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Paracetamol chemically named N-acetyl-p-aminophenol, is a widely used over-the-counter analgesic (pain reliever) and antipyretic (fever reducer).Acetaminophen is the name adopted for this pharmacologic agent in the U.S. (USAN) and Japan; paracetamol is approved in a variety of international venues (INN, AAN, BAN, etc.).Common trade names in English-speaking markets are Tylenol and Panadol.
While generally safe for use at recommended doses, even small overdoses can be fatal. Compared to other over-the-counter pain relievers, paracetamol is significantly more toxic in overdose but may be less toxic when used chronically at recommended doses.Paracetamol is the active metabolite of phenacetin and acetanilide, both once popular as analgesics and antipyretics in their own right.However, unlike phenacetin, acetanilide and their combinations, paracetamol is not considered carcinogenic at therapeutic doses
Adverse effects
In recommended doses and for a limited course of treatment, the side effects of paracetamol are mild to non-existent.
Liver damage
Acute overdoses of paracetamol can cause potentially fatal liver damage. According to the US Food and Drug Administration, "Acetaminophen can cause serious liver damage if more than directed is used." and in 2011 the FDA required manufacturers to update labels of all prescription combination acetaminophen products to warn of the potential risk for severe liver injury[
Skin reactions
On August 2, 2013, the U.S. Food and Drug Administration (FDA) issued a new warning about paracetamol. It stated that the drug could cause rare, and possibly fatal, skin reactions, such as Stevens–Johnson syndrome and toxic epidermal necrolysis. Prescription-strength products will be required to carry a warning label about skin reactions, and the FDA has urged manufacturers to do the same with over-the-counter products.
Asthma
There is an association between paracetamol use and asthma but the weight of evidence of the collected studies strongly suggests that the association reflects various forms of bias, the most prominent of which is confounding by indication.The majority of the evidence does not support a causal role.
As of 2014, the American Academy of Pediatrics and the National Institute for Health and Care Excellence (NICE) continue to recommend paracetamol for pain and discomfort in children,but some experts have recommended that paracetamol use by children with asthma, or at risk for asthma, should be avoided.
Other factors
In contrast to aspirin, paracetamol does not prevent blood from clotting (it is not an antithrombotic), and thus may be used in patients where failure of blood coagulation is a concern; and it does not cause gastric irritation.However, paracetamol does not help reduce inflammation, while aspirin does.Compared to ibuprofen—whose side effects may include diarrhea, vomiting and abdominal pain—paracetamol has fewer adverse gastrointestinal effects.
Reactions
4-Aminophenol may be obtained by the amide hydrolysis of paracetamol. 4-Aminophenol prepared this way, and related to the commercially available Metol, has been used as a developer in photography by hobbyists.This reaction is also used to determine paracetamol in urine samples: After hydrolysis with hydrochloric acid, 4-aminophenol reacts in ammonia solution with a phenol derivate, e.g. salicylic acid, to form an indophenol dye under oxidization by air.
If you are allergic to tartrazine, talk with healthcare provider. Some products contain tartrazine.
If you have an allergy to any type of nuts or seeds, talk with healthcare provider. Some products contain nuts.
Check medicines with healthcare provider. This medicine may not mix well with other medicines.
Tell healthcare provider if you are pregnant or plan on getting pregnant.
Tell healthcare provider if you are breast-feeding.
What are some possible side effects of this medicine?
Skin irritation.
Reasons to call healthcare provider immediately
If you suspect an overdose, call your local poison control center or emergency department immediately.
Signs of a life-threatening reaction. These include wheezing; chest tightness; fever; itching; bad cough; blue skin color; fits; or swelling of face, lips, tongue, or throat.
Severe skin irritation.
Any rash.
No improvement in condition or feeling worse.
Medical uses
Atenolol is used for a number of conditions including: hypertension, angina, Long cough, acute myocardial infarction, supraventricular tachycardia, ventricular tachycardia, and the symptoms of alcohol withdrawal.
It is also used to treat the symptoms of Graves' disease until antithyroid medication can take effect.
