MANAGEMENT OF PAIN AND FEVER IN DIFFERENT MEDICINAL SYSTEM- A REVIEW
HTML Full TextMANAGEMENT OF PAIN AND FEVER IN DIFFERENT MEDICINAL SYSTEM- A REVIEW
Sushma Singh 1, Sandeep Kumar Singh * 1 and Kuldeep Singh 2
Department of Pharmacology 1, School of Pharmacy, Babu Banarsi Das University, Lucknow - 226028, Uttar Pradesh, India.
Faculty of Pharmacy 2, Integral University Kursi Road, Dasauli, Lucknow - 226028, Uttar Pradesh, India.
ABSTRACT: Pain is a subjective, multidimensional and unpleasant experience allied with actual or potential tissue damage comprising sensory, affective and cognitive components. Pain signals interpretation is a complex process that entails excitation of peripheral nerves and further excitation of nociceptive inputs. Painkiller is member of diverse group of drugs used to relieve pain and to achieve analgesia. Fever is recognized as physiological response which is triggered by infectious stimuli or aseptic stimuli. Elevation in body temperature occur when concentrations of prostaglandin-E2 (PGE2) increases within certain areas of the brain. These elevations alter the firing rate of neurons that control thermoregulation in the hypothalamus. It is commonly suppressed with antipyretic medications. Several traditional medicinal systems are available for the treatment of pain & fever like Ayurveda, Unani, Chinese, homeopathic, physiotherapy & non- pharmacological procedures etc. Pain & fever treatment in allopathic system are frequently used but has many adverse effects like renal & liver dysfunction, ulceration, sedation, dizziness, nausea, vomiting, constipation, physical dependence, tolerance, and respiratory depression, etc. This compilation addresses the different medicinal systems and therapies used for the treatment of pain and fever.
Keywords: Pain, Fever, Allopathic, Ayurvedic, Homeopathic, Unani
INTRODUCTION: Pain is an ill-defined, unpleasant sensation which is evoked by external and internal noxious stimuli 1. Pain is useful in some situations that motivate individual to withdraw from damaging situations that may lead to many diseases such as a tumor, physical trauma, surgical procedures, noxious chemical stimulation, etc. 2 Thus, pain can be known as the protector as well as predictor 3.
Pain Pathophysiology: A painful stimulus elicits activation of receptors in the periphery, which transduces the stimulus into an electrical impulse 4. Pain signals is a complex process which results in local interactions within the spinal dorsal horn, and then activation of ascending and descending circuits that comprise a loop from the spinal cord to supraspinal structures and finally exciting nociceptive inputs at the spinal level 5.
Numerous chemical substances play important role in generating nociceptive impulses (e.g., prostaglandins, histamine, serotonin). Furthermore, the role of neuropeptides as calcitonin gene-related peptide and particularly substance P has been demonstrated in the activation of early neurogenic inflammation. Bradykinin and cytokines are also involved in prolonging the sensation of pain 6.
Nociceptive Pain Mechanism: Nociceptive pathway, consist of a three-neuron chain, is now understood to be a dual system at each level, and the sensation of pain is thought to arrive in the central nervous system with the discriminative component of pain ("first pain") carried separately from the affective-motivational component of pain ("second pain") 7. In addition to spinal control mechanisms of nociceptive transmission, descending pathways originates in three major areas that are cortex, thalamus, and brain stem and can modify functions at the spinal level. The nociceptive ending is stimulated by prostaglandins, bradykinin, and other neurotransmitter, metabolites and ions 8. Each of these factors sensitizes (lowers the threshold) or excite the terminals of the nociceptor by interacting with cell-surface receptors expressed by these neurons whereby release of substance P, neurotransmitters, and calcitonin gene-related peptide (CGRP), from the peripheral terminal, induces vasodilation and plasma extravasation 9.
Fever: Fever or pyresis is recognized as a complex, coordinated, autonomic, behavioral response, and neuroendocrine, which occurs due to acute phase reaction to immune challenge 10.
Pathophysiology of Fever: Fever appears evolved in vertebrate hosts as an adaptive mechanism to control infection. This phenomenon is produced by some exogenous (largely microbial) stimuli that activated bone-marrow-derived phagocytes to release an endogenous pyrogen. That circulates to the thermoregulatory center of the brain (preoptic area of the anterior hypothalamus) where it causes an elevation in the "set-point" for normal body temperature 11.
Molecular Mechanism of Fever: Distinct members of Toll receptors in macrophages receptor family recognize different and specific microbial components, but biosynthesis and releases same endogenous pyrogens, such as IL-1β, TNF, and IL-6 12. These pyrogenic cytokines acts on organum vasculosum area of the brain known as laminae terminalis leading to activation of the enzyme cyclooxygenase-2 (COX-2) that results in release of prostaglandin E2 (PGE2), which binds to receptors in the hypothalamus leading to an increase in heat production and a decrease in heat loss until the temperature in the hypothalamus reaches an elevated set-point 13.
TABLE 1: ALLOPATHIC TREATMENT OF PAIN
For mild pain | For moderate pain | For severe pain |
A non-narcotic analgesic or NSAIDs like Aspirin14, paracetamol 15, ibuprofen 16, acetaminophen 17, diclofenac 18, meloxicam 19 are used to treat mild pain if the pain is unable to recover then narcotic drugs is recommended
Adverse effect- Renal & liver dysfunction, ulceration 20 |
Narcotic (opioid) analgesics or low-efficacy opioids are codeine, dihydrocodeine 21, dextropropoxyphene, pentazocine 22, Alfentanyl 23, Tramadol 24.
