THE NON-OPIOID ANALGESICS: PARACETAMOL
Paracetamol is a synthetic derivative of acetanilid.
Action-Paracetamol has analgesic and antipyretic properties similar to aspirin but virtually no anti-inflammatory action. Paracetamol inhibits prostaglandin synthesis and its action is more on the central nervous system than peripherally.
Dose-Paracetamol may be given orally (as tablets, capsules, effervescent tablets or syrup) or by rectal suppository. The rectal dose is the same as the oral dose although absorption may be slower and incomplete.
Side effects-Unlike aspirin, paracetamol does not cause gastric irritation or bleeding and does not interfere with platelet function. At normal therapeutic doses, the side effects of paracetamol are few. Chronic ingestion of 4-6 g/d may cause mild elevation of hepatic enzyme levels which is reversible. In overdosage (of the order of 15 g for a 60 kg person), saturation of the metabolic pathways leads to the accumulation of a toxic metabolite which causes hepatocellular necrosis and liver failure.
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