Efficacia e tollerabilità dell'associazione di paracetamolo e codeina nel dolore moderato severo.

The aim of this work is to evaluate the dose of analgesic efficacy and tolerability of codeine phosphate in combination with fixed dose of paracetamol and the time required to achieve a clinically relevant reduction in moderate-severe intensity. Paracetamol is the drug of first choice;in cases where it is ineffective,the therapeutic choice involves the addiction of weak opioids,which represent a valid safer,more effective and tolerable alternative to non-steroidal anti-inflammatory drugs(NSAIDs). The analgesic action of paracetamol is essentially due,through its central mechanism of action,to the ability to selectively inhibit cyclooxygenases,with subsequent inhibition of prostglandin synthesis in the nervous system. codeine is a weak opioid which induces analgesia by acting at different levels of the central nervous system.It's a monomethyl ether of morphine,it binds to the micron receptor for opioids causing hyperpolarization of neurons which lead to the inhibition of the release of nociceptive neurotransmitters with consequent analgesic effect and greater pain tolerance. Codeine does not alter the pain threshold or act on the conductance of nerve impulses,but in modifying the perception of pain,especially when used in combination with paracetamol.