A survey on PPA-containing products consumption was conducted in 10 pharmacies located in Hanoi from February to May 2002. It revealed that there were 20 such products available in the market(of them, 16 were domestic). The PPA content as base form in a single dose of all these preparations was not exceeded 25mg. During the studied period, out of 250 people buying medication for cough and cold, 74 people (29.6% bought PPA-containing products with the most purchased ones were Decolgen forte and Rhumenol. Many patients with cough and cold consumed relatively high amount of PPA, not being aware of its adverse effects and contraindications
Pharmacy ; Analgesics, Non-Narcotic ; utilization ; Drugs, Investigational

An HPLC method for simultaneous determination of Dextromethorphan hydrobromide, Clorpheniramine maleate, Guaiphenesin, and Phenylpropanolamine hydrochloride in tablets, capsules or in syrups is introduced. The chromatographic conditions are as follows: Column: Lichrosorb Si 60(250X 4 mm; 5mm); Mobile phase: Water: 0.001 M Ammonium Perchlorate methanolic solution pH6.7:20:80; Flow rate: 0.8 ml/min; UV- Detector at 254 nm. Experimental results showed that the method is accurate (er = 0.69 - 3.19%; recoveries: 98.7-101.9%).
Pharmaceutical Preparations ; Dextromethorphan ; Chlorpheniramine ; Analgesics, Non-Narcotic ; Analgesics

Cancer pain patients have various diagnosis, stage of disease, response to pain, and treatments and individualized treatment methods are thus needed. Use of Nonopioid analgesics is the first step treatment (according to WHO ladder) for mild to moderate pain, and may be useful for second or third step treatments when combined with weak or strong opioids to reduce side effects of opioids and to create synergy between the two drugs. Acetaminophen and nonsteroidal antiinflammatory drugs(NSAIDs) are also nonopioid analgesics. NSAIDs have a ceiling effect, along with antipyretic, analgesic and antiinflammatory effects, while not producing physical and psychological dependence. Adverse effects of NSAIDs include gastrointestinal hemorrhage, coagulopathy, and deterioration of renal function.
Acetaminophen ; Analgesics ; Analgesics, Non-Narcotic ; Analgesics, Opioid ; Anti-Inflammatory Agents, Non-Steroidal ; Gastrointestinal Hemorrhage ; Humans ; Resin Cements

An association between non-opioid analgesic agents and chronic kidney disease has long been suspected. The presumed development of chronic renal impairment following protracted and excessive use of non-opioid analgesia is known as analgesic nephropathy. Many clinicians accept analgesic nephropathy as a real entity despite the paucity of scientific evidence. This narrative review aims to summarize the literature in the field. The weight of available observational literature suggests that long-term ingestion of paracetamol and combination mixtures of aspirin and paracetamol are likely to contribute to chronic renal impairment. However, there is no convincing data to implicate non-steroidal anti-inflammatory drugs or aspirin monotherapy in the development of analgesic nephropathy. In the absence of high-level evidence, while controversy persists, it may be prudent for physicians to consider all non-narcotic analgesics to be nephrotoxic with long-term use.
Acetaminophen ; Analgesia ; Analgesics* ; Analgesics, Non-Narcotic ; Aspirin ; Eating ; Renal Insufficiency ; Renal Insufficiency, Chronic

An association between non-opioid analgesic agents and chronic kidney disease has long been suspected. The presumed development of chronic renal impairment following protracted and excessive use of non-opioid analgesia is known as analgesic nephropathy. Many clinicians accept analgesic nephropathy as a real entity despite the paucity of scientific evidence. This narrative review aims to summarize the literature in the field. The weight of available observational literature suggests that long-term ingestion of paracetamol and combination mixtures of aspirin and paracetamol are likely to contribute to chronic renal impairment. However, there is no convincing data to implicate non-steroidal anti-inflammatory drugs or aspirin monotherapy in the development of analgesic nephropathy. In the absence of high-level evidence, while controversy persists, it may be prudent for physicians to consider all non-narcotic analgesics to be nephrotoxic with long-term use.
Acetaminophen ; Analgesia ; Analgesics* ; Analgesics, Non-Narcotic ; Aspirin ; Eating ; Renal Insufficiency ; Renal Insufficiency, Chronic

A review of the literature on cancer pain revealed that many persons with cancer receive inadequate analgesia for pain control, due in part to a lack of knowledge of the control of cancer pain by both physicians and nurses. This study is composed of two parts : one is to train nurses to change their knowledge of and attitude toward the pain management of patients having cancer and to evaluate the effectiveness of this training in comparison with other non-trained group ; the other is to test the applicability of the pain management method knowledge and attitude in the levels of pain of oncology patients. General characteristics of nurses such as age, education, educational experiences of cancer pain management were not different in both groups except the clinical experience. General characteristics of cancer patients and pain-related variables such as pain, sleep, daily activities, treatment modalities, causes of pain were not different in both groups except the educational levels of patients. After an eight-hour educational program given to the experimental nurse group, the knowledge and attitude about assessment of cancer pain, pain medication, and pharmacological knowledge were significantly higher in the experimental group than in the control group, while knowledge about classification of analgesics was not significantly different. The amount of analgesics, measured by the morphine equivalent doses, used in the experimental group was significantly lower than in the control group in the first and the last days. The experimental group used more systematic ways of drug changes from non-narcotic analgesics to narcotic analgesics than the control group. This indicated that the control group used fentanyl patches more commonly than in the control group. Cancer pain scores of both group of patients were measured on an hourly bases for a week in both groups. The patients' pain scores of the first day of measurement in experimental group were not significantly higher than those of control group of patients, while those of the last day were significantly higher than those of the control group. This study supports the need for educational program for the management of cancer pain to the nurses and the doctors.
Analgesia ; Analgesics ; Analgesics, Non-Narcotic ; Classification ; Education ; Fentanyl ; Humans ; Morphine ; Narcotics ; Pain Management*

