Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942012000300011
Brazilian Journal of Anesthesiology
Review Article

Cafeína para o tratamento de dor

Caffeine in the treatment of pain

Cristiane Tavares; Rioko Kimiko Sakata

Downloads: 1
Views: 1068

Resumo

JUSTIFICATIVA E OBJETIVOS: A cafeína é uma substância amplamente consumida com efeitos em diversos sistemas e que apresenta farmacocinética e farmacodinâmica características, causando interações com diversos medicamentos. O objetivo deste estudo é fazer uma revisão sobre os efeitos da cafeína. CONTEÚDO: Nesta revisão, são abordados a farmacologia da cafeína, os mecanismos de ação, as indicações, as contraindicações, as doses, as interações e os efeitos adversos. CONCLUSÕES: Faltam estudos controlados, randomizados e duplos-cegos para avaliar a eficácia analgésica da cafeína nas diversas síndromes dolorosas. Em pacientes com dor crônica, é necessário ter cautela em relação ao desenvolvimento de tolerância, abstinência e interação medicamentosa no uso crônico de cafeína.

Palavras-chave

analgesia, dor, drogas, alcaloide

Abstract

BACKGROUND AND OBJECTIVES: Caffeine is a widely used substance with effects on several systems, presenting characteristic of pharmacokinetic and pharmacodynamic which cause interactions with several drugs. This study's objective is to review the effects caused by caffeine. CONTENT: This review assesses the caffeine pharmacology, its action mechanisms, indications, contraindications, doses, interactions and adverse effects. CONCLUSIONS: There are insufficient double-blind randomized controlled studies that assess the analgesic effect of caffeine on several painful syndromes. Patients presenting chronic pain need caution when it comes to tolerance development, abstinence and drug interaction from chronic caffeine use.

Keywords

analgesia, caffeine, molecular mechanisms of pharmacological action, pain

References

Daly JW. Caffeine analogs: biomedical impact. Cell Mol Life Sci. 2007;64:2153-2169.

Fredholm BB, Battig K, Holmen J. Actions of caffeine in the brain with special reference to factors that contribute to its widespread use. Pharmacol Rev. 1999;51:83-133.

Goldstein J, Silberstein SD, Saper JR. Acetaminophen, aspirin and caffeine in combination versus ibuprofen for acute migraine: results from a multicenter, double- blind, randomized, parallel-group, single-dose, placebo- controlled study. Headache. 2006;46:444-453.

Sawynok J. Methylxanthines and pain. Handb Exp Pharmacol. 2011;200:311-329.

Schmidt B, Roberts RS, Davis P. Caffeine therapy for apnea of prematurity. N Engl J Med. 2006;354:2112-2121.

Sawynok J, Yaksh TL. Caffeine as an analgesic adjuvant: a review of pharmacology and mechanisms of action. Pharmacol Rev. 1993;45:43-85.

Juliano LM, Griffiths RR. A critical review of caffeine withdrawal: empirical validation of symptoms and signs, incidence, severity, and associated features. Psychopharmacology. 2004;176:1-29.

Ribeiro JA, Sebastião AM. Caffeine and adenosine. J Alzh Dis. 2010;20:S3-S15.

Davis JK, Green JM. Caffeine and anaerobic performance: ergogenic value and mechanisms of action. Sports Med. 2009;39(10):813-832.

Carrillo JA, Benitez J. Clinically significant pharmacokinetic interactions between dietary caffeine and medications. Clin Pharmacokinet. 2000;39(2):127-153.

Shi D, Padgett WL, Daly JW. Caffeine analogs: effects on ryanodine-sensitive calcium-release channels and GABAa receptors. Cell Mol Neurobiol. 2003;23:331-347.

Sawynok J. Caffeine and pain. Pain. 2010.

Sawynok J, Reid AR, Fredholm BB. Caffeine reverses antinociception by amitriptyline in wild type mice but not in those lacking adenosine A1 receptors. Neurosci Lett. 2008;440(2):181-184.

Castro A, Jerez MJ, Gil C. Cyclic nucleotide phosphodiesterases and their role in immunomodulatory responses: advances in the development of specific phosphodiesterase inhibitors. Med Res Rev. 2005;25:229-224.

Cheng LZ, Lü N, Zhang YQ. Ryanodine receptors contribute to the induction of nociceptive input-evoked long-term potentiation in the rat spinal cord slice. Mol Pain. 2010;20:1-6.

Cauli O, Morelli M. Caffeine and the dopaminergic system. Behav Pharmacol. 2005;16:63-77.

Xu K, Bastia E, Schwarschild M. Therapeutic potential of adenosine A2a receptor antagonists in Parkinson's disease. Drugs Aging. 2005;22:471-482.

Maia L, De Mendonça A. Does caffeine intake protect from Alzheimer disease?. Eur J Neurol. 2002;9:377-382.

Arendash GW, Schleif W, Rezai-Zadeh K. Caffeine protects Alzheimer's mice against cognitive impairment and reduces brain beta-amyloid production. Neuroscience. 2006;142:941-952.

Yang H, Rouse J, Lukes L. Caffeine suppresses metastasis in a transgenic mouse model: a prototype molecule for prophylaxis of metastasis. Clin Exp Metastasis. 2004;21:719-735.

Petrie HJ, Chown SE, Belfie LM. Caffeine ingestion increases the insulin response to na oral-glucose- tolerance test in obese men before and after weight loss. Am J Clin Nutr. 2004;80:22-28.

Zhang W Y. A benefit- risk assessment of caffeine as an analgesic adjuvant. Drug Safety. 2001;24:1127-1142.

Mercadante S, Serretta R, Casuccio A. Effects of Caffeine as an adjuvant to morphine in advanced cancer patients: a randomized, double-blind, placebo-controlled, crossover study. J Pain Symptom Manage. 2001;21(5):369-372.

Peroutka S, Lyon JA, Swarbrick J. Efficacy of diclofenac sodium softgel 100 mg with or without caffeine 100 mg in migraine without aura: a randomized, double-blind, crossover study. Headache. 2004;44:136-141.

Diamond S, Balm TK, Freitag FG. Ibuprofen plus caffeine in the treatment of tension-type headache. Clin Pharmacol Ther. 2000;68(3):312-319.

Renner B, Clarke G, Grattan T. Caffeine accelerates absorption and enhances the analgesic effect of acetaminophen. J Clin Pharmacol. 2007;47:715-726.

Ewans RW, Armon C, Frohman EM. Assessment: prevention of post-lumbar puncture headaches. Neurology. 2000;55:909-914.

Lin W, Geiderman J. Myth: fluids, bed rest, and caffeine are effective in preventing and treating patients with post-lumbar puncture headache. West J Med. 2002;176(1):69-70.

Palmer H, Graham G, Williams K. A risk-benefit assessment of paracetamol (acetaminophen) combined with caffeine. Pain Med. 2010;11(6):951-965.

Feinstein AR, Heinemann LA, Dalessio D. Do caffeine-containing analgesics promote dependence?: A review and evaluation. Clin Pharmacol Ther. 2000;68(5):457-467.

Morelli M, Simola N. Methylxantines and drug dependence: a focus on interactions with substances of abuse. Handb Exp Pharmacol. 2011;200:483-507.

5dd2e3290e88255825c63493 rba Articles
Links & Downloads

Braz J Anesthesiol

Share this page
Page Sections