Articles: analgesics.
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Comparative Study Clinical Trial
An analgesic relative potency assay comparing zomepirac sodium and aspirin.
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Postoperative pain relief is only apparently an easy task. A brief survey of literature investigating the discomfort experienced in the postoperative phase is all but encouraging. ⋯ An alternative strategy introducing "On-Demand" analgesia administering prescribed doses at the right moment is presented and analysed a) as an operant conditioning process implementing a particular reinforcement schedule (behavioural sciences), as well as b) a negative feedback control loop that entrust the central judgement to the patient (system theory). Both approaches give insight into the results: the technique copes with biological variability; anticipating pain induced by fear disappears; the feedback strategy works well and patients adapt to a wide range in prescriptions; intermittent administration makes more efficient use of the analgesic; an optimal result is demonstrated in studies comparing on-demand analgesia with the normal IM-regime and epidural analgesia; continuity in pain relief can be obtained in routine clinical practice.
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Eur. J. Clin. Pharmacol. · Jan 1980
Clinical pharmacokinetics and oral bioavailability of ketobemidone.
The basic pharmacokinetics and oral bioavailability of ketobenmidone have been studied in 6 patients after surgery. Plasma concentrations were first determined following intravenous administration of Ketogin 2 ml, containing ketobemidone chloride 10 mg and the spasmolytic N,N-dimethyl-3,3-diphenyl-1-methylallylamine chloride 50 mg, and then, on the second postoperative day, following oral administration of 2 tablets of Ketogin, each containing ketobemidone chloride 5 mg and the spasmolytic agent 25 mg. ⋯ The mean plasma half-life of elimination (t1/2 beta) was about the same following oral (2.45 +/- 0.73 h; SD, n = 5) as after intravenous administration (2.25 +/- 0.35 h; SD, n = 6). The low oral bioavailability and rapid elimination of ketobemidone demonstrated in this study suggest that the usual dosage recommendation for oral Ketogin (ketobemidone 5--10 mg every 6--7 h) in patients with severe pain is too low.
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The use of analgesic drugs is only one part of a multidisciplinary approach which offers also other possible palliative procedures for pain therapy. Pain complaints are placed against the background of terminal illness. ⋯ The way of adminstration may have some impact on the efficacy of the analgesic regimen. Side effects and concomitant medication are reviewed.