Relevant bibliographies by topics / Paracetamol

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  1. Journal articles
  2. Dissertations / Theses
  3. Books
  4. Book chapters
  5. Conference papers
  6. Reports

Academic literature on the topic 'Paracetamol'

Author: Grafiati
Published: 4 June 2021
Last updated: 10 May 2025

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Journal articles on the topic "Paracetamol"

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Hinz, Burkhard, and Kay Brune. "Paracetamol and cyclooxygenase inhibition: is there a cause for concern?" Annals of the Rheumatic Diseases 71, no. 1 (October 28, 2011): 20–25. http://dx.doi.org/10.1136/ard.2011.200087.

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Paracetamol is recommended as first-line therapy for pain associated with osteoarthrosis and is one of the most widely used over-the-counter analgesic drugs worldwide. Despite its extensive use, its mode of action is still unclear. Although it is commonly stated that paracetamol acts centrally, recent data imply an inhibitory effect on the activity of peripheral prostaglandin-synthesising cyclooxygenase enzymes. In this context paracetamol has been suggested to inhibit both isoforms in tissues with low levels of peroxide by reducing the higher oxidation state of cyclooxygenase enzymes. Two recent studies have also demonstrated a preferential cyclooxygenase 2 (COX-2) inhibition by paracetamol under different clinically relevant conditions. This review attempts to relate data on paracetamol's inhibitory action on peripheral cyclooxygenase enzymes to the published literature on its anti-inflammatory action and its hitherto underestimated side-effects elicited by cyclooxygenase inhibition. As a result, a pronounced COX-2 inhibition by paracetamol is expected to occur in the endothelium, possibly explaining its cardiovascular risk in epidemiological studies. A careful analysis of paracetamol's cardiovascular side-effects in randomised studies is therefore strongly advised. On the basis of epidemiological data showing an increased gastrointestinal risk of paracetamol at high doses or when co-administered with classic cyclooxygenase inhibitors, paracetamol's long-term gastrointestinal impact should be investigated in randomised trials. Finally, paracetamol's fast elimination and consequently short-lived COX-2 inhibition, which requires repetitive dosing, should be definitely considered to avoid overdosage leading to hepatotoxicity.
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Begum, Shaheen, Poojitha Harisree G, and Rashida Anjum M S. "A Short Review on Biological Activities of Paracetamol Derivatives." International Journal of Pharmaceutical Sciences and Nanotechnology(IJPSN) 16, no. 1 (February 13, 2023): 6309–25. http://dx.doi.org/10.37285/ijpsn.2023.16.1.5.

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Paracetamol reduces body temperature with multiple mechanisms. Paracetamol is chemically 4-hydroxy acetanilide and has a good safety profile. Following its successful use as an over-the-counter antipyretic and analgesic medication, several attempts were made to increase the potency, mask the bitter taste, and decrease the toxicity of this drug by modifications at the phenyl ring, acetamido group, and hydroxyl group. The free hydroxyl group of paracetamols was masked to obtain prodrugs (carbonate prodrugs, ester prodrugs like alanine-prodrug, proline-prodrug, galactosylated prodrug, and mutual prodrugs with other drugs and NSAIDs). Propacetamol is a commercially available prodrug derived from paracetamol that is effective in parenteral form. Paracetamol ester prodrugs with sulfur-containing amino acids such as N-acetyl cysteine, cysteine, and methionine showed low hepatotoxicity compared to the parent drug. In addition, paracetamol derivatives including metal complexes, chalcones, Mannich bases, nucleoside analogs, hybrids with the aryl-imidazolidinyl ring, thymol, and triazole ring displayed diverse activities like antioxidant, anticancer, and antimicrobial activities.
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Coman, Laurențiu, Horia Păunescu, Cristina Isabel Viorica Ghiță, Radu Ciprian Țincu, Sorina Vasile, Delia Cinteza, Ion Fulga, and Oana Andreia Coman. "Paracetamol-Induced Hypothermia in Rodents: A Review on Pharmacodynamics." Processes 10, no. 4 (March 31, 2022): 687. http://dx.doi.org/10.3390/pr10040687.

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Paracetamol can induce hypothermia in humans and rodents. The study’s aim is to review the mechanisms of paracetamol-induced hypothermia in rodents or the results issued from in vitro studies on the same species’ tissues (in doses that do not produce hepatic impairment) using the latest developments published in scientific journals over the last 15 years. Available human studies are also analysed. An extensive search in PubMed databases exploring the hypothermic response to paracetamol was conducted. 4669 articles about paracetamol’s effects on body temperature in mice or rats were found. After applying additional filters, 20 articles were selected for review, with 9 of them presented in tabular forms. The analysis of these articles found that the hypothermic effect of paracetamol is due to the inhibition of a cyclooxygenase-1 variant, is potentiated by endothelin receptor antagonists, and can be mediated through GABAA receptors and possibly through transient receptor potential cation channel subfamily A member 1 via N-acetyl-p-benzoquinone imine in the central nervous system. Human studies confirm the in vivo and in vitro experiments in rodents regarding the presence of a hypothermic effect after high, non-toxic doses of paracetamol. Further research is required to understand the mechanisms behind paracetamol’s hypothermic effect in humans.
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Hamed Almurisi, Samah, Khater AL-Japairai, Farhan Alshammari, Fawaz Alheibshy, Rana M. F. Sammour, and Abd Almonem Doolaanea. "Stability of Paracetamol Instant Jelly for Reconstitution: Impact of Packaging, Temperature and Humidity." Gels 8, no. 3 (February 25, 2022): 144. http://dx.doi.org/10.3390/gels8030144.

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The stability of the medicinal product is a major concern in the pharmaceutical industry and health authorities, whose goal is to guarantee that drugs are delivered to patients without loss of therapeutic properties. This study aims to evaluate the effect of environmental conditions and packaging on the stability of paracetamol instant jelly sachets based on both chemical and physical stability. The paracetamol instant jelly was packaged in plastic sachets (packaging 1) and sealed aluminium bags in screw-capped amber glass bottles (packaging 2), which were stored in real-time and accelerated stability chambers for 3 months. Samples were taken out from the chambers and were characterised for appearance, moisture content, texture, viscosity, in vitro drug release, paracetamol content, and 4-aminophenol level at different time points. The real-time storage condition at a lower temperature maintained the stability of the paracetamol instant jelly, while the accelerated condition led to a significant change in the formulation properties. In addition, the proper packaging of paracetamol instant jelly maintained the paracetamol’s stability, regardless of environmental conditions, for three months. The results show that the environmental conditions and packaging play a significant role in maintaining paracetamol instant jelly stability.
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Mohamed, Ashma, Alexa Wacker, and Martin Schmidt. "Chronic Misuse of Paracetamol in OCD Without Hepatic Injury: A Case Report and Literature Review." BJPsych Open 8, S1 (June 2022): S123. http://dx.doi.org/10.1192/bjo.2022.364.

