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Oksikam türü steroid olmayan anti-enflamatuar ilaçlar (NSAEİ'ler) (meloksikam, piroksikam ve tenoksikam), yan etkilerinin daha az olması sebebiyle ve siklodekstrin ile kombine edilerek, fizyolojik ortamda daha hızlı, daha kolay çözülerek etkin bir şekilde kana kontrollü salınımı ve karışması sağlandığı için çok tercih edilen ağrı kesicilerdir. Ağrı kesiciler pek çok hastalıkta sıklıkla kullanılmaktadır. Aynı zamanda, gıdalardan vitamin ve minerallerin yeteri kadar alınamamasından dolayı vitamin-mineral kombinasyonu ilaçların alınması da oldukça yaygındır. Bu nedenle oksikam türü NSAEİ'lerle birlikte alınan vitamin-mineral kombinasyonu ilaçların içeriğinde makro miktarda bulunan demir ve eser (iz) oranda bulunan çinko, bakır, kobalt ve mangan gibi metallerin oksikamlarla kompleks oluşturma ve her iki ilacın da etkinliklerinin azalmasına sebep olma olasılığının incelenmesi büyük önem taşımaktadır. Oksikam türü NSAEİ'ler, piroksikam (PRX), tenoksikam (TNX), meloksikam (MLX) ve naproksen (NPRX) bileşiklerinin metal bağlama özellikleri spektroflorimetrik metot kullanarak incelenmiştir. Bu oksikam türü NSAEİ'lerden belirlenen uygun deney koşullarında yapılan florimetrik çalışmayla, yalnızca Zn(II) iyonunun, MLX ile etkileşimi ve en uygun deney koşulları tayin edilebilmiştir. MLX-Zn(II) kompleksinin uyarma ve emisyon dalga boyları, pH 3.0 ve asetonitril ortamında sırasıyla ex= 406 nm ve em= 474 nm olarak belirlenmiştir. Kompleks oluşumu için çözeltiler 15 dakika bekletildikten sonra alınan emisyon spektrumlarından floresans şiddeti değerleri ölçülmüştür. Belirlenen deney şartlarında, kalibrasyon grafiği ([Zn2+]-F grafiği) çizilmiştir ve en uygun koşullar altında MLX-Zn (II) kompleksi için doğrusal çalışma aralığı, 0.1-1.0 μM olark belirlenmiştir. Gözlenebilme sınırı (LOD) ve alt tayin sınırı (LOQ) sırasıyla 0.012 ve 0.370 μM olarak hesaplanmıştır. MLX'ın Zn(II) iyonlarıyla oluşturduğu komplekse dayalı florimetrik yöntem, çinko içeren bir ilaca (Redoxon) uygulanmış, ancak uygun ve başarılı sonuçlar elde edilememiştir., Oxicam-type non-steroidal anti-inflammatory drugs (NSAIDs) (meloxicam, piroxicam and tenoxicam) which are combined with cyclodextrin because of their less side effects and combined with cyclodextrin to dissolve faster and more easily in the physiological environment to ensure controlled release and mixing into the blood are preferred painkillers. Painkillers are frequently used in many diseases. It is also common to take vitamin-mineral combination medicines because vitamins and minerals cannot be adequately removed from food. For this reason, it is very important to investigate the possibility of complexation of oxicam-type NSAIDs together with vitamin-mineral combination drugs which are present in macro amounts of iron and trace amounts of zinc, copper, cobalt and manganese and to decrease the effectiveness of both drugs. Metal binding properties of oxicam-type NSAIDs, piroxicam (PRX), tenoxicam (TNX), meloxicam (MLX) and naproxen (NPRX) compounds were investigated using spectrofluorimetric method. With the fluorimetric study carried out under the appropriate experimental conditions determined from these oxicam type NSAIDs, only the interaction of Zn (II) ion with MLX and the most suitable experimental conditions could be determined. The excitation and emission wavelengths of the MLX-Zn (II) complex were determined as ex= 406 nm and em= 474 nm in pH 3.0 and acetonitrile media, respectively. Fluorescence intensity values were measured from emission spectra taken after the solutions were left for 15 minutes for complex formation. Under the specified experimental conditions, the calibration graph ([Zn2+] - F graph) was plotted and under optimal conditions the linear operating range for the MLX-Zn (II) complex was determined to be 0.1-1.0 μM. Observability limit (LOD) and lower detection limit (LOQ) were calculated as 0.012 and 0.370 μM, respectively. The fluorimetric method based on the complex of MLX with Zn (II) ions was applied to a zinc-containing drug (Redoxon), but the appropriate and successful results could not be obtained.

Co-application of local anesthetics as lidocaine and nonsteroidal anti-inflammatory drugs (NSAIDs) can enhance local analgesia. Co-formulation of lidocaine with NSAIDs can modulate physicochemical properties like melting point which can affect transdermal delivery. The purpose was to probe lidocaine as eutectic forming drug for enhanced transdermal delivery of a series of NSAIDs with increasing melting points. NSAIDs included ketoprofen, flurbiprofen, aceclofenac, tenoxicam and meloxicam. Each drug was co-ground with lidocaine at increasing molar ratios. The products were characterized by thermal analysis and Fourier-transform infrared (FTIR). Saturated aqueous solutions containing excess of optimum NSAID/lidocaine were evaluated for transdermal delivery with reference to the corresponding saturated aqueous solution of each drug. Thermal analysis and FTIR suggested eutectic system formation. Drugs with lower melting points formed eutectic with smaller proportion of lidocaine. Ketoprofen, flurbiprofen and aceclofenac separated as oily liquid from the saturated aqueous solution of their mixtures with lidocaine. Eutectic mixtures of lidocaine with tenoxicam and meloxicam melted above 50 °C and separated from saturated aqueous solution as solid system. Eutexia increased the transdermal flux of NSAIDs. The extent of increase depended on the melting point of the developed system. The study introduced lidocaine as eutectic co-former for enhanced skin delivery of NSAIDs.

In general, theoretical computation was performed to improve the efficacy of regular experiments by predicting possible interaction sites. At present work, density functional theory (DFT) was employed to study the interactions between active pharmaceutical ingredients (API) and cocrystal formers (CCF) to screen appropriate molecules for the rational design of cocrystals salts. On the basis of theoretical calculations, four salt solvates of piroxicam(PX), tenoxicam(TNX), lornoxicam(LNX) and meloxicam(MLX) were synthesized with norfloxacin(NF) and ciprofloxacin(CIP), namely, PX•NF•2MeOH (1:1:2), TNX•CIP•2MeOH (1:1:2), MLX•CIP•ACN (1:1:1), and LNX•NF•H2O•0.3MeOH (1:1:1:0.3). The structures were characterized by single crystal X-ray diffraction (SCXRD), powder X-ray diffraction (PXRD), differential scanning calorimeter (DSC), and thermogravimetric analysis (TGA). The results showed that the solubility of oxicams salts were improved remarkably compared with original components and it can be a useful method to improve the bioavailability of oxicams followed by the removal of solvents in further research.

