OBJECTIVES: The aim of this review is to describe the effects of analgesics on sleep. DATA SOURCES: Systematic search of the databases of PubMed and the Cochrane Library was performed between January and September 2021. REVIEW/ANALYSIS METHODS: The search included all articles on the topic published during the past 20 years (2000-2020). The search strategy was developed using a controlled vocabulary of known studies meeting the inclusion criteria and focused on the following terms: chronic pain, pain, sleep disturbance, insomnia, analgesic, analgesic medication, antidepressants, antiepileptic drugs, nonsteroidal drugs, opioids, and quality of life. Two reviewers independently considered the studies for inclusion in the review, assessed the risk of bias, and extracted data. DESIGN: Review and analysis. RESULTS: A total of 37 studies met the inclusion criteria: 15 analyzed the effects of opioids, 6 those of nonsteroidal anti-inflammatory drugs and acetaminophen, and 16 the effects of adjuvant analgesics. CONCLUSIONS: Sleep quality may be adversely affected by a variety of medications used in clinical practice, including those used in analgesic indications. The class of analgesics most affecting sleep quality are opioids.

• MeSH
• analgetika škodlivé účinky   MeSH
• antiflogistika nesteroidní terapeutické užití   MeSH
• chronická bolest * farmakoterapie   MeSH
• kvalita života MeSH
• lidé MeSH
• opioidní analgetika škodlivé účinky   MeSH
• poruchy iniciace a udržování spánku * farmakoterapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• analgetika MeSH
• antiflogistika nesteroidní MeSH
• opioidní analgetika MeSH

The observation of the immunomodulatory effects of opioid drugs opened the discussion about possible mechanisms of action and led researchers to consider the presence of opioid receptors (OR) in cells of the immune system. To date, numerous studies analyzing the expression of OR subtypes in animal and human immune cells have been performed. Some of them confirmed the expression of OR at both the mRNA and protein level, while others did not detect the receptor mRNA either. Although this topic remains controversial, further studies are constantly being published. The most recent articles suggested that the expression level of OR in human peripheral blood lymphocytes could help to evaluate the success of methadone maintenance therapy in former opioid addicts, or could serve as a biomarker for chronic pain diagnosis. However, the applicability of these findings to clinical practice needs to be verified by further investigations.

• Klíčová slova
• addiction, chronic pain, immune cells, opioid drugs, opioid receptors, stem cells,
• MeSH
• biologické markery MeSH
• chronická bolest farmakoterapie   etiologie   metabolismus   MeSH
• imunitní systém účinky léků   imunologie   metabolismus   MeSH
• kmenové buňky účinky léků   metabolismus   MeSH
• lidé MeSH
• opioidní analgetika farmakologie   MeSH
• receptory opiátové genetika   metabolismus   MeSH
• regulace genové exprese * MeSH
• zánět komplikace   etiologie   metabolismus   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• biologické markery MeSH
• opioidní analgetika MeSH
• receptory opiátové MeSH

OBJECTIVES: Recent years have seen an increase in the adoption of cannabinoid medicines, which have demonstrated effectiveness for the treatment of chronic pain. However, the extent to which frequent cannabis use (CU) influences sensitivity to acute pain has not been systematically examined. Such a determination is clinically relevant in light of hypersensitivity to pain associated with prolonged use of other analgesics such as opioids, and reports of increased pain sensitivity to experimentally induced pain during acute cannabis intoxication. This study explored differences in measures of pain intensity and tolerance. The authors hypothesized that individuals who report frequent CU would demonstrate greater experimental pain sensitivity. MATERIALS AND METHODS: Frequent cannabis users (≥3× per week; n=40) and nonusers (n=40) were compared on pain sensitivity, pain tolerance, and pain intensity in response to a cold-pressor task. Group differences were examined. RESULTS: Frequent CU was not associated with hyperalgesia as cannabis users and nonusers did not exhibit differences on measures of pain tolerance (t (78)=-0.05; P=0.96), sensitivity (t (78)=-0.83; P=0.41), or intensity (t (78)=0.36; P=0.72). DISCUSSION: Frequent cannabis users did not demonstrate hyperalgesia. This finding should help to inform evaluations of the relative harms and benefits of cannabis analgesic therapies.

