Paracetamol : The Mechanism Of Action Of Paracetamol Essay

Paracetamol : The Mechanism Of Action Of Paracetamol Essay

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Intravenous (IV) paracetamol was administered to Patient-F for pain management. The mechanism of action of paracetamol involves the inhibition of cyclo-oxygenase 3 (COX3) (Sharma and Mehta,2013), found only in the central nervous system (Anderson, 2008), affecting prostaglandin synthesis in the central nervous system, reducing the pain impulses (Gibbs and Anderson,2008). Paracetamol activates descending spinal serotonergic pathways, which modulate pain (Hader and Guy, 2004) and does not appear to have a major effect peripherally (Jin and Chung,2001). Paracetamol has been shown to be as effective in paediatric orthopaedic pain management (Cakan et al, 2008; APA, 2012) and does not have anti-inflammatory effects or effect in the gut (J’Ewiak, and Nowa,2014). While oral paracetamol is financially preferable to intravenous (Graham and Scott,2005), paracetamol bioavailability is greater (80-90%) when it administrated intravenously (Gibb and Anderson,2008) and produce much higher plasma concentration (Hiller et al,2012). Paracetamol has good safety profile (Craig et, al,2012) with side effects and adverse reactions being uncommon (Lachiewcz,2013), making an attractive analgesic use for orthopaedic surgical patients (Khalili et al,2012)
Hepatotoxicity is however, a recognised complication of overdose (Sinatra, 2002) and therefore meticulous care needs to be taken in its administration (Anderson, 2008).
Several clinical studies have demonstrated the efficancy and safe administration of IV paracetamol in orthopaedic surgery (Hiller et al, 2012; Sinatra et al, 2012;Khalili et al, 2013). In 2012 Sinatra et al, study of IV paracetamol for pain after major orthopedic surgery found that pain intensity differences over 24 hours ...

... middle of paper ...

...euron crosses over the spinal cord through the anterior joined (Sarpell, 2006) where it enters in the sponothalamic tract (Wright, 2015) to ascending pathways carrying signals into the brain (Brenner, 2006) causing Patient-F to experience pain.

The process of action potential can be interrupted by local anaesthetic (ANZCA, 2015). Patient- F was given femoral block in theatre (APA, 2012). The local anaesthetic works by blocking pain sensation of the surgical incision (APA, 2012). Thereby blocking the conduction of action potential by blocking the voltage-gate of sodium channels (Briggs, 2010). As the sodium channels are accessible from the outside of the membrane and local anaesthetic drugs penetrate the axonal membrane in order to gain access to bind, the site of the sodium channels (Sarpell, 2009) blocking the transmission of painful impulses to CNS (Yaksh, 2009)

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