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1

Loes, Michael. The Aspirin alternative: The natural way to overcome chronic pain, reduce inflammation and enhance the healing response. Freedom Press, 1999.

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2

H, Stewart J., ed. Analgesic and NSAID-induced kidney disease. Oxford University Press, 1993.

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3

W, Houde Raymond, Ley Timothy J, and Hollister Leo E. 1920-, eds. Analgesics and NSAID. Futura Pub. Co., 1985.

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4

E, Short Charles, ed. Alpha2-agents in animals: Sedation, analgesia, and anaesthesia. Veterinary Practice Pub. Co, 1992.

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5

E, Short Charles, ed. Alpha₂-agents in animals: Sedation, analgesia, and anaesthesia. Veterinary Practice Pub. Co., 1992.

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6

Kay, Brune, ed. New pharmacological and epidemiological data in analgesics research. Birkhäuser, 1990.

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7

Kay, Brune, Santoso B. 1950-, and International Symposium on Antipyretic Analgesics (1990 : Yogyakarta, Indonesia), eds. Antipyretic analgesics: New insights : Yogyakarta, March 30th, 1990. Birkhäuser Verlag, 1992.

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8

Aronson, J. K. Meyler's side effects of analgesics and anti-inflammatory drugs. Elsevier Science, 2010.

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9

N.Y.) Research and Scientific Development Conference (1984 New York. Innovations: Proceedings, the Proprietary Association's 1984 Research and Scientific Development Conference, December 5-6, 1984, the Waldorf-Astoria, New York City. The Association, 1985.

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10

Jacob, Stanley W. MSM - the definitive guide: A comprehensive review of the science and therapeutics of methylsulfonylmethane. Freedom Press, 2003.

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11

International, Meeting on the Side-effects of Anti-inflammatory Analgesic Drugs (2nd 1985 Cambridge England). Side-effects of anti-inflammatory drugs: Proceedings of the 2nd International Meeting on the Side-effects of Anti-inflammatory Analgesic Drugs, held at Cambridge, England, 31st July-2nd August 1985. MTP Press, 1987.

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12

Group, Medical Economics Research, ed. Omnibus survey: A confidential report. Medical Economics Pub. Co., 1992.

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13

S, Agoston, and Bowman W. C, eds. Muscle relaxants. 2nd ed. Elsevier, 1990.

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14

F, Willkens Robert, and Dahl Stephen L, eds. Therapeutic controversies in the rheumatic diseases. Grune & Stratton, 1987.

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15

Jaap, Vuyk, Engbers Frank H. M, and Groen-Mulder Sandra M, eds. On the study and practice of intravenous anaesthesia. Kluwer Academic Publishers, 2000.

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16

1926-, Lawrence Ronald Melvin, and Zucker Martin, eds. The miracle of MSM: The natural solution for pain. Putnam, 1999.

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17

N, Cohn Jay, and Abrams William B, eds. Cardiovascular drugs. Futura Pub. Co., 1985.

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18

D, Catto Graeme R., ed. Drugs and the kidney. Kluwer Academic Publishers, 1990.

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19

Patel, Mayur B., and Pratik P. Pandharipande. Analgesics in critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0043.

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Analgesia is a critical component of intensive care unit (ICU) care. Accordingly, understanding the mechanism, physiological consequences, and assessment of pain is important when caring for the ICU patient. Non-pharmacological approaches should be attempted before supplementing analgesia with pharmacological agents. Pharmacologically-based therapies are divided into regional and systemic therapies. Regional analgesic therapies target specific areas of the body while limiting the systemic effects of intravenous analgesics, but at the risk of invasiveness, local anaesthetic toxicity, and infect
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20

Waldmann, Carl, Neil Soni, and Andrew Rhodes. Neurological drugs. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199229581.003.0013.

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Opioid and non-opioid analgesics in the ICU 206Sedation management in ICU 208Muscle relaxants 210Anticonvulsant drugs 212Cerebroprotective agents 214Mannitol and hypertonic saline 216Opioid analgesic drugs remain the mainstay of pain relief in the Critical Care Unit. Abnormal GI function in the critically sick consequently makes enteral administration undesirable. IV administration remains the mainstay. Pharmacokinetic considerations consequent upon organ dysfunction leading to altered absorption, distribution and metabolism usually play the most important role in the choice of agent....
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21

Foo, Joanne, Benazir Saleem, and Philip G. Conaghan. Analgesics. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0078.