The effect of expired tenoxicam drug as an inhibitor on the corrosion inhibition of carbon steel in 0.5 M HCl was examined at different concentrations. Besides, the effect of potassium iodide additives on inhibition was investigated. All of these are applied by three methods; electrochemical studies (electrochemical frequency modulation, potentiodynamic and electrochemical impedance spectroscopy, superficial studies (XPS, FTIR, and UV-spectroscopy) and theoretical studies (quantum chemistry calculations and molecular dynamic calculations). The presence of tenoxicam as an inhibitor in the solution gives an increase in charge transfer resistance and a decrease in the capacity of the double layer. Potentiodynamic polarization studies have demonstrated that tenoxicam is a mixed inhibitor. In this study, we examined the influence of temperature on the inhibition of corrosion of carbon steel, and we also computed the thermodynamic parameters. The potentiodynamic method designated that the inhibitor was used showed the best protection productivity of up to 81.0% for C-steel at 4 × 10−4 M from tenoxicam in 0.5 M HCl solutions at 30 °C. On the other hand, the inhibition efficiency (I%) increased synergistically on the addition of potassium iodide to 90.3%. Tenoxicam adsorption was found on the C-steel surface for Temkin's isothermal obedience. The mechanism of the inhibition process was discussed in light of the chemical composition and theoretical study of the inhibitor probe. Expired Tenoxicam was first studied as a carbon steel corrosion inhibitor in a solution of hydrochloric acid. It provides a way to deal with expired medications, thus reducing environmental pollution. The study explored the inhibition mechanism affecting expired tenoxicam, and provided theoretical support for the results obtained from experimental studies. The expired tenoxicam drug can be used as a cheap and safe corrosion inhibitor for the studied system.

Aim To review the evidence for the use of different non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of biliary colic. Methods The strategies employed included an extensive literature review for articles and studies related to biliary colic from electronic databases including PubMed, Science Direct, Wiley Inter Science, Medline and Cochrane from last 15 years. Keywords: "Biliary colic", "management of biliary colic", "non-steroidal anti-inflammatory drugs", "cholelithiasis" and "biliary colic management". Six randomized control trials, 1 non-randomized trial and 1 meta-analysis were included in this review. The outcomes of these studies and their significance have been reviewed in this paper. Results Current evidence suggests there are no set protocols for biliary colic pain management. NSAIDs are potent in the management of biliary colic, not only in terms of symptom control but in disease progression as well. Apart from the studies on diclofenac and ketorolac, there are studies which have shown that intravenous tenoxicam and injectable flurbiprofen are equally effective in managing biliary colic. The efficacy of NSAIDs is superior in terms of lower number of doses and longer duration of action in comparison to other analgesic agents. Conclusion This literature review has found that NSAIDs are safe and effective for pain control in biliary colic, and reduce the likelihood of further complications.

Subacromial impingement syndrome (SIS) is one of the most frequent shoulder pathologies. Initial treatment is conservative. Subacromial injection of drugs achieves a high concentration at the pathologic site with less drug use and fewer systemic side effects. Glucocorticoids are most frequently injected. One concern with steroid use is the wide array of potential systemic and local complications. Nonsteroidal anti-inflammatory drugs (NSAIDs) are also peripherally acting and can be used locally. Although intraarticular (IA) use of NSAIDs is common in orthopedic practice, it is mostly restricted to the knee joint. Reports of local NSAID for joint pathologies are relatively rare. This study compared the efficacy of single-dose subacromial injections of betamethasone and lornoxicam for treatment of SIS. Subacromial injections of either 7.0 mg betamethasone or 8 mg lornoxicam were received by 70 patients with mean age 53 (46-68) years. Treatment outcome was assessed with Constant-Murley and UCLA questionnaires before injection and at 2aEuro, 4aEuro, and 6aEuroweek follow-ups. The change in outcome scores compared to pretreatment was higher in the steroid group at all follow-ups (p < 0.001). Patients in the steroid group showed a significant improvement at all follow-ups compared to pretreatment (p < 0.001) and previous follow-ups (p < 0.05) at all times. Patients in the lornoxicam group showed a significant functional improvement in week 2 (p < 0.001), which was not evident in the following weeks (p > 0.05). Although functional recovery halted after week 2, outcome scores remained significantly higher than the pretreatment values at all weeks (p < 0.001). Although a single subacromial lornoxicam injection provides rapid functional recovery, which partially extends into the intermediate term, its results are inferior to betamethasone and it may be an alternative only in patients where corticosteroids are contraindicated.

Clinical Scenario:For active individuals, plantar fasciitis (PF) is one of the most clinically diagnosed causes of heel pain. When conservative treatment fails, one of the next most commonly used treatments includes corticosteroid injections. Although PF has been identified as a degenerative condition, rather than inflammatory, corticosteroid injection is still commonly prescribed. However, the literature has not been examined to determine the effect of corticosteroid injection on PF.Focused Clinical Question:Are corticosteroid injections more effective than other interventions (placebo, platelet-rich plasma, and tenoxicam injections) in the short- and long-term treatment of PF?Summary of Key Findings:Corticosteroid injections are not more effective in the long-term treatment of PF pain than other treatments (platelet-rich plasma, tenoxicam).Clinical Bottom Line:The level 2 and 3 evidence shows that corticosteroids are more effective than placebo injections but are no more effective than tenoxicam injections and perhaps less effective than platelet-rich plasma treatment.Strength of Recommendation:Level 2 and 3 evidence suggests that corticosteroid injections are not more effective in the long-term treatment of PF than platelet-rich plasma or tenoxicam.

The profusely employed drugs Piroxicam (Piro), Tenoxicam (Teno) and Meloxicam (Melo) belonging to the non-steroidal antiinflammatory drug (NSAID) family of the Oxicams (Oxis) were studied in the frame of two specific conditions: (a) their ROS scavenging ability, in relation to a possible biological antioxidant action and (b) their photodegradability under environmental conditions, in the context of Oxi-contaminated waters. Singlet molecular oxygen (O2(1Δg)) and superoxide radical anion (O2 -) were photogenerated through Riboflavin (Rf, vitamin B2)-photosensitization in aqueous and aqueous-methanolic solutions in the presence of Oxi concentrations in the range 50-500 μM. The visible-light absorber vitamin is currently present in all types of natural waters and constitutes the most frequent endogenous photosensitizer in mammals. Hence, it was employed in order to mimic both natural sceneries of interest. All three Oxis quench O2(1Δg) with rate constants in the order of 108 M- 1 s- 1 showing a significant photodegradation efficiency given by a dominant reactive fashion for deactivation of the oxidative species. Although this is not a desirable property in the context of photoprotection upon prolonged photoirradiation, constitutes in fact a promissory aspect for the degradation NSAIDs, in waste waters. Indirect evidence indicates that Melo is also oxidized through a O2 --mediated component. The simultaneous presence of Piro plus tryptophan or tyrosine under Rf-photosensitizing conditions, which has taken the amino acids as photooxidizable model residues in a proteinaceous environment, indicates that the NSAID induces a protection of the biomolecules against photodynamic degradation. Fil: Ferrari, Gabriela Verónica. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Departamento de Química. Area de Química Física; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Natera, Jose Eduardo. Universidad Nacional de Río Cuarto. Facultad de Ciencias Exactas Fisicoquímicas y Naturales. Departamento de Química; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Montaña, Maria Paulina. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Área Química General e Inorgánica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Muñoz, Vanesa Alejandra. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Área Química General e Inorgánica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Gutiérrez, Eduardo Luciano. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Área Química General e Inorgánica; Argentina Fil: Massad, Walter Alfredo. Universidad Nacional de Río Cuarto. Facultad de Ciencias Exactas Fisicoquímicas y Naturales. Departamento de Química; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Miskoski, Sandra. Universidad Nacional de Río Cuarto. Facultad de Ciencias Exactas Fisicoquímicas y Naturales. Departamento de Química; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Garcia, Norman Andino. Universidad Nacional de Río Cuarto. Facultad de Ciencias Exactas Fisicoquímicas y Naturales. Departamento de Química; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina

