Articles: acetaminophen.
-
Minerva Gastroenterol Dietol · Dec 2014
ReviewGastrointestinal damage by non-steroidal anti-inflammatory drugs: updated clinical considerations.
Gastrointestinal (GI) damage by non-steroidal anti-inflammatory drugs (NSAIDs) is an important Public Health problem due to morbility and elevated mortality rate. The logic behind the development and sale of molecules which are selective cyclooxegnase-2 (COX-2) inhibitors called coxibs, is to limit the undesired effects of traditional NSAIDs, which should theoretically derive from the inhibition of COX-1. With respect to the emphasis of the initial trials, to now epidemiological studies, open-label studies, meta-analyses and reviews of the same data with longer follow-up, have produced opposite conclusions. ⋯ In this context, in the case of moderate pain intensity, it is possible to use combinations with weak opioids, such as paracetamol-tramadol. Though intestinal damage by NSAIDs are a nosological entity of growing interest, to now no trial has been conducted with optimal criteria to demonstrate the superiority of coxibs over traditional NSAIDs. For this reason, chronic inflammation of the intestine still represents a contraindication to the administration of coxibs.
-
Randomized Controlled Trial
Opioid use in knee arthroplasty after receiving intravenous acetaminophen.
Intravenous (IV) acetaminophen may be an effective component of multimodal postoperative pain management. The primary objective of this study was to evaluate the impact of IV acetaminophen on total opioid use in postoperative patients. The secondary objective was to evaluate the effect of IV acetaminophen on hospital length of stay. ⋯ IV acetaminophen did not significantly decrease postoperative opioid use in patients who underwent surgical knee procedures. In addition, there was a nonsignificant trend toward increased opioid use in the IV acetaminophen group. There was no significant difference in hospital length of stay between the IV acetaminophen group and the control group. These findings require further study in larger patient populations and in other orthopedic procedures that typically require longer hospital stays.
-
Evidence-based dentistry · Dec 2014
CommentIbuprofen is superior to paracetamol for pain relief following third molar removal.
The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase and the metaRegister of Controlled Trials were searched with no language restrictions. ⋯ There is high quality evidence that ibuprofen is superior to paracetamol at doses of 200 mg to 512 mg and 600 mg to 1000 mg respectively based on pain relief and use of rescue medication data collected at six hours postoperatively. The majority of this evidence (five out of six trials) compared ibuprofen 400 mg with paracetamol 1000 mg, these are the most frequently prescribed doses in clinical practice. The novel combination drug is showing encouraging results based on the outcomes from two trials when compared to the single drugs.
-
To evaluate the appropriateness of intravenous acetaminophen dosing-prescribed dose, frequency, duration, and indication-based on United States Food and Drug Administration (FDA)-approved prescribing guidelines and to evaluate the adverse effect profile of intravenous acetaminophen. ⋯ Intravenous acetaminophen appeared to be a safe and effective analgesic and antipyretic agent. Dosing for patients weighing less than 50 kg needs to be appropriately weight adjusted. Intravenous acetaminophen can be used alone or in conjunction with opioids and other analgesics. Limitations of this study include its retrospective design, inability to assess outcomes of reducing opioid use, and short-term observation period.
-
Pain is the presenting symptom in 20 to 30% of patients with autosomal dominant polycystic kidney disease (ADPKD) and occurs in 50 to 60% of patients at some stage of the disease process, but its frequency increases with age and size of the cysts. Back pain is caused by kidney enlargement as well as rupture, hemorrhage, or infection of cysts. Other causes of pain include nephrolithiasis and urinary tract infections (UTIs). Analgesic options for patients with ADPKD include transcutaneous electrical nerve stimulation (TENS), spinal cord stimulation, low-dose opioids, and local anesthetics.