NSAID, in combination with a low-efficacy opioid, can be used in case of acute pain but less convenient for chronic pain Adverse effect- respiratory depression, sedation, dependence, tolerance, dizziness, vomiting, constipation 25 |
High-efficacy opioids are used in case of severe pain these are morphine 26, diamorphine 27, buprenorphine 28
Adverse effect- Sedation, drowsiness, sleep disturbance, seizures, hyperalgesia and tolerance 29, constipation, hallucinations 30 |
TABLE 2: CERTAIN CLINICAL PAIN AND THEIR TREATMENT
Clinical Pain Condition | Drug of Choice |
Acute abdominal pain | Strong opioids 31 |
Acute migraine | Aspirin, acetaminophen, NSAID’s, opioid analgesics 32 |
Atypical facial pain | Ibuprofen, naproxen, procaine, lidocaine, sodium hyaluronate, cyclobenzaprine, amitriptyline, nortriptyline 33 |
Fibromylgia | Pregabalin, duloxetine, milnacipran, amitriptyline, cyclobenzaprine, gabapentin, tramadol, fluoxetine, sodium oxybate 34 |
Burn injury
Neuropathic pain
|
Opioids, NSAIDs, paracetamol and dipyrone, gabapentin and pregabalin, ketamine, amitriptyline 35
First-line medications- nortriptyline or desipramine 36 Second-line medications- Tramadol 37 Third-line medications- antidepressant, antiepileptic medications, capsaicin, dextromethorphan, memantine, mexiletine 38 |
Inflammatory arthritis | NSAID’s, Paracetamol 39,capsaicin, cannabinoids, antidepressant, strong opioid 40 |
Postoperative cancer pain | Strong opioids 41, capsaicin 42 |
Osteoarthritis | Strong opioids, weak arthritis, NSAID’s 43 |
Targets of New Analgesics: Ion channels are integral membrane proteins that contain pathways through which ions can flow 44. They are considered likely targets in the treatment of pain 45. Members of Voltage-gated calcium channels family contain a2d, b and g subunits, and play a role in neuronal excitation. The a2d subunit of L-type calcium channels is the target of the established co-treatments for neuropathic pain 46. These calcium channels also play key role in chronic pain 47. They are coded by the CACNA1B gene and expressed at the presynaptic terminals of primary afferent neurons that end in the dorsal horn of the spinal cord 48. Potassium channel KIR3.2, a two-transmembrane-one pathway potassium channel, is involved in opioid signaling on postsynaptic inhibition 49 and mediates a significant component of analgesia 50. Cerebral endocannabinoid signaling is involved in antinociception 51.
5-HT receptors are expressed in the central and peripheral nervous systems where they mediate both excitatory and inhibitory neurotransmission 52. Several 5-HT receptor subtypes are involved in nociception 53. Currently, only the 5-HT1A receptor is being studied as the target of an analgesic. trkA is a catalytic receptor being approached as an analgesics target 54.
Allopathic Treatment of Fever: For the treatment of fever it is necessary to know the fever’s underlying cause. Different over the counter are used in reducing body temperature to a normal level as well as to treat the underlying cause. OTC antipyretic that are used normally includes nonsteroidal anti-inflammatory drugs like aspirin 55, nimesulide 56, paracetamol 57, ketoprofen 58, ibuprofen 59, meloxicam 60, celecoxib 61, rofecoxib 62.
The Target of Antipyretic: Cyclooxygenase (COX), also known as prostaglandin endoperoxide synthase, is the key enzyme required for the conversion of arachidonic acid to prostaglandins. Two COX isoforms have been identified, COX-1 and COX-2. In many situations, the COX-1 protein is produced constitutively (e.g., in gastric mucosa), whereas COX-2 is highly inducible (e.g., at sites of inflammation and cancer). Traditional nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit both enzymes, and a new class of COX-2 selective inhibitors (COXIBs) preferentially inhibits the COX-2 enzyme 63.
Herbal Treatment of Pain: Many medicines of plant origin had been used since ages without any adverse effects. There is much importance of pain relief from these analgesic herbs; some are the best-loved and most popular remedies. Some uses for Analgesic herbs are mostly common in neuralgia, toothaches, sore muscles lower back pain and headaches 64.
TABLE 3: SOME OF the HERBS WITH ANALGESIC ACTIVITY
Plant name | Family | Part used | Chemical Constituent | Activity may be due to |
Cleome rutidosperma (Purple Cleome) | Capparidaceae | Ariel part | Tannins, steroids, flavonoids, terpenoids | Inhibition of cyclooxygenase, a prostaglandin derivative 65 |
Psidium Cattleianum (araça-rosa) | Myrtaceae | Leaves | Phenolic compounds such as gallic acid and epicatechin | Its antioxidant effect 66 |
Caralluma dalzielii (mosque stalk) | Asclepiadaceae | Whole plant | Saponins, alkaloids, glycosides, tannins, terpenoids, flavonoid | Inhibition of either synthesis, release or action of PGE2, PGF2α, serotonin, and histamine 67 |
Urtica circularis (ortiga) | Urticaceae | Ariel part | Caffeic acid, chlorogenic acid, and vitexin | Increased cGMP concentration which will lead to hyperpolarization
thereby inducing analgesia 68 |
Artemisia scoparia (Jhahoo) | Asteraceae | Whole plant | Chlorogenic acid, coumarin, capillariasis, butyl ester, magnolioside, and b-sitosterol | An inhibitory effect on the production or action of inflammatory mediators 69 |
Indigofera cassioides (Cassia Indigo) | Fabaceae | Leaves | Phenols, quercetin, flavonoids | Inhibition of both
cyclooxygenase and 5-lipooxygenase pathways 70 |
Cyathula prostrate (Prostrate pasture weed) | Amaranthaceae | Leaves | Flavonoids | Inhibition of cyclooxygenase and 5-lipooxygenase pathways 71 |
Impatiens balsamina (Dopati) | Balsaminaceae | Flower | Phenols, flavonoids, and tannins | Decreased cAMP level, potassium ion efflux, and subsequent hyperpolarization of the nerves which give the anti-nociceptive effect 72 |
Alpinia calcarata (Heen-araththa) | Zingiberaceae | Rhizome | Phenol, flavonoids | Inhibition of the production of prostaglandins (E2 & F 73 |
Herbal Treatment of Fever: Traditional systems of medicine or care by herbals are used throughout the world and from century’s herbs have been the source for most of the drugs. Numerous medicinal plants are available today for treating fever 74.
