|Analgesia and Pain management
|Sedation and Analgesia on ITU
|Neuropathic Pain Management
Fizzy dispersible tablets (500 mg) for adults who have trouble swallowing tablets. The paracetamol is mixed with citric acid and sodium hydrogen carbonate which effervesce when put into water. The effervescence rapidly disperses the drug into a fine suspension. However, if taken regularly this is a high salt intake.
- A cheap and useful analgesia with few side-effects
- Only concern though highly significant is its use in overdose.
- University of Strassburg in the 1880s
- Professor Kussmaul's assistants discovered the antipyretic effects.
Mode of action
- Mild anti inflammatory drug
- Acts on COX indirectly by reversible non-competitive inhibition.
- Pure Paracetamol/Acetaminophen is a white crystalline solid which melts at 169-171°C.
- Its solubility in cold water is low but it is much more soluble in hot water and ethanol
- Paracetamol (US Tylenol) 500 mg - 1 g QDS PO or PR or IV
- Half dose in those with weight < 50 kg or malnourished
- Use PO if possible as IV is expensive
- Analgesia, Mild anti-inflammatory, Antipyretic
- In overdose can cause liver necrosis and acute kidney injury due to the formation of N-acetyl p-benzoquinone imine (NADQI) when the usual liver conjugation systems are saturated.
- Prothrombin time is elevated as well as transaminases. Liver transplantation may be needed. Death is not uncommon.
- Paracetamol/Acetaminophen (US Tylenol) increases the anticoagulant effect of Warfarin.
- Both Paracetamol/Acetaminophen and alcohol (beverage) can increase the risk of hepatotoxicity.