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AimsParacetamol is a commonly used antipyretic and analgesic over the counter medication. In acute or chronic overuse it is associated with dose-dependent hepatic injury. There is a narrow therapeutic margin and that consistent use of as little as 7.5 g/day may be hazardous. Unintentional overdose with paracetamol is the most common cause of acute liver failure in the United Kingdom Here we present an unusual case of a 60-year-old lady with a reported chronic history of self-medicating with an above daily recommended dose of paracetamol without evidence of hepatic injury.MethodsA 60-year-old Caucasian lady known to psychiatric services for 20 years with Recurrent Depressive disorder, Obsessive Compulsive Disorder (OCD), Dependent Personality Disorder with Borderline personality traits. She reported consuming 32 tablets of paracetamol (16gm per day) every day for the past 11 years. She experienced obsessions of fear that if she did not take a particular number of paracetamols in a day then her friends will come to harm and her anxiety was relieved by the compulsion of consuming supratherapeutic doses of paracetamol. There was no evidence of misuse of any other medications other than paracetamol. Her blood investigations revealed liver function tests within normal limits and ultrasound of the liver was unremarkable.ResultsA literature search of “paracetamol or acetaminophen” and “no liver or hepatic” and “damage or injury” found only one case report. The case reported that studies of paracetamol metabolism were performed in a 58-year-old female with rheumatoid arthritis who had consumed 15–20 g paracetamol daily for 5 years without developing liver damage and data were compared with results in seven normal volunteers. The report concluded that a combination of slow paracetamol absorption, enhanced detoxication of paracetamol (by sulphation) and reduced metabolism to potentially cytotoxic metabolites may have reduced the risk of liver damage in this patient.ConclusionIn OCD, misusing medications can be an uncommon presentation of compulsive acts to relieve anxiety. The diagnostic dilemma of factitious illness is probable, however supratherapeutic use of paracetamol without physical harm is rare but possible.
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Ahmed Mejbel, Elham, Saif Subhi Noori, Adeeb Shakir Mahmood, Hussein Riyadh Abdul Kareem Al-Hetty, and Mohammed H. Musleh. "Oleuropein Protects against the Development of Kidneys Induced by Paracetamol in Albino Male Rats." HAYATI Journal of Biosciences 32, no. 1 (November 22, 2024): 254–62. http://dx.doi.org/10.4308/hjb.32.1.254-262.

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Paracetamol treatment is considered one of the treatments used to relieve pain and antipyretic. Therefore, excessive doses and long-term use lead to organ toxicity. Paracetamol treatment is considered one of the treatments used to relieve pain and antipyretic. Therefore, excessive doses and long-term use lead to organ toxicity. The aim of the study was to investigate the protective effect of Oleuropein extracted from olive leaves on the physiological and histological aspects induced by Paracetamol in a rat model. The methods used 25 albino Swiss rats randomly distributed into five groups with the same number. The unit of control is given normal saline. Paracetamol (750 mg/kg) was injected into the group once. In the treatment groups (50 mg/kg, 100 mg/kg, 150 mg/kg). The Administration of Paracetamol's result significantly increased blood urea, creatinine, sodium, and potassium levels, and their blood concentrations decreased with Oleuropein (P 0.05). In addition, Oleuropein extracted from olive leaves relieved some symptoms, including acute vascular congestion caused by a dose of Paracetamol. Compared with paracetamol treatment, there is an infiltration of inflammatory cells and severe nephrotoxicity in the tubules. According to this study, the Oleuropein extracted from olive leaves can be used to prevent kidney damage, and It is not recommended to give Paracetamol, which increases kidney disorders.
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LORELL, Juan, Kathy IVANA, Joselyn P. W. TANOTO, Michael MICHAEL, Sarah JESCIKA, Nicolaas R. P. GAUTAMA, Olivia TJOA, Keisha ALINA, Arli A. PARIKESIT, and Fandi SUTANTO. "In silico testing of C9H12ClNO2 and C6H5Cl2NO as derivatives of acetaminophen using molecular docking method." Notulae Scientia Biologicae 16, no. 1 (March 11, 2024): 11632. http://dx.doi.org/10.55779/nsb16111632.

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Paracetamol, a commonly used analgesic and antipyretic medication, is well-known for its ability to relieve pain and reduce temperature. However, there is a constant push to improve its therapeutic efficacy, especially towards increasing its oral bioavailability. The increase in bioavailability will lead to a better reception of the drugs by the body. This research aims to provide valuable insights into the molecular mechanisms underlying paracetamol’s mode of action and propose novel strategies for enhancing its therapeutic effectiveness. We investigated the notion of functional group alteration by molecular docking as a strategy to increase the efficacy of paracetamol in this work. Using modern computational approaches, it could be conducted through the examination of the structural characteristics and active regions of paracetamol and its target receptors. Additionally, molecular docking simulations were used to examine the binding interactions between paracetamol and its target receptors, offering insights into the essential functional groups required for ligand-receptor recognition. Tests of several molecular docking techniques and scoring functions allowed the researchers to find potential alterations that might improve its pharmacological characteristics. By integrating structural analysis, molecular docking studies, and computational screening, the uncovering of promising modifications that can significantly improve paracetamol’s efficacy was expected. Ultimately, this work may lead to the development of next-generation analgesics with superior pharmacological profiles, providing enhanced pain relief and fever reduction for patients.
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&NA;. "Paracetamol see Dextropropoxyphene/paracetamol." Reactions Weekly &NA;, no. 350 (May 1991): 10. http://dx.doi.org/10.2165/00128415-199103500-00043.

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&NA;. "Paracetamol see Aspirin + paracetamol." Reactions Weekly &NA;, no. 360 (July 1991): 9. http://dx.doi.org/10.2165/00128415-199103600-00053.

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Nguyen, Tinh Thu, Dung Thi Ngoc Nguyen, Tam Thi Thanh Pham, and Ju-Lee Oei. "Prophylaxis of Patent Ductus Arteriosus with Paracetamol in Extremely Low Gestational Age Newborns (ELGANs): A Single-Institution Observational Study in Vietnam." Children 10, no. 12 (December 17, 2023): 1934. http://dx.doi.org/10.3390/children10121934.