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Pain is one of the commonest presenting symptoms of musculoskeletal disorders and may be one the hardest to treat successfully. The available analgesic options provide different modes of action and their ranks continue to expand with new agents, some with multiple target action. This chapter reviews currently available analgesics (paracetamol and opioids) used for managing musculoskeletal pain and the agents used for neuropathic pain, including their mechanism of action, pharmacokinetics and side effects. The role of neuroleptic agents is reviewed, and a brief outline of some newer therapies f
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22

Candido, Kenneth D., and Teresa M. Kusper. Long-Acting Perioperative Opioids. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190457006.003.0009.

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Opioid medications are extensively utilized in the management of acute and chronic pain in the outpatient and inpatient clinical settings, as well as being used worldwide during both routine and complex surgeries. They have a long-standing, proven history of providing pain control during the perioperative period and have become an indispensable element of postsurgical analgesia. This chapter describes perioperative application of opioid medications, with a special focus on the long-acting opioids, morphine and hydromorphone. Most common side effects engendered using these agents and the remedi
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23

Otis, James A. D. Non-Opioid Pharmacotherapies for Chronic Pain (DRAFT). Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190265366.003.0015.

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The objective of chapter 15 is to describe analgesic approaches to chronic pain, excluding opioids. As such, it emphasizes, first, the available pharmacotherapies; and then procedures. The pharmacotherapies divide into analgesics, such as non-steroidal anti-inflammatory drugs (NSAIDs); adjuvant analgesics, such as tricyclic antidepressants and anticonvulsants; oral anesthetic agents (cardiotropics); adrenergic agonists; topical agents such as capsaicin and local anesthetic solutions and ointments; and muscle relaxants such as cyclobenzaprine, tizanidine, and baclofen. Interventions include man
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24

Rainsford. Anti-Inflammatory and Analgesic Drugs. Wiley & Sons, Limited, John, 2022.

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25

Williams, John, and Francis Bonnet. Analgesics in anaesthetic practice. Edited by Michel M. R. F. Struys. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0018.

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Each year, approximately 230 million major surgical procedures are undertaken worldwide, with over three-quarters of the patients complaining of pain postoperatively and 10% complaining of severe pain. Pain is not, however, just an unpleasant sensory consequence of surgery, but can also have significant physiological implications impacting negatively on well-being and postoperative outcome. Postoperative pain may also result in changes within the central nervous system, leading to the development of chronic pain states lasting in excess of 3–6 months. Adequate analgesia has proven to be effect
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26

Howard, Richard F. Acute pain in children. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199234721.003.0010.

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Age and maturity affect the perception and expression of pain in children. A variety of pain assessment tools are needed to cover different age groups. The British National Formulary for Children is a source of correct formulations and doses of analgesics for children of different ages. Neonates show very high interindividual response to analgesic drugs. Between 2yrs and 12yrs, the clearance of drugs exceeds that of adults and relatively higher doses may be needed. Patient-controlled, nurse-controlled, and neuraxial analgesia can all be used in infants and children. Reducing procedural pain in
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27

Furnish, Timothy, and Engy Said. New Vistas in Perioperative Pain Management. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190457006.003.0022.

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The chapter “New Vistas in Perioperative Pain Management” provides an overview of analgesics for acute pain that have been recently introduced and that are in development as well as a discussion of enhanced recovery after surgery (ERAS) programs that make use of multimodal analgesic regimens. It reviews the innovation in analgesics that has focused on new formulations and uses of older compounds including oral, intravenous, and transmucosal agents. It describes the potential role of mu-opioid g-protein modulators as novel opioids with an improved adverse effect profile as well as a novel opioi
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28

Nagy, Istvan. VR1 in inflammatory thermal hyperalgesia. Edited by Paul Farquhar-Smith, Pierre Beaulieu, and Sian Jagger. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198834359.003.0028.

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The landmark paper discussed in this chapter, published by Davis et al. in 2000, describes the role of the capsaicin receptor, which is called transient receptor potential cation channel subfamily vanilloid member 1 (TRPV1), in inflammatory thermal hyperalgesia. Capsaicin, the pungent agent found in hot peppers, has been linked to pain for centuries because it induces a burning pain sensation which, after prolonged application of the agent, turns into analgesia. Because of this, capsaicin has been used to relieve pain, most likely since prehistoric times. The elucidation of the role of TRPV1 i
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29

Wagg, Adrian, and Shashi Gadgil. Acute pain in the elderly. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199234721.003.0011.

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Physiological changes that occur with age affect the pharmacokinetics and pharmacodynamics of drugs used in acute pain management. Elderly patients are often reluctant to complain of pain and seek treatment and may sometimes be unable to express pain due to impaired cognition or language. Evidence suggests the elderly as a group that receive inadequate analgesia and are often in pain. Health care professionals are often reluctant to administer sufficient analgesia due to fear of encouraging addiction or inducing side effects. The approach to pain management in this group should follow the Worl
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30

Ivanova, Iskra I., and Lynn D. Martin. Sedation and Analgesia. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199918027.003.0010.

