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Oral route: Acetaminophen and codeine oral suspension is used to relieve mild to moderate pain.

By mouth: Treats mild to moderately severe pain. This medicine contains a narcotic pain reliever.

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Results: 21 to 40 of 84

Opioid therapy for treating rheumatoid arthritis pain 

This summary of a Cochrane review presents what we know from research about the effect of opioids for treating rheumatoid arthritis pain.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Opioid-induced respiratory depression in paediatrics: a review of case reports

Opioids remain the cornerstone of modern-day pain treatment, also in the paediatric population. Opioid treatment is potentially life-threatening, although there are no numbers available on the incidence of opioid-induced respiratory depression (OIRD) in paediatrics. To get an indication of specific patterns in the development/causes of OIRD, we searched PubMed (May 2012) for all available case reports on OIRD in paediatrics, including patients 12 yr of age or younger who developed OIRD from an opioid given to them for a medical indication or due to transfer of an opioid from their mother in the perinatal setting, requiring naloxone, tracheal intubation, and/or resuscitation. Twenty-seven cases are described in 24 reports; of which, seven cases were fatal. In eight cases, OIRD was due to an iatrogenic overdose. Three distinct patterns in the remaining data set specifically related to OIRD include: (i) morphine administration in patients with renal impairment, causing accumulation of the active metabolite of morphine; (ii) codeine use in patients with CYP2D6 gene polymorphism associated with the ultra-rapid metabolizer phenotype, causing enhanced production of the morphine; and (iii) opioid use in patients after adenotonsillectomy for recurrent tonsillitis and/or obstructive sleep apnoea, where OIRD may be related to hypoxia-induced enhancement of OIRD. Despite the restrictions of this approach, our analysis does yield an important insight in the development of OIRD, with specific risk factors clearly present in the data.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Pharmacologic interventions in the treatment of temporomandibular disorders, atypical facial pain, and burning mouth syndrome: a qualitative systematic review

AIMS: To carry out a systematic review of the literature in order to assess the pain-relieving effect and safety of pharmacologic interventions in the treatment of chronic temporomandibular disorders (TMD), including rheumatoid arthritis (RA), as well as atypical facial pain (AFP), and burning mouth syndrome (BMS).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2003

Pharmacological and non-pharmacological interventions for cough in adults with respiratory and non-respiratory diseases: a systematic review of the literature

The authors concluded that the evidence for the effectiveness of pharmacological and non-pharmacological interventions to relieve cough in adults with non-malignant respiratory conditions was limited. Many trials had conflicting results and were hindered by variable quality scores and small sample sizes. The authors' conclusion is likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Assessment and Management of Chronic Cough [Internet]

Cough is the most common complaint for patients seeking medical attention in the United States. Although the most common cause of cough is acute self-limited viral infections, chronic cough (cough that lasts more than 4 weeks in children <14 years of age or more than 8 weeks in adolescents and adults) has a significant impact on quality of life and is responsible for up to 38 percent of pulmonary outpatient visits. Furthermore, a treatable cause is absent in up to 46 percent of patients with chronic cough despite a thorough diagnostic investigation. The comparative value of tools for assessing cough and the comparative effectiveness of treatments for unexplained or refractory cough are uncertain.

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: January 2013
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Opioids for chronic noncancer pain: a meta-analysis of effectiveness and side effects

The review concluded that opioids are superior to placebo for pain relief and functional outcomes in all types of chronic noncancer pain; non-opioids are superior to weak opioids for functional outcomes; strong opioids are superior to non-opioids for pain relief; and constipation and nausea occur more commonly with opioids. The conclusion appears reliable according to the evidence presented.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2006

Opioids for osteoarthritis

This summary of a Cochrane review presents what we know from research about the effect of opioids on osteoarthritis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Reducing prescribed opioid use in chronic non‐cancer pain

