Paracetamol suspension child 120mg / 5ml 100ml
Farmgroup:Analgesic non-narcotic agent.
Pharmaceutical action:Non-narcotic analgesic, blocks TSOG1 and TSOG2 mainly in the central nervous system, affecting the centers of pain and thermoregulation.
In inflammatory tissues, cellular peroxidases neutralize the effect of paracetamol on COX, which explains the almost complete absence of an anti-inflammatory effect.
The absence of a blocking effect on the synthesis of Pg in peripheral tissues determines the absence of a negative effect on the water-salt metabolism (the delay of Na + and water) and the gastrointestinal mucosa.
Pharmacokinetics:Absorption - high, TCmax - 0.5-2 hours; Cmax - 5-20 mcg / ml. Communication with plasma proteins - 15%. Penetrates the BBB. Less than 1% of the paracetamol dose taken by the nursing mother passes into breast milk.
Metabolized in the liver in three main ways: conjugation with glucuronides, conjugation with sulfates, oxidation by microsomal liver enzymes. In the latter case, toxic intermediate metabolites are formed, which are subsequently conjugated with glutathione, and then with cysteine and mercapturic acid. The main isoenzymes of cytochrome P450 for this pathway are the isoenzyme CYP2E1 (predominantly), CYP1A2, and CYP3A4 (secondary role). When glutathione is deficient, these metabolites can cause damage and necrosis of hepatocytes.
Additional metabolic pathways are hydroxylation to 3-hydroxy paracetamol and methoxylation to 3-methoxy paracetamol, which are subsequently conjugated with glucuronides or sulfates.
In adults, glucuronidation prevails, in newborns (including premature babies) and small children - sulfation. Conjugated paracetamol metabolites (glucuronides, sulfates and conjugates with glutathione) have low pharmacological (including toxic) activity.
T1 / 2 - 1-4 hours. It is excreted by the kidneys as metabolites, mainly conjugates, only 3% unchanged. In elderly patients, the clearance of the drug decreases and T1 / 2 increases.
Indications:Febrile syndrome on the background of infectious diseases;
pain syndrome (mild to moderate): arthralgia, myalgia, neuralgia, migraine, toothache and headache, algomenorrhea.
Contraindications:Hypersensitivity, neonatal period (up to 1 month.).
Carefully.Renal and hepatic failure, benign hyperbilirubinemia (including Gilbert's syndrome), viral hepatitis, alcoholic liver damage, alcoholism, diabetes (for syrup),
pregnancy, lactation, old age, early infancy (up to 3 months).
Dosing:Inside, with a large amount of liquid, 1-2 hours after a meal (taking immediately after a meal leads to a delay in the onset of action).
Adults and adolescents over 12 years old (body weight more than 40 kg) single dose - 500 mg; maximum single dose - 1 g. The multiplicity of the appointment - up to 4 times per day. The maximum daily dose is 4 g; The maximum duration of treatment is 5-7 days.
Children: the maximum daily dose for children up to 6 months (up to 7 kg) is 350 mg, from 6 months to 1 year (up to 10 kg) - 500 mg, 1-3 years (up to 15 kg) - 750 mg, 3-6 years (up to 22 kg) - 1 g, 6-9 years (up to 30 kg) - 1.5 g, 9-12 years (up to 40 kg) - 2 g
In the form of a suspension: children 6–12 years old — 10–20 ml each (in 5 ml - 120 mg), 1–6 years - 5–10 ml, 3–12 months - 2.5–5 ml. The dose for children aged 1 to 3 months is determined individually. The multiplicity of appointments - 4 times a day; the interval between each dose is not less than 4 hours.
The maximum duration of treatment without consulting a doctor is 3 days (when taken as an antipyretic drug) and 5 days (as an analgesic).
Rectally. Adults - 500 mg 1-4 times a day; maximum single dose - 1 g; maximum daily dose - 4 g.
Children 12-15 years old - 250-300 mg 3-4 times a day; 8-12 years - 250-300 mg 3 times a day; 6-8 years - 250-300 mg 2-3 times a day; 4-6 years - 150 mg 3-4 times a day; 2-4 years - 150 mg 2-3 times a day; 1-2 years - 80 mg 3-4 times a day; from 6 months to 1 year - 80 mg 2-3 times a day; from 3 months to 6 months - 80 mg 2 times a day.
Side effect:Allergic reactions (including skin rash, itching, angioedema).
Rarely - blood disorders (anemia, thrombocytopenia, methemoglobinemia).
Overdose:Symptoms: during the first 24 hours after administration - pallor of the skin, nausea, vomiting, anorexia, abdominal pain; violation of glucose metabolism, metabolic acidosis. Symptoms of abnormal liver function may appear 12-48 hours after an overdose.
In severe overdose - liver failure with progressive encephalopathy, coma, death; acute renal failure with tubular necrosis (including in the absence of severe damage to the liver); arrhythmia, pancreatitis.
Hepatotoxic effect in adults appears when taking 10 g or more.
Treatment: the introduction of SH-group donators and precursors of the synthesis of glutathione - methionine within 8-9 hours after an overdose, and acetylcysteine - within 8 hours.The need for additional therapeutic measures (the further introduction of methionine, in / in the introduction of acetylcysteine) is determined depending on the concentration of paracetamol in the blood, as well as the time elapsed after taking it.
Interaction:Reduces the effectiveness of uricosuric drugs.
The concomitant use of paracetamol in high doses increases the effect of anticoagulant drugs (a decrease in the synthesis of procoagulant factors in the liver).
Inductors of microsomal oxidation in the liver (phenytoin, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants), ethanol and hepatotoxic drugs increase the production of hydroxylated active metabolites, which makes it possible to develop severe intoxication even with a small overdose.
Prolonged use of barbiturates reduces the effectiveness of paracetamol.
Ethanol contributes to the development of acute pancreatitis.
Inhibitors of microsomal oxidation (including cimetidine) reduce the risk of hepatotoxic action.
Prolonged joint use of paracetamol and other NSAIDs increases the risk of developing "analgesic" nephropathy and renal papillary necrosis, the onset of end-stage renal failure.
The simultaneous long-term administration of paracetamol in high doses and salicylates increases the risk of developing kidney or bladder cancer.
Diflunisal increases the plasma concentration of paracetamol by 50% - the risk of developing hepatotoxicity.
Myelotoxic drugs increase the hematotoxicity of the drug.
Special instructions: With continued febrile syndrome with the use of paracetamol for more than 3 days and pain syndrome for more than 5 days, consultation with a doctor is required.
The risk of developing liver damage increases in patients with alcoholic liver disease.
Distorts the performance of laboratory tests in the quantitative determination of glucose and uric acid in plasma.
During long-term treatment, it is necessary to control the picture of peripheral blood and the functional state of the liver.
Simultaneous administration with ethanol is not recommended.
Syrup contains 0.06 XE sucrose in 5 ml, which should be considered when treating patients with diabetes.
It is a pharmaceutical drug. Use only as directed by your doctor.