Lecture notes Pharmacy

Clinical 04

Painful OTC conditions:
Clinical use of paracetamol and
NSAIDs



Roger Knaggs

, Aim of this lecture

 Describe the clinical use of paracetamol and NSAIDs
 Side effects & management
 Interactions
 Important dosing information


 Explain the mechanisms of paracetamol metabolism and rationale for its tre

 The role of paracetamol and NSAIDs in the treatment of back pain and
osteoarthritis

, Paracetamol
 Mechanism of action?
 Don’t fully know how it works and how it provides its analgesic and antipyretic actions
 There have been suggestions that it interacts w almost every endogenous analgesic system
body
 Like interactions w the opioid system, the endocannabinoid system
 Also interfering w prostaglandin synth (not in the periphery like NSAIDs, but most likely ce
in the CNS)
 ^^ we know this cos the antipyretic effects tell us that it must get to the temp regulating ce
the brain (hypothalamus)

 Available in many formulations
 Tablets, capsules, soluble tablets, suspension, suppository, infusion (only available for last 2
 IV – issues was tryna get pretty large doses (500mg/1g) into a solution for IV admin, this w
formulation challenge, hence why took so long to produce

 Known as acetaminophen in USA