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)
Need Writing Help?
Get feedback on grammar, clarity, concision and logic instantly.Check your paper »
- 1-Paracetamol ( PCT), acetaminophen or N-acetyl-p-aminophenol (APAP) is an acylated aromatic amide derived from aniline  [s073][so96089] .It has antipyretic and analgesic properties and it is a synthetic non-opioid. In 1893, acetaminophen was first described as an analgesic and antypiretic.. [s17] In 1866, acetanilide, another derived from aniline, was discovered to have antipyretic properties and has started to be used to treat fever. However, it was proved to have toxicity. Thus, others derivatives from aniline such as paracetamol and phenacetin were assumed to be toxic as well.... [tags: Acetaminophen, Pain, Drugs]
1202 words (3.4 pages)
- ... The starting material, phenol, is first undergoes nitration with the use of dilute sulfuric acid and sodium nitrate. This is an electrophilic aromatic substitution reaction where a hydrogen on the aromatic ring is replaced with a nitro group. The hydroxyl group on the aromatic ring is an electron-donating group and therefore serves as an ortho-para director. Through the nitration reaction, two products are formed: o-nitrophenol and p-nitrophenol. In comparing the stability of the two resulting products, o-nitrophenol is less stable due to steric hinderance and proximity of the hydroxyl and nitro group to one another.... [tags: harmon northrop morse]
1101 words (3.1 pages)
- Native proteins generally function in a fully folded tertiary structure conformation in biological cells. In contrast, some native proteins have regions which are not properly structured also called as low-complexity domains (LC). For instance, RNA-binding FET family proteins, which include: Fused in sarcoma (FUS), Ewing’s sarcoma (EWS), and TATA-binding protein-associated factor (TAF15) have regions containing low complexity domains characterized by the abundance of only four amino acids; G, S, Q, &Y.... [tags: genetic biology study]
878 words (2.5 pages)
- Defense Mechanisms As Ms. Bullock walked toward the check-in area, she began to feel her body stiffen. Negative thoughts began to run through her mind, afraid of what the results from her colonoscopy would say. After checking in, she found a seat and sat down. She tried to think positive and set her mind on something more uplifting. As time went by she began to think about her grandkids and how she couldn 't wait to see them tomorrow. When it was time for her to meet with the doctor, she was relaxed and ready to hear the results, good or bad.... [tags: Defence mechanism, Psychological projection]
1164 words (3.3 pages)
- Defense mechanism, in psychoanalysis, any of a variety of unconscious personality reactions which the ego uses to protect the conscious mind from threatening feelings and perceptions. Sigmund Freud first used defense as a psychoanalytic term (1894), but he did not break the notion into categories, viewing it as a singular phenomenon of repression. His daughter, Anna Freud, expanded on his theories in the 1930s, distinguishing some of the major defense mechanisms recognized today. Primary defense mechanisms include repression and denial, which serve to prevent unacceptable ideas or impulses from entering the conscience.... [tags: Defense Mechanisms]
3474 words (9.9 pages)
- Affirmative action is a policy or action that favors those who tend to be discriminated against. It is seen as positive discrimination by some. Others refer to it as reverse discrimination. Reverse discrimination is when people of a majority are discriminated in favor of a disadvantage group or minority (Schindler, 2015). The idea of affirmative action dates all the way back to post Civil War Reconstruction Era. It gives an advantage to newly freed slaves who lacked skills to get a job and live a fulfilled life ("International Index to Black Periodicals", 2005).... [tags: Affirmative action, Discrimination, Black people]
1734 words (5 pages)
- Affirmative Action Affirmative action is a deliberate effort to provide full and equal opportunities in employment, education, and other areas for women, minorities, and individuals belonging to other traditionally disadvantaged groups. As an issue of today's society, affirmative action requires corporations, universities and other organizations to establish programs designed to ensure that all applicants are treated fairly. It also places a burden of proof on the providers of opportunities; to some degree, the providers must be able to demonstrate that their granting of opportunities to white males is not discriminatory.... [tags: Affirmative Action]
1138 words (3.3 pages)
- Affirmative action caught in tale of the two cities of Boston, Massachusetts and Denver, Colorado. Since the late 1980s, race and sex-based contracting preference programs in the U.S. cities have faced significant challenges in the courts (Rubin). On February 7th, Boston Mayor Thomas Menino announced his plan to eliminate a 15 year old program that required bidders on city construction contracts to subcontract 15% of work to minority-owned business enterprises and 5% to women-owned firms (Rubin).... [tags: Affirmative Action]
870 words (2.5 pages)
- â€œThe â€˜under representationâ€™ of any racial group, it was decided, was evidence of discriminationâ€?(Guernsey). Affirmative action did not start out as a reverse discrimination towards white males, but it was meant to help everybody, but failed nearly completely after a time of which it was affected. The original concept of affirmative action excluded any mention of preference. â€œLaunched during the late 1960s by the administration of President Richard M. Nixon, affirmative action programs call for guidelines and goals in the hiring of racial and ethnic minorities, the handicapped, and women.... [tags: Affirmative Action Essays]
1662 words (4.7 pages)
- Affirmative action- a plan to offset past discrimination in employing or educating women, blacks etc. (Websters New World Dictionary.) The history of affirmative action has its roots in the Civil Rights Act of 1964, and stems from the United States Supreme case of Brown vs. Board of Education of Topeka Kansas. In 1965, President Linden B. Johnson issued Executive Order #11246 at Howard University that required federal contractors to undertake affirmative action to increase the number of minorities that they employ.... [tags: Affirmative Action Essays]
782 words (2.2 pages)