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Introduction: Prophylactic paracetamol for extremely low gestation age neonates (ELGAN, <27 weeks’ gestation) with symptomatic patent ductus arteriosus (sPDA) in high-income countries (HIC) reduces medical and surgical interventions. Its effectiveness in low-to-middle-income countries (LMIC) remains uncertain. This study assesses prophylactic paracetamol’s impact on sPDA interventions in ELGANs in an LMIC. Methods: This is a retrospective cohort study that compared a historical cohort of ELGANs that were treated with oral ibuprofen or intravenous paracetamol after diagnosis of sPDA (n = 104) with infants (n = 76) treated with prophylactic paracetamol (20 mg/kg loading, 7.5 mg/kg qid for 4 days), in a tertiary neonatal intensive care unit (NICU) in Vietnam. Oral ibuprofen or intravenous therapeutic paracetamol were administered if prophylactic paracetamol failed to close sPDA. Surgical ligation was conducted if targeted medical intervention failed, or the infant deteriorated from conditions attributable to sPDA. Results: In the historical cohort, 57 (55%) infants died within 7 days of life compared to 18 (24%) from the prophylactic cohort (p < 0.01). Of the survivors, 21 (45%) of the historical and 23 (39.7%) of the prophylactic cohort required surgical ligation (p = 0.6). Duration of hospitalization for survivors was lower in the prophylactic cohort (mean 74 vs. 97 days, p = 0.01). In the prophylactic cohort, 24 (41%) infants did not need further treatment while 34 (59%) required further treatment including ibuprofen and/or paracetamol 28 (48%) and surgical ligation 22 (38%). Conclusions: Prophylactic paracetamol for ELGAN in LMIC does not reduce the need for surgical ligation, sPDA rates, and other PDA-related morbidities in infants who survive beyond 7 days of age. It may reduce the risk of death and the duration of hospitalization but further study into the reasons behind this need to be determined with larger studies.
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Dissertations / Theses on the topic "Paracetamol"

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Mohd, Zaki Hamizah. "Spectroscopy surface analysis of paracetamol and paracetamol and excipient systems." Thesis, University of Manchester, 2011. https://www.research.manchester.ac.uk/portal/en/theses/spectroscopy-surface-analysis-of-paracetamol-and-paracetamol-and-excipient-systems(2f50af69-fb35-487b-8065-46aa3c86f96c).html.

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A detailed, fundamental understanding of the surface properties of molecular crystals and their interaction with adsorbing molecules (e.g. excipients) is important for tailoring the stability of formulations and the bioavailability of Active Pharmaceutical Ingredient (APIs). Few fundamental experimental studies with surface sensitive probes have been carried out for organic molecular crystals. X-ray photoelectron spectroscopy (XPS) is an established surface analysis method in the fields of adsorption, catalysis and surface chemistry of inorganic crystals. It has high surface sensitivity, probing approximately the top 1-3 nm of a crystal, and allows surface elemental analysis combined with the determination of the chemical state of the elements. To explore the possibilities and limitations of XPS for the surface characterisation of molecular crystal systems, investigation has been made on a range of paracetamol systems, three different poloxamers and blends of paracetamol with poloxamer 188. It was found by investigations of a range of polycrystalline paracetamol forms that the C1s, N1s and O1s core level emissions from the amide group of paracetamol allow to quantify, for the first time, the influence of surface contamination and adsorbed species on the paracetamol XPS data. Results of quantitative XPS analyses must be critically evaluated taking the material and energy-specific escape depth of the photoelectron signals into account. Analysis of the polycrystalline powder samples, including two different polymorphs and various partially amorphous forms of paracetamol, indicated that the core-level shifts associated with varying intermolecular interactions do not perturb the local electronic structure variations in paracetamol enough to become detectable through chemical shifts in the core level photoemission spectra. Subsequently, large, high quality single crystals of the monoclinic form I (with facet diameters between ~5 and ~10 mm) were obtained from different solvents (methanol, ethanol, acetone) to examine the influence of the crystallisation medium on the surface properties. Small spot XPS analysis was performed in several areas across facets to examine the possible influence of roughness and other lateral inhomogeneities. Careful curve-fitting of all results reveals only minor variations in the XPS data as a function of facet orientation, crystallisation medium or degree of crystallinity. Moreover, results indicate that any variations seen in XPS data very likely stem from low-level surface contamination, which is very difficult to avoid, even in a clean-room laboratory environment. In fact, the results indicate that the level of surface contamination depends significantly on the crystallisation apparatus cleanliness. Even minute concentrations of surface active components in the solutions, i.e. below the detection level of techniques for routine analytical methods, are likely to cause significant surface concentrations on crystal facets emersed from the solutions. The study thus highlights the paramount importance of microscopic surface cleanliness when assessing macroscopic facet-specific phenomena such as contact angles. Finally, XPS was employed to analyse milled and physical mixtures of paracetamol with poloxamer 188 at different percent. At minimum mass percentages poloxamer 188 adsorbs on the paracetamol surfaces; in the presence of poloxamer 188 excess the conformation of adsorbed poloxamer on the paracetamol surface changes. Studies of radiation damage on the poloxamer samples were performed both for several pure polxamers as well as for milled mixtures with paracetamol. They allowed the proposal of radiation-induced degradation mechanisms.
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Castro, Pedro Luís Pereira de. "Farmacocinética do paracetamol." Master's thesis, [s.n.], 2014. http://hdl.handle.net/10284/4415.

