Paper I
2023 March (Supplementary) (2010 Scheme) · 40 marks · 120 min

Question

Paracetamol

Q73 marksShort Notes

Answer

Paracetamol (Acetaminophen) is an analgesic-antipyretic with weak peripheral anti-inflammatory action.

MOA: inhibits prostaglandin synthesis predominantly in the CNS (central COX inhibition), with only weak peripheral COX inhibition — explaining its analgesic/antipyretic efficacy alongside its lack of clinically useful anti-inflammatory action and lack of GI/platelet toxicity, unlike NSAIDs.

Uses: mild-moderate pain, fever — first-line antipyretic/analgesic in children and in patients where NSAIDs/aspirin are contraindicated (peptic ulcer disease, bleeding risk, children with viral illness).

Adverse effects: well tolerated at therapeutic doses; hepatotoxicity in overdose — the toxic metabolite NAPQI (normally detoxified by conjugation with glutathione) accumulates once glutathione stores are depleted, causing centrilobular hepatic necrosis; N-acetylcysteine is the antidote, replenishing glutathione.

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