Paracetamol - benefits and damages

Abstract

Introduction. Paracetamol and the combined drugs, which belong to the OTC list that are released without a prescription, are most commonly used in the symptomatic treatment or selftreatment

of acute respiratory infections. The diversity of trade names often misleads patients who resort to their administration without consulting a doctor. For these reasons, there is an increase in the incidence of acute intoxication and fatal adverse reactions (fulminant hepatic necrosis, etc.). Aim of the study. The aim of the study consisted in analyzing the presence on the pharmaceutical market of mono- and combined drugs containing paracetamol and estimating possible risk of side effects in self-treatment with them. Materials and methods. Based on the study of the State Drug Nomenclature, were selected drugs containing paracetamol with analysis of single dose and combination diversity. Results. In the Republic of Moldova there are 95 mono- or combined drugs containing paracetamol (acetaminophen), including producers from: Moldova - 22, Romania - 20, Ukraine 13, Belarus - 12, Turcia - 5, Russia - 5, Slovenia - 6, Georgia - 4, India - 4, Bosnia and Herzegovina - 2, United Kingdom -1, Germany - 1. The presence of single-dose mono drugs containing paracetamol of 50-250 mg for children and 500-600 mg for adults was found. There is a wide range of combined drugs including: paracetamol + decongestant adrenomimetics (phenylephrine, pseudoephedrine), paracetamol + H1-antihistamines (pheniramine, chlorophenamine), paracetamol + adrenomimetics + H1-anehistamine +, paracetamol + opacimetamine ), paracetamol + H1-anihistamines + opioid analgesics (codeine, promethazine), paracetamol + non-inflammatory anti-inflammatory drugs (propifenazone), paracetamol + antitussive opioid analgesics (codeine, dextromethorphan), which in some cases may have caffeine and / or ascorbic acid added. In accordance with the recommendations of the European Medicines Association the dose of paracetamol in adults for 24 hours is 3.2 g, and in the case of people with pre-existing hepatitis and those who suffer from alcohol abuse, of 2g / 24 hours. The presence of the H1-antihistamine component can result in diminished attention with tragic consequences for drivers, people who do machinery work, as well as the development of dry mucous membranes, including the tracheo-bronchial mucosa, which can enhance the dry cough and decrease the bronchial drainage creating the feeling of ineffectiveness of said drugs. The effect of improved breathing, through the decongestant adrenomimetics, is of short duration (1-2 hours), especially in the first 24-48 hours, which stimulates the more frequent use of drugs with systemic effects, including increased blood pressure, palpitations, tremor. Conclusions. The number and variety of drug combinations of paracetamol impose caution for their use, in order to avoid overdose and the possibility of developing hepatotoxicity.