Why paracetamol (acetaminophen) is a suitable first choice for treating mild to moderate acute pain in adults with liver, kidney or cardiovascular disease, gastrointestinal disorders, asthma, or who are older

Alchin, John; Dhar, Animesh; Siddiqui, Kamran; Christo, Paul J.

doi:10.1080/03007995.2022.2049551

Cited by 28 publications

(28 citation statements)

References 126 publications

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“…Paracetamol was also considered the first choice in mild chronic pain in agreement with the current literature [25]. In addition, a review of guideline recommendations found that the majority recommend paracetamol as first-or second-line for both acute and chronic pain [26].…”

Section: Discussionsupporting

confidence: 55%

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New Perspectives on the Adverse Effects of NSAIDs in Cancer Pain: An Italian Delphi Study from the Rational Use of Analgesics (RUA) Group

Varrassi¹,

Coluzzi²,

Fornasari³

et al. 2022

Preprint

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Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most frequently prescribed drugs for cancer pain. We used Delphi methodology to evaluate the opinions of clinicians on NSAIDs and paracetamol, with a specific focus on their safety profile. Consensus was reached on 7 statements. High level of consensus was reached regarding use of NSAIDs and gastrointestinal, cardiovascular, and renal risk in patients taking low-dose aspirin and assessment of liver function during long-term treatment with paracetamol. Consensus was also reached that assessment and monitoring of eGFR is important in the elderly being administered NSAIDs. It was further agreed that NSAIDs can often play a key role in association with opioids in treatment of cancer pain and that paracetamol is the analgesic of first choice for patients with mild chronic pain. When NSAIDs are administered in combination with steroids, it was agreed that the risk of gastrointestinal damage is increased since steroids delay the healing of ulcers, and that paracetamol can be used during pregnancy and does not affect the health of the fetus. This Delphi study highlights that there is a poor agreement on how these drugs are routinely prescribed. However, the consensus was reached for 7 key statements and may represent a valid contribution to daily practice.

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Section: Discussionsupporting

confidence: 55%

“…It can be prescribed to patients with limited therapeutic options, for those with liver, kidney or cardiovascular diseases, and gastrointestinal disorders, as well as in the elderly [25,26]. Moreover, kidney disease has been shown to be highly prevalent in cancer patients.…”

Section: Discussionmentioning

confidence: 99%

New Perspectives on the Adverse Effects of NSAIDs in Cancer Pain: An Italian Delphi Study from the Rational Use of Analgesics (RUA) Group

Varrassi¹,

Coluzzi²,

Fornasari³

et al. 2022

Preprint

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“… 32 , 56 Paracetamol remains a first-choice analgesic for most adults to manage mild-to-moderate pain, wherein the recommended dose of ≤4g/day was typically well-tolerated in healthy adults. 43 , 57 Delayed gastric emptying due to aging- or comorbidities-associated physiological changes has been reported to influence the pharmacokinetics and pharmacodynamics of drugs. 10 , 12 , 13 However, there is a paucity of large-scale randomized clinical trials demonstrating the efficacy or dosing suitability of APAP among patients advancing age or comorbidities, thereby suggesting a potential need to rely on clinician expertise and observations of the real-world clinical settings to understand the relevance of an innovative formulation for managing pain.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…10,12,13 However, there is a paucity of large-scale randomized clinical trials demonstrating the efficacy or dosing suitability of APAP among patients advancing age or comorbidities, thereby suggesting a potential need to rely on clinician expertise and observations of the real-world clinical settings to understand the relevance of an innovative formulation for managing pain. [57][58][59] Based on the evidence shared, FD-APAP was shown to have better GI suitability, disintegration and absorption, and was able to provide faster pain relief compared to standard APAP with no differences in the side-effects. 9,16,43,44 Alternatively, opioid analgesics have also become a more prevalent treatment for chronic pain.…”

Section: Discussionmentioning

confidence: 99%

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Perspectives on Using Fast-Dissolving Paracetamol for Mild-to-Moderate Pain Management in Elderly or Diabetic Patients with Delayed Gastric Emptying Rates: An Exploratory Study

