Analgesic Efficacy of Paracetamol/Codeine and Paracetamol/Dextropropoxyphene in Pain after Episiotomy and Ruptures in Connection with Childbirth

1987 ◽  
Vol 15 (2) ◽  
pp. 89-95 ◽  
Author(s):  
J. Jacobson ◽  
S. O. Bertilson
Keyword(s):  
Side Effects ◽  
Pain Relief ◽  
Side Effect ◽  
Post Partum ◽  
Analgesic Efficacy ◽  
Side Effect Profile ◽  
Combination Analgesics

Pain after episiotomy and/or perineal/vaginal rupture in childbirth is severe in many patients and in most cases it can be treated with oral analgesics. In this trial the efficacy and side-effect profile of two combination analgesics, paracetamol/codeine and paracetamol/dextropropoxyphene hydrochloride, were compared in post-partum pain after episiotomy and/or rupture of the perineum. Eighty-five patients were analysed for efficacy and 96 were included in an analysis of side-effects. Paracetamol/codeine was shown to give faster and more efficient pain relief while not causing constipation or other troublesome side-effects.

Analgesic Efficacy and Side-Effect Profile of Paracetamol/Codeine and Paracetamol/Dextropropoxyphene after Surgical Removal of a Lower Wisdom Tooth

1987 ◽  
Vol 15 (2) ◽  
pp. 83-88 ◽  
Author(s):  
S. Sagne ◽  
P.-Å. Henrikson ◽  
K.-E. Kahnberg ◽  
H. Thiiander ◽  
S. O. Bertilson
Keyword(s):  
Side Effects ◽  
Pain Relief ◽  
Analgesic Efficacy ◽  
Surgical Removal ◽  
Side Effect Profile ◽  
Wisdom Tooth ◽  
Double Blind ◽  
Patient Groups ◽  
The Mean ◽  
Observation Period

A double-blind randomized analgesic trial was carried out on 180 patients undergoing surgical removal of an impacted lower wisdom tooth. The patients took their first dose of either 1000 mg paracetamol plus 60 mg codeine or 650 mg paracetamol plus 65 mg dextropropoxyphene when pain appeared after the decline of the local anaesthesia. If needed, another two doses were available during the observation period (≤10 h). The analgesic efficacy of paracetamol/codeine was overall superior to paracetamol/dextropropoxyphene in all variables. Sufficient pain relief was obtained in most patients. The pain reduction after the first dose was 64% in the group receiving paracetamol/codeine compared with 53% in the group receiving paracetamol/dextropropoxyphene and the mean durations of effect of the first dose were 6.6 and 5.8 h, respectively. Side-effects appeared in all patient groups but were most frequent in women taking paracetamol/codeine.

scholarly journals Morphine versus Nalbuphine for Open Gynaecological Surgery: A Randomized Controlled Double Blinded Trial

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Shiv Akshat ◽  
Rashmi Ramachandran ◽  
Vimi Rewari ◽  
Chandralekha ◽  
Anjan Trikha ◽  
...  
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Respiratory Depression ◽  
Postoperative Period ◽  
Postoperative Nausea ◽  
Side Effect ◽  
Analgesic Efficacy ◽  
Side Effect Profile ◽  
Gynaecological Surgery ◽  
Rescue Analgesia

