Isoxsuprine in the Treatment of Sickle Cell Painful Crises: A Double-Blind Comparative Study with Narcotic Analgesic

Al‐Jam'a, Ali H.; Al-Dabbous, Ibrahim A.; Rafiq, Muhammad Salman; Al-Khatti, Adil A.; Al-Salem, Ahmed H.; Al-Baharna, Abdalali; Boholaiga, Mohammed

doi:10.5144/0256-4947.1999.97

Cited by 10 publications

(6 citation statements)

References 15 publications

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“…In accordance with such temperature-related low-flow states, several studies have proposed that reduced shear flow may facilitate occlusion of vessels by promoting greater interaction and adherence between S-erythrocytes, adherent leukocytes, and vessel endothelium (15)(16)(17). Further correlation to the above mechanism can be inferred from studies by Al-Jam'a et al and Mack et al, wherein isoxsuprine and nitric oxide, respectively, both potent vasodilators and promoters of greater blood flow, were shown to be effective in the treatment of VOC (18,19). Concordant to the low flowadherence theory, Turhan et al showed that defecting adherent activity of leukocytes via knockout of P-and S-selectins protected cremasteric venule walls against vasoocclusion in mice with human-type sickle cells (20).…”

Section: Discussionmentioning

confidence: 99%

Pediatric Vasoocclusive Crisis and Weather Conditions

Rogovik

Persaud

Friedman

et al. 2011

The Journal of Emergency Medicine

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Section: Discussionmentioning

confidence: 99%

Pediatric Vasoocclusive Crisis and Weather Conditions

Rogovik

Persaud

Friedman

et al. 2011

The Journal of Emergency Medicine

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“…N ‐methyl‐ d ‐aspartate (NMDA)‐receptor antagonists) produce analgesia mainly in pain‐sensitized individuals (antihyperalgesia) (Kawamata et al., 2000). Because analgesic action of isoxsuprine has been reported in women suffering from dysmenorrhoea (Akerlund and Andersson, 1977), in patients with painful crises because of sickle cell disease (Al‐Jam'a et al., 1999) and in mice submitted to an acetic acid constriction test (Bentley and Starr, 1986), it might be possible that isoxsuprine produces antihyperalgesia rather than analgesia.…”

Section: Discussionmentioning

confidence: 99%

“…This is likely due to penetration of isoxsuprine into the cell membrane of the erythrocytes, which may increase their deformability. It is feasible that a rheological effect may account for the therapeutic mode of action of isoxsuprine in patients suffering from dysmenorrhoeic pain (Akerlund and Andersson, 1977), sickle cell disease painful crises (Al‐Jam'a et al., 1999) and intermittent claudication because of obstructions at the femoro‐popliteal level (Skotnicki et al., 1984). A rheological effect also has been proposed as a possible therapeutic mechanism of action for isoxsuprine in laminitic horses (Brumbaugh et al., 1999) and horses suffering from navicular disease (Erkert and MacAllister, 2002), but this has not been investigated.…”

Section: Discussionmentioning

confidence: 99%

“…This raises the possibility that isoxsuprine's beneficial effects might be mediated by additional mechanisms of action to that of peripheral vasodilatation. In this regard, it is known that isoxsuprine reduced the C‐fibre discharge in a rabbit vagus nerve preparation (den Hertog, 1976), diminished the number of writhes in mice submitted to an acetic acid constriction test (Bentley and Starr, 1986) and produced analgesia in women suffering from dysmenorrhoea (Akerlund and Andersson, 1977) and in patients with painful crises because of sickle cell disease (Al‐Jam'a et al., 1999). These data lead to the theory that the therapeutic effects of isoxsuprine in horses might be mediated by inducing analgesia (Brumbaugh et al., 1999).…”

Section: Introductionmentioning

confidence: 99%

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An Analgesic Evaluation of Isoxsuprine in Horses

Lizarraga

Castillo

Valderrama

2004

Journal of Veterinary Medicine Series A

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Isoxsuprine is used clinically to treat navicular disease and laminitis in horses. Although it is thought to increase digital and laminar blood flow, isoxsuprine's mechanism of action remains controversial, and analgesia has been suggested recently as such possible mechanism. This research investigated the analgesic potential of isoxsuprine in healthy horses submitted to a mechanical nociceptive test. Isoxsuprine (1.2 mg/kg), xylazine (1.1 mg/kg), distilled water : ethanol 95% (2 : 1, v/v, 20 ml) and saline (0.9%, 20 ml) were injected intravenously, and nociceptive thresholds were measured over 90 min. Only xylazine significantly increased nociceptive thresholds, confirming that alpha(2)-adrenoceptor agonists produce analgesia in horses. Our results do not support an analgesic mechanism of action for isoxsuprine in horses, suggesting that other mechanisms might account for the clinical efficacy of this drug or that mechanical nociceptive testing may not be sufficiently sensitive to demonstrate an analgesic effect for this drug.

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“…Ali H. Al-Jam’a et al . ( Al-Jam'a et al, 1999 ) performed a double-blind randomized comparative study, they divided the patients to receive either isoxsuprine 5–10 mg or meperidine (pethidine) 50–100 mg IM. Overall, they observed no significant statistical difference among the two groups regarding their age, gender, weight, or height.…”

Section: Resultsmentioning

confidence: 99%

Commonly used agent for acute pain management of sickle cell anemia in Saudi Emergency Department: A narrative review

Hejazi

Mandourah

Alsulami

et al. 2021

Saudi Pharmaceutical Journal

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Introduction Sickle-cell disease (SCD) is one of the most common hematologic inherited disorders in Saudi Arabia. Vaso-occlusive pain crisis in SCD is a major cause for emergency visits and patients’ pain may be undertreated. This study presents a narrative literature review of current agents used to manage acute pain crisis in SCD patients presenting to the emergency department in hospitals of Saudi Arabia. Method We conducted a narrative review on relevant published articles about sickle cell disease pain crisis management in Saudi Arabia and included seven relevant studies based on our inclusion criteria. Results Using our search strategy, we included 7 studies Out of 4052. Studies included were conducted in different locations in the country. Four studies were in the Eastern region while only one in Western and One in Central regions. Those studies included around 2441 patients, in total. Morphine was used in 5 studies out of the 7 included. Pethidine was used in 4. One study used Isoxsuprine and another study used tinzaparin. Conclusion We found that continuous administration of IV morphine accompanied by oral analgesics including NSAIDs and acetaminophen is the most commonly used practice for treating SCD patients presenting with a vaso-occlusive pain crisis. Possible effectiveness of tinzaparin, isoxsuprine, and pethidine as therapeutic options may be considered. However, there was no recommendation for a certain agent to be prescribed. We recommend conducting further clinical randomized-controlled trials.

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Isoxsuprine in the Treatment of Sickle Cell Painful Crises: A Double-Blind Comparative Study with Narcotic Analgesic

Cited by 10 publications

References 15 publications

Pediatric Vasoocclusive Crisis and Weather Conditions

Pediatric Vasoocclusive Crisis and Weather Conditions

An Analgesic Evaluation of Isoxsuprine in Horses

Commonly used agent for acute pain management of sickle cell anemia in Saudi Emergency Department: A narrative review

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