1. What Pethidine Tablets Are and What They Are Used for 2. Before You
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Effects of Prophylactic Ketamine and Pethidine to Control Postanesthetic Shivering: a Comparative Study
Biomedical Research and Therapy, 5(12):2898-2903 Original Research Effects of prophylactic ketamine and pethidine to control postanesthetic shivering: A comparative study Masoum Khoshfetrat1, Ali Rosom Jalali2, Gholamreza Komeili3, Aliakbar Keykha4;∗ ABSTRACT Background: Shivering is an undesirable complication following general anesthesia and spinal anesthesia, whose early control can reduce postoperative metabolic and respiratory complications. Therefore, this study aims to compare the effects of prophylactic injection of ketamine and pethi- dine on postoperative shivering.Methods: This double-blind clinical trial was performed on 105 patients with short-term orthopedic and ENT surgery. The patients were randomly divided into three groups; 20 minutes before the end of the surgery, 0.4 mg/kg of pethidine was injected to the first group, 0.5 mg/kg of ketamine was injected to the second group, and normal saline was injected to the third group. After the surgery, the tympanic membrane temperature was measured at 0, 10, 20, and 30 minutes. The shivering was also measured by a four-point grading from zero (no shiv- ering) to four (severe shivering). Data were analyzed by one-way ANOVA, Kruskal Wallis, Chi-square 1Doctor of Medicine (MD), Fellow of and Pearson correlation. Results: The mean age of patients was 35.811.45 years in the ketamine Critical Care Medicine (FCCM), group, 34.811.64 years in the normal saline group, and 33.1110.5 years in the pethidine group. Department of Anesthesiology and The one-way ANOVA showed no significant difference in the mean age between the three groups Critical Care, Khatam-Al-Anbiya (P=0.645). -
The In¯Uence of Medication on Erectile Function
International Journal of Impotence Research (1997) 9, 17±26 ß 1997 Stockton Press All rights reserved 0955-9930/97 $12.00 The in¯uence of medication on erectile function W Meinhardt1, RF Kropman2, P Vermeij3, AAB Lycklama aÁ Nijeholt4 and J Zwartendijk4 1Department of Urology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands; 2Department of Urology, Leyenburg Hospital, Leyweg 275, 2545 CH The Hague, The Netherlands; 3Pharmacy; and 4Department of Urology, Leiden University Hospital, P.O. Box 9600, 2300 RC Leiden, The Netherlands Keywords: impotence; side-effect; antipsychotic; antihypertensive; physiology; erectile function Introduction stopped their antihypertensive treatment over a ®ve year period, because of side-effects on sexual function.5 In the drug registration procedures sexual Several physiological mechanisms are involved in function is not a major issue. This means that erectile function. A negative in¯uence of prescrip- knowledge of the problem is mainly dependent on tion-drugs on these mechanisms will not always case reports and the lists from side effect registries.6±8 come to the attention of the clinician, whereas a Another way of looking at the problem is drug causing priapism will rarely escape the atten- combining available data on mechanisms of action tion. of drugs with the knowledge of the physiological When erectile function is in¯uenced in a negative mechanisms involved in erectile function. The way compensation may occur. For example, age- advantage of this approach is that remedies may related penile sensory disorders may be compen- evolve from it. sated for by extra stimulation.1 Diminished in¯ux of In this paper we will discuss the subject in the blood will lead to a slower onset of the erection, but following order: may be accepted. -
Post- Operative Pain- Relief
