Paracetamol " : " Acetaminophen
Trade names: acamol, panadol
Class: antipyretic, non opioid analgesic, Para-aminophenol type.
Pregnancy: (Category B)
Action: Acetaminophen decrease fever by an effect on hypothalamus
leading to sweating & vasodilatation.
It also inhibits the effect of pyrogens on the heat-regulating
Center on the hypothalamus.
It may cause analgesia by inhibiting CNS prostaglandin syntheses
So it has no anti-inflammatory effect.
It doesn’t manifest any anticoagulant effect or any ulceration of GIT.
Uses:
1. Pain due to Headache, dysmenorrhea, arthralgia, myalgia, muscluoskletal pain,
immunization, teething, tonsillectomy.
2. To reduce fever due to bacterial & viral infection.
3. As a substitute for aspirin when contraindicated.
Contraindications:
Renal insufficiency, anemia.
Side effects:
Chronic & even acute toxicity can occur after long symptom-free usage.
Hemolytic anemia, neutropnea, thrombocytopenia
Skin rashes, fever, jaundice, and hypoglycemia.
Symptoms of over dosage:
Hepatic toxicity general malaise, delirium, depression seizures,
Coma & death, nausea, vomiting, fever, and vascular collapse.
Treatment of overdose:
1- Induction of emesis.
2- Gastric lavage.
3- Activated charcoal.
4- Oral N-acetyleystine (mucomyst) is said to reduce or prevent hepatic
damage by inactivating acetaminophen metabolites which cause liver effects.
Dose: by mouth, 0.5–1 g every 4–6 hours to a max. Of 4 g daily;
Child:
2 months 60 mg for post-immunization pyrexia;
Otherwise under 3 months (on doctor's advice only), 10 mg/kg
(5 mg/kg if jaundiced);
3 months–1 year 60–120 mg,
1–5 years 120–250 mg,
6–12 years 250–500 mg;
These doses may be repeated every 4–6 hours when necessary
(Max. of 4 doses in 24 hours)
Nursing considerations:
1- Suppositories should be stored below 27C.
2- Liver function studies for long term therapy.
3- Note signs of met-hemoglobinemia: bluish discoloration of gum & fingernails.
4- Have mucomyst available for signs of toxicity.
5- Teach patient signs of toxicity to be reported immediately.
