Paracetamol
Start with the big picture
Paracetamol inhibits cyclooxygenase activity in the central nervous system, reducing prostaglandin synthesis. Its limited peripheral effects help explain why it has negligible anti-inflammatory activity and does not significantly inhibit platelet function. After rapid oral absorption, it is mainly metabolized in the liver through glucuronidation and sulfation; a smaller CYP2E1 pathway produces the toxic metabolite NAPQI. In overdose, normal conjugation pathways can become overwhelmed, allowing NAPQI to accumulate and damage the liver. Risk may be increased by factors such as chronic alcohol use, malnutrition, CYP-inducing medicines, or fasting. The deeper lesson develops the pharmacokinetics, clinical use, cautions, interactions, and principles of overdose management, including the roles of serum-level assessment and N-acetylcysteine.
What you'll learn
- Explain paracetamol’s central mechanism and limited anti-inflammatory effect.
- Describe its absorption, metabolism, and elimination.
- Identify major clinical uses, cautions, and drug interactions.
- Explain how overdose can cause liver injury and outline key management principles.
Continue your study
Work through the complete notes and reinforce the topic with the study tools available in the full lesson.
