Paracetamol is the most widely used over the counter pain reliever (analgesic) and fever reducer (antipyretic) in the world. It is considered a mild pain killers and most use it as a pain reliever for headaches and other relatively mild pains. I have personally used paracetamol in various instances of headaches and a fever and have experience with the drug. I only use it to treat the mentioned conditions.
In the ancient medieval are, antipyretic agents were sourced from the barks of trees in the white willow. In the 1880s, the cinchona tree that was also a source of antipyretics, and around that time the tree became scarce. This saw the development of two alternatives, acetanidiline (1886) and phenacitin (1887). By then Harmon Northop Morse had already synthesized paracetamol. Paracetamol was then discovered in the urine of individuals who had taken phenacetin. It would not be used till 1945 when it was discovered that phenacetin had some toxic effects. At the time it was called Tylenol.
Therapeutic uses of Paracetamol
Since paracetamol is classified as an effective antipyreptic and analgesic, it is widely used for treating numerous conditions. They include:
- Muscle ache
- Arthritis: it does not affect the swelling in the joints and body inflammations while reducing the pain in mild arthritis. In the case of osteoarthritis, it is most effective in the form of ibuprofen, which is an anti-inflammatory drug that contains no steroid compound.
- Fever: the drug has been medically approved for the reduction of fever in individuals of all ages. In children, the World Health Organization only recommend that it is used to reduce fever if temperature in above 101.3 ⁰ F.
Mechanism of Action
When paracetamol is used within the recommended dose range, it does not have any effects on the central nervous system functions. When taken in large doses, still the effects are not seen but only if the patient has taken large amounts of the dose together with some other CNS agents.
Paracetamol is classified as a schedule II Drug. This class of drugs are classified by the US government as potential physical dependence drugs when they are misused.
Since the discovery and eventual use of paracetamol, the drug has revolutionized the drug industry due to its mild nature compared to its predecessors.
The drug has however had a slight negative impact on a global scale. This is because many individuals have successfully used it to cause harm to either themselves or others directly. This is because though the drug is mild, it is in fact poisoning when taken in large doses. This is because many take it intentionally with intent of committing suicide. However a small number of cases have been reported of patients admitted due to taking the drug with therapeutic intent or an accidental overdose.
How Paracetamol is made
This drug is usually manufactured in large quantities due to its global usage. The raw material that is used in the manufacturing of paracetamol is phenol. This goes through a nitration process and produces a mixture of para-nitrotoluene and ortho. Using steam distillation, the o-isomer is detached and a p-amino group is derived from reducing the p-nitro group. A final process, acetylation is undertaken to give the final product of paracetamol.
The paracetamol drug can be classified as a moderately effective antipyretic and analgesic drug. When the drug is overdosed, it can cause condiderable mortality and morbidity. The research underway at the moment to reduce the toxicity of the drug has seen moderate and variable effects. There is however a great need for further research into the reduction of its toxicity. There is also a great need for public education on the proper use of paracetamol and the effects of overdose. A legal change also has to be made to restrict adult doses to prescription-only status.
Ellis, F., et al. Paracetamol: A curriculum resource. London: Royal Society of Chemistry, 2002.
Marcel, C. D. Paracetamol, widely used hardly understood. 2003.
Prescott, L. F. Paracetamol (Acetaminophen): A critical bibliographic review. London: Taylor & Francis, 2000.