Clinical pharmacology and therapeutics
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Clin. Pharmacol. Ther. · Aug 1983
Clinical Trial Controlled Clinical TrialIbuprofen, zomepirac, aspirin, and placebo in the relief of postepisiotomy pain.
Our purpose was to compare the analgesic efficacy of single oral doses of ibuprofen, zomepirac, aspirin, and placebo in severe postepisiotomy pain. One hundred twenty subjects participated in a double-blind, single-dose, parallel-group, 4-hr trial comparing 400 mg ibuprofen, 100 mg zomepirac sodium, 600 mg aspirin, and placebo. For most parameters, including the sum of the pain intensity differences (SPID) and the sum of the hourly pain relief values (TOTAL), which are summary variables, each of the drugs was more effective than placebo. ⋯ Zomepirac and aspirin were equally effective for most of the analgesic variables. There were no adverse effects. Ibuprofen, 400 mg, is an effective oral analgesic and is more effective than 100 mg zomepirac and 600 mg aspirin in most parameters of pain.
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Clin. Pharmacol. Ther. · Aug 1983
Studies with different types of visual analog scales for measurement of pain.
We compared the sensitivity of different types of visual analog scales and of descriptive pain terms in healthy volunteers and in postoperative patients. One hundred and seven volunteers marked visual analog scales according to their perception of the descriptive pain terms--little, mild, some, moderate, severe, agonizing. Individual variation in values and preferences between the five following five different visual analog scales were analyzed: 10-cm linear horizontal and vertical scales, a curvilinear scale, and graded horizontal and curvilinear scales. ⋯ There were significant changes in the values of pain intensity measured on visual analog scales by patients using the same descriptive pain term on successive observations. However, the patients' values for pain terms in the preoperative pain-free state were not significantly different from those during postoperative pain. We conclude that graded linear horizontal scales are both more reliable and preferred by participants and that visual analog scales give a more sensitive and accurate representation of pain intensity than do descriptive pain scales.
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Clin. Pharmacol. Ther. · Oct 1982
Comparative StudyAnalgesic effects of oral nalbuphine and codeine in patients with postoperative pain.
Efficacy and safety of oral nalbuphine in doses of 15 and 45 mg were compared with those of the standard oral analgesic codeine in single doses of 30 and 90 mg in 153 patients with acute postoperative pain; data on 20 more patients were excluded because they received potentially interfering medications. All patients had pain ranging from moderate to severe in intensity and most had severe pain related to orthopedic procedures or trauma. ⋯ The most common side effect was sedation, which was greatest in patients who received the higher doses of codeine and nalbuphine. The effects of oral nalbuphine are much like those of oral codeine in patients with acute postoperative pain.
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Clin. Pharmacol. Ther. · Dec 1980
Age and morphine analgesia in cancer patients with postoperative pain.
Our objective was to identify age-related differences in analgesia after 8 and 16 mg morphine intramuscularly. Retrospective analyses of controlled relative analgesic potency assays in 947 postoperative cancer patients revealed differences among age groups (18 to 29, 30 to 49, 50 to 69, and 70 to 89 yr) in total pain relief and duration of relief with little differences in peak relief. Weight and initial pain intensity were in the same range among age and dose groups. ⋯ The difference in total relief between the extremes of adult age was approximately twice that with twice the dose. While in 50% of the oldest group relief was no longer obtained at 5 hr, in 50% of the youngest group relief was no longer obtained at 3 hr. These observations suggest that age is a factor in morphine analgesia.
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Clin. Pharmacol. Ther. · Aug 1980
Clinical Trial Controlled Clinical TrialDiphenhydramine in Orientals and Caucasians.
The kinetics and psychomotor effects of diphenhydramine were investigated in Orientals and Caucasians. Each of 5 Oriental and 5 Caucasian young adults received on 1 of 3 occasions diphenhydramine 50 mg/70 kg body weight either intravenously or orally, or placebo. Plasma levels of diphenhydramine were measured hourly for 8 hr at each session. ⋯ With the assumption of linear kinetics and a 1-compartment open model, analysis of the data showed that the volume of distribution (VD) and plasma clearance (Cl) but not plasma half-life (t 1/2) were higher in Orientals than Caucasians: [VD = 480 +/- 24 (SEM) and 292 +/- 36 1/70 kg; Cl = 79 +/- 7 and 51 +/- 7 1/70 kg/hr; t 1/2 = 4.1 +/- 0.4 and 4.3 +/- 0.4 hr]. Unbound diphenhydramine in fresh plasma was higher in Orientals than Caucasians [24.0 +/- 1.9% (SEM) and 14.8 +/- 1.5%] and probably explains the increased VD in Orientals. Orientals had significantly less sedation and deterioration in psychomotor performance.