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pregabalin induced balance disorder,asthenia,edema,and constipation in an elderly adult:A case report

World Journal of Clinical Cases 2023年第17期11卷 4060-4064页

作者： Li-Ping Ma Cheng Wen Tong-Xiang Zhao Xiang-Ming Jiang Jin Gu Office of Clinical Trial Institution Peking University Shougang HospitalBeijing 100144China Department of Pharmacy Administration and Clinical Pharmacy School of Pharmaceutical SciencesPeking UniversityBeijing 100191China Department of Gastrointestinal Surgery Peking University Shougang HospitalBeijing 100144China

BACKGROUND pregabalin is widely used to treat neuropathic pain associated with postherpetic neuralgia.To our knowledge,this is the first report on simultaneously occurring dose-related adverse drug reactions(ADRs)of balance disorder,asthenia,peripheral edema,and constipation in an elderly patient after pregabalin.CASE SUMMARY A 76-year-old female with a history of postherpetic neuralgia was prescribed pregabalin(300 mg daily).After taking pregabalin for 7 d,the patient developed balance disorder,weakness,peripheral pitting edema(2+),and constipation.On days 8-14,the pregabalin dose was reduced to 150 mg/d based on creatinine clearance.The patient’s peripheral edema improved significantly with the disappearance of all other adverse symptoms.On day 15,the pregabalin dose was increased to 225 mg/d to relieve pain.Unfortunately,the symptoms mentioned earlier gradually reappeared after 1 wk of pregabalin treatment.However,the complaints were not as severe as when taking 300 mg/d pregabalin.The patient consulted her pharmacist by telephone and was advised to reduce the dose of pregabalin to 150 mg/d and add acetaminophen(0.5 g,q6h)to relieve pain.The patient’s ADRs gradually improved over the following week.CONCLUSION Older patients should be prescribed a lower initial dose of pregabalin.The dose should be titrated to the maximum tolerable dose to avoid dose-limiting ADR.Dose reduction and the addition of acetaminophen may help limit ADR and improve pain control.

关键词： pregabalin Dose-dependent AEs The elderly population Adverse drug reaction Case report

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pregabalin Attenuates Docetaxel-induced Neuropathy in Rats

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2012年第4期32卷 586-590页

作者：彭平席青松夏曙庄亮桂琦陈豫黄玉邹曼饶洁于世英 Department of Oncology Tongji HospitalTongji Medical CollegeHuazhong University of Science and Technology

Chemotherapy-induced neuropathy is a serious clinical problem for patients receiving cancer treatment.The aim of this study was to investigate the potential efficacy of pregabalin in chemotherapy-induced neuropathy in rats.A total of 35 male Sprague-Dawley rats were randomly divided into 5 groups:group 1,naive control;group 2,treated with pregabalin(30 mg/kg p.o.,for 8 days);group 3,docetaxel was given by single intravenous infusion at 10 mg/kg;groups 4 and 5,pregabalin at 10 mg/kg and 30 mg/kg respectively was orally administered for 8 days after the docetaxel treatment.On day 8,behavioral test was performed,and substance P and CGRP release in dorsal root ganglion(DRG) and sciatic nerve were analyzed by electron microscope.Our results showed that docetaxel induced mechanical allodynia,mechanical hyperalgesia,heat hypoalgesia,cold allodynia,and sciatic nerve impairment and substance P and CGRP release in DRG.However,oral administration of pregabalin(10 mg/kg and 30 mg/kg) for 8 consecutive days significantly attenuated docetaxel-induced neuropathy by ameliorating heat hypoalgesia,cold allodynia,impairment of sciatic nerve and reducing the release of substance P and CGRP.The findings in the present study reveal that pregabalin may be a potential treatment agent against chemotherapy-induced neuropathy.

关键词： pregabalin docetaxel substance P CGRP neuropathy

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Effect of pregabalin and Gabapentin on Nociceptive Behaviors Induced by Spinal Nerve Ligation

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Journal of Biosciences and Medicines 2022年第3期10卷 114-123页

作者： Itzel I. Ramos-Rodríguez Crystell G. Guzmán Priego Erick J. Rodríguez-Palma Guadalupe del C. Baeza-Flores Jorge E. Torres-López Pain Mechanisms Laboratory Divisi&oacute n Acadé mica de Ciencias de la Salud Universidad Ju&aacute rez Autó noma de Tabasco Villahermosa Mexico Neurobiology of Pain Laboratory Departamento de Farmacobiología Neurobiology of Pain Departamento de Farmacobiología Cinvestav Sede Sur México City México

