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[Deciding on analgesic prescription dosing for acute back pain: Once daily or more?]
Presse Med. 2008 Jan;37(1P1):14-20
Authors: Perrot S, Concas V, Allaert F, Laroche F
INTRODUCTION: Decisions about treatment prescriptions depend on many factors. For example, the choice of once-daily or multiple administration of an analgesic, an aspect that is not determined by guidelines, depends essentially on medical practice habits, patient preferences, or both. We analyzed this treatment decision for acute back pain in a case-control study. PATIENTS AND METHODS: A case-control study was conducted in metropolitan France between October and December 2005 among outpatients seeing general practitioners and specialists for acute back pain (cervical, thoracic, lumbar and low back pain). We compared the group treated by a once-daily analgesic (tramadol) with those treated by analgesics (WHO analgesic ladder steps 1 and 2) administered twice daily or more. Patients and physicians were questioned about the different supposed determinants of the treatment choice for acute back pain. RESULTS: Patients for whom physicians prescribed a once-daily analgesic had a history of back pain and previous prescriptions for other analgesics more frequently than the other patients, experienced significantly greater pain and more marked disability. The time to recovery estimated by the physicians was shorter for these patients, as was the time to return to work, estimated by patients. Treatment choice was also guided by the patient's choices: the once-daily analgesic was reserved for patients who prefer to take drugs to prevent pain and prefer a single dose daily. CONCLUSION: The choice of type of analgesic treatment for acute back pain depends not only on clinical condition (pain and disability), but also on clinical history, the future as envisioned by the physician and the patient's desires. Action to improve treatment choices must integrate these factors, especially as part of an overall education in therapeutics.
PMID: 18031980 [PubMed - as supplied by publisher]
(Source: Presse Medicale)
Why is this medication prescribed?
Tramadol is used to relieve moderate to moderately severe pain. Tramadol extended-release tablets are only used by people who are expected to need medication to relieve pain around-the-clock for a long time. Tramadol is in a class of medications called opiate agonists. Read the rest of this entry »
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[Pharmacological treatment of fibromyalgia.]
Reumatismo. 2007;59(4):280-291
Authors: Cazzola M, Sarzi-Puttini P, Buskila D, Atzeni F
Fibromyalgia syndrome (FM) is a condition of chronic and diffuse muscular pain affecting particularly middle aged women. The aetiology of FM is not completely understood and it is currently considered a disorder of pain regulation. The most efficacious compounds include the tricyclic drugs and mixed reuptake inhibitors. Recent works suggest that the anticonvulsant medications pregabalin and gabapentin are also effective. Moreover, two serotonin and norepinephrine-reuptake inhibitors-duloxetine and milnacipran show encouraging results in treating FM symptoms. The results of clinical trials of anti-inflammatory medications have been generally disappointing, but three RCTs have found that tramadol (with or without acetaminophen) is effective in FM.
PMID: 18157284 [PubMed - as supplied by publisher]
(Source: Reumatismo)