Analgesic drugs combining

Unlike hydrocodone, it is used as an analgesic in combination with other drugs, such as aspirin or acetaminophen. Oxycodone is similar to morphine in terms of durational efficacy and is intended for oral use. Synonyms for this drug are roxicodone, proladone, per-ketan, eutagen, oxycon, and many others. 

Related to codeine, dihydrocodeine is a rather weak analgesic, usually combined with other drugs and used as a headache suppressant, ft is often, however, prescribed for postoperative pain, dyspnea, and as an antitussive. Dihydrocodeine is twice as potent as codeine. 

Acetaminophen, sold under the trade name Tylenol, is a widely used analgesic and antipyretic that is an over-the-counter drug. Combined with codeine it is one of the top five prescription drugs. Acetaminophen is prepared by treating p-aminophenol with a mixture of glacial acetic acid and acetic anhydride. 

Large doses of caffeine cause diuresis. Daily consumption of caffeine citrate increased the mean urinary excretion rate of tubular cells and erythrocytes in volunteers (25). The nephrotoxicity of analgesic antipyretic drug combinations may result from a combined effect, in which aspirin, phenacetin, and caffeine all play a role (SEDA-4, 5). In 10 asymptomatic women and 20 women with confirmed detrusor instability, caffeine caused a significant increase in detrusor pressure on bladder filling in the latter, but no difference in volume at first contraction, height of contraction, or bladder capacity (26). 

As the debate developed, the safety of paracetamol and its combination with aspirin, which had only come to the fore on a large scale as phenacetin disappeared, also came to be questioned. The difficulty in assigning specific roles to the various analgesics is partly related to the use of drug combinations but largely because of the prolonged time over which the disorder develops. 

Phenothiazines do not produce analgesia but can potentiate the efficacy of other analgesic drugs, such as the opioids (p. 276). An exception to this is levomepromazine (methotrimeprazine), a phenothiazine used formerly in the horse in combination with the opioid etorphine (Petts Pleuvry 1983). Phenothiazines lower the MAC of inhalation anesthetics. In one controlled study, acepromazine was shown to decrease the MAC of halothane by approximately 37% (Doherty et al 1997b). 

Both codeine and dihydrocodeine are widely used analgesic drugs, often formulated in combination with aspirin or paracetamol (e.g. cocodamol, co-dydramol). 

None of the widely quoted statistics embrace all those individuals dependent on drugs and medicaments, but always only those who attract attention because of crime, their lifestyle, or their social environment. In the case of benzodiazepines, appetite-suppressants and combinations of analgesics with caffeine, the low-dose dependence of the patient is often associated with social conditions, so that the problem is often seen in the context of the particular decade in which the abuse occurs. The same is true of the experimental drug-taker who discontinues his or her consumption after a short time and is not noticed. For this reason, exact national statistics on consumption behavior are difficult to obtain. Moreover, it is possible to detect trends, e.g. the appearance of new dependence phenomena, patterns of abuse, drug combinations or methods of application, and the analyst must arrange his work accordingly. 

Tavassoli N, Lapeyre-Mestre M, Sommet A, Montastruc J-L. Reporting rate of adverse drug reactions to the French pharmacovigilance system with three step 2 analgesic drugs dextropropoxyphene, tramadol and codeine (in combination with paracetamol). Br J Clin Pharmacol 2009 68 (3) 422-6. 

---