Paracetamol is a non-steroidal anti-inflammatory drug that is often used to reduce temperature and eliminate high fever in infectious diseases. Prevalence of use Paracetamol tablets associated with the availability of the drug - it is inexpensive, you can find the drug in any pharmacy. Paracetamol for head patients often use it because in addition to the antipyretic effect, the drug also has an analgesic effect.
Compound
Paracetamol is a white tablet, sometimes with a creamy tint. In addition, there is also syrup, which is often prescribed to small children.
One tablet of the drug contains either 200 or 500 mg of paracetamol as a chemical substance (depending on the dosage). The drug also contains auxiliary compounds, for example, potato starch, povidone, stearic acid, and croscarmellose sodium.
In what cases is it effective?
The drug has an effect in various febrile conditions associated with elevated temperature. Particularly effective for colds.
Paracetamol is able to cope with pain of varying intensity. It is often used for headaches and toothaches. Helps women with pain during menstruation.
The drug is allowed to be taken by pregnant women and babies from 3 months. For children there are baby candles and syrup. The product is often given to babies who are starting to cut their teeth.
Pharmacodynamics
The drug belongs to the group of non-narcotic analgesics - the drug has an analgesic effect. Paracetamol has a pronounced antipyretic and analgesic effect. The biochemical basis of these reactions is inhibition of cyclooxygenase (one of the leading enzymes responsible for the synthesis of prostaglandins - mediators of inflammation).
Thus, the synthesis of prostaglandins is inhibited in the nervous system, which, moreover, have a pyrogenic effect (leading to an increase in temperature) on the hypothalamus, where the thermoregulation center is located. The hypothalamus is a brain structure responsible for both maintaining the required body temperature and producing certain hormonal factors. Inhibition of prostaglandin synthesis leads to a decrease in their pyrogenic effect on the hypothalamus, heat transfer from the body increases, and temperature decreases.
In parallel, Paracetamol affects the conduction of pain sensitivity impulses along afferent nerve fibers. This mechanism of action provides an analgesic effect.
Research is being conducted on the effect of Paracetamol on the serotonin system, as well as cannabinoid transmission in the brain.
Indications and contraindications for use
Systemic use of Paracetamol by a patient is possible only with a prescription from the attending physician. Self-medication is strictly prohibited, because the drug has both strict indications for use and a number of contraindications.
Paracetamol is a symptomatic remedy. The drug reduces the severity of some symptoms without affecting the actual cause of their occurrence.
Indications for use
| Indications for use | Decoding |
| Different types of pain | Paracetamol is effective for eliminating headaches, dental pain, muscle pain, and discomfort during the menstrual cycle. In addition, the drug is prescribed for the initial stages of arthritis in patients to relieve joint pain. Paracetamol has a moderate analgesic effect, which explains its use in the presence of mild pain. |
| Feverish conditions | Provides relief of fever as a symptom of acute respiratory viral infections, influenza, and other infectious diseases accompanied by an increase in body temperature. The drug is able to effectively reduce body temperature and alleviate the patient's condition. |
Contraindications for use
| Contraindication for use | Decoding |
| Presence of hypersensitivity to one or more components of the drug | The use of Paracetamol is prohibited in patients with episodes of allergic reactions after taking the drug. With repeated use, severe hypersensitivity reactions may develop, including the development of anaphylactic shock. |
| Children under 6 years old | The age-related contraindication to Paracetamol therapy also cannot be ignored: taking the drug in childhood is not allowed. |
| Combinations with other medicinal compounds containing paracetamol | It is prohibited to take Paracetamol while using certain other medications that contain the chemical compound “paracetamol” as an active ingredient. Often, medications to eliminate some symptoms of infectious diseases contain paracetamol. When taking Paracetamol tablets and other substances containing paracetamol, the side effects of the drugs may increase. |
| Liver diseases | The drug should be used with caution in patients with liver diseases, for example: benign hyperbilirubinemia, viral hepatitis, alcoholic liver damage. This is due to impaired liver detoxification function. |
| Pregnancy and lactation period | The drug should be used as carefully as possible during pregnancy and breastfeeding. The dosage should be selected individually with your doctor. |
| Elderly age | Warning when using Paracetamol in old age is associated with physiological changes in metabolism in the body of an elderly person, which also requires careful adjustment of the dosage of the drug. |
Effect of the drug
Paracetamol has been considered a popular and sought after pain reliever and antipyretic for half a century. Efficiency is associated with uniform distribution across tissues.
The active ingredients block the action of prostaglandins, which are sources of pain. This eliminates moderate pain. The drug also copes well with fever. This serious symptom can indicate a variety of infectious and inflammatory diseases.
Before taking it, you should consult your doctor and read the instructions to prevent side effects. You should strictly follow the dosage, otherwise complications related to the functioning of the heart and kidneys may occur. The risk increases when taken concomitantly with alcoholic beverages.
Signs of poisoning do not appear immediately. Initially, your general well-being may only slightly deteriorate.
Instructions for use: methods, dosage
The instructions indicate that the medicine must be taken orally (by mouth), in the case of tablets, washed down with one glass of water. The instructions for use of Paracetamol also note that the dosage and frequency of taking the drug varies depending on the age of the patient.
