What is the mechanism of action of paracetamol? Not a weak peripheral COX1 and COX2 inhibitor, anti-inflammatory agent. It blocks COX3 in the CNS and activates the reduction of serotonergic analgesic pathways. Antipyretic: Direct effect on the thermoregulatory center of the hypothalamus. How is it different from aspirin? Aspirin is an irreversible non-selective blocker of cyclooxygenase (COX) that blocks COX1 and 2. This reduces the production of prostaglandins (PG), thromboxane (TXA), and prostacyclin (PGI). Name the indication for paracetamol. Under what circumstances is the drug of choice for the treatment of mild pain and fever? • Relief of mild to moderate pain of somatic origin • Suitable for patients with contraindications for NSAIDs Asthma, gastric ulcer, hemophilia • Treatment choices for children • Rash and urticaria • No effect on platelet adhesion • No effect Therefore, for uricosuric, it can be used with uricosuric drugs. Name the side effects that you may experience when using paracetamol. • Antipyretic • False safety delusion: 1015g (ie 2030 tablets) can be fatal • Chronic consumption of 2g / day can also lead to acetaminophen poisoning. • Painkiller combinations can increase toxicity. • Alcohol addicts: Even therapeutic doses can be hepatotoxic • Overdose: Hepatotoxicity Discusses acute acetaminophen toxicity and produces reports highlighting doses, signs and symptoms, and treatment increase. Signs and symptoms: Within 12 days: • Abdominal pain • Nausea and vomiting • Loss of appetite • Tired and weak 12 days later: • Lower right rib • Jaundice • Tar liver • Development of renal failure • Liver necrosis and death Dosage: 1015 g (Ie 2030 tablets) can be fatal. Chronic intake of 2 g / day can also lead to acetaminophen poisoning. Treatment: • Immediate supplementation of the SH group to supplement liver glutathione and prevent hepatocellular necrosis. • N-Acetylcysteine ​​(Parvolex®) IV administration within 812 hours. • Starting dose: 200 ml in 15 minutes 150 mg / kg with 5% glucose, • 500 ml in 4 hours 50 mg / kg with 5% glucose, • 1,000 ml 100 mg / kg with 5% glucose 16 hours • Oral treatment: Acetylcysteine ​​(Solmucol®, ACC®), 140 mg / kg or Carboscistein (Mucosirop®, Flemex®) 150 mg / kg • Within 1 hour after poisoning: • Inducing vomiting • Gastric lavage • Administer activated charcoal when using IV treatment • Note: Treatment is only effective within 10 hours of poisoning