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Great article Dr. Fudin vs Kolodny round 3 lol
“What he said about kidney stones is not correct. In fact, it’s cruel. What he said about tooth extractions is correct,” says Jeffrey Fudin, PharmD, an expert in pharmacology and pain management. https://www.painnewsnetwork.org/stories/2021/4/25/htdmcso3u8aio588kdq6vg9dgdpfja
Great article Dr. Fudin vs Kolodny round 3 lol
“What he said about kidney stones is not correct. In fact, it’s cruel. What he said about tooth extractions is correct,” says Jeffrey Fudin, PharmD, an expert in pharmacology and pain management. https://www.painnewsnetwork.org/stories/2021/4/25/htdmcso3u8aio588kdq6vg9dgdpfja
“But encouraging expanded chronic NSAID use without preliminary discussion with a physician or pharmacist is bad and he is oversimplifying. Pain source, cause, quality and quantity all need to be assessed.”
“And he didn’t offer what should be done for those patients that can’t take NSAIDs due to medical disorders or who can’t tolerate them or they don’t work. What do we do, not treat them?”
The study that has been referred to by kolodny regarding kidney stone pain is shown below
The study that has been referred to by kolodny regarding kidney stone pain is shown below
This study regarding comparing NSAIDS vs opioids for acute renal colic I will highlight some limitations with the study below
Also in this systematic review most of the trials included used the opioid pethidine which means it reduces how this data is generalizable to other opioids
Also very short follow up time so you can’t assess long term side effects..
So this study showed NSAIDS and opioids BOTH provided clinically important analgesic effect with acute renal colic, they also stated that there was a lower pain score in the NSAID group but this was a very small difference..
The only reason this study recommended NSAIDS over opioids for acute renal colic is the side effect profile of the opioid (vomiting, only used pethidine) and use of rescue analgesia, lower pain score (which was small)
So in conclusion in my opinion you can’t use this study to say NSAIDS should be utilized over opioids in acute renal colic, to many limitations to make that definitive conclusion!! #TwitteRx
Here is the study for anyone interested... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC421776/
