ABSTRACT
Paracetamol (acetaminophen) has been used in clinical practice for over one hundred years and is the most commonly prescribed paediatric medicine. The popularity of paracetamol over the non-steroidal antiinflammatory agents increased after the reported association between Reye’s syndrome and aspirin in the 1980s. Paracetamol is widely used in the management of pain and fever, but is lacking antiinflammatory effects. The mechanism of action of paracetamol analgesia is multifactorial. It is a potent inhibitor of prostaglandin synthesis within the central nervous system but also acts peripherally by blocking impulse generation within the bradykinin-sensitive chemoreceptors responsible for the generation of nociceptive impulses. Paracetamol is also thought to have an analgesic effect by antagonising N-methyl-D-aspartate (NMDA) and substance P in the spinal cord, with some inhibitory action on spinal nitric oxide mechanisms [1–3] and serotonergic pathways [4].