Adult patients and children over the age of 12 years are recommended to take 2 tablets with a dosage of 200 mg or one tablet with a dosage of 500 mg (from 400 to 500 mg) every 4-6 hours when the temperature rises or pain increases. It is important to remember that the maximum dose of Paracetamol that can be consumed per day is 4 g. That is, if the patient takes 500 mg tablets, then no more than 8 tablets are allowed to be taken in 24 hours. Accordingly, if a person takes tablets with a dosage of 200 mg, you can drink no more than 20 tablets per day.
If Paracetamol tablets are prescribed to a child aged 6 to 12 years, the dosage changes significantly, the calculation is made individually. How much Paracetamol should children take? If in the instructions for adults the height and weight of the patient do not matter, then in the case of a child these are the key parameters. Paracetamol for fever or as a pain reliever should be used, observing the following rules:
- dose per dose (single dose) is 10-15 mg per 1 kilogram of the child’s body weight. So, per day the maximum dose is 60 mg per 1 kilogram of body weight;
- Often in children, Paracetamol is used in a dosage of 250 mg or 500 mg (respectively, half a tablet or one tablet with a dosage of 500 mg) 3-4 times a day when the temperature rises or pain increases;
- the child should not be given the medicine more often than once every 4 hours, or more than 4 times a day;
- It is prohibited to use Paracetamol tablets for more than 3 days without consulting the child’s attending physician.
For children under 6 years of age there is Paracetamol syrup. The fact is that up to 6 years of age, a child may have difficulty swallowing hard tablets, so the syrup will relieve the child’s psychological and physical discomfort when using the medicine. The use of syrup should be discussed with the child’s attending physician: he will explain the frequency of use of the drug and calculate the volume of syrup per use.
Publications in the media
Paracetamol is included in more than 200 drugs with various brand names, incl. numerous children's liquid forms used as analgesics and antipyretics. Paracetamol is also used in photography and as a textile azo dye. Poisoning usually occurs after a single dose of large doses of combination drugs containing paracetamol, as well as as a result of long-term use of paracetamol in smaller doses due to hypersensitivity to the drug, alcohol abuse, poor diet, or when combined with drugs that affect its metabolism in the liver.
Frequency. Due to the widespread use of paracetamol, the number of poisonings with it has recently increased (including in Russia, especially in children). In 1993, 94,000 cases of poisoning from drugs containing paracetamol were reported to poison control centers in the United States. Of these, in 92 cases the patients died. Etiopathogenesis • In the liver, conjugation of paracetamol with glucuronic acid and sulfate occurs, as well as oxidation by the microsomal system to hepatotoxic intermediate metabolites, including acetimidoquinone (N-acetyl-p-benzoquinone imine; N-acetylimidoquinone), followed by conjugation with glutathione, release of cysteine and mercapturate conjugates • When glutathione reserves are depleted, fulminant (centrilobular) liver necrosis develops. Glutathione depletion in adults usually occurs with paracetamol doses greater than 10 g. Genetic aspects . Non-hemolytic familial jaundice (#143500, ) - the formation of paracetamol glucuronides is seriously impaired, which is potentially dangerous due to the increased formation of hepatotoxic acetimidoquinone. Risk factors • Simultaneous poisoning with other substances, alcoholism, domestic drunkenness • Insufficiency of liver function.
Clinical picture . During poisoning, 4 stages are distinguished depending on the time elapsed after taking the drug and its amount. With long-term use of the drug in subtoxic doses, poisoning can begin with symptoms of any of stages I–III. Symptoms of liver damage are not always obvious, but can develop rapidly from the 2nd to the 5th day after poisoning. • Stage I usually begins a few hours after taking the drug and lasts up to 24 hours •• With mild poisoning, there are no symptoms •• In other cases - symptoms from the gastrointestinal tract (anorexia, nausea and vomiting), pallor of the skin, sweating •• With severe poisoning may cause symptoms of damage to the pancreas and heart •• If consciousness is impaired (stupor, coma), poisoning with another drug (possibly taken together with paracetamol) should be suspected. • Stage II begins after 24 hours after poisoning and lasts up to 3-4 days •• Symptoms from the gastrointestinal tract, possible pain in the right upper quadrant of the abdomen due to liver enlargement •• With a moderate amount of the drug taken, the symptoms do not progress, the patient usually recovers • • With liver damage, the content of AST and ALT, bilirubin in the blood serum increases, and PT is prolonged. • Stage III develops 3-5 days after taking the drug •• Symptoms of toxic liver damage, a further increase in the values of AST, ALT, bilirubin, PT •• In severe cases - signs of impaired consciousness (usually stupor), jaundice, impaired hemocoagulation, hypoglycemia and encephalopathy. Renal failure and myocardiopathy are possible. • Phase IV (after 5 days) - gradual weakening of symptoms of liver damage or death from irreversible liver failure.
