Chapter 15 - Intravenous paracetamol: Features and applications

Abstract

Paracetamol (acetaminophen) is analgesic and antipyretic that is widely used to relieve mild to moderate pain and fever. This drug is an acetaniline derivative and was first used in 1883 in Europe. The most commonly used route for introducing paracetamol in addition to oral and rectal administration is intravenous route. Mechanism of this drug including inhibition of COX pathways, nitric oxide, and modulating endocannabinoid system. Intravenous use of paracetamol is carried out in critically ill patients, postsurgical patients, and pediatric patients that need immediate pain treatment. The use of Intravenous paracetamol has the advantage of being absorbed more quickly by the body than the oral or rectal routes. Intravenous use of paracetamol also makes it possible for little first-pass metabolism in the liver and higher bioavailability compared to the other routes (i.e., oral and rectal). However, intravenous use of paracetamol has also been reported to cause hemodynamic changes and also need careful deliberations due to effectiveness and cost considerations.