Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acetaminophen is an effective mild analgesic and antipyretic agent. In double-blind, controlled experimental pain studies of short duration, acetaminophen is superior to placebo and produces analgesia comparable to that produced by aspirin. The frequency of adverse reactions to therapeutic doses of acetaminophen is low, as is that of aspirin. Overdosage with acetaminophen, however, may result in irreversible hepatotoxicity. Since clinical manifestations of intoxication can be of slow onset, physicians may tend to delay initiation of definitive therapy. Intravenous cysteamine, and possibly oral methionine, appear to be effective in preventing hepatotoxicity if they are administered with 10 h of drug ingestion. Physicians should be aware of the potential danger of acetaminophen overdosage and alerted to its clinical manifestations.
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PMID:Acetaminophen. 32 28

Several drugs and techniques have been developed to improve the quality of post operative analgesia. Opiates are always the first intention drugs, specially with new molecules (buprenorphine, nalbuphine ...). Paracetamol and non-steroid anti-inflammatory drugs can be efficacious in the post operative period alone or as adjuvants. The alpha 2 adrenergic agonists use must be specify. The patient auto-controlled administration and the transdermal administration of opiates are useful techniques to provide effective analgesia with optimal safety.
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PMID:[Drug treatment of perioperative pain]. 130 40

The relationship between plasma levels of paracetamol and its analgesic effect was studied in the rat using a model of pain-induced functional impairment (PIFI). Female Wistar rats received an intraarticular injection of 30% uric acid in the knee of the right hind limb, inducing its dysfunction. Animals then received oral paracetamol at doses of 178, 316 or 562 mg kg-1 and the recovery of functionality over time was considered as an expression of analgesia. Paracetamol plasma levels were determined by HPLC. Results showed that there is a direct relationship between paracetamol plasma levels and its analgesic effect that follows a sigmoidal model according to the Hill equation. The PIFI model appears to be a useful tool to establish pharmacokinetic/pharmacodynamic relationships for non-narcotic analgesics.
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PMID:Relationship between paracetamol plasma levels and its analgesic effect in the rat. 136 May 26

The pathophysiology, assessment, and pharmacologic management of acute pain in infants and children are reviewed, and the mechanism of action, pharmacokinetics, clinical efficacy, adverse effects, and dosages of opioid analgesics, nonopioid analgesics, and local anesthetics used for regional blocks are discussed. The pathophysiology of pain and the physiologic rationale for treatment of pain are similar in children and adults. Severe pain can be controlled by i.v. or epidural administration of opioid analgesics. Neonates are more susceptible to the depressant effects of opioids, and opioid analgesia must be administered with caution in infants who are not receiving mechanical ventilation because of the associated risk of respiratory depression. Patient-controlled analgesia is a useful technique in older children. Acetaminophen and NSAIDs are useful for relieving milder pain of noninflammatory and inflammatory origin, respectively. Epidural or intrathecal administration of local anesthetics provides regional analgesia with minimal physiologic alterations. Topical application of local anesthetics is effective for many minor procedures. A variety of pain management techniques are available for the management of acute pain in pediatric patients. The development of drugs having fewer adverse effects and noninvasive administration techniques will be important research priorities in the coming years.
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PMID:Management of acute pain in children. 168 May 98

We compared acetaminophen (APAP) double dose 2000 mg twice a day on the day of oral surgery, decreasing to 1000 mg twice a day for the next 2 days, to a standard dose 1000 mg 4 times a day then 500 mg 4 times a day for 2 days. Compared to the double dose, there was 19% (p = 0.03) less edema after the standard regimen on the third postoperative day. No statistical difference was seen between the two treatments with respect to ability to open the mouth, temperature on the nonoperated versus operated side, or summary analgesic efficacy measures. However, pain intensity scores indicate that APAP double dose gave less analgesia toward the end of the dosing interval than the standard regimen. It is proposed that double-dose APAP twice daily does not have any analgesic and antiedematous advantages over the standard dose 4 times a day. The analgesic and antiphlogistic efficacies of APAP apparently do not coincide.
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PMID:Effects of acetaminophen after bilateral oral surgery: double dose twice daily versus standard dose four times daily. 174 23

