Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
BRAND NAMES: Darvocet A500; Darvocet-N (Darvocet, Wygesic: These brands no
longer are available in the U.S.)
DRUG CLASS AND MECHANISM:Propoxyphene is a strong narcotic pain-reliever and
cough suppressant but is weaker than other narcotics such as morphine, codeine,
and hydrocodone. The precise mechanism of action is not known but may involve
stimulation of opioid receptors in the brain. Propoxyphene increases pain
tolerance and decreases discomfort, but the presence of pain is still apparent.
In addition to pain reduction, propoxyphene also causes sedation and respiratory depression. Acetaminophen is a non-narcotic analgesic and antipyretic (fever
reducer). Acetaminophen relieves pain by elevating the pain threshold. It
reduces fever through its action on the heat-regulating center of the brain. The
combination of propoxyphene and acetaminophen achieves greater pain relief than
either taken separately. For more information on acetaminophen, please see
acetaminophen (Tylenol). The FDA first approved propoxyphene/acetaminophen
combinations in October 1972.
STORAGE: Tablets should be stored at room temperature, 15 to 30 C (59 to 86
F).
PRESCRIBED FOR: Propoxyphene/acetaminophen combinations are used for the
treatment of mild to moderate pain.
DOSING: The recommended adult dose is 1-2 tablets every 4 hours as needed for
relief of pain. Do not exceed six 100/650 mg tablets or twelve 50/325 mg tablets
in a 24-hour period.
DRUG INTERACTIONS: Propoxyphene, like other narcotic pain-relievers,
increases the effect of drugs that slow brain function, such as alcohol,
barbiturates, skeletal muscle relaxants, for example, carisoprodol (Soma) and
cyclobenzaprine (Flexeril), and benzodiazepine sedatives, for example, diazepam
(Valium) and lorazepam (Ativan). Combined use of muscle relaxants and
propoxyphene may lead to greater respiratory depression than either drug alone.
Combining propoxyphene with carbamazepine
(Tegretol, Tegretol XR , Equetro, Carbatrol) may have severe effects on the
brain including coma.
Since propoxyphene causes constipation, the use of antidiarrheals, for
example, diphenoxylate (Lomotil) and
loperamide (Imodium), in persons taking
propoxyphene, can lead to severe constipation.
Drugs which both stimulate and block opioid receptors for example
pentazocine
(Talwin), nalbuphine (Nubain),
butorphanol (Stadol), and buprenorphine
(Buprenex), may reduce the effect of propoxyphene and may precipitate withdrawal
symptoms from propoxyphene.
Acetaminophen is metabolized (eliminated by conversion to other chemicals) by
the liver. Therefore drugs that increase the action of liver enzymes that
metabolize acetaminophen, for example, carbamazepine (Tegretol),
isoniazid (INH,
Nydrazid, Laniazid), and rifampin (Rifamate, Rifadin, Rimactane), reduce the
levels of acetaminophen and therefore may decrease its action. Doses of
acetaminophen greater than the recommended doses are toxic to the liver and may
result in severe liver damage. The potential for acetaminophen to harm the liver
is increased when it is combined with alcohol or drugs that also harm the liver.
Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of
arthritis including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout,
and pseudogout.
Drug-induced liver diseases are diseases of the liver that are caused by physician-prescribed medications, OTC medications, vitamins, hormones, herbs, illicit (“recreational”) drugs, and environmental toxins. There are three types of liver toxicity; dose-dependent toxicity, idiosyncratic toxicity, and drug allergy. The types of liver disease drugs cause include: mild elevations of blood levels of liver enzymes, hepatitis, necrosis, cholestasis, steatosis, cirrhosis, mixed disease, fulminant hepatitis, and blood clots.
Tylenol liver damage (acetaminophen) can occur from accidentally ingesting too much acetaminophen, or intentionally. Acetaminophen is a drug contained in over 200 OTC and prescription medications from NyQuil to Vicodin. Avoiding unintentional overdoses include reading medication labels, write down the dosages of medications you are taking, do not drink excessive alcohol while taking acetaminophen. In severe cases, a liver transplant may be necessary.
Pain management and treatment can be simple or complex, according to its cause. There are two basic types of pain, nociceptive pain and neuropathic pain. Some causes of neuropathic pain includes: complex regional pain syndrome, interstitial cystitis, and irritable bowel syndrome. There are a variety of methods to treat chronic pain, which are dependant on the type of pain experienced.
Chronic pain is pain (an unpleasant sense of discomfort) that persists or progresses over a long period of time. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.
Drug-induced liver diseases are diseases of the liver
that are caused by physician-prescribed medications, over-the-counter
medications, vitamins,
hormones, herbs, illicit ("recreational") drugs, and environmental toxins.
What is the liver?
The liver is an organ that is located in the upper right
hand side of the abdomen, mostly behind the
rib cage. The liver of an adult normally weighs close
to three pounds and has many functions.
The liver produces and secretes bile into the
intestine where the bile
assists with the digestion of dietary fat.
The liver helps purify the blood by changing potentially harmful chemicals
into harmless ones. The sources of these chemicals can be outside the body (for
example, medications or alcohol), or inside the body (for example, ammonia,
which is produced from the break-up of proteins; or bilirubin, which is produced
from ...
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