Laboratory tests • 4 hours or more after poisoning, the content of paracetamol in the blood plasma is determined (a study carried out earlier than 4 hours is not informative) • When taking long-acting paracetamol preparations, the paracetamol content is recommended to be determined again 4-6 hours after the first analysis. If, during the second determination, the indicator has increased relative to the initial one or is within the range of possible risk (above 75 μg/ml [497 μmol/l]), repeated determinations are necessary every 2 hours until the indicator stabilizes or decreases • Examination of blood plasma for the presence of other toxic substances (for example , acetylsalicylic acid) • The concentration of AST, ALT (sometimes more than 1000 U/l, rarely more than 20,000 U/l) and bilirubin begins to increase at stage II and reaches a maximum at stage III. In case of severe poisoning, a parallel change in PV occurs • In case of liver damage, renal dysfunction is often detected with corresponding changes in blood and urine tests.
Differential diagnosis • It is necessary to identify/exclude the simultaneous intake of other toxic substances, especially alcohol • Paracetamol poisoning is differentiated from food poisoning with toxic substances that cause acute liver damage (for example, Amanita phalloides mushrooms; products containing phosphorus or carbon tetrachlorides).
TREATMENT Diet. A special diet is prescribed only for liver damage - diet options No. 5; with the development of hepatic encephalopathy - a quick change in diet: • Elimination of animal proteins • Sharp limitation or complete exclusion of fats • Introduction of easily digestible carbohydrates - fruit and berry juices rich in K salts (orange, grape, etc.), infusion of dried apricots, apricots, prunes; jelly, compotes • Parenteral nutrition (glucose, isotonic sodium chloride solution, Ringer's solution, thiamine, riboflavin, pyridoxine, cyanocobalamin, ascorbic acid and other vitamins). Management tactics • Immediate gastric emptying: inducing vomiting (emetics), gastric lavage through a tube (effective up to 4 hours after poisoning), enterosorbents (activated carbon) • Specific (antidote) therapy • Symptomatic therapy: treatment of liver failure, etc. Specific (antidote) therapy . To stimulate the formation of glutathione in the liver and prevent the development of liver necrosis - acetylcysteine. It is effective if this therapy is started no later than 10–12 hours after taking the drug; after 16–20 hours the effect is doubtful • Prescribed orally (140 mg/kg and then 70 mg/kg every 4 hours for 3 days) or intravenously (300 mg/kg over 20 hours, half the dose during the first 15 min) • Indicated when the concentration of paracetamol in the blood plasma is not lower than the level of possible risk (150 µg/ml [933 µmol/l], 75 µg/ml [497 µmol/l] and 40 µg/ml [265 µmol/l] through 4, 8 and 12 hours after poisoning, respectively). Nonspecific drug therapy • If the patient is conscious, an emetic, such as ipecac syrup, can be prescribed, especially for children (from 6 months to 1 year - 5 ml, from 1 year to 12 years - 15 ml, after 12 years - 30 ml; give with 240 ml of water), adults - no more than 100-150 mg/kg. If there is no effect, the drug can be repeated after 30 minutes • Activated carbon (1 hour or more after the administration of acetylcysteine) at an initial dose of 1 g/kg.
The prognosis depends on the dose of the drug (toxic dose 140 mg/kg in children, more than 10 g in adults; lethal dose - over 25 g; toxic and lethal dose is much less in alcohol abusers and with chronic liver pathology), timeliness and adequacy assistance provided • Usually - complete recovery if treatment is started in a timely manner and carried out in full (irreversible liver damage develops in less than 1% of adults) • In children under 6 years of age, liver failure is observed very rarely. Age characteristics. Poisoning is possible at any age, half of patients are under 6 years of age • Children under 6 years of age (compared to adults) are more resistant to the toxic effects of paracetamol (liver damage is rare in them) • In adolescents, liver damage is more severe than in adults • In adults liver damage occurs more often with chronic use of hepatotoxic drugs (especially alcohol) • During pregnancy, there is a high risk of spontaneous abortion, especially if poisoned in the early stages.
ICD-10 • T39.1 Poisoning with 4-aminophenol derivatives
Side effects
The instructions indicate that some adverse reactions may occur in response to taking the drug.
On the part of the immune system, a person may notice hypersensitivity skin reactions. Local inflammation, redness, and rash may occur after taking the drug. In more severe situations, an anaphylactic reaction occurs, accompanied by Quincke's edema and Stevens-Johnson syndrome. In this case, toxic epidermal necrolysis may occur as a skin manifestation. A pronounced reaction of the immune system, in particular the occurrence of anaphylactic shock, is often associated with a person’s allergy to the drug. Therefore, it is very important to find out in time whether there is a history of allergic reactions in order to promptly prevent the development of anaphylaxis.
On the part of the hematopoietic organs, anemia may develop as a side reaction. Anemic syndrome is a condition based on a decrease in the number of red blood cells and/or hemoglobin in the patient’s blood. Sometimes thrombocytopenia occurs (a decrease in the number of platelets - the cells responsible for the formation of blood clots). In this case, the patient may notice frequent and intense bleeding (for example, nosebleeds) that do not stop for a long time. This is due to a decrease in platelet count: it takes longer for a blood clot to form. Methemoglobinemia and agranulocytosis are likely to occur, which are quite specific side effects and require immediate discontinuation of the drug. Changes in the circulatory system can be noticed both by clinical signs (for example, with anemia, the patient experiences pallor, drowsiness, lethargy, hemorrhagic manifestations are possible) and by laboratory data. The determining factor here is a general and biochemical analysis of the patient’s blood, where a complete picture of the state of various human blood cells will be visible.