Pain is defined as an unpleasant sensory and emotional experience, associated with actual or potential tissue damage. According to its neurobiological mechanism, pain is classified into nociceptive, inflammatory, dysfunctional, and neuropathic. Neuropathic pain (NP) is caused by a lesion or disease of the somatosensory nervous system. Both pregabalin and gabapentin are pharmaceuticals used as validation drugs in experimental models of NP. pregabalin was shown to produce significant antihyperalgesic and antiallodynic effects. Gabapentin is used as a reference compound for new analgesics and reduces tactile allodynia in rats. The aim of this work is to evaluate pregabalin and gabapentin effects on nociceptive behaviors induced by spinal nerve ligation (SNL). Female Wistar rats of 140 - 160 g were used, divided into five groups: Naive, SHAM, SNL rats treated with saline solution, SNL rats treated with pregabalin 30 mg/kg p.o., SNL rats treated with gabapentin 300 mg/kg p.o. Nociceptive behaviors were determined by the up and down method. In the establishment of SNL-induced allodynic behavior, a reduction in paw withdrawal threshold was observed in the time course, which was present from day 1 and it was maintained for 28 days post-ligation. With the administration of pregabalin and gabapentin, anti-allodynic behavior was observed in the time course and in the areas under the curve (AUC) of the time course of anti-allodynic behavior, significant difference was observed between pregabalin, and gabapentin groups compared to vehicle with a value of p pregabalin and gabapentin induce an antinociceptive effect in rats subjected to SNL.

关键词： Tactile Allodynia Neuropathic Pain pregabalin Gabapentin

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Analytical method development of pregabalin and related substances in extended release tablets containing polyethylene oxide

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Asian Journal of Pharmaceutical Sciences 2016年第1期11卷 229-230页

作者： Jin Seob Oh Seo Hyun Lim Sung Ha Ryu Kyung Hun Kim Kyung Soo Lee Woo Heon Song Jun Sang Park GL PharmTech Corporation

pregabalin,(S)-3-amino methyl hexanoic acid,is a structural analogue ofγ-amino butyric acid(GABA)which has been widely used to treat partial seizures and neuropathic pain[1].It is soluble in aqueous solution and sparingly soluble in organic solvents such as ethanol,DMSO and DMF.Polyethylene oxide(PEO)has a strong negative effect on analysis of hydrophilic active ingredient and its relative substances due to extremely high viscosity of PEO in aqueous media.The aim of this study is to develop a fast and precise method for the determination of pregabalin and its relative substances in extended release tablets including PEO using sodium sulfate for the treatment of sample solution.

关键词： pregabalin Polyethylene oxide Related compound HPLC

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Expert consensus of the Chinese Association for the Study of Pain on ion channel drugs for neuropathic pain

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World Journal of Clinical Cases 2021年第9期9卷 2100-2109页

作者： Hong Xiao Ke Ma Dong Huang Xian-Guo Liu Tang-Hua Liu Qing Liu Guang-Zhao Liu Tao Song Wei Tao Da-Sheng Wu Yun-Xia Wang Xiao-Qiu Yang Xiao-Mei Zhang Hui Liu Yan-Qing Liu Department of Algology West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Algology Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200092China Department of Algology The Third Xiangya Hospital of Central South UniversityChangsha 410013Hunan ProvinceChina Department of Physiology and Pain Research Center Sun Yat-Sen UniversityGuangzhou 510080Guangdong ProvinceChina Department of Algology The Third People's Hospital of YibinYibin 644000Sichuan ProvinceChina Department of Algology The Affiliated T.C.M Hospital of Southwest Medical UniversityLuzhou 646000Sichuan ProvinceChina Department of Algology The Second Hospital of Hebei Medical UniversityShijiazhuang 050000Hebei ProvinceChina Department of Algology The First Affiliated Hospital of China Medical UniversityShenyang 110001Liaoning ProvinceChina Department of Neurosurgery Shenzhen University General HospitalShenzhen 518055Guangdong ProvinceChina Department of Algology The People's Hospital of Jilin ProvinceChangchun 130021Jilin ProvinceChina Department of Algology Hubei Third People’s Hospital of Jianghan UniversityWuhan 430033Hubei ProvinceChina Department of Algology The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China Department of Algology The First Affiliated Hospital of Kunming Medical UniversityKunming 650032Yunnan ProvinceChina Department of Algology Beijing Tiantan HospitalCapital Medical UniversityBeijing 100070China

Neuropathic pain(NPP)is a kind of pain caused by disease or damage impacting the somatosensory system.Ion channel drugs are the main treatment for NPP;however,their irregular usage leads to unsatisfactory pain relief.To regulate the treatment of NPP with ion channel drugs in clinical practice,the Chinese Association for the Study of Pain organized first-line pain management experts from China to write an expert consensus as the reference for the use of ion channels drugs.Here,we reviewed the mechanism and characteristics of sodium and calcium channel drugs,and developed recommendations for the therapeutic principles and clinical practice for carbamazepine,oxcarbazepine,lidocaine,bulleyaconitine A,pregabalin,and gabapentin.We hope this guideline provides guidance to clinicians and patients on the use of ion channel drugs for the management of NPP.

