Articles: acetaminophen.
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Clin. Pharmacol. Ther. · Dec 1988
Randomized Controlled Trial Clinical TrialThe combination of ibuprofen and oxycodone/acetaminophen in the management of chronic cancer pain.
Thirty subjects with chronic moderate to severe pain who were receiving oxycodone/acetaminophen (oxy/APAP) for analgesia were initially evaluated for at least 7 days for oxy/APAP requirements for pain control. Each subject then received, in a randomized double-blind fashion, either 600 mg ibuprofen or placebo for an additional 7 days while hospitalized. Oxy/APAP usage was recorded daily along with efficacy and toxicity parameters. ⋯ Overall global scores showed a marked preference for the ibuprofen combination over placebo (p less than 0.01). Daily pain intensity (p less than 0.05) and pain relief scores (p less than 0.05) also improved with the addition of ibuprofen. This study indicates that ibuprofen is efficacious in the management of chronic cancer pain, resulting in both enhanced analgesia and a reduction in concomitant narcotic use.
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Randomized Controlled Trial Comparative Study Clinical Trial
Double-blind parallel comparison of ketoprofen (Orudis), acetaminophen plus codeine, and placebo in postoperative pain.
One hundred sixty-one patients with postoperative pain were treated at a single center in a double-blind, randomized, parallel study designed to compare the efficacy and safety of single oral doses of ketoprofen (50 and 150 mg), an acetaminophen (650 mg) plus codeine (60 mg) combination, and placebo. From 1 through 4 hours after administration of the study drugs, the mean summed pain intensity difference (SPID) and time-weighted total pain relief (TOPAR) scores for the three active treatments generally were significantly (P less than 0.05) higher than those for placebo but not significantly different from each other. ⋯ As a result of a higher frequency of somnolence, there was a significantly (P less than 0.05) greater incidence of central nervous system adverse drug reactions among patients treated with acetaminophen plus codeine than among those treated with 150 mg of ketoprofen. These results indicate that the analgesic efficacy of both 50 and 150 mg doses of ketoprofen equals that of acetaminophen 650 mg plus codeine 60 mg and the duration of the analgesic effect of ketoprofen is significantly longer.
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Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical Trial
Comparative study of ketorolac and paracetamol/codeine in alleviating pain following gynaecological surgery.
In a randomized, double-blind, multiple-dose, parallel study of 107 patients, the safety and analgesic efficacy of single and multiple doses of orally administered ketorolac tromethamine (10-40 mg/day) were compared with orally administered paracetamol (1000-4000 mg/day)/codeine (60-240 mg/day) for treating moderate to severe pain after gynaecological surgery. Both drugs effectively reduced pain intensity. After the first dose of medication, over 90% of the patients in each treatment group reported pain reduction of at least 50%. ⋯ No statistically significant differences in analgesic efficacy were observed in the two treatment groups. Ketorolac tromethamine-treated patients reported a total of 62 adverse events (17 considered drug-related) and the paracetamol/codeine-treated patients reported 65 (20 considered drug-related); the adverse event profiles of the two treatment regimens were similar. Thus, both the single and the multiple doses of ketorolac tromethamine (10 mg) alleviated moderate to severe pain after gynaecological surgery as safely and efficaciously as paracetamol (1000 mg)/codeine (60 mg).
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Clinical Trial Controlled Clinical Trial
The effect of metoclopramide and prochlorperazine on the absorption of effervescent paracetamol in migraine.
Antiemetics modify gastric emptying, a rate-limiting step in drug absorption. The absorption of effervescent paracetamol in water solution was studied in three groups of 10 female patients during acute migraine attacks. Paracetamol was preceded 30 min earlier by a rectal dose of metoclopramide, prochlorperazine maleate, or placebo. ⋯ Migraine attacks delayed slightly the absorption of paracetamol solution. Prior administration of rectal prochlorperazine had a minor delaying effect on paracetamol absorption. The peak concentration, the time to reach the peak, and the area under the time-concentration curve from 0 to 6 h of paracetamol were similar with the three treatments.
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Comparative Study Clinical Trial Controlled Clinical Trial
Pharmacokinetics and clinical efficacy of intrarectal solution of acetaminophen.
Acetaminophen is frequently administered orally to children for its analgesic properties, although its potency has never been clearly evaluated in this population. In certain situations (patients vomiting or unconscious), acetaminophen has to be given rectally. However, the rectal absorption of suppositories is frequently erratic. ⋯ The absorption of acetaminophen was incomplete (peak serum concentration: 70.8 mumol. L-1) and delayed. We conclude that the rectal administration of acetaminophen at the induction of anesthesia results in incomplete and delayed absorption and does not prevent the occurrence of immediate postoperative pain in children undergoing adeno-tonsillectomy.