Articles: acetaminophen.
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Comparative Study
[Study of codeine-paracetamol combination treatment compared with tramadol-paracetamol in the control of moderate-to-severe low back pain].
The objective of this study was to compare the analgesic efficacy and tolerability of tramadol hydrochloride compared with codeine phosphate in combination with paracetamol in patients with moderate-to-severe low back pain caused by osteoarthritis. In fact, while paracetamol is the analgesic of choice for this disease, in cases where this treatment may be ineffective, the therapeutic choice involves the addition of weak opioids. Due to the chronic nature of the disease, these drugs represent a safer alternative compared to anti-inflammatory drugs (NSAIDs) and selective inhibitors of cyclooxygenase 2 (COX-2). ⋯ The study, although conducted on a limited number of patients and for a relatively short time, demonstrates the greater efficacy and tolerability of the association codeine-paracetamol compared to tramadol-paracetamol.
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Paracetamol poisoning remains a major cause of morbidity and mortality. Clinical care of paracetamol poisoning depends on a range of patient variables and typically involves both medical and nursing care. An integrated care pathway (ICP) is a multidisciplinary management plan that incorporates guidelines and best practice to enhance care and documentation for a specific patient group. Paracetamol overdose is thus amenable to an ICP. ⋯ Implementation of an ICP for paracetamol poisoning significantly improved patient management and helped to standardise inter-professional decision making in this challenging patient group. This is likely to improve patient outcome.
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Aliment. Pharmacol. Ther. · Jun 2012
The sequential organ failure assessment (SOFA) score is an effective triage marker following staggered paracetamol (acetaminophen) overdose.
The sequential organ failure assessment (SOFA) score is an effective triage marker following single time point paracetamol (acetaminophen) overdose, but has not been evaluated following staggered (multiple supratherapeutic doses over >8 h, resulting in cumulative dose of >4 g/day) overdoses. ⋯ A SOFA score <6 at tertiary care admission following a staggered paracetamol overdose, is associated with a good prognosis. Both the SOFA and APACHE II scores could improve triage of high-risk staggered paracetamol overdose patients.
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Because pain is a very common condition in children, such as after musculoskeletal injuries, many parents ask whether they can alternate over-the-counter analgesics to treat their children's pain. While some guidelines advise against this, it is common practice. Should alternating acetaminophen and ibuprofen be recommended for treating pain in children? ⋯ Children who have unresolved pain despite the use of either ibuprofen or acetaminophen should have their medication regimen reviewed to ensure they are receiving the medication at an adequate dose and interval. If monotherapy has failed, a short trial of an alternating regimen could be implemented. However, there is a lack of evidence for safety with long-term use of alternating ibuprofen and acetaminophen.
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Acetaminophen (APAP) overdose induces massive hepatocyte necrosis. Necrotic tissue releases high mobility group B1 (HMGB1), and HMGB1 contributes to liver injury. Even though blockade of HMGB1 does not protect against APAP-induced acute liver injury (ALI) at 9 h time point, the later time points are not studied and the role of HMGB1 in APAP overdose is unknown, it is possible that neutralization of HMGB1 might improve hepatocyte regeneration. This study aims to test whether blockade of HMGB1 improves hepatocyte regeneration after APAP overdose. ⋯ HMGB1 impairs hepatocyte regeneration after APAP overdose; Blockade of HMGB1 enhances liver recovery and may present a novel therapy to treat APAP overdose.