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Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Ciências Farmacêuticas
O paracetamol é um dos analgésicos e antipiréticos mais utilizados em crianças e adultos por possuir uma janela terapêutica larga com poucos efeitos adversos. No entanto, por ser um medicamento não sujeito a receita médica, é por vezes utilizado em sobredosagem, podendo provocar hepatotoxicidade decorrente do esgotamento dos níveis de glutationa hepática e do excesso de produção de N-acetil-p-benzoquinonaimina (NAPQI), um metabolito alquilado, que se liga aos grupos sulfidrilo das proteínas hepáticas originando necrose dos hepatócitos. Com vista a descrever o comportamento deste fármaco num organismo e determinar a influência de fatores como o síndrome de Gilbert, o jejum, o alcoolismo e a administração de doses supraterapêuticas na sua ação terapêutica e possível toxicidade têm sido sugeridos diversos modelos farmacocinéticos compartimentais e fisiológicos. Nesta dissertação é apresentada uma revisão bibliográfica, organizada cronologicamente, dos modelos que, em virtude da informação cinética e dinâmica que fornecem, são considerados mais relevantes. Um dos modelos mais completos e importantes foi o proposto em 2013 por Pery e colaboradores. Trata-se de um modelo de base fisiológica que permitiu estudar a distribuição e caraterizar a hepatotoxicidade de uma dose supraterapêutica de paracetamol. Dada a sua relevância e atualidade, este modelo foi analisado em maior detalhe tendo sido simulado em Microsoft Excel®. Os resultados obtidos mostram que após administração de uma dose supraterapêutica de paracetamol pode ocorrer saturação das reações de fase II no fígado (sulfatação e de glucuronidação), verificando-se a presença de elevadas concentrações de paracetamol inalterado no organismo, podendo-se associar a este factor, a formação de quantidades elevadas de NAPQI. Pery et al., a partir dos resultados obtidos numa simulação idêntica, juntamente com extrapolações realizadas com softwares especializados, previram que a dose para qual seria de esperar efeitos significativos na viabilidade celular no Homem, seria de 155 mg/kg. Paracetamol is one of the most widely used analgesics and antipyretics in children and adults by having a wide therapeutic window with few adverse effects. However because it is an over-the-counter (OTC) drug, is sometimes used in overdose and may cause hepatotoxicity resulting from the depletion of hepatic glutathione levels and excessive production of N-acetyl-p-benzoquinoneimine (NAPQI), an alkylated metabolite which binds to sulfhydryl groups of hepatic proteins leading to necrosis of the hepatocytes. Many compartimental and physiologically based pharmacokinetic models have been suggested to describe the pharmacokinetics of paracetamol and to determine how fators such as the Gilbert syndrome, fasting, alcoholism and supratherapeutic dosages influence the therapeutic action and toxicity of the molecule. This thesis presents a literature review of how the pharmacokinetics of paracetamol has been studied. References were selected and organized chronologically and according to the dynamic or kinetic information they provide, in order to expose the different pharmacokinetic models that have been proposed, clarify their application and limitations. One of the most complete and important models was the one proposed by Pery et al. in 2013. It is a physiologically based model which enabled to study the distribution and characterize the hepatotoxicity of a supratherapeutic dosage of paracetamol. Given its relevance and topicality, this model was analyzed in further detail being simulated in Microsoft Excel®. The results obtained indicate that, when a supratherapeutic paracetamol is administered, there can be a saturation of phase II reactions in liver (sulfonation and glucoronidation) and high concentrations of unchanged paracetamol in several organs that may be associated with the formation of high concentrations of NAPQI. From the results of a similar simulation, together with extrapolations perfomed with specialized softwares, Pery et al. predicted that the dosage which could lead to significant effects on cell viability in humans would be 155 mg/kg.
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Robinson, D. "Factors influencing paracetamol overdose." Thesis, Queen's University Belfast, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.403484.

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Flodell, Amanda. "Risker vid användning av paracetamol under graviditet : Risker vid användning av paracetamol under graviditet." Thesis, Umeå universitet, Kemiska institutionen, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-102007.

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Cabral, Flavia Helena Costa. "Alterações morfologicas testiculares provocadas pelo cadmio, paracetamol e cadmio associado ao paracetamol, em ratos." [s.n.], 1996. http://repositorio.unicamp.br/jspui/handle/REPOSIP/317850.

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Orientador: Mary Anne Heidi Dolder
Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia
Made available in DSpace on 2018-07-21T09:40:36Z (GMT). No. of bitstreams: 1 Cabral_FlaviaHelenaCosta_M.pdf: 7932022 bytes, checksum: 5df8caed27891d2ed2c74e69d6748a6b (MD5) Previous issue date: 1996
Resumo: O cádmio é um elemento químico, reconhecido atualmente como perigoso devido sua alta toxicidade e os efeitos deletérios que provoca nos seres vivos. Recentemente também tem sido investigadas com maior interesse e atenção, algumas drogas vendidas sem prescrições médicas como por ex. o paracetamol, cujos efeitos tóxicos são pouco informados aos usuários. O presente trabalho tem por objetivos analisar e avaliar os efeitos do cádmio (sob forma de CdCI2.H20), do paracetamol (na forma de Tylenol @ - gotas) e destas substâncias administradas simultaneamente, sobre os testículos de ratos. Neste estudo foram utilizados 44 ratos, do sexo masculino (adultos-jovens) da linhagem Wistar. Realizaram-se estudos histológicos qualitativos e quantitativos à microscopia de luz. Os animais foram submetidos à diferentes dosagens do cádmio (2,5; 7,5; 10 e 15 IJmols I kg), do paracetamol (4,4 e 8,8 mmols I kg) e do cádmio associado ao paracetamol (2,5 IJmols I kg + 4,4 mmols I kg; 7,5 IJmols I kg + 8,8 mmols I kg; 15 IJmols I kg + 8,8 mmols I kg). As observações histológicas revelaram, para os animais submetidos ao cádmio nas doses de. 10 IJmols I kg (com duração de 83 dias) ou 15 IJmols I kg (duração de 06 dias), alterações morfológicas graves em todo o parênquima testicular. Estas alterações são caracterizadas por necrose coagulativa do epitélio seminífero, espessamento da túnica albugínea e degeneração do tecido intersticial. Para os animais tratados com 15 IJmols I kg, houve perda de peso corporal e os resultados quantitativos demonstram valores significativos pela redução dos diâmetros de túbulos seminíferos. Para. os animais tratados com 10 Jjmols I kg, os resultados qualitativos revelaram uma diminuição dos pesos testiculares. Nas doses do cádmio com 2,5 e 7,5 Jjmols I kg e do paracetamol com 4,4 e 8,8 mmols I kg respectivamente, não se observou efeitos lesivos graves nos testículos dos animais investigados. Entretanto quando estas duas substâncias foram administradas simultaneamente, observou-se o efeito aditivo que provocou alterações testiculàres, detectadas à microscopia de luz. A administração do cádmio (7,5 e 15 Jjmols I kg) com o paracetamol (8,8 mmols I kg), leva a uma potencialização dos efeitos deletérios, sendo evidenciada pela redução altamente significativa dos diâmetros dos túbulos seminíferos
Abstract: Cadmium is a chemical element recognized today as dangerous due to its high toxicity and harmful effects toward life. Also recently, drugs sold freely without prescription, such as paracetamol, are being investigated for their toxic effects, of which the public is frequently not aware. This study was undertaken to analyse and evaluate the effects on rat testicles of cadmuim (CdCI2.H20), of paracetamol (in the form of Tylenol @ ­drops) and of these two substances administered simultaneously. For this work, 44 male rats (young adults) of the Wistar lineage were used. Quantitative and qualitativ.e evaluations were made with light microscopy. The animais received various dosages of cadmium (2.5, 7.5,10 and 15 I-Imols I kg), of paracetamol (4.4 and 8.8 mmols I kg) and of cadmium associated with paracetamol (2.5 I-Imols I kg + 4.4 mmols I kg; 7.5 I-Imols I kg + 8.8 mmols I kg; 15 I-Imols I kg + 8.8 mmols I kg). Histological observations showed severe alterations of the testicles for animais that received cadmium in the dose of 10 I-Imols I kg (followed for a 83 day period) or 15 I-Imols I kg (for 06 days). These alterations were classified as coagulative necrosis of the seminal epithelium, tunica albuginea thickening and degeneration of the interstitial tissue. Animais treated with 15 I-Imols I kg lost body weight and the reduction in diameter of the seminal tubules was highly significant. Animais which received 10 I-Imols I kg had a reduction in weight of their testicles. In the cadmium doses of 2.5 and 7.5 I-Imols I kg and of paracetamol in doses of 4.4 and 8.8 mmols I kg no serious lesions were encountered in the animais studied. However, when these substances were administered simultaneously, an additive effect was shown to cause slight. testicular alterations, observed with the light microscope. Higher cadmium doses (7.5 and 15 I-Imols I kg) and the larger paracetamol dose (8.8 mmols I kg) resulted in a potentiation of the harmful effects, measured by the highly significant reduction _n diameter of the seminal tubules
Mestrado
Biologia Celular
Mestre em Ciências Biológicas
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Chiew, Angela. "Changing paradigms of paracetamol poisoning." Thesis, University of Sydney, 2020. https://hdl.handle.net/2123/23382.

