The Uncertainties of Metamizole Use

Cascorbi, Ingolf

doi:10.1002/cpt.2258

Cited by 20 publications

(14 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Currently, while evidence exists for the use of IV ketorolac, a non-selective cyclooxygenase (COX) enzyme inhibitor, as a safe and effective component of multimodal analgesia [ 75 , 76 ], data are emerging to support the use of IV and topically applied meloxicam in postoperative medication management based on its longer half-life and cyclooxygenase-2 only inhibition [ 77 , 78 ]. Additionally, use of metamizole (dipyrone) as a unique analgesic with a mechanism mediated through non-COX enzymatic inhibition of prostaglandin E2 formation, is widely employed in Europe for postoperative pain [ 79 , 80 , 81 ]. Limited evidence from a recent Cochrane review of its oral use as a single dose in acute postoperative pain demonstrated efficacy but without any comparators [ 82 ].…”

Section: Resultsmentioning

confidence: 99%

Positive Patient Postoperative Outcomes with Pharmacotherapy: A Narrative Review including Perioperative-Specialty Pharmacist Interviews

Parrish

Bodenstab²,

Carneal

et al. 2022

JCM

View full text Add to dashboard Cite

The influence of pharmacotherapy regimens on surgical patient outcomes is increasingly appreciated in the era of enhanced recovery protocols and institutional focus on reducing postoperative complications. Specifics related to medication selection, dosing, frequency of administration, and duration of therapy are evolving to optimize pharmacotherapeutic regimens for many enhanced recovery protocolized elements. This review provides a summary of recent pharmacotherapeutic strategies, including those configured within electronic health record (EHR) applications and functionalities, that are associated with the minimization of the frequency and severity of postoperative complications (POCs), shortened hospital length of stay (LOS), reduced readmission rates, and cost or revenue impacts. Further, it will highlight preventive pharmacotherapy regimens that are correlated with improved patient preparation, especially those related to surgical site infection (SSI), venous thromboembolism (VTE), nausea and vomiting (PONV), postoperative ileus (POI), and emergence delirium (PoD) as well as less commonly encountered POCs such as acute kidney injury (AKI) and atrial fibrillation (AF). The importance of interprofessional collaboration in all periprocedural phases, focusing on medication management through shared responsibilities for drug therapy outcomes, will be emphasized. Finally, examples of collaborative care through shared mental models of drug stewardship and non-medical practice agreements to improve operative throughput, reduce operative stress, and increase patient satisfaction are illustrated.

show abstract

Section: Resultsmentioning

confidence: 99%

Positive Patient Postoperative Outcomes with Pharmacotherapy: A Narrative Review including Perioperative-Specialty Pharmacist Interviews

Parrish

Bodenstab²,

Carneal

et al. 2022

JCM

View full text Add to dashboard Cite

show abstract

“…It can be assumed that this is due to the fact that these studies did not examine surgical patients and that they were performed in countries where metamizole is not approved [ 25 ]. Considering the administration of metamizole (dipyrone) as an antipyretic and nonopioid analgesic drug frequently approved for severe pain upon surgery [ 26 ] in 19 European as well as in several Latin American and Middle East countries clearly demonstrates the urgent need for a method enabling TDM for levosimendan including surgical patients and those receiving metamizole. Finally, the TDM protocols established here may be used for clinicians and researchers to obtain data on the therapeutic serum or plasma levels of levosimendan and its metabolites, investigating the effect of different doses in children, patients with myocardial dysfunction undergoing cardiac surgery, sepsis, and weaning failure.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous LC-ESI-MS/MS Quantification of Levosimendan and Its Metabolites for Therapeutic Drug Monitoring of Cardiac Surgery Patients

et al. 2022

View full text Add to dashboard Cite

Levosimendan is used in severe chronic cardiac insufficiency, also within the peri-operative setting. Real-life pharmacokinetic data in surgical patients is lacking, making therapeutic drug monitoring (TDM) of levosimendan, its pharmacologically active metabolite OR-1896, and its intermediate OR-1855 important. A simultaneous highly sensitive quantification of levosimendan and its metabolites in small-volume samples has not yet been described. Here, levosimendan (LLOQ 0.450 nM), OR-1896, and OR-1855 (LLOQ both 1.0 nM) were successfully quantified by LC-ESI-MS/MS after liquid-liquid extraction in 300 µL of blood. A short C8 column under reversed-phase conditions enabled simultaneous and fast quantification of levosimendan in the negative and the metabolites in the positive ionization mode in a single run within 2 min. Interestingly and unexpectedly, constitutional isomers of levosimendan metabolites with identical mass transitions and similar retention times were observed in surgical patients’ samples, which we identified as the metamizole metabolites 4-aminoantipyrine and 4-acetamidoantipyrine. A longer C8 column and a modified mobile phase enabled selective quantification of all analytes in a single run within 7 min. We developed, validated, and applied highly sensitive LC-ESI-MS/MS methods for simultaneous quantification of levosimendan and its metabolites, enabling efficient TDM of cardiac surgery patients even with additional metamizole administration.

show abstract

“…Намира широко приложение в много страни от Европа, Азия и Южна Америка, но поради потенциално животозастрашаващите странични ефекти като агранулоцитоза и чернодробна недостатъчност е забранен за употреба в САЩ, Австралия, Канада и някои европейски държави (7).…”

Section: Metamizole(analgin)unclassified

Current trends in the treatment of postoperative pain in abdominal surgery. A review

Zanev,

Naydenova

2022

vmf

View full text Add to dashboard Cite

Следоперативната болка е една от основните причини за настъпили ранни постоперативни усложнения. Тя влияе върху сърдечносъдовата, дихателната, ендокринната, нервната и други системи. Лошият й контрол може да доведе до повишена заболеваемост и смъртност, хронифициране на болката и удължен болничен престой. В съвременната медицина се използват множество техники и медикаменти за лечение на острата постоперативна болка, всяка от които със своите ограничения. Цел на настоящия обзор е да обобщи съвременните тенденции в постоперативната аналгезия, използвани при хирургия в долен коремен отдел.

show abstract

The Uncertainties of Metamizole Use

Cited by 20 publications

References 13 publications

Positive Patient Postoperative Outcomes with Pharmacotherapy: A Narrative Review including Perioperative-Specialty Pharmacist Interviews

Positive Patient Postoperative Outcomes with Pharmacotherapy: A Narrative Review including Perioperative-Specialty Pharmacist Interviews

Simultaneous LC-ESI-MS/MS Quantification of Levosimendan and Its Metabolites for Therapeutic Drug Monitoring of Cardiac Surgery Patients

Current trends in the treatment of postoperative pain in abdominal surgery. A review

Contact Info

Product

Resources

About