Whilst I would accept that in A&E you don't always know the suicide
potential of the patients, having just had a severe tooth ache overnight I
now realise that when you need real pain relief you need real painkillers.
Don't throw Coproxamol out for everyone. We are after all supposed to be
doctors who consider the pro's & con's of prescribing, become too much like
a load of old nannies and there won't be a need for doctors, the job could
be done by trained chimpanzees.
----- Original Message -----
From: "andrew WEBSTER" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, June 13, 2003 8:44 AM
Subject: Re: Evidence Based Analgesic use
>
> 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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