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Poisoning
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Patients may develop nausea, vomiting and abdominal pain in the first few hours of paracetamol overdose and following this there can be a period in which the patient is asymptomatic. Clinical signs of liver injury, such as jaundice and right upper quadrant tenderness, typically develop 24–48 hours post-overdose.
Critical care, neurology and analgesia
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
Paracetamol (acetaminophen) has been used in clinical practice for over one hundred years and is the most commonly prescribed paediatric medicine. The popularity of paracetamol over the non-steroidal antiinflammatory agents increased after the reported association between Reye’s syndrome and aspirin in the 1980s. Paracetamol is widely used in the management of pain and fever, but is lacking antiinflammatory effects. The mechanism of action of paracetamol analgesia is multifactorial. It is a potent inhibitor of prostaglandin synthesis within the central nervous system but also acts peripherally by blocking impulse generation within the bradykinin-sensitive chemoreceptors responsible for the generation of nociceptive impulses. Paracetamol is also thought to have an analgesic effect by antagonising N-methyl-D-aspartate (NMDA) and substance P in the spinal cord, with some inhibitory action on spinal nitric oxide mechanisms [1–3] and serotonergic pathways [4].
Pain management
Published in Barbara Smith, Linda Field, Nursing Care, 2019
Paracetamol can be used to relieve headache, muscle aches and general pain and to reduce fever. It can also be given in combination with an opioid to help control breakthrough pain.
Protective effects of resveratrol and avocado oil against paracetamol-induced hepatotoxicity in rats
Published in Drug and Chemical Toxicology, 2022
Erdi Onur Gokkaya, Sukriye Yesilot, Meltem Ozgocmen, Rahime Aslankoc, Cigdem Aydin Acar
Paracetamol, which is also known as acetaminophen, is a powerful analgesic and antipyretic drug. It is among those drugs that are affordable, easily accessible, and available without a prescription. Paracetamol is considered to be very safe when used in therapeutic doses, in addition to being associated with few side effects, which has led to its widespread use worldwide. However, the risk of paracetamol toxicity is acknowledged to be high due to the drug’s widespread use, high safety profile, and easy availability without a prescription. Moreover, paracetamol overdose has been reported to result in severe hepatotoxicity in experimental animals and humans (Lewis and Paloucek 1991, McGill et al.2012, Jaeschke et al.2013, Ingawale et al.2014, Brune et al.2015).
Evidence of drug-induced hepatotoxicity in the Maghrebian population
Published in Drug and Chemical Toxicology, 2022
Mohammed Bourhia, Riaz Ullah, Ali S. Alqahtani, Samir Ibenmoussa
Paracetamol was reported to have side effects on the liver with 3.09% in total cases of drug-induced liver damage. The secondary effect of paracetamol on the liver is induced in a dose-dependent manner upon massive ingestion (doses higher than 125 mg/kg in adults and 100 mg/kg in children). Paracetamol is predicted to induce major clinical symptoms in the liver such as cytolytic icterus and hepatocellular insufficiency upon 2–3 days of administration in patients massively use alcohol or adversely affected by malnutrition and even those concomitantly intake of cytochromatic inducer (Claridge et al.2010). Paracetamol toxicity is considered as one of the most important causes of poisoning worldwide. It is known to induce toxicity when taken in highly repeated doses. Paracetamol is responsible for approximately half of the confirmed cases with liver failure in the United States and remains the principal cause of liver transplantation (Tittarelli et al.2017). However, other data reported no adverse effects of paracetamol on the health of volunteers concomitantly consuming 1–3 units of alcohol and 4 g of paracetamol per day (no change in ALT and AST; Heard et al.2007).
Why paracetamol (acetaminophen) is a suitable first choice for treating mild to moderate acute pain in adults with liver, kidney or cardiovascular disease, gastrointestinal disorders, asthma, or who are older
Published in Current Medical Research and Opinion, 2022
John Alchin, Arti Dhar, Kamran Siddiqui, Paul J. Christo
Paracetamol has antipyretic and analgesic effects (Figure 1), with complex mechanisms that distinguish it from non-steroidal anti-inflammatory drugs (NSAIDs) and opioids1,2,6,9. Its most common everyday uses in adults include headaches, and musculoskeletal, or menstrual pain7; musculoskeletal pain and sprains/injury account for 45% of pain episodes for which adults may use OTC or prescription analgesics (Figure 2)10. The standard adult dose of paracetamol is 0.5–1.0 g, taken as needed at least 4–6 h apart, to a maximum of 4 g/day; it is recommended to use the lowest dose that relieves symptoms, taken for the shortest possible treatment duration8,11,i.