Analgesics and pain management

Question 1

A non-narcotic analgesic-antipyretic agent

Answer 1

Paracetamol

Question 2

Excellent antipyretic and analgesic properties, lack of anti-inflammatory action, often not classified as an NSAID. Name that agent

Answer 2

Paracetamol

Question 3

Mechanism of action for paracetamol

Answer 3

Mechanisms of analgesic action not completely established- inhibit prostaglandin synthesis in the brain, but not peripherally (explaining the lack of anti-inflammatpry activity).

Question 4

Paracetamol is free of which side effects for of other NSAIDS

Answer 4

Free of gastric and platelet side effects

Question 5

Co-admister paracetemol with which drugs classes

Answer 5

NSAIDs/weak opioids

Question 6

Indication for paracetamol

Answer 6

Pyrexia, mild to moderate pain

Question 7

Explain the pharmacokinectics for Paracetamol
1. Oral bioavailability
2. Half-life

Answer 7

OB- 73-93%
1-4 hours

Question 8

explain the excretion of paracetamol

Answer 8

90-95 % of dose os conjugated in the liver and excreted renally as glucuronide and suphate metabolites. Potentially toxic intermediate formed by CYP450 ozidative enzyme system, usually detoxified by glutathione. Toxic effects on the liver and kidney may occur if glutathione stores are depleted

Question 9

explain the adverse effects for Paracetamol

Answer 9

Few in therapeutic doses
Rare- hypersensitivity skin reactions, neutropenia, thrombocytope
Long-term chronic use higher than recommended doses:
Nephro and hepatotoxicity
Potentially fatal hepatic and renal necrosis may pccur with acute overdose