• MeSH
• analgetika farmakologie   MeSH
• Cannabis * škodlivé účinky   MeSH
• chronická bolest * farmakoterapie   MeSH
• lidé MeSH
• opioidní analgetika farmakologie   MeSH
• práh bolesti MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• analgetika MeSH
• opioidní analgetika MeSH

Chronic low back pain (CLBP) syndrome represents one of the leading causes of long-term disability worldwide. The prevalence of CLBP has been rising significantly in relation to increasing average life expectancy. CLBP results from chronification of acute low back pain. There are many factors contributing to the CLBP crisis; common etiopathogenetic factors include e.g., functional blockage of intervertebral joints. The treatment of CLBP is complex. An important part of treatment consists of pain pharmacotherapy, for which several groups of drugs are used. The problem lies in the side effects of many of these traditionally used medications. Therefore, new and safer treatment methods are being sought. Innovative options for CLBP pharmacology include injections containing collagen, which can be combined with other traditionally used drugs, which helps reduce dosages and increase the overall safety of CLBP therapy.

• Klíčová slova
• Chronic low back pain, chronic pain management, collagen-containing injections, pain control, pharmacotherapy of chronic pain, safe therapy of pain.,
• MeSH
• analgetika terapeutické užití   MeSH
• chronická bolest farmakoterapie   MeSH
• kvalita života MeSH
• lidé MeSH
• lumbalgie farmakoterapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• analgetika MeSH

Chronic pain is a common health problem related to most of inflammatory rheumatic disorders. It is pain that has persisted for at least 3 month and cannot be fully relieved by standard pain medication. 40-60 % of patients do not have adequate relief of their pain. Paramount in the management of chronic pain patients is assessment of the pain and its impact on physical and psychosocial functioning. Multidisciplinary and multimodal approach is of vital importance. Non-steroidal anti-rheumatic drugs (NSA) have been used mainly due to their strong analgesic effect, especially in the treatment of acute pain as well as their anti-inflammatory effect in the treatment of chronic i pain. Long-term systemic administration of NSA may be associated with a number of serious side effects, which significantly limit NSA use in long term therapy. Due to opiophobia, opioids are insufficiently used treatment modality. Knowledge about pain and its management, as well as an awareness of barriers to effective pain therapy, are important not only for pain specialists but also primary care physicians.Key words: chronic pain - non-steroidal antirheumatic drugs - opiophobia - opioids - pain assessment - paracetamol - rheumatoid arthritis.

• MeSH
• antiflogistika nesteroidní terapeutické užití   MeSH
• chronická bolest * farmakoterapie   etiologie   MeSH
• lidé MeSH
• opioidní analgetika terapeutické užití   MeSH
• revmatoidní artritida * komplikace   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antiflogistika nesteroidní MeSH
• opioidní analgetika MeSH

Non-opioid analgesics are commonly used to treat mild and moderate acute and chronic pain. They can be used as monotherapy; however, they have greater efficacy in combination with weak and strong opioids. Unlike opioids, long-term use of non-steroidal anti-inflammatory drugs does not lead to physical dependence. One of the main disadvantages of the NSA is the risk of gastrointestinal side effects, especially bleeding into the digestive tract. This is increased especially in ulcerative disease and in higher doses, but also in the elderly (over 65 years), also with concomitant administration of corticosteroids, anticoagulants or other NSAIDs.