Niosomes vesicles are microscopic lamellar structures formed by mixing with nonionic surfactant, cholesterol and phosphate in aqueous media. Using niosomes as drug delivery system affords several significant advantages over conventional drug therapy. The main aim of this study was to formulate suitable niosome-encapsulated drug delivery for tenoxicam (antiinflammatory drug) and estimate the percentage encapsulation efficiency, in-vitro release and in-vivo anti-inflammatory effect. Different non-ionic surfactants, cholesterol and different charge inducing agents were used in different molar ratios. Three different methods were used for niosomes preparation. The higher entrapment efficiency was observed with niosomes prepared from span 40, cholesterol and stearylamine in 45:45:10 molar ratios (N11). The invitro release study was found that niosomes exhibiting higher entrapment efficiency showed slower release rate of drug than other formulae. The results of in-vivo study revealed that the niosomes significantly enhanced the anti-inflammatory effect of tenoxicam. The present work concluded that tenoxicam loaded niosomes was effective in sustaining the drug release resulting in diminished side effects and improved patient compliance.

The objective of the present study was to optimize and evaluate a buccal mucoadhesive tenoxicam (TNX) local delivery system for the treatment of chronic periodontitis. Full 32 factorial design was adopted to evaluate the effect of the concentration of chitosan and polyvinyl pyrrolidone (PVP) on buccal film characteristics. The results showed that PVP concentration exerted a significant synergistic effect on film swelling, while chitosan slightly, but insignificantly, retarded film swelling. In addition, chitosan exhibited the only significant agonistic effect on mechanical film properties. Furthermore, PVP significantly enhanced the Higuchi diffusion slope of the drug release from buccal films, while it was antagonized by chitosan. The optimized formula showed adequate mechanical properties for buccal films. The in vivo salivary pharmacokinetic study of the optimized film revealed rapid and sustained salivary TNX delivery in the buccal cavity. This study indicated that the optimized TNX mucoadhesive buccal film is an optimal alternative dosage form to oral therapy for the treatment of chronic periodontitis and can provide a means to overcome the off-targeted side effects of orally delivered drug.

Aim: This study aimed to determine the risk factors for postoperative nausea and vomiting (PONV) in children receiving dental treatment under general anesthesia and to identify the subcategories leading to risk formation. Materials and Methods: The study comprised of 100 American Society of Anesthesiologists I patients aged 2–7 years who were administered dental treatment under general anesthesia. Patients were evaluated with regard to PONV risk. Eight different independent risk factors were identified as follows: age, gender, weight, duration of anesthesia, duration of recovery, postoperative pain, rescue analgesia, and type of dental treatment. Classification and regression trees method was used to choose the best predictor for PONV. Results: The incidence of PONV was 25%. No significant difference was found between those with PONV and those without PONV with regard to gender, weight, duration of anesthesia, duration of recovery, or the type of dental treatment (P > 0.05). However, postoperative pain level and use of rescue analgesia with tenoxicam were both predictors of PONV (P < 0.05). For the postoperative pain (≤1.5) subgroup, age proved to be the best predictive variable. Conclusion: The risk limit for PONV was determined to be ≥5.5 years for children who underwent dental procedures under general anesthesia. Postoperative pain and rescue analgesia constituted risks for PONV.Keywords: Children, postoperative nausea and vomiting, postoperative pain, risk factors

Background/aim: This study aimed to compare two nonsteroidal antiinflammatory agents in relation to pain, swelling, and trismus following impacted third molar surgery. Materials and methods: The study was a randomized and a double-blinded study and included 50 healthy individuals. After the operation, patients were randomly assigned to 2 groups in which diclofenac potassium and tenoxicam were used. Impacted third molars were surgically extracted with local anesthesia. Pain was assessed postoperatively by visual analog scale at the 2nd, 6th, 8th, 12th, 24th, and 48th hours and on the 3rd, 5th, and 7th days. Swelling was evaluated using the method of Ustun et al. and trismus was measured with calipers on the postoperative 3rd and 7th days. Results: There was statistically significant difference between the groups in VAS levels at the 2nd and 6th hours; however, VAS levels of the tenoxicam group were significantly lower as compared to diclofenac potassium at the 8th, 12th, 24th, and 48th hours and on the 3rd, 5th, and 7th days (P < 0.05, P < 0.01). No difference was noted regarding trismus and swelling between the groups. Conclusion: Diclofenac potassium and tenoxicam are similarly effective for reduction of swelling and trismus following the extraction of mandibular third molars; however, tenoxicam surpasses diclofenac potassium for controlling pain.

Pain is an undesirable side effect of orthodontic tooth movement, which causes many patients to give up orthodontic treatment or avoid it altogether. The aim of this study was to investigate, through an analysis of the scientific literature, the best method for managing orthodontic pain. The methodological aspects involved careful definition of keywords and diligent search in databases of scientific articles published in the English language, without any restriction of publication date. We recovered 1281 articles. After the filtering and classification of these articles, 56 randomized clinical trials were selected. Of these, 19 evaluated the effects of different types of drugs for the control of orthodontic pain, 16 evaluated the effects of low-level laser therapy on orthodontic pain, and 21 evaluated other methods of pain control. Drugs reported as effective in orthodontic pain control included ibuprofen, paracetamol, naproxen sodium, aspirin, etoricoxib, meloxicam, piroxicam, and tenoxicam. Most studies report favorable outcomes in terms of alleviation of orthodontic pain with the use of low-level laser therapy. Nevertheless, we noticed that there is no consensus, both for the drug and for laser therapy, on the doses and clinical protocols most appropriate for orthodontic pain management. Alternative methods for orthodontic pain control can also broaden the clinician's range of options in the search for better patient care.

