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  • Paracetamol

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    Shaun Sp
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    Paracetamol provides rapid relief for minor to severe pain via multiple mechanisms of action in the body. It weakly inhibits prostaglandin synthesis and has a similar mechanism to COX-2 inhibitors. It also activates serotenergic pathways, enhances endocannabinoids in the central nervous system, and inhibits nitric oxide formation in the spinal cord. Paracetamol has synergistic effects when taken with opioids and NSAIDs. It is considered the cornerstone of continued analgesia when taken properly at doses of up to 4g daily for adults over 50kg, with doses spaced 4-6 hours apart. Ensuring timely dosing is an important nursing consideration.

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    Paracetamol

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    Paracetamol provides rapid relief for minor to severe pain via multiple mechanisms of action in the body. It weakly inhibits prostaglandin synthesis and has a similar mechanism to COX-2 inhibitors. It also activates serotenergic pathways, enhances endocannabinoids in the central nervous system, and inhibits nitric oxide formation in the spinal cord. Paracetamol has synergistic effects when taken with opioids and NSAIDs. It is considered the cornerstone of continued analgesia when taken properly at doses of up to 4g daily for adults over 50kg, with doses spaced 4-6 hours apart. Ensuring timely dosing is an important nursing consideration.

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    10 views1 page

    Paracetamol

    Uploaded by

    Shaun Sp
    Paracetamol provides rapid relief for minor to severe pain via multiple mechanisms of action in the body. It weakly inhibits prostaglandin synthesis and has a similar mechanism to COX-2 inhibitors. It also activates serotenergic pathways, enhances endocannabinoids in the central nervous system, and inhibits nitric oxide formation in the spinal cord. Paracetamol has synergistic effects when taken with opioids and NSAIDs. It is considered the cornerstone of continued analgesia when taken properly at doses of up to 4g daily for adults over 50kg, with doses spaced 4-6 hours apart. Ensuring timely dosing is an important nursing consideration.

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    © All Rights Reserved
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    of 1

    Rapid

    pain relief for minor to severe pain. Basis of the WHO pain ladder. Well known safety profile.

    Weak inhibitor of the synthesis of prostaglandins (PG)


    MoA similar to those of the selective cyclooxygenase-2 (COX-2) inhibitors.
    Serotenergic pathway activation (5HT3)
    Endocannabinoid enhancement in the CNS - could lead to antipyretic effect too
    Oddly, will decrease PG concentrations in vivo, but wont suppress rheumatoid arthritis inflammation.
    Decrease swelling after oral surgery in humans and suppresses inflammation in rats and mice
    Inhibition of nitrogen oxide (NO) formation (neurotransmitter of nociception, in the spinal cord)
    (NO production is activated by substance P and NMDA receptors)

    Multiple synergistic effects reported with opiates and NSAIDs like ibuprofen, some even report
    effects with dexamethasone and lidocaine* - boosting analgesia.

    With proper use & dose timings (4-6h to a max of 4g daily in adults >50kg) - paracetamol remains the
    cornerstone of continued analgesia. It should not be stopped (unless indicated) in patients with pain, should you
    escalate to more potent medications. IV to oral switch is a key consideration, but you will lose some of the
    analgesic effect. It is an extremely important nursing/medical consideration to ensure timely doses at
    appropriate intervals.
    http://ceaccp.oxfordjournals.org/content/early/2013/10/10/bjaceaccp.mkt049.full
    *http://www.sciencedirect.com/science/article/pii/S1110184915001026?np=y

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