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Acetaminophen

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Www.bmj
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27

A dose of humility

Paracetamol has come in for a bit of a kicking in recent months (doi:10.1136/bmj.h1186). So we asked James Dear and colleagues to comment (doi:10.1136/bmj.h3705). They confirm that important questions about this most commonly used drug remain unanswered. The evidence of effectiveness is patchy and depends on the condition: it’s good for postoperative dental pain; okay for headache, though not as good as other analgesics; of small and probably clinically irrelevant benefit for hip and knee pain; no better than placebo for back pain; and without enough evidence of benefit for the common cold. As for its safety, nearly 60 years of widespread use are reassuring. But there are simmering concerns about subclinical liver and cardiovascular effects and questions about whether or not to intervene in cases of small therapeutic overdose.  
feeds.bmj.com
over 4 years ago
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16

Nonsteroidal anti-inflammatory drugs for dysmenorrhoea | Cochrane

Are nonsteroidal anti-inflammatory drugs (NSAIDs) safe and effective for relief of period pain (dysmenorrhoea) and how do they compare with each other and with paracetamol?  
cochrane.org
over 4 years ago
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4

Utility of Pre-4-Hour Acetaminophen Levels in Acute Overdose

Utility of Pre-4-Hour Acetaminophen Levels by Dr. Bryan Hayes  
aliem.com
over 4 years ago
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5

Venlafaxine for neuropathic pain in adults | Cochrane

Neuropathic pain is pain that arises from damaged nerves. It is different in nature than pain that arises from damaged tissue, such as a cut, although that type of pain is also carried along nerves. Drugs that are commonly used to treat pain, such as paracetamol, ibuprofen, or morphine, are not very good at treating neuropathic pain. However, other drugs, such as gabapentin, which are also used to prevent or treat epilepsy (fits), do appear to be of some benefit in treating neuropathic pain. There is also a great deal of interest in using antidepressant drugs to treat neuropathic pain. This does not imply that the person with neuropathic pain is depressed, but simply that these drugs may have benefits in neuropathic pain. However, while some doctors prescribe antidepressants in people with neuropathic pain, their benefits have not been confirmed in large clinical trials.  
cochrane.org
over 4 years ago
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75

Change in paracetamol advice for new meningitis vaccine

Nurses delivering a new vaccine protecting against meningitis should encourage parents to give their children paracetamol following immunisation, due to increased risk of fever.  
nursingtimes.net
over 4 years ago
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Meningitis jab: 'infant paracetamol will help baby avoid fever'

Meningitis B vaccine campaign launched by Public Health England with advice to parents to give babies analgesic to ward off high temperatures after jab  
theguardian.com
over 4 years ago
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September 2015 Summary statement: new guidelines for the management of paracetamol poisoning in Australia and New Zealand

updated ANZ paracetamol poisoning guidelines released by @theMJA today https://t.co/XjdXuQ7Oa3 #FOAMtox— Michael Downes (@ToxTalks) September 7, 2015 //platform.twitter.com/widgets.js  
prehospitalmed.com
over 4 years ago
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A bitter pill to swallow – Don't Forget the Bubbles

Earlier this month the MJA published the latest consensus guidelines for the management of paracetamol (acetominophen) poisoning.  Whilst there is very little that is new for those of us used to dealing with this problem in adults, the document now makes some recommendations regarding the management of paracetamol overdose in children.  
dontforgetthebubbles.com
over 4 years ago
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Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised placebo controlled trials

Objective To investigate the efficacy and safety of paracetamol (acetaminophen) in the management of spinal pain and osteoarthritis of the hip or knee.  
feeds.bmj.com
over 4 years ago
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Acetaminophen for Fever Did Not Reduce ICU Days or Deaths

Early use of acetaminophen to treat fever in patients in the intensive care unit who had probable infection did not reduce intensive care unit stay or mortality, according to a randomized trial.  
medscape.com
over 4 years ago
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The HEAT Trial - Acetaminophen in ICU Patients with Fever - R.E.B.E.L. EM - Emergency Medicine Blog

This post is a review of the HEAT Trial discussing the evidence that acetaminophen treatment of fever due to probable infection is beneficial, ineffective, or harmful.  
rebelem.com
over 4 years ago
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Milnacipran for fibromyalgia in adults | Cochrane

Fibromyalgia is characterised by persistent, widespread pain and tenderness, sleep problems, and fatigue. Common pain-relieving medicines such as paracetamol and ibuprofen are not usually considered effective. Medicines used to treat epilepsy or depression can be effective in some people with fibromyalgia and other forms of chronic (persistent, long-lasting) pain where there may be nerve damage. Milnacipran is an antidepressant, and antidepressants are widely recommended for treating fibromyalgia. Milnacipran is licensed to treat fibromyalgia only in some parts of the world, particularly the USA.  
cochrane.org
over 4 years ago
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Hyperkalaemia on the surgical ward