To study the changes in pain syndrome and its characteristic in patients with ankylosing spondylitis (AS) who received tenoxicam after non-effective treatment with NSAIDs on the 'on-demand' basis.Forty patients with AS, who had BASDAI ≥4.0 at baseline and after 52 weeks of NSAIDs on the 'on-demand' basis, were randomized into 2 groups: 30 patients were prescribed 20 mg of tenoxicam oraly per day, 10 patients continued previous therapy. The BASDAI, ASDAS indices were calculated in 52 and 56 weeks.BASDAI and ASDAS indices decreased in patients treated with tenoxicam, the AS activity in patients with on-demand NSAID intake did not change. The change of the ineffective long-term NSAID intake in the 'on-demand' basis to permanent drug intake was associated with a rapid (within 4 weeks) decrease in the clinical activity of ankylosing spondylitis.Цель исследования. Изучить изменение болевого синдрома и отдельных его характеристик у больных с анкилозирующим спондилитом, получающих лечение теноксикамом после неэффективного приема нестероидных противовоспалительных препаратов (НПВП) в режиме 'по требованию'. Материал и методы. В исследование включены 40 пациентов с анкилозирующим спондилитом, имевших BASDAI ≥4,0 исходно и через 52 нед приема НПВП в режиме 'по требованию'. Больные были рандомизированы в 2 группы: 30 пациентам назначили постоянный пероральный прием теноксикама в дозировке 20 мг/сут, 10 пациентов продолжали проводимую ранее терапию. Рассчитывали индексы BASDAI, ASDAS через 52 и 56 нед лечения. Результаты и заключение. На фоне постоянного приема НПВП (теноксикам) уменьшились исходно повышенные индексы BASDAI и ASDAS. Показатели активности анкилозирующего спондилита у больных, принимавших НПВП по требованию, не изменились. Замена неэффективного длительного приема НПВП в режиме 'по требованию' на постоянный прием теноксикама ассоциируется с быстрым (в течение 4 нед) уменьшением клинической активности анкилозирующего спондилита.

Objective Postoperative dynamic cryo-compression (DC) therapy has been proposed as a method of reducing pain and the inflammatory response in the early postoperative period after orthopedic joint reconstruction surgery. Our aim was to analyze the analgesic efficacy of DC therapy after adult lumbar spinal surgery. Methods DC was applied for 30 minutes every 6 hours after surgery. Pain was measured by a visual analogue scale (VAS) in the preoperative period, immediately after surgery, and every 6 hours postoperatively for the first 72 hours of the hospital stay. Patients’ pain medication requirements were monitored using the patient-controlled analgesia system and patient charts. Twenty patients who received DC therapy were compared to 20 historical controls who were matched for demographic and surgical variables. Results In the postanesthesia care unit, the mean VAS back pain score was 5.87 ± 0.9 in the DC group and 6.95±1.0 (p=0.001) in the control group. The corresponding mean VAS scores for the DC vs. control groups were 3.8±1.1 vs. 5.4±0.7 (p < 0.001) at 6 hours postoperatively, and 2.7±0.7 vs. 6.25±0.9 (p

The goal of our study was to investigate the incidence of Stevens-Johnson syndrome (SJS), the frequency of SJS diagnosis, and the association between SJS and prior use of allopurinol, carbamazepine or phenytoin. This case-control study utilized data from the National Health Insurance Research Database (NHIRD) of Taiwan. Controls visited the emergency department of the same hospital for trauma or fractures (excluding burns) and used allopurinol, carbamazepine or phenytoin during the past 3 months. We determined whether patients were prescribed a combination of drugs in addition to allopurinol, carbamazepine or phenytoin within the last 3 months. We identified 1 853 985 controls and 7327 SJS-diagnosed patients using the Taiwan NHIRD records for 2000-2008. Higher use of allopurinol (49.8%), carbamazepine (39.1%) or phenytoin (21.3%) was observed among patients (n = 3131) than among controls (n = 2858). The overall SJS incidence rate was 3.6/1 000 000. Drug combinations were uncommon (

Giriş ve Amaç: Nöral tüp adı verilen yapı beyin dokusundan başlayıp, boylu boyunca omuriliği de içine alacak şekilde aşağı doğru uzanan bir yapıdır. Gelişimin her hangi bir nedenle (genetik veya çevresel) sorunlu olması, tüpün herhangi bir bölgesinin açık kalmasına neden olur ki bu duruma Nöral Tüp Defekti adı verilir. Nöral tüp defekti yaklaşık olarak 6/10000 gebelikte görülür. En sık görülen nöral tüp defekti anensefali ve spina bifidadır. Yenidoğanlarda %3–5 oranında doğum defektine rastlanmaktadır ve nöral tüp defektleri (NTD) doğum defektine bağlı yenidoğan ölümlerinin %7'sini oluşturmaktadır.Tenoksikam (TEN), oksikam grubundan tienotiazin türevi non-steroid antiinflamatuar ve analjezik bir ilaçtır. TEN'in siklooksijenazı inhibe ederek prostaglandin sentezini baskılaması yanında, inflamasyon gelişimindeki rolleri son yıllarda daha iyi anlaşılmasına rağmen diğer NSAİ ilaçların aksine gebelikteki teratojenik etkisi net olarak bilinmemektedir.Biz bu çalışmada sık kullanılan antiinflamatuar ve analjezik ilaç olan tenoksikamın civciv embriyolarında orta hat kapanmasına etkisi ve NTD oluşturma mekanizmasını incelemeyi amaçladık.Gereç ve Yöntem: Bu çalışma Ankara Üniversitesi Tıp FakültesiNöroşirürji Anabilim Dalı Nöroembriyoloji Laboratuarı'nda gerçekleştirildi. 160 fertil yumurta, 24 saatlik inkübasyon sonrası pencereleme yöntemi ile açıldı.Tenoksikam, 20 μL volümde subblastodermik olarak uygulanarak dört grup oluşturuldu. Bu dört gruba artan TEN dozları (0.01mikgr, 0.02mikgr, 0.10 mikgr) ve kontrol grubuna (%0.9 SF) enjekte edildi. Yumurtalar steril drape ile kapatıldıktan sonra 24 saat daha inkübe edildi. Tüm yumurtalar 48. saate açılarak, embriyolar morfolojik ve histopatolojik olarak değerlendirildi.Sonuçlar: Çalışma sonucunda veriler değerlendirildiğinde, tenoksikam dozu ile embriyo etkilenimi arasında bir korelasyon olduğu sonucuna varıldı. Bu bulgular eşliğinde tenoksikam kullanımının, artan konsantrasyonlarda erken tavuk embriyolarında orta hat kapanma kusurlarına yol açtığı sonucuna varıldı.Tartışma: Sık kullanılan antiinflamatuar ve analjezik bir ilaç olan, etkisini daha çok prostoglandin sentezini bloke ederek gösteren tenoksikam, doz bağımlı olarak embriyolarda orta hat kapanma kusurlarına neden olmaktadır. Yapılacak daha ileri çalışmalarla, embriyonik hasarlanmanın mekanizması ile genetik ve çevresel etmenlere bağlı teratojen etkiler arasındaki mekanizmaları ortaya koymak ve konjenital defektlerin oluşumunu en aza indirmek mümkün olabilecektir.Anahtar Kelimeler: Tenoksikam, Siklooksijenaz, Prostoglandin, Nöral tüp defekti, Tavuk embriyosu Introduction and Purpose: The structure called a neural tube is a structure that starts in the brain tissue and extends downward incorporating the spinal cord. Whenever there is a problem in development caused by any reasons (genetic or environmental) and any part of the tube remains open, this condition is called the Neural Tube Defect. NTD occurs in approximately 6/10000 pregnancies. The most common neural tube defects are anencephaly and spina bifida. Neural tube defects (NTD) constitute 3-5% of overall defects in new-borns and cause 7% of neonatal deaths due to birth defects.Tenoxicam (TEN) is a tienotiazin derivative non-steroidal anti-inflammatory and analgesic drug of oxicam group. Besides suppressing prostaglandin synthesis by inhibiting cyclooxygenase, although the role of TEN in inflammation development is better understood in recent years, the teratogenic effect on pregnancy against other NSAI drugs has not been clearly investigated.In this study, our aim was to investigate the effects of tenoxicam, a common anti-inflammatory and analgesic drug, on the midline fusion in chick embryos and the mechanism of NTD formation.Materials and Methods: This study was carried out in Ankara University, Faculty of Medicine, Department of Neurosurgery, the Laboratory of Neuro Embryology. 160 fertile eggs were opened using windowing method after 24 hours of incubation.Tenoxicam was administered subblastodermically at a volume of 20 μL and four groups were established. Increased TEN doses (0.01 mcg, 0.02 mcg, 0.10 mcg) were injected into these four groups and the control group (0.9% SF). After the eggs were closed with sterile drape, they were incubated for another 24 hours. All eggs were opened on the 48th hour and embryos were evaluated morphologically and histopathologically.Results: As a result of the study, it was concluded that there was a correlation between tenoxicam dose and effect on embryos. These findings show that the use of increased concentration of tenoxicam caused midline fusion defects in early chicken embryos.Discussion: Tenoxicam, which is commonly used as an anti-inflammatory and analgesic drug, has the effect of blocking prostaglandin synthesis, causing dose-dependent midline fusion defects in embryos. With further studies, it will be possible to demonstrate the mechanisms of embryonic damage and the mechanisms between teratogenic effects related to genetic and environmental factors to minimize the occurrence of congenital defects.Keywords: Tenoxicam, Cyclooxygenase, Prostoglandin, Neural Tube Defect, Chicken embryo 48

