Objectives: There is good evidence that opioids can potentiate analgesic activity of some older non-opioid analgesics (such as paracetamol or ibuprofen) but it is not known whether this also holds true for newer non-opioid analgesics that selectively inhibit cyclooxygenase 2 (coxibs). This study was undertaken to determine the nature of the interaction between codeine and celecoxib or etoricoxib in peritoneal irritation-induced visceral pain in mice. For comparison, interactions of codeine with paracetamol and ibuprofen were also tested using the same method.
Material And Methods: A small volume of a weak acetic acid (0.6%) was injected into the peritoneal cavity and the number of writhes (contractions of abdominal muscles) was counted. All drugs were given orally. Their interaction was characterized using isobolographic analysis.
Results: Codeine, etoricoxib, celecoxib, ibuprofen and paracetamol all independently produced dose-dependent suppression of writhing. The isobolographic analysis carried out using equipotent dose ratios showed that the interactions between codeine and etoricoxib or celecoxib were sub-additive or additive, respectively. This was in contrast to combinations of codeine with ibuprofen or paracetamol, which were supra-additive. Interaction indexes γ, determined as a ratio between experimental and theoretical ED50 values of the mixture, were as follows: 2.7 for codeine + etoricoxib, 0.62 for codeine + celecoxib, 0.43 for codeine + ibuprofen and 0.33 for codeine + paracetamol.
Conclusions: These and other results suggest that opioids do not seem to potentiate analgesic effects of selective COX-2 inhibitors, in contrast to nonselective COX inhibitors or paracetamol.
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J Pediatr Nurs
January 2025
University of Newcastle, Australia; Centre for Transformative Nursing, Midwifery, and Health Research: A JBI Centre of Excellence, Australia.
Objective: This review aims to investigate parents' preference for and use of Ibuprofen and Paracetamol in managing and treating children's fevers as well as the factors influencing their decision-making and practices.
Introduction: Parents globally face concern over managing children's fever, seeking relief while ensuring safety, often relying on accessible medications like Paracetamol and Ibuprofen.
Inclusion Criteria: The review included quantitative studies involving parents and caregivers managing fever in children aged 0-17 years.
J Psychoactive Drugs
January 2025
Department of Pharmaceutical Care, King Fahad Medical City, Riyadh, Saudi Arabia.
The use of analgesics has increased globally over the last three decades. Prescription drug abuse has increased significantly, and opioids have been identified as causing further harm to the world. This study explored the utilization and expenditure associated with opioids and non-steroidal anti-inflammatory drugs (NSAIDs) from 2010 to 2020 in Saudi Arabia.
View Article and Find Full Text PDFBackground: Opioids are still being prescribed to manage acute postsurgical pain. Unnecessary opioid prescriptions can lead to addiction and death, as unused tablets are easily diverted.
Methods: To determine whether combination nonopioid analgesics are at least as good as opioid analgesics, a multisite, double-blind, randomized, stratified, noninferiority comparative effectiveness trial was conducted, which examined patient-centered outcomes after impacted mandibular third-molar extraction surgery.
Toxins (Basel)
December 2024
Nephrology and Renal Transplantation, Hospital Clínic de Barcelona, 08036 Barcelona, Spain.
Pain is a frequent and disturbing symptom among hemodialysis patients. Protein-bound uremic toxins (PBUTs) are related to cardiovascular and overall mortality, and they are difficult to remove with current hemodialysis treatments. The PBUT displacers, such as furosemide, tryptophan, or ibuprofen, may be promising new strategies for improving their clearance.
View Article and Find Full Text PDFOpen Access Emerg Med
December 2024
Department of Emergency Medicine, Northwell, New Hyde Park, NY, USA.
Purpose: We describe emergency medical services (EMS) protocols for pain management in the United States to elucidate systemic variability in protocols. We describe types of pain medications included in protocols, routes of administration, indications for use, standing orders for dosing, and use in pediatric patients.
Methods: We performed a review of all publicly accessible EMS protocols from the website http://www.
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