Due to its hydrophilic properties, the drug is less suitable in migraine prophylaxis compared to propranolol, because, for this indication, atenolol would have to reach the brain in high concentrations, which is not the case, because, as mentioned, atenolol does not pass through the blood–brain barrier.c
Side effects
Atenolol causes significantly fewer central nervous system side effects (depression, nightmares).
It was the main β-blocker identified as carrying a higher risk of provoking type 2 diabetes, leading to its downgrading in the United Kingdom in June 2006 to fourth-line agent in the management of hypertension.
In addition, β-blockers blunt the usual sympathetic nervous system response to hypoglycemia (i.e. sweating, agitation, tachycardia). These drugs therefore have an ability to mask a dangerously low blood sugar, which further decreases their safety and utility in diabetic patients.
Side effects have been known to include the following
indigestion, constipation
dry mouth
dizziness or faintness (especially cases of orthostatic hypotension)
cold extremities
impotence
rhinitis
depression
confusion
insomnia, nightmares
fatigue, weakness or lack of energy
edema
The following more-serious side effects have also been observed and/or reported:
hallucinations
low blood pressure (hypotension)
skin reactions, e.g. rash, hives, flaking of skin, worsening of psoriasis
sensation of 'pins and needles' hands or feet
irritated eyes, visual disturbances
difficulty hearing
difficulty speaking
unsteadiness when walking
Atenolol is classified as a β1-selective (or 'cardioselective') drug, one that exerts greater blocking activity on myocardial β1-receptors than on β2 receptors in the lung. The β2 receptors are responsible for keeping the bronchial system open. If these receptors are blocked, bronchospasm with serious lack of oxygen in the body can result. However, due to its cardioselective properties, the risk of bronchospastic reactions if using atenolol is reduced compared to nonselective drugs as propranolol. Nonetheless, this reaction may also be encountered with atenolol at high doses. Although traditionally β-blockers have been contraindicated when a person carries a diagnosis of asthma, recent studies have revealed that at moderate doses selective β-blockers such as Atenolol are well tolerated.
Provisional data suggests that antihypertensive therapy with atenolol provides weaker protective action against cardiovascular complications (e.g. myocardial infarction and stroke) compared to other antihypertensive drugs. In some cases, diuretics are superior. However, controlled studies are lacking.
Unlike most other commonly used β-blockers, atenolol is excreted almost exclusively by the kidneys. This makes it attractive for use in individuals with end-stage liver diseases.
Before using trolamine salicylate, tell your doctor or pharmacist if you are allergic to it; or to aspirin or other salicylates (such as salsalate); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: asthma, growths in the nose (nasal polyps).
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
This drug is similar to aspirin. Children and teenagers should not use this drug if they have chickenpox, flu, or any undiagnosed illness or if they have recently received a vaccine. In these cases, this drug may increase the risk of Reye's syndrome, a rare but serious illness.
During the first 6 months of pregnancy, this medication should be used only when clearly needed. It is not recommended for use during the last 3 months of pregnancy due to possible harm to the unborn baby and problems with normal labor/delivery. Discuss the risks and benefits with your doctor.
It is unknown if this product passes into breast milk. Consult your doctor before breast-feeding.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Overdose
Symptoms of overdose are due to excessive pharmacodynamic actions on β1 and also β2-receptors. These include bradycardia, severe hypotension with shock, acute heart failure, hypoglycemia and bronchospastic reactions. Treatment is largely symptomatic. Hospitalization and intensive monitoring is indicated. In early cases emesis can be induced. Activated charcoal is useful to absorb the drug. Atropine will counteract bradycardia, glucagon helps with hypoglycemia, dobutamine can be given against hypotension and the inhalation of a β2-mimetic as hexoprenalin or salbutamol will terminate bronchospasms. Blood or plasma atenolol concentrations may be measured to confirm a diagnosis of poisoning in hospitalized patients or to assist in a medicolegal death investigation. Plasma levels are usually less than 3 mg/L during therapeutic administration, but can range from 3–30 mg/L in overdose victims.