A 56 year old woman was admitted with an infected stump wound at the site of a below the knee amputation. Her medical history included type 2 diabetes, diabetic foot ulcer, and painful peripheral neuropathy. Her regular drugs were metformin, amitriptyline, lansoprazole, Humulin I and Novorapid SC insulin, aspirin, paracetamol, morphine sulfate, gabapentin, and carbamazepine. In hospital, she was also prescribed dalteparin 5000 units subcutaneously once daily, intravenous benzylpenicillin, and flucloxacillin.  
feeds.bmj.com
over 4 years ago
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0

Hyperkalaemia on the surgical ward

A 56 year old woman was admitted with an infected stump wound at the site of a below the knee amputation. Her medical history included type 2 diabetes, diabetic foot ulcer, and painful peripheral neuropathy. Her regular drugs were metformin, amitriptyline, lansoprazole, Humulin I and Novorapid SC insulin, aspirin, paracetamol, morphine sulfate, gabapentin, and carbamazepine. In hospital, she was also prescribed dalteparin 5000 units subcutaneously once daily, intravenous benzylpenicillin, and flucloxacillin.  
feeds.bmj.com
over 4 years ago
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0

Hyperkalaemia on the surgical ward

A 56 year old woman was admitted with an infected stump wound at the site of a below the knee amputation. Her medical history included type 2 diabetes, diabetic foot ulcer, and painful peripheral neuropathy. Her regular drugs were metformin, amitriptyline, lansoprazole, Humulin I and Novorapid SC insulin, aspirin, paracetamol, morphine sulfate, gabapentin, and carbamazepine. In hospital, she was also prescribed dalteparin 5000 units subcutaneously once daily, intravenous benzylpenicillin, and flucloxacillin.  
feeds.bmj.com
over 4 years ago
Preview
0
0

Hyperkalaemia on the surgical ward

A 56 year old woman was admitted with an infected stump wound at the site of a below the knee amputation. Her medical history included type 2 diabetes, diabetic foot ulcer, and painful peripheral neuropathy. Her regular drugs were metformin, amitriptyline, lansoprazole, Humulin I and Novorapid SC insulin, aspirin, paracetamol, morphine sulfate, gabapentin, and carbamazepine. In hospital, she was also prescribed dalteparin 5000 units subcutaneously once daily, intravenous benzylpenicillin, and flucloxacillin.  
feeds.bmj.com
over 4 years ago
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Dual Therapy No Better Than NSAIDs Alone for Low Back Pain

In patients with acute nontraumatic lower back pain, adding cyclobenzaprine or oxycodone/acetaminophen to naproxen alone did not improve functional outcomes or pain at 1 week.  
medscape.com
over 4 years ago
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Osteoarthritis: care and management | Guidance and guidelines | NICE

This guideline update was originally intended to include recommendations based on a review of new evidence about the use of paracetamol, etoricoxib and fixed-dose combinations of NSAIDs (non-steroidal anti-inflammatory drugs) plus gastroprotective agents in the management of osteoarthritis. Draft recommendations based on the evidence reviews for these areas were presented in the consultation version of the guideline. Stakeholder feedback at consultation indicated that the draft recommendations, particularly in relation to paracetamol, would be of limited clinical application without a full review of evidence on the pharmacological management of osteoarthritis. NICE was also aware of an ongoing review by the MHRA (Medicines and Healthcare Products Regulatory Agency) of the safety of over-the-counter analgesics. Therefore NICE intends to commission a full review of evidence on the pharmacological management of osteoarthritis, which will start once the MHRA's review is completed, to inform a further guideline update.  
nice.org.uk
about 4 years ago
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Acetaminophen for ICU Fever Did Not Reduce Stay, Mortality CME/CE

: A randomized trial indicates that routine application of acetaminophen among febrile patients in the intensive care unit with suspected infection does not improve outcomes.  
medscape.org
about 4 years ago
Sinaiem dark
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a-pain-in-the-back-do-patients-need-more-than-nsaids

A recent double-blinded, RCT from JAMA investigated the relative efficacies of naproxen + placebo, naproxen + cyclobenzaprine and naproxen + oxycodone/acetaminophen on functional impairment in acute onset (<2 weeks), non-traumatic, non-radicular low back pain in the non-elderly (<64).   
sinaiem.org
about 4 years ago