Aceclofenac is an NSAID that selectively inhibits COX-2 and has been shown to reduce inflammation and pain. It is well-absorbed orally and metabolized to active metabolites. Clinical trials demonstrate aceclofenac is effective for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and other conditions, with fewer side effects than other NSAIDs like diclofenac. The recommended dosage is 100 mg twice daily by mouth.
A PowerPoint presentation on "NSAIDS" suitable for reading by UG and PG Medical/Paramedical students of Pharmacology and Pharmacy sciences. This Ppt. is prepared for academic purpose only and already presented to my students in one of the theory classes of mine.
A PowerPoint presentation on "NSAIDS" suitable for reading by UG and PG Medical/Paramedical students of Pharmacology and Pharmacy sciences. This Ppt. is prepared for academic purpose only and already presented to my students in one of the theory classes of mine.
Arthritis and Joint Pain:New treatment option Supported by Natural Synergy - ...VISHAL CHANDRA
A Scientifically developed and clinically Proven NATURAL MEDICINE- FLEXICART has cleared its Clinical Trail.
The trial is Registered on WHO PORTAL for INTERNATIONAL CLINICAL TRIAL REGISTRATION (ICTRP) # CTRI/2012/09/002965 and published in international journals
It is supposedly a superior alternate to Glucosamine/Chondroitin and similar combination supplements.
The slideshow portrays Scientific parameters on which the product was evaluated in patients with arthritis.
Highlight: Complete withdrawal of NSAID ( Chemical based pain killers) with time dependent progress of Treatment regime of this research product.
The product can potentially become a better and affordable alternate to Glucosamine & Chondroitin and at the same time be more environment friendly.
The Standardized ingredients of FLEXICART are 100% natural , do not contain any animal content ( Source of Glucosamine/Chondroitin: Fish/Pork/Crabs/Beef ) and devoid of harmful toxic metals as well.
Arthritis and Joint Pain:New treatment option Supported by Natural Synergy - ...VISHAL CHANDRA
A Scientifically developed and clinically Proven NATURAL MEDICINE- FLEXICART has cleared its Clinical Trail.
The trial is Registered on WHO PORTAL for INTERNATIONAL CLINICAL TRIAL REGISTRATION (ICTRP) # CTRI/2012/09/002965 and published in international journals
It is supposedly a superior alternate to Glucosamine/Chondroitin and similar combination supplements.
The slideshow portrays Scientific parameters on which the product was evaluated in patients with arthritis.
Highlight: Complete withdrawal of NSAID ( Chemical based pain killers) with time dependent progress of Treatment regime of this research product.
The product can potentially become a better and affordable alternate to Glucosamine & Chondroitin and at the same time be more environment friendly.
The Standardized ingredients of FLEXICART are 100% natural , do not contain any animal content ( Source of Glucosamine/Chondroitin: Fish/Pork/Crabs/Beef ) and devoid of harmful toxic metals as well.
COX inhibitors have been known to cause platelet inhibition by inhibiting thromboxane A2 production. Aspirin causes irreversible inhibition of COX, and therefore, the duration of platelet inhibition lasts until 7 to 10 days after drug discontinuation.
A type of drug that is used to treat inflammation and pain, and is being studied in the prevention and treatment of cancer. COX inhibitors belong to the family of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Also called cyclooxygenase inhibitor.
Pain and inflammation treatment with NSID drugs Akshay Kumar
Acenofenac and acetaminophen( paracetamol) role as N.S.I.D in the treatment of pain and Inflammation with pharmacology and indication, adverse effects and contraindications
Newer Trends and Recent Advances in Parasympathomimetics and parasympatholyticsShubham Marbade
It describes about newer trends and Recent Advances in Parasympathomimetics and parasympatholytics and their mechanism of actions
by Shubham marbade
Department of Pharmacology
Kesimpulan:
ANTI INFLAMMATORY DRUGS
a valuable adjuvant as part of a multimodal analgesic regimen for the management of pain in the perioperative period
effective adjunct in multimodal regimens to reduce postoperative pain
Our joints are subject to wear and tear and with increasing age the lining of joints, the cushioning cartilage, gradually degenerates. When cartilage has reached significant abrasion articular tissue will be affected and tissue trauma initiates a local inflammation. The consequence is a reduced flexibility of joints and predominantly pain. Inflammatory cells accelerate degeneration of joints by secreting reactive oxygen species (“oxidative
burst”), pro-inflammatory cytokines and degenerative enzymes matrix metalloproteinases (MMPs).
