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[e-drug] June 08 Australian Prescriber covers pain in children

E-DRUG: June 08 Australian Prescriber covers pain in children

The whole issue is worth a look and can be downloaded completely
or individual articles can be accessed at


There are several issues of current interest covered.

Often the excitement around the launch of a new drug is
soon tempered by the emergence of problems in practice.
Mark Boyd and Sarah Pett inform us that the uptake of
enfuvirtide has been limited, and Gillian Shenfield considers
the adverse effects of 'glitazones'.

Sometimes a patient has to take a drug despite its serious
adverse effects. Cecilie Lander tells us that this is a particular
problem for pregnant women who need treatment for
epilepsy.  Antiepileptic drugs are also used in bipolar disorders, but
Ajeet Singh and Michael Berk say that lithium still has an
important role.

For pain in children, paracetamol and ibuprofen are also old drugs which 
widely used. E-drugger, Sean Beggs reviews how they compare when
used to relieve pain in children. He provides a very useful anaylsis.

Here is a summary:
Three main analgesics are routinely used for
treating pain in children -- paracetamol, ibuprofen
and codeine. Paracetamol and ibuprofen are
equally effective when used in recommended
doses. Codeine has high inter-individual variation
in its effectiveness, particularly in children, which
significantly limits its routine use in paediatrics.
Paracetamol is associated with fewer adverse
effects than ibuprofen and so generally remains
the first-line analgesic drug in children. However,
paracetamol may not be the most appropriate
choice in all patients depending on the type of
pain being treated and the presence of comorbid
illnesses. Paracetamol has unpredictable
absorption with rectal administration so this route
is no longer recommended. The combined use of
paracetamol with non-steroidal anti-inflammatory
drugs may be of benefit for some postoperative
and musculoskeletal pain.

*Beverley Snell*

*Senior Fellow*

*Centre for International Health*

*Macfarlane Burnet Institute for Medical Research & Public Health *

*GPO Box 2284, Melbourne 3001 Australia*


*Telephone 613 9282 2115 / 9282 2275*

*Fax 61 3 9282 2144 or 9282 2100*

*Time zone: 10 hours ahead of GMT.*

*email <bev@burnet.edu.au>*

*Site: Alfred Medical Research & Education Precinct (AMREP),*

*85 Commercial Road, Prahran 3004*


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