Friday, 1 July 2016

Most Common Disease of 50plus: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Fibromyalgia Treatment - Other oral administration medicines

Kyle J. Norton(Scholar, Master of Nutrients), all right reserved.
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
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Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Musculoskeletal disorders (MSDs) are  medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed(1).

      Types of Musculo-Skeletal disorders in elder

1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia


Fibromyalgia, according to the American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia in the newly proposed criteria for the classification of fibromyalgia are 1) widespread pain in combination with 2) tenderness at 11 or more of the 18 specific tender point sites(a) as a result in responding to pressure.

                        The Treatment
In conventional medicine perspective
FM usually involves females, particular to women entering stage of menopause. But it is often diagnosed both in young as well as elderly individuals. Diagnosis of pediatric FMS is a lengthy and frustrated condition affecting children and adolescents physical and emotional development, as the disease mimicked a spectrum of inflammatory joint disorders such as juvenile idiopathic arthritis (JIA), juvenile ankylosing spondylitis, etc, according to the study by Soroka Medical Center, Beer-Sheva(193)
A.2. Medications
4.  Other oral administration medicines
4.1. Cyclobenzaprine
Cyclobenzaprine is muscle relaxant used to relieve chronic fibromyalgia pain, by blocking nerve impulses sending pain sesation to your brain. According to the Laval University, the medication is highly effective in reduced chronic pain a short term in patients with fibromyalgia(222), probably through induced sleep physiology and symptoms of fibromyalgia(223).
According to the side effects are mot limit to, headache, dizziness; drowsiness, tired feeling; trouble concentrating; blurred vision, dry mouth or throat, altered sense of taste; or. nausea, upset stomach, constipation(224).

4.2. Pregabalin(see above)
4.3. Duloxetine See above
4.4  Milnacipran
Milnacipran is a serotonin–norepinephrine reuptake inhibitor used in the clinical treatment of fibromyalgia, ysed for treatment of Fibromyalgia depending to expression of key sumptoms Accoridng to the Klinikum Saarbrücken(225).
In the review of 5 studies (4138 participants) placebo-controlled, involved participants with fibromyalgia, and used titration to a target dose of 100 mg or 200 mg milnacipran, milnacipran 100 mg or 200 mg is effective for a minority in the treatment of pain due to fibromyalgia, providing moderate levels of pain relief (at least 30%) to about 40% of participants(226).

According to LX list the side effects of the medicine are not limit to, nausea, vomiting, upset stomach, bloating, dry mouth, constipation, loss of appetite, dizziness, drowsiness, tired feeling, increased sweating, headache, hot flashes (flushing),....(227).

5. Topical analgesics(capsaicin, lidocaine, salicylates) if localized neuropathic or arthritic pain
Topical analgesics, such as formulated creams, gels, and patches are applied locally to the skin and influence for treatment of Fibromyalgia's pain(228)
Most common side effects are skin irritation

6. Opioids
Opioids is an opiumlike compound binded to one or more of the three opioid receptors of the body for pain relief, including hydrocodone (e.g., Vicodin), oxycodone (e.g., OxyContin, Percocet). According to Dr. Ngian GS and research team at the Monash Medical Centre, suggested the medicine have a significant adverse effect profile, their inefficacy may be due to their inability to target the pathophysiologic processes involved in this central sensitization syndrome in patients with FM(229).
The common side effects of Opioids are not limit to sedation,dizziness, nausea, vomiting, constipation, physical dependence, tolerance, and respiratory depression,./... according to the Millennium Pain Center, Bloomington(230).

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(222) Comparison of amitriptyline, cyclobenzaprine, and placebo in the treatment of fibromyalgia. A randomized, double-blind clinical trial by Carette S1, Bell MJ, Reynolds WJ, Haraoui B, McCain GA, Bykerk VP, Edworthy SM, Baron M, Koehler BE, Fam AG, et al.(PubMed)
(223) The effects of cyclobenzaprine on sleep physiology and symptoms in patients with fibromyalgia by Reynolds WJ1, Moldofsky H, Saskin P, Lue FA.(PubMed)
(224) Cyclobenzaprine side effects by
(225) Comparative efficacy and harms of duloxetine, milnacipran, and pregabalin in fibromyalgia syndrome by Häuser W1, Petzke F, Sommer C.(PubMed)
(226) Milnacipran for neuropathic pain and fibromyalgia in adults by Derry S1, Gill D, Phillips T, Moore RA.(PubMed)
(227) Side effects of Milnacipran by LXlist
(228) Compounded pain formulations: what is the evidence? by Asbill S, Sweitzer SM, Spigener S, Romero-Sandoval A.(PubMed)
(229) The use of opioids in fibromyalgia by Ngian GS1, Guymer EK, Littlejohn GO.(PubMed)
(230) Opioid complications and side effects by Benyamin R1, Trescot AM, Datta S, Buenaventura R, Adlaka R, Sehgal N, Glaser SE, Vallejo R.(PubMed)


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