Panactol effervescent powder 250mg khapharco is sweet, not bitter, antipyretic, pain relief for children (48 packs x 1.5g)

Paracetamol (acetaminophen or N-acetyl-P-P-Aminophenol) is a metabolic substance that has the activity of phenacetin, an analgesic-antipyretic drug that can replace aspirin; However, unlike aspirin, paracetamol is not effective in treating inflammation. With the equal doses of the province, Paracetamol has analgesic, reducing fever similar to aspirin.

paracetamol reduces the body temperature in fever, but rarely reduces the body temperature in normal people. The drug acts on the hypothalamus causing cooling, radiating heat due to increased vasodilation and increasing peripheral blood flow.

Paracetamol is often chosen as an analgesic and antipyretic, especially in the elderly, people with contraindicated use of salicylate or other NSAIDs, such as people with asthma, a history of peptic ulcer and children.

pharmacokinetic

absorption

Paracetamol is absorbed quickly and almost entirely through the digestive tract. Carbohydrate -rich foods reduce the absorption rate of paracetamol. The peak concentration of plasma is within 30 - 60 minutes after drinking with the dose of treatment.

distribution

Paracetamol is distributed quickly and evenly in most body tissues. About 25% Paracetamol in the sample combined with plasma protein.

metabolism and elimination

Paracetamol's waste sale time is 1.25 - 3 hours, which can last for toxic doses or in patients with liver damage. After the treatment dose, 90 - 100%of the urine can be found on the first day, mainly after the liver combination with glucuronic acid (about 60%), sulfuric acid (about 35%), or cysteine ​​(about 3%); also detected a small amount of hydroxyl and acetyl metabolites.

Children are less likely to glucuro than drugs than adults.

paracetamol is n-hydroxylation by cytochrom p ... to form N-acetyl-Benzoquinonimin (NAPQ), a highly reactive intermediate. This substance normally reacts with sulfhydryl groups in glutathion and is activated. However, if taking high doses of paracetamol, this metabolic is formed in sufficient amount to exhaust the glutathion of the liver; In that situation, NAPQ is not connected with glutathion toxic to liver cells, leading to inflammation and maybe liver cell necrosis.

Special objects such as mild to moderate liver failure patients, chronic alcoholism, gilbert syndrome, chronic malnutrition, dehydration should consider minimum doses that are effective and no more than 3g/day.

Note: Do not prolong the use of drugs for children but need a doctor's opinion when:

What to do when overdose?

The risk of severe poisoning may be higher in the elderly, in young children, in patients with liver damage, chronic alcoholism, chronic malnutrition and in patients with enzyme induction. In these cases, poisoning can be fatal. The clinical symptoms of liver damage are usually seen after two days, and is clear after 4-6 days.

Symptoms

Nausea, vomiting, anorexia, pale, fatigue, sweating, abdominal pain usually appear in the first 24 hours. Overdose, from 10g Paracetamol a single dose in adults and 150 mg/kg single dose
in children, can lead to liver necrosis. Hepatic impairment, metabolic acidosis, brain disease can lead to coma and death.

Management

Immediately transfer to the hospital or medical facility. Sampling of blood test in blood paracetamol levels from 4 hours after drinking. However, do not delay treatment while waiting for the test results if the history is suggested to overdose. When severe poisoning, it is important to treat positive support. Need to wash the stomach in any case, preferably within 4 hours after drinking.

The main detoxification is the use of sulfhydryl compounds. N-acetylcystein works when taken or intravenously. Must give the drug immediately if less than 36 hours after taking paracetamol.

Treatment with N - Acetylcystein is more effective when giving the drug for less than 10 hours after taking paracetamol. Without N - Acetylcystein, methionine can be used. Also can use activated carbon and/or salt bleach, they have the ability to reduce the absorption of paracetamol.

In an emergency, call the 115 emergency center immediately or go to the nearest local health station.

What to do when forgetting 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

Caution when using

Paracetamol is relatively non -toxic at the treatment dose and when used under the guidance of a physician. However, overdose of paracetamol is the cause of acute liver failure. Using many preparations containing paracetamol and can lead to harmful consequences (such as paracetamol overdose).

Serious, fatal skin reactions include Stevens - Johnson syndrome, poisoned epidermal necrosis (Ten), all -body pustules syndrome (AGEP), lyell syndrome but rarely occurring with paracetamol, often regardless of the effect of other drugs. Although other painkillers, antipyretic (such as NSAIDs) can cause similar reactions, cross -sensitive with paracetamol.

