Articles: acetaminophen.
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Both the incidence and prevalence of osteoarthritis increase with advancing age. Management of osteoarthritis in older adults focuses on reducing pain and other symptoms, minimizing functional limitation and disability from the disease, and avoiding the side effects associated with pharmacologic therapy. ⋯ We conclude that acetaminophen, when given at full doses of 4,000 mg/day, is more efficacious than placebo and has comparable efficacy to ibuprofen in the management of patients with osteoarthritis of the knee who have mild to moderate pain. Thus, acetaminophen merits a trial as initial therapy based on its cost-effectiveness and safety profile relative to NSAIDs.
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The mechanism of hepatotoxicity caused by paracetamol (acetaminophen) overdose and the treatment of patients is reviewed. Paracetamol is widely used over-the-counter drug with analgesic and antipyretic properties. Although it is considered to be safe at therapeutic doses, the incidence of hepatotoxicity caused by overdose or inadvertent application has been increasing lately. ⋯ Until now there is no complete therapeutic strategy for the effective treatment of hepatotoxicity caused by paracetamol. Gut decontamination, N-acetylcysteine antidote administration and enhancement of elimination is used for the management of paracetamol overdose. Those with severe hepatotoxicity and neurological symptoms can benefit from removal of necrotic liver and undergo transplantation.
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Anesthesia and analgesia · Feb 2001
Randomized Controlled Trial Comparative Study Clinical TrialPostoperative analgesia at home after ambulatory hand surgery: a controlled comparison of tramadol, metamizol, and paracetamol.
We compared in a prospective, randomized, double-blinded study the analgesic efficacy of three drugs in 120 ASA I and II patients scheduled to undergo ambulatory hand surgery with IV regional anesthesia. At discharge, oral analgesic tablets were prescribed as follows: tramadol 100 mg every 6 h, metamizol 1 g every 6 h, and paracetamol (acetaminophen) 1 g every 6 h. Rescue medication consisted of oral dextropropoxyphene 100 mg on demand. ⋯ Although tramadol was more effective, its use was associated with the highest frequency and intensity of adverse effects and the most patient dissatisfaction. Metamizol and acetaminophen provided good analgesia with a small incidence of side effects. For patients undergoing ambulatory hand surgery, postoperative pain can last longer than 2-3 days, and there is a need for both better education before the procedure and oral analgesic therapy at home.
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Comparative Study
Comparative study of diclofenac sodium and paracetamol for treatment of pain after adenotonsillectomy in children.
To compare the analgesic efficacy of diclofenac sodium and paracetamol on post adenotonsillectomy postoperative pain and oral intake. ⋯ Diclofenac sodium has a significant effect on decreasing the pain associated with swallowing postoperatively and on the general condition of the patient. Improved oral intake resulted in a lower incidence of nausea and vomiting and allowed safer and earlier hospital discharge.
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Acetaminophen was administered to mice by spinal (intrathecal, i.t.) injection alone or with phentolamine (11.3 microg = 0.03 micromol). Acetaminophen produced dose-related antinociception in the abdominal irritant test with an ED(50) value of 137.2 microg (0.9 micromol) Phentolamine had no effect. For combined administration, the potency of acetaminophen was significantly increased (ED50=24.4 vs. 137.2 microg), indicative of multiplicative interaction and strong synergism. These results reveal the significant and surprising interaction of spinal cord adrenoceptors or ion channel subtypes with acetaminophen-induced antinociception.