Introduction. Pain is the commonest morbidity after open surgical procedures. The most effective treatment of postoperative pain is opioid therapy. Morphine, the commonly used opioid, is associated with many side effects including respiratory depression, sedation, postoperative nausea vomiting, and pruritus. Nalbuphine, on the other hand, is known to cause less respiratory depression. Thus this study was undertaken to compare the intraoperative and postoperative analgesic efficacy and side effect profile of the two drugs. Methodology. 60 patients undergoing open gynaecological surgery were randomized to receive either morphine (Group M) or nalbuphine (Group N) in the intraoperative and postoperative period. Intraoperative analgesic efficacy (measured by need for rescue analgesics), postoperative pain by visual analogue scale, and side effects like postoperative nausea, vomiting, sedation, respiratory depression, and pruritus were compared in both groups. Intraoperative and postoperative heart rate and blood pressure were also compared between the groups. Results. Need for intraoperative analgesia was significantly more in Group N (P=0.023). Postoperative VAS scores were significantly different between the groups at various time points; however, none of the patients required any rescue analgesia. The incidence of various side effects was not significantly different between the groups. The haemodynamic profile of patients was comparable between the groups in both intraoperative and postoperative period. Conclusion. Nalbuphine provides less effective intraoperative analgesia than morphine in patients undergoing open gynaecological surgery under general anaesthesia. Both drugs, however, provided similar postoperative analgesia and had similar haemodynamic and side effect profile.

scholarly journals Suvorexant: A boon for Sleepless Nights

2016 ◽  
Vol 14 (1) ◽  
pp. 43-45
Author(s):  
Anjan Khadka ◽  
Dick Brashier ◽  
Amol Vijay Khanpure ◽  
Pem Chuki
Keyword(s):  
General Practice ◽  
Side Effects ◽  
Side Effect ◽  
Sleep Onset ◽  
Side Effect Profile ◽  
New Class ◽  
Sleep Maintenance ◽  
Nonrestorative Sleep ◽  
Arousal System ◽  
Falling Asleep

Insomnia is characterized by difficulty in falling asleep, difficulty maintaining sleep, or experiencing nonrestorative sleep. Insomnia is the most common medical complaint in general practice.  Low efficacy and various side effects limit the use of existing treatment option. Suvorexant is an orexin receptor antagonist (ORA), first in a new class of drugs in development for the treatment of insomnia. It inhibits the wakefulness-promoting orexin neurons of the arousal system thereby promoting the natural transition from wakefulness. It also improves sleep onset and sleep maintenance and has a favorable tolerability and limited side-effect profile.

Syndrome of Inappropriate Antidiuretic Hormone Associated with Escitalopram Therapy

CNS Spectrums ◽  
2006 ◽  
Vol 11 (6) ◽  
pp. 429-432 ◽  
Author(s):  
Anjali Nirmalani ◽  
Saundra L. Stock ◽  
Glenn Catalano
Keyword(s):  
United States ◽  
Side Effects ◽  
High Risk ◽  
Antidiuretic Hormone ◽  
Side Effect ◽  
Parent Compound ◽  
The United States ◽  
Side Effect Profile ◽  
Significant Side Effect ◽  
Risk Patients

ABSTRACTEscitalopram is the selective serotonin reuptake inhibitor (SSRI) most recently approved for use in the United States. It is structurally related to citalopram, but is felt to have a more tolerable side-effect profile than its parent compound. Side effects are not generally serious and include headache, diarrhea, and nausea. While hyponatremia and the syndrome of inappropriate antidiuretic hormone (SIADH) have been associated with treatment with other SSRIs, there has only been one case of escitalopram-induced SIADH reported in the literature to date. We now report another case of a patient who developed SIADH after being treated with escitalopram for 4 weeks. The patient's hyponatremia improved following the discontinuation of escitalopram. Clinicians should be aware of this uncommon but significant side effect of SSRIs and monitor high-risk patients for the development of SIADH.

