Articles: analgesics.
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Randomized Controlled Trial Multicenter Study
Methylnaltrexone for treatment of opioid-induced constipation in advanced illness patients.
Methylnaltrexone, a peripheral mu-opioid receptor antagonist with restricted ability to cross the blood-brain barrier, may relieve opioid-induced constipation (OIC) without reversing analgesia. A total of 154 patients with advanced illness and OIC enrolled in a double-blind, randomized, placebo-controlled trial, with optional open-label phases (up to 4 months) in hospice and palliative care centers during 2003-2005. They received a single subcutaneous injection of methylnaltrexone (0.15 mg/kg or 0.3 mg/kg) or placebo. ⋯ The most common adverse events (AEs) were abdominal pain and flatulence. Three patients had serious AEs attributed to methylnaltrexone. Subcutaneous methylnaltrexone was efficacious in rapidly inducing laxation and was generally well tolerated in patients with advanced illness and OIC.
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Randomized Controlled Trial Multicenter Study
A randomised controlled trial with prolonged-release oral oxycodone and naloxone to prevent and reverse opioid-induced constipation.
Opioid-induced constipation can have a major negative impact on patients' quality of life. This randomised, double-blinded study evaluated the analgesic efficacy of prolonged-release (PR) oral oxycodone when co-administered with PR oral naloxone, and its impact on opioid-induced constipation in patients with severe chronic pain. Another objective was to identify the optimal dose ratio of oxycodone and naloxone. ⋯ Co-administration of PR oral naloxone and PR oral oxycodone is associated with a significant improvement in bowel function compared with PR oral oxycodone alone, with no reduction in the analgesic efficacy of oxycodone.
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Osteoarthr. Cartil. · Jan 2009
Randomized Controlled Trial Multicenter Study Comparative StudyA 4-week randomized study of acetaminophen extended-release vs rofecoxib in knee osteoarthritis.
To compare the safety and efficacy of acetaminophen extended-release (APAP ER) with rofecoxib for the management of pain associated with knee osteoarthritis (OA). ⋯ APAP ER 3900 mg daily was noninferior to rofecoxib 12.5mg daily, but noninferiority was not established to rofecoxib 25mg daily. APAP ER was well tolerated and no safety issues were identified. Based on the results of this study, APAP ER 3900 mg daily is an alternative to nonsteroidal anti-inflammatory drugs (NSAIDs), such as rofecoxib, in treating pain associated with knee OA.
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Randomized Controlled Trial Multicenter Study
Validation of the Bowel Function Index to detect clinically meaningful changes in opioid-induced constipation.
The Bowel Function Index (BFI) is a clinician-administered, patient-reported, 3-item questionnaire to evaluate opioid-induced constipation in cancer and non-cancer chronic pain patients. The objective of the present analysis was to evaluate the psychometric characteristics of the BFI using data from clinical studies of oral prolonged release (PR) oxycodone/naloxone. ⋯ The BFI is a valid and reliable instrument for the assessment of opioid-induced constipation in chronic pain patients. Psychometric analyses from clinical trials support the BFI's psychometric properties.
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Int. J. Clin. Pract. · Jan 2009
Multicenter StudyEfficacy and tolerability of ready-to-use intravenous paracetamol solution as monotherapy or as an adjunct analgesic therapy for postoperative pain in patients undergoing elective ambulatory surgery: open, prospective study.
Paracetamol (acetaminophen) is one of the most widely used drugs for analgesia. We aimed to investigate the use of a ready-to-use intravenous (i.v.) paracetamol 1 g solution (Perfalgan) as monotherapy or as adjunct therapy in patients undergoing elective ambulatory surgery. ⋯ Ready-to-use i.v. paracetamol, used as monotherapy or in combination with other analgesics, may be effective for alleviating postoperative pain and well tolerated in patients undergoing ambulatory surgery.