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children paracetamol acetaminophen oral rectal

Ewan D McNicol, McKenzie C Ferguson, Simon Haroutounian, Daniel B Carr, Roman Schumann
BACKGROUND: This is an updated version of the original Cochrane review published in Issue 10, 2011. Paracetamol (acetaminophen) is the most commonly prescribed analgesic for the treatment of acute pain. It may be administered orally, rectally, or intravenously. The efficacy and safety of intravenous (IV) formulations of paracetamol, IV paracetamol, and IV propacetamol (a prodrug that is metabolized to paracetamol), compared with placebo and other analgesics, is unclear. OBJECTIVES: To assess the efficacy and safety of IV formulations of paracetamol for the treatment of postoperative pain in both adults and children...
2016: Cochrane Database of Systematic Reviews
Anna Hobson, Philip J Wiffen, Joy A Conlon
BACKGROUND: Acute postoperative pain occurs as a result of tissue damage following surgery. Administering the appropriate analgesia to children is a complex process and it is unclear whether children's postoperative pain is more successfully treated by using 'as required' (when pain occurs) (termed 'pro re nata' or PRN) or (irrespective of pain at the time of administration). OBJECTIVES: To assess the efficacy of as required versus fixed schedule analgesic administration for the management of postoperative pain in children under the age of 16 years...
2015: Cochrane Database of Systematic Reviews
Sebastiano A G Lava, Giacomo D Simonetti, Gian Paolo Ramelli, Sibylle Tschumi, Mario G Bianchetti
BACKGROUND: Symptomatic management is often all that is recommended in children with fever. To date, only 2 nationwide surveys of pediatricians regarding their attitudes toward fever have been published. OBJECTIVE: The aim of this study was to describe the management of children with fever by pediatricians in Switzerland. METHODS: For this survey, an initial close-ended questionnaire was tested and subsequently corrected. Between June 2010 and March 2011, an invitation was sent via electronic mail containing a link to the final version of the questionnaire...
January 2012: Clinical Therapeutics
Nadine De Ronne
Fever represents a normal physiological response as a result of the introduction of an infectious agent producing exogenous and endogenous pyrogenes influencing the central set point of body temperature. This response is an important immunological defence. Fever can be defined as any elevation of body temperature above 38 degrees C. Infancy body temperature should be measured rectal. Fever is mostly caused by a benign viral infection, but it can be an indicator of a major illness such as meningitis, septicaemia, pneumonia...
September 2010: Journal de Pharmacie de Belgique
Hannu Kokki
The NSAID ketoprofen is used widely in the management of inflammatory and musculoskeletal conditions, pain, and fever in children and adults. Pharmacokinetic studies show that drug exposure after a single intravenous dose is similar in children and adults (after dose normalization), and thus similar mg/kg bodyweight dosing may be used in children and adults. Ketoprofen crosses the blood-brain barrier and therefore has the potential to cause central analgesic effects. Ketoprofen has been investigated in children for the treatment of pain and fever, peri- and postoperative pain, and inflammatory pain conditions...
October 1, 2010: Paediatric Drugs
Hannu Kokki, Merja Kokki
Fever is a common symptom in children and one of the major concerns of parents of younger and preschool-age children. To compare the efficacy and safety of ketoprofen with that of paracetamol (acetaminophen) and ibuprofen in the treatment of febrile conditions in children. Two prospective, randomized, double-blind, double-dummy, repeated-dose, multicentre, phase III studies with two parallel groups in each study were conducted in primary-care outpatient clinics. Children aged 6 months to 6 years presenting with a febrile condition and an oral body temperature of > or =38...
2010: Clinical Drug Investigation
Hannu Kokki, Merja Kokki
BACKGROUND: Ketoprofen is a highly effective NSAID with antipyretic and analgesic properties for the symptomatic management of pain and fever in both adults and children. OBJECTIVE: To compare three dose levels of ketoprofen with paracetamol (acetaminophen) in the management of fever in children. METHODS: Two prospective, randomized, single-blind, comparator-controlled, single-dose, multicentre, phase II studies with four parallel groups in each study were conducted in primary-care outpatient clinics...