Günübirlik ameliyatlardan sonra yeterli ağrı kontrolü hastaların erken taburcu olmalarında önemlidir. Çalışmamızda, günübirlik operatif histeroskopi geçiren hastalarda preemptif uygulanan intravenöz parasetamol ile intravenöz tenoksikamın postoperatif analjezik etkinliklerini retrospektif olarak karşılaştırmayı planladık. Bu amaçla 01.01.2016- 01.08.2016 tarihleri arasında operatif histeroskopi ameliyatı geçiren ASA I - II grubu, operasyon ve anestezi onamları alınmış, 20-60 yaş arası, 83 hasta dosyası çalışmaya dâhil edildi. Bilgiler hastane elektronik kayıt sisteminden, hasta dosyalarından, anestezi takip formlarından, ameliyathane defterlerinden, post- operatif bakım ünitesinde kullanılan tüm hasta değerlendirme kayıtlarından ve/veya kişiye telefonla ulaşılarak elde edildi. Hastalar iki gruba ayrıldı. Operasyondan 30 dk önce iv. 15 mg/kg parasetamol almış olanlar Grup P, operasyondan 30 dk önce iv. tenoksikam 0.5 mg/kg (max. 40 mg) almış olanlar Grup T olarak belirlendi. İntraoperatif hemodinamik bulgular ve postoperatif 15 dk, 30 dk, 1.saat, 2 saat ve 3. saat'lerde Görsel Ağrı Skalası (VAS) ile ağrı şiddeti, sedasyon, bulantı-kusma skorları, hemodinamik parametreler, diğer yan etkiler ve ek analjezik ihtiyaçları incelendi. Görsel Ağrı Skalası skorları Grup T'de postoperatif 15 dk ve 30 dk 'da Grup P'ye göre istatiksel olarak anlamlı derecede daha düşük bulundu (p=0,00- p=0,021).. Hastaların postop 3. saatte tenoksikam grubunda parasetamol grubunun aynı dönemine göre istatistiksel olarak anlamlı sayılacak ölçüde daha memnun olduğu tesbit edildi. İki grup arasında yan etkiler açısından postoperatif 30. dk'daki sedasyon düzeyleri parasetamol grubunda istatiksel olarak anlamlı ölçüde yüksek bulundu (p=0,027). Sonuç olarak günübirlik operatif histeroskopi olgularında preemptif uygulanan tenoksikamın postoperatif analjezide parasetamole göre daha etkin olduğu düşünüldü.AnahtarKelimeler: Operatif histeroskopi, preemptif analjezi, tenoksikam, parasetamol Adequate pain management is important on patients early discharge after outpatient surgeries. In our study, we planned to compare postoperative analgesic effects of preemptive adminestered intravenous paracetamol and intravenous tenoxicams retrospectively. For this purpose, 83 patients files who were taken to operative hysteroscopy surgery between the dates 01.01.2016-01.08.2016, aged 20- 60 aged, ASA physical status classification I-II, operation and anesthesia informed consent taken were included to the study. The information was collected from hospital electronic record system, patient files, anesthesia follow-up forms, operating room notebooks, postoperative care unit recordings and or phone calls to the patients. The patients divided into two groups. In Group P, 15 mg/kg paracetamol administered to the patient intravenously 30 minutes before the surgery, in Group T,0.5 mg/kg (max. 40 mg) tenoxicam administered to the patient intravenously 30 minutes before the surgery. Intraoperative hemodynamic findings and postoperative 15th min, 30th min, 1st hour, 2nd hour and 3rd hour pain severity determined with Visual Analoque Scale (VAS), sedation, nause-vomiting scores, hemodynamic parameters and other side effects and additional analgesic requirements were inspected after obtained from recent recordings. Postoperative 15th min and 30th min Visual Analoque Scale scores of Group T were found statistically significantly lower than Group P (p=0,00-p=0,021). The patients in tenoxicam group were statistically significantly more satisfied at postoperative 3rd hour than the patients in paracetamol group. Considering the side effects of two groups, postoperative 30th min sedation levelswerefoundsignificantlyhigherinparacetamolgroup(p=0,027). Consequently, tenoxicam administered preemptive was found more effective than paracetamol at postoperative analgesia in same-day operative hysterescopy cases. Key Words: Operative hysteroscopy, preemptive analgesia, tenoxicam, paracetamol 77

