Journal of clinical pharmacy and therapeutics
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Randomized Controlled Trial Multicenter Study
Efficacy of oxycodone/paracetamol for patients with bone-cancer pain: a multicenter, randomized, double-blinded, placebo-controlled trial.
Bone-cancer pain is a common and refractory cancer pain. Opioids, on their own, do not control this type of pain well enough, and co-analgesics are necessary. ⋯ Patients with bone-cancer pain, already on opioids, obtain clinically important, additional pain-control, with regular oxycodone/paracetamol dosing.
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Interindividual variability in drug responses may be attributable to genetically determined alteration in enzyme activity. In this study, we investigated the association between cytochrome P450 3A4 (CYP3A4) genetic polymorphisms and post-operative fentanyl requirements. ⋯ CYP3A4*4 and CYP3A4*5 are rare in the Malaysian Malay population. Genetic polymorphism of CYP3A4*18 may not play an important role in influencing postoperative fentanyl requirements.
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Adherence to evidence-based drug therapy after acute myocardial infarction has increased over the last decades, but is still unsatisfactory. Our objectives are to set out to analyse patterns of evidence-based drug therapy after acute myocardial infarction (AMI), and evaluating socio-demographic differences. ⋯ The availability of information systems offers the opportunity to monitor the quality of care and identify weaknesses in public health-care systems. Our results identify specific factors contributing to non-adherence and hence define areas for more targeted health-care interventions. Our results suggest that efforts to improve adherence should focus on women and older patients.
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Morphine is used routinely in clinical practice to manage moderate to severe pain, whereas levomepromazine is commonly used at low doses to manage intractable nausea and vomiting. While it has been reported that an injection combination of morphine sulphate (0·5 mg/mL) and levomepromazine (0·1 mg/mL) was physically compatible, data on the chemical stability of combinations of these drugs has not been reported. Thus, a method was required for the assessment of the stability of morphine sulphate/levomepromazine hydrochloride combinations. ⋯ Morphine sulphate was stable under all storage conditions, but the degree of degradation of levomepromazine hydrochloride increased as the storage temperature increased. The disappearance of levomepromazine hydrochloride was correlated with the appearance of a sulphoxide degradant. WHAT IS NEW CONCLUSION: The injection combinations of morphine sulphate and levomepromazine hydrochloride were shown in the current study to have a limited storage life with respect to their levomepromazine hydrochloride content.