2010: Clinical Drug Investigation
Elena Chiappini, Nicola Principi, Riccardo Longhi, Pier-Angelo Tovo, Paolo Becherucci, Francesca Bonsignori, Susanna Esposito, Filippo Festini, Luisa Galli, Bice Lucchesi, Alessandro Mugelli, Maurizio de Martino
OBJECTIVE: This article summarizes the Italian Pediatric Society guideline on the management of the signs and symptoms of fever in children, prepared as part of the National Guideline Program (NGLP). METHODS: Relevant publications in English and Italian were identified through searches of MEDLINE and the Cochrane Database of Systematic Reviews from their inception through December 31, 2007. Based on the consensus of a multidisciplinary expert panel, the strength of the recommendations was categorized into 5 grades (A-E) according to NGLP methodology...
August 2009: Clinical Therapeutics
Helga Lára Helgadóttir, Margaret E Wilson
Paracetamol is one of the most common medicines administered to children and is available in suppositories, mixtures, drops and tablets. Orally administered paracetamol is more rapidly and completely absorbed and is, in general, more acceptable to children. In Iceland, the most common route of paracetamol administration is per rectum. The purpose of the study was to explore parents' knowledge and usage of paracetamol for 3- to 6-year-old children. Parents (n = 103) of children in four playschools in Reykjavík participated in this survey research...
March 2008: Scandinavian Journal of Caring Sciences
G M Palmer, S P Chen, K R Smith, W Hardikar
Although intravenous (i.v.) paracetamol is an attractive analgesic, there is little information on its paediatric use. During an introduction phase with limited prescribing rights, an audit was performed to assess its use and cost impact at a tertiary paediatric centre. Patients receiving IV paracetamol prescribed by two pain specialists for restricted indications had their medical records retrospectively reviewed for age, weight, diagnosis, indications/dose for IV (and other route) paracetamol/other analgesics/antiemetics, vomiting/oral intake and liver function tests if performed...
October 2007: Anaesthesia and Intensive Care
Bernard Bannwarth, Fabienne Péhourcq
The advantage of paracetamol (acetaminophen) is that it can be administered via the oral, intravenous or rectal routes. The last mentioned differs from the oral route in the slow and irregular absorption of the active substance. At therapeutic concentrations, the pharmacokinetics of paracetamol are linear--that is, independent of the dose, and constant with repeated administration. The efficacy of paracetamol has been demonstrated in a wide variety of acute or chronic painful syndromes. In adults, the optimum unit dose is 1 g...
2003: Drugs
Eva Kokinsky, Eva Thornberg
Postoperative pain in children can usually be well controlled with a combination of analgesics, including acetaminophen (paracetamol), NSAIDs, opioids, and local/regional anesthesia. Recent research has shown that the dosage of acetaminophen required to provide analgesia is higher than the traditional dosages used for the regulation of elevated body temperature. Rectal administration of acetaminophen gives a lower and more variable bioavailability compared with oral administration. There is growing experience with the use of NSAIDs in children and several studies have demonstrated the relatively strong analgesic potential of these drugs...
2003: Paediatric Drugs
Amnon C Sintov, Igor Krymberk, Vladimir Gavrilov, Rafael Gorodischer
Paracetamol is a safe and effective analgesic and antipyretic agent, and is one of the most widely used medications for infants and children. The formulations currently available have been designed for oral and rectal administration. However, they are not practical in young patients with vomiting and diarrhoea, or in those who refuse to take the full dose. An alternative route of administration would be a significant contribution to the paediatric pharmacopoeia. The aim of this study was to develop a new transdermal system for optional therapeutic administration of paracetamol in infants and children...
July 2003: Journal of Pharmacy and Pharmacology
Maja Buljcik, Dusan Milosević, Zoran Komazec
Relief of pain after tonsilloadenoidectomy in preschool children is the precondition of good postoperative recovery of that group of patients. The aim of this project is to study, to estimate and to relieve the pain. It focuses on dosage and ways of using medication, and establish the difference between Paracetamol and Ibuprofen i.e. their respective effects after oral, rectal or rectal-oral application. This (prospective/open-ended) study included 50 children recovering from tonsilloadenoidectomy, 5.7 years of age on average, classified into 5 groups according to medication used and method of treatment...