Background and Aim: Postoperative pain is well known and usually disturbing complication of surgery. Inflammation plays an important role in the development and progression of postoperative pain. We aimed to investigate possible relationship between preoperatively measured neutrophil‑lymphocyte ratio (NLR) – as an inflammation marker – and postoperative analgesic demand in patients underwent orthognathic surgery.Materials and Methods: We retrospectively investigated medical and anesthesia records of 177 patients underwent orthognathic surgery. Demographical data, preoperative NLR, type of surgery, modified Mallampati score, difficulty degree of intubation, duration of surgery, and postoperative analgesic (tenoxicam – as the first drug of choice, paracetamol, tramadol, or pethidine) usage were recorded. A cutoff value of NLR ≥2 was determined for inflammation threshold. Two groups (Group 1 NLR ≥2, Group 2 NLR

WOS: 000371084600025, PubMed ID: 26374114, Aim There are many alternatives for post-operative pain relief in patients who have had general anaesthesia. The aim of this study was to evaluate the efficacy of intra-articular bupivacaine + morphine and bupivacaine + tenoxicam applications in post-operative pain control in patients undergoing knee arthroscopy with general anaesthesia. Method This was a prospective study. Standard anaesthesia procedures were applied to each patient, and the 240 patients chosen at random were then divided into two groups. Each group received a different combination of drugs for this double-blind study. The first group (group A: 120 patients) received 0.5 % bupivacaine 100 mg + tenoxicam 20 mg (22 ml); the second group (group B) received 0.5 % bupivacaine 100 mg + morphine 2 mg (22 ml); both groups received their drugs at the end of the intra-articular operation before tourniquet deflation. Before the operation, patients were asked about their post-operative pain at particular periods over the following 24 hours using the visual analogue scale (VAS) and the numeric rating scale (NRS). An additional analgaesic requirement and possible side effects were also recorded. Results Group A patients needed analgaesics sooner after operation than patients in group B. In Group B, VAS and NRS values were statistically higher compared with group A at the 12th hour. There were also fewer side effects seen in group A versus group B. Conclusion Effective and reliable results were obtained in post-operative pain control in bupivacaine added to the morphine or tenoxicam groups following arthroscopic meniscectomy. In the tenoxicam group, patients reported less pain, fewer side effects and less need for analgesics at 12 hours after the operation.

Non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly used analgesics and antipyretics, which form an interesting drug group because of their new and alternate functions. The ability of the NSAIDs belonging to the oxicam chemical group to induce membrane fusion at low physiologically relevant concentrations is a new function that has drawn considerable attention. Membrane fusion is dependent on the interplay of physicochemical properties of both drugs and membranes. Here, we have elucidated the effects of different oxicam drugs, Meloxicam, Piroxicam, Tenoxicam, Lornoxicam, and Isoxicam, on an identical membrane-mimetic system. This highlights only the differential effects of the drugs on drug-membrane interactions, which in turn modulate their role as membrane fusogens. The partitioning behavior and the location of the drugs in dimyristoylphosphatidylcholine vesicles have been studied using second-derivative absorption spectroscopy, fluorescence quenching, steady-state fluorescence anisotropy, and time-resolved fluorescence lifetime measurements. Fusion kinetics has been monitored by fluorescence assays and dynamic light scattering was used to provide a snapshot of the vesicle diameter distribution at different time points. The differential perturbing effect of the drugs on the membrane is dependent both on their partitioning and location. Although partitioning governs the extent of fusion, the location modulates the rates of each step.

Bilosomes represent an evolving vesicular carrier that have been explored for oral vaccines delivery based on its ability to resist enzymes and bile salts in the gastrointestinal tract (GIT). Bilosomes vesicles are formed of bilayer membrane of non-ionic surfactant molecules encompassing bile salts. Although, bilosomes have not been proposed for transdermal drug delivery, this carrier seems to have promising potential in this regard. Accordingly, the aim of this investigation was to assess the capability and safety of utilizing bilosomes for transdermal delivery of tenoxicam (TX) as a model drug. A 3(1)2(2) full factorial design was adopted to study the effects of different formulation parameters on bilosomes properties and select the optimal formulation using Design-Expert(®) software. The selected formulation displayed nano-sized spherical vesicles (242.5 ± 6.43nm) with reasonable entrapment efficiency percent (68.33 ± 2.33%). Confocal laser scanning microscopy confirmed the capability of the flourolabeled bilosomes to penetrate deep within the skin. Both, ex vivo permeation and in vivo skin deposition studies confirmed the superiority of bilosomes over drug solution in delivering TX transdermally. In addition, in vivo histopathological study proved the safety of topically applied bilosomes. In summary, the highlighted results confirmed that bilosomes can be further adopted for delivering drugs transdermally.

Non-steroidal anti-inflammatory drugs (NSAIDs) show chemopreventive and chemosuppressive effects on various cancer cell lines. They exert anticancer activities by inhibiting both at the protein level and/or at the transcription level. Thus, in this paper, the interaction between tenoxicam (TXM) and calf thymus DNA (ct-DNA) was investigated by UV–visible light, fluorescence, viscosity experiments and DNA melting studies. The results showed that TXM could bind to ct-DNA in the groove binding mode. The binding constants were 7.67 × 103 and 5.48 × 103 M−1 at 293 and 300 K, respectively. Furthermore, the calculated thermodynamic parameters suggested that hydrogen bonds or van der Waals force might play an important role in the binding of TXM to ct-DNA. The obtained results should give new insight into the pharmacological activity of TXM. Copyright © 2015 John Wiley & Sons, Ltd.

This work dealt with the spectrophotometric and electrochemical determination of the thermodynamic formation constants, K f , of the host–guest inclusion complex between diverse tenoxicam species in aqueous solution, Tenox, and β-cyclodextrin (β-CD) namely: β-CD-H 2 Tenox + , β-CD-HTenox(z) and β-CD-Tenox − . It was found that it is possible to form the said inclusion complex regardless of the nature of the tenoxicam chemical species and that for each case, similar values of K f were found from both experimental techniques. Moreover, the values of the Tenox’s acidity constants are also reported. From all these estimated thermodynamic equilibrium constants, the 3D distribution diagram for the different species of the Tenox in the space molar fraction-[β-CD]-pH was constructed.

NSAIDs and analgesic drugs are used intra-articularly after knee arthroscopy for pain relief. However, synovial effusion is still a common cause of delayed physical therapy. The aim of this study was to demonstrate the beneficial effect of intra-articular injection of Tenoxicam on knee effusion after arthroscopy. This was a prospective non-randomized study on 134 patients with a mean age of 36.7 years. Knee arthroscopy on a day-case basis was performed; normal saline was used for irrigation. At the end of the procedure, fluid was aspirated from the knee joint and 20 ml of Tenoxicam diluted with 20 ml of 0.9 % normal saline was injected into the knee five minutes before deflation of limb tourniquet. The same surgeon performed clinical examination for knee effusion 14 days postoperatively. Encountered pathologies included meniscal injury, degenerative arthropathy, synovial plica and ACL rupture. Knee effusion developed in 15.7 % of the patients, particularly in those with degenerative arthropathy (p = 0.006) and meniscal lesions (p = 0.06). Intra-articular Tenoxicam is a simple method for the prevention of postoperative knee effusion. Degenerative arthropathy and meniscal lesions are major risk factors for post arthroscopy knee effusion.

