Articles: acetaminophen.
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Basic Clin. Pharmacol. Toxicol. · Feb 2013
Review Randomized Controlled TrialThe effect of paracetamol and tropisetron on pain: experimental studies and a review of published data.
Experimental studies suggest that paracetamol-induced analgesia is mediated via central serotonergic pathways and attenuated by 5-HT3-antagonists. However, clinical studies do not support this, and 5-HT3-antagonists are expected to reduce pain by blocking the descending pronociceptive pathway. The current project tested whether tropisetron attenuates analgesia by paracetamol. ⋯ As paracetamol did not have a measurable analgesic effect in these tests, no conclusions can be drawn about the interaction between paracetamol and tropisetron. However, tropisetron may have an analgesic effect of its own. Clinicians should not avoid using these drugs together, unless larger clinical studies indicate otherwise.
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Clinical therapeutics · Feb 2013
Randomized Controlled Trial Comparative StudyPharmacokinetic comparison of acetaminophen elixir versus suppositories in vaccinated infants (aged 3 to 36 months): a single-dose, open-label, randomized, parallel-group design.
Because of practical problems and ethical concerns, few studies of the pharmacokinetics (PK) of acetaminophen (ACET) in infants have been published. ⋯ No statistically significant differences were found between the rates or extent of absorption of the suppository and elixir preparations in this small, infant population. Both preparations were well tolerated. Vaccinated infants were a useful population in which to conduct a PK study of this antipyretic, analgesic product. Delays in publishing pediatric trials can occur as a result of a number of issues even when results are positive.
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Prescrire international · Feb 2013
ReviewInjectable paracetamol in children: yet more cases of 10-fold overdose.
Intravenous paracetamol injection is associated with a risk of 10-fold overdose. This is due to confusion between normal dose prescription in milligrams and administration in millilitres of injectable solution (containing 10 mg per ml). ⋯ In practice, injectable paracetamol should only be prescribed when oral administration is not possible. Care must be taken when calculating the dose to be administered, and the calculation must be double checked before the drug is administered.
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Current drug metabolism · Feb 2013
ReviewParacetamol (acetaminophen) efficacy and safety in the newborn.
Neonates can perceive pain, therefore an adequate analgesic therapy is a major issue not only from an ethical perspective but also to improve short- and long-term outcome. Fever during the neonatal period requires hospitalization and needs a treatment with an antipyretic agent because of the high risk of severe complications. ⋯ Moreover, drug tolerability is discussed in the light of its potential hepatotoxicity and the unique characteristics of the newborn patient. By analyzing the available literature and the dosing guidelines, a mismatch exists between the current clinical use of paracetamol and the recommendations, suggesting a cautious approach particularly in extremely preterm neonates.
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Multimodal pain management should be considered for all perioperative orthopedic patients. The goal of reducing the amount of perioperative opioid medication given may be achieved by using nonopioid medications, including intravenous acetaminophen. ⋯ The safety profile and relative lack of systemic adverse reactions make this an attractive analgesic for a wide variety of orthopedic surgical patients. Clinical studies have demonstrated the efficacy and safety of intravenous acetaminophen in elective total hip and knee arthroplasty, knee arthroscopy, lumbar spine surgery, and for acute traumatic limb pain.