On the part of the respiratory system, the occurrence of bronchospasm was observed in those patients who had already noted increased sensitivity to other non-steroidal anti-inflammatory drugs (for example, aspirin). Bronchospasm is associated with a hypersensitivity reaction of the body, and if, after taking Paracetamol tablets, the patient complains of difficulty breathing or shortness of breath, the drug should be immediately noted and the hypersensitivity phenomenon should be stopped.
On the part of the liver, in some rare cases, the development of acute liver failure has been observed. Due to the metabolism of the drug in the liver, as well as the detoxification function of the liver, you should be careful about the state of the hepatobiliary system during Paracetamol therapy. There have been isolated cases that required liver transplantation after active and long-term use of Paracetamol: probably, patients took this non-steroidal anti-inflammatory drug for a long time, which led to the formation of drug-induced hepatitis, or even cirrhosis of the liver.
All patients taking Paracetamol tablets or Paracetamol syrup should remember: the occurrence of any adverse reactions listed in this section or other nonspecific manifestations while taking the drug must be reported to your doctor! The doctor will adjust the dose of Paracetamol or select another drug on an individual basis.
Paracetamol for children oral suspension 120 mg/5 ml 100 ml bottle + measuring spoon (Ozone)
Registration Certificate Holder
ATOLL (Russia)
Dosage form
Medicine - Paracetamol for children
Description
Oral suspension for children
in the form of a homogeneous suspension of pink color, with a characteristic odor.
100 ml
paracetamol 2.4 g
Excipients
: malic acid - 0.05 g, xanthan gum - 0.6 g, maltitol - 80 g, non-crystallizing sorbitol 70% - 1.33 g, anhydrous citric acid - 0.02 g, sodium nipasept (sodium methyl parahydroxybenzoate, sodium ethyl parahydroxybenzoate, sodium propyl parahydroxybenzoate) - 0.15 g, flavoring strawberry - 0.1 g, azorubine dye - 0.001 g, water - up to 100 ml.
100 ml - dark glass bottles (1) (complete with a measuring cup or measuring spoon) - cardboard packs. 100 ml - polymer bottles (1) (complete with a measuring cup or measuring spoon) - cardboard packs. 100 ml - bottles made of polyethylene terephthalate (1) (complete with a measuring cup or measuring spoon) - cardboard packs. 100 ml - dark glass bottles (1) - cardboard packs. 100 ml - polymer bottles (1) - cardboard packs. 100 ml - polyethylene terephthalate bottles (1) - cardboard packs.
Indications
Pain syndrome of weak and moderate intensity of various origins (including headache, migraine, toothache, neuralgia, myalgia, algodismenorrhea; pain from injuries, burns). Fever in infectious and inflammatory diseases.
Contraindications for use
Chronic alcoholism, hypersensitivity to paracetamol.
pharmachologic effect
Analgesic-antipyretic. It has analgesic, antipyretic and weak anti-inflammatory effects. The mechanism of action is associated with inhibition of prostaglandin synthesis, with a predominant effect on the thermoregulation center in the hypothalamus.
Drug interactions
When used simultaneously with inducers of microsomal liver enzymes and drugs with hepatotoxic effects, there is a risk of increasing the hepatotoxic effect of paracetamol.
When used simultaneously with anticoagulants, a slight or moderate increase in prothrombin time is possible.
When used simultaneously with anticholinergic drugs, the absorption of paracetamol may be reduced.
When used simultaneously with oral contraceptives, the elimination of paracetamol from the body is accelerated and its analgesic effect may be reduced.
When used simultaneously with uricosuric drugs, their effectiveness decreases.
With simultaneous use of activated carbon, the bioavailability of paracetamol decreases.
When used simultaneously with diazepam, the excretion of diazepam may be reduced.
There are reports of the possibility of enhancing the myelosuppressive effect of zidovudine when used simultaneously with paracetamol. A case of severe toxic liver damage has been described.
Cases of toxic effects of paracetamol have been described when used simultaneously with isoniazid.
When used simultaneously with carbamazepine, phenytoin, phenobarbital, primidone, the effectiveness of paracetamol decreases, which is due to an increase in its metabolism (glucuronidation and oxidation processes) and excretion from the body. Cases of hepatotoxicity have been described with the simultaneous use of paracetamol and phenobarbital.
When using cholestyramine for a period of less than 1 hour after taking paracetamol, the absorption of the latter may be reduced.
When used simultaneously with lamotrigine, the excretion of lamotrigine from the body moderately increases.
When used simultaneously with metoclopramide, it is possible to increase the absorption of paracetamol and increase its concentration in the blood plasma.
When used simultaneously with probenecid, the clearance of paracetamol may be reduced; with rifampicin, sulfinpyrazone - it is possible to increase the clearance of paracetamol due to an increase in its metabolism in the liver.
When used simultaneously with ethinyl estradiol, the absorption of paracetamol from the intestine increases.
