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Latest & greatest articles for acetaminophen
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Long term effect of reduced pack sizes of paracetamol on poisoning deaths and liver transplant activity in England and Wales: interrupted time series analyses. To assess the long term effect of United Kingdom legislation introduced in September 1998 to restrict pack sizes of paracetamol on deaths from paracetamol poisoning and liver unit activity.Interrupted time series analyses to assess mean quarterly changes from October 1998 to the end of 2009 relative to projected deaths without (...) the legislation based on pre-legislation trends.Mortality (1993-2009) and liver unit activity (1995-2009) in England and Wales, using information from the Office for National Statistics and NHS Blood and Transplant, respectively.Residents of England and Wales.Suicide, deaths of undetermined intent, and accidental poisoning deaths involving single drug ingestion of paracetamol and paracetamol compounds in people aged 10 years and over, and liver unit registrations and transplantations for paracetamol induced
Pharmacol. 1986;31:217-222. 3. Prescott LF, Donovan JW, Jarvie DR, et al. The disposition and kinetics of intravenous N-acetylcysteine in patients with paracetamol overdosage. Eur J Clin Pharmacol. 1989;37:501-506. 4. Buckley NA, Whyte IM, O’Connell DL, et al. OralorintravenousN-acetylcysteine:whichis the treatment of choice for acetaminophen (paracetamol) poisoning? Clin Toxicol. 1999;37:759-767. 5. Yarema MC, Johnson DW, Berlin RJ, et al. Comparison of the 20-hour intravenous and 72-hour oral (...) Is Intravenous Acetylcysteine More Effective Than Oral Administration For the Prevention of Hepatotoxicity in Acetaminophen Overdose? Systematic Review Snapshot TAKE-HOME MESSAGE Rates of hepatotoxicity from acetaminophen appear to be similar whether acetylcysteine is administered orally or intravenously. Is Intravenous Acetylcysteine More Effective Than Oral Administration for the Prevention of Hepatotoxicity in Acetaminophen Overdose? EBEM Commentators Evan Schwarz, MD Brian Cohn, MD
Does Combination Treatment With Ibuprofen and Acetaminophen Improve Fever Control? SystematicReviewSnapshot TAKE-HOME MESSAGE Combination treatment with ibuprofen and acetaminophen is bene?cial over either agent alone for sustained fever reduction in children older than 6 months. METHODS DATA SOURCES The author searched MEDLINE (1948 to May 2011) and EMBASE (1980 to May 2011). Additional hand searches of references from the UK National Institute for Health and Clinical Excellence guidelines (...) Standards of Re- porting Trials (CONSORT) crite- ria to score the quality of the included trials and abstract the data. Does Combination Treatment With Ibuprofen and Acetaminophen Improve Fever Control? EBEM Commentator Rohith R. Malya, MD, MSc Department of Emergency Medicine University of Texas at Houston Houston, TX Results Seventrialswereretrievedandallmet the inclusion criteria and most of the itemsontheCONSORTchecklist.Dif- ferences in dosing interval limited di- rect comparison between any 2
Ibuprofen, paracetamol, and steam for patients with respiratory tract infections in primary care: pragmatic randomised factorial trial. To assess strategies for advice on analgesia and steam inhalation for respiratory tract infections.Open pragmatic parallel group factorial randomised controlled trial.Primary care in United Kingdom.Patients aged ≥ 3 with acute respiratory tract infections.889 patients were randomised with computer generated random numbers in pre-prepared sealed numbered (...) envelopes to components of advice or comparator advice: advice on analgesia (take paracetamol, ibuprofen, or both), dosing of analgesia (take as required v regularly), and steam inhalation (no inhalation v steam inhalation).Primary: mean symptom severity on days 2-4; symptoms rated 0 (no problem) to 7 (as bad as it can be). Secondary: temperature, antibiotic use, reconsultations.Neither advice on dosing nor on steam inhalation was significantly associated with changes in outcomes. Compared
Effect of intravenous paracetamol on postoperative morphine requirements in neonates and infants undergoing major noncardiac surgery: a randomized controlled trial. Continuous morphine infusion as standard postoperative analgesic therapy in young infants is associated with unwanted adverse effects such as respiratory depression.To determine whether intravenous paracetamol (acetaminophen) would significantly (>30%) reduce morphine requirements in neonates and infants after major surgery.Single (...) -center, randomized, double-blind study conducted in a level 3 pediatric intensive care unit in Rotterdam, The Netherlands. Patients were 71 neonates or infants younger than 1 year undergoing major thoracic (noncardiac) or abdominal surgery between March 2008 and July 2010, with follow-up of 48 hours.All patients received a loading dose of morphine 30 minutes before the end of surgery, followed by continuous morphine or intermittent intravenous paracetamol up to 48 hours postsurgery. Infants in both