There is growing interest in re-evaluation of older antibiotics with the wide spread of pathogen resistance, especially gram negative bacteria, which impair treatment of some infections. In contrast various studies have reported that some antibiotics have efficacy in clearing resistant bacterial infections. On account of that it was interesting to evaluate the efficacy of erythromycin, chloramphenicol and/or tenoxicam in curing and/or relieving wound infection of highly resistant Escherichia coli and investigate the possible mechanisms beyond their antibacterial activity. This was achieved through evaluating highly resistant E. coli strains in vitro using agar dilution and in vivo rat models of E. coli infected wound and acute inflammation by carrageenin, where possible mechanisms were evaluated through measuring immunological mediators and histopathological examination. This study revealed that in vivo, erythromycin alone or in combination with tenoxicam significantly improved the healing of infected skin wounds with E. coli irresspective of resistancy in vitro. In addition to the improvement of immunological mediators involved in inflammatory reaction, oxidative stress and in cytokines expression as response to the bacterial infection in vivo. On the other hand chloramphenicol neither alone nor in combination with tenoxicam, achieved any significant effect. Tenoxicam didn’t show antimicrobial activity alone nor in combination with tested antibiotics in vitro, but it has shown synergestic activity in combination with tested antibiotics in vivo. Thus we concluded that immunomodulatory activity of erythromycin through anti-inflammatory and antioxidant effects was the possible mechanisms by which this antibiotic had healed infection with resistant E. coli in vivo, despite its resistancy to this antibiotic in vitro.

Fixed drug eruption (FDE) with oxicams is very rare. FDE due to tenoxicam has been reported in several case reports. Skin patch test with the suspected or responsible drug is applied on sites of previous lesions developing with FDE. Recently, the test has been used quite often for diagnosis of FDE although results are variable. Our case was a 63-year-old woman who had developed itching and erythematous lesions 3-5 cm in size localized on her hands and elbows 3-4 hours after the intake of tenoxicam and ranitidine. The lesion became vesiculobullous a few days later. After two weeks, it resolved with hyperpigmentation. The diagnosis of tenoxicaminduced FDE was confirmed after applying patch and provocation tests. Here we described a case of bullous fixed drug eruption due to tenoxicam and we demonstrated the contribution of skin patch tests to the FDE diagnosis.

Recently, one of the most common conditions that manifests as joint and muscle inflammation is rheumatoid arthritis. One of the treatments for this arthritis includes non-steroidal anti-inflammatory drugs (NSAIDs) of the oxicam family, and the widest used drug in this family is tenoxicam (Tenox). In this study, the complexation properties of the drug Tenox with Ca(II), Sr(II) and Ba(II) ions in a (dichloromethane + water) binary solvent system are reported. The formed metal complexes were characterized structurally, thermally, and biologically. Tenox was found to act as a chelate monoanionic ligand towards all metal ions with complexation stoichiometry of 1:2 (Metal: Tenox) for Ca(II) and Sr(II) ions, and 1:1 for Ba(II) ions. The Tenox ligand behaves as a bidentate ligand when coordinated with Sr(II) or Ba(II) ions and as a tridentate ligand when coordinated with Ca(II) ions. The Sr(II) and Ba(II) complex of the Tenox ligand exhibited marked inhibitory effect on the cell growth of the C. albicans species.

The fate of the pharmaceutical drugs tenoxicam, piroxicam and meloxicam in river water is evaluated here for first time. So, biological, photochemical and thermal degradation assays have been conducted to estimate their degradation rates and know their degradation products. Results indicated that the direct sunlight irradiation, without any protection, promoted a fast degradation of the oxicams while the chemical reactions in solution were less important. The biological degradation in water was negligible except for tenoxicam in whose case its influence was scarce. When the exposition of river water to sunlight was partially limited and kept under the natural day-night cycle, as occurs inside a body of water, tenoxicam, piroxicam and meloxicam (at 2 μg L−1) were detected during a period of 15, 27 and 45 days, respectively. Residues were monitored by ultra-pressure liquid chromatography/quadrupole time-of-flight/mass spectrometry after solid-phase extraction and several degradation products were found (10 for tenoxicam, 9 for piroxicam and 7 for meloxicam) and monitored over time. Their structures were proposed from the molecular formulae and fragmentation observed in high-resolution tandem mass spectra; the nature of the transformation products found in the long-term resulted to be very variable for each oxicam. Furthermore, the degradation in presence of river sediment was also monitored over time, with some differences being noted; the adsorption coefficients of the compounds on sediment were calculated, meloxicam exhibited a higher sorption capacity. The ecotoxicity of the different compounds in aquatic ecosystems was predicted, too.

Non-ionic surfactant (NIS) based in situ forming vesicles (ISVs) present an affordable alternative to the traditional systems for the parenteral control of drug release. In this work, NIS based ISVs encapsulating tenoxicam were prepared using the emulsion method. Tenoxicam-loaded ISVs were prepared using a 22.31 full factorial experimental design, where three factors were evaluated as independent variables; type of NIS (A), molar ratio of NIS to Tween®80 (B), and phase ratio of the internal ethyl acetate to the external Captex® oil phase (C). Percentage drug released after 1 h, particle size of the obtained vesicles and mean dissolution time were chosen as the dependent variables. Selected formulation was subjected to morphological investigation, injectability, viscosity measurements, and solid state characterization. Optimum formulation showed spherical nano-vesicles in the size of 379.08 nm with an initial drug release of 37.32% in the first hour followed by a sustained drug release pattern for 6 days. DSC analysis of the optimized formulation confirmed the presence of the drug in an amorphous form with the nano-vesicles. Biological evaluation of the selected formulation was performed on New Zealand rabbits by IM injection. The prepared ISVs exhibited a 45- and 28-fold larger AUC and MRT values, respectively, compared to those of the drug suspension. The obtained findings boost the use of ISVs for the treatment of many chronic inflammatory conditions.

