There has been a trend over recent years for combining a nonsteroidal antiinflammatory drug (NSAID) with paracetamol (acetaminophen) for pain management. However, therapeutic superiority of the combination of paracetamol and an NSAID over either drug alone remains controversial.
A new systematic review has been published involving 20s RCTs and 1852 patients compared paracetamol/NSAID combinations with paracetamol alone.
In 16 studies (80%), an analgesic combination was more effective than acetaminophen alone for at least one of three measures of the following:
- pain score
- need for supplemental analgesia
- globally assessed pain relief).
The mean reduction in pain intensity was 35%, and the mean reduction in need for supplemental analgesics was 39%.
Click here for Journal Watch commentary.
Showing posts with label analgesia. Show all posts
Showing posts with label analgesia. Show all posts
Monday, April 12, 2010
Monday, January 11, 2010
CME Final Year Medical Students
Analgesia, Anaesthestics and Sedative Agents
Note:
Often my students have asked me what to present for this topic tutorial. I have revised, updated and included a few different links for you to prepare for this presentation.
Objective of this CME topic:
To give students a basic understanding on:
- the definition of pain as defined by the International Association for the Study of Pain (IASP).
(Click here for a list of definitions by IASP).
- the importance of pain management in emergency cases
- the different types of pain management modalities including pharmacological and non-pharmacological measures
- the physiological and psychological effects of pain
- the differences between analgesia and anaesthesia
- the different types of opioids used in emergency department including full agonists and partial agonists
- the different types of sedatives used in emergency department
- the different types of muscle relaxants used in emergency department
Topics for discussion:
TOPIC #1: Pain - In General
Definition by IASP
The importance of pain management in emergency cases
Physiological and psychological effects of pain
The WHO Pain Relief Ladder (click here for a description)
A general overview of the different modalities of pain treatment, divided according to pharmacological and non-pharmacological methods
TOPIC #2: Opioids
Discuss on the pharmacodynamics and pharmacokinetics of these common opioids used:
- Morphine
- Pethidine
- Fentanyl
Click here for the Merck Manual online.
TOPIC #3: Sedative Agents
Discuss on the concept of dissociative anaesthesia
Discuss on the pharmacology of
- Ketamine
- Propofol
- Etomidate
- Midazolam (as a prototype for benzodiazepine)
Know when to use which drugs under the different circumstances
Click here for the Wikipedia Portal Pharmacy and Pharmacology
Click here for the Virtual Anaesthesia Textbook online.
TOPIC #4: Muscle Relaxants
Discuss on the two classes of muscle relaxants - depolarizing and non-depolarizing and the differerences between these two in terms of mechanisms of action, and their basic pharmacodynamic and pharmacokinetics
Discuss pharmacodynamics and pharmacokinetics, and including side effects on
- succinylcholine
- atracurium and the concept of Hofmann elimination
- rocuronium and why it can be used for rapid sequence intubation in emergency department
- vecuronium and the importance of its cardio-stability properties.
- pancuronium - and its vagolytic effects.
Click here for comprehensive resource on rocuronium
Note:
Often my students have asked me what to present for this topic tutorial. I have revised, updated and included a few different links for you to prepare for this presentation.
Objective of this CME topic:
To give students a basic understanding on:
- the definition of pain as defined by the International Association for the Study of Pain (IASP).
(Click here for a list of definitions by IASP).
- the importance of pain management in emergency cases
- the different types of pain management modalities including pharmacological and non-pharmacological measures
- the physiological and psychological effects of pain
- the differences between analgesia and anaesthesia
- the different types of opioids used in emergency department including full agonists and partial agonists
- the different types of sedatives used in emergency department
- the different types of muscle relaxants used in emergency department
Topics for discussion:
TOPIC #1: Pain - In General
Definition by IASP
The importance of pain management in emergency cases
Physiological and psychological effects of pain
The WHO Pain Relief Ladder (click here for a description)
A general overview of the different modalities of pain treatment, divided according to pharmacological and non-pharmacological methods
TOPIC #2: Opioids
Discuss on the pharmacodynamics and pharmacokinetics of these common opioids used:
- Morphine
- Pethidine
- Fentanyl
Click here for the Merck Manual online.
TOPIC #3: Sedative Agents
Discuss on the concept of dissociative anaesthesia
Discuss on the pharmacology of
- Ketamine
- Propofol
- Etomidate
- Midazolam (as a prototype for benzodiazepine)
Know when to use which drugs under the different circumstances
Click here for the Wikipedia Portal Pharmacy and Pharmacology
Click here for the Virtual Anaesthesia Textbook online.
TOPIC #4: Muscle Relaxants
Discuss on the two classes of muscle relaxants - depolarizing and non-depolarizing and the differerences between these two in terms of mechanisms of action, and their basic pharmacodynamic and pharmacokinetics
Discuss pharmacodynamics and pharmacokinetics, and including side effects on
- succinylcholine
- atracurium and the concept of Hofmann elimination
- rocuronium and why it can be used for rapid sequence intubation in emergency department
- vecuronium and the importance of its cardio-stability properties.
- pancuronium - and its vagolytic effects.
Click here for comprehensive resource on rocuronium
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