Prohemorrhagic Potential of Dipyrone, Ibuprofen, Ketorolac, and Aspirin: Mechanisms Associated with Blood Flow and Erythrocyte Deformability

Bozzo, J.; Escolar, Ginés; Hernández, M. R.; Galán, Ana M.; Ordinas, Antonio

doi:10.1097/00005344-200108000-00003

Cited by 35 publications

(15 citation statements)

References 30 publications

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“…A study by O'Neal 57 showed a peak plasma concentration 15 minutes after administration, compared with greater than 45 minutes with oral administration. 51 The risk of hospitalization for gastrointestinal bleeding is also higher with ketorolac. They also have the advantage of more predictable and precise therapeutic dosing.…”

Section: Nsaids and Acetaminophenmentioning

confidence: 99%

ISIS Alleges Inaccuracies in FDA Epidural Steroid Injection Alert

2014

Topics in Pain Management

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Learning Objectives: After participating in this CME activity, the physician should be better able to: 1. Identify the challenges of managing acute pain in obese patients in the perioperative period. 2. Describe the relationship between anatomic, physiologic, genetic, and psychologic changes that occur in obesity and their roles in complicating acute pain management. 3. Evaluate the factors that guide the selection process of the optimal pain regimen in this population.Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maxi mum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation assessment survey on the enclosed form, answering at least 70% of the quiz questions correctly. This activity expires on August 31, 2015.

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Section: Nsaids and Acetaminophenmentioning

confidence: 99%

ISIS Alleges Inaccuracies in FDA Epidural Steroid Injection Alert

2014

Topics in Pain Management

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“…Apart from a minor central effect metamizol and its metabolites act mainly via both COX 1 and COX 2 inhibition [3] [4]. In vitro studies showed that the prohaemorrhagic effect of metamizol was comparable with the one of aspirin [5]. In contrast to classical COX inhibitors metamizol is a stronger inhibitor of platelet aggregation [5], but has no anti-inflammatory effect and low gastrointestinal toxicity, indicating a different mode of action [2].…”

Section: Introductionmentioning

confidence: 99%

“…In contrast to classical COX inhibitors, metamizol is a stronger inhibitor of platelet aggregation [5], but has no anti-inflammatory effect and low gastrointestinal toxicity, indicating a different mode of action [2]. The classical NSAIDs act by competing with arachidonic acid for binding to the cyclooxygenase active site.…”

mentioning

confidence: 99%

“…Bozzo et al [5] compared the prohaemhorragic effect of different NSAIDs (dipyrone/metamizol, ibuprofen, ketorolac and aspirin) under experimental conditions. They performed perfusion studies and demonstrated that aspirin showed the most remarkable effects on platelet function under experimental conditions, closely followed by metamizol [5].…”

mentioning

confidence: 99%

“…They performed perfusion studies and demonstrated that aspirin showed the most remarkable effects on platelet function under experimental conditions, closely followed by metamizol [5].…”

mentioning

confidence: 99%

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Can High Dose Metamizol Medication Contribute to Postsurgical Hemorrhage:A Case Report

Wildpaner¹,

Flueckiger²,

Schmid³

et al. 2015

OJMN

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The use of metamizol significantly increased in the last decade, especially in non US countries [1]. Although metamizol is known to be a non selective COX inhibitor and therefore has platelet inhibiting potential, it is widely used in pain management in postsurgical setting. Methods: We present a case of bleeding after microsurgical decompression of a narrow lumbar spinal canal. Our patient developed a bleeding complication 3 days after the surgery. The bleeding spontaneously resolved after stopping the application of metamizol. Metamizol is a non selective COX inhibitor and is used as standard analgetic drug after surgery in our department, whereas other COX inhibitors are not. We made an intensive literature research to evaluate the prohaemorrhagic potential of metamizol. Metamizol has proven dose dependent platelet inhibiting effect. Conclusions: This is a quite ordinary case and there is no proof of metamizol being responsible for the bleeding in this case, it still poses questions at our daily routine and the question about a dose dependent clinically relevant prohaemorrhagic effect of metamizol remains unanswered. A proper study is needed.

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