关键词： Ion channel drug Neuropathic pain Expert consensus Guideline Gabapentin Carbamazepine Oxcarbazepine Lidocaine Bulleyaconitine A pregabalin

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Paroxetine vs pregabalin for the management of neuropathic pain in multiple sclerosis

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World Journal of Anesthesiology 2014年第2期3卷 181-188页

作者： Dana A Turcotte Malcolm Doupe Mahmoud Torabi Andrew J Gomori Karen Ethans Farid Esfahani Katie Galloway Michael P Namaka Faculty of Pharmacy University of ManitobaWinnipeg Manitoba R3E 0T5 Canada Manitoba Centre for Health Policy Winnipeg Manitoba R3E 3P5 Canada Department of Community Health Sciences Faculty of Medicine University of ManitobaWinnipeg Manitoba R3E 3P5 Canada Section of Neurology Faculty of MedicineUniversity of ManitobaWinnipeg Manitoba R3T 2N2 Canada Section of Physical Medicine and Rehabilitation University of ManitobaWinnipegManitoba R3A 1R9 Canada Winnipeg Clinic Winnipeg Manitoba R3C 0N2 Canada Department of Statistics University of ManitobaWinnipeg Manitoba R3T 2N2 Canada Department of Human Anatomy Faculty of Medicine University of ManitobaWinnipeg Manitoba R3E 0J9Canada

AIM: To compare the effectiveness and tolerability of paroxetine vs pregabalin for the management of multiple sclerosis(MS)-induced neuropathic pain(NPP).METHODS: A randomized, flexible-dose open-label 8-wk study involving 21 relapsing-remitting MS patients with MS-induced NPP was conducted to evaluate the effectiveness and tolerability of pregabalin versus paroxetine for pain management. The trial included a 3-wk dose titration phase followed by a 5-wk stable dose phase. Primary outcome measures included daily patient-reported pain intensity as measured using a 100 mm visual analogue scale(VAS pain) and daily impact of pain on daily activities(VAS impact). Hierarchical regression modeling was conducted on each outcome to determine if within person VAS trajectory for pain and impact differed across study groups, during 56 d follow-up. RESULTS: Attrition rates were significantly greater(P pregabalin study group(70% vs 18.2%, respectively). Average study duration between study groups also significantly differed(P pregabalin group, with the majority of patients withdrawing due to adverse events. Due to the high attrition rates in the paroxetine study arm, the investigators stopped the study prior to achieving complete recruitment. As such, no significant differences between pregabalin and paroxetine study arms were noted for the primary outcome measures(VAS pain, VAS impact). Comparative assessment of baseline patient characteristics also revealed no significant differences between the study arms. CONCLUSION: High attrition rates associated with paroxetine use suggest that it be used with caution for MS-induced NPP. Efficacy outcomes could not be assessed due to attrition.

关键词： Multiple sclerosis Neuropathic pain Paroxetine pregabalin Clinical trial

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Preoperative Sedation, Hemodynamic Stability during General Anesthesia and Improving Postoperative Pain: pregabalin Is the Answer

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Open Journal of Anesthesiology 2018年第1期8卷 14-26页

作者： Heba El-Hussiny Huda Fahmy Ayman Mohammad Eldemrdash Department of Anesthesia Aswan University Hospital Aswan Egypt

