Paracetamol Tablets Research Articles

Penetapan Kadar Parasetamol dalam Sediaan Tablet Secara Spektrofotometri Inframerah

Paracetamol is paraaminophenol which is a metabolite of phenacetin and has been used since 1893, paracetamol (acetaminophen) has a working power analgesics, antipyretics, not has anti- inflammatory work power and does not cause irritation and inflammation of the stomach. According to Law Number 36 of 2009 concerning Health in paragraph 1 article 105, it is stated that pharmaceutical preparations in the form of drugs and medicinal raw materials must meet the requirements of Indonesian Pharmacopoeia or other standard books.Thepurpose of this study was to determine paracetamol levels in tablet preparations with a trade name and generic and to determine the suitability of the requirements of Indonesian Pharmacopoeia.Determination of paracetamol levels by Fourier Transform Infra Red (FTIR) spectrophotometry using methanol solvent in the wave number range 4000 - 650 cm-1.The results showed that paracetamol levels in Sanmol®tablets (102,69±9,35)%; Erphamol®tablets(95,42 ± 0,26)%; Farmadol®tablets (99,67±9,87)%; Biogesic®tablets (96,7±2,14)%; Paracetamol tablets (97,98± 0.29)%. From the method validation, the results of the recovery test was 100,18%, RSD was 0.03%, and LOD and LOQ respectively was 0.0973 mg / mL and 0,3244 mg / mL. These results indicate that the method performed shows accurate and precise results. The results of this study concluded that the determination of paracetamol levels could be carried out by Fourier Transform Infra Red (FTIR) spectrophotometry and the levels of paracetamol tablets had met the requirements.

The effect of partially pregelatinized cassava starch as disintegrant for paracetamol tablet

The use of partially pregelatinized starch in tablet formulations is entirely various; one of them is disintegrant. Present pregelatinized starch is imported from another country, which is relatively expensive. In contrast, many plants can be used as starch sources, including cassava which is relatively abundant in Indonesia. This study aimed to determine the effect of using partially pregelatinized starch from cassava as a disintegrant in paracetamol tablets. In this study, seven formulas were used with different disintegrants, three formulas using partially pregelatinized starch from cassava with concentrations of F1 5%, F2 10%, and F3 15%, three formulas using Starch 1500 with the same concentration as partially pregelatinized starch from cassava and one control formula without disintegrant. The tablet was made using the wet granulation method. The tablets produced were tested for physical properties (hardness, disintegration, and dissolution). In addition, compact ability of partially pregelatinized starch from cassava was compared with Avicel, Starch 1500, and cassava starch. Based on the results of the study showed that partially pregelatinized starch from cassava produced tablets that tended to be capping with less hardness than tablets with Starch 1500 and control tablets. The compact ability test results showed that the compact ability of partially pregelatinized starch from cassava was better than Starch 1500 and cassava starch. The disintegration test results showed that tablets with partially pregelatinized starch from cassava had faster disintegration than tablets with Starch 1500 and control tablets. The dissolution profile of tablets with partially pregelatinized starch from cassava is also better than other formulas.

The Use of Ambon Banana Starch (Musa paradisiaca var. sapientum L.) as a New Binder in Tablet Formulation

Background: Synthetic materials are commonly used as binders in tablet formulations, this causes the price of tablets to be more expensive. For this reason, new discoveries are sought that can replace synthetic materials by utilizing materials from nature. One of the binders that comes from natural ingredients and is easily obtained is the Ambon Banana Starch (Musa paradisiaca var. sapientum (L.)). Objectives: This study was conducted to determine the physical characteristics of paracetamol tablets from Ambon banana starch (Musa paradisiaca var. sapientum L.) as a binder. Materials and Methods: Paracetamol tablets were compressed using the wet granulation method by adding a binder in the form of Ambon banana starch mucilago. The consentration of Ambon banana starch used was Formula I (15%), Formula II (17.5%) and Formula III (20%). Evaluation of the physical characteristics of the preparation is determined through the parameters of granule testing and tablet testing. Results: Formulation I, II, and III have met the requirements for the granule test. Meanwhile, in tablet testing, the results of size uniformity test, weight uniformity test, hardness test, and disintegration time test met the requirements for all formulations. However, in the friability test, Formula I (15%) did not meet the requirements with a value of 2.07% (requirement <1%), while formulas II and III had met the requirements. Conclusions: This study showed that Ambon banana starch can be used as a binder in tablet formulation.

