Articles: acetaminophen.
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Randomized Controlled Trial Clinical Trial
Twenty-four-hour pharmacokinetics of rectal acetaminophen in children: an old drug with new recommendations.
Rectal acetaminophen is often administered during operation to provide supplemental analgesia or antipyresis in children. Recent studies examining current dose guidelines are limited by short sampling times. The authors extended the drug sampling period to more clearly define acetaminophen pharmacokinetics in children having surgery. ⋯ The current recommended rectal acetaminophen dose of 10-15 mg/kg yields peak serum concentrations less than the antipyretic serum concentration of 10-20 microg/ml. Based on the observed kinetics, the authors recommend that the initial dose should be approximately 40 mg/kg.
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It has been suggested that the combination of analgesic drugs may have additive or synergistic effects. In clinical practice, this might allow better analgesia and reduction of side effects. ⋯ This study found a synergy between intravenous morphine and diclofenac that is consistent with and helps explain the clinical value of this type of combination in the treatment of acute pain in humans.
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Paracetamol is a common cause of fatal self-poisoning in the UK every year. Despite this, it continues to be sold freely without medical supervision and can be found in quantity in most household medicine cabinets.
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The occurrence of hepatotoxicity and acute renal dysfunction following an acute paracetamol overdose has been well documented. Acute pancreatitis, however, has been rarely described. ⋯ To our knowledge, this represents the first description in a dialysis patient of paracetamol induced pancreatitis. Given the frequency of paracetamol usage in these patients, we believe that it is important to consider this diagnosis in patients with unexplained acute pancreatitis, particularly if there is associated hepatic dysfunction.