Dosage regimen
Orally or rectally in adults and adolescents weighing more than 60 kg, use a single dose of 500 mg, frequency of administration - up to 4 times a day. The maximum duration of treatment is 5-7 days.
Maximum doses:
one-time - 1 g, daily - 4 g.
Single oral doses for children aged 6-12 years - 250-500 mg, 1-5 years - 120-250 mg, from 3 months to 1 year - 60-120 mg, up to 3 months - 10 mg/kg. Single doses for rectal use in children aged 6-12 years - 250-500 mg, 1-5 years - 125-250 mg.
Frequency of use - 4 times a day with an interval of at least 4 hours. Maximum duration of treatment - 3 days.
Maximum dose:
4 single doses per day.
Side effect
From the digestive system:
rarely - dyspeptic symptoms; with long-term use in high doses - hepatotoxic effects.
From the hematopoietic system:
rarely - thrombocytopenia, leukopenia, pancytopenia, neutropenia, agranulocytosis.
Allergic reactions:
rarely - skin rash, itching, urticaria.
special instructions
Use with caution in patients with impaired liver and kidney function, with benign hyperbilirubinemia, as well as in elderly patients.
With long-term use of paracetamol, monitoring of the peripheral blood picture and the functional state of the liver is necessary.
Use during pregnancy and breastfeeding
Restrictions during pregnancy - With caution. Restrictions when breastfeeding - With caution.
Paracetamol penetrates the placental barrier. To date, there have been no negative effects of paracetamol on the fetus in humans.
Paracetamol is excreted in breast milk: the content in milk is 0.04-0.23% of the dose taken by the mother.
If it is necessary to use paracetamol during pregnancy and lactation (breastfeeding), you should carefully weigh the expected benefits of therapy for the mother and the potential risk to the fetus or child.
Experimental
studies
have not established the embryotoxic, teratogenic and mutagenic effects of paracetamol.
Use for renal impairment
Restrictions for impaired renal function - With caution.
Use with caution in patients with impaired renal function.
Use for liver dysfunction
Restrictions for liver dysfunction - With caution.
Use with caution in patients with impaired liver function.
Use in elderly patients
Restrictions for elderly patients - Use with caution.
Use with caution in elderly patients.
Use in children
Restrictions for children - No restrictions.
Application is possible according to the dosage regimen.
Pregnancy and lactation
The use of Paracetamol during pregnancy is justified if the potential benefit to the mother outweighs the risk to the health of the fetus. During the period of active breastfeeding, the mother is not prohibited from taking Paracetamol. It has been proven that the medicinal compound passes into breast milk in very small quantities, which does not affect the baby’s health. In addition, published data regarding the use of Paracetamol during lactation indicate that breastfeeding is not a contraindication for taking the drug.
Interaction with other drugs
The instructions for use of Paracetamol indicate that using the drug together with other non-steroidal anti-inflammatory drugs or painkillers can lead to toxic damage to the kidneys. Moreover, the combined use of different NSAIDs threatens the occurrence of acute renal failure - an emergency condition that requires prompt relief.
Care should be taken when prescribing Paracetamol in high doses and salicylates. There is a possibility of oncological neoplasms of the urinary system, for example, the kidney or bladder.
If a patient, for certain indications, takes drugs that inhibit the process of hematopoiesis, then the attending physician should be aware of the increased toxicity of the drug in this case. It is necessary to think about prescribing another drug or adjusting the dosage.
When a person takes anticoagulant therapy for direct indications, especially indirect anticoagulants (warfarin and other coumarin drugs), the risk of bleeding increases. At the same time, single doses of Paracetamol do not lead to bleeding; such a possibility exists only with systemic administration of the drug.
If a person is prescribed liver enzyme activators (for example, barbiturates, tricyclic antidepressants, rifampicin and other drugs), the risk of liver toxicity increases significantly, especially in overdoses.
Antiemetic drugs - metoclopramide, domperidone significantly increase the rate of absorption of Paracetamol. At the same time, cholestyramine reduces the intensity of absorption of the drug. It should be remembered that ethyl alcohol in combination with Paracetamol becomes a serious risk factor for the development of pancreatitis.
It is noted that Paracetamol can reduce the degree of activity of uricosuric drugs.
Paracetamol for fever
Paracetamol can be used at a temperature if it has reached 38.5 degrees or higher. This is explained by the fact that elevated temperature has a negative effect on harmful microorganisms, and, therefore, allows you to recover faster.
It should be taken strictly according to the instructions, without exceeding the dosage. The tablet should be taken with a sufficient amount of drinking water, which will speed up the absorption of the active ingredient and minimize the negative impact on the liver.
Single dose 400-500 mg. If the temperature reaches 40 degrees, the dose can be doubled.
For children and adults, a single dose is determined based on weight. A child can take the drug 4 times per day. Duration of treatment – up to 3 days.
Precautionary measures
Paracetamol tablets with particular caution to patients suffering from arthritis. It is strictly not recommended to take Paracetamol for more than 3 days in a row without a doctor’s prescription. If pain syndrome, as well as high temperature, persists for 3 days of taking Paracetamol, you should definitely consult a doctor for advice!
It is strictly prohibited to exceed the maximum daily dose of the drug: there are situations where a patient has developed acute liver failure with the need for an organ transplant or even death. Drinking alcohol during Paracetamol therapy is prohibited.
