ul><ul><ul><ul><li>Most viral illnesses follow a pretty predictable course and last between 7-14 days. If your symptoms are not improving over time, or a cough is prominent and keeping you awake at night, or the course of the illness simply continues, it is important to seek medical advice. </li></ul></ul></ul>
  16. 16. When to Seek Medical Help <ul><ul><li>Underlying Illness </li></ul></ul><ul><ul><ul><li>If you have an underlying illness like asthma, diabetes or cancer it is important to seek medical assistance or advice. </li></ul></ul></ul><ul><ul><li>Change of Symptoms </li></ul></ul><ul><ul><ul><li>Sometimes a viral infection will lead to a secondary bacterial infection. If your symptoms change or become suddenly more severe, it is important to seek evaluation. </li></ul></ul></ul>
  17. 17. A Multicenter, Randomized, Double-Blind, Double-Dummy, Placebo- and Active- Controlled, Parallel-Group Comparison of Diclofenac-K and Ibuprofen for the Treatment of Adults with Influenza-like Symptoms
  18. 18. RATIONAL ? <ul><li>The alleviation of influenza-like symptoms, such as fever, headache, and muscle/joint aches and pains, is important so that sufferers can return to their normal daily activities. </li></ul><ul><li>This study assessed the efficacy and tolerability of diclofenac-K 12.5 mg versus ibuprofen 200 mg and placebo against influenza-like symptoms (oral temperature >38.1°C, and at least moderate headache and muscle/joint aches and pains). </li></ul>
  19. 19. RATIONAL ? <ul><li>Infection with a variety of viruses can produce an acute illness associated with influenza-like symptoms--fever, myalgia, headache, and cough. </li></ul><ul><li>The median duration of fever and associated headache in influenza is 3 days , but cough and malaise often persist for 1 to 2 weeks. </li></ul><ul><li>The alleviation of influenza-like symptoms , such as fever, headache, and muscle/joint aches and pains, is important in maintaining a more or less normal degree of daily activity </li></ul><ul><li>With their antipyretic and analgesic activity, nonsteroidal anti-inflammatory drugs (NSAIDs) are a choice for the management of such symptoms, although they have no effect on the duration of illness or spread of the virus. </li></ul>
  20. 20. RATIONAL ? <ul><ul><li>Cataflam, the first member of the phenylacetic acid class of NSAIDs, has been shown to effectively lower body temperature when administered as a 25-mg tablet . </li></ul></ul><ul><ul><li>A new immediate-release formulation containing of diclofenac-K has been developed to allow safe and effective use of diclofenac-K at a low dose that could be suitable for nonprescription use . </li></ul></ul>
  21. 21. Effect From 1 st . hour 87%
  22. 22. 1 st . Day Assessment 96% 87% 94% 95%
  23. 23. EOS Assessment 93% 97%
  24. 24. Rescue Medication <ul><li>The numbers of patients who took rescue medication during the entire treatment period were 1 (0.8%), and 14 (12.2%) in the diclofenac-K, and placebo groups, respectively. </li></ul>
  25. 25. Results <ul><li>Compared to placebo, the initial dose of diclofenac-K (2 x 12.5 mg) significantly lowered body temperature as early as 30 minutes after dosing. </li></ul><ul><li>The onset (within 30 minutes), duration (-4 hours), and magnitude of the antipyretic effect (peak effect, ~0.8°C ) were </li></ul><ul><li>In this 3-day study, diclofenac-K was effective compared with placebo in relieving influenza-like symptoms , with comparable tolerability. </li></ul>
  26. 26. At the 1 st . Day of pharyngiotonsilitis
  27. 27. At the 4 th . Day of pharyngiotonsilitis
  28. 28. Questions ??

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