European journal of clinical pharmacology
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Eur. J. Clin. Pharmacol. · Jan 1998
Randomized Controlled Trial Clinical TrialLack of acetaminophen ceiling effect on R-III nociceptive flexion reflex.
The analgesic efficacy of intravenous doses of acetaminophen (paracetamol) 0.5 g, 1 g and 2 g (administered as propacetamol) was assessed in 11 healthy subjects in a randomised, double-blind, placebo-controlled crossover study. The antinociceptive effect was assessed over 8 h by measurement of the nociceptive flexion reflex threshold (R-III) in response to selective transcutaneous electrical stimulations. ⋯ After acetaminophen 0.5 g, R-III increased to a mean maximum of 23% over baseline values; after 1 g to 28%, and after 2 g to 40%. The AUC(0-8 h) of the analgesic effects and the AUC(0-8 h) of plasma concentrations closely correlated and were dose-dependent: rs = 0.37, for R-III and rs = 0.94, for the plasma concentrations. Intravenous acetaminophen exerted a dose-dependent central antinociceptive effect.
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Eur. J. Clin. Pharmacol. · Jan 1998
Variability of morphine disposition during long-term subcutaneous infusion in terminally ill cancer patients.
To study the plasma concentrations of morphine and its glucuronides to assess the intra- and interindividual variability of the disposition of morphine administered by subcutaneous infusion in cancer patients. ⋯ During subcutaneous infusion of morphine, there is a large intra- and interindividual variability of the morphine disposition which could be of clinical relevance.
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To investigate the potential for embolisation, due to the piercing of suspect rubber seals ('coring') of intravenous (IV)-solution bottles by the sharp (plastic, non-patient end) spike of commonly used infusion sets. ⋯ The defectively packaged solutions (from B. Braun) have been used extensively in at least 21 different countries during the past decade and, unknown to clinicians, constituted a source of potential rubber emboli. The multinational manufacturer responsible has largely rectified the fault. Discovery of such defects requires prompt reporting to relevant government departments and the manufacturer, so that appropriate action may be taken nationally and internationally. Good manufacturing practice and drug regulatory surveillance should extend to the way in which the final packaged forms are used.