Articles: acetaminophen.
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Intravenous paracetamol (acetaminophen) has recently been registered for treatment of pain in neonates but the pharmacodynamics, including effects on body temperature, have not been reported. ⋯ Administration of intravenous paracetamol does not result in hypothermia in normothermic neonates. In those with fever, maximal temperature reduction is achieved within 2 h following paracetamol administration.
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Randomized Controlled Trial
[Merits of paracetamol in osteoarthritic hypertensive patients].
Nonsteroidal anti-inflammatory drug (NSAID) side effects can impair quality of life in patients with osteoarthritis. Due to its particular mechanism of action, paracetamol might bypass these negative effects. ⋯ Blood pressure control was unchanged in the amiodipine group across the study periods and impaired in the lisinopril/ hydrochlorothiazide group during either ibuprofen or piroxicam, but not during paracetamol. In the amlodipine +/- ibuprofen subgroup, the reduction of the average pain intensity score throughout the study was significant (chi2 = 8.250; df 3; P = 0.037). In the lisinopril/hydrochlorothiazide +/- piroxicam subgroup, the assessed quality of life differed significantly (chi2 = 9.716; df 3; P = 0.018), while in the amlodipine +/- ibuprofen and amlodipine +/- piroxicam subgroups the changes were marginal (chi2 = 6.936; df 3; P = 0.072 and chi2 = 7146; df 3; P = 0.065, respectively).
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Case Reports
Intravenous paracetamol overdose: two case reports and a change to national treatment guidelines.
Two cases of 10-fold accidental overdose with intravenous paracetamol are presented. Case 1: A 5-month-old child with intussusception received 90 mg/kg intravenous paracetamol over an 8 h period. She was not initially treated with an antidote and developed hepatic impairment. ⋯ This should be taken into consideration when prescribing the intravenous formulation. The concentration-time nomogram used following oral paracetamol overdose should be used with caution following intravenous overdose. Significant overdose should be discussed with the National Poisons Information Service whose guidance suggests intervention with antidote following an overdose above 60 mg/kg.
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Anesteziol Reanimatol · Mar 2011
Clinical Trial[Paracetamol (perfalgane) as analgesic component of medicinal sedation].
This article reviews the possibility of the use of paracetamol (perfalgane) as an analgesic component of medical sedation. The actuality of the problem is the choice effective pharmacological means of protection from peri-operative pain. The theoretical advantages of paracetamol in the scheme of sedoanalgesia are exquisite. ⋯ The sedative agent in both groups was midazolam. It turned out, that despite the high efficacy of tramadol as a component of sedoanalgesia, the quality of anialgesia when using perfalagane is almost 5 times higher, both due to the significant number of good results, and to reduced number of adverse events. Use of paracetamol (Perfalgane) instead of tramadol for medical sedation during fibrotracheoscopy in patients in the early postoperative period leads to better quality of analgesia, thus avoiding such undesirable phenomena as hypersedation, respiratory depression, dizziness, and nausea.
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Clin. Exp. Pharmacol. Physiol. · Mar 2011
Systematic evaluation of the nefopam-paracetamol combination in rodent models of antinociception.
1. The aim of the present study was to explore the concept of multimodal anaesthesia using a combination of two non-opioid analgesics, namely nefopam, a centrally acting non-opioid that inhibits monoamine reuptake, and paracetamol, an inhibitor of central cyclo-oxygenases. The antinociceptive characteristics of the combination were evaluated using four different animal models of pain. 2. ⋯ In a rat incision model of postoperative thermal hyperalgesia, coadministration of nefopam at a non-analgesic dose (3 mg/kg) with paracetamol at a low analgesic dose (300 mg/kg) showed the appearance of a strong antihyperalgesic effect, maintained for at least 3 h. In rat carrageenan-induced tactile allodynia, the combination of low analgesic doses of nefopam (10 or 30 mg/kg) with a non-analgesic dose of paracetamol (30 mg/kg), significantly blocked allodynia with a longer duration of efficacy. 4. In conclusion, coadministration of nefopam with paracetamol is worthy of clinical evaluation.