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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 ?
Half a Paracetomol for a headache - might as well just drink the water.
I was in such agony that I would have swallowed a whole bottle of paracetomol willingly though I was a little concerned when the nurse put on a pair of rubber gloves
GPs in the area also reported a flood of patients and advise people with flu to stay in bed, take paracetomol and drink plenty of hot drinks.
His advice to flu victims is to keep warm, take paracetomol and have warm drinks.
Fentanyl 50mg iv and inj paracetomol 750mg iv was used for the intra operative analgesia.
Meanwhile, her killer bought vodka and paracetomol, sought refuge under a platform at Marton railway station - where he played as a child - and took an overdose.
Kim overdosed on paracetomol in January when she was told the court case might not go ahead.
Meanwhile, another study claimed that Irish shopkeepers are ignoring government guidelines for the sales of paracetomol.
Intercostal nerve block was given by the surgeon at the end of surgery for post operative analgesia and later on maintained with drugs like fentanyl, tramadol and paracetomol IV.
Osbourne undoubtedly regretted his actions afterwards, taking an overdose of about 60 paracetomol with vodka, added Mr Muller.
Kelly, of Stockbridge Village, near Liverpool, took a Paracetomol after saying she had a headache and went to bed early.
HOW IT WORKS: Contains paracetomol for headaches and sodium bicarbonate for settling upset tummies.