TABLE 4: SOME OF THE HERBS WITH ANTIPYRETIC ACTIVITY
S. no. | Botanical/ Common name | Family | Part used | Chemical
constituent |
Activity may be due to |
1 | Magnolia obovate
(inha-do-brejo) |
Magnoliaceae | Trunk bark | Costunolide and related sesquiterpene lactones | Inhibition
of COX-2 75 |
2 | Vernonia cinerea | Asteraceae | Leaf | Terpenoid, alkaloid, flavonoid | CNS depression which is due to decreased excitatory activities of the monoamines 76 |
3 | Artemisia scoparia (Worm wood) | Asteraceae | Whole plant | Chlorogenic acid butyl ester, Magnoliopsida | Inhibitory influence on prostaglandin biosynthesis or release 77 |
4 |
Bauhinia racemosa (Mountain ebony) | Caesalpiniaceae | Stem bark | Flavonoids, coumarins, triterpenoids, stilbenes, steroids, and tannin | Unknown 78 |
5 |
Clitoria ternatea (Butterfly pea) | Fabaceae | Root | Flavonoids | Unknown 79 |
6 | Phrygilanthus acutifolius (corpo) | Loranthaceae | Flowers | - | Inhibition of prostaglandin synthesis 80 |
7 | Mallotus peltatus(Pataque | Euphorbiaceae | Leaves | Sitosterol | Inhibition of prostaglandin synthesis 81. |
8 | Hyoscyamus niger (henbane) | Solanaceae | Seed | Cleomiscosin A | Unknown 82 |
9 | Diospyros mespiliformis (Jackal berry tree) | Ebenaceae | Stem bark | Alkaloids, quinones,
saponins, sterol, tannins |
Inhibition of
sensitization of pain receptors by prostaglandin at the inflammatory site 83 |
10 | Caesalpinia bonducella
(Yellow nicker) |
Caesalpiniaceae | Leaves | Flavonoids, alkaloids, saponins, triterpenes, tannins, and steroids | Inhibition of prostaglandin synthesis 84 |
Homeopathy Treatment of Pain: Homeopathic Remedies have an essential role in body pains and aches treatment. Homeopathic treatment does not have side effect and can be obtained from naturally occurring plant and substance 85.
Unani Treatment of Pain: In the Unani literature, Arabic word Waja’ is used for pain. Unani medicine system uses naturally the treatment of different alignment. These drugs treat the disease and have no side effect 87.
TABLE 5: HOMEOPATHIC REMEDIES FOR PAIN 85
Homeopathic Remedies | Treatment |
Rhus toxicodendron | Essential in treatment of pain and aches at resting position and are of a better choice in overstraining and overstretching |
Arnica montana | It is effective in sore body pain and joint pain |
Bryonia alba | It is of use in pain and aches resulting from muscle and joint |
Magnesium phosphorica | It is useful in pains and aches of wide varieties (shooting, cutting or stitching in nature) |
Ruta graveolens | Useful when pain is associated with weakness |
Gelsemium sempervirens | Useful in pain associated with drowsiness |
Eupatorium perfoliatum | It is useful in pains that are associated with fever |
Bryonia alba | It is useful in joint pian due to Rheumatoid arthritis. |
TABLE 6: HOMEOPATHY TREATMENT OF FEVER 86
Homeopathic Remedies | Treatment |
Aconite | When skin is dry and restless |
Belladonna | When there is delirium with the fever |
Bryonia | When the patient is restlessness and wants to rest |
Gelsemium | When the patient is drowsy and sleepy |
Mercurius Vivus | When there are chill and sweating |
Nux Vomica | When the body is hot |
Pulsatilla | When there is constant chillness |
Pyrogeneum | When the temperature is high and low in an alternating way |
Rhus Toxicodendron | When fever is caused by getting wet |
TABLE 7: UNANI DRUGS FOR PAIN
Plant | Family | Part used |
Zingiber officinale | Zingiberaceae | Rhizome 88 |
Piper nigrum | Piperaceae | Fruits 89 |
Bambusa arundinaceae | Bambusaceae | Leaves 89 |
Curcuma longa | Zingiberaceae | Rhizome 90 |
Saussurea lappa | Asteraceae | Roots 91 |
TABLE 8: UNANI TREATMENT OF FEVER
Plant | Family | Part used |
Piper longum Linn. | Piperaceae | Fruits, root 92 |
Cassia fistula Linn. | Leguminosae | Resin 93 |
Eugenia jambolana Lam. | Myrtaceae | Seed, bark, leaf 94 |
Plumbago zeylanica Linn | Plumbaginaceae | Root, root bark 95 |
Zingiber officinale Rosc. | Zingiberaceae | Rhizome 96. |
Home Remedies for the Treatment of Fever: When there is mild fever home remedy is sufficient to treat it, mainly when there is a mild infection like flu and cold. Some of the remedies are
- Fluid intake should be increased.