Paracetamol is allowed to be taken with great caution in patients with insufficiency of liver and kidney function. If a patient has a non-cirrhotic form of liver damage due to alcohol abuse, there is an increased risk of drug overdose.
If an allergic reaction occurs, you should seek qualified medical help.
Harmless paracetamol is deadly.
Paracetamol is one of the most common analgesics and antipyretics in the world, having anti-inflammatory, antipyretic and analgesic effects. It is included both in the WHO list of the most important modern medicines and in the main list of medicines necessary for medicine in the Russian Federation. However, the availability and low cost of paracetamol often provokes an overdose of this medicine in all categories of the population.
Many people treat colds on their own, without consulting a doctor and thereby not observing the dosage and combination of antipyretic and cold medications. In addition, people are poorly versed in the purpose of medications, very often taking complex medications along with medications to lower their temperature. However, they do not know that paracetamol has a very low safety bar.
December 28 at the RKB named after. ON THE. Semashko by air ambulance, due to deteriorating condition, a patient was transported from the central regional hospital, who, unfortunately, could not be saved.
“We were very worried about this patient, since she is a very young woman, only 24 years old. We offer our deepest condolences to the family, friends and children who lost their mother.
You need to take care of yourself.
One of my friends came from Italy and fell ill during the trip. As usual, I went into an Italian pharmacy and noticed that it didn’t look like a pharmacy at all. In our understanding, these are many shelves with medicines, powders, tablets, injectables; instead, at the exhibition there were various creams, personal hygiene products and everything like that. Where are the medicines? To which he was told that they had all the medications and the only thing needed was a card with the names of the medications that the doctor prescribed. And he also noticed that there are practically no medicines in television advertising, while in Russia, every second advertisement is medicine “from head to toe”, which says that when taking this or that medicine, beautiful people are beautiful recover, unfortunately this is not always the case. Moreover, the drug load can have a negative impact on the patient.
In our patient, several damaging factors came together - a weight loss diet that disrupted the functioning of the liver enzyme system, a previous infection with viral hepatitis B, the fact of which was confirmed using laboratory tests, and, in addition to everything, the drug Paracetamol, which is available in European countries and is a leading drug worldwide that attacks the liver and causes severe necrosis that often requires organ transplantation.
When this patient was admitted, she was given a set of antidote therapy measures, i.e. we administered drugs that neutralize the remnants of toxic substances, detoxification was carried out using an extracorporeal method to remove poisons and toxic compounds from the blood, unfortunately, even such intensive therapy did not allow us to stabilize her body, moreover, since we understood that a lot needs to be used We checked our possibilities and treatment with colleagues from the Federal State Budgetary Institution “National Medical Research Center for Transplantation and Artificial Organs named after. ak. IN AND. Shumakov,” leading specialists in liver transplantation provided significant assistance; we checked hours, appointments, diagnostic and therapeutic measures with them, but unfortunately the patient could not be saved.
For the residents of our republic, I would like to say that any medicine is poison - the only question is the dose. Therefore, you need to be more careful and balanced when taking medications, and, if possible, believe less in advertising and trust doctors more. Maybe I was lucky, but I have not met a single doctor who would wish harm on his patients. I think that they won’t recommend a bad doctor and it will be better if you took care of your health together with a doctor you trust! Be healthy and take care of yourself." – commented the head of ICU No. 1 Filippov Vladimir Aleksandrovich
Head of the Gastroenterology Department Tsyrempilova Aryuna Chimitdorzhiena:
“The liver is the main laboratory of our body; it performs a neutralizing, detoxifying function, i.e. cleanses the body: everything passes through it: alcohol, poor quality food, toxins contained in it, polluted surrounding air and even bad mood. It has been proven that if at least 30% of liver cells are preserved and not damaged by toxins, then our “hard worker” liver will perform all its main functions (there will be normal biochemical parameters in the blood). This is a “grateful” organ, if you follow proper nutrition, eliminate all bad habits, take hepotoxic drugs, uncontrolled use of antibacterial, non-steroidal drugs, maintain a healthy lifestyle, the liver will and will try to function normally.
On a note
Taking 100 grams of cottage cheese has a protective, hepatoprotective effect, because cottage cheese contains protein, incl. essential amino acid – methionine
You need to lose weight gradually - you need to lose no more than 300 grams per week. In our case, the patient lost 10 kg in a month, which became one of the detrimental factors that affected her body. The second factor was infection with the hepatitis B virus. Given the already damaged liver, she started taking paracetamol - 2 tablets 3 times a day together with acetylsalicylic acid. Although, even 1.5 tablets of paracetamol for the liver is considered a toxic dose. As a result, the liver could not cope with the load. Despite intensive treatment, the patient fell into a coma, after which, unfortunately, she died.
Taking medications must be taken very responsibly. Take medications only as prescribed by your doctor and follow the dosage of the medications.
Unfortunately, you very often hear in pharmacies when specialists, pharmacists standing on the other side of the counter categorically and authoritatively recommend treatment for: runny nose, allergies, diarrhea, fever, and the buyer - the patient trustingly purchases: paracetamol, nise, citramon, aspirin and many other drugs.