Patients need to stop using paracetamol and see a doctor as soon as they see rash, or other skin manifestations, or sensitive reactions during treatment. Patients with a history of such reactions should not be used in preparations containing paracetamol.

Sometimes there are skin reactions including itchy and urticaria, other sensitive reactions including larynx edema, angioedema, anaphylactic reactions that may occur, thrombocytopenia, leukopenia, and all bloody reductions that have occurred with the use of p-aminophenol derivatives, especially when used to prolong large doses. Neutral leukopenia and thrombocytopenic hemorrhage occur when using paracetamol. Rarely loss of granulocytes in patients who are using paracetamol.

Be cautious when using paracetamol in patients with liver failure, renal failure, gilbert syndrome, glucose-6-phosphate dehydrogenase enzyme (G6PD), alcoholic, malnutrition, chronic or dehydrated malnutrition. Avoid high doses, prolonged use for people with liver failure. If the hepatitis is detected, it is recommended to stop treatment.

Must use paracetamol carefully in patients with anemia before because purple blue may not manifest clearly although the high concentration is dangerous of methemoglobin in the blood.

Drinking plenty of alcohol can increase the toxicity of paracetamol, should avoid or limit drinking.

The drug contains 18 mg of aspartame in each package of 1.5g effervescent powder. After drinking, aspartame will metabolize in the stomach - intestines into phenylalanine. Therefore, caution when taking drugs for people with phenylceton-dermatology (gene deficiency determines the condition of phenylalanine hydroxylase) and people must limit the amount of phenylalanine into the body.

Sodium benzoat in the drug may increase the risk of yellow eye and jaundice in newborns (up to 4 months of age).

The drug contains Sunsetyellow color so it can cause allergies.

This drug contains white sugar, patients with rare genetic disorders such as fructose intolerance, glucose-galactose absorption or a deficiency of sucrase-isomaltase enzymes should not be used.

This drug contains about 140mg of sodium (the main ingredient in the salt) in each package of effervescent powder 1.5g, equivalent to 7.0% in the maximum daily sodium diet is recommended for adults is 2g.

Use drugs for women during pregnancy and lactation

Pregnant women

Epidemic research on pregnant women does not show a risk of defects or toxic to the fetus. Strictly adhering to the dosage and treatment time. Usually, the drug can be indicated during pregnancy.

breastfeeding women

The drug is excreted through breast milk but in very small amounts, does not cause pharmacological effects. At the treatment dose, the drug can be used for breastfeeding women.

The effect of the drug on the ability to drive and operate machinery

The drug does not have or does not significantly affect the ability to drive, operate machinery.

Medicinal interaction

Anticoagulant oral medications: Paracetamol long -dose long -dose taken to slightly increase coagulating drugs of COMAARIN and Indandion derivatives. Research data is still conflicting and also doubted about this interaction, so paracetamol is preferred than salicylate when it is necessary to relieve mild analges or reduce fever for patients using cooumarin or indoplasm.

It is necessary to pay attention to the possibility of serious heat lowering the patient and phenothiazine and cooling (such as paracetamol).

Out of alcohol too much and long may increase the risk of Paracetamol's liver toxicity.

Anti -convulsions (including Phenytoin, Barbiturat, Carbamazepin) that causes enzyme induction in the liver microsom, which can increase the toxicity of the liver toxicity of paracetamol due to increased drug conversion into toxic substances to the liver. In addition, simultaneous use of isoniazid with paracetamol can also lead to an increase in the risk of toxicity to the liver, but it has not been determined the exact mechanism of this interaction. The risk of paracetamol is toxic to the liver is significantly increasing in patients with paracetamol -dose than the recommended dose, while taking anti -convulsions or isoniazid. Often do not need to reduce the dose in patients with simultaneous doses of paracetamol treatment and anti -convulsions; However, patients must limit their own use of paracetamol while taking anti -convulsions or isoniazid.

Probenecid may reduce paracetamol elimination and increase the half -life of plasma of paracetamol.

Salycinamide can cause extension of paracetamol's sale time when combined.

Isoniazid and anti -tuberculosis drugs increase the toxicity of paracetamol for the liver.

metoclopramid, domeridon increases the absorption speed of paracetamol, cholestiramin reduces the absorption rate of paracetamol.

Due to the absence of studies on the correlation of the drug, not mixing this drug with other drugs.