PPoosstt-- OOppeerraattiivvee PPaaiinn-- RReelliieeff • Pain is often the patient’s presenting symptom. It can provide useful clinical information and it is your responsibility to use this information to help the patient and alleviate suffering. • Manage pain wherever you see patients (emergency, operating room and on the ward) and anticipate their needs for pain management after surgery and discharge. • Do not unnecessarily delay the treatment of pain; for example, do not transport a patient without analgesia simply so that the next practitioner can appreciate how much pain the person is experiencing. • Pain management is our job. Pain Management and Techniques • Effective analgesia is an essential part of postoperative management. • Important injectable drugs for pain are the opiate analgesics. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as diclofenac (1 mg/kg) and ibuprofen can also be given orally and rectally, as can paracetamol (15 mg/kg). • There are three situations where an opiate might be given: pre- operatively, intra-operatively, post-operatively. •• Opiate premedication is rarely indicated, although an injured patient in pain may have been given an opiate before coming to the operating room. • Opiates given pre- or intraoperatively have important effects in the postoperative period since there may be delayed recovery and respiratory depression, even necessitating mechanical ventilation. (continued to next page) PPoosstt-- OOppeerraattiivvee PPaaiinn-- RReelliieeff ((ccoonnttiiinnuueedd)) • Short acting opiate fentanyl is used intra-operatively to avoid this prolonged effect. • Naloxone antagonizes (reverses) all opiates, but its effect quickly wears off. • Commonly available inexpensive opiates are pethidine and morphine. • Morphine has about ten times the potency and a longer duration of action than pethidine. -
A Nurse with Pethidine Addiction
Case Report Eur J Gen Med 2012;9(1):59-61 A Nurse with Pethidine Addiction Bilge Burçak Annagür ABSTRACT Pethidine is a synthetic opioid substance with high addiction potential. It is commonly used in medicine pre and postoperatively to relieve the pain. A Pethidine addiction generally starts as iatrogenic and may be a problem for the clinicians when there is a real pain. Its opioid analgesic usage is legal, yet it is possible that it can be abused by the health care workers and addiction may become a frequent case. In order to attract attention to this issue a case of a nurse who was given pethidine after an operation to ease her pain and whom addiction is developed was presented. When the medicines with high addiction potential are given for the treatment, the patients must be followed closely in terms of addiction and drug abuse. Key words: Addiction, nurses, pethidine Pethidin Bağımlılığı Gelişen Bir Hemşire ÖZET Pethidin bağımlılık potansiyeli yüksek sentetik opioid bir maddedir. Tıpta ameliyat öncesi hazırlık döneminde ve ameliyat sonrası ağrıların giderilmesinde sıklıkla kullanılmaktadır. Pethidin bağımlılığı genellikle iatrojenik olarak başlar ve gerçek bir ağrı nedeni olduğunda klinisyenleri zor durumda bırakabilir. Bir opioid analjezik olarak kullanımı yasal olan pethidinin sağlık çalışanları arasında kötüye kullanımı ya da bağımlılığı sık karşılaşılabilecek bir durumdur. Bu konuya dikkat çekmek amacıyla geçirdiği bir ameliyat sonrasında ağrılarını dindirmek için pethidin verilen ve pethidin bağımlılığı gelişen bir hemşire olgu sunulmuştur. Tedavi amacıyla verilen ve bağımlılık potansiyeli yüksek olan ilaçlar kullanıldığında kötüye kullanım ve bağımlılık açısından hastalar yakından izlenmelidir. Anahtar Kelimeler: bağımlılık, hemşireler, pethidin INTRODUCTION very few presentations about the psychiatric problems of Pethidine is a synthetic opioid substance with high addic- these drugs and the fact that they can develop addiction tion potential. -
Treatment for Acute Pain: an Evidence Map Technical Brief Number 33
Technical Brief Number 33 R Treatment for Acute Pain: An Evidence Map Technical Brief Number 33 Treatment for Acute Pain: An Evidence Map Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, MD 20857 www.ahrq.gov Contract No. 290-2015-0000-81 Prepared by: Minnesota Evidence-based Practice Center Minneapolis, MN Investigators: Michelle Brasure, Ph.D., M.S.P.H., M.L.I.S. Victoria A. Nelson, M.Sc. Shellina Scheiner, PharmD, B.C.G.P. Mary L. Forte, Ph.D., D.C. Mary Butler, Ph.D., M.B.A. Sanket Nagarkar, D.D.S., M.P.H. Jayati Saha, Ph.D. Timothy J. Wilt, M.D., M.P.H. AHRQ Publication No. 19(20)-EHC022-EF October 2019 Key Messages Purpose of review The purpose of this evidence map is to provide a high-level overview of the current guidelines and systematic reviews on pharmacologic and nonpharmacologic treatments