The central nervous system effect of acetaminophen (paracetamol) and acetylsalicylic acid was investigated in healthy volunteers according to a crossover, double-blind, and placebo-controlled design. Ten subjects received, by intravenous route, a placebo, 1 gm acetaminophen, and 1 gm acetylsalicylic acid. Analgesia was assessed by measurement of the subjective pain threshold and the objective nociceptive flexion reflex threshold in response to selective transcutaneous electrical stimulations. A close correlation was observed between subjective and objective pain thresholds. Acetaminophen increased both thresholds for more than 4 hours (24% and 23% of baseline value at 120 minutes, respectively; p less than 0.001, ANOVA). In contrast, acetylsalicylic acid had no noticeable effect on either threshold. These findings show that acetaminophen-induced analgesia is centrally mediated, in contrast to aspirin. The time delay between plasma concentration kinetics and acetaminophen analgesic effect is another argument in favor of its direct action on the central nervous system.
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PMID:Central analgesic effect of acetaminophen but not of aspirin. 201 24

Although biochemical data suggest a direct effect of paracetamol on the CNS, its mode of action is still poorly understood. We investigated the central impact of paracetamol compared to acetylsalicylate in response to transcutaneous electrical nerve stimulation in man. Healthy volunteers received i.v. paracetamol, acetylsalicylic acid, and placebo. Analgesia was assessed by measurement of objective (R-III reflex) and subjective (VAS) pain thresholds. A close correlation was observed between both objective and subjective thresholds. Paracetamol raised the objective and subjective thresholds. In contrast, acetylsalicylic acid had no noticeable effect on either threshold. These data demonstrate a central analgesic effect of paracetamol.
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PMID:[Central analgesic effect of paracetamol]. 227 Apr 52

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 evaluations were also recorded on completion of the study. Comparison of mean differences before and after treatment with ibuprofen or placebo indicated a marked decrease in oxy/APAP use with ibuprofen (p less than 0.01) and a slight increase in use in the placebo group. Reduction in oxy/APAP usage occurred within 24 hours and maximized at 5 days. 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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PMID:The combination of ibuprofen and oxycodone/acetaminophen in the management of chronic cancer pain. 246 23

The influence of a painful stimulus and lumbar epidural morphine on gastric emptying, the orocecal transit time and small intestinal transit were studied in nine healthy volunteers. Acetaminophen absorption was used as a measure of the rate of gastric emptying. Orocecal transit time was determined by measuring the end-expiratory hydrogen concentration. Small intestinal transit was calculated from measurements of the orocecal transit time and gastric emptying. Cold pain stress with intermittent immersion of the feet in ice-cold water was used as a painful stimulus. Each volunteer was investigated on 3 different days: once after receiving 4 mg of epidural morphine and during cold pain; once during cold pain; and once under control conditions without pain and epidural morphine. Immersion of the feet in ice-cold water was always very painful, but was more tolerable during epidural morphine analgesia. The increase in blood pressure which accompanied the cold pain was the same whether this pain was induced without or during epidural morphine analgesia. Gastric emptying, orocecal transit time and small intestinal transit were delayed during epidural morphine analgesia compared with the findings under the control and plain cold pain conditions. Cold pain stress alone did not influence gastric emptying, orocecal transit time or intestinal transit. To conclude, epidural morphine in itself delayed gastric emptying, orocecal transit and transit through the small intestine in healthy volunteers.
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PMID:Epidural morphine delays gastric emptying and small intestinal transit in volunteers. 292 84

Acute soft tissue injuries create pain and limitation of function. Treatment requires analgesia and time for full recovery. Acetaminophen with codeine (650 mg plus 60 mg, respectively, every 4 to 6 hours) is used frequently as the analgesic of choice. Diflunisal (1,000 mg initially then 500 mg twice a day) vs acetaminophen with codeine was prospectively studied in the treatment of acute mild to moderate pain from soft tissue injuries. Thirty-five patients with acute strains, sprains, or low back pain were randomized to treatment (17 acetaminophen with codeine vs 18 diflunisal). Both groups were similar in the amount of pain and type of injury at initiation of therapy. Patient pain rating went from 3.3 +/- 0.6 to 1.6 +/- 1.5 for acetaminophen with codeine and from 3.3 +/- 0.6 to 1.3 +/- 1.1 for diflunisal. However, 65 percent of acetaminophen with codeine patients experienced side effects, with 35 percent of these patients stopping the medication because of intolerable side effects. In the diflunisal group, 28 percent of the patients experienced side effects and 5 percent had to stop the medication early. Diflunisal was found to be an effective analgesic in mild to moderate pain of acute soft tissue injuries, and caused fewer and more tolerable side effects than did acetaminophen with codeine.
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PMID:Treatment of mild to moderate pain of acute soft tissue injury: diflunisal vs acetaminophen with codeine. 294 30


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