Greater efficacy or not co-proxamol is more lethal in overdose, which is
a more than sensible reason for abandoning it's use.
Andy Webster
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Chris Kirke
Sent: 12 June 2003 22:22
To: Andrew Webster
Subject: Re: Evidence Based Analgesic use
Maybe your GP had read the Drugs and Therapeutics Bulletin review
comparing
paracetamol and coproxamol a few years ago. This stated that there was
no
evidence to suggest that coproxamol was any better than paracetamol
alone.
They then went on to imply that because of this, coproxamol should be
abandoned in favour of paracetamol, I seem to remember.
Clearly, lack of evidence is not a good reason for abandoning a
treatment,
it just means the appropriate trials have not been done. If you read
into it
a little more deeply it seems as though the existing trials were either
underpowered or not well enough designed to detect a difference.
Chris Kirke
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]]On Behalf Of
[log in to unmask]
Sent: 12 June 2003 21:39
To: [log in to unmask]
Subject: Evidence Based Analgesic use
Hi there on the chat lines, has anyone done any work on Analgesic use in
the Emergency Department.
This is my next project with the Clinical Effectiveness Committee and
being
one to plagarise when I can I wonder if anyone has any good references
or
has done a clinical review for the test that I can mercilessly plunder?
By the way, my local PCT wrote telling me I should not give Co-codamol
to
my patients because one of the GP's said there was no evidence that it
was
better than paracetamol. He is technicaly true since I can find no
studies
of low dose codiene/paracetamol mixes compared with paracetamol, but
since
our audit studies and personal use tells me my migraines respond to the
one
and not the other, I told them that since the GP in question never sees
acute patients, they all come to see us, and they like our extra strong
paracetamol, the PCT could stuff it or PC words to that effect.
I hope the Ketamine guidelines hit the web site soon
Andy Volans
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