I would like to say TAKE CARE OF YOURSELF, APPRECIATE YOUR HEALTH, BECAUSE HEALTH IS IN YOUR HANDS!!!.”
Alexandra Mikhailovna Danchinova, chief freelance clinical pharmacologist of the Ministry of Health of the Republic of Belarus: “Self-medication is dangerous!”
“First of all, we must think about the dangers of self-medication. All drugs that are approved for over-the-counter use and advertised in the media seem to be absolutely safe. In fact, no drug is safe. This also applies to such common drugs as paracetamol and acetylsalicylic acid (aspirin). These drugs belong to the group of potentially toxic substances; if the dose is exceeded, toxic properties appear. The maximum daily dose of paracetamol allowed in our country is 4 grams or 8 tablets. The patient took paracetamol 3 g - 6 tablets for 3 days simultaneously with 2 aspirin tablets and other drugs. This resulted in fatal liver damage. I strongly recommend against self-medication."
Experts urge respected residents of the Republic of Buryatia to seek medical help from doctors, carefully read instructions on the medical use of medications, take medications in recommended doses, and use medications with caution to relieve cold symptoms.
Reviews
As soon as the temperature starts to rise, I take Paracetamol, and its rise immediately slows down. An effective and inexpensive product!
I always use Paracetamol if I feel like I'm starting to get sick. It reduces the temperature perfectly, and if you need to reduce it again, the drug can be taken every 4 hours.
I like the price of Paracetamol. The drug is absolutely accessible to all people due to its low price.
Question answer
- How to take Paracetamol for children?
The instructions for the drug indicate the dosage regimen for children. It is important for parents to remember that up to 6 years of age, a child can only take Paracetamol syrup, and at the age of 6 to 12 years, the dosage of the drug is calculated individually.
- How often can I take the drug?
When the temperature rises, the drug is allowed to be taken every 4 hours (2 tablets at a dose of 200 mg, one tablet - 500 mg). The maximum daily dose should not exceed 4 g.
- How many days can you take Paracetamol?
You are allowed to take the drug for no more than 3 days in a row. If fever or pain does not subside, you should consult a doctor.
Questions and answers - Temperature in a child
Izyakov Dmitry Nikolaevich
Pediatrician
April 25, 2021
In 2015, in the series of clinical recommendations of the Union of Pediatricians of Russia, the collection “Feverish Child” was published. Diagnostic and treatment protocols." It revises some points regarding the actions of doctors and parents when the temperature rises in children with various diseases. In this article, I tried to collect answers to the most frequently asked questions by parents, taking into account modern recommendations and practical experience.
What temperature is a reason to panic?
What you don't need is panic. According to modern data, only temperatures above 40 degrees can harm children with chronic diseases.
Initially healthy children tolerate high fever without health consequences. A healthy child is simply not able to heat himself up to dangerous levels. But it can be heated this way from the outside, by wrong actions. For example, with a normal fever, cover with a blanket when the air temperature in the room is above 22°C. But this is no longer a fever, but hyperthermia, a condition in which you need to call an ambulance. The main difference is that antipyretics and rubdowns do not help.
But does a high temperature indicate a dangerous disease?
In children, it is not the thermometer numbers that indicate danger. It is not the temperature that is dangerous, but the disease that caused it. A high temperature can also occur with an uncomplicated acute respiratory viral infection, which will subside in 2-3 days. Or in case of a safe childhood infection - sudden exanthema, also called: roseola, three-day fever, temperature is often 40-41°C. And with a dangerous disease, meningitis, it can often not exceed 39.5. There are also dangerous diseases accompanied by fever. This is what requires calling an ambulance:
- age up to 3 months
- the appearance, along with cold hands and feet, of a “marble” pattern on “goose bumps”
- absence of visible signs of illness, except for elevated temperature in a child under 3 years of age
- maintaining a temperature above 38.5 on the 4th day of illness with the appearance of rapid breathing
- skin rash that does not blanching when pressed with a finger
- inability to press the chin to the chest and/or bulging fontanelle
- abdominal pain
- pain in the legs and/or arms
- the temperature 2 hours after taking the antipyretic drug became higher, this is a sign of overheating - hyperthermia.
What about cramps?
They are observed in approximately four children out of a hundred and do not directly depend on the height of the temperature rise. In addition, they are not hazardous to health, although they undoubtedly frighten parents very much. Help for febrile seizures is to turn your head to the side and provide access to fresh air. All necessary medications are administered by an ambulance doctor, who must be called and met by another adult.
And is there really nothing dangerous about high temperatures?
Yes, this is dehydration - loss of fluid due to evaporation through breathing and sweat. When a child has a fever, it is difficult to persuade a child to drink, but it is at this moment that he needs it.
What about cold hands and feet?
Most often, this is a short-term phenomenon that does not require medical intervention and does not pose a threat to health.
How much do you need to lower the temperature?
1-1.5 degrees is enough, because only by raising the temperature does the child’s body fight infection.
At what thermometer readings should antipyretics be given?
I give general recommendations; you need to consult with the doctor who is treating your particular child.
