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In a hospital setting, an intravenous PCA (IV PCA) refers to an electronically controlled infusion pump that delivers an amount of analgesic when the patient presses a button. [4] IV PCA can be used for both acute and chronic pain patients. It is commonly used for post-operative pain management, and for end-stage cancer patients. [5]
For these reasons, IV methods invoke implicit assumptions on behavioral response, or more generally assumptions over the correlation between the response to treatment and propensity to receive treatment. [18] The standard IV estimator can recover local average treatment effects (LATE) rather than average treatment effects (ATE). [1]
This is not to be confused with dose regimen, which is a type of drug therapy in which the dose [mg] of a drug is given at a regular dosing interval on a repetitive basis. Continuing the maintenance dose for about 4 to 5 half-lives (t 1/2 ) of the drug will approximate the steady state level. [ 1 ]
The area under the effect curve (AUEC) is an integral of the effect of a drug over time, estimated as a previously-established function of concentration. It was proposed to be used instead of AUC in animal-to-human dose translation, as computer simulation shows that it could cope better with half-life and dosing schedule variations than AUC.
Acute use (1–3 days) yields a potency about 1.5× stronger than that of morphine and chronic use (7 days+) yields a potency about 2.5 to 5× that of morphine. Similarly, the effect of tramadol increases after consecutive dosing due to the accumulation of its active metabolite and an increase of the oral bioavailability in chronic use.
Morphinan is the prototype chemical structure of a large chemical class of psychoactive drugs, consisting of opiate analgesics, cough suppressants, and dissociative hallucinogens, among others. Typical examples include compounds such as morphine, codeine, and dextromethorphan (DXM).
The elimination rate constant K or K e is a value used in pharmacokinetics to describe the rate at which a drug is removed from the human system. [1] It is often abbreviated K or K e. It is equivalent to the fraction of a substance that is removed per unit time measured at any particular instant and has units of T −1.
Dose for dose it is roughly ten times more potent than morphine, with 1 mg desomorphine being equivalent 10 mg morphine, via the intravenous (IV) or intramuscular (IM) routes. [ 10 ] Desomorphine is a morphine analogue where the 6-hydroxyl group and the 7,8 double bond have been reduced. [ 8 ]