- If the fever is high then bath to reduce it and not to eliminate it, the room should be well ventilated.
- If the fever raises continuously then sponging with lukewarm water can be useful.
- Any type of stress should be avoided.
- Herbs and other cooking ingredient are also used to reduce fever.
- Boiled filterate of basil leaves in the water on drinking once a day reduces the temperature.
- When fever is present, then a half teaspoon of saffron is taken with warm water.
- Grapefruit juice with water is useful in reducing fever.
- Honey mixed with ginger is useful in fighting fever 97.
Non-Pharmacological Treatment of Pain:
Physiotherapy: Physiotherapy modalities are commonly used in the treatment of pain, especially in rheumatoid arthritis. These consist of heat & cold applications, hydrotherapy, electrical stimulation, etc. By applying heat, muscle spasm is relieved, analgesia is accomplished and elasticity of periarticular structures obtained. The intra-articular temperature increased by superficial heat application 98. In cold application opposite of hot application occurs. Effects of heat application change between normal healthy subjects and patients with inflamed joints 99. Electrostimulation is used in patients with rheumatoid arthritis. Transcutaneous electrical nerve stimulation (TENS) therapy is the most commonly used method in which analgesia is persisted up to 18 hours 100. Massage is a commonly used treatment tool that enhances a feeling of connection with other treatment modalities, improves flexibility, general well being, and useful in inflamed joints 101. Massage is found to be effective on depression, anxiety, mood, and pain 102. Maintenance of normal muscle strength can be maintained by exercise therapy has beneficial effects on increasing physical capacity 103.
Magnetic Therapy: Magnetic therapy is a simple, non-invasive, and safe technique, usually administered over the site of a painful injury or inflammation. It has analgesic efficacy 104.
Psychological Therapy: Pain is also related to underlying physiological processes; there is evidence that indicates that psychological and social factors also play an important role in the experience and impact of pain 105.
Acupuncture: Acupuncture is used in eastern medicine. In these endogenous analgesics is released within the spinal cord 106. Acupuncture is reported to be effective in treating many conditions including, fibromyalgia 107, chronic low back pain 108, as well as chronic pain caused by osteoarthritis 109. Due to its analgesic effects, acupuncture is widely used, cost-effective 110 and a relatively safe non-pharmacological treatment of musculoskeletal pain 111.
CONCLUSION: Allopathic treatment is the most frequently used system, potent and beneficial in emergencies like postoperative pain, burn pain, and acute abdominal pain. Thus in chronic conditions of pain and fever, allopathic medicine system is the preferred as the choice of treatment but has many adverse effects like renal & liver dysfunction, ulceration, sedation, dizziness, nausea, vomiting, constipation, physical dependence, tolerance, respiratory depression, angioneurotic edema, and GI hemorrhage, etc.
Herbal medicines make an enormous contribution to primary health care and have shown great potential in modern phytomedicine against pain and fever. Several plants have been described in Ayurveda, Unani, homeopathy and another traditional medicinal system for the management and prevention of pain and fever according to the perceived needs of the patient and based upon the individual herb’s constituents. Disease with pain and fever are widespread and required more attention; a large number of people these days are looking for herbal remedies and relief for their ailments.
Besides these other non-pharmacological treatments such as physiotherapy, acupuncture, magnetic therapy is used to alleviate pain. Ayurvedic, homeopathic, Siddha, Unani, physiotherapy offers a wide range of preventive and curative treatments that are both cost effective and efficacious. Therefore, our efforts should be directed towards the review of different medicinal system with their target for the treatment of pain and fever with major drugs.
ACKNOWLEDGEMENT: I would like to express my sincere thanks to Prof. Rajiv Gupta, Dean, School of Pharmacy, BBD University, Lucknow, Uttar Pradesh for encouragement and providing library facilities to access the journals. I would also like to thank organizers of the national conference entitled ‘Novel Tools and Treatment Approaches in Health Care System’ for selecting my paper for poster presentation, organized at Faculty of Pharmacy, Integral University, Lucknow on 3rd March 2015.
CONFLICT OF INTEREST: Nil
REFERENCES:
- Dey Y and Gosh A: Evaluation of the analgesic activity of methanolic extract of Amorphophallus paniifolius International Journal of Pharma and Biosciences 2010. 1: 229-44.
- Hanumanthappa S, Hanumanthappa M and Krishnappa P: Analgesic activity of methanolic extract of Cryptostegia grandiflora Asian Pacific Journal of Tropical Disease 2012; 1: 494-98.
- Malviya KG, Shivhare UD and Srivastava P: Evaluation of the analgesic potential of Cyathocycline lyrta plant on rats. Asian Journal of Pharmacology 2013; 2: 82-85.
- Schafer M: Physiology and pathophysiology of pain. European Journal of Pharmacology 1999; 8: 426-30.
- Vanderah TW: Pathophysiology of pain. Medical Clinics of North America 2007; 91: 1-12.
- Besson JM: The complexity of psychopharmacologic aspects of pain. Drugs 1997; 53: 1-9.
- Cross SA: Pathophysiology of pain. Mayo Clinic Proceedings 1994; 64: 375-83.
- Ritter JM, Lewis LD, Mant TGK and Ferro A: A Textbook of Clinical Pharmacology and Therapeutics. Hodder Arnold, Great Britain edition 5, 2008: 155-56.
