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Latest & greatest articles for acetaminophen
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: non-steroidal anti-inflammatory drugs are slightly better than paracetamol for reducing pain in osteoarthritis Free David Felson , MD, MPH Statistics from Altmetric.com Wegman A, van der Windt D, van Tulder M, et al. Nonsteroidal antiinflammatory drugs or acetaminophen for osteoarthritis of the hip or knee? A systematic review of evidence and guidelines. J Rheumatol 2004 ; 31 : 344 –54. Q In patients with osteoarthritis (OA) of the knee or hip, are non-steroidal anti-inflammatory drugs (NSAIDs (...) ) more effective than paracetamol (acetaminophen) for reducing OA related pain or disability? Clinical impact ratings GP/FP/Primary care ★★★★★★☆ Rheumatology ★★★★☆☆☆☆☆ METHODS Data sources: Medline, EMBASE/Excerpta Medica, and the Cochrane Database (all up to December 2001), and bibliographies of relevant articles. Study selection and assessment: randomised controlled trials (RCTs) (full reports published in any language) that compared an NSAID with paracetamol in patients with OA of the hip or knee
NSAIDS or paracetamol, alone or combined with opioids, for cancer pain. NSAIDs are widely applied to treat cancer pain and are frequently combined with opioids in combination preparations for this purpose. However, it is unclear which agent is most clinically efficacious for relieving cancer-related pain, or even what may be the additional benefit of combining an NSAID with an opioid in this setting.To assess the effects of NSAIDs, alone or combined with opioids, for the treatment of cancer
Effects of acetaminophen on morphine side-effects and consumption after major surgery: meta-analysis of randomized controlled trials 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.
Paracetamol versus nonsteroidal anti-inflammatory drugs for rheumatoid arthritis. Nonsteroidal anti-inflammatory drugs (NSAIDs) are usually preferred for simple analgesics such as paracetamol for rheumatoid arthritis. It is not clear, however, whether the trade-offs between benefits and harms of NSAIDs are preferable to those of paracetamol (paracetamol is also called acetaminophen).To compare the benefits and harms of paracetamol with NSAIDs in patients with rheumatoid arthritis.Medline (...) versus 5 out of 35 for paracetamol in another trial. However, because of the weaknessess in the trials, no firm conclusion can be drawn.When considering the trade off between the benefits and harms of non-steroidal anti-inflammatory drugs and paracetamol/acetaminophen, it is not known whether one is better than the other for rheumatoid arthritis. But people with rheumatoid arthritis and the researchers in the study did prefer non-steroidal anti-inflammatory drugs more than acetaminophen/paracetamol
Restricting paracetamol in the United Kingdom to reduce poisoning: a systematic review 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.
Acetaminophen for osteoarthritis. Osteoarthritis (OA) is the most common form of arthritis. Published guidelines and expert opinion are divided over the relative role of acetaminophen (also called paracetamol or Tylenol) and non-steroidal anti-inflammatory drugs (NSAIDs) as first-line pharmacologic therapy. The comparative safety of acetaminophen and NSAIDs is important to consider as NSAIDs have the potential for serious gastrointestinal, renal, and cardiovascular toxicities, and acetaminophen (...) in high dosages (greater than or equal to 2 grams per day), may also have the potential for serious upper gastrointestinal toxicity.To assess the efficacy and safety of acetaminophen versus placebo and versus NSAIDs (ibuprofen, arthrotec, celecoxib,naproxen, rofecoxib) for treating OA.We searched the Cochrane Controlled Trials Register (Issue 3, 2002), MEDLINE (up to July 2002), and Current Contents (up to March 2002). Reference lists of identified RCTs and pertinent review articles were also hand
Costs and effectiveness of rofecoxib, celecoxib, and acetaminophen for preventing pain after ambulatory otolaryngologic surgery Costs and effectiveness of rofecoxib, celecoxib, and acetaminophen for preventing pain after ambulatory otolaryngologic surgery Costs and effectiveness of rofecoxib, celecoxib, and acetaminophen for preventing pain after ambulatory otolaryngologic surgery Watcha M F, Issioui T, Klein K W, White P F Record Status This is a critical abstract of an economic evaluation (...) that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Three oral analgesic regimens for preventing pain after ambulatory surgery were examined. The regimens were acetaminophen (2 g), celecoxib (200 mg) and rofecoxib (50 mg). The drugs were administered 15 to 45 minutes before entering the operating room. Type
Effect of acetylcysteine on prothrombin index in paracetamol poisoning without hepatocellular injury. Acetylcysteine treatment reduces liver damage after paracetamol overdose, but can affect the prothrombin index, which is used to assess the progress of overdose patients. We aimed to assess retrospectively the effect of intravenous acetylcysteine on the prothrombin index in patients with paracetamol poisoning without signs of hepatocellular injury. Prothrombin index had been recorded before (...) , and serially during, acetylcysteine treatment in 87 patients. After initiation of treatment, prothrombin index decreased (mean 0.33, 95% CI 0.29-0.38) in all patients, and was strongly associated with the start of acetylcysteine infusion. In patients with uncomplicated paracetamol poisoning, a fall in this index might be misinterpreted as a sign of liver failure, leading to prolonged treatment time.
