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There is a lot of information in the following pages – I have summarised some of it below

Drug

Cautions

Contraindications

Side effects

Paracetamol

0.5 – 1g

every 4-6hrs

Max 4g / d

Alcohol dependence

Hepatic impairment

Renal impairment

None listed in BNF 50

Rare: Rashes, BP

Rare: blood disorders**

Severe hepatic damage in overdose

Ibuprofen

1.2 – 1.8 g

Daily in divided doses ideally after food Max = 2.4 g

Active gout

Elderly

Renal failure

Cardiac failure

Hypertension

Oedema

Hepatic failure

Pregnancy

Breastfeeding

Coagulation defects

Previous active peptic ulceration

GI discomfort

Nausea

Diarrhoea

Bleeding

Ulceration

Tinnitus

Fluid retention

Codeine

30-60 mg every 4 hrs

Max dose 240 mg / d

Hypotension

Hypothyoidism

Pregnancy

Breastfeeding

Hepatic impairment

Prostatic hypertrophy

dose in elderly

Acute respiratory depression

Acute alcoholism

ICP / head injury

Nausea and vomiting

Constipation

Drowsiness

Headache

Facial flushing

Hallucinations

Mood changes

libido / potency

Morphine*

10-15 mg every 2-4 hrs

* Dose listed is for postoperative pain. Dose may differ for other uses and for children. May be given PO, IM, IV, SC but IM / SC is the usual for postoperative pain.

**thrombocytopaenia, neutropaenia, leucopaenia

Combination agents

Content

Dose

Co-codamol 8/500

Codeine phosphate 8 mg; Paracetamol 500 mg

T-TT t/qds

Co-codamol 15/500

Codeine phosphate 15 mg; Paracetamol 500 mg

T-TT t/qds

Co-codamol 30/500

Codeine phosphate 30 mg; Paracetamol 500 mg

T-TT t/qds

Co-dydramol 10/500

Di-hydrocodeine tartrate 10 mg, Paracetamol 500 mg

TT qds

Co-dydramol 20/500

Di-hydrocodeine tartrate 20 mg, Paracetamol 500 mg

TT qds

Co-dydramol 30/500

Di-hydrocodeine tartrate 30 mg, Paracetamol 500 mg

TT qds

WHO Level 1

Paracetamol by Vic Robinson

Mode of operation

Paracetamol is one of the most commonly used non-narcotic analgesic-antipyretic agents. It has relatively weak anti-inflammatory properties. Precise mode of action is unclear.  

Paracetamol is usually given orally and is well absorbed. Peak plasma concentrations are reached in 30-60 minutes and it is inactivated in the liver. The plasma half-life is 2-4 hours.

Side effects – are rare at therapeutic doses but reported side effects include;

Rashes

Blood disorders (including thrombocytopenia, leucopenia, neutropenia)

Important: liver damage (and less frequently renal damage) following overdose

2

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