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The overall objective of this thesis was to identify and examine areas for improvement in the management of paracetamol poisoning. Paracetamol is one of the commonest drugs taken in overdose in Australia and a common cause of acute liver injury in Western countries. Management of paracetamol poisoning includes assessment for the need of antidote (acetylcysteine) administration and decontamination in patients at risk of toxicity. Management in most follows standard guidelines and in those receiving early acetylcysteine are at very low risk of developing acute liver injury. However, circumstances were arising when some patients were developing acute liver injury despite early acetylcysteine. In this thesis we firstly review the evidence for the current assessment and treatment of paracetamol poisoning and identified risk factors associated with treatment failure. This allowed us to identify and examine those patient groups that were at higher risk of acute liver injury with standard treatment protocols such as massive and modified-release paracetamol overdose. However, these cases were uncommon so a means to recruit these patients from many centres was required. The Australian Toxicology Monitoring study (ATOM) is a prospective observational study that recruits patients from calls to two poisons information centres and five clinical toxicology units. An arm of ATOM the Australian Paracetamol Project (APP) recruited an enriched dataset of problematic paracetamol poisoning. From APP three studies form a part of this thesis. ATOM-2 investigated massive immediate-release paracetamol ingestion and found increased acetylcysteine dose and early decontamination decreases the risk of liver injury. ATOM-3 investigated modified-release paracetamol ingestion and found many required prolonged treatment and some developed liver injury despite early acetylcysteine treatment. The results of these studies subsequently resulted in change to the national guidelines for the management of these patients. ATOM-5 examined a new biomarker paracetamol-protein adducts and showed that it can be used to stratify patients at low and high risk of acute liver injury. This thesis shows that recruitment of patients from many centres can be performed to examine uncommon and problematic overdoses.
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Arakji, Jawad Ola. "Effekter av begränsad förpackningsstorlek för paracetamol." Thesis, Umeå universitet, Farmakologi, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-121837.

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SCIEUX, PIERRE. "Intoxication par le paracetamol chez l'adulte." Lille 2, 1989. http://www.theses.fr/1989LIL2M033.

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Bashir, Shazma. "Mechanism of Paracetamol (acetaminophen) induced hypothermia." Thesis, University of East London, 2018. http://roar.uel.ac.uk/7308/.

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Paracetamol is a potent analgesic and antipyretic with limited side effects compared to the nonsteroidal anti-inflammatory drugs (NSAIDs) and opiates. Worldwide paracetamol is commonly used to treat pain and fever in both children and adults. Although, this drug has been in clinical use for more than a century, the mechanisms of action are not fully understood. Historically some of the actions of paracetamol were attributed to the inhibition of central cyclooxygenase (COX-1 and COX-2) enzymes however given the weak inhibitory effects on COX-1 and COX-2 enzymes, alternative targets have been suggested including a possible novel COX-3. The inhibition of COX-2 is accepted as the mechanism by which paracetamol reduces core temperature (Tc) in febrile animals. However, in non-febrile animals where COX-2 is not induced, paracetamol has also been shown to cause hypothermia by a mechanism that is not fully understood. Both the reduction of pyresis and induction of hypothermia can only occur when peripheral metabolic rate decreases and/or heat loss increases. In terms of antipyresis and hypothermia, the inhibition of lipolysis, fatty acid oxidation and mitochondria function are obvious alternative targets. Studies were undertaken to identify and characterise the putative COX-3 at protein and mRNA level using western blot analysis and reverse transcription polymerase chain reaction (RT-PCR) in mouse brain endothelial cells (b.End3) and whole brain tissues isolated from male C57BL/6 mice. Additional studies were also undertaken to assess if the hypothermic properties of paracetamol could be attributed to direct inhibition of thermogenic pathways in both 3T3-L1 adipocytes and primary brown adipocytes isolated from male Wistar rats. Adipocytes and isolated mitochondria were exposed to paracetamol and lipolysis, fatty acid oxidation (FAO), mitochondrial electron transport chain (ETC), assessed by measuring oxygen consumption rate (OCR). In these studies no expression of the COX-3 protein could be detected in brain endothelial cells and homogenates and no evidence of a COX-3 was detected at mRNA level. However, paracetamol caused a significant decrease (upto 70%; P < 0.01, from control) in both basal and stimulated lipolysis at 1, 3 and 24 hours without affecting cell viability. Paracetamol (10 mM) and its metabolite N-acetyl-p-benzoquinone imine (NAPQI) at 50 μM also significantly (P < 0.01, from control), reduced endogenous and exogenous FAO by 50% and 70% respectively. NAPQI (50 μM) had limited effect on mitochondrial uncoupling. Finally, paracetamol and other antipyretic compounds also significantly reduced ETC activity (upto 90%; P < 0.01, from control). Both the maintenance of normal body temperature (Tb) and the induction of pyresis require increased mitochondrial ETC activity normally initiated centrally and driven peripherally by reduction of substrates such as fatty acids and glucose. The failure to identify the COX-3 protein and the direct inhibition of lipolysis, FAO and ETC activity indicate that antipyretic actions of paracetamol could partly be attributed to it actions on peripheral energy generation systems and provide new drug targets for reducing fever and chemically inducing hypothermia.
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Chevallier, Thierry. "Pharmacologie clinique du paracetamol en collyre." Nice, 1992. http://www.theses.fr/1992NICE6556.

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Books on the topic "Paracetamol"

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J, Meredith T., World Health Organization, Commission of the European Communities., and International Program on Chemical Safety., eds. Antidotes for poisoning by paracetamol. Cambridge: Published by Cambridge University Press on behalf of the World Health Organization and of the European Commission, 1995.

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N, Gregg, and Great Britain. Health and Safety Executive., eds. Paracetamol: Criteria document for an occupational exposure limit. London: HSE Books, 1994.

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Kiel, Universität, ed. Regionalanästhesie (Ilioinguinalblock) versus systemische Analgesie (Paracetamol): Vergleichende Untersuchung der Analgesiequalität nach kinderchirurgischen Eingriffen. [s.l.]: [s.n.], 1998.

