Articles: analgesics.
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Clinical therapeutics · Jan 2005
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialCombination oxycodone 5 mg/ibuprofen 400 mg for the treatment of pain after abdominal or pelvic surgery in women: a randomized, double-blind, placebo- and active-controlled parallel-group study.
The sensation of pain arises from both central and peripheral sites, and inflammation may be one of its underlying causes. Combination therapy with analgesic agents having multimodal mechanisms of action and complementary pharmacokinetic properties enhances pain relief by addressing the different pathways of pain while limiting individual drug doses and, therefore, the potential for adverse effects caused by any single agent. Oxycodone and ibuprofen each have been used effectively as monotherapy and in other combinations for the treatment of acute pain; a fixed combination of these analgesics may improve pain relief in the setting of abdominal or pelvic surgery, where trauma and any resultant inflammation may be present at the same time. ⋯ In this population of women who had undergone abdominal or pelvic surgery, the combination of oxycodone 5 mg/ibuprofen 400 mg was significantly more effective than either agent alone or placebo in the treatment of moderate to severe postoperative pain.
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J Pain Symptom Manage · Jan 2005
Randomized Controlled Trial Multicenter Study Clinical TrialEfficacy, safety, and steady-state pharmacokinetics of once-a-day controlled-release morphine (MS Contin XL) in cancer pain.
The efficacy, safety, and pharmacokinetics of a novel once-daily morphine formulation (OAD morphine) and a 12-hourly formulation (twice-daily CR morphine) were compared in a double-blind, multi-centered crossover study. Chronic cancer pain patients (n=25) were randomized to OAD morphine (mean 238 +/- 319 mg q24h) or twice-daily CR morphine (mean 119 +/- 159 mg q12h) for one week. They then crossed over to the alternate drug, which also was taken for one week. ⋯ The AUC ratio was 100.3%, indicating equivalent absorption. Fluctuation indices were 93.5 +/- 28.8% and 179.3 +/- 41.3% (P=0.0001) for OAD morphine and twice-daily CR morphine, respectively. OAD morphine provides analgesia similar to twice-daily CR morphine with reduced fluctuation in plasma morphine concentration and more stable pain control.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Effects of application site and subject demographics on the pharmacokinetics of fentanyl HCl patient-controlled transdermal system (PCTS).
The fentanyl HCl patient-controlled transdermal system (PCTS) is a self-contained, preprogrammed, needle-free system currently in development for acute pain management in a medically supervised setting. The objectives of these studies were to evaluate skin application sites for the fentanyl HCl PCTS and to evaluate the effect of patient demographics on its pharmacokinetics. ⋯ Fentanyl HCl is comparably absorbed from the PCTS when it is applied to the upper outer arm or chest. The pharmacokinetics of fentanyl HCl delivered by the PCTS are unaffected by sex, age, race or weight.
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Multicenter Study Comparative Study
Usage of pain medications during stroke rehabilitation: the Post-Stroke Rehabilitation Outcomes Project (PSROP).
Pain remains one of the most common, yet most challenging, medical problems in health care today, and it is one of the most common complications that occurs after a stroke. Pain can affect the course of stroke rehabilitation adversely, and it occasionally may be a cause for transfer back to an acute care hospital. The Post-Stroke Rehabilitation Outcomes Project (PSROP) database was used to describe the incidence of pain by body location and trends in the use of different classifications of medications to treat pain. ⋯ Other frequently prescribed pain medications included sumatriptan (migraine analgesic), cyclobenzaprine (muscle relaxant), and baclofen (antispasticity muscle relaxant). Medications should be chosen based upon the medical condition causing pain, the ability of the stroke survivor to comply with administration of the medication, and the cost of the medication. Appropriate and timely treatments of painful conditions result in maximum function and the ability to lead active lives and maintain an adequate quality of life.