Paracetamol Control Research Articles

Effect of timing of intraoperative administration of paracetamol on postoperative shivering: A randomised double-blind controlled trial.

Paracetamol (PCM) has an anti-shivering effect and may also exacerbate intraoperative hypothermia. This study compares the incidence of shivering as the primary outcome and the incidence of perioperative hypothermia (<36°C) and the time to the analgesic requirement as secondary outcomes when PCM was administered after induction of anaesthesia or towards the end of surgery. In this randomised study, 225 adult patients of either gender undergoing elective surgical procedures under general anaesthesia with an expected duration of surgery of 1-4 h were studied. They received intravenous (IV) PCM 15 mg/kg (maximum 1 g) immediately after anaesthesia induction (Early PCM group), 30 min before completion of surgery (Late PCM group) or no PCM (Control group). IV morphine 0.1 mg/kg was administered for analgesia in all three groups. The Chi-square test and repeated measures analysis of variance followed by Tukey's test were used for statistical analysis. The incidence of shivering was lower in Late PCM (12%) than in Early PCM (29.3%) (P = 0.009) and Control groups (30.6%) (P = 0.005). The incidence of postoperative hypothermia was also significantly lower in the Late PCM group than in the Early PCM (P = 0.002) and Control groups (P = 0.016). Early PCM and Control groups did not significantly differ. The number of patients requiring postoperative analgesia was smaller, and the time to the analgesic requirement was longer in Late PCM compared to other groups. Administration of IV PCM 30 min before completion of surgery results in a lower incidence of postoperative shivering and hypothermia when compared to PCM administered after induction of anaesthesia or no PCM.

Isolation and characterization of bioactive components from hydroalcoholic extract of Cymbopogon jwarancusa (Jones) Schult. to evaluate its hepatoprotective activity

Ethnopharmacological relevanceCymbopogon jwarancusa (Jones) Schult. (Family: Poacea/Gramineae) is being used to treat numerous ailments in traditional/folklore and indigenous system of medicine due to its antioxidant, anti-allergic, antiparasitic, analgesic, antipyretic and anticancer activities; however there is no documented evidence regarding its hepatoprotective efficacy. AimThis study was aimed to evaluate hepatoprotective activity of hydroalcoholic extract of Cymbopogon jwarancusa (HECJ) against paracetamol (PCM) induced liver damage in albino Wistar rats, and to identify the bioactive components present in the extract responsible for the said activity. Materials and methodsFive groups of rats (n = 6) were orally treated with: 0.5% carboxymethyl cellulose (normal control), 50 mg/kg silymarin (reference standard), HECJ [515 mg/kg (low dose) and 720 mg/kg (high dose)] (test groups) for 7 days daily, followed by induction of hepato-toxicity using PCM (2 gm/kg) on 7th day (PCM control; reference standard; test groups). The blood samples to estimate the level of AST, ALT, ALP, total bilirubin and total protein; liver tissue homogenate for antioxidant markers (GSH, GST, GPx, and LPO) and liver section for histopathological analysis were collected. Isolation and characterization of phytochemicals from HECJ was done by preliminary screening, determination of phenolic, flavonoid and terpenoid content, and GC-MS analysis. ResultsThe animals pre-treated with HECJ dose-dependently and significantly alleviated the PCM-induced alterations in liver enzymes, plasma proteins, serum total bilirubin and antioxidant markers levels. The histopathological analysis suggest that PCM causes marked necrosis and lymphocyte infiltration, while preservation of the normal hepatic architecture was observed in groups pre-treated with, reference standard drug silymarin, and HECJ. Preliminary screening of the extract, determination of phenolic, flavonoid and terpenoid content, and GC-MS analysis revealed the presence of some important bioactive components such as phenolics, flavonoids, glycoside, tannins, steroids, fatty acids, sterols, esters, saponins, terpenes/terpenoids and essential oil which could be synergistically responsible for the plant's hepatoprotective effect. ConclusionsThis study concluded that C. jwarancusa could be taken as a beneficial natural product for its hepatoprotective efficacy; however, future line of work is required to establish its precise mechanism of action.

In Vitro and in Vivo Evaluation Of Pharmacological Activites of Pouzolzia Sanguinea