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Ricardo, Royder Yáñez, and Cruz Catata Teodora, eds. Mentisán, paracetamol o wira wira?: Jóvenes, salud e interculturalidad en los barrios mineros de Potosí. La Paz: PIEB, Programa de Investigación Estratégica en Bolivia, 2006.

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National Register of Foreign Collaborations (India) and India. Dept. of Scientific & Industrial Research., eds. Technology in Indian paracetamol industry: A status report prepared under the National Register of Foreign Collaborations. New Delhi: Govt. of India, Dept. of Scientific & Industrial Research, Ministry of Science and Technology, 1994.

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Dan, Micon. Paracetamol. Independently Published, 2018.

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Joe, Smith. Paracetamol. Independently Published, 2018.

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executive, Health and safety. Paracetamol. Health and Safety Executive (HSE), 1994.

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Paracetamol. Royal Society of Chemistry, 2002.

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Goody, Bob. War & Paracetamol. Burning Eye Books, 2021.

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Book chapters on the topic "Paracetamol"

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McAllister-Williams, R. Hamish, Daniel Bertrand, Hans Rollema, Raymond S. Hurst, Linda P. Spear, Tim C. Kirkham, Thomas Steckler, et al. "Paracetamol." In Encyclopedia of Psychopharmacology, 952. Berlin, Heidelberg: Springer Berlin Heidelberg, 2010. http://dx.doi.org/10.1007/978-3-540-68706-1_7004.

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Beyer, Karl-Heinz. "Paracetamol." In Biotransformation der Arzneimittel, 419–23. Berlin, Heidelberg: Springer Berlin Heidelberg, 1990. http://dx.doi.org/10.1007/978-3-642-74386-3_242.

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Vidal, C., and W. R. Külpmann. "Paracetamol." In Lexikon der Medizinischen Laboratoriumsdiagnostik, 1–2. Berlin, Heidelberg: Springer Berlin Heidelberg, 2018. http://dx.doi.org/10.1007/978-3-662-49054-9_2343-1.

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Vidal, C., and W. R. Külpmann. "Paracetamol." In Springer Reference Medizin, 1820–21. Berlin, Heidelberg: Springer Berlin Heidelberg, 2019. http://dx.doi.org/10.1007/978-3-662-48986-4_2343.

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Schneider, Achim, Günther Schlunck, and Viola Sieber. "Paracetamol." In Geburtshilfefibel, 284–85. Berlin, Heidelberg: Springer Berlin Heidelberg, 1991. http://dx.doi.org/10.1007/978-3-642-97317-8_66.

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Bateman, D. Nicholas. "Acetaminophen (Paracetamol)." In Critical Care Toxicology, 1–25. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-20790-2_108-1.

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Bateman, D. Nicholas. "Acetaminophen (Paracetamol)." In Critical Care Toxicology, 1–25. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-20790-2_108-2.

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Wilson, John Fawcett. "Paracetamol (Acetaminophen)." In The Immunoassay Kit Directory, 1572–73. Dordrecht: Springer Netherlands, 1995. http://dx.doi.org/10.1007/978-94-011-0679-5_38.

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Bateman, D. Nicholas. "Acetaminophen/Paracetamol." In Critical Care Toxicology, 1145–69. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-17900-1_108.

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Ginat, Daniel Thomas. "Acetominophen (Tylenol, Paracetamol)." In Neuroimaging Pharmacopoeia, 341–45. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-12715-6_49.

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Conference papers on the topic "Paracetamol"

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Santos, Nayara Julielen, ALEX TEODORO FERREIRA, and CRISTIANE MARIA FERNANDES DE MELO. "INTOXICAÇÃO POR PARACETAMOL EM FELINOS." In III Congresso Nacional de Especialidades Veterinárias On-line. Revista Multidisciplinar em Saúde, 2024. http://dx.doi.org/10.51161/convesp2024/33331.

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Malia, R. G., H. J. Kennedy, D. R. Triger, and F. E. Preston. "PROTECTIVE EFFECT OF VITAMIN K AGAINST ACETAMINOPHEN (PARACETAMOL) TOXICITY IN THE HAMSTER." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644341.

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We have previously reported that paracetamol may interfere with the metabolism of vitamin K via the vitamin K 2, 3-epoxide cycle. (Thrombosis and Haemostasis, 54,205,1985). In this study we have examined the effects of large doses of vitamin K on experimentally induced paracetamol hepatic necrosis in a hamster model. Paracetamol (1.2g/Kg) when given by gavage to 24 hamsters (Group I) resulted in 10 deaths (42%) at 24 hours. Simultaneous administration of lmg vitamin K intraperitoneally (Group II) reduced mortality to 3/24 (12%); mortality was 2/24 (8%) if vitamin K was given 4 hours after the paracetamol (Group III). In a further series of experiments (N=18) the prothrombin time in Group I was prolonged by 28 seconds compared with 14 seconds in Group II and 10 seconds in Group III. In samples taken for biochemical and histological analysis there was evidence of severe hepatic necrosis in all groups. When the dose of paracetamol was reduced to 1.0g/Kg (N=18) there was substantially less histological damage in Group II compared with other groups and the prothrombin times were only prolonged by 2 seconds (Group I); 1.5 seconds (Group II) and 3-5 seconds (Group III) respectively. In the final experiment (N=18) when Group II animals were divided into 3 sub-groups and the dose of vitamin K given was altered to 1.0, 0.5 and O.lmg following the paracetamol (1.2g/Kg) the prothrombin times were prolonged by 8 seconds, (1-0mg vitamin K), 21 seconds (0.5mg vitamin K) and 35 seconds (0.1mg vitamin K) respectively, indicating a dose dependant effect. The hypothesis that paracetamol induced hepatic necrosis occurs solely as a consequence of failure of glutathione to conjugate the reactive metabolites of paracetamol is not consistent with the protective effects of vitamin K observed here and the known mode of action of the vitamin. Other mechanisms such as free radical scavenging deserve to be studied.
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Hidayati, Ika Ratna, Elys Oktaviana, Irma Nurtiana Syafitri, and Liza Pristianty. "Knowledge Levels and Paracetamol Self-Medication." In Health Science International Conference (HSIC 2017). Paris, France: Atlantis Press, 2017. http://dx.doi.org/10.2991/hsic-17.2017.42.

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Meng, Cui, Ruijuan Qu, Jinyan Liang, Xi Yang, Fangming Jin, Qi Zhou, and Bing Wu. "Photodegradation of Paracetamol in Nitrate Solution." In 2nd International Symposium on Aqua Science, Water Resource and Low Carbon Energy. AIP, 2010. http://dx.doi.org/10.1063/1.3529338.