This process is paralleled by increasing pain which, left untreated, may reach excruciating levels.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
2. Specifics of action
• 1 trial studied the in • Although all tested • Considering the
vitro effects of NSAIDs caused a above results, it is
several (NSAIDs) on statistically reasonable to
pro-inflammatory significant propose that the
cytokines and PGE2 decrease on IL-6 prophylactic
production by and TNF-α levels, treatment with
synovial membrane aceclofenac & aceclofenac could
from loose tenoxicam were delay the process
endoprosthesis of seen to be more of the aseptic
hip / knee effective loosening of
arthroplasty tissue.
4. Benefits of action
Aceclofenac and its metabolite penetrate the
inflammatory cells like
neutrophils, monocytes and synovial cells
Get hydrolyzed to the
active diclofenac &
4`-hydroxydiclofenac
Inhibits cytokine Suppress
release by production of
inflammatory PGE 2 at the site
cells of inflammation
5. Benefits of action
Suppression of cytokine
mediated proteases & Stimulates the synthesis of the
increases production/ cytokine receptor antagonists in
release of proteoglycan the articular chondrocytes
Chondro-
Stimulatory effects on cartilage
protective
matrix synthesis.
properties
Synthesis of
glycosaminoglycan in
Inhibition of
osteoarthritic cartilage.
cytokine release
by inflammatory Net result is decrease in
cells disease progression & repair
6. Translation of Benefits of action
↓ joint Better outcome
Decreases pain
inflammation
intensity
Visibility
Reduces disease
Improves of benefits
of action severity / progression
mobility
↓ duration of Improves functional
morning stiffness capacity of the joints
like knee
7. Pharmacokinetics
• Rapidly and completely absorbed after oral
administration [Bioavailability = nearly 100%],
• Peak plasma concentrations are reached 1-3 hours
after an oral dose.
• Highly protein bound (approx. 99%).
• Presence of food does not alter the extent of
absorption but absorption rate is reduced [↑ Tmax].
• After multiple dosing, aceclofenac penetrates into
the synovial fluid
– Concentration = approximately 60% of plasma level
8. Metabolism
• Metabolized to
1. Major metabolite = 4'-hydroxyaceclofenac; &
2. Other metabolites = Diclofenac, 4'-
hydroxydiclofenac & 5-hydroxydiclofenac.
• Main route of elimination
– Renal, with 70 to 80% of an administered dose
found in the urine, mainly as the glucuronides of
aceclofenac and its metabolites
• Plasma elimination half-life
– Approximately 4 hours.
9. Observation of Selectivity
• Inhibition of cox-2 by both aceclofenac and
4'-hydroxyaceclofenac but with minimal
effects on cox-1. How can we say so?
• IC50 values of cox-1 and cox-2 respectively
have been observed as follows:
Cox-1 Cox-2
Aceclofenac > 100 0.8
4-Hydroxy-aceclofenac > 100 36
Further evidence of cox-2 selectivity of aceclofenac has been
shown by an IC50 ratio (cox-2: cox-1) of 0.26
11. Aceclofenac – clinical efficacy
• In large trials of 2 to 6 months duration in
various diseases, aceclofenac significantly
reduced pain and improves functional
capacity and mobility relative to baseline in
patients with
– osteoarthritis,
– rheumatoid arthritis or
– ankylosing spondylitis
• In addition, reduced inflammation in patients
with rheumatoid arthritis. [Disease progression?]
12. Use in OA
• One trial was a controlled, comparative, randomized, and
double-blind study that included 247 patients suffering from
osteoarthritis.
• Patients were randomized to receive either aceclofenac
(100 mg twice daily) or diclofenac (75 mg twice daily).
• Clinical assessment was done at screening, randomization,
and at 2 weeks, 4 weeks and 8 weeks of treatment by
calculating
– Western Ontario MacMaster (WOMAC) scores,
– time taken to walk 100 feet,
– visual analogue scores for pain,
– investigator's assessment on a Likert scale and
– joint tenderness.
• Tolerability assessment was based on adverse events.
• Patient compliance was also assessed.
Curr Med Res Opin. 2006; 22(5):977-88
13. Use in OA
• Aceclofenac was found to be statistically superior to
diclofenac in efficacy parameters of
– WOMAC scores,
– investigator's assessment and
– joint tenderness.
• Aceclofenac was found to be statistically superior to
diclofenac in terms of GI tolerance.