PURPOSE: To assess the effectiveness of a care map for a fast-track discharge program after colorectal cancer surgery. METHODS: Ninety-nine patients who underwent colorectal surgery were retrospectively analyzed: 45 patients who were placed in a conventional program (January 3 to March 13, 2013) and 44 patients who were placed in a fast-track program using the care map (July 26 to September 24, 2014). Patients in the fast-track program started eating on postoperative day 1, while those in the conventional program started eating on post-operative day 2. complications, and pain were compared between the two groups. RESULTS: A slight decrease in the average duration of hospitalization was observed for the fast-track group (5.31+/-0.98 days) compared to the conventional group (5.38+/-2.80 days), although this difference was not statistically significant. All other outcomes for the fast-track group were scored as 0. Furthermore, there was no statistically significant differences between pain, narcotics administration, and non-narcotic analgesics (aside from patient-controlled analgesia). CONCLUSION: The care map for the colorectal surgery fast-track program was effective and program validation and supplementation of the active standardization early recovery program should be performed using multi-disciplinary research.
Analgesics, Non-Narcotic ; Colorectal Neoplasms* ; Colorectal Surgery ; Eating ; Hospitalization ; Humans ; Narcotics ; Retrospective Studies

OBJECTIVES: The hepatotoxicity of acetaminophen is not a result of the parent compound but is mediated by its reactive metabolite N-acetyl-p-benzoquinone imine. Cytochrome P4502E1 (CYP2E1) is the principal enzyme of this biotransformation, which accounts for approximately 52% of the bioactivation in human microsomes. Recently, chlormethiazole a sedative drug, is reported to be an efficient inhibitor of CYP2E1 activity in human beings. In this study we wished to evaluate whether chlormethiazole, an inhibitor of CYP2E1, could prevent acetaminophen-induced liver injury in mice. METHODS: Acetaminophen, at doses ranging from 200 to 600 mg/kg, was injected into the peritoneum of female C57BL/6 inbred mice fasted for four hours. Chlormethiazole (60 mg/kg) or 5% dextrose water was given 30 min before or 2 h after acetaminophen. Serum aminotransferase activities, histologic index score, survival rate and hepatic malondialdehyde levels were compared. RESULTS: Pretreatment with chlormethiazole 30 min before 400 mg/kg of acetaminophen completely inhibited acetaminophen-induced liver injury (median 118.5 U/L, range 75 to 142 vs. 14,070 U/L, range 5980 to 27,680 for AST; 49 U/L, range 41 to 64 vs. 15,330 U/L, range 13,920 to 15,940 for ALT). In mice receiving chlormethiazole 2 h after acetaminophen, the mean AST and ALT levels were also less elevated, reaching only 20% of the value of acetaminophen-only group. These protective effects were confirmed histologically. Whereas more than 50% of mice died at 500 mg/kg of acetaminophen, all the mice pretreated with chlormethiazole survived at the same dose. CONCLUSION: Chlormethiazole effectively reduces acetaminophen-induced liver injury in mice. Further studies are needed to assess its role in humans.
Acetaminophen/toxicity* ; Acetaminophen/metabolism ; Acetaminophen/antagonists & inhibitors ; Analgesics, Non-Narcotic/toxicity* ; Analgesics, Non-Narcotic/metabolism ; Analgesics, Non-Narcotic/antagonists & inhibitors ; Animal ; Chlormethiazole/pharmacology* ; Cytochrome P-450 CYP2E1/antagonists & inhibitors ; Enzyme Inhibitors/pharmacology ; Female ; Human ; Liver/metabolism ; Liver/injuries* ; Liver/drug effects* ; Mice ; Mice, Inbred C57BL ; Sedatives, Nonbarbiturate/pharmacology* ; Support, Non-U.S. Gov't

Chronic pain is associated with disabling physical and emotional symptoms. Patients with chronic pain utilize more health services, have an impaired sense of well-being and frequently experience anxiety or depression. Unfortunately, treatment for chronic pain is not always correctly targeted, which leads to a reduced quality of life. Treatment of chronic pain involves a comprehensive approach using medication and functional rehabilitation. The usual approach for mild to moderate pain is to start with nonopioid analgesics. Also, trying antidepressant drugs for sleep loss and gabapentin for neuropathic pain or fibromyalgia is appropriate. For moderate to severe chronic pain, opioid analgesics can be used without any serious side effects if adequately used at the right dosage. It is important to provide guidance on the safe use of analgesics and other psychoactive drugs. Dosing of acetaminophen should be limited to avoid liver toxicity, and topical analgesics are preferred for focal pain. Full-dose nonsteroidal anti-inflammatory drugs should not be used for more than short periods, in order to avoid gastrointestinal, renal, and cardiovascular complications. Mechanisms of analgesia, drug selection, and recommendations for clinical usage for the management of chronic pain are reviewed in this paper.
Acetaminophen ; Amines ; Analgesia ; Analgesics ; Analgesics, Non-Narcotic ; Analgesics, Opioid ; Antidepressive Agents ; Anxiety ; Chronic Pain ; Cyclohexanecarboxylic Acids ; Depression ; Fibromyalgia ; gamma-Aminobutyric Acid ; Health Services ; Humans ; Liver ; Neuralgia ; Psychotropic Drugs ; Quality of Life

Acetaminophen ; therapeutic use ; Analgesics, Non-Narcotic ; therapeutic use ; Aspirin ; therapeutic use ; Fever ; drug therapy ; etiology ; Humans ; Ibuprofen ; therapeutic use ; Sulfonamides ; therapeutic use