PANADOL- Paracetamol
PRESENTATION- Tab 80 mg , 500 mg , liqd 120 mg , Supp 125 mg, 250 mg , Drops 80 mg / 0.8 ml .
ACTIONS- Analgesic and antipyretic.
pharmacokinetics- After oral administration, paracetamol is absorbed rapidly and completely from the small intestine ; peak plasma levels occur 30-120 min after administration.
Paracetamol is uniformly distributed throughout most body fluids; the apparent volume of distribution is 1.2 L/kg. It can cross the placenta and is excreted in milk . Plasma protein -binding is negligible at usual therapeutic concentrations but increases with increasing concentrations.
Paracetamol is metabolised by the hepatic microsomal enzyme system in adults at therapeutuic does and is mainly conjugated with glucuronide ( 45-55% ) or sulfate ( 20-30% ) . A minor proportion (< 20%) is metabolised to catechol derivatives and mercapturic acid compounds via oxidation.
paracetamol is differently metabolished by infants and children compared to adults. the sulfate conjugate being predominant . Paracetamol is excreted in the urine mainly as the glucuronide and sulfate conjugates. Less than 5% is excreted as unchanged paracetamol with 85-90% of the administered dose eliminated in the urine within 24 hrs of ingestion. The elimination half life varies from about 1-4 hrs. Food intake delays paracetamol absorption.
INDICATIONS- Relief of pain and fever.
DOSAGE&ADMINISTRATIONS-Tablet ;Adults and Children > 12 Years: 500 mg to 1 g every 3-4 hrs, up to 4 g may be taken
Children 7- 12 years:250-500 mg every 3-4 hrs, up to 2 g may be taken.
Liquid: Children 6 -12 years: 2-4 tsp;1-6 years :1-2 tsp, 3 months to 1 year 1/2 -1 tsp.
Drops : Children 3-6 years:2-3 drops; 1-3 years:1 1/2 -2 drops;4 months to 1 year : 1-1 1/2 drops.
OVEDOSAGE : Toxic symptoms include vomiting ,abdominal pain, hypotension and sweating .The most serious adverse effect of acute overdosage of paracetamol is a dosage- dependent,m potentially fatal hepatic necrosis . In adults, hepatotoxiocity may occur after ingestion of a signal dose of paracetamol 10-15 g ( 30 tabs) a dose of _> 25 g ( 50 tabs) is potentially fatal.Symptoms during the first 2 days of acute poisoning by paracetamol do not reflect the potential seriousness of the intoxication. Major manifestations of hepatic failure, eg jaundice , hypoglycemia and metabolic acidosis may take at least 3 days to develop .
PRECAUTIONS: Administer with caution to patients with hepatic or renal dysfunction.
Use in pregnancy: Paracetamol can cross the placenta;however ,no teratogenic effects have been observed in rats or mice, after doses of up to 250 mg / kg.
Use in lactation: Paracetamol is excreted in breast milk. The amount available for ingestion by the infant has been reported variously as < 0.1% of a single 500 mg dose and as 0.04-0.23% of a single 650 mg dose. Maternal ingestion of paracetamol in usual analgesic doses does not appear to present a risk to the breastfed infant.
ADVERSE REACTIONS: When taken in recommended doses, paracetamol is usually free from adverse effects and will not upset the stomach. Skin reactions, eg urticaria have been described rarely.
INTERACTIONS: Anticoagulant dosage may require reduction if panadol medication is prolonged. Paracetamol absortion is increased by drugs which increas gastric emptying, eg propantheline, antidepressants with anticholinegric properties, narcotic analgesics Paracetamol may increase chloramphenicol concentrations. The likelihood of paracetamol toxicity may be increased by the concomitant use of enzyme- including agents, eg alcohol or anticoagulant drugs.
paracetamol is differently metabolished by infants and children compared to adults. the sulfate conjugate being predominant . Paracetamol is excreted in the urine mainly as the glucuronide and sulfate conjugates. Less than 5% is excreted as unchanged paracetamol with 85-90% of the administered dose eliminated in the urine within 24 hrs of ingestion. The elimination half life varies from about 1-4 hrs. Food intake delays paracetamol absorption.
INDICATIONS- Relief of pain and fever.
DOSAGE&ADMINISTRATIONS-Tablet ;Adults and Children > 12 Years: 500 mg to 1 g every 3-4 hrs, up to 4 g may be taken
Children 7- 12 years:250-500 mg every 3-4 hrs, up to 2 g may be taken.
Liquid: Children 6 -12 years: 2-4 tsp;1-6 years :1-2 tsp, 3 months to 1 year 1/2 -1 tsp.
Drops : Children 3-6 years:2-3 drops; 1-3 years:1 1/2 -2 drops;4 months to 1 year : 1-1 1/2 drops.
OVEDOSAGE : Toxic symptoms include vomiting ,abdominal pain, hypotension and sweating .The most serious adverse effect of acute overdosage of paracetamol is a dosage- dependent,m potentially fatal hepatic necrosis . In adults, hepatotoxiocity may occur after ingestion of a signal dose of paracetamol 10-15 g ( 30 tabs) a dose of _> 25 g ( 50 tabs) is potentially fatal.Symptoms during the first 2 days of acute poisoning by paracetamol do not reflect the potential seriousness of the intoxication. Major manifestations of hepatic failure, eg jaundice , hypoglycemia and metabolic acidosis may take at least 3 days to develop .
PRECAUTIONS: Administer with caution to patients with hepatic or renal dysfunction.
Use in pregnancy: Paracetamol can cross the placenta;however ,no teratogenic effects have been observed in rats or mice, after doses of up to 250 mg / kg.
Use in lactation: Paracetamol is excreted in breast milk. The amount available for ingestion by the infant has been reported variously as < 0.1% of a single 500 mg dose and as 0.04-0.23% of a single 650 mg dose. Maternal ingestion of paracetamol in usual analgesic doses does not appear to present a risk to the breastfed infant.
ADVERSE REACTIONS: When taken in recommended doses, paracetamol is usually free from adverse effects and will not upset the stomach. Skin reactions, eg urticaria have been described rarely.
INTERACTIONS: Anticoagulant dosage may require reduction if panadol medication is prolonged. Paracetamol absortion is increased by drugs which increas gastric emptying, eg propantheline, antidepressants with anticholinegric properties, narcotic analgesics Paracetamol may increase chloramphenicol concentrations. The likelihood of paracetamol toxicity may be increased by the concomitant use of enzyme- including agents, eg alcohol or anticoagulant drugs.
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