NEURO: PARACETAMOL

Question 1

PARACETAMOL: INDICATIONS

Answer 1

• Acute and Chronic Pain

- Antiphyretic = for fever

Question 2

PARACETAMOL: MOA

Answer 2

• Weak inhibitor of COX (involved in PG metabolism)
• CNS = COX inhibition ppears to increase the pain threshold and reduce PGE2 concentrations in the thermoregulatory region of the hypothalamus = control fever
• Specificity for COX -2

Question 3

PARACETAMOL: ADVERSE EFFECTS

Answer 3

• V few SEs
• Lack of COX 1 = does not cause peptic ulceration, renal impairment or precipitate CV events
• OD = Liver Failure => NAPQI, Michelle Ramsey

Question 4

PARACETAMOL: WARNINGS

Answer 4

• Reduce dose in people at risk of liver toxicity
• Chronic excessive alcohol use
• Reduced GLUTATHIONE STORES = malnutrition, low body weight, severe hepatic impairment

Question 5

PARACETAMOL: IMPORTANT INTERACTIONS

Answer 5

• Cytochrome P450 inducers ( phenytoin and carbamzepine) = increase the rate of NAPQI production and risk of liver toxicity