1. PARACETAMOL N-acetyl-p-aminophenol
Discovered in 1877.
aka acetaminophen (APAP).
Mild analgesic.
Antipyretic.
Not NSAIDs.
C8H9NO2

2. MAIN MEDICATION USED To treat PAIN & FEVER
Painkiller - headache, sprains, toothache, backache, arthritis, muscle ache
Reducing fever in people of all ages. (antipyretic) - flu (influenza) - cold

3. Commercial products Over-the-counter drugs Panadol Paracetamol Calpol
Types: - Tablets Capsules Oral suspension

5. Precautions
Dose recommended > Adult: 1000 mg per dose > Kids: mg/kg/dose (1 month to 12 year-old) > Adolescence: mg (>=12 year-old) (in every 4 to 6 hrs) > Alcoholic dependent individual: 500mg per dose > Individual with liver and/or kidney problem; deficiency in glucose-6-phosphate dehydrogenase enzyme: professional advice required

6. Causes (TOXICITY)
Allergy - rash/ swelling (face, lips, tongue, throat) - hypotension (low BP) - difficulty breathing - hives
Excessive used/ overdose (Paracetamol toxicity) - > 0.2 mg/ml (4hrs) or 0.05 mg/ml (12hrs) - ACUTE LIVER FAILURE - HEPATOTOXICITY - ANALGESIC NEPHROPATHY

7. ALF & ANALGESIC NEPHROPATHY
Acute Liver Failure (ALF) - hepatocellular dysfunction (80-90%) - complications
Hepatotoxicity - chemical-driven liver damage
Analgesic Nephropathy - chronic kidney disease - damage/injuries induced by excessive used of analgesic - renal papillary necrosis; chronic interstitial nephritis - acute tubular necrosis

8. Methods for diagnosing of diseases caused by Paracetamol
Drug Nomogram - Prognosis of risk of potential hepatotoxicity
Emergency & Overdose Drug Testing - Toxicology assay: quantifying the amount of drugs
Hepatic Function Panel = Liver Panel - symptoms: jaundice, fatigue, dark urine/ light stool, nausea, vomit, loss of appetite, etcetera.
CT Scan - diagnosis of analgesic nephropathy

9. Principle of method
Hepatic function panel > a group of tests > diagnosis of liver injury/ viral infections > Evaluates: Alanine aminotransferase (ALT) -> increased Alkaline phosphatase (ALP) -> increased Aspartate aminotransferase (AST) -> increased Total Bilirubin -> increased Albumin & total protein -> decreased

10. Sources
AACC Lab Tests Online® (2015) Emergency and Overdose Drug Testing. Available at: [Accessed 14 February 2016]
AACC Lab Tests Online® (2015) Liver Panel. Available at: [Accessed 13 February 2016]
Boots Pharmaceutical, (2016). Boots-Paracetamol-500mg-Capsules. [image] Available at: Capsules_ / [Accessed 10 February 2016]
Boots Pharmaceutical, (2016) Paracetamol-Tablets-500mg. [image] Available at: Tablets_228844/ [Accessed 10 February 2016]
Calpol, (2016) Calpol Infant Liquid Suspension Sugar Free 100ml. [image] Available at: [Accessed 10 February 2016]
Drugs.com (2016) Paracetamol. Available at: [Accessed 11 February 2016]
Durani Y. (2014) Blood Test: Hepatic (Liver) Function Panel. Available at: [Accessed 13 February 2016]
Panadol, (2016) Panadol-optizorb-tablets. [image] Available at: [Accessed 10 February ]
Panadol, (2016) Panadol-Ultra-Tablets-20. [image] Available at: [Accessed 10 Febuary 2016]
WIKIPEDIA, The Free Encyclopedia (2016) Analgesic Nephropathy. Available at: [Accessed 12 February ]
WIKIPEDIA, The Free Encyclopedia (2016) Acute Liver Failure. Available at: [Accessed 12 February 2016]
Willacy H. (2013) Paracetamol poisoning. Available at: [Accessed 12 February 2016]