The Science of Antipsychotics: Mechanistic Insight

CNS Spectrums ◽  
2003 ◽  
Vol 8 (S2) ◽  
pp. 5-9 ◽  
Author(s):  
Carol A. Tamminga
Keyword(s):  
Side Effects ◽  
Tardive Dyskinesia ◽  
Side Effect ◽  
Negative Symptoms ◽  
New Drugs ◽  
Receptor Subtypes ◽  
Side Effect Profile ◽  
Cognitive Symptoms ◽  
Conventional Antipsychotics ◽  
New Antipsychotics

ABSTRACTWith the introduction of conventional antipsychotics in the 1950s, clinicians began to expect effective treatment of positive symptoms of schizophrenia. However, these drugs do not resolve negative and cognitive symptoms of schizophrenia and are also associated with serious side effects, including extrapyramidal side effects (EPS) and tardive dyskinesia. In 1989, clozapine was introduced and labeled the first new antipsychotic owing to its improved efficacy and side-effect profile. Clozapine proved effective in alleviating many of the positive, negative, and cognitive symptoms of schizophrenia, without causing inevitable EPS or tardive dyskinesia. Over the past decade, a number of different new antipsychotics have been developed. These drugs have an affinity for multiple dopamine-receptor subtypes as well as serotonin, norepinephrine, and glutamate receptors, allowing for better treatment outcomes. The antagonism of the 5-HT2A receptor may be responsible for improvement in negative symptoms and decrease in EPS. In addition to providing enhanced efficacy, the affinity of the new drugs for multiple receptors introduces new side effects not seen with the conventional agents, including weight gain. Each new antipsychotic has a unique receptor-binding profile that corresponds to its pharmacologic and side-effect profile. Understanding the differences in mechanisms of action of new antipsychotics will allow physicians to better choose treatment that meets the needs of each individual patient.

scholarly journals Adenosine Receptor Antagonists Do Not Disrupt Rodent Prepulse Inhibition: An Improved Side Effect Profile in the Treatment of Parkinson's Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Carina J. Bleickardt ◽  
Abigail L. LaShomb ◽  
Carrie E. Merkel ◽  
Robert A. Hodgson
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Side Effects ◽  
Dopamine Receptor ◽  
Prepulse Inhibition ◽  
Adenosine Receptor ◽  
Side Effect ◽  
Side Effect Profile ◽  
Dopamine Receptor Agonists ◽  
Receptor Agonists

Parkinson's disease (PD) is characterized by loss of dopaminergic neurons in the substantia nigra. Current treatments for PD focus on dopaminergic therapies, including L-dopa and dopamine receptor agonists. However, these treatments induce neuropsychiatric side effects. Psychosis, characterized by delusions and hallucinations, is one of the most serious such side effects. Adenosine receptor antagonism is a nondopaminergic treatment for PD with clinical and preclinical efficacy. The present studies assessed antagonists SCH 412348 and istradefylline in rodent prepulse inhibition (PPI), a model of psychosis. Dopamine receptor agonists pramipexole (0.3–3 mg/kg), pergolide (0.3–3 mg/kg), and apomorphine (0.3–3 mg/kg) significantly disrupted PPI; ropinirole (1–30 mg/kg) had no effect; L-dopa (100–300 mg/kg) disrupted rat but not mouse PPI. SCH 412348 (0.3–3 mg/kg) did not disrupt rodent PPI; istradefylline (0.1–1 mg/kg) marginally disrupted mouse but not rat PPI. These results suggest that antagonists, unlike dopamine agonists, have an improved neuropsychiatric side effect profile.

Baricity, Needle Direction, and Intrathecal Sufentanil Labor Analgesia

1997 ◽  
Vol 86 (3) ◽  
pp. 592-598 ◽  
Author(s):  
Fazeela Ferouz ◽  
Mark C. Norris ◽  
Valerie A. Arkoosh ◽  
Barbara L. Leighton ◽  
Louis M. Boxer ◽  
...  
Keyword(s):  
Side Effects ◽  
Pain Relief ◽  
Normal Saline ◽  
Analgesic Efficacy ◽  
Study Drug ◽  
Labor Analgesia ◽  
Labor Pain ◽  
Double Blind Study ◽  
Drug Injection ◽  
Double Blind

