Acetaminophen
Although the class of para-aminophenol derivatives includes two
drugs—phenacetin and acetaminophen—only acetaminophen is available in the
United States. Acetaminophen is an
OTC drug that produces analgesic and antipyretic effects. It appears in many
products designed to relieve the pain and symptoms associated with colds and
influenza.
Acetaminophen is absorbed rapidly and completely from
the GI tract. It’s also absorbed well from the mucous membranes of the rectum.
Acetaminophen is distributed widely in body fluids
and readily crosses the placental barrier. After acetaminophen is metabolized
by the liver, it’s excreted by the kidneys and, in small amounts, in breast
milk.
Acetaminophen reduces pain and fever, but unlike
salicylates, it doesn’t affect inflammation or platelet function. It can cause
anti-coagulation in the patient taking warfarin.
The pain-control effects of acetaminophen aren’t
well understood. The drug may work in the central nervous system (CNS) by
in-hibiting prostaglandin synthesis and in the peripheral nervous sys-tem in
some unknown way. It reduces fever by acting directly on the heat-regulating
center in the hypothalamus.
Acetaminophen is used to reduce fever and relieve
headache, muscle ache, and general pain.
Acetaminophen is the drug of choice to treat fever
and flulike symptoms in children. Additionally, the American Arthritis
Associ-ation has indicated that acetaminophen is an effective pain reliev-er
for some types of arthritis.
Acetaminophen can produce the following drug
interactions:
·
The effects of oral anticoagulants and thrombolytic drugs may be
slightly increased.
·
The risk of liver toxicity is increased when long-term alcohol use,
phenytoin, barbiturates, carbamazepine, and isoniazid are combined with
acetaminophen.
· The effects of lamotrigine, loop diuretics, and zidovudine may be
reduced when these drugs are taken with acetaminophen. (See Adverse reactions to acetaminophen.)
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