About 1 in 5 adults suffer from moderate or severe chronic pain that is not caused by cancer. Some people with this type of pain are treated with opioids (typically with drugs like morphine, codeine, oxycodone, fentanyl, or buprenorphine, either as tablets or as patches placed on the skin). It is not unusual for this medication to be ineffective or to stop working over time, and, sometimes, effective pain relief is not achieved despite doses being increased. Stopping using opioid drugs is not easy, especially when they have been used for some time, because stopping abruptly can cause unpleasant side effects. This review looked for high quality studies (randomised controlled trials) of treatments to help people safely stop taking opioids prescribed for their pain. Only two studies were found, and they investigated only 86 people. No conclusions can be drawn from this small amount of information. Non‐randomised studies, not included in this review, do indicate that in most people intensive rehabilitation packages can bring about major reduction in opioid use. Reducing prescribed opioid use in chronic non‐cancer pain is an important topic in need of more research.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Single dose oral aceclofenac for postoperative pain in adults

Pain is commonly experienced after surgical procedures. Acute postoperative pain of moderate or severe intensity is often used (as a model) to test whether or not drugs are effective painkillers. In this case we could find only a single study testing oral aceclofenac 150 mg against placebo, and aceclofenac was not statistically better than placebo. It is possible that other studies were done, possibly at larger or more effective doses, but not reported because they were used only to register aceclofenac with licensing authorities throughout the world. However, this leaves an important gap in our knowledge, and it means that we cannot be confident about using oral aceclofenac for acute painful conditions.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Comparing single doses of oral analgesics for acute pain in adults postoperation

All analgesic drugs (painkillers) are tested in standardised clinical studies of people with established pain following surgery, and often after removal of third molar (wisdom) teeth. In all these studies the participants have to have at least moderate pain in order for there to be a sensitive measure of pain‐relieving properties. The Cochrane Library has 35 reviews of oral analgesic interventions, with 38 different drugs, at various doses involving 45,000 participants in about 350 studies. This overview sought to bring all this information together, and to report the results for those drugs with reliable evidence about how well they work or any harm they may do in single oral doses.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Analgesic therapy in postherpetic neuralgia: a quantitative systematic review

The authors concluded that there was support for the use of tricyclic antidepressants, certain opioids, gabapentinoids and topical lidocaine and capsaicin. Overall, the review was well-conducted and the authors' conclusion reflects the evidence presented.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

Systematic review of the analgesic efficacy and tolerability of COX-2 inhibitors in post-operative pain control

OBJECTIVE: To evaluate the relative analgesic efficacy and tolerability of single-dose COX-2 inhibitors in post-operative pain management.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

Inpatient versus other settings for detoxification for opioid dependence

Dependence on opioid drugs, such as heroin, morphine, and codeine, is a serious problem in many societies. Opioids are very difficult to quit using. The first step to quitting is detoxification, which can cause a number of painful symptoms as the drug withdraws from the body. Many people choose an inpatient detoxification program rather than trying to stop using opioids on their own. In an inpatient program, medications such as methadone can ease the symptoms of withdrawal and patients are in a secure, supportive environment with no access to opiates. However, inpatient programs are expensive and can disrupt patients' lives. An increasing number of outpatient programs are available, providing medication and some support while keeping the drug user in the community. In addition to drop‐in programs, there are day centres and even residential facilities which are not staffed 24 hours, unlike inpatient programs. The authors of this review looked for research comparing inpatient and other types of opiate withdrawal programs to see which is more effective. They found only one study from 1975, which had 40 participants. The study suggested inpatient therapy might be more effective than outpatient therapy in the short‐term, but all of the inpatients relapsed within three months after detoxification. Since they found only one outdated study which included very few patients, the Cochrane review authors could not conclude whether inpatient treatment is more effective than outpatient or other settings. More research must be done to measure the benefits and costs of inpatient detoxification, especially for more severely dependent users.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Dihydrocodeine in a single dose in the treatment of acute postoperative pain