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Manzotti de Souza, Fernando, Gabriela Nascimento Silva, Melissa Gurgel Adeodato Vieira, and Onélia Aparecida Andreo dos Santos. "Adsorção de Paracetamol em Argilas Bentoníticas Organomodificadas." In Simpósio de Bioquímica e Biotecnologia. Londrina - PR, Brazil: Galoa, 2017. http://dx.doi.org/10.17648/simbbtec-2017-80793.

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Pérez, Marina, Marta Freire, María Ramos, Pelayo Frank, Berta Sanz, Maria Jesús Caldeiro, Pablo Docio, Beatriz Jimenez, and Domigno Gonzalez-Lamuño. "NEFROPATÍA AGUDA INDUCIDA POR PARACETAMOL SIN HEPATOTOXICIDAD." In 38 Congreso Nacional de la Sociedad Española de Pediatría y Atención Primaria - SEPEAP 2024. Grupo Pacífico, 2024. http://dx.doi.org/10.48158/sepeap2024.o015.

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Conceição, Jeanderson de Souza, Izabelly Correia Ferreira Barbosa, Josiane Maraína Piveta, Matheus Henrique Cargnin Borella, and Aline Tramontini Zanluchi Queiroz. "Uso da hemodiálise no tratamento de intoxicação grave por paracetamol em um cão: relato de caso." In II Congresso Internacional Interdisciplinar da Uningá. Editora Uningá, 2023. http://dx.doi.org/10.46311/ed.un.20221018206.

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Os cães correspondem à espécie animal mais exposta a intoxicações acidentais por medicamentos de uso humano. O objetivo do presente relato é destacar o papel da hemodiálise como opção de tratamento nos quadros de intoxicações graves por paracetamol em cães, visto que apesar da alta incidência dessas intoxicações esta terapia não é frequentemente empregada nestes casos. O presente relato demonstra a importância do emprego da técnica dialítica e a sua contribuição na reversão da intoxicação e da lesão renal aguda causada pela nefrotoxidade do paracetamol.
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Michael, Omokafe Seun, Esther Oluwafunmike Aduloju, and Thompson Arakaseun. "Experimental Evaluation of Unpreprocessed-Expired Paracetamol Drugs as Corrosion Inhibitor for Mild Steel in Hydrochloric Acid." In 2023 School of Engineering and Engineering Technology Annual Conference. Switzerland: Trans Tech Publications Ltd, 2024. http://dx.doi.org/10.4028/p-ry1luu.

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The widespread corrosion of critical oil and gas infrastructure requires development of innovative and environmentally sustainable solutions. This research considers the repurposing of hitherto un-useful expired drugs to meet this challenge and to do so in ways that also puts stop to the menacing and illegal circulation of expired pharmaceuticals in developing economies. The corrosion inhibitory potential of expired paracetamol was evaluated for mild steel in acidic environment. Electrochemical analysis revealed that the corrosion current decreased from for the mild steel immersed in the blank/uninhibited 0.5M HCl environment to in the case of the sample in the 8g/l environment. The concentration of dissolved ions of iron in the acidic environment also followed this trend supported by the results obtained from the gravimetric analysis. Optical microscopy showed gradual covering of the corroding surface by a layer of inhibitor film with increasing concentration of the additive in the acidic environment. The corrosion inhibition efficiency increased with increasing concentration of the expired drug, reaching a maximum of 73.24% for 8.0 mM of expired paracetamol directly dissolved in the acid. Expired paracetamol acted as a mixed-type inhibitor for mild steel in 0.5M HCl and the corrosion inhibition process was spontaneous. All analyses agreed that expired paracetamol drug is capable of inhibiting corrosion of mild steel in HCl and that the corrosion inhibition is achievable without prior pretreatment. The research is fundamental as it attempts to lay some groundwork for further research towards developing viable and marketable product from this category of materials.
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Crook, J., H. Yorke, and R. Cooper. "G107(P) Reducing paracetamol medication errors in children." In Royal College of Paediatrics and Child Health, Abstracts of the RCPCH Conference–Online, 25 September 2020–13 November 2020. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2020. http://dx.doi.org/10.1136/archdischild-2020-rcpch.84.

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Martins, Fabíola Ribeiro, BRUNO FULAN DE ANDRADE, JONATHAS MACHARETH GONÇALVES PEREIRA, RENATA CORRÊA HEINEN, and ELAINE CRISTINA RODRIGUES DA COSTA. "RISCOS NO CONSUMO INDISCRIMINADO DE DIPIRONA E PARACETAMOL." In I Congresso Nacional On-line de Pesquisa e Inovação em Farmacologia. Revista Multidisciplinar em Saúde, 2022. http://dx.doi.org/10.51161/inofarm/13823.

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Reports on the topic "Paracetamol"

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Sentcоv, Valentin, Andrei Reutov, and Vyacheslav Kuzmin. Electronic training manual "Acute drug poisoning". SIB-Expertise, January 2024. http://dx.doi.org/10.12731/er0776.29012024.

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The widespread use in modern medicine of hypnotics, sedatives, tricyclic antidepressants, antihypertensive drugs and antipyretics, even in therapeutic dosages, sometimes leads to adverse consequences for the patient. Accidental or intentional excess of therapeutic dosages leads to severe poisoning. This fact indicates the high relevance of doctors’ knowledge of any clinical specialty and the treatment of poisoning by these groups of drugs. This electronic educational resourse consists of six theoretical educational modules: poisoning with barbituric acid derivatives, acute poisoning with tricyclic antidepressants, acute poisoning with beta-blockers, poisoning with clonidine, acute poisoning with anti-tuberculosis drugs, acute poisoning with paracetamol. The theoretical block of modules is presented by presentations, the text of lectures with illustrations. Control classes in the form of test control accompany each theoretical module. After studying all modules, the student passes the final test control. Mastering the electronic educational resourse will ensure a high level of readiness to provide specialized toxicological care by doctors of various specialties.
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พนมวัน ณ อยุธยา, ดวงจิต, ปฏิภาณ พนมวัน ณ อยุธยา, and อภิฤดี เหมะจุฑา. การสำรวจการใช้ยาของโรงพยาบาล มหาวิทยาลัยในกรุงเทพมหานครระหว่าง พ.ศ. 2523-2525 : รายงานผลการวิจัย. จุฬาลงกรณ์มหาวิทยาลัย, 1985. https://doi.org/10.58837/chula.res.1985.14.

