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ac·et·a·min·o·phen (APAP),

An antipyretic and analgesic, with potency similar to that of aspirin.
Synonym(s): paracetamol


(păr′ə-sē′tə-môl′, -môl′)



An over-the-counter analgesic used for headaches, muscle or joint pain, and fever, which lacks anti-inflammatory activity.
Therapeutic range
10–25 mg/L
Critical value
≥ 300 mg/L

Overdose can cause fatal liver failure. Up to 10% of hospitalisations for overdose and 40% of acute hepatic failure are linked to paracetamol overdose, which is more often accidental—e.g., children, alcoholics—than suicidal. Doses of > 150 mg/kg/24 hours cause acute liver failure.

Clinical stage of paracetamol toxicity
1. 1–24 hours—Non-specific.
2. 24–48 hours—Right upper quadrant pain, tenderness with elevated liver enzymes.
3. 72–96 hours—Marked increase in liver enzymes; fulminant hepatic failure, coagulopathy, acidosis.
4. 4–14 days—Liver recuperates or patient dies.

Pathogenesis of paracetamol overdose
90% is metabolised in the liver to non-toxic glucuronide and sulphate conjugates; 5% is oxidised by cytochrome p450 to NAPQI, which covalently binds to hepatocyte macromolecules, leading to hepatocyte death; 5% is excreted unchanged in urine.

Blood, urine.


A drug widely used to relieve pain and reduce fever. The drug does not irritate the stomach, as ASPIRIN does, but overdose causes liver and kidney damage and may cause death from liver failure. 15 g or more is potentially serious. The victim remains well for a day or two and liver failure develops between the third and fifth day. The drug is on the WHO official list. Brand names are Alvedon, Calpol Disprol Paediatric, Infadrops, Medinol and Salzone. Preparations that include paracetamol include Cosalgesic, Distalgesic, Domperamol, Fortagesic, Kapake, Midrid, Migraleve, Paradote, Paramax, Remedeine and Solpadol.
acetaminophen; N -acetyl- p -aminophenol; paracetamol a non-opioid analgesic with little or no anti-inflammatory action; first-line painkiller of choice; used with care in patients with hepatic or renal impairment, or alcohol dependency, or those taking metoclopramide; overdose causes severe liver damage and death; recommended adult dose: daily maximum of 4 g (i.e. 8 × 500 mg tablets) (see Table 1)
Table 1: Principles of pain management
StepPain typeManagement regimeExamples of drug
1Mild to moderateNon-opioid analgesics:
  • NSAIDs:

  • Pyrazoles

± Adjuvant drugs:
Aspirin; ibuprofen pheylbutazone;
2Moderate to severeLess potent opioidsCodeine
  • Dihydrocodeine

  • Dextropropoxyphene

± Non-opioid analgesics
± Adjuvant drugs
As above
3SeverePotent opioidsMorphine
± Non-opioid analgesics
± Adjuvant drugs
As above

Pain management should address both the nociceptive and neuropathic components of pain.

NSAIDs, non-steroidal anti-inflammatory drugs.


see acetaminophen.

acetaminophen, paracetamol

an analgesic and antipyretic drug in dogs. It is contraindicated for cats because of serious side-effects which include intravascular hemolysis, methemoglobinemia and hepatic necrosis.
References in periodicals archive ?
The use of oral and IV paracetamol in post-operative pain management as a single drug or in combination with another drugs has been demonstrated in numerous studies.
Pfaffenrath and the Badr Al Samaa Polyclinic at Ruwi, says every third patient he sees takes painkillers, mostly paracetamol, almost on a daily basis.
Mr King said in a statement that Mr Gourlay became depressed and convinced that the police and other law agencies were monitoring him, and in April of last year he took an overdose of paracetamols.
Gardner said after Miss Longe had died he had taken about 50 paracetamols and he had intended to take his own life 'because of what happened to Nina'.
Arron has to take five different tablets - steroids, anti-inflammatory, folic acid, paracetamols and a cancer drug found to help some children with arthritis.
If the same product is made by 50 companies in three formulations each the registration numbers allotted to paracetamols will be 150 instead of 50 while the product is, actually one.
Even registered medicines such as paracetamols, diabetes, cancer and cholesterol medication can cause a reaction if they are being overused or ingested by someone randomly without proper prescription," he informed.
The machine left Sean's ribs black and blue and he needed eight paracetamols a day to ease the pain.
O, a dwi angen prynu 'baby wipes' hefyd mae'n debyg ( nid ar gyfer y wers efo'r athrawon), a beryg y byddai stoc o paracetamols yn handi ( i mi).
By putting them in the First Division they just want to give them a couple of Paracetamols instead.
Having had no medication besides two paracetamols in the morning, I was in agony.
Mum rang the GP who told me to take a couple of paracetamols but that didn't work and the pain got worse.