Background Intrathecal sufentanil relieves labor pain but centrally mediated side effects are common. Preventing rostral spread of intrathecal sufentanil should limit these side effects. Both direction of the lateral opening of a pencil-point needle and drug baricity modify the spread of intrathecal local anesthetics. This randomized, prospective, double-blind study examines the effects of these variables on intrathecal sufentanil labor analgesia. Methods Forty laboring, full-term parturients, whose cervixes were dilated less than 5 cm and who requested analgesia for labor were enrolled. Combined spinal epidural analgesia was induced in patients in the sitting position. They were allocated to receive 10 micrograms intrathecal sufentanil diluted with either normal saline or dextrose with the aperture of the pencil-point needle directed cephalad or caudad during drug injection. Thus there were four groups of ten patients: dextrose up, dextrose down, saline up, and saline down. Sufentanil was diluted with normal saline to a concentration of 10 micrograms/ml. The study drug was made by mixing 1 ml sufentanil solution with either 1 ml 10% dextrose or 1 ml normal saline. Visual analog scores for pain, pruritus, nausea, and pain relief were recorded before and 5, 10, 15, and 30 min after drug injection. Results Baricity, but not needle orientation, influenced pain relief and pruritus. Sufentanil in dextrose produced less itching but also less analgesia. Nine of 20 women in the dextrose groups compared with 1 of 20 in the saline groups requested additional analgesia by 30 min. Conclusions Little or no labor analgesia developed for patients receiving sufentanil with dextrose. A supraspinal action may contribute to intrathecal sufentanil's analgesic efficacy.

A Multicentre Double Blind Trial of Fluoxetine versus Amitriptyline in the Treatment of Depressive Illness

1993 ◽  
Vol 27 (1) ◽  
pp. 49-55 ◽  
Author(s):  
Fiona K. Judd ◽  
Kate Moore ◽  
Trevor R. Norman ◽  
Graham D. Burrows ◽  
Ramesh K. Gupta ◽  
...  
Keyword(s):  
Side Effects ◽  
Side Effect ◽  
Serotonin Reuptake ◽  
Depressive Illness ◽  
Fixed Dose ◽  
Side Effect Profile ◽  
Double Blind Trial ◽  
Double Blind ◽  
Antidepressant Efficacy ◽  
To Receive

The antidepressant efficacy and side effect profile of a fixed dose of 20 mg/day of fluoxetine, a specific serotonin reuptake inhibitor, were compared to those of amitriptyline. Fifty-eight patients with DSM-III-R depression were randomly assigned to receive either fluoxetine or amitriptyline. Fifty-six patients (fluoxetine N = 23, amitriptyline N = 23) completed the 6 week study. Comparable antidepressant efficacy was demonstrated for the two drugs. Patients taking fluoxetine reported less side-effects than those taking amitriptyline.

Comparative study of the side-effect profile between clozapine and non-clozapine patients

2016 ◽  
Vol 33 (S1) ◽  
pp. s261-s261
Author(s):  
S. Ramos Perdigues ◽  
A. Mane Santacana ◽  
P. Salgado Serrano ◽  
E. Jove Badia ◽  
X. Valiente Torrelles ◽  
...  
Keyword(s):  
Heart Rate ◽  
Side Effects ◽  
Side Effect ◽  
Care Facility ◽  
Good Evidence ◽  
Side Effect Profile ◽  
Continuous Variables ◽  
Wide Range ◽  
Competing Interest ◽  
Main Barrier