Hydrocodone-acetaminophen for pain control in first-trimester surgical abortion: a randomized controlled trial Although hydrocodone-acetaminophen is commonly used for pain control in first-trimester abortion, the efficacy of oral opioids for decreasing pain has not been established. Our objective was to estimate the effect of hydrocodone-acetaminophen on patient pain perception during first-trimester surgical abortion.We conducted a randomized, double-blinded, placebo-controlled trial. Patients (...) (before 11 weeks of gestation) received standard premedication (ibuprofen and lorazepam) and a paracervical block with the addition of 10 mg hydrocodone and 650 mg acetaminophen or placebo 45-90 minutes before surgical abortion. A sample size of 120 was calculated to provide 80% power to show a 15-mm difference (α=0.05) in the primary outcome of pain with uterine aspiration (100-mm visual analog scale). Secondary outcomes were pain at additional time points, satisfaction, side effects, adverse events
Paracetamol effective for perineal pain in the early postpartum period PEARLS Practical Evidence About Real Life Situations PEARLS are succinct summaries of Cochrane Systematic Reviews for primary care practitioners. They are funded by the New Zealand Guidelines Group. PEARLS provide guidance on whether a treatment is effective or ineffective. PEARLS are prepared as an educational resource and do not replace clinician judgement in the management of individual cases. View PEARLS online (...) at: www.cochraneprimarycare.org Paracetamol effective for perineal pain in the early postpartum period Clinical question How effective is a single administration of paracetamol for the relief of acute postpartum perineal pain? Bottom line More women experienced pain relief with paracetamol compared with placebo (most pain was caused by episiotomies). In addition, there were significantly fewer women having additional pain relief with paracetamol compared with placebo. Both the 500mg to 650mg and 1000mg doses were effective
Codeine and acetaminophen for pain relief: a review of the clinical efficacy and safety Codeine and acetaminophen for pain relief: a review of the clinical efficacy and safety Codeine and acetaminophen for pain relief: a review of the clinical efficacy and safety CADTH Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation CADTH. Codeine (...) and acetaminophen for pain relief: a review of the clinical efficacy and safety. Ottawa: Canadian Agency for Drugs and Technologies in Health (CADTH). 2012 Authors' conclusions Based on this review, both codeine and acetaminophen/codeine provide better chronic pain relief than placebo. Chronic use of acetaminophen at doses higher than 2000 mg per day may be associated with increased risk of gastrointestinal events, liver toxicity, and renal dysfunction or failure. This review found evidence of increased risk
Use of Aspirin, Other Nonsteroidal Anti-Inflammatory Drugs, and Acetaminophen and Postmenopausal Breast Cancer Incidence The associations between use of aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen and breast cancer incidence in postmenopausal women are uncertain. We examined these associations with breast cancer, both overall and by molecular subtype.We observed 84,602 postmenopausal women, free of cancer in 1980, until June 2008 and prospectively collected (...) progesterone receptor (PR) -positive breast cancer (95% CI, 0.77 to 1.06; P(trend) = 0.17), and 0.91 for ER-negative PR-negative breast cancer (95% CI, 0.68 to 1.22; P(trend) = 0.97). Results did not vary appreciably by past or current use, days per week of use, or dosage of use. Use of other NSAIDs and acetaminophen was largely not significantly associated with breast cancer risk. Additionally, use of higher doses of each analgesic (≥ six tablets per week) for more than 10 years was generally
Intravenous Lornoxicam Is More Effective than Paracetamol as a Supplemental Analgesic After Lower Abdominal Surgery: A Randomized Controlled Trial The aim of this prospective, randomized, double-blind study was to determine the more effective supplemental analgesic, paracetamol or lornoxicam, for postoperative pain relief after lower abdominal surgery.Sixty patients scheduled for lower abdominal surgery under general anesthesia were randomly allocated to receive either isotonic saline (control (...) group), intravenous paracetamol 1 g every 6 h (paracetamol group), or lornoxicam 16 mg then 8 mg after 12 h (lornoxicam group). Additionally pain was treated postoperatively with morphine patient-controlled analgesia. Postoperative pain scores measured by the verbal pain score (VPS), morphine consumption, and the incidence of side effects were measured at 1, 2, 4, 8, 12, and 24 h postoperatively.Morphine consumption at 12 and 24 h was significantly lower in the lornoxicam group (19.25 ± 5.7 mg