- Mense S: Basic neurobiological mechanisms of pain and analgesia. American Journal of Medicine 1983; 75: 4-15.
- Kothari VM and Karnad DR: New Onset Fever in Intensive Care. Department of Medicine 2005; 53: 43-49.
- Bernheim, HA, Block LH and Atkins E: Fever: pathogenesis, pathophysiology, and purpose. Annals of Internal Medicine 1979; 21: 261-70.
- Bartfai T and Conti B: Fever. Scientific World Journal 2010; 10: 490-03.
- Young PJ and Saxena M: Fever management in intensive care patients with infections. Young and Saxena Critical Care 2014: 1-8.
- Vane JR, Flower RJ and Botting RM: History of aspirin and its mechanism of action. Stroke 1980; 21: 12-23.
- Hyllested M, Jones S, Pedersen JL and Kehlet H: Comparative effect of paracetamol, NSAIDs, or their combination in postoperative pain management. British Journal of Anaesthesia 2002; 88: 199-14.
- Laska EM, Sunshine A and Marrero I: The correlation between blood levels of ibuprofen and clinical analgesic response. Clinical Pharmacology and Therapeutics 1986; 40: 1-7.
- Cooper SA: Comparative analgesic efficacies of aspirin and acetaminophen. Archives of Internal Medicine 1981; 141: 282-85.
- Brogden RN, Heel RC, Pakes GE, Speight TM and Avery GS: Diclofenac sodium: a review of its pharmacological properties and therapeutic use in rheumatic diseases and pain of varying origin. Drugs 1980; 20: 24-48.
- Engelhardt, Homma GD, Schlegel K, Utzmann R and Schnitzler C: Antiinflammatory, analgesic, antipyretic and related properties of meloxicam, a new nonsteroidal anti-inflammatory agent with favorable gastrointestinal tolerance. Journal of Inflammation Research 1995; 44: 423-33.
- Dundee, JM: Clinical evaluation of mild analgesics. British Journal of Clinical Pharmacology 1980; 10: 329-34.
- Trescot AM, Datta S, Lee M and Hansen H: Opioid pharmacology. Pain Physician 2008; 11: 133-53.
- Becker DE: Managing Acute and Postoperative Dental Pain. Nurse Anesthesia Program 2010; 57: 67-79.
- Servin FS and Billard V: Remifentanil and other opioids. Handbook of Experimental Pharmacology 2008; 182: 283-11.
- Reeves RR and Burke RS: Tramadol: basic pharmacology and emerging concepts. Drugs Today 2008; 44: 827-36.
- Benyamin R, Trescot AM, Datta S, Buenaventura R, Adlaka R, Sehgal N, Glaser SE and Vallejo R: Opioid Complications and Side Effects. Pain Physician Opioid Special 2008; 11: 105-20.
- Paul D, Standifer KM, Inturrisi CE and Pasternak GW: Pharmacological characterization of morphine-6 beta-glucuronide, a very potent morphine metabolite. Journal of Pharmacology and Experimental Therapeutics 1989; 251: 477-83.
- Sawynok J: The therapeutic use of heroin: a review of the pharmacological literature. Canadian Journal of Physiology and Pharmacology 1986; 64: 1-6.
- Muller S, Bedson J and Mallen CD: The association between pain intensity and the prescription of analgesics and non-steroidal anti-inflammatory drugs. European Journal of Pain 2012; 16: 1014-20.
- Brincat JV and Macleod AD: Adverse effects of opioids on the central nervous systems of palliative care patients. Journal of Pain & Palliative Care Pharmacotherapy 2007; 21: 15-25.
- Manchikanti L, Manchikanti KN, Pampati V and Cash KA: Prevalence of side effects of prolonged low or moderate dose opioid therapy with concomitant benzodiazepine and antidepressant therapy in chronic non-cancer pain. Pain Physician, 2009; 12: 259-67.
- Manterola C, Vial M, Moraga J and Astudillo P: Analgesia in patients with acute abdominal pain. Cochrane Database of Systematic Reviews 2011.
- Maagd GD: The Pharmacological Management of Migraine. Overview and Abortive Therapy. Continuing education 33: 404-419.
- Reyes MM and Uyanik JM: Orofacial pain management: current perspectives. Journal of Pain Research 2014; 7: 99-114.
- Arnold LM, Clauw DJ and Dunegan LJ: A Framework for Fibromyalgia Management for Primary Care Providers. Mayo Clinic Proceedings 2012; 87: 488-96.
- Castro RJA, Leal PC and Sakata RK: Pain management in burn patients. Revista Brasileria Anestesiologia 2013: 63.
- Finnerup NB, Otto M, McQuay H J, Jensen TS and Sindrup SH: Algorithm for neuropathic pain treatment: an evidence based proposal. Pain 2005; 118: 289-05.
- Raja SN, Haythornthwaite JA and Pappagallo M: Opioids versus antidepressants in postherpetic neuralgia: a randomized, placebo-controlled trial. Neurology 2002; 59: 1015-21.
- Robert H, Dworkin, Connor ABO, Audette J, Baron R, Gourlay GK, Haanpaa ML and Kent JL: Recommendations for the Pharmacological Management of Neuropathic Pain. Mayo Clinic Proceedings 2010; 5: 3-14.
- Gotzsche PC and Johansen HK: Short-term low-dose corticosteroids vs. placebo and nonsteroidal anti-inflammatory drugs in rheumatoid arthritis. Cochrane Database Systematic Reviews 2004: 3.
- Whittle SL, Richards BL, Husni E and Buchbinder R: Opioid therapy for treating rheumatoid arthritis pain. Cochrane Database Systematic Reviews 2011: 11.