• Klíčová slova
• hepatic insufficiency renal insufficiency., metamizol, non-steroidal anti-inflammatory drugs, pain, paracetamol ibuprofen,
• MeSH
• antiflogistika nesteroidní terapeutické užití   MeSH
• chronická bolest * farmakoterapie   MeSH
• lidé MeSH
• neopioidní analgetika * terapeutické užití   MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antiflogistika nesteroidní MeSH
• neopioidní analgetika * MeSH

Multiple voltage-gated calcium channels (VGCCs) contribute to the processing of nociceptive signals in primary afferent fibers. In addition, alteration of calcium channel activity is associated with a number of chronic pain conditions. Therefore, VGCCs have emerged as prime target for the management of either neuropathic or inflammatory pain, and selective calcium channel blockers have been shown to have efficacy in animal models and in the clinic. However, considering that multiple calcium channels contribute pain afferent signaling, broad-spectrum inhibitors of several channel isoforms may offer a net advantage in modulating pain. Here, we have analyzed the ability of the compound surfen to modulate calcium channels, and assessed its analgesic potential. We show that surfen is an equipotent blocker of both low- and high-voltage-activated calcium channels. Furthermore, spinal (intrathecal) delivery of surfen to mice produces sustained analgesia against both acute and chronic pain. Collectively, our data establish surfen as a broad-spectrum calcium channel inhibitor with analgesic potential, and raise the possibility of using surfen-derived compounds for the development of new pain-relieving drugs.

• Klíčová slova
• Calcium channel, Calcium channel blocker, DRG neuron, Inflammatory pain, Pain, Surfen,
• MeSH
• analgetika farmakologie   MeSH
• blokátory kalciových kanálů farmakologie   MeSH
• chronická bolest farmakoterapie   MeSH
• chronická nemoc farmakoterapie   MeSH
• lidé MeSH
• modely nemocí na zvířatech MeSH
• myši inbrední C57BL MeSH
• neuralgie farmakoterapie   MeSH
• vápník metabolismus   MeSH
• vápníková signalizace účinky léků   MeSH
• zánět farmakoterapie   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• analgetika MeSH
• blokátory kalciových kanálů MeSH
• vápník MeSH

BACKGROUND: The antinociceptive effect of intrathecal midazolam is based on its affecting spinal gamma-amino butyric acid receptors. OBJECTIVE: To evaluate pain relief in patients with chronic low back pain and failed back surgery syndrome after a single-shot intrathecal administration of midazolam. DESIGN: A prospective, open-label study. OUTCOME MEASURES: The analgesic effect was determined using a patient questionnaire during subsequent visits to the pain therapy service. We classified at least a 50% pain reduction with improved quality of life and improved functional condition as a positive outcome. RESULTS: Between 1995 and 2010, we performed 500 administrations: 227 administrations in 57 male patients and 273 administrations in 69 female patients. We performed 81 administrations for chronic low back pain and 419 administrations for failed back surgery syndrome. The average age of our patients was 50 years (range 28 to 86). The dose administered ranged from 2 to 5 mg of midazolam. The analgesic effect lasted 9.7 weeks on average, ranging from 1 week to 3 years; the most common reported duration was between 4 and 12 weeks (3 months). In 65% of patients, we achieved pain relief lasting 4 weeks or longer; in 13%, the administration provided no analgesic effect at all. The incidence of side effects (drowsiness, nausea, headache, or transient worsening of complaints) was rather low. CONCLUSION: Intrathecal midazolam is a useful supplement to standard analgesic therapy with opioids, non-opioids, or spinal steroids.

• MeSH
• adjuvancia anestetická aplikace a dávkování   škodlivé účinky   MeSH
• časové faktory MeSH
• chronická bolest farmakoterapie   MeSH
• dospělí MeSH
• failed back surgery syndrom farmakoterapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lumbalgie farmakoterapie   MeSH
• midazolam aplikace a dávkování   škodlivé účinky   MeSH
• prospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• spinální injekce metody   MeSH
• výsledek terapie MeSH
• vztah mezi dávkou a účinkem léčiva MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• Názvy látek
• adjuvancia anestetická MeSH
• midazolam MeSH