Blood lactate as an early predictor of outcome in paracetamol-induced acute liver failure: a cohort study. Although the King's College Hospital (KCH) selection criteria for emergency liver transplantation in paracetamol-induced acute liver failure are widely used, strategies to improve sensitivity and facilitate earlier transplantation are required. We investigated the use of arterial blood lactate measurement for the identification of transplantation candidates.In a single-centre study, we (...) measured arterial blood lactate early (median 4 h) and after fluid resuscitation (median 12 h) in patients admitted to a tertiary-referral intensive-care unit. Threshold values that best identified individuals likely to die without transplantation were derived in a retrospective initial sample of 103 patients with paracetamol-induced acute liver failure and applied to a prospective validation sample of 107 patients. Predictive value and speed of identification were compared with those of KCH
Interventions for paracetamol (acetaminophen) overdoses. Self-poisoning with paracetamol (acetaminophen) is a common cause of hepatotoxicity in the Western World. Interventions for paracetamol poisoning encompass inhibition of absorption, removal from the vascular system, antidotes, and liver transplantation.The objective was to assess the beneficial and harmful effects of interventions or combination of interventions for paracetamol overdose.The Cochrane Hepato-Biliary Group Controlled Trials (...) of methodological quality.Nine RCTs (all small and of low methodological quality), one quasi-randomised trials, 37 observational studies, and nine randomised trials including human volunteers were identified. It was impossible to perform meta-analyses including more than two RCTs. Activated charcoal, gastric lavage, and ipecacuanha are able to reduce the absorption of paracetamol but the clinical benefit is unclear. Of these, activated charcoal seems to have the best risk-benefit ratio. N-acetylcysteine seems
Paracetamol for treating fever in children. Paracetamol (acetaminophen) is widely used for treating fever in children. Like ibuprofen, aspirin, and physical methods (such as fanning), paracetamol aims to provide relief from symptoms and prevent febrile convulsions. Uncertainty exists about the benefits of using it to treat fever in children.To assess the effects of paracetamol for treating fever in children in relation to fever clearance time, febrile convulsions, and resolution of associated (...) symptoms.We searched the Cochrane Infectious Diseases Group specialized trials register (November 2001), The Cochrane Controlled Trials Register (The Cochrane Library Issue 4, 2001), MEDLINE (1966 to November 2001), EMBASE (1988 to November 2001), LILACS (2001, 40a Edition CD-ROM), Science Citation Index (November 2001), and reference lists of articles. We also contacted researchers in the field.Randomized and quasi-randomized trials of children with fever from infections comparing: (1) paracetamol
Efficacy of rofecoxib, celecoxib, and acetaminophen in osteoarthritis of the knee: a randomized trial. Osteoarthritis (OA) is often treated with nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, or specific inhibitors of cyclooxygenase 2 (COX-2).To assess the relative therapeutic efficacy of rofecoxib, celecoxib, and acetaminophen in adults with OA.Randomized, parallel-group, double-blind trial, conducted from June 1999 to February 2000, in 29 clinical centers in the United (...) States.Three hundred eighty-two patients aged at least 40 years who had OA of the knee that was previously treated with NSAIDs or acetaminophen.Patients were randomly assigned to receive rofecoxib, 12.5 mg/d (n = 96); rofecoxib, 25 mg/d (n = 95); celecoxib, 200 mg/d (n = 97); or acetaminophen, 4000 mg/d (n = 94) for 6 weeks.Assessments over days 1 to 6 and over 6 weeks included pain on walking, night pain, pain at rest, and morning stiffness as measured on a Western Ontario McMaster Universities
' or 'pyrexia' or ' temperature') and ('paracetamol' or 'acetaminophen') and 'ibuprofen'. Textbooks and reference lists were also searched. Study selection Study designs of evaluations included in the review Studies that reported sufficient statistics to allow the calculation of effect size were eligible. The included studies were randomised controlled trials (RCTs), including double-blind RCTs, and controlled trials in which it was unclear whether they were randomised or not. Specific interventions (...) Treating fever in children: paracetamol or ibuprofen? Treating fever in children: paracetamol or ibuprofen? Treating fever in children: paracetamol or ibuprofen? Purssell E Authors' objectives To compare the effectiveness of paracetamol and ibuprofen as antipyretic medications for children. Searching MEDLINE, EMBASE, CINAHL and the Royal College of Nursing database were searched from 1970. The keywords used were ('children' or 'infants' or 'paediatric' or 'pediatric') and ('fever' or 'febrile
