Articles: acetaminophen.
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Clin. Pharmacol. Ther. · Nov 1993
Randomized Controlled Trial Clinical TrialKetoprofen, acetaminophen plus oxycodone, and acetaminophen in the relief of postoperative pain.
Ketoprofen (Orudis) is a nonsteroidal anti-inflammatory drug that is currently approved in the United States for the management of mild to moderate pain. The objective of this trial was to determine the effectiveness of orally administered ketoprofen in the management of severe postoperative pain. This randomized, double-blind parallel study compared the efficacy and safety of single doses of 100 mg or 50 mg ketoprofen, the combination of 650 mg acetaminophen plus 10 mg oxycodone hydrochloride, 650 mg acetaminophen, or placebo in 240 patients with severe postoperative pain after cesarean section. ⋯ Remedication time for the group receiving 100 mg ketoprofen was significantly longer than for the other treatment groups. Significantly more patients who took repeated doses of the combination (84%) than those who took either dose of ketoprofen (70%) had adverse effects. Ketoprofen at both dose levels was shown to be effective, long-lasting, and well tolerated, and it should be considered as a viable option for the management of moderate to severe postoperative pain.
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From 1989 to 1991, 104 Chinese patients were admitted to the Prince of Wales Hospital with paracetamol poisoning. Only 11 subjects had a plasma paracetamol concentration above the published treatment line. Intravenous N-acetylcysteine (NAC) was completely effective when given within 8 hours (3 patients), while late treatment with NAC at 16 and 26 hours after overdose (2 patients) was ineffective in preventing liver damage as evidenced by elevations in plasma alanine transaminase concentrations. ⋯ Two other subjects who presented late or in whom a plasma paracetamol concentration was not measured also developed liver damage. Fortunately, none of these 6 subjects developed hepatic encephalopathy. We recommend that a standard protocol be readily available for junior hospital staff to use when treating patients with paracetamol overdosage.
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J. Pharm. Pharmacol. · Jul 1993
Characterization of the analgesic effect of paracetamol and caffeine combinations in the pain-induced functional impairment model in the rat.
The analgesic activities of paracetamol (100, 178, 316 and 562 mg kg-1), caffeine (10, 18, 32 and 56 mg kg-1) and combinations of these doses were tested on a pain-induced functional impairment model in the rat. Dysfunction of the right hind limb was induced by an intra-articular injection of 30% uric acid in the knee. Drugs were given orally and the recovery of functionality over time was considered as an expression of analgesia. ⋯ Paracetamol plasma levels and analgesic effect observed with administration of 316 mg kg-1 paracetamol alone or 316-32 mg kg-1 of paracetamol-caffeine were fitted to the sigmoidal Emax model according to the Hill equation. The curves obtained were parallel, but that of the combination was shifted to the left. It is concluded that caffeine is able to potentiate the analgesic effect of paracetamol by a pharmacodynamic mechanism, but this only occurs at certain dose combinations.
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Randomized Controlled Trial Comparative Study Clinical Trial
Overexertional lumbar and thoracic back pain among recruits: a prospective study of risk factors and treatment regimens.
A total of 395 male infantry recruits were evaluated in a prospective study of possible risk factors for overexertional back pain and the efficacy of drug treatment regimens for this syndrome. Recruits were classified into subgroups of lumbar or thoracic, and paraspinal or spinous process pain. Recruits were divided into three treatment groups: Ibuprofen, Paracetamol, and no drug treatment. ⋯ By multivariate analysis low body mass index was found to be a risk factor for overexertional lumbar pain (p = 0.005) and increased lumbar lordosis a risk factor for overexertional thoracic pain (p = 0.005). Of recruits with overexertional back pain, 65% were asymptomatic by the end of basic training. There was no statistically significant difference between cure rates according to treatment groups.
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Clinical therapeutics · May 1993
Randomized Controlled Trial Clinical TrialPain relief after dental impaction surgery using ketorolac, hydrocodone plus acetaminophen, or placebo.
In a double-blind, placebo-controlled study, 207 patients with moderate pain after surgical removal of impacted third molars were randomly assigned to receive a single oral dose of 10 mg of ketorolac tromethamine, 10 mg of hydrocodone plus 1000 mg of acetaminophen, or placebo. Analgesic effect as assessed by summed pain intensity difference at 3 and 6 hours was significantly (P < or = 0.01) greater after ketorolac than after hydrocodone/acetaminophen. ⋯ In this single-dose study, adverse events were reported more frequently by patients taking hydrocodone/acetaminophen than with ketorolac or placebo. It is concluded that, in this pain model, 10 mg of ketorolac affords better pain relief with fewer side effects than hydrocodone/acetaminophen.