fever

Question 1

paracetemol indications

Answer 1

• analgesic

- fever

Question 2

paracetamol MOA

Answer 2

Weak inhibitor of COX. in breain COX inhibition increases pain threshold and reduce PGE2 conc in thermoregulatory region of hypothalamys controlling fever

• specific to COX2 but weak antiinflammatory as actions inhibited in inflammatory lesions by peroxides

Question 3

paracetamol SE

Answer 3

• In OD - liver failure.

- NAPQI increase in OD = HCC necrosis.

Question 4

Paracetemol relative CI

Answer 4

• reduce dose in those at increased risk of liver toxicity either because of increased NAPQI (e.g. in chronic excessive alcohol use, inducing metabolic enzymes)

or reduced glutathione stores
- malnutrition, low body weight <50kg, severe hepatic impairment

Question 5

interactions paracetamol

Answer 5

• CYP inducers increase rate of NAPQI production and risk liver toxicity after paracetamol OD