for acute pain. We map the evidence for several acute pain conditions including postoperative pain, dental pain, neck pain, back pain, renal colic, acute migraine, and sickle cell crisis. Improved understanding of the interventions studied for each of these acute pain conditions will provide insight on which topics are ready for comprehensive comparative effectiveness review. Key messages • Few systematic reviews provide a comprehensive rigorous assessment of all potential interventions, including nondrug interventions, to treat pain attributable to each acute pain condition. Acute pain conditions that may need a comprehensive systematic review or overview of systematic reviews include postoperative postdischarge pain, acute back pain, acute neck pain, renal colic, and acute migraine. -
0 Cover Part Two\374
PART TWO DEUXIÈME PARTIE SEGUNDA PARTE ﺍﳉﺰﺀ ﺍﻟﺜﺎﱐ 第二部分 ЧАСТЬ ВТΟΡАЯ - (...), [...] - (-)-3-hidroxi-N- (-)-(2R)-N-méthyl-1- fenacilmorfinán → Levophenacyl-morphan phénylpropan-2-amine → Levometamfetamine (-)-3-hidroxi-N- (-)-(3S,6R)-6- metilmorfinán → Levorphanol (dimethylamino)-4,4- (-)-3-hydroksymorfinan → Norlevorphanol diphenyl-3-heptanol → Betamethadol (-)-3-hydroksy-N- (-)-(3S,6R)-6- fenacylmorfinan → Levophenacyl-morphan (dimethylamino)-4,4- (-)-3-hydroksy-N- diphenyl-3-heptanol metylmorfinan → Levorphanol acetate (ester) → Betacetylmethadol (-)-3-hydroxymorphinan → Norlevorphanol (-)-(5R)-4,5-epoxy-3- (-)-3-hydroxy-N- methoxy-9α-methyl methylmorphinan → Levorphanol → Thebacon morphin-6-en-6-yl acetate (-)-3-hydroxynormorphinan → Norlevorphanol (-)-(5R,6S)-3-benzyloxy-4,5- (-)-3-hydroxy-N- epoxy-9a-methylmorphin- phenacylmorphinan → Levophenacyl-morphan 7-en-6-yl myristate → Myrophine (-)-3-hydroxytropane-2- (-)-(5R,6S)-4,5-epoxy carboxylat → Ecgonine morphin-7-en-3,6-diol → Normorphine (-)-3-idrossi-N- (-)-(5R,6S,14S)-4,5-epoxy- metilmorfinano → Levorphanol 14-hydroxy-3-methoxy- (-)-3-methoxy-N- 9a-methylmorphinan-6- methylmorphinan → Levomethorphan one → Oxycodone (-)-3-metil-2,2-difenil-4- (-)-(R)-4,5-epoxy-3- morfolinbutirilpirrolidina → Levomoramide methoxy-9a-methyl (-)-3-metoksy-N- morphinan-6-one → Hydrocodone metylmorfinan → Levomethorphan (-)-(R)-6-(dimethylamino)- (-)-3-metossi-N-metil- 4,4-diphenyl-3-heptanone → l-methadone morfinano → Levomethorphan (-)-(R)-N,α-dimethyl (-)-3-metoxi-N- phenethylamine → Levometamfetamine -
A Comparison of Tramadol and Pethidine Analgesia on the Duration of Labour: a Randomised Clinical Trial
Australian and New Zealand Journal of Obstetrics and Gynaecology 2009; 49: 59–63 DOI: 10.1111/j.1479-828X.2009.00949.x OriginalBlackwell Publishing Asia Article A comparison of tramadol and pethidine analgesia on the duration of labour: A randomised clinical trial Maryam KHOOSHIDEH1 and Ali SHAHRIARI2 1Department of Obstetrics and Gynaecology, and 2Department of Anaesthesiology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran Background: The ideal obstetric analgesia should provide analgesic efficacy without attenuation of uterine contractions. Aims: To compare the outcome of intramuscular administration of pethidine and tramadol in labour analgesia. Methods: One hundred and sixty full-term parturients were randomly assigned to two equal groups in active labour. Group P received 50 mg pethidine; and group T, 100 mg tramadol intramuscularly. Primary outcome measure was the duration of the labour. The analgesic efficacy, maternal side-effects, mode of delivery, maternal satisfaction and Apgar score as the secondary outcome were assessed. Results: The duration of labour was shorter in group T, for first stage (190 vs 140 min; P < 0.0001) and for second stage (33 vs 25 min; P = 0.001). There were no differences in Groups P and T with respect to median (7 vs 8) and maximum (7.5 vs 8) visual analog scores (VAS) for pain at 10 min and one hour after drug administration. Women in group P had lower VAS pain scores than those in group T in the second stage of labour (8 vs 9; P = 0/009). There was a significantly higher incidence of nausea and vomiting (35% vs 15%; P = 0.003) and drowsiness (80% vs 29%; P < 0.0001) in group P. -
Pain Management
