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Latest & greatest articles for acetaminophen
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Acetaminophen (Paracetamol) is the short-term drug of choice for orthodontic pain UTCAT3387, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Acetaminophen (Paracetamol) is the short-term drug of choice for orthodontic pain. Clinical Question In patients experiencing pain from orthodontic tooth movement, what is the drug of choice to relieve pain without the inhibition of orthodontic tooth movement? Clinical Bottom Line (...) Acetaminophen is comparable to systemic NSAIDs in terms of relieving orthodontic pain without the side effects of NSAIDs that could inhibit orthodontic tooth movement. 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) Fang et al/2016 128 patients undergoing orthodontic treatment Meta-Analysis Key results Throughout five different studies included, celecoxib, acetaminophen, and aspirin were used to determine
Effect of Intravenous Acetaminophen vs Placebo Combined With Propofol or Dexmedetomidine on Postoperative Delirium Among Older Patients Following Cardiac Surgery: The DEXACET Randomized Clinical Trial. Postoperative delirium is common following cardiac surgery and may be affected by choice of analgesic and sedative.To evaluate the effect of postoperative intravenous (IV) acetaminophen (paracetamol) vs placebo combined with IV propofol vs dexmedetomidine on postoperative delirium among older (...) patients undergoing cardiac surgery.Randomized, placebo-controlled, factorial clinical trial among 120 patients aged 60 years or older undergoing on-pump coronary artery bypass graft (CABG) surgery or combined CABG/valve surgeries at a US center. Enrollment was September 2015 to April 2018, with follow-up ending in April 2019.Patients were randomized to 1 of 4 groups receiving postoperative analgesia with IV acetaminophen or placebo every 6 hours for 48 hours and postoperative sedation
Effect of Combination of Paracetamol (Acetaminophen) and Ibuprofen vs Either Alone on Patient-Controlled Morphine Consumption in the First 24 Hours After Total Hip Arthroplasty: The PANSAID Randomized Clinical Trial. Multimodal postoperative analgesia is widely used but lacks evidence of benefit.Investigate beneficial and harmful effects of 4 nonopioid analgesics regimens.Randomized, blinded, placebo-controlled, 4-group trial in 6 Danish hospitals with 90-day follow-up that included 556 (...) patients undergoing total hip arthroplasty (THA) from December 2015 to October 2017. Final date of follow-up was January 1, 2018.Participants were randomized to receive paracetamol (acetaminophen) 1000 mg plus ibuprofen 400 mg (n = 136; PCM + IBU), paracetamol 1000 mg plus matched placebo (n = 142; PCM), ibuprofen 400 mg plus matched placebo (n = 141; IBU), or half-strength paracetamol 500 mg plus ibuprofen 200 mg (n = 140; HS-PCM + IBU) orally every 6 hours for 24 hours postoperatively, starting 1
Intravenous vs Oral Acetaminophen for Analgesia After Cesarean Delivery: A Randomized Trial Examination of postoperative analgesia with intravenous and oral acetaminophen.Prospective, three-arm, nonblinded, randomized clinical trial.A single academic medical center.Parturients scheduled for elective cesarean delivery.This trial randomized 141 parturients to receive intravenous acetaminophen (1 g every eight hours, three doses), oral acetaminophen (1 g every eight hours, three doses (...) ), or no acetaminophen. All patients received a standardized neuraxial anesthetic with intrathecal opioids and scheduled postoperative ketorolac. The primary outcome, 24-hour opioid consumption, was evaluated using the Kruskal-Wallace test and Tukey-Kramer adjustment for multiple comparisons. Secondary outcomes included 48-hour opioid consumption, first opioid rescue, pain scores, patient satisfaction, times to ambulation and discharge, and side effects.Over 18 months, 141 parturients with similar demographic
Randomized Clinical Trial of Intravenous Acetaminophen as an Analgesic Adjunct for Older Adults With Acute Severe Pain Older adults are at risk for undertreatment of pain. We examined intravenous (IV) acetaminophen as an analgesic adjunct to IV opioids in the care of older emergency department (ED) patients with acute severe pain.This was a randomized clinical trial conducted in two EDs in the Bronx, New York. Eligible adults aged 65 years and older with acute severe pain were randomized to 0.5 (...) mg of IV hydromorphone and 1 g of IV acetaminophen or 0.5 mg of IV hydromorphone and 100 mL of normal saline placebo. The primary outcome was the between group difference in improvement of numerical rating scale (NRS) pain scores at 60 minutes. Secondary outcomes were the between-group differences in the proportion of patients who chose to forgo additional pain medications at 60 minutes; the proportion who developed side effects; the proportion who required rescue analgesia; and between-group