May 2002: Srpski Arhiv za Celokupno Lekarstvo
M E Stocker, J E Montgomery
Paracetamol is usually given in adults at a dose of 10-20 mg kg(-1) orally or rectally. Work in children suggests that doses of 40 mg kg(-1) are needed to provide therapeutic concentrations when this drug is used by the rectal route. We have investigated the dose of rectal paracetamol needed to achieve serum concentrations within the accepted therapeutic range of 10-20 microg ml(-1) in adults. Ten healthy adult volunteers received increasing doses of rectal paracetamol (15, 25, 35, and 45 mg kg(-1)). Following suppository administration, serum paracetamol concentrations were measured half hourly to 4 h then hourly to 8 h...
October 2001: British Journal of Anaesthesia
C D van der Marel, R A van Lingen, M A Pluim, G Scoones, M van Dijk, J M Vaandrager, D Tibboel
BACKGROUND: Analgesic acetaminophen (INN, paracetamol) plasma concentrations after major surgery in neonates and infants have not yet been established in the literature. We therefore conducted a study in our intensive care unit. METHODS: Forty children, mean (standard deviation) age, 10.3 (2.3) months, received 20 mg/kg acetaminophen either orally (n = 20) or rectally (n = 20) every 6 hours after a rectal loading dose (40 mg/kg) during elective craniofacial correction...
July 2001: Clinical Pharmacology and Therapeutics
F Camu, A Van de Velde, C Vanlersberghe
The cyclooxygenase enzymes produce large amounts of prostaglandins in presence of tissue injury and inflammation. Prostaglandins exert their influence on nerve membrane excitability both at the peripheral site and at the spinal dorsal horn. Their key role in peripheral tissue inflammation and central sensitization warrants their incorporation in pain management strategies for children. As the COX2 isoenzyme is the main target for controlling hyperalgesia, nonsteroidal anti-inflammatory drugs (NSAIDs) with high affinity for this enzyme will provide reliable antihyperalgesic effects...
2001: Acta Anaesthesiologica Belgica
A Arana, N S Morton, T G Hansen
BACKGROUND: Paracetamol (N-acetyl-p-amino-phenol) or acetaminophen has become the most widely used analgesic and antipyretic in children. However, there is a wide discrepancy between the extent to which paracetamol is used and the limited available pharmacological data in small infants. The purpose of this article is to present a review of the current literature regarding the use of paracetamol in neonates and infants with a particular emphasis on pharmacological issues. METHODS: A MEDLINE search (up to March 2000) was conducted to identify relevant English-language publications using paracetamol, children, infants and neonates as search terms...
January 2001: Acta Anaesthesiologica Scandinavica
B J Anderson, G A Woollard, N H Holford
AIMS: The aims of this study were to describe paracetamol pharmacokinetics in neonates and infants. METHODS: Infants in their first 3 months of life (n = 30) were randomised to sequentially receive one of three paracetamol formulations (dose 30-40 mg kg-1) over a 2 day period. The formulations were (a) elixir, (b) glycogelatin capsule suppository and (c) triglyceride base suppository. Approximately six blood samples were taken after each dose over the subsequent 10-16 h...
August 2000: British Journal of Clinical Pharmacology
B J Anderson, S G Rees, A Liley, A W Stewart, M J Wardill
The effect preoperative paracetamol elixir has on gastric contents is unknown. Children presenting for elective adenotonsillectomy were randomized to receive either paracetamol elixir (40 mg x kg(-1)) 90 min before surgery or paracetamol suppositories (40 mg x kg(-1)) intraoperatively. Following induction of anaesthesia a 16 Fr multiple-oriface orogastric tube was passed into the stomach and measure taken of the residual gastric volume and pH. The children had a mean age of 8.5 years (SD 3.2) with a weight of 35 kg (SD 16...
1999: Paediatric Anaesthesia
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