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This chapter on sedation and analgesia provides essential information on how to achieve and monitor the comfort of patients safely in the pediatric intensive care unit. Included is succinct information about dosing, pharmacodynamics, and pharmacokinetics of benzodiazepines, opiates, and other sedatives (propofol, etomidate, ketamine, dexmedetomidine, and nonsteroidal anti-inflammatory agents), as well as the antagonists naloxone and flumazenil. Information is also provided about the use and dosage of both depolarizing and nondepolarizing neuromuscular blocking agents (muscle relaxants) and Ame
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31

Sjøgren, Per, Frank Elsner, and Stein Kaasa. Non-opioid analgesics. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0096.

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Non-opioid analgesics encompass the non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol (acetaminophen). The NSAIDs include acetylsalicylic acid (ASA, aspirin), dipyrone (metamizole), and numerous other drugs in diverse classes. The NSAIDs have potent anti-inflammatory, analgesic and antipyretic activity, and are among the most widely used drugs worldwide. In palliative medicine, they represent the first step of the World Health Organization’s analgesic ladder used for mild pain and they are an important supplement to opioids and adjuvant drugs at higher steps of the ladder. The dis
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32

Bonnet, Francis, Marc E. Gentili, and Christophe Aveline. Post-surgical analgesia and acute pain management. Edited by Jonathan G. Hardman. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0046.

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Postoperative and acute pain remains uncontrolled in many instances, leading to the risk of development of chronic pain syndromes. After tissue damage, activation of postsynaptic NMDA receptors, also induced by opioid administration, plays a key role in postoperative pain sensitization, allodynia, and hyperalgesia. Pain intensity may depend on sex, age, anxiety, and genetic factors but in clinical practice, surgical procedure is the main determinant of pain, although pain may vary from one patient to one another. Serial pain measurements are mandatory to assess pain intensity and to guide pain
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33

Lussier, David, and Russell K. Portenoy. Adjuvant analgesics. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0097.

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In the management of pain associated with serious illness, ‘adjuvant analgesics’ usually are administered in concert with opioid therapy in an effort to improve outcomes when an opioid does not provide satisfactory relief with tolerable side effects. They may be divided into categories, including multipurpose drugs, and drugs used selectively for neuropathic pain, bone pain, pain due to bowel obstruction, or musculoskeletal pain. These drugs are selected for a trial based on limited data available and clinical experience; sequential trials may be undertaken when pain is refractory. Multipurpos
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34

Bannwarth, Bernard, and Francis Berenbaum. Systemic analgesics (including paracetamol and opioids). Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0029.

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Apart from non-steroidal anti-inflammatory drugs (NSAIDs), there are only two categories of systemic analgesics, namely paracetamol (acetaminophen) and opioids, that are currently available worldwide for clinical use. Paracetamol is poorly effective in relieving pain and improving function in patients with symptomatic osteoarthritis (OA). Furthermore, its safety profile is less favourable than classically thought. In fact, there is evidence paracetamol acts as a weak inhibitor of the cyclooxygenase enzymes. Given that paracetamol poses a lower risk of severe adverse events than NSAIDs while be
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35

Analgesia Methods And Protocols. Humana Press, 2010.

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36

BRUNE and SANTOSO. Antipyretic Analgesics : New Insights. Birkhauser, 1992.

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37

Poison Pills: The Untold Story of the Vioxx Drug Scandal. St. Martin's Griffin, 2009.

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38

Dodds, Chris, Chandra M. Kumar, and Frédérique Servin. Postoperative care and analgesia. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198735571.003.0011.

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There are many reasons for delayed recovery, but, usually, it is due to residual effects of anaesthetic agents/premedication. There are guidelines for recognizing and managing these cases. Emergence delirium may be dangerous, and it should be recognized and treated as an emergency. Elderly patients may have impaired hearing and vision. Spectacles and hearing aids should be given back to them as soon as possible in the recovery area to limit disorientation. Pain and its intensity may be difficult to recognize and quantify in the elderly. Increased inter-individual variability in the elderly mea
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39

Stevens, Craig W. Spinal opioid analgesia in the rat. Edited by Paul Farquhar-Smith, Pierre Beaulieu, and Sian Jagger. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198834359.003.0020.