Background and objective: The use of transversus abdominis plane block with different local anesthetics is considered as a part of multimodal analgesia regimen in laparoscopic cholecystectomy patients. However no studies have been published comparing bupivacaine and levobupivacaine for transversus abdominis plane block. We aimed to compare bupivacaine and levobupivacaine in ultrasound-guided transversus abdominis plane block in patients undergoing laparoscopic cholecystectomy. Methods: Fifty patients (ASA I/II), undergoing laparoscopic cholecystectomy were randomly allocated into two groups. Following anesthesia induction, ultrasound-guided bilateral transversus abdominis plane block was performed with 30 mL of bupivacaine 0.25% in Group B (n = 25) and 30 mL of levobupivacaine 0.25% in Group L (n = 25) for each side. The level of pain was evaluated using 10 cm visual analog scale (VAS) at rest and during coughing 1, 5, 15, 30 min and 1, 2, 4, 6, 12 and 24 h after the operation. When visual analogue scale > 3, the patients received IV tenoxicam 20 mg. If visual analogue scale remained >3, they received IV. tramadol 1 mg.kg−1. In case of inadequate analgesia, a rescue analgesic was given. The analgesic requirement, time to first analgesic requirement was recorded. Results: Visual analogue scale levels showed no difference except first and fifth minutes postoperatively where VAS was higher in Group L (p 3, os pacientes receberam 10 mg de tenoxicam por via intravenosa (IV). Se a escala visual analógica permanecesse > 3, os pacientes recebiam tramadol IV (1 mg.kg−1). Em caso de analgesia inadequada, um analgésico de resgate foi administrado. A necessidade de analgésico e o tempo até a primeira solicitação de analgésico foram registrados. Resultados: Os escores da escala visual analógica não mostraram diferença, exceto no primeiro e quinto minutos de pós-operatório, onde a escala visual analógica foi maior no Grupo L (p < 0,05). A necessidade de analgésico foi semelhante em ambos os grupos. O tempo até a primeira solicitação de analgésico foi menor no Grupo L (4,35 ± 6,92 min vs. 34,91 ± 86,26 min, p = 0,013). Conclusões: Bupivacaína e levobupivacaína apresentaram eficácia similar no bloqueio TAP em pacientes submetidos à colecistectomia laparoscópica. Keywords: Bupivacaine, Cholecystectomy, Laparoscopic surgery, Levobupivacaine, Postoperative analgesia, Palavras-chave: Bupivacaína, Colecistectomia, Cirurgia laparoscópica, Levobupivacaína, Analgesia pós-operatória

Tenoxicam and lornoxicam are nonsteroidal anti-inflammatory drugs, were subjected to photoirradiation at 254 nm led to the photodegradation of the pharmaceutical agents. Both, the isolated photodegradation products and the pharmaceutical agents were examined toward DNA binding and degradation. The photodegradation products degrade calf thymus in concentration dependent manner.

Postoperatif ağrı kontrolünün hem hasta açısından hem de çalışan açısından oldukça önemli bir yeri vardır. Özellikle postoperatif ağrı iyi kontrol edildiğinde hastanede kalış sürelerini kısaltmakta ve tedavi masraflarını azaltmaktadır. Cerrahi travmanın başlangıcından itibaren olan bu ağrı, anestezistler tarafından iyi değerlendirilmeli ve yönetilmelidir. Postoperatif ağrıda analjezik seçimi, yapılan cerrahiye, cerrahinin süresine göre ve özellikle anestezistin deneyimine göre değişiklikler gösterir. Postoperatif ağrı beklentisi az olan cerrahilerde tek bir ajan yeterli olurken bazen de hiç analjezik ilaç ihtiyacı olmaz. Hastanın tıbbi durumu da mutlaka ilaç seçiminde değerlendirilmelidir. Postoperatif ağrıda en sık kullanılan IV ajanlar nonsteroid antiinflamatuar (NSAİ) ve opioid grubu ilaçlardır.Çalışmamızda septorinoplasti cerrahisi geçiren hastaların postoperatif ağrılarını değerlendirdik. Hastaların VAS skoru ve tramadol tüketimlerini takip ederek kullanılan üç farklı analjezik ilacın etkinliğini karşılaştırdık. Çalışmaya dâhil edilen tüm hastalar, preoperatif dönemde uygulanacak işlem hakkında bilgilendirildi ve yazılı onamları alındı. Hastalara premedikasyon uygulanmadı. Hastalar üç gruba ayrıldı ve her gruba tramadol ile birlikte farklı analjezik ilaç verildi. Ayılmada, postoperatif 8. 16. ve 24. saatteki VAS skorları kaydedildi. VAS skoru dördün üzerinde olan hastalara tramadol 0,5 mg/kg IV yapıldı.Kliniğimizde sıkça kullandığımız ilaçlar; deksketoprofen, parasetamol, tenoksikam çalışma için seçildi. Deksketoprofen ve parasetamol 8 saat aralıklarla uygulanırken tenoksikam tek doz olarak kullanıldı. Postoperatif dönem takiplerde 0. saat VAS skorlarında, parasetamol ve tenoksikam arasında istatistiksel olarak anlamlı bir fark bulunmazken deksketoprofen verdiğimiz hastalarda ayılma ünitesinde (0.saat) daha düşük VAS skoru elde edildi. Bu fark istatistiksel olarak anlamlıydı. Hastaların ek tramadol ihtiyaçları karşılaştırıldığında, deksketoprofen alan hastalarda postoperatif dönem tramadol ihtiyacı diğer iki gruba göre daha az oldu ve bu fark istatistiksel olarak anlamlıydı. Bu yüzden deksketoprofen tramadol kombinasyonunun parasetamol-tramadol ve tenoksikam-tramadol kombinasyonuna göre septorinoplasti cerrahilerinden sonra daha etkin analjezi sağladığı sonucuna ulaşıldı. Postoperative pain control has a rather important role both for the patient and the employee. Especially when postoperative pain is controlled well, hospitalization durations are shortened and treatment costs decrease. This pain which is present since the beginning of the surgical trauma should be evaluated and managed well by the anaesthetists. Selection of the analgesic in postoperative pain changes according to the duration of the surgery and especially the experience of the anaesthetist. While a single agent is enough in surgeries with a low postoperative pain expectation, sometimes it is not required at all. Medical condition of the patient should definitely be evaluated in drug selection. IV agents most commonly used in postoperative pain are non-steroid anti-inflammatory and upload group of drugs.In our study, we evaluated postoperative pains of the patients who had septorhinoplasty surgery. Following VAS score and tramadol consumptions of the patients, we compared the efficiency of three different analgesic drugs used. All patients participating in the study were informed on the operation to be applied in preoperative period and their written consents were taken. Premedication was not applied for the patients. Separating the patients into three groups, each group was given a different analgesic drug together with tramadol. VAS scores were recorded revival and postoperative 8, 16, 24th hours. 16. Tramadol 0.5 mg/kg IV was given to the patients with a VAS score above 4. 63

Two stability-indicating micellar liquid chromatographic methods were developed and validated for the determination of three oxicams, namely piroxicam (PX), tenoxicam (TX), and lornoxicam (LX), in presence of their degradation product and potential impurity (2-aminopyridine, AP). The analyses were achieved using C8 column (150 mm × 4.6 mm i.d., 5 µm particle size). In Method I, a micellar mobile phase consisting of 0.15 M SDS, 10% n-propanol, 0.3% triethylamine, and 0.02 M orthophosphoric acid (pH 3.0) was used for simultaneous determination of PX, TX, and AP. In Method II, a mobile phase of the same composition but at pH 6.0 was used for separation of LX and AP. Time-programmed UV detection was applied to allow sensitive determination of the drugs and AP. Method I showed good linearity for PX, TX, and AP over the concentration ranges of 1.0–32.0, 1.0–20.0, and 0.5–10.0 µg/mL, respectively, while Method II was linear over the concentration ranges of 0.8–32.0 and 0.5–10.0 µg/mL for LX and AP, respectively....