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9:55 AM Truth behind PARACETAMOL

Paracetamol (acetaminophen) is a widely used analgesic (pain reliever) and antipyretic (fever reducer). It is commonly used to treat fever, headaches, and other minor aches and pains. Available both over the counter and as a part of prescription medications, paracetamol is sold the world over under various brands, and is celebrated as a particularly effective and versatile drug. Particular features include: • Its analgesic (pain relief) and antipyretic (fever relief) effects are comparable to those of aspirin. • There are virtually no groups of people who should not take it. • Interaction with other drugs is not a problem. • At the recommended dosage there are virtually no side-effects. • It is suitable for small children and the elderly. • It can be taken by those sensitive to aspirin. • It can also be used to reduce fever in certain ailments like malaria, dengue and chikunguniya. • It is the safest medicine prescribed in pregnant women. Advantages over NSAIDs: Unlike aspirin and other non steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, paracetamol acts in the brain, blocking an enzyme involved in the transmission of pain. It has a broad tolerability and is of particular value in the treatment of patients in whom non - steroidal anti-inflammatory drugs are contraindicated such as aspirin-sensitive asthmatics and people at risk of gastrointestinal complications. Even though Paracetamol is one of the safest drugs around, people sometimes tend to take recourse to the less safe NSAIDs. This may especially be put down to the fact that comparatively speaking NSAIDs offer faster relief. Says Dr Tarun Sahni, Consultant Physician, Apollo Hospital, New Delhi, "The Paracetamol formulations currently available do bring in effective relief but it would really be nice if the onset of action were somehow to be a little quicker. A faster acting paracetamol would hold a definite edge over NSAIDs especially in terms of safety.” Current status… History of this drug dates back to over 100 years. Paracetamol did not appear commercially until 1950 in the United States and 1956 in Australia. During the 1960s and 1970s, increasing concern was raised about the toxicity of nonprescription analgesics, but in normal use paracetamol exhibited a consistent safety profile. A turning point in the choice of pediatric analgesic came in the 1980s when aspirin was linked to Reye's syndrome. As a consequence, paracetamol became the recommended analgesic and antipyretic for children with a subsequent reduction in the incidence of Reye's syndrome. Currently, according to World Health Organization and the American Academy of Pediatrics, paracetamol, chiefly known as Crocin, is a first-line choice for pain management and fever in a variety of patients, including children, pregnant women, the elderly, those with osteoarthritis, simple headaches, and those with non-inflammatory musculoskeletal conditions. But it is poignant that despite being such an important drug and inspite of the fact that it has been more than a century since the first clinical use of paracetamol, no steps have been taken so far to improve the efficacy of this drug. There’s a need for improving the efficacy of the drug. The idea is to make it act faster. Methods need to be devised to make this safe and efficacious drug bring quicker relief. In the future, a better insight into the mechanism of action of paracetamol may be gained to maximize its utility in years to come.

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