Background: Tracheal intubation is a noxious stimulus that tends to provoke a marked sympathetic response which is potentially deleterious in some patients. Various methods have been used to minimize and attenuate these potentially harmful responses. Aim of the study: The present study compared the efficacy and safety of two different doses (150 mg and 300 mg) of oral pregabalin premedication on attenuation of the hemodynamic pressor response to airway instrumentation, perioperative hemodynamic stability, preoperative sedation, and postoperative pain reduction. Patients and methods: This prospective, observational study consisted of 60 adult patients scheduled for laparoscopic cholecystectomy. The patients were randomized into three groups of 20 patients each. Group I (P0) received an oral placebo, group II (P150) received 150 mg of oral pregabalin and group III (P300) received 300 mg of oral pregabalin 1 h prior to induction. All patients were assessed for pre-operative sedation, perioperative hemodynamic changes, Post-operative pain and analgesic consumption. Results: Regarding the efficacy of the preoperative administration of oral pregabalin, a dose dependent attenuation in the increased in heart rate, systolic, and diastolic blood pressure, and mean arterial blood pressure resulting from laryngoscopy and intubation was observed (300 mg > 150 mg), along with a subsequent decrease in intraoperative fentanyl supplementation. On anxiolysis, patients were more comfortable and asleep in the pregabalin groups as compared with the control group, in which more patients were awake and agitated. Post-operative pain and analgesic consumption were effectively reduced by (150 mg and 300 mg) pregabalin in a dose-dependent manner. Postoperative nausea and vomiting were significantly lower with the administration of pregabalin compared with the placebo group (P pregabalin increased the incidence of dizziness and visual disturbances in a dose-dependent manner. Conclusion: Oral pregabalin premedication

关键词： pregabalin Premedication Sedation Postoperative Pain

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Comparative Study between the Benefit of Pre-Emptive pregabalin and Gabapentin on Acute Postoperative Pain for Elective Gynecological Surgery

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Open Journal of Anesthesiology 2019年第12期9卷 227-237页

作者： Gamal A. Abd Elhameed Simon Armanios Ain Shams University Cairo Egypt

Gabapentin, and pregabalin had been used in analgesic field some studies. This double blind randomized clinical trial was conducted to evaluate the pre-emptive use of gabapentin 900 mg and pregabalin 300 mg in reducing postoperative pain. Methods: A total number of 75 patients undergoing lower gynecological procedures were prospectively randomized, into three groups (group A, B and C), each group including 25 patients with total 75 patients. pregabalin, gabapentin or placebo, the pain was assessed on a visual analogue scale (VAS) at 0, 6, 12, 18 & 24 hours postoperatively. Duration of effective analgesia was documented, and administration of extra analgesic doses of meperedine required in the first 24 hours. Results: Patients in the gabapentin or pregabalin had significantly lower VAS scores at 6, 12, 18 and 24 hours, than those in the placebo group. As for rescue analgesia with mepredine consumed in the gabapentin, and pregabalin were significantly less than in the placebo. As for the complications, both drugs had increased incidence of nausea, vomiting and dizziness postoperatively, while no significance was found between all groups as regard hypotension, bradycardia and shivering. Conclusion: Preoperative use of pregabalin or gabapentin provides comparable but significant prolonged postoperative analgesia, less nausea and vomiting compared to placebo after gynecological surgeries. However, it was associated with increased incidence of postoperative dizziness.

关键词： Gabapentine pregabalin Postoperative Pain

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Pain in chronic pancreatitis: Managing beyond the pancreatic duct

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World Journal of Gastroenterology 2013年第38期19卷 6319-6328页

作者： Rupjyoti Talukdar D Nageshwar Reddy Department of Medical Gastroenterology Asian Institute of GastroenterologySomajigudaHyderabad 500082India Asian Healthcare Foundation SomajigudaHyderabad 500082India

Chronic pancreatitis(CP)continues to be a clinical challenge.Persistent or recurrent abdominal pain is the most compelling symptom that drives patients to seek medical care.Unfortunately,in spite of using several treatment approaches in the clinical setting,there is no single specific treatment modality that can be earmarked as a cure for this disease.Traditionally,ductal hypertension has been associated with causation of pain in CP;and patients are often subjected to endotherapy and surgery with a goal to decompress the pancreatic duct.Recent studies on humans(clinical and laboratory based)and experimental models have put forward several mechanisms,including neuroimmune alterations,which could be responsible for pain.This might explain the partial or no response to single modality treatment in a significant proportion of patients.The current review discusses the recent concepts of pain generation in CP and evidence based therapeutic approaches(other than ductal decompression)to handle persistent or recurrent pain.We focus primarily on parenchymal and neural components;and discuss the role of antioxidants and the existing controversies,drugs that interfere with neural transmission,pancreatic enzyme supplementation,celiac neurolysis,and pancreatic resection procedures.The review concludes with the treatment approach that we follow at our institute.

关键词： Pain Chronic pancreatitis Nociception Neuroplasticity Antioxidant micronutrients pregabalin Pancreatic enzymes

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pregabalin对纤维肌痛症有效

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国外医学（药学分册） 2003年第2期30卷 125-126页

作者：张蕾

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