• mechanism of paracetamol and how differs from aspirin

paracetamol is a weak cox 1 and cox 2 inhibitor peripheral, has no anti-inflammatory effect, blocks cox 3 CNS activating declining serotonergic analgesic pathway. differs from aspirin because aspirin has an inflammatory effect and it does have an effect on cox 3

• indication of paracetamol and condition which it may be used for mild pain and fever

pain , fever , as an antipyretic( temperature regulation, peptic ulcer, hemophilia and asthma and it can be used on mild pain and fever as choice if they are of somatic origin

 

• side effects of paracetamol

-low fever , nausea, dark urine , jaundice and loss of  appetite

• acute paracetamol toxicity, doses , symptoms and treatment

paracetamol is only safe in low doses but in high doses it becomes very toxic, though at therapeutic dosage it is well tolerated but it must be adjusted in alcoholic people , people with liver and kidney diseases and in people with anemia as it may cause more damage

paracetamol toxicity may lead skin rash and urticaria

within 1-2 day of paracetamol poisoning the patient may experience nausea , vomiting , abdominal pain decreased appetite ,tired and powerless and then after the 1-2 days they maybe start experiencing right subcostal pain , tar liver , jaundice renal insufficiency and liver necrosis or death

treatment 

immediate supplementation  of SH-groups to supplement glutathione in liver and prevent liver cell necrosis 

N-acetylcysteine (parrolex) administered within 8-12 hours , Initial  dose 150mg/kg in 200 ml 5% glucose over 15 minutes , thereafter 50 mg/kg in 500 ml 5% glucose over 4 hours , thereafter 100mg/kg in 1000 ml 5% glucose over 16 hours 

oral treatment: acetylcysteine 140mg/kg or carboscistein 150 mg/kg