Pouzolzia sanguinea grows in tropical and sub-tropical regions of Bangladesh, used for a variety of purposes including pain, rheumatoid kidney diseases in traditional medicine. The crude ethanolic leaf extract of P. sanguinea with its different fractions (ethanol, n-hexane, and chloroform) was investigated for phytochemical constituents, in vitro antioxidant, anti-inflammatory effects, in-vivo analgesic and antipyretic activities. Preliminary phytochemical constituents were identified by chemical group test. P. sanguinea fractionated extracts contain alkaloids, glycosides, tannins, flavonoids, saponins, gums, and amides. Antioxidant activity test was performed by both qualitative (TLC and Rf value) and quantitative tests (inhibition of DPPH free radical scavenging). Extracts exhibited significant (p &lt;0.001, p &lt;0.0001) inhibition of DPPH free radical scavenging activity as compared to the standard drug ascorbic acid at similar doses. In vitro anti-inflammatory activity was determined by protein denaturation of egg albumin method. The percent inhibition of protein denaturation in the experiment of ethanol extract was found significantly higher (p &lt;0.0001) compared with chloroform and n-hexane extracts. In addition, in vivo analgesic and antipyretic effects were determined in mice by acetic acid-induced writhing and yeast-induced pyrexia methods. The ethanol extracts of P. sanguinea exhibited inhibition of writhing reflex on mice by 71.58% at the dose of 500 mg/kg body weight which had greater analgesic activity than other n-hexane and chloroform extracts. In the anti-pyretic test, fractional extracts ethanol, chloroform, and n-hexane at a dose of 500 mg/kg body weight significantly (p &lt;0.05) decreased pyrexia in mice up to 3 h as compared with the positive control paracetamol drug at a dose of 150 mg/kg body weight. In our in vitro and in vivo study models, it is evident that Pouzolzia sanguinea fractionated extracts showed significant antioxidant, anti-inflammatory, analgesic, and antipyretic activities. J. Bio-Sci. 29(2): 31-42, 2021 (December)

Evaluation of Hepatoprotective Effect of a Polyherbal Megakutki against Paracetamol-Induced Hepatotoxicity

Background: Megakutki® (MK) is a polyherbal preparation of 11 standardized extracts that are individually proven for hepatoprotection scientifically. Aim: Study evaluated MK’s hepatoprotective potential against paracetamol (PCM) in in-vitro on Hep G2 cells using cell viability, cell cycle analysis and apoptotic studies and in in-vivo in Wistar rats using liver function tests, histological and DNA fragmentation study. Materials and Methods: In in-vitro studies, IC50 (50% inhibition in viability) values of silymarin, MK and PCM were found out by MTT assay. In-vitro hepatoprotection was found out by pretreating the cells with below-IC50 concentrations of MK and silymarin for 24h followed by PCM (at IC50 concentration) challenge for next 24h and % viability was evaluated using MTT assay. Same treatment protocol was followed for cell cycle analysis and apoptotic studies (100 and 200 µg/ml for MK and 50 µg/ml for silymarin and 40µM for PCM). In in-vivo study, animals were grouped in six, namely, vehicle, PCM control, silymarin (50 mg/kg, standard), MK (100 and 300 mg/kg) groups. Animals were dosed for 8 days while they were challenged on day 6 (except vehicle group) with PCM (2.75 g/kg p.o). On day 8, blood and livers were collected under anaesthesia and analyzed. Results: In-vitro results showed hepatoprotection by MK and silymarin by inhibition of PCM-induced cell death apoptotic cells percentage. In in-vivo study, MK and silymarin reversed the altered liver function and elevated oxidative stress markers (catalase, SOD, GSH, total thiols and lipid peroxidation) compared to paracetamol alone group. Both MK and silymarin decreased the percentage of DNA fragmentation and histopathological changes in liver tissue compared to the PCM group. Conclusion: The in-vitro and in-vivo studies showed the hepatoprotective effect of MK by the prevention of PCM-induced induction of oxidative stress by its antioxidant potential thereby preventing PCM-induced DNA damage.

The Potential Hepatoprotective and Antioxidant Activities of Astragalus davisii against Paracetamol Induced Liver Damage in Rats

The current study aimed to estimate in vitro antioxidant effect of Astragalus davisii (A. davisii) extract. Further, the possible protective effect of A. davisii against paracetamol (PCM)-induced liver injury was assessed in rats. A. davisii was tested for its antioxidant activity using DPPH radical scavenging assay. The hepatoprotective potential of the extract was assessed in rats following oral administration for 7 days. Liver injury was induced in rats following oral administration of PCM overdose. Hepatic biomarkers; alanine-aminotransferase, aspartate-aminotransferase, alkaline-phosphatase, γ-glutamyl transferase and bilirubin were increased, while total protein and albumin were reduced in PCM control animals. Additionally, the activities of superoxide dismutase (SOD), catalase and glutathione-peroxidase (GPx) and the levels of glutathione were significantly declined, while levels of hepatic malondialdehyde (MDA) were significantly elevated in PCM alone treated rats. Oral administration of A. davisii (400 mg/kg) prior to PCM inhibited the elevation in the levels of liver damage markers in serum and protected against oxidative stress. Histopathological remarks confirmed the hepatoprotective potential of the extract. The results suggest that A. davisii extract at 400 mg/kg protects liver against injury induced by PCM overdose.

Intravenous paracetamol for fever control in acute brain-injured patients: cerebral and hemodynamic effects

Background Fever occurs frequently in acute brain injury patients, and its occurrence is associated with poorer outcomes. Paracetamol, an antipyretic frequently employed in patients with cerebral damage, may cause hypotension. We evaluated the cerebral and hemodynamic effects of intravenous (IV) paracetamol for the control of fever in Neuro-Intensive Care Unit (NICU) patients.