- Derry S, Moore RA and McQuay HJ: Single dose oral codeine, as a single agent, for acute postoperative pain in adults. Cochrane Database Systematic Reviews 2010: 4.
- Quigley C: Hydromorphone for acute and chronic pain. Cochrane Database Systematic Reviews 2002: 1.
- Towheed T, Shea B, Wells G and Hochberg M: Analgesia and non-aspirin, non-steroidal anti-inflammatory drugs for osteoarthritis of the hip. Cochrane Database Systematic Reviews 2000: 2.
- Di RC and Becchetti A: Introduction to ion channels. Advances in Experimental Medicine and Biology 2010; 674: 9-21.
- Mathie A: Ion channels as novel therapeutic targets in the treatment of pain. Journal of Pharmacology and Pharmacotherapeutics 2010; 62: 1089-95.
- Perret D and Luo ZD: Targeting voltage-gated calcium channels for neuropathic pain management. Neuro-therapeutics 2009; 6: 679-92.
- Swayne LA and Bourinet E: Voltage-gated calcium channels in chronic pain, the emerging role of alternative splicing. Pflugers Archives 2008; 456: 459-66.
- Gohil K, Bell JR, Ramachandran J and Miljanich GP: Neuroanatomical distribution of receptors for a novel voltage-sensitive calcium-channel antagonist, SNX-230. Brain Research 1994; 653: 258-66.
- Mitrovic I, Margeta MM, Bader S, Stoffel M, Jan LY and Basbaum AI: Contribution of GIRK2-mediated postsynaptic signaling to opiate and alpha 2-adrenergic analgesia and analgesic sex differences. Proceedings of National Academy of Sciences 2003; 100: 271-76.
- Marker CL, Stoffel M and Wickman K: Spinal G-protein-gated K+ channels formed by GIRK1 and GIRK2 subunits modulate thermal nociception and contribute to morphine analgesia. Journal of Neuroscience 2004; 24: 2806-12.
- Wilson RI and Nicoll RA: Endocannabinoid signaling in the brain. Science 2002; 296: 678-82.
- Hoyer D, Clarke D, Fozard J, Hartig P, Martin G and Mylecharane E: International Union of Pharmacology classification of receptors for 5- hydroxytryptamine (Serotonin). Pharmacological Reviews 1994; 46: 157-03.
- Xu W, Qiu XC and Han JS: Serotonin receptor subtypes in spinal antinociception in the rat. Journal of Pharmacology and Experimental Therapeutics 1994; 269: 1182-89.
- Wang T, Yu D and Lamb ML: Trk kinase inhibitors as new treatments for cancer and pain. Expert Opinion on Therapeutic Patents, Informa Healthcare 2009; 19: 305-19.
- Terrie YC: Managing Fever with Antipyretics 2012. Pharmacy Times.
- Botting R: Antipyretic Therapy. Frontiers in Bioscience 2004; 9: 956-66.
- Lal A, Gomber S and Talukdar B: Antipyretic effects of nimesulide, paracetamol and ibuprofen-paracetamol. Indian Journal of Pediatrics 2000; 67: 865-70.
- Sarzi PP, Atzeni F, Lanata L, Bagnasco M, Colombo MFF and Imporzano M: Pain and ketoprofen: what is its role in clinical practice. Reumatismo 2010; 62: 172-88.
- Pursell E: Systematic review of studies comparing combined treatment with paracetamol and ibuprofen, with either drug alone. Archives of Disease in Childhood 2001: 1-5.
- Degner F, Turck D and Pairet M: Pharmacological, pharmacokinetic and clinical profile of meloxicam. Drugs of Today 1997; 33: 739-58.
- Silverstein FE, Faich G, Goldstein JL, Simon LS, Pincus T, Whelton A, Makuch R, Eisen G, Agrawal NM and Stenson WF: Gastrointestinal toxicity with celecoxib vs. nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis. The class study: a randomized controlled trial. Journal of American Medical Association 2000; 284: 1247-55.
- Schwartz JI, Chan S, Mukhopadhyay KJ, McBride TM, Jones S, Adcock C, Moritz J, Hedges K, Grasing D and Dobratz RA: Cyclooxygenase-2 inhibition by rofecoxib reverses naturally occurring fever in humans. Clinical Pharmacology and Therapeutics 1999; 65: 653-60.
- Turini ME, DuBois RN: Cycloxygenase 2, a therapeutic target. Review of Medicine 2002; 53: 35-57.
- Sharma JP, Srivastava A, Thakur SP, Barpete PK and Singh S: Herbal medicine as antipyretic: A comprehensive review. International Journal of Pharmacy & Life Sciences 2010; 1: 18-22.
- Bose A, Mondal S, Gupta JK, Ghosh T, Dash GK and Si S: Analgesic, anti-inflammatory and antipyretic activities of the ethanolic extract and its fractions of Cleome rutidosperma. Fitoterapia 2007; 78: 515-20.
- Alvarenga FQ, Mota BCF, Leite MN, Fonseca JMS, Oliveira DA, Royo VA, Silva MA., Esperandim V, Borges A and Laurentiz RS: In-vivo analgesic activity, toxicity and phytochemical screening of the hydroalcoholic extract from the leaves of Psidium cattleianum Journal of Ethnopharmacology 2013; 150: 280-84.
- Oguejiofor CJC, Abubakar K, Ugwah MO and Njan AA: Evaluation of the antinociceptive and anti-inflammatory effect of Caralluma dalzielii. Journal of Ethno-pharmacology 2013; 150: 967-72.