Postoperative Pain Management Total Hysterectomy with Intravenous Patient-Controlled Analgesia Oxycodone: A Case Series

Introduction: Patient-controlled analgesia (PCA) with intravenous opioids is a more efficient method to achieve better postoperative analgesia. This study aims to describe the use of patient-control analgesia in post-hysterectomy patients.
 Case presentation: There were two total hysterectomy postoperative patients who used PCA as postoperative pain management. Postoperatively, the first patient has given paracetamol tablets 500 mg every 6 hours orally, a santagesic 1 gram every 8 hours intravenously, and oxycodone intravenously with PCA. The second patient was given paracetamol tab 1 gram every 8 hours intravenously, analgesics 1 gram every 8 hours intravenously, and PCA intravenous oxycodone. Both patients felt the effectiveness of PCA as postoperative pain management.
 Conclusion: Multimodal analgesia or balanced analgesia is one method of managing acute postoperative pain. The success of using PCA is very much determined by the knowledge of the patient and the pain management team on PCA tools. Oxycodone provides fairly good analgesia with minimal side effects.

Comparative Evaluation of the Disintegrant Properties of Starches from Three Cultivars of Dioscorea rotundata (Poir)

Poir starches from three cultivars (Lagos, Giwa, and Sule) were evaluated asexo-disintegrants (5 and 10%w/w) in paracetamol tablet formulations to determine whether the similarity in their physicochemical and material properties translates to performance in tablet formulation. The tablets were prepared by wet granulation and were evaluated for compressional properties (Heckel equation), mechanical strength (crushing strength and friability), and drug release (disintegration and dissolution times). Plastic deformation occurred in all tablets with rank order for the onset of plastic deformation Lagos>Giwa>Sule. An increase in the concentration of disintegrants in the tablets led to a decrease in mean yield pressure, total relative precompression density, and relative density at low pressure, but an increase in relative density at zero pressure. The crushing strength and disintegration times of the tablets were dependent on the disintegrants' concentration. All tablets passed the disintegration test (≤15min) with tablets containing the Sule cultivar producing the fastest disintegration (p<0.05). Tablets containing 10% of the Sule cultivar had the fastest release of paracetamol (t80=32.1min), though it failed the compendial standard for immediate release tablets (t80≤30min). Starches from the three cultivars despite their similar physicochemical and material properties exhibited different disintegrant properties and could find different applications as excipients in tablet formulations.

Direct visualizing of paracetamol immediate release tablet disintegration in vivo and in vitro

The purpose of the present study was to study tablet disintegration by direct visualization, in vivo and in vitro. Based on literature data, a standard conventional paracetamol (CP) tablet, Panodil®, and a rapidly absorbed paracetamol (RP) tablet, Panodil® Zapp, were chosen as model systems to study tablet disintegration in the human stomach. Based on the obtained in vivo results, an in vitro disintegration method was designed to reproduce the visualized disintegration process occurring in the human stomach.For the clinical study, CP and RP tablets fastened to digital endoscopic camera capsules were administered to fasted human volunteers (n = 4). The disintegration time and process were visualized by the real time video recordings, using the endoscopic camera capsule. The average disintegration time was found to be 26 ± 13 min and 10 ± 7 min, for CP (n = 4) and RP (n = 4) tablets, respectively.It was possible to reproduce the in vivo disintegration data in vitro using a USP 2 dissolution apparatus with 250 mL of viscous Fasted State Simulated Gastric Fluid (vFaSSGF*), simulating the rheological profile of human fasted state gastric fluid following administration of a glass of water. The viscosity of the simulated fasted state gastric fluid was found to have a large impact on the disintegration time of the tested immediate release tablets. Therefore, it is recommended to mimic gastric fluid viscosity during in vitro tablet disintegration studies.