Mind the gap on acetaminophen/fevers pathophysiology and patient outcomes Core IM: Mind the Gap on Acetaminophen/Fevers Pathophysiology and Patient Outcomes – Clinical Correlations Search Core IM: Mind the Gap on Acetaminophen/Fevers Pathophysiology and Patient Outcomes December 19, 2018 14 min read Podcast: | Subscribe: | Join us in this episode as we question everything you ever thought you knew about… acetaminophen and fevers || By Steven R. Liu MD and Dr. Janine Knudsen MD || Graphic Design (...) by Ramon Thompson Time Stamps: What data is there to support the use of acetaminophen as a fever reducer? (2:08) Does acetaminophen improve patient outcomes? (4:30) How does acetaminophen compare to other medications like NSAIDs? (9:56) What is the mechanism of acetaminophen action? (10:50) Review of teaching points (16:02) Thank you to Dr. Michael Pillinger, Professor of Rheumatology at NYU and Chief of Rheumatology at the NY Harbor VA Hospital, for peer reviewing this podcast! Subscribe to CORE IM
Intravenous versus oral acetaminophen for postoperative pain: systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email
Association of acetaminophen use with risk of renal impairment: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files
Acetaminophen and Febrile Seizure Recurrences During the Same Fever Episode To confirm the safety of using acetaminophen for febrile seizures (FSs) and to assess its efficacy in preventing FS recurrence during the same fever episode.In this single-center, prospective, open, randomized controlled study, we included children and infants (age range: 6-60 months) with FSs who visited our hospital between May 1, 2015, and April 30, 2017. The effectiveness of acetaminophen was examined by comparing (...) the recurrence rates of patients in whom rectal acetaminophen (10 mg/kg) was administered every 6 hours until 24 hours after the first convulsion (if the fever remained >38.0°C) to the rates of patients in whom no antipyretics were administered. No placebo was administered to controls. The primary outcome measure was FS recurrence during the same fever episode.We evaluated 423 patients; of these, 219 were in the rectal acetaminophen group, and 204 were in the no antipyretics group. In the univariate analysis
Randomized Controlled Trial of Intravenous Acetaminophen Versus Intravenous Hydromorphone for the Treatment of Acute Pain in the Emergency Department As clinicians look to nonnarcotic analgesics in the emergency department (ED), it is essential to understand the effectiveness and adverse effects of nonopioid medications in comparison with existing opioid treatments. Studies of intravenous acetaminophen for acute pain in the ED demonstrate mixed results and suffer from small sample sizes (...) and methodological limitations. This study compares intravenous hydromorphone with intravenous acetaminophen in adult ED patients presenting with acute pain.This was a prospective, randomized, clinical trial comparing 1 g intravenous acetaminophen with 1 mg intravenous hydromorphone for treatment of adults with severe, acute pain in the ED. The primary outcome was between-group difference in change in numeric rating scale from baseline to 60 minutes postadministration of study medication. Secondary outcomes
Acetaminophen Top results for acetaminophen - Trip Database or use your Google+ account Turning Research Into Practice ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2 (...) ) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Latest & greatest articles for acetaminophen The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms
Effect of ibuprofen vs acetaminophen on postpartum hypertension in preeclampsia with severe features: a double-masked, randomized controlled trial Nonsteroidal antiinflammatory drug use has been shown to increase blood pressure in nonpregnant adults. Because of this, the American College of Obstetricians and Gynecologists suggests avoiding their use in women with postpartum hypertension; however, evidence to support this recommendation is lacking.Our goal was to test the hypothesis (...) that nonsteroidal antiinflammatory drugs, such as ibuprofen, adversely affect postpartum blood pressure control in women with preeclampsia with severe features.At delivery, we randomized women with preeclampsia with severe features to receive around-the-clock oral dosing with either 600 mg of ibuprofen or 650 mg of acetaminophen every 6 hours. Dosing began within 6 hours after delivery and continued until discharge, with opioid analgesics available as needed for breakthrough pain. Study drugs were encapsulated
Intravenous acetaminophen for postoperative supratentorial craniotomy pain: a prospective, randomized, double-blinded, placebo-controlled trial In BriefThe authors designed a randomized, double-blinded, placebo-controlled trial to evaluate intravenous acetaminophen as a scheduled adjunct with our standardized craniotomy pain control regimen. No statistically significant effect was found in narcotic consumption at 24 or 48 hours after surgery. At 24 but not 48 hours, patients treated (...) with intravenous acetaminophen did report significantly lower pain scores than patients given the placebo. These data provide only modest support for using intravenous acetaminophen to improve postoperative craniotomy pain.
