Partamol Tab 500mg Stella treats pain and fever from mild to medium (10 blisters x 10 tablets)

pharmacokinetics

paracetamol is easily absorbed through the gastrointestinal tract with peak concentration in plasma from 10 - 60 minutes after drinking.

paracetamol is distributed in most body tissues. The drug is given the placenta and is present in breast milk. The cohesion of the drug to the plasma proteins is negligible at conventional treatment concentrations but increases when the drug concentration increases. Selling time is about 1-3 hours.

paracetamol metabolizes most and excreted through urine mainly in the form of assembled with glucuronic and sulfate. Under 5% of drugs are eliminated in a constant form. The secondary metabolic substance caused by hydroxyi (n-acetyl-p-benzoquinoneimin) is usually generated in very small amounts in the liver and kidneys. This substance is detoxified by a combination with glutathion but can accumulate after paracetamol overdose and damage tissue.

Do not arbitrarily use paracetamol to reduce fever in cases of too high fever (above 39.6 ° C), fever lasts more than 3 days or recurrent fever.What to do when overdose? Hepatic necrosis depends on the dose is the most dangerous toxicity of paracetamol poisoning and can be fatal.

Management

When Paracetamol poisoning, Acetylcysten is used as a detox. Using acetylcysten by oral, the starting dose is 140 mg/kg; Next is the maintenance dose of 70 mg/kg every 4 hours x 17 doses. Within 1 hour after the starting dose or the dose of acetylcysteine ​​maintenance, if the patient has vomiting, the dose should be repeated. If the patient still cannot drink, Acetylcystein can be taken through the catheter into the duodenum. An anti -vomiting drug can also be used for patients who often vomit.

If the poison has just occurred, using activated carbon can reduce the absorption of paracetamol and should be treated as soon as possible (preferably within 1 hour after being poisoned). Other stomach detoxification methods (such as IPECA syrup) are less effective and often not recommended.

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

What to do when you forget 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 doses to compensate for missed dose.

Be cautious when using

do not use this medication for children under 6 years old, patients with G6PD deficiency can cause hemolysis, anorexia patients, malnutrition (conditions that cause glutathion decreased in the liver).

Paracetamol is relatively non -toxic to the treatment and when used under the guidance of a physician. However, overdose of paracetamol is the main cause of acute liver failure. Using many preparations containing paracetamol (acetaminophen) and can lead to unwanted effects (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 not dependent on the effects of other drugs. Although other painkillers and antipyretic (such as NSAIDs) can cause similar reactions, cross -sensitive with paracetamol. Patients need to stop using paracetamol and see a physician as soon as they see rash or other manifestations in the skin 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 rashes and urticaria; Other sensitive reactions include larynx edema, angioedema and anaphylactic reactions that may rarely occur. Platelets, hypoglycemia and all bloody hematuria have occurred with the use of p-aminophenol derivatives, especially when used for large doses. Neutral leukopenia and thrombocytopenic hemorrhage occur when using paracetamol. Rarely cool leukocytes in patients using paracetamol.

Be cautious when using paracetamol for people with liver failure, kidney failure, alcoholic, chronic malnutrition or dehydration. Avoid high doses, prolonged use for people with liver failure.

Must use paracetamol carefully in patients with anemia before, because purple blue may not manifest clearly, although high concentrations at a dangerous level of methemoglobin in the blood.

Drinking plenty of alcohol can cause toxicity to the liver of paracetamol, should avoid or limit drinking alcohol.

The effect of the drug on driving and operating machinery

Paracetamol does not affect the ability to drive and operate machinery.

Use drugs for women during pregnancy and lactation

Pregnant women

The safety of paracetamol has not been determined during pregnancy is related to unwanted effects that may be possible for fetal development. Therefore, Paracetamol should only be used in pregnant women when needed.

breastfeeding women

Research in nursing mothers, using paracetamol does not see unwanted effects in breastfed children.

Interactive drug

anticoagulant drugs: Paracetamol long -dose long -dose taken to slightly increase coagulating effects 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 antipyretics in patients using simultaneously phenothiazine and cooling therapy (such as paracetamol).

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

Anti -convulsions (including Phenytoin, Barbilurat, 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 causes liver toxicity significantly increases in patients with paracetamol doses greater 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 restrict self -use of paracetamol while taking anti -convulsions or isoniazid.

Probenecid can reduce paracetamol elimination and increase the half -life period in the plasma of paracetamol.

Lsoniazid and tuberculosis drugs increase the toxicity of paracetamol for the liver.

Metoclopramid or domperidon: The increase in paracetamol absorption speed due to metoclopramid or domperidon. However, avoid simultaneous use of both drugs.

cholestyramin: Cholestyramn reduces the absorption rate of paracetamol. Therefore, cholestyramin should not drink within 1 hour if you want to maximize pain.