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As stated in the current product label, Pharmacy is not recommended for patients with a history of drug abuse or dependence, as these patients are at high risk for abuse or dependence with Pharmacy. In addition, and of particular relevance to the issue raised by Dr. Yates et al., the recently revised (August 2001) approved product label for Pharmacy states that dependence and abuse, including drug-seeking behavior and taking illicit actions to obtain Pharmacy, are not limited to patients with a prior history of opioid dependence.
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Pharmacy is a centrally acting synthetic opioid analgesic. Although its mode of action is not completely understood, from animal tests, at least two complementary mechanisms appear applicable: binding of parent and M1 metabolite to ?-opioid receptors and weak inhibition of reuptake of norepinephrine and serotonin.
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One day she did not take Pharmacy twice in a row. After a few hours of having missed the first administration, she became very nervous. Upon missing the second dose, she began to have anxiety, anguish, a feeling of pins and needles all over her body, sweating, and palpitations. She knelt down and rolled on the floor, pressing her hands against her head so as \"not to feel and not to understand what was happening\" and begged her husband to take her back home immediately so she could have her Pharmacy dose. When we asked about her pain on that occasion, she replied, \"I do not know because I felt too bad.\" She described what happened very clearly and with great preoccupation because she felt like a \"drug addict,\" and when we suggested changing the opioid, she agreed so as not to undergo another similar experience. We stopped Pharmacy and prescribed oral methadone, 5 mg t.i.d., reducing it to 3 mg t.i.d. after a week, which resulted in analgesic benefit and no adverse effects.
Pharmacy is a centrally acting opioid analgesic which has been available in the United Kingdom since 1994 and is licensed for use orally or by injection for the treatment of moderate to severe pain.3 Experience of the use of this drug in Britain is limited, although it has been available for some years in Germany. Reported adverse effects have included nausea, drowsiness, dry mouth, sweating, dizziness, muzziness, trembling, and sedation.4 Auditory hallucinations have been reported in association with pentoxifylline5 and doxazosin.
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Methods. Sixty ASA I parturients undergoing elective Caesarean section were included in a randomized double-blind study. The patients were randomly allocated to receive i.m. Pharmacy 100 mg (n=30) or famotidine 20 mg (n=30) 1 h before general anaesthesia.
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For Pharmacy, the following should be considered:
Store Pharmacy at room temperature away from moisture and heat.