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It is hard to imagine a time when the world of science and medicine did not know that morphine or other opioids administered to the spinal cord produced analgesia. However, this was the current state of knowledge in the early 1970s before the studies of Yaksh and Rudy created one of the most important paradigm shifts in the treatment of pain. The landmark paper is a pharmacology paper describing the results of the first comprehensive study of spinal opioid analgesia in the rat. The study produced the first full dose-response curves for morphine, fentanyl, methadone, and meperidine and proved a
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40

Short, Charles E. Alph A-2 Agents in Animals Sedation Analgesia and Anesthesia. Veterinary Practice Pub., 1992.

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41

Buttram, Sandra D. W., and Anne-Michelle Ruha. Toxicological Emergencies. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199918027.003.0017.

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This chapter includes essential information about common toxic exposures requiring pediatric intensive care unit care. Specific agents, grouped into categories, are reviewed, including analgesics (acetaminophen and aspirin), opiates, carbon monoxide, cardiovascular medications (calcium channel antagonists and β‎ blockers), tricyclic antidepressants, sulfonylureas, and toxic alcohols. An overview of each agent followed by clinical presentation, and appropriate diagnostic evaluation and management are provided, including alkalinization with administration of sodium bicarbonate, need for hemodial
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42

Rainsford, K. D., and M. C. Powanda. Safety and Efficacy of Non-Prescription Analgesics and NSAIDs: Proceedings of the International Conference held at The South San Francisco . . . Francisco, CA, USA on Monday 17th March 1997. Springer, 2012.

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43

(Editor), K. D. Rainsford, and M. C. Powanda (Editor), eds. Safety and Efficacy of Non-Prescription (OTC) Analgesics and NSAIDs. Springer, 1997.

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44

Galvin, Sinead, Lisa Burry, and Sangeeta Mehta. Rethinking Sedation in the ICU. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199653461.003.0040.

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Analgesic and sedative medications are commonly given to manage pain, anxiety, and delirium in critically ill patients; such agents are also used to facilitate painful procedures and to promote greater tolerance of mechanical ventilation. The manner in which we administer, titrate, and monitor analgesia and sedation in the ICU can have an impact on both short- and long-term patient outcomes. The benefit of sedation strategies that limit drug exposure and promote greater wakefulness and patient interaction has been demonstrated in several randomized trials. The overall objective of sedation in
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45

Yogyakarta, Indonesia) International Symposium on Antipyretic Analgesics (1990 :. Antipyretic Analgesics: New Insights : Yogjakarta, March 30, 1990. Birkhauser, 1999.

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46

Bulk ibuprofen from India: Determination of the Commission in investigation no. 701-TA-308 (preliminary) under the Tariff Act of 1930, together with the information obtained in the investigation : determination of the Commission in investigation no. 731-TA-526 (preliminary) under the Tariff Act of 1930, together with the information obtained in the investigation. U.S. International Trade Commission, 1991.

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47

Non-opioid (OTC) analgesics: Risks/benefits in perspective (Agents and actions supplements). Birkhauser Verlag, 1988.

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48

Columb, Malachy O. Local anaesthetic agents. Edited by Michel M. R. F. Struys. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0017.

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Local anaesthetic agents cause a pharmacologically induced reversible neuropathy characterized by axonal conduction blockade. They act by blocking the sodium ionophore and exhibit membrane stabilizing activity by inhibiting initiation and propagation of action potentials. They are weak bases consisting of three components: a lipophilic aromatic ring, a link, and a hydrophilic amine. The chemical link classifies them as esters or amides. Local anaesthetics diffuse through the axolemma as unionized free-base and block the ionophore in the quaternary ammonium ionized form. The speed of onset of b
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49

Harrison, Mark. Anaesthesia. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198765875.003.0047.

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This chapter describes the pharmacology of anaesthesia as it applies to Emergency Medicine, and in particular the Primary FRCEM examination. The chapter outlines the key details of intravenous agents, inhalational agents, sedatives and analgesics, muscle relaxants, antagonist agents, and local anaesthesia. This chapter is laid out exactly following the RCEM syllabus, to allow easy reference and consolidation of learning.
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50

Nagy, Istvan. The capsaicin receptor. Edited by Paul Farquhar-Smith, Pierre Beaulieu, and Sian Jagger. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198834359.003.0027.

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The landmark paper discussed in this chapter is ‘The capsaicin receptor: A heat activated ion channel in the pain pathway’, published by Caterina et al. in 1997. The identification of the molecular basis for the sensitivity of a major proportion of nociceptive primary sensory neurons for capsaicin, the pungent agent in chilli pepper, was undoubtedly one of the most significant pain-related discoveries in the twentieth century, for at least three reasons. First, the mechanism for capsaicin-induced responses could unequivocally be explained. Second, the discovery heralded the starting point for
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