Raza¹,

Keith²,

Koh³

2022

JPR

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Purpose Pain is considered a major clinical and socioeconomic problem worldwide. Delayed gastric emptying rates allegedly influence the suitability of pain-relief medications in patient populations such as the elderly and individuals with diabetes. Faster pain relief was reportedly achieved by using a fast-dissolving paracetamol (FD-APAP) formulation. This study aims to gain insights to healthcare professionals’ (HCPs) perspectives towards using FD-APAP in addressing barriers of pain relief in patient populations susceptible to delayed gastric emptying rates. Patients and Methods A two-step modified Delphi consensus study was conducted among a panel of 10 general practitioners (GPs) and four endocrinologists. The first step comprises in-depth discussions around evidence relevant to FD-APAP for pain management in patient populations with delayed gastric emptying rates (elderly/diabetics). The second step (a survey) was based on the summarized input from the first step. Consensus was accepted upon ≥70% agreement. Perspectives on pain management by FD-APAP for elderly patients were explored among GPs, while those for diabetic patients were explored among GPs and endocrinologists. Results Consensus was achieved, whereby all panel members found FD-APAP to be favorable and relevant for pain management in the elderly and the diabetic patient populations. GPs additionally raised the consensus on the importance of considering comorbidities associated with diabetes while having minimal complications during pain management. Conclusion The panel found the faster disintegration and absorption of FD-APAP relevant and useful for patients with delayed gastric emptying, wherein, pain in the elderly and those with diabetes could be treated effectively with limited side-effects.

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A Robust In Vitro Anti‐tuberculosis, Antimicrobial, and Anti‐inflammatory Activities Based on Azomethine Chelates Incorporating Co(II), Ni (II), Cu(II), and Zn(II) Ions: Synthesis, Characterization, and Investigation of the Aspects of Docking Interaction

Rani,

Devi,

Kumar

et al. 2024

Applied Organom Chemis

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In recent times, there has been a growing exploration of transition metal complexes as potential solutions for significant health challenges, including tuberculosis, microbes infection, and inflammation. Therefore, in our ongoing effort to identify biologically effective agents, Co(II), Ni(II), Cu(II), and Zn(II) metal complexes of H2L1–H2L2 hydrazone ligands were synthesized. The structural features of synthesized compounds were recognized by employing several techniques such as FT‐IR, 1H NMR, 13C NMR, powder x‐ray diffraction (XRD), UV‐Vis, ESR, TG‐DTA, mass spectrometry, and molar conductance measurements. The bonding of ligands via Ophenolic, Oenolic, and Nazomethine donor atoms and the attachment of the three water molecules with metal ion to form the octahedral structure of complexes were corroborated by different spectroscopic techniques. The anti‐tuberculosis, antimicrobial, and anti‐inflammatory activities of the synthesized compounds were assessed using the microplate alamar blue assay, serial dilution, and bovine serum albumin (BSA) methods, respectively, and highlighted the more potency of the complexes than ligands. The synthesized Cu(II) (9) and Zn(II) (10) metal complexes exhibited excellent ability to inhibit the growth of H37Rv strain of Mycobacterium tuberculosis in comparison to standard drug streptomycin. The Cu(II) (6 and 9) and Zn(II) (10) complexes showed superb ability as antimicrobial agents, whereas Cu(II) (5) and Zn(II) (6) complexes exhibited significant anti‐inflammatory ability. The in vitro findings on the antituberculosis activity were reinforced by a significant molecular docking study, which has become a crucial component of computational research utilizing the enzyme Mtb Pks13 thioesterase domain of M. tuberculosis. Additionally, in this research work, the absorption–distribution–metabolism–excretion–toxicity (ADMET) study sparked the compounds' drug‐like behavior.

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Why paracetamol (acetaminophen) is a suitable first choice for treating mild to moderate acute pain in adults with liver, kidney or cardiovascular disease, gastrointestinal disorders, asthma, or who are older

Cited by 28 publications

References 126 publications

New Perspectives on the Adverse Effects of NSAIDs in Cancer Pain: An Italian Delphi Study from the Rational Use of Analgesics (RUA) Group

New Perspectives on the Adverse Effects of NSAIDs in Cancer Pain: An Italian Delphi Study from the Rational Use of Analgesics (RUA) Group

Perspectives on Using Fast-Dissolving Paracetamol for Mild-to-Moderate Pain Management in Elderly or Diabetic Patients with Delayed Gastric Emptying Rates: An Exploratory Study

A Robust In Vitro Anti‐tuberculosis, Antimicrobial, and Anti‐inflammatory Activities Based on Azomethine Chelates Incorporating Co(II), Ni (II), Cu(II), and Zn(II) Ions: Synthesis, Characterization, and Investigation of the Aspects of Docking Interaction

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