This review assessed the efficacy of single‐dose dihydrocodeine in adults with moderate/severe postoperative pain using information from randomised placebo controlled trials. There was a lack of data that could be included in the analyses; all assessed the oral form of the drug and none assessed dihydrocodeine 60 mg. The results were not robust. The implication was that single‐dose oral dihydrocodeine 30 mg was more effective than placebo, but was inferior to ibuprofen 400 mg. Dizziness, drowsiness and confusion were commonly reported.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Single dose oral fenoprofen for acute postoperative pain in adults

Fenoprofen is a non‐steroidal anti‐inflammatory drug (NSAID) that is used as a painkiller (analgesic). Five studies looking at a total of 696 participants were included. Because fewer than 200 participants were treated with any one dose of fenoprofen within each study, results must be treated with caution. A good level of pain relief was experienced by better than one in two (over half; 57%) of those with moderate or severe postoperative pain after a single dose of fenoprofen 200 mg, compared to about 1 in 7 (14%) with placebo. This level of pain relief is comparable to that experienced with ibuprofen 400 mg. The frequency of adverse events did not differ between fenoprofen 200 mg and placebo in these studies.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Single dose oxycodone and oxycodone plus paracetamol (also known as acetaminophen) for analgesia in adults with acute postoperative pain

This review update assessed evidence from 2641 participants in 20 randomised, double blind, placebo‐controlled clinical trials of oxycodone, with or without paracetamol, in adults with moderate to severe acute postoperative pain. Oral oxycodone 10 mg plus paracetamol 650 mg provided effective analgesia. About half of those treated experienced at least half pain relief over 4 to 6 hours, and the effects lasting up to 10 hours. Higher doses gave more effect. Associated adverse events (predominantly nausea, vomiting, dizziness and somnolence) were more frequent with oxycodone or oxycodone plus paracetamol than with placebo, but studies of this type are of limited use for studying adverse effects. Limited information about oxycodone on its own suggests that it provided analgesia at doses greater than 5 mg, and that addition of paracetamol made it more effective.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Single dose oral diflunisal for acute postoperative pain in adults

This review assessed evidence from nine randomised, double‐blind, placebo‐controlled clinical trials, in which there were 906 adults in comparisons of diflunisal (a non‐steroidal, anti‐inflammatory drug) with placebo for treatment of moderate to severe acute post‐operative pain. It is an effective analgesic over the dose range 250 mg to 1000 mg, with a long duration of action. At 1000 mg, the analgesic effect over 4 to 6 hours is as good as the combination of paracetamol 1000 mg and codeine 60 mg in similar studies using the same methods.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Regular painkillers in people undergoing laparoscopic cholecystectomy

About 10% to 15% of the adult western population have gallstones. Between 1% and 4% become symptomatic each year. Removal of the gallbladder (cholecystectomy) is the mainstay treatment for symptomatic gallstones. More than half a million cholecystectomies are performed per year in the US alone. Laparoscopic cholecystectomy (removal of gallbladder through a keyhole, also known as port) is now the preferred method of cholecystectomy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Single dose oral paracetamol (acetaminophen) for postoperative pain relief in adults

Pain is commonly experienced after surgical procedures, and is not always well controlled. This review assessed data from fifty‐one studies and found that paracetamol provided effective pain relief for about half of participants experiencing moderate to severe pain after an operation, including dental surgery for a period of about four hours. There were no clear differences between doses of paracetamol typically used. These single dose studies did not associate paracetamol with any serious side effects.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Dextropropoxyphene in a single dose taken on its own and also with paracetamol to treat postoperative pain

This review assessed the analgesic efficacy and adverse effects that single dose oral dextropropoxyphene taken alone or in combination with paracetamol had in treating moderate to severe postoperative pain. The combination of dextropropoxyphene 65 mg with paracetamol 650 mg showed similar efficacy to that of tramadol 100 mg for single dose studies in postoperative pain but with a lower incidence of side effects. This review also highlighted that Ibuprofen 400 mg was yet more effective than both tramadol 100 mg and dextropropoxyphene 65 mg.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Systematic Reviews in PubMed

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