Pain management Preeyaphan Arunakul MD FRCAT Department of Anesthesia Faculty of Medicine, Thammasat University Definition “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” Classification of pain by time • Acute pain - Pain less than 12 weeks • Chronic pain - Pain longer than 12 weeks Nociceptive Nonnociceptive Somatic Visceral Neuropathic Psychogenic sharp, dull Poorly localized, Burning, electrical -Rarely pure aching deep squeezing, (lancinating), -No nociceptive or crampy numbing, neuropathic mechanism allodynia, can be identified -Myofascial hyperalgesia -With sufficient -Metastatic -Small bowel psychogenic symptoms bone pain obstruction -Postsurgical -Carcinomatosis -Trigeminal neuralgia -Arthritis peritonii -Postherpetic neuralgia -Painful peripheral neuropathy NSAIDs -CRPS I,II Opioids TCA/SSRI -Phantom limb pain Muscle relaxants Gabapentin Aniline deriv. Opioids Anticonvulsants Antidepressants Multimodalities Interventions Antidepressants Psychological therapy Psychotherapy Interventions Multimodalities Acute Postoperative Pain ผู้ป่วยมีอาการปวดเฉียบพลัน “5th Vital sign” มีสาเหตุที่ท าให้เกิดอาการปวด รักษาสาเหตุ ประเมินระดับความปวด ไม่ต้องการ อาการปวดต้องการการรักษาหรือไม่ ประเมินซ ้าและบันทึก ต้องการ (PS ≥ 4 หรือปวดปานกลางขึ้นไป) เครื่องมือที่ใช้ประเมินความปวด รักษาโดยใช้ยา - VAS/VRS/NRS รักษาโดยไม่ใช้ยา - FACE/FLACCs รักษาแบบผสมผสาน - CHEOPS ไม่ได้ผล การรักษาได้ผลดีหรือไม่ ปรึกษาผู้เชี่ยวชาญ ได้ผลดี เกิด เกิดภาวะแทรกซ้อนจากการรักษาหรือไม่ -
Codeine and Its Alternates for Pain and Cough Relief* 2
Bull. Org. mond. Sante Bull. Wid Hith Org. J 1969, 40. 1-53 Codeine and its Alternates for Pain and Cough Relief* 2. Alternates for Pain Relief NATHAN B. EDDY, M.D.,1 HANS FRIEBEL, Dr med.,2 KLAUS-J)RGEN HAHN, Dr med.3 & HANS HALBACH, Dr med. Dr-Ing. 4 This report-the second of a series on codeine and its alternates for pain and cough relief-contains a detailed evaluation of experimental and clinical data on newer sub- stances having analgesic properties comparable to and in approximately the same range as those ofcodeine. The data are discussed under the headings: analgesic effects in animals; clinical usefulness; side-effects with particular reference to dependence andabuse liability. CONTENTS CARISOPRODOL ............... 1 PRODILIDINE ........... ... .. 42 DEXTROPROPOXYPHENE ........... 6 INDANES .................. 44 DHYDROCODEINE ............... 22 PHTHALIMIDES ............... 44 ETHOHEPTAZINE ............... 24 PYRROLIDINES .......... .... 45 ETYMIDE.. .............. 29 SPECIFIC OPIATE ANTAGONISTS .... 45 FENYRAMIDOL ............... 32 Risum .................... 47 METOFOLINE. .............. 33 REFERENCES ............. ... 48 CARISOPRODOL 5 propanediol carbamate isopropyl carbamate) was evaluated initially for paralysis of the intact animal, After the discovery and development of mepro- depression of spinal reflexes, anticonvulsant effect bamate, further exploitation of the dicarbamate molecule resulted in the preparation of substances 0 which differed widely in their pattern of activity. CH3-CH2-CH2 CH2-O-C-NHCH (CH3)2 One of these, carisoprodol (2-methyl-2-propyl-1,3- \I/ c * This review of the analgesic and antitussive effects of CH3 CH2-0-C-NH2 codeine and its alternates is being published in the Bulletin of the World Health Organization in five instalments. The first, devoted to an assessment of codeine as a pain reliever, was published in Bull. -
Comparison of Preoperative Tramadol and Pethidine on Postoperative
Evangelista et al. BMC Veterinary Research 2014, 10:252 http://www.biomedcentral.com/1746-6148/10/252 RESEARCH ARTICLE Open Access Comparison of preoperative tramadol and pethidine on postoperative pain in cats undergoing ovariohysterectomy Marina C Evangelista*, Rodrigo A Silva, Larissa B Cardozo, Marcia A P Kahvegian, Thais C Rossetto, Julia M Matera and Denise T Fantoni Abstract Background: A variety of analgesic agents are available, and which one can be used in dogs and cats is a highly controversial issue, existing however a fear in the use of opiates due to possible adverse effects that these drugs can cause. The aim of this study was to compare the analgesic effect provided by the administration of tramadol or pethidine on early postoperative pain of cats undergoing ovariohysterectomy in a double-blind prospective study. Fourty-two animals were randomly assigned