Articles: acetaminophen.
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Acta Anaesthesiol Belg · Jan 2012
Paracetamol and ketorolac pharmacokinetics and metabolism at delivery and during postpartum.
During pregnancy, changes in renal elimination, body composition and metabolic activity occur. Since these important alterations in physiology also affect drug disposition, pregnancy warrants a focused approach. ⋯ We report on our observations on i.v. paracetamol and ketorolac disposition following cesarean delivery to illustrate the feasibility of such focused studies and the impact of pregnancy on drug disposition. The clinical relevance of these observations are subsequently discussed, and some future research directions are suggested.
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The Journal of pediatrics · Jan 2012
Comparative StudyCentral nervous system depression of neonates breastfed by mothers receiving oxycodone for postpartum analgesia.
To quantify the incidence of central nervous system (CNS) depression in neonates breastfed by mothers medicated with oxycodone as compared with neonates whose breastfeeding mothers used codeine or acetaminophen only. ⋯ Oxycodone is not a safer alternative to codeine in breastfed infants.
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Comment
Ethyl pyruvate for the treatment of acetaminophen intoxication: alternative to N-acetylcysteine?
N-acetylcysteine is the classical antidote for acetaminophen overdose-induced hepatotoxicity, but its efficacy is limited by the need for early and only temporary treatment. Therefore, Yang and colleagues tested the hypothesis of whether ethyl pyruvate--another anti-inflammatory and antioxidant compound, which they had previously shown to protect against liver injury of various other etiologies--may allow circumventing these limitations. ⋯ On the one hand, this research paper confirms the need for biomarkers to monitor organ recovery after acetaminophen. On the other hand, this paper adds to the ongoing discussion on the usefulness of ethyl pyruvate as a resuscitation fluid in the critically ill.
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J. Biomed. Biotechnol. · Jan 2012
The impact of Caesarean delivery on paracetamol and ketorolac pharmacokinetics: a paired analysis.
Pharmacokinetics is a first, but essential step to improve population-tailored postoperative analgesia, also after Caesarean delivery. We therefore aimed to quantify the impact of caesarean delivery on the pharmacokinetics of intravenous (iv) paracetamol (2 g, single dose) and iv ketorolac tromethamine (30 mg, single dose) in 2 cohorts eachof 8 women at caesarean delivery and to compare these findings with postpartum to quantify intrapatient changes. We documented a higher median paracetamol clearance at delivery when compared to 10-15 weeks postpartum (11.7 to 6.4 L/h·m², P < 0.01), even after correction for weight-related changes. ⋯ These differences likely reflect pregnancy- and caesarean-delivery-related changes in drug disposition. Moreover, postpartum paracetamol clearance was significantly lower when compared to estimates published in healthy young volunteers (6.4 versus 9.6 L/h·m²), while this was not the case for ketorolac (1.43 versus 1.48 L/h·m²). This suggests that postpartum is another specific status in young women that merits focused, compound-specific pharmacokinetic evaluation.
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Clin Exp Obstet Gyn · Jan 2012
Randomized Controlled Trial Comparative StudyThe efficacy of paracetamol versus tenoxicam on postoperative pain and morphine consumption after abdominal hysterectomy: a placebo-controlled, randomized study.
The purpose of this study was to determine the analgesic efficacy and side-effects of paracetamol and tenoxicam in comparison with placebo in patients with postoperative pain after elective abdominal hysterectomy. ⋯ A single dose of 20 mg tenoxicam provided effective analgesia and reduced total morphine consumption in comparison with paracetamol and placebo after abdominal hysterectomy.