- Gorzalczanya S, Marrassinib C, Minoa J, Acevedoa C and Ferrarob G: Antinociceptive activity of ethanolic extract and isolated compounds of Urtica circularis. Journal of Ethnopharmacology 2011; 134: 733-38.
- Habib M and Waheed I: Evaluation of anti-nociceptive, anti-inflammatory and antipyretic activities of Artemisia scoparia hydroethanolic extract. Journal of Ethno-pharmacology 2013; 145: 18-24.
- Kumar RS, Rajkapoor B and Peruma P: Anti-inflammatory and anti-nociceptive activities of methanolic leaf extract of Indigofera cassioides Ex. DC. Journal of Acute Disease 2013: 322-326.
- Ibrahim B, Sowemimo A, Rooyen A and Venter M: Anti-inflammatory, analgesic and antioxidant activities of Cyathula prostrata (Linn.) Blume (Amaranthaceae). Journal of Ethnopharmacology 2012; 141: 282-89.
- Imam MZ, Nahar N, Akter S and Rana S: Antinociceptive activity of methanol extract of flowers of Impatiens balsamina. Journal of Ethnopharmacology 2012; 142: 804-10.
- Anbarasu K, Manisenthil K and Ramachandran S: Antipyretic, anti-inflammatory and analgesic properties of nilavembu kudineer choornam: a classical preparation used in the treatment of chikungunya fever. Asian Pacific Journal of Tropical Medicine 2011: 819-23.
- Shah BN and Seth AK: Medicinal plants as a source of antipyretic agents a review. Archives of Applied Science Research 2010; 2: 188-95.
- Kassuya CAL, Cremonezea A, Barrosb LFL, Simasa AS, Lapaa FR, Silvac RM, Stefanellob M EA and Zampronioa AR: Antipyretic and anti-inflammatory properties of the ethanolic extract, dichloromethane fraction and costunolide from Magnolia ovata (Magnoliaceae). Journal of Ethnopharmacology 2009; 124: 369-76.
- Iwalewa EA, Iwalewa OJ and Adeboye JO: Analgesic, antipyretic, anti-inflammatory effects of methanol, chloroform and ether extracts of Vernonia cinerea less leaf. Journal of Ethnopharmacology 2003; 86: 229-34.
- Habib M and Waheed I: Evaluation of anti-nociceptive, anti-inflammatory and antipyretic activities of Artemisia scoparia hydromethanolic extract. Journal of Ethnopharmacology 2013; 145: 18-24.
- Gupta JK, Mishra P, Rani A and Mitra M: Blood glucose lowering potential of stem bark of Berberis aristata DC in alloxan-induced diabetic rats. Iranian Journal of Pharmacology and Therapeutics 2010; 9: 21-24.
- Devi DP, Boominathan R and Mandal SC: Anti-inflammatory, analgesic and antipyretic properties of Clitoria ternatea Fitoterapia 2003; 74: 345-49.
- Daud A, Habib NA and Riera SA: Anti-inflammatory, anti-nociceptive and antipyretic effects of extracts of Phrygilanthus acutifolius Journal of Ethnopharmacology 2006; 108: 198-03.
- Chattopadhyay D, Arunachalam G, Mandal AB and Mandal SC: Evaluation of the antipyretic activity of leaf extracts of Mallotus peltatus (Geist) Muell. Arg. var acuminatus: A folk medicine. Phytomed 2002; 9: 727-30.
- Begum S, Saxena B, Goyal M, Ranjan R, Joshi VB, Rao B, Krishnamurthy S and Sahai M: Study of anti-inflammatory, analgesic and antipyretic activities of seeds of Hyoscyamus niger and isolation of a new coumarinolignan, Fitoterapia 2010; 81: 78-184.
- Azu B, Amos S, Dzarma S, Muazzam I and Gamaniel KS: Pharmacological evidence favoring the folkloric use of Diospyros mespiliformis Hochst in the relief of pain and fever. Journal of Ethnopharmacology 2002; 82: 191-95.
- Gupta M, Mazumder UK, Kumar RS, Gomathi P, Rajeshwar Y, Kakoti BB and Selven VT: Anti-inflammatory, analgesic and antipyretic effects of methanol extract from Bauhinia racemosa stem bark in animal models. Journal of Ethnopharmacology 2003; 98: 267-73.
- http://www.drhomeo.com/pain/naturalhomeopathicremedies- for-body-pains-and aches. [Accessed 11/07/2014].
- http://treatment.hpathy.com/homeo-medicine/homeopathy-fever/.[Accessed11/07/2014].
- Alam T, Ansari H., Ahmad W and Perveen A: Pain: Concept and Description in Unani System of Medicine. International Journal of Traditional and Herbal Medicine 2013; 1: 147-52.
- Ali BH, Blunden G, Tanira MO and Nemmar A: Some phytochemical, pharmacological and toxicological properties of ginger (Zingiber officinale Roscoe): A review of recent research. Food and Chemical Toxicology 2008; 46: 409-20.
- Nafees M, Khan NA, Amin KMY and Ahmad G: Antinociceptive and antipyretic effect in animal models treated with a polyherbal Unani medicine - Habb-E-Gul-E-Aakh. Pharma Science Monitor 2014; 5: 163-72.
- Hasan MN, Ferdoushi A, Ara N, Rahman S, Hossan M and Rahmatullah M: Preliminary phytochemical screening, toxicity, antihyperglycemic and analgesic activity studies with curcuma longa leaves. World Journal of Pharmacy and Pharmaceutical Sciences 2014; 3: 81-91.