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The top 200 drug products most frequently dispensed in the university hospitals in Bangkok during 1980 to 1982 were identified and ranked. Paracetamol was ranked number one with the highest number of tablets dispensed while Ampicillin was ranked number one with the highest value dispensed. The top 200 drug products accounted for approximately 82 percent of the total value of drug dispensed in a year. At the same time, the drugs were classified according to their pharmacological action. Penicillins was the sub-pharmacological class with the highest value dispensed which accounted for approximately 10-12 percent of the total value of drug dispensed in a year while drug acting on the Neuro-Muscular system which accounted for approximately 25 percent of the total value of drug dispensed in a year was idenified as the pharmacological class with the highest value dispensed. Lastly, the top 200 drug products were compared with the 1981 National List of Essential Drugs. Of the top 200 drug products approximately 52 percents of them contains the generic names which are in the essential drug list. Half of the drug products which are not in the essential drug list are combination drugs.
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Chou, Roger, Azrah Y. Ahmed, Tracy Dana, Benjamin J. Morasco, Christina Bougatsos, Rongwei Fu, Leah Williams, and Ilya Ivlev. Living Systematic Review on Cannabis and Other Plant-Based Treatments for Chronic Pain: 2024 Update. Agency for Healthcare Research and Quality (AHRQ), September 2024. https://doi.org/10.23970/ahrqepccer250.2024update.

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Objectives. To update the evidence on benefits and harms of cannabinoids and other plant-based compounds to treat subacute and chronic pain in adults and adolescents using a living systematic review approach. Data sources. Ovid® MEDLINE®, PsycINFO®, Embase®, the Cochrane Library, and SCOPUS® databases, and reference lists of included studies were searched to June 30, 2024. Review methods. We grouped studies based on their tetrahydrocannabinol (THC) to cannabidiol (CBD) ratio and by product type: synthetic, purified (plant-derived product consisting of a single cannabinoid, e.g., dronabinol or CBD), or extracted (from whole plant, containing multiple cannabinoids). We conducted random effects meta-analyses and categorized magnitude of benefit (large, moderate, small, or no effect [less than small]). Results. Three new randomized controlled trials (RCTs) in four publications (n=134, 86, and 60) and two new observational studies (N=296 and 32,332) were added for this annual update; no study addressed subacute pain or adolescents. One new RCT compared high THC, low THC, and combination THC to CBD ratio products versus placebo in patients with neuropathic pain; one new RCT evaluated oral CBD plus paracetamol versus paracetamol alone for knee osteoarthritis; and one new RCT evaluated a topical (intraoral) CBD product versus placebo for temporomandibular disorders. Since the inception of this living review, from 5,894 total abstracts identified, 26 RCTs (in 27 publications) (N=2,315) and 12 observational studies (N=48,468) assessing different cannabinoids have been included; no study evaluated kratom. Studies were primarily short term, and 53 percent enrolled patients with neuropathic pain. Comparators were primarily placebo or usual care. Strength of evidence (SOE) was low unless indicated otherwise. Compared with placebo, extracted, comparable ratio THC to CBD oral spray was associated with a small decrease in pain severity (7 RCTs, N=878, 0 to 10 scale, mean difference [MD] −0.54, 95% confidence interval [CI] −0.95 to −0.19, I2=39%; SOE: moderate); improvement in overall function favored the cannabis product but was slightly below the threshold for small (negative values for function indicate improved function; 6 RCTs, N=616, 0 to 10 scale, MD −0.42, 95% CI −0.73 to −0.16, I2=32%; SOE: moderate) versus placebo. There was no effect on study withdrawals due to adverse events (WAEs). There was a large increased risk of dizziness and sedation, and a moderate increased risk of nausea (dizziness: 6 RCTs, N=866, relative risk [RR] 3.57, 95% CI 2.42 to 5.60, I2=0%; sedation: 6 RCTs, N=866, RR 5.04, 95% CI 2.10 to 11.89, I2=0%; and nausea: 6 RCTs, N=866, RR 1.79, 95% CI 1.19 to 2.77, I2=0%). Synthetic and purified high THC to CBD ratio products were associated with a small improvement in pain severity, with no effect on overall function or disability. There was a moderate increase in risk of WAEs, a moderate increase in sedation, and a large increase in risk of nausea (pain: 8 RCTs, N=507, 0 to 10 scale, MD −0.78, 95% CI −1.59 to −0.08, I2=64%; WAEs: 6 RCTs, N=487, RR 1.92, 95% CI 1.10 to 4.80, I2=0%; sedation: 5 RCTs, N=458, RR 1.57, 95% CI 1.11 to 2.29, I2=0%; nausea: 4 RCTs, N=425, RR 2.12, 95% CI 1.09 to 3.96; I²=0%). There was also moderate SOE for a large increased risk of dizziness (4 RCTs, N=425, RR 2.30, 95% CI 1.53 to 3.52, I2=22%). Synthetic or purified oral CBD alone was not associated with decreased pain intensity (4 RCTs, N=334, 0 to 10 scale, MD 0.40, 95% CI −0.14 to 1.00, I2=20%; SOE: moderate), greater likelihood of pain response (4 RCTs, N=334, RR 0.84, 95% CI 0.62 to 1.10; I2=0%; SOE: moderate), or improved function (3 RCTs, N=272, standardized mean difference [SMD] 0.11, 95% CI −0.14 to 0.41, I2=0%; SOE: moderate) versus placebo, and combined oral THC plus CBD (~1:2 ratio) was not associated with decreased pain intensity (2 RCTs, N=123, 0 to 10 scale, MD 0.12, 95% CI −0.71 to 0.93, I2=0%), greater likelihood of experiencing ≥30 percent improvement in pain (2 RCTs, N=123, RR 1.07, 95% CI 0.73 to 1.57, I2=0%), or improved function (1 RCT, n=60, SMD 0.29, 95% CI −0.21 to 0.80) versus placebo. Evidence (including observational studies) on whole-plant cannabis, topical CBD, other cannabinoids, comparisons with active noncannabis treatments or between cannabis-related products, and impact on use of opioids remained insufficient. Evidence was not available on important harms such as psychosis, cannabis use disorder, and cognitive effects. Conclusions. Low- to moderate-strength evidence suggests small improvements in pain (mostly neuropathic) and moderate to large increases in common adverse events (dizziness, sedation, nausea) with extracted, comparable THC to CBD ratio and synthetic or purified high THC to CBD ratio products versus placebo during short-term treatment (1 to 6 months). Low- to moderate-strength evidence suggests that low THC to CBD ratio products may not be associated with improved outcomes versus placebo. Evidence for whole-plant cannabis and other comparisons, outcomes, and plant-based compounds was unavailable or insufficient to draw conclusions.
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Paracetamol may be ineffective in treating lower back pain. National Institute for Health Research, July 2015. http://dx.doi.org/10.3310/signal-000102.

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Paracetamol is a weak painkiller for regular tension headaches. National Institute for Health Research, September 2016. http://dx.doi.org/10.3310/signal-000299.

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Diclofenac or etoricoxib, but not paracetamol, is effective for treating osteoarthritis. National Institute for Health Research, May 2016. http://dx.doi.org/10.3310/signal-000245.

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Paracetamol and alcohol are the most common substances taken by young people and rates of poisoning are increasing. National Institute for Health Research, December 2018. http://dx.doi.org/10.3310/signal-000694.

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