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  • Paracetamol

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    Paracetamol, also known as acetaminophen and APAP, is a medicine used to treat pain and fever. It is typically used for mild to moderate pain relief. Evidence for its use to relieve fever in children is mixed. It is often sold in combination with other medications, such as in many cold medications. In combination with opioid pain medication, paracetamol is also used for severe pain such as cancer pain and pain after surgery. It is typically used either by mouth or rectally, but is also available intravenously. Effects last between 2 and 4 hours. Paracetamol is generally safe at recommended doses. The recommended maximum daily dose for an adult is 3 or 4 grams. Higher doses may lead to toxicity, including liver failure. Serious skin rashes may rarely occur. It appears to be safe during pregnancy and when breastfeeding. In those with liver disease, it may still be used, but in lower doses. It is classified as a mild analgesic. It does not have significant anti-inflammatory activity and how it works is not entirely clear. Paracetamol was first made in 1877. It is the most commonly used medication for pain and fever in both the United States and Europe. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. Paracetamol is available as a generic medication with trade names including Tylenol and Panadol, among others. The wholesale price in the developing world is less than US$ 0.01 per dose. In the United States, it costs about US$0.04 per dose.

  • Oxycodone

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    Oxycodone, sold under brand name OxyContin among others, is an opioid medication used for treatment of moderate to severe pain. It is usually taken by mouth, and is available in immediate release and controlled release formulations. Onset of pain relief typically begins within 15 minutes and lasts for up to six hours with the immediate release formulation. In the United Kingdom, it is available by injection. Combination products are also available with paracetamol (acetaminophen) or aspirin. Common side effects include constipation, nausea, sleepiness, dizziness, itching, dry mouth, and sweating. Severe side effects may include addiction, respiratory depression (a decreased effort to breath), and low blood pressure. Those allergic to codeine may also be allergic to oxycodone. Use of oxycodone in early pregnancy appears relatively safe. Opioid withdrawal may occur if rapidly stopped. Oxycodone acts by activating the μ-opioid receptor. When taken by mouth, it has roughly 1.5 times the effect of the equivalent amount of morphine. Oxycodone was first made in Germany in 1916 from thebaine. It is avaliable as a generic medication. In the United States the wholesale cost per dose is less than 0.30 USD as of 2018. In 2016 it was the 54th most prescribed medication in the United States with more than 14 million prescriptions. Oxycodone has been a common drugs of abuse. A number of abuse-deterrent formulations are avaliable such as in combination with naloxone.

  • Codeine

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    Codeine is an opiate used to treat pain, as a cough medicine, and for diarrhea. It is typically used to treat mild to moderate degrees of pain. Greater benefit may occur when combined with paracetamol (acetaminophen) or a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin or ibuprofen. Evidence does not support its use for acute cough suppression in children or adults. In Europe it is not recommended as a cough medicine in those under twelve years of age. It is generally taken by mouth. It typically starts working after half an hour with maximum effect at two hours. The total duration of its effects last for about four to six hours. Common side effects include vomiting, constipation, itchiness, lightheadedness, and drowsiness. Serious side effects may include breathing difficulties and addiction. It is unclear if its use in pregnancy is safe. Care should be used during breastfeeding as it may result in opiate toxicity in the baby. Its use as of 2016 is not recommended in children. Codeine works following being broken down by the liver into morphine. How quickly this occurs depends on a person's genetics. Codeine was discovered in 1832 by Pierre Jean Robiquet. In 2013 about 361,000 kilograms of codeine were produced while 249,000 kilograms were used. This makes it the most commonly taken opiate. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. The wholesale cost in the developing world is between 0.04 and 0.29 USD per dose as of 2014. In the United States it costs about one dollar a dose. Codeine occurs naturally and makes up about 2% of opium.

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