Articles: acetaminophen.
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Randomized Controlled Trial
Effect of rectal diclofenac and acetaminophen alone and in combination on postoperative pain after cleft palate repair in children.
Acetaminophen and diclofenac are prescribed as postoperative analgesic agents in children. However, the efficacy of their combination is not studied sufficiently. We compare the analgesic effects of acetaminophen, diclofenac, and their combination after cleft palate surgery. ⋯ Adverse effects were comparable among groups. Rectal acetaminophen plus diclofenac was found to be the most effective in pain control. However, both rectal acetaminophen and diclofenac were more effective than placebo, whereas diclofenac was more effective than acetaminophen.
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Drug Metab. Dispos. · Sep 2011
Paracetamol-induced hypothermia is independent of cannabinoids and transient receptor potential vanilloid-1 and is not mediated by AM404.
In recent years, there has been increasing interest in hypothermia induced by paracetamol for therapeutic purposes, which, in some instances, has been reported as a side effect. Understanding the mechanism by which paracetamol induces hypothermia is therefore an important question. In this study, we investigated whether the novel metabolite of paracetamol, N-(4-hydroxyphenyl)arachidonylamide (AM404), which activates the cannabinoid (CB) and transient receptor potential vanilloid-1 (TRPV1) systems, mediates the paracetamol-induced hypothermia. ⋯ Paracetamol also induced hypothermia in FAAH knockout mice to the same extent as wild-type mice. We conclude that paracetamol induces hypothermia independent of cannabinoids and TRPV1 and that AM404 does not mediate this response. In addition, potential therapeutic value of combinational drug-induced hypothermia is supported by experimental evidence.
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There is little information on the use of paracetamol for septic critically ill patients. We hypothesised that paracetamol use is common in such patients, but its administration is not predictably related to body temperature. ⋯ Paracetamol administration is common among septic critically ill patients with or without fever, and more likely to occur when fever is present. However, paracetamol is not predictably given for the highest temperature in febrile patients. Future investigations are needed to understand under what circumstances and why paracetamol is given or not given to febrile or afebrile septic ICU patients.
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To assess the level of paracetamol off label prescribing in the community and the potential for paracetamol under or overdosing. ⋯ Paracetamol off label prescribing is common in primary care, with relatively high levels of potential overdosing in the youngest children and potential underdosing in the oldest children.
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According to international recommendations, acetaminophen should be used as a first-line therapy in patients with osteoarthritis, because of its safety and effectiveness. NSAIDs should be considered in patients unresponsive to acetaminophen, and should be prescribed at the lowest effective dose and for the shortest duration. ⋯ Symptomatic slow acting drugs (avocado soybean unsaponifiable, chondroitin sulphate, diacerein, glucosamine sulphate, hyaluronan injections) have mild symptomatic effects and may reduce the consumption of NSAIDs. Intra-articular injections of glucocorticoids are indicated for flare of knee pain, especially if accompanied by effusion.