Paracetamol / Acetaminophen

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Paracetamol: 

It is a very good and promptly acting antipyretic having negligible anti-inflammatory action.

Goodness:

  • Does not stimulate respiration or affect acid-base balance; 
  • Does not increase cellular metabolism. 
  • Has no effect on CVS. 
  • Gastric irritation is insignificant— mucosal erosion and bleeding occur rarely only in overdose. 
  • Does not affect platelet function or clotting factors and is not uricosuric.

Adverse effects: 

  • In isolated antipyretic doses paracetamol is safe and well tolerated. 
  • Nausea and rashes occur occasionally, leukopenia is rare.

Uses:

 Paracetamol is one of the most commonly used ‘over-the-counter’ analgesics for 

  • Headache, 
  • Mild migraine, 
  • Musculoskeletal pain, 
  • Dysmenorrhea, etc. 
  • Recommended as first choice analgesic for osteoarthritis by many professional bodies. 
  • One of the best drugs to be used as antipyretic, especially in children (no risk of Reye’s syndrome). 
  • Can be used in all age groups (infants to elderly), pregnant/lactating women, in presence of other disease states and in patients in whom aspirin is contraindicated. 
  • Does not have significant drug interactions.

Acute paracetamol poisoning:

  • Occurs especially in small children who have low hepatic glucuronide conjugating ability. 
  • If a large dose (> 150 mg/kg or > 10 g in an adult) is taken, serious toxicity can occur. 
  • Fatality is common with > 250 mg/kg

Dose: 

325–650 mg (children 10–15 mg/kg) 3–5 times a day. 

Examples:

  • CROCIN 0.5, 1.0 g tabs; 
  • METACIN, PARACIN 500 mg tab, 125 mg/5 ml syrup, 150 mg/ml paed. drops, 
  • ULTRAGIN, PYRIGESIC, CALPOL 500 mg tab, 125 mg/5 ml syrup, 
  • NEOMOL, FEVASTIN, FEBRINIL 300 mg/2 ml inj., 
  • CROCIN PAIN RELIEF: 650 mg + Caffeine 50 mg tab. 
  • JUNIMOL-RDS 80, 170, 250 mg suppository (for children), 
  • PARACETAMOL RECTAL SUPPOSITORY 80, 170 mg
References:
  1. Tripathi KD. Essentials of medical pharmacology. JP Medical Ltd; 2013 Sep 30.
  2. https://www.typharm.com/products/paracetamol-suppositories/ photo credit
  3. https://www.1mg.com/drugs/dolo-650-tablet-74467 photo credit
  4. https://www.flipkart.com/crocin-650-advance-tablets/p/itm3ee60252e3497photo credit
  5. https://www.calpol.co.uk/our-products/calpol-infant-suspension photo credit

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