- In children under 3 months of age - from 38°C
- In children older than 3 months who do not have chronic diseases - from 39°C
- In children with diseases of the brain, heart and lungs - from 38.5°C
Are these numbers the only basis?
No. The numbers on the thermometer do not matter when starting to take an antipyretic if the child:
- does not tolerate high temperatures very well, behaves restlessly
- has a “marbled” pattern on pale “goose bumps”
- trembles, he gets chills
What medications should I use?
Only based on ibuprofen and paracetamol, the names of the active substance are always indicated on the packaging under the antipyretic brand.
Why don't they help?
The most common reason is incorrect dosage, calculating the dose based on the child’s age and not on the weight of the child. The second common cause is dehydration. Third - the child is dressed too warmly, covered, the room is warm.
What dose should I give?
The most popular antipyretic based on ibuprofen is “Nurofen for children” in the form of syrup. You need to divide the child's weight in kilograms in half. For example, if the weight is 10 kg, then 10:2 = 5 ml of children's Nurofen and should be given to him. This dose can be repeated no earlier than 8 hours have passed.
The most successful antipyretic in terms of release form is “Efferalgan” syrup for children with the active ingredient paracetamol. Its measuring spoon allows you to take the dose of medicine directly by weight, without calculating it in mg.
All other drugs “Panadol”, “Calpol”, “Paracetamol” syrup, etc. require mathematical operations, multiplying the weight by 0.6. For example, if a child weighs 10 kg, then 10 * 0.6 = 6 ml of Panadol should be given. This dose can be repeated after 6 hours.
Is it possible to alternate them?
It is possible, but at least 2 hours should pass between taking paracetamol and ibuprofen. If taken together, there is a risk of kidney damage.
Why not other medications for fever?
Medical studies have not revealed any real benefits from other drugs, but they have identified the harm of each:
- “No-spa” has no effect on cold hands and feet, but it has a list of side effects.
- "Analgin" is dangerous for the development of loss of consciousness and should not be used by parents without the presence of ambulance and emergency services workers.
- Nise caused liver damage in one of the 250 patients who took it
- Aspirin can cause liver and brain damage in children
How much fluid do you need to drink to reduce your temperature?
For every kilogram of weight, a child needs to drink 4 ml per hour. That is, if a child weighs 10 kg, then every hour he should drink at least 10 * 4 = 40 ml.
Is it possible to wipe?
After taking an antipyretic, you can wipe with water at a temperature 1-2 degrees lower than the child’s body temperature. That is, if it is 40 °C, then the water temperature should be 38-39 °C. You need to wipe all areas of the skin that are hot to the touch, leaving them wet until dry. Then measure the temperature again. A decrease of 1-1.5 degrees is enough to stop the procedure.
What to do with cold hands and feet?
They need to be carefully warmed, gently rubbing until the skin becomes slightly red, using wool, a terry towel, or just your palms.
How long to expect the effect of antipyretic and rubdown?
Two hours. If the temperature has not decreased, then a second antipyretic should be given, and rubbing and drinking should continue for another 2 hours. If the temperature has not decreased and/or has increased, call an ambulance.
How can the ambulance help?
Assess the child’s condition and determine whether hospitalization is necessary in this case. Provide assistance by injecting medications and medical methods to reduce the child’s temperature. It is for fever, in fact, it is needed in a very small percentage of cases, the ineffectiveness of antipyretics associated with hyperthermia - a condition complicating fever, when the child is not able to give off body heat.
How to measure temperature correctly?
Measuring armpit temperature with a mercury glass thermometer in children has already been recognized as the least preferable due to the danger of breaking it. It was replaced by electronic and infrared thermometers. Few people know, but to obtain a result comparable to a mercury thermometer, the electronic one must be under the armpit for the same time. That is, 5 minutes if the child was at room temperature. And 10 minutes if it was at a lower temperature before measurement.
Why do electronic thermometers show lower temperatures?
The reasons are clear: loose pressure, measurement less than 5 minutes, sweat, spasm of skin blood vessels, low battery, lack of factory settings for measuring skin temperature. These thermometers can be used subject to correction. To do this, an adult without a fever puts an electronic one under one armpit and a mercury one under the other. Measures 5 minutes and compares. For example, we received 35.6 and 36.6, respectively. In subsequent electronic measurements you will add 1 degree.
Which thermometer is better?
The temple area has a temperature equal to the axillary one. To measure it, infrared thermometers are used. This is the most optimal method for parents today. For proper use, you need much fewer subtleties: wipe the sweat from your temple, remove your hair, hold it at the correct distance (indicated in the instructions), change the battery on time, set up to measure the temperature of the temporal region (also written in the instructions). The use of other thermometers: nipple, ear, forehead strips is fraught with measurement errors in the direction of underestimation or false increase.
How often should I measure my temperature?
A child with a fever needs temperature control:
- every 6 hours unless antipyretics are required
- every 4 hours when used effectively
- every 2 hours if use is ineffective.
For a child with normal temperature, but with an acute illness, measure every 12 hours in the evening. For a healthy child at risk of an acute illness due to contact or an increase in temperature for vaccination, according to the condition, for control, measure once a day, in the evening. Healthy children without risk of illness do not need it.
