Analgesic efficacy of intramuscular flunixin meglumine compared to meperidine: a preliminary report.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to E Laska.
Explore the source record for details and available documents.
Under either the random patient-effect model with sequence effects or the fixed patient-effect model, the usual two-period, two-treatment crossover design, AB,BA, cannot be used to estimate the contrast between direct treatment effects when unequal carryover effects are present. If baseline observations are available, the design AB,BA can validly be used to estimate a treatment contrast. However, the design AB,BA,AA,BB with baseline observations is more efficient. In fact, we show that this design is optimal whether or not baseline observations are available. For experiments with more than two periods, universally optimal designs are found for both models, with and without carryover effects. It is shown that uncertainty about the presence of carryover effects is of little or no consequence, and the addition of baseline observations is of little or no added value for designs with three or more periods; however, if the experiment is limited to only two periods the investigator pays a heavy penalty.
Approximately equianalgesic oral doses of codeine, an oxycodone compound resembling Percodan, and pentazocine were compared for adverse effects in a double-blind, randomized study of four doses of each drug given over two days to 247 postsurgical patients with pain. Placebo and parenteral morphine were also treated as negative and positive controls, respectively. Approximately 50 patients each received one of the five drugs. Codeine, pentazocine, and morphine had the same incidence of adverse effects (22 to 28 per cent). One capsule of oxycodone compound was the analgesic equivalent of 12.5 mg morphine with an adverse effect incidence of 4 per cent (placebo 8 per cent). Smoking made no difference in analgesic effect or adverse effects. Analgesics given in the evening intervening between the two days may have affected the analgesic performance of placebo.
A computerized drug-review system both reviews drug orders and notifies clinicians of orders that are considered exceptions to some clinical guidelines. The impact of this system in a psychiatric center in which it has been used since December 1975 is examined in terms of the reduction of the percentage of orders of psychotropic drugs that involve polypharmacy or dose-range exceptions. The results show a substantial reduction in orders in exception since the implementation of the system.
Analgesia through nefopam (30 mg, 60 mg, 90 mg), aspirin (325 mg, 650 mg), and placebo were compared in 122 hospitalized patients with moderate to severe postoperative, fracture, or other somatic pain. A double-blind noncrossover study design was used, and patients were evaluated for pain intensity and pain relief over a 6-hr period. Based on sum of pain intensity differences (SPID) scores, treatment effects were consistent and indicative of good dose response to both active medications. Pain relief scores were more variable but were generally in accordance with SPID values. Time-effect curves were similar. Estimated relative potency of nefopam to aspirin was 10.4 with a 95% confidence interval of 6.3 to 20.8 for SPID, indicating that the analgesic potency of nefopam, 60 mg, was equivalent to that of aspirin, 650 mg. Side effects were minimal.
An approach for developing quantitative care norms for outpatient acute psychiatric patients is presented. Both the methodological concept of the norming procedure and its application to the needs of Medicaid in Rockland County, New York are given. The methodology is totally general in that it could be applied to concerns related to characterization of services rendered in a wide variety of applications ranging from planning to utilization review. The norms developed relate both to monthly quantity of services rendered and length of active treatment period. Further, the impact of a review rule is discussed in terms of its implication to number of cases reviewed.
A new analgesic, nefopam, is chemically distinct and pharmacologically unrelated to any presently known analgesic. A comparison was made of morphine and nefopam in 74 patients who required parenteral analgesia for moderate to severe postoperative and somatic pain, using a single administration, 2-dose level, double-blind design. A significant dose-response curve was obtained with nefopam and with morphine, and there was no significant deviation from parallelism. The time-effect curves for the 2 drugs were similar. The estimated relative potency of nefopam to morphine indicates that 20 mg of nefopam HCl is the approximate analgesic equal of 12 mg of morphine SO4. There were no adverse effects with nefopam and one adverse reaction to morphine.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Dosage estimates of antiinflammatory drugs in human arthritis Phase II trials are difficult to obtain and prolong such trials unnecessarily. Antiinflammatory drugs almost always have analgesic properties in man and good dose estimates for analgesic activity can be obtained. In 140 patients with surgical pain, 300, 600, and 1200 mg of aspirin were compared to 75, 150, and 300 mg of 43-715 (1-isopropyl-4-phenyl-7-methyl-2 (1H) quinazolone), an antiinflammatory quinazolone derivative, for analgesia in a double-blind trial using subjective response methodology. The test drug was shown to be analgesic at a level four times more potent, milligram for milligram, than aspirin, an estimate that should be useful for later definitive Phase II trials in arthritis.
Explore the source record for details and available documents.