• Patient compliance was also better with better
acceptance.
• The overall response of patients' osteoarthritis to
aceclofenac was found to be statistically superior to
diclofenac by both physician and patient.
Curr Med Res Opin. 2006; 22(5):977-88
14. Use in RA
• In randomized, double blind comparative trial in 170
patients in each group, aceclofenac (100 mg twice
daily for 3 or 6 months) was compared wioth
diclofenac 50 mg. tid
– Although both treatment groups showed significant
improvement in all evaluations of pain and inflammation
& a progressive reduction in morning stiffness, there
were no significant differences between the groups.
– But, greater improvement in hand grip strength was seen
with aceclofenac (22% improvement) than diclofenac
(17% improvement). Adverse GI events were less with
aceclofenac (13%) than with diclofenac (17%).
Curr Med Res Opin. 1995;13(6):305-15
15. Use in ankylosing spondylitis
• In randomized, double blind trials involving
104 to 308 patients after aceclofenac 100 mg
twice daily for 3 months, Improvements were
observed similar to those observed with
indomethacin, naproxen or tenoxicam.
1. Reduced duration of morning stiffness and pain
intensity and
2. Improved spinal mobility.
J Rheumatol. 1996 Jul;23(7):1194-9.
16. Use in acute lumbago
• In a comparative study, Aceclofenac (100 mg
orally, twice daily) was superior to diclofenac
in alleviating functional impairment in a 7
days study in 100 patients with acute
lumbago.
• In a non-comparative study in 67 patients,
aceclofenac 100 mg twice daily was
associated with symptomatic relief of acute
low back pain.
17. Use in dental pain
• The analgesic efficacy as single doses of
aceclofenac 100 mg has been assessed in
patients with moderate to severe tooth pain
and in extraction of impacted third molars
and found to be greater than that of placebo.
• Aceclofenac was more efficient in controlling
pain when administered before the surgery
as maximum impact of activity for this
condition was evident at 6h after surgery,
which is the time of maximum pain for this
surgical procedure.
Int J Oral Maxillofac Surg. 2006 Jun;35(6):518-21
18. Other uses
Post Operative Dysmenorrhoea Musculoskeletal trauma
In various studies, In a more recent Aceclofenac 100 mg
aceclofenac 100 mg has noncomparative study in twice daily has also been
been superior to 1338 women with assessed in patients with
paracetamol 650 mg in dysmenorrohea treated musculoskeletal trauma,
providing relief from for first 3 days of 2 although only non-
postepisiotomy pain, consecutive cycles, comparative studies are
particularly 3 to 5 hours aceclofenac appeared to available.
after ingestion. be effective as other
NSAIDs with lesser side
effects.
19. Drug interactions
• Concomitant administration of aceclofenac
and antidiabetic drugs = hypo or
hyperglycaemia
• Co-administration with other NSAIDS of
corticosteroids may result in increased
frequency of adverse event.
• ↓ the activity of diuretics, but ↑ the activity of
anticoagulants and also ↑ cyclosporin
nephrotoxicity
• May ↑ plasma concentrations of lithium,
digoxin and methotrexate.
20. ADRs
• Most adverse events affect mainly the GI system;
are minor, reversible and include
– dyspepsia (7.5%), nausea (1.5%), diarrhea (1.5%),
flatulence (0.8%), gastritis (0.6%), constipation (0.5%),
vomiting (0.5%), ulcerative stomatitis (0.1%), pancreatitis
(0.1%).
• Rare adverse effect
– dizziness (1%), vertigo (0.3%), paraesthesia and tremor.
• Withdrawal rates significantly lower than other
NSAIDS in relation to incidence of GI adverse
events.
21. Dosage
• 100 mg given twice daily by mouth, one
tablet in the morning and one in the evening.
• In patients with mild renal impairment, there
is no evidence to suggest dosage
modification but caution should be exercised
as with other NSAIDS.
22. Summary
Faster, safer onset of
action
Pain control +
More potent effect with
2. Repair, and selectivity for Cox-2
3. ↓ in disease
progression
Protection of
chondrocytes against Aceclofenac Well tolerated and
ROS and breakdown better GI tolerability
Classical inhibition of
Stimulatory effects on
prostaglandins E2
matrix component
synthesis Decrease in the
expression of cytokines
like IL-1 & TNF-α
23. Summary
Osteoarthritis
Ankylosing
RA Spondylitis
Dental pain
Dysmenorrhoea