IntroductionFor resistant schizophrenia, the only approved treatment is clozapine. However, clozapine is underused, mainly due to its wide range of side-effects. Secondary effects differ amongst antipsychotics (Leucht et al., 2009). Despite that there is no good evidence that combined antipsychotics offer any advantage over the use of a single antipsychotic, combination increases the frequency of adverse events (Maudsley guidelines).ObjectivesTo compare the side-effect profile between clozapine and non-clozapinepatients.AimsTo provide evidence that clozapine patients do not show a worse side-effects profile.MethodsWe cross-sectionally analysed all patients from a Spanish long-term mental care facility (n = 139). Schizophrenic/schizoaffective patients were selected (n = 118) and their treatment was assessed, 31 patients used clozapine. We paired clozapine and non-clozapine patients by sex and age and assessed antipsychotic side effects and possible confounder variables.ResultsOur sample was 27 clozapine patients and 29 non-clozapine patients. 67,9% were male with a mean age of 51.3 (SD 9.6) years. For continuous variables: age, BMI, waist/hip, cholesterol, TG, glucose, prolactin, heart-rate, blood pressure, sleeping hours, the only statistical differences found were lower heart-rate (P = 0.001) in clozapine group and higher salivation subscale of SAS (P = 0.002) in clozapine group. For discrete variables: monotherapy, obesity, overweight, metabolic syndrome or possible confounders as propranolol, laxative, diet, antiglycemiant or insulin, fibrates or statins, antihypertensive or anticholinergic, no statistical differences were found.ConclusionsWe did not find differences in cardiometabolic parameters, which are the main barrier to prescribing clozapine, probably due to the concomitant use of other drugs in both groups.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Oral Oxycodone for Acute Postoperative Pain: A Review of Clinical Trials

2017 ◽  
Vol 2 (20;2) ◽  
pp. sE33-sE52 ◽  
Author(s):  
Chi-Wai Cheung
Keyword(s):  
Clinical Trials ◽  
Pain Management ◽  
Side Effects ◽  
Postoperative Pain ◽  
Pain Relief ◽  
Hospital Stay ◽  
Spine Surgery ◽  
Analgesic Efficacy ◽  
Postoperative Pain Management ◽  
Acute Postoperative Pain

Background: Opioids are the mainstay of pain management for acute postsurgical pain. Oral oxycodone is an opioid that can provide effective acute postoperative pain relief. Objectives: To evaluate the use of oral oxycodone for acute postoperative pain management. Study Design: This is a narrative review based on published articles searched in PubMed and Medline from 2003 to 2015 on oral oxycodone for acute postoperative pain management. Methods: Clinical trials related to the use of oral oxycodone for acute postoperative pain management were searched via PubMed and Medline from 2003 to 2015. The search terms used were “oral strong opioids,” “postsurgical,” “postoperative,” “post-surgical,” and “postoperative.” Treatment interventions were compared for analgesic efficacy, rescue medication use, side effects, recovery, length of hospital stay, and patient satisfaction. Results: There were 26 clinical trials included in the review. Oral oxycodone showed superior postoperative analgesic efficacy compared with placebo in patients undergoing laparoscopic cholecystectomy, abdominal or pelvic surgery, bunionectomy, breast surgery, and spine surgery. When compared with intravenous opioids, oral oxycodone provided better or comparable pain relief following knee arthroplasty, spine surgery, caesarean section, laparoscopic colorectal surgery, and cardiac surgery. One study of dental postsurgery pain reported inferior pain control with oral oxycodone versus rofecoxib. (withdrawn from the US market due to cardiac safety concerns). In many studies, the demand for rescue analgesia and total opioid consumption were reduced in the oxycodone treatment arm. Patients receiving oral oxycodone experienced fewer opioid-related side effects than those on other opioids, and had a similar occurrence of postoperative nausea and vomiting as patients on placebo. Furthermore, oral oxycodone did not prolong hospital stay and was associated with lower drug costs compared with epidural and intravenous analgesics. Oxycodone administered as part of a multimodal analgesic regimen produced superior pain relief with fewer side effects and a reduced hospital stay. Limitation: There is a limited number of randomized double blinded studies in individual surgical operations, thus making it more difficult to come up with definitive conclusions. Conclusion: Oral oxycodone appears to offer safe and effective postoperative analgesia, and is a well-accepted and reasonable alternative to standard intravenous opioid analgesics. Key words: Postoperative, pain, analgesia, oral oxycodone, opioid

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