English

This research is aimed at producing alternative starch used for tablet binding from amura tuber. The microbiological load and physicochemical properties of native and modified amura starches were determined using plate counting method and standard method of BP. Amylose and amylopectin content of native and modified amura starches were determined using spectrophotometric method. Binding and disintegrant abilities of these starches were studied using paracetamol as a model drug. Paracetamol tablets were formulated by wet granulation method using NAS, AS, and EHS as binders. The tablet characteristics were evaluated using standard method of BP. The results of this study indicates that microbial and Fungi load of NAS, AS, EHS and MS range from 1 to 30 colonies forming unit (cfc/g). The swelling power and solubility of the starches were found to increase with temperature and the values are higher for EHS and AS. Also the NAS have crushing strength of (4.766 ± 0.152), AS (7.000 ± 0.500), EHS (3.900 ± 0.100) and MS (5.633±1.184) and are significant different at (p<0.05) while friability of NAS is (0.760 ± 0.068, AS (1.060 ± 0.121, EHS (0.556 ± 0040) and MS (0.873 ± 0.1007) and they are significant different at (p<0.05). The results of disintegration of the tablets indicate that EHS disintegrate faster than NAS, AS and MS. The results of dissolution of paracetamol tablets formulated with NAS, AS, EHS and MS at t50, t70 and t90 minutes are within range of 70%-97%. (quantity dissolved in 45 min ≥ 70% BP standard). Key words: NAS = Amura Starch (Tacca involucrate), EHS = Enzyme hydrolysed Starch, AS = Acetylate Starch, MS = Maize starch, Amylose, Amylopectin, Paracetamol tablet and BP= British Pharmacopia.

Evaluation of Modified Date Palm (Phoenix dactylifera L.) Mucilage as a Potential Pharmaceutical Excipient

Investigation on natural sources from plants, animals, and microorganisms that produce gums and mucilages goes on increasing day by day to check their pharmaceutical applications. Different mucilages have been studied for their pharmaceutical effects but the use of date palm (Phoenix dactylifera L.) mucilage as a pharmaceutical excipient is still under the cover. The aim of this study was therefore to evaluate and compare the flow property and binding ability of crude, purified, modified (hydrolyzed and grafted), green synthesized nanoparticles (Zinc oxide (ZnO), cuperic oxide (CuO), silver (Ag), and gold (Au)) of date palm mucilage with hydroxy propyl methyl cellulose (HPMC) and commercially available paracetamol tablets. Previously purified mucilage (with 58.4% yield) was subjected to modification (i.e., acidic, basic, and enzymatic), grafting (polyacrylamide), and green synthesis of nanoparticles. Flow properties of powdered (granular) crude, purified, modified, and nanoparticles were studied and compared with flow properties of HPMC and paracetamol tablet granules. Tablets were made using granules of all types of date palm mucilage (discussed above), HPMC, and granules of paracetamol tablets to study and compare weight uniformity, hardness, friability, dissolution rate, and disintegration time. When 100 mg/kg of mucilage sample was given to mice no oral toxicity was found. The results obtained during this study were within the acceptable ranges given in pharmacopeias. The pseudoplastic flow behavior, hygroscopic nature, increased solubility, and swelling index across the increase in temperature, hardness of the tablets, friability, and drug release behavior were found better than HPMC and the binders used in commercially available paracetamol, hence making the date palm mucilage (crude, purified, and modified) an excellent excipient to be used in pharmaceutical dosage forms.