into three groups. Pet received pethidine (6 mg/kg), Tra 2 received tramadol (2 mg/kg) and Tra 4 received tramadol (4 mg/kg); all intramuscularly and associated with acepromazine (0.1 mg/kg). The efficacy of each analgesic regimen was evaluated prior to surgery (baseline - TBL), during surgery and 1, 3 and 6 hours after extubation with subjective pain scale, physiologic parameters, serum concentrations of glucose, cortisol and IL-6. Results: Changes in cardiovascular system were not clinically relevant. There were no significant differences in pain scores (P > 0.05) during the study, although the number of rescue analgesia was significantly higher (P < 0.05) at Pet group (5/14) than Tra 4 group (0/14), whereas in Tra 2, two animals (2/14) required additional analgesia. -
Parenteral Pethidine for Labour Pain Relief and Substance Use Disorder: 20-Year Follow-Up Cohort Study in Offspring
Open Access Research BMJ Open: first published as 10.1136/bmjopen-2011-000719 on 30 May 2012. Downloaded from Parenteral Pethidine for labour pain relief and substance use disorder: 20-year follow-up cohort study in offspring Robert Rodrigues Pereira,1,2,3 Humphrey Kanhai,4 Frits Rosendaal,5 Paula van Dommelen,6 Dick Swaab,7 Erik Rodrigues Pereira,8 Ben van de Wetering9 To cite: Rodrigues Pereira R, ABSTRACT ARTICLE SUMMARY Kanhai H, Rosendaal F, et al. Objective: To determine whether use of intrapartum Parenteral Pethidine for Pethidine pain analgesia increases the risk for Article focus labour pain relief and substance use disorder in adult offspring. - substance use disorder: Research question: does perinatal Pethidine for 20-year follow-up cohort Design: Analysis of data from a cohort study. labour pain relief lead to substance use disorder study in offspring. BMJ Open Setting: Academic hospital in Leiden, the Netherlands. in later life? 2012;2:e000719. doi:10. Participants: 133 cases and 164 control individuals, - Is it possible to confirm the published data on an 1136/bmjopen-2011-000719 aged 18e20 years at follow-up. OR of around 5? Main outcome measure: Incidence of substance use - We hypothesise that there is no relationship. < Prepublication history for disorder or use of alcohol and tobacco. this paper is available online. Key messages Results: The lifetime use of addictive substances in To view these files please - We cannot confirm earlier data on the risk of visit the journal online (http:// children exposed to intrapartum Pethidine analgesia substance use disorder after perinatal analgesia. dx.doi.org/10.1136/ was 45% of 133 children versus 48% of 164 not- - We did not find a risk for smoking and drinking bmjopen-2011-000719). -
Alcohol, Drug, and Medicine Guide
National Epidemiologic Survey on Alcohol and Related Conditions -III (NESARC-III) Alcohol, Drug, and Medicine Guide 1 Index · Cooler and Prepared Cocktail Brands · Beer Brands · Wine Brands · Liquor Brands · Liquor Brands-by type of Liquor · Sedatives/Tranquilizers · Painkillers · Stimulants · Marijuana · Cocaine and Crack · Club Drugs · Hallucinogens/Psychedelics · Inhalants/Solvents · Heroin · Other Medicines or Drugs 2 Cooler and Prepared Cocktail Brands A K Alize Cocktails Kahlua Cocktails (Ready to Drink, Mudslide, White Russian, B52) B Bacardi Classic Cocktails M Bacardi Party Drinks (Bahama Mama, etc.) Margaritaville Bacardi Hurricane Mike’s Hard Lemonade and Ice Tea Bacardi Silver Malt Beverages Montebello Bartenders Mr. Boston Prepared Cocktail Bartles & Jaymes Barton (Long Island Iced Tea, etc.) P Burnetts (Cosmo, Margarita) Party a Go Go C R Captain Morgan Cocktails Rick’s Spiked Lemonade Captain Morgan Malt Beverage Caribbean Classic Coolers Chi Chi’s Cocktails S Club Cocktails Salvador’s Margarita Cruzan Mojito Cocktail Cube Sauza Original Margarita, Cocktail Cubes Seagram’s Coolers D Seagram’s Gin and Juice Dave’s Ice Cooler Skyy Blue Malt Beverage Desert Island Long Island Iced Tea Smirnoff Cocktails Doc Otis Hard Lemon Smirnoff Twisted Malt beverages Sparks Malt Beverage E Stolichnaya Citrona Malt beverage Everclear Purple Passion Cooler T F Tarantula (various Margarita flavors) Firefly Sweet Tea and Lemonade Cocktails TGI Friday’s TGI Friday’s Blenders H The Club Hello Lovely Cocktails Hublein Cocktails U UV Lemonade