Codeine and Acetaminophen for Pain Relief: A Review of the Clinical Efficacy and Safety Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources and a summary of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time allowed (...) to CADTH. Links: This report may contain links to other information available on the websites of third parties on the Internet. CADTH does not have control over the content of such sites. Use of third party sites is governed by the owners’ own terms and conditions. TITLE: Codeine and Acetaminophen for Pain Relief: A Review of the Clinical Efficacy and Safety DATE: 12 April 2012 CONTEXT AND POLICY ISSUES Pain has been defined as “an unpleasant sensory and emotional experience arising from actual
-specific safety data to draw conclusions. There were some limitations of the review process (only one reviewer was involved), but the authors' conclusions appear suitably cautious and reliable. Authors' objectives To assess the efficacy and safety of paracetamol (acetaminophen) in the management of pain in inflammatory arthritis. Searching MEDLINE, EMBASE and The Cochrane Library were searched from inception to May 2010 for studies published in English, Dutch, French, German or Portuguese; search terms (...) Paracetamol for the management of pain in inflammatory arthritis: a systematic literature review Paracetamol for the management of pain in inflammatory arthritis: a systematic literature review Paracetamol for the management of pain in inflammatory arthritis: a systematic literature review Hazlewood G, Van Der Heijde DM, Bombardier C CRD summary The authors concluded that there was weak evidence for the efficacy of paracetamol in patients with inflammatory arthritic, and insufficient disease
A randomised controlled trial of ibuprofen, paracetamol or a combination tablet of ibuprofen/paracetamol in community-derived people with knee pain To compare the efficacy and safety of single versus combination non-prescription oral analgesics in community-derived people aged 40 years and older with chronic knee pain.A randomised, double-blind, four-arm, parallel-group, active controlled trial investigating short-term (day 10) and long-term (week 13) benefits and side-effects of four regimens (...) , each taken three times a day: ibuprofen (400 mg); paracetamol (1000 mg); one fixed-dose combination tablet (ibuprofen 200 mg/paracetamol 500 mg); two fixed-dose combination tablets (ibuprofen 400 mg/paracetamol 1000 mg).There were 892 participants (mean age 60.6, range 40-84 years); 63% had radiographic knee osteoarthritis and 85% fulfilled American College of Rheumatology criteria for osteoarthritis. At day 10, two combination tablets were superior to paracetamol (p<0.01) for pain relief
NSAIDs vs acetaminophen in knee and hip osteoarthritis: a systematic review regarding heterogeneity influencing the outcomes Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Liver Toxicity in Patients using Acetaminophen UTCAT842, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Liver Toxicity In Patients Using Acetaminophen Clinical Question In patients with Post-operative pain, does the use of acetaminophen cause hepatotoxicity versus other analgesics? Clinical Bottom Line Use of acetaminophen has caused increased rates of hepatotoxicity. (See Comments on the CAT below) Best Evidence (you (...) may view more info by clicking on the PubMed ID link) PubMed ID Author / Year Patient Group Study type (level of evidence) #1) Guggenheimer/2011 N/A Systematic Review Key results Increased use of acetaminophen has increased the number of cases of hepatotoxicity. Since acetaminophen is found in many analgesics, unintentional overdose can occur. Evidence Search Liver toxicity and acetaminophen Comments on The Evidence The study is a systematic review of articles. The authors reviewed the literature
Paracetamol use in early life and asthma: prospective birth cohort study. To determine if use of paracetamol in early life is an independent risk factor for childhood asthma.Prospective birth cohort study.Melbourne Atopy Cohort Study.620 children with a family history of allergic disease, with paracetamol use prospectively documented on 18 occasions from birth to 2 years of age, followed until age 7 years.The primary outcome was childhood asthma, ascertained by questionnaire at 6 and 7 years (...) . Secondary outcomes were infantile wheeze, allergic rhinitis, eczema, and skin prick test positivity.Paracetamol had been used in 51% (295/575) of children by 12 weeks of age and in 97% (556/575) by 2 years. Between 6 and 7 years, 80% (495/620) were followed up; 30% (148) had current asthma. Increasing frequency of paracetamol use was weakly associated with increased risk of childhood asthma (crude odds ratio 1.18, 95% confidence interval 1.00 to 1.39, per doubling of days of use). However, after