The Effect of Topical Diltiazem on Post-Hemorrhoidectomy Pain: A Cohort Study

Background: Diltiazem is a calcium channel blocker that can prevent calcium absorption by myocytes and decrease the tone of the internal anal sphincter. Thus, it can be used for the treatment of anal fissures; however, its effect on post-hemorrhoidectomy pain is unclear. Accordingly, the current study aimed to evaluate the effect of topical diltiazem on post-hemorrhoidectomy pain. Methods: This cohort study included 50 candidates of hemorrhoidectomy referred to Shahid Mohammadi Hospital, Bandar Abbas, Iran from March 20, 2020, to March 21, 2021. First, the characteristics of the patients, including age, gender, degree of hemorrhoid, and the number of hemorrhoid pockets were recorded based on the study purpose. One group received topical diltiazem 2% three times a day for three days after hemorrhoidectomy, and the other group received Vaseline®. Both groups also received 500 mg paracetamol tablets. Post-hemorrhoidectomy pain was assessed using a numerical rating scale (NRS) by patients on the first and third days after surgery. The cumulative amount of consumed paracetamol was also noted on the third day. Results: Patients in both groups were comparable regarding age, gender, degree of hemorrhoids, and the number of pockets. There was no significant difference between groups in terms of pain on the first day after surgery (P=0.626), while the mean pain score was significantly lower in the diltiazem group on the third day compared to the placebo group (P<0.001). Finally, the cumulative amount of consumed paracetamol was significantly higher in the placebo group (P=0.001). Conclusion: Overall, topical diltiazem appears to be more effective than placebo for post-hemorrhoidectomy pain reduction.

A Novel Electrochemical Sensor Based on Samarium Vanadate and Single-Walled Carbon Nanotubes for the Determination of Paracetamol

In this work, samarium vanadate (SmV) and single-walled carbon nanotubes (SWCNTs) were self-assembled by ultrasonic treatment to obtain a novel SmV/SWCNTs nanocomposite. Subsequently, an electrochemical sensor based on SmV/SWCNTs nanocomposite modified glassy carbon electrode (GCE) was constructed. SmV/SWCNTs/GCE exhibited high selectivity, excellent anti-interference, good stability and reproducibility toward paracetamol (PA) detection. The outstanding performances of the developed electrochemical sensor could be mainly attributed to its high electrocatalytic activity for PA, which might be caused by the synergistic effect of SmV and SWCNTs. Under optimized experimental conditions, SmV/SWCNTs/GCE exhibited a good linear relationship between current signal and PA concentration over a wide concentration range 1–100 μM, and limit of detection (LOD) (signal-to-noise ratio of 3, S/N = 3) was calculated to be 0.035 μM. The satisfactory recoveries of 98.06%–104.20% and 98.55%–101.88% could be obtained in the bovine serum and PA tablet samples, respectively. We anticipated this work could provide a reference for the future development and application of samarium-based materials in the field of electroanalysis.

Assessment of in vitro Quality Tests of Paracetamol Brands 500mg in Karachi, Pakistan

Objective: The main purpose of this study is to perform the quality assessment of three different brands of Paracetamol tablets (500 mg) available in local market of Karachi, Pakistan.
 Methodology: Several pharmacopeial and non-pharmacopeial tests were applied on selected brands coded as P1, P2 and P3, respectively. A sample of (n = 20) tablets from each coded brand were subjected to pharmacopeial tests such as weight variation, friability, disintegration, assay and dissolution and non- pharmacopeial tests such as hardness, diameter and thickness. Dissolution data were subjected to model dependent and model independent kinetic approaches using Dissolution Data solver.
 Results: The Average weight in mg, hardness in kg , thickness and diameter in mm of (n=20) tablets of brands P1, P2, and P3 were noted and their standard deviation were calculated which were found to be 520.625mg (± 0.49 mg), 519.53 mg (± 0.472 mg) and 521.20 mg (±0.494mg),7.25(±0.45kg), 7.48(±0.29kg) and 6.64(±0.11kg), 4.3(±0.15mm), 3.2(±0.15mm), 3.2(±0.11mm) and 12.2(±0.13mm), 12.4(±0.14mm) and 12.6(±0.15mm). Friability of selected brands were found to be 0.37%, 0.41% and 0.26%. Disintegration time were found to be 2minutes26seconds, 2minutes56seconds and 1minute 54 seconds. Percentage Assay of (n=20) tablets of selected brands were found to be as P