Paracetamol (acetaminophen) for patent ductus arteriosus in preterm or low birth weight infants. In preterm newborns, the ductus arteriosus frequently fails to close and the infants require medical or surgical closure of the patent ductus arteriosus (PDA). A PDA can be treated surgically; or medically with one of two prostaglandin inhibitors, indomethacin or ibuprofen. Case reports suggest that paracetamol may be an alternative for the closure of a PDA. An association between prenatal
Association of Placebo, Indomethacin, Ibuprofen, and Acetaminophen With Closure of Hemodynamically Significant Patent Ductus Arteriosus in Preterm Infants: A Systematic Review and Meta-analysis. Despite increasing emphasis on conservative management of patent ductus arteriosus (PDA) in preterm infants, different pharmacotherapeutic interventions are used to treat those developing a hemodynamically significant PDA.To estimate the relative likelihood of hemodynamically significant PDA closure (...) with common pharmacotherapeutic interventions and to compare adverse event rates.The databases of MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception until August 15, 2015, and updated on December 31, 2017, along with conference proceedings up to December 2017. Randomized clinical trials that enrolled preterm infants with a gestational age younger than 37 weeks treated with intravenous or oral indomethacin, ibuprofen, or acetaminophen vs each other, placebo
Efficacy of Intravenous Acetaminophen in Periimplantation Pain of Cardiac Electronic Devices: A Randomized Double-Blinded Study. Although intravenous acetaminophen has been administered to reduce postoperative pain, it has not been used during cardiac implantable electronic devices (CIEDs) implantation.This was a randomized double-blinded interventional study.Thirty-two patients who were referred for new CIED implantation during July 2012 until April 2013 randomly received placebo or 1 g (...) of intravenous acetaminophen. All patients were treated with local anesthesia. Pain score during incision, pocket creation, and in the recovery room, and the patients' need for analgesics during the 6 hours after the procedure were recorded in both groups.Seventeen and 15 patients received acetaminophen and placebo, respectively. Pain scores in patients treated with acetaminophen were significantly lower (4.4 vs 2.9, P = .004), and they received less analgesics (17% vs 60%, P = .014).Intravenous
Preoperative cesarean delivery intravenous acetaminophen treatment for postoperative pain control: a randomized double-blinded placebo control trial The United States currently has an opioid use disorder epidemic and research evaluating ways to minimize the use of opioids postsurgery are needed. One of these options is intravenous acetaminophen. If the use of preoperative intravenous acetaminophen was found to be effective for cesarean delivery, this would be beneficial for both the mother (...) and breast-feeding neonate.The primary study objective was to see if maternal opioid use was significantly less in the postoperative period for the study group that received 1 g of intravenous acetaminophen preoperatively compared with a control group that received placebo. The secondary objectives were to evaluate maternal length of stay and pain scores postoperatively, and assess the acetaminophen level in cord blood at delivery.This study was a prospective double-blinded randomized placebo-controlled
Interventions for paracetamol (acetaminophen) overdose. Paracetamol (acetaminophen) is the most widely used non-prescription analgesic in the world. Paracetamol is commonly taken in overdose either deliberately or unintentionally. In high-income countries, paracetamol toxicity is a common cause of acute liver injury. There are various interventions to treat paracetamol poisoning, depending on the clinical status of the person. These interventions include inhibiting the absorption of paracetamol
CRACKCast Episode 148 – Acetaminophen CRACKCast Episode 148 - Acetaminophen - CanadiEM CRACKCast Episode 148 – Acetaminophen In , by Adam Thomas January 29, 2018 This 148th episode of CRACKCast covers Rosen’s 9th edition, Chapter 143, acetaminophen. Also known as paracetamol and Tylenol, you need to know this overdose cold! Shownotes – Rosen’s In Perspective YOU NEED TO KNOW THIS OVERDOSE COLD!!! Acetaminophen (aka paracetamol aka APAP) is ubiquitous. It’s hard to find a house these days (...) , vinyl chloride, and polychlorinated biphenyls) Core questions  Describe the metabolism of acetaminophen 4 pathways Glucuronidation (50% range 40-67%) Sulfation (30% range 20-46%) CYP (~10%) Direct Renal Clearance (~10%) Where it all goes bad for the body: N-acetyl-P-Aminophenol (aka Tylenol) gets oxidised via CYP2E1 to N-acetyl- p-benzoquinone imine NAPQI This is the TOXIC METABOLITE NAPQI usually combines with glutathione and gets excreted (renal) With toxic ingestion, this system gets over-run