- Ravishankar B and Shukla VJ: Indian Systems of Medicine: A brief profile of Indian Systems of Medicine. African Journal of Traditional, Complementary and Alternative Medicines 2014; 4: 319-37.
- Satyavati GV, Gupta AK and Tandon NE: Piper Linn. Medicinal plants of India. Indian Council of Medical Research 1987; 2: 426-56.
- Joshi PK: Pharmaco-clinical study of Argavadha with special reference to vicharchika. (Ayu) Dissertation submitted to Gujarat Ayurved University, Jamnagar India 1998.
- Sharma PC, Yelne MB and Dennis TJ: Raktapunarnava (Boerhavia diffusa). Data base on Medicinal Plants used in Ayurveda. Central Council for Research in Ayurveda and Siddha. New Delhi, Vol. 1, 2000: 360-77.
- Sharma PC, Yelne MB and Dennis TJ: Chitraka (Plumbago zeylanica). Data base on Medicinal Plants used in Ayurveda. Central Council for Research in Ayurveda and Siddha. New Delhi 2000: 102-113.
- Sharma PC, Yelne MB and Dennis TJ: Shunthi (Zingiber officinale Rosc). Data base on Medicinal Plants used in Ayurveda. Central Council for Research in Ayurveda and Siddha. New Delhi 2002: 315-90.
- http://www.naturalnews.com/038785_home_remedies_fever_flu_season.html. Assessed on 11/07/2014 at11:00 am.
- Oosterveld FG and Rasker JJ: Effects of local heat and cold treatment on the surface and articular temperature of arthritic knees. Arthritis and Rheumatology 1994; 37: 1578-82.
- Fredriku GJ, Oosterveld FG and Rasker J: Treating arthritis with locally applied heat or cold. Seminars in Arthritis and Rheumatology 1994; 24: 82.
- Mannheimer C and Carlsson CA: The analgesic effect of transcutaneous electrical nerve stimulation (TENS) in patients with rheumatoid arthritis. A comparative study of different pulse patterns. Pain 1979; 6: 329-33.
- Dhondt W, Willaeys LA, Verbruggen A, Oostendorp RAB and Duquet W: Pain threshold in patients with rheumatoid arthritis and effect of manual oscillations. Scandinavian Journal of Rheumatology 1999; 28: 88-93.
- Walach H, Guthlin C and Konig M: Efficacy of massage therapy in chronic pain: a pragmatic randomized trial. Journal of Alternative and Complementary Medicine 2003; 9: 837-46.
- Van den Ende CHM, Vliet VTPM, Munneke M and Hazes JMW: Dynamic exercise therapy in rheumatoid arthritis: a systematic review. British Journal of Rheumatology 1998; 37: 677-87.
- Fernandez MI, Watson PJ and Rowbotham DJ: Effect of pulsed magnetic field therapy on pain reported by human volunteers in a laboratory model of acute pain. British Journal of Anaesthesia 2007; 99: 266-69.
- Nieto R, Raichle KA, Jensen MP and Miro J: Changes in pain-related beliefs, coping, and catastrophizing predict changes in pain intensity, pain interference, and psychological functioning in individuals with myotonic muscular dystrophy and facio scapula humeral dystrophy. Clinical Journal of Pain 2012; 28: 47-54.
- Collede NR, Walker BR and Ralston SH: Davidson’s principles and practice of Medicine, Harvard, 18th ed, 2010: 283-84.
- Iannuccelli C, Mannocci F, Guzzo MP, Olivieri M, Gerardi MC, Atzeni F, Sarzi PP, Valesini G and Di FM: Complementary treatment in fibromyalgia: combination of somatic and abdominal acupuncture. Clinical and Experimental Rheumatology 2012; l30: 112-16.
- Lee JH, Choi TY, Lee MS, Lee H, and Shin BC and Lee H: Acupuncture for acute low back pain: a systematic review. Clinical Journal of Pain 2013; 29: 172-85.
- Witt C, Brinkhaus B, Jena S, Linde K, Streng A, Wagenpfeil S, Hummelsberger J, Walther HU, Melchart D and Willich SN: Acupuncture in patients with osteoarthritis of the knee: a randomized trial. Lancet 2005; 366: 136-43.
- Kim SY, Lee H, Chae Y, Park HJ and Lee H: A systematic review of cost-effectiveness analyses alongside randomized controlled trials of acupuncture. Acupuncture Medicine 2012; 30: 273-85.
- Reinhold T, Witt CM, Jena S, Brinkhaus B and Willich SN: Quality of life and cost-effectiveness of acupuncture treatment in patients with osteoarthritis pain. European Journal of Health Economics 2008; 9: 209-19.
- Deare JC, Zheng Z, Xue CC, Liu JP, Shang J, Scott SW and Littlejohn G: Acupuncture for treating fibromyalgia. Cochrane Database Systematic Review 2013: 5.
How to cite this article:
Srivastava S, Saeed SH, Rahman S and Kumar S: Electronic Nose Applications in Medical Field. Int J Life Sci & Rev 2015; 1(5): 150-59. doi: 10.13040/IJPSR.0975-8232.IJLSR.1(5).150-59.
All © 2015 are reserved by International Journal of Life Sciences and Review. This Journal licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License.
Article Information
1
150-159
741
1374
English
IJP
S. Singh, S. K. Singh * and K. Singh
Department of Pharmacology, School of Pharmacy, Babu Banarsi Das University, Lucknow, Uttar Pradesh, India.
sandeepbbdu@gmail.com
21 February 2015
26 March 2015
27 April 2015
10.13040/IJPSR.0975-8232.IJLSR.1(5).150-59
30 May 2015