-inflammatory drugs (NSAIDs), and their combinations in post-operative pain management. Searching MEDLINE (from 1966 to January 2001) and the Cochrane Library (January 2001) were searched for articles published in full in the English language. The search strategy used pain terms combined with the keywords 'paracetamol', 'acetaminophen', 'proparacetamol', 'non-steroidal anti-inflammatory drugs (NSAID)', or individual drug names. The reference lists from identified studies were also examined. Study selection (...) Software. 3. Moore A, Collins S, Carroll D, McQuay H, Edwards J. Single dose oral paracetamol (acetaminophen) with and without codeine for postoperative pain (Cochrane Review). In: The Cochrane Library, 1998. Oxford: Update Software. Indexing Status Subject indexing assigned by NLM MeSH Acetaminophen /therapeutic use; Analgesics, Non-Narcotic /therapeutic use; Anti-Inflammatory Agents, Non-Steroidal /therapeutic use; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Pain, Postoperative
Cost-efficacy of rofecoxib versus acetaminophen for preventing pain after ambulatory surgery Cost-efficacy of rofecoxib versus acetaminophen for preventing pain after ambulatory surgery Cost-efficacy of rofecoxib versus acetaminophen for preventing pain after ambulatory surgery Issioui T, Klein K W, White P F, Watcha M F, Skrivanek G D, Jones S B, Hu J, Marple B F, Ing C Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each (...) abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Selective non-steroidal anti-inflammatory drugs (NSAIDs) given alone, or in combination, prior to outpatient otolaryngologic surgery were considered. The NSAIDs studied were rofecoxib (a cyclooxygenase-2 inhibitor; 50 mg) and acetaminophen (2 mg). Type of intervention Secondary prevention and treatment
Blood lactate as an early predictor of outcome in paracetamol-induced acute liver failure: a cohort study PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
Acetaminophen, aspirin, and chronic renal failure. Several epidemiologic studies have demonstrated an association between heavy consumption of nonnarcotic analgesics and the occurrence of chronic renal failure, but it is unclear which is the cause and which is the effectIn a nationwide, population-based, case-control study of early-stage chronic renal failure in Sweden, face-to-face interviews were conducted with 926 patients with newly diagnosed renal failure and 998 control subjects, of whom (...) 918 and 980, respectively, had complete data. We used logistic-regression models to estimate the relative risks of disease-specific types of chronic renal failure associated with the use of various analgesicsAspirin and acetaminophen were used regularly by 37 percent and 25 percent, respectively, of the patients with renal failure and by 19 percent and 12 percent, respectively, of the controls. Regular use of either drug in the absence of the other was associated with an increase by a factor
Referral patterns and social deprivation in paracetamol-induced liver injury in Scotland. Paracetamol overdose is the commonest cause of acute liver failure in the UK, which has led to measures to restrict its sale. We aimed to establish whether changes in the referral of patients with paracetamol-induced acute liver failure have occurred since the introduction of legislation. We compared data from patients admitted to the Scottish Liver Transplantation Unit in 1992-98 with those admitted (...) in 1998-2001. The incidence of paracetamol-induced liver failure, severity of patients' illness, and outcome did not differ between the groups. Patients with paracetamol-induced acute liver failure had higher Carstairs scores (1.99 [95% CI 1.33-2.65]; n=190) than patients with non-paracetamol acute liver failure (0.02 [-0.79 to 0.84]; n=68). We have shown an association between paracetamol-induced acute liver failure and social deprivation.
wide-scale clinical use. Bibliographic details Willems M, Quartero A O, Numans M E. How useful is paracetamol absorption as a marker of gastric emptying: a systematic literature study. Digestive Diseases and Sciences 2001; 46(10): 2256-2262 PubMedID Indexing Status Subject indexing assigned by NLM MeSH Acetaminophen /metabolism; Analgesics, Non-Narcotic /metabolism; Dyspepsia /physiopathology; Gastric Emptying /physiology; Humans; Intestinal Absorption; Reproducibility of Results AccessionNumber (...) How useful is paracetamol absorption as a marker of gastric emptying: a systematic literature study How useful is paracetamol absorption as a marker of gastric emptying: a systematic literature study How useful is paracetamol absorption as a marker of gastric emptying: a systematic literature study Willems M, Quartero A O, Numans M E Authors' objectives To evaluate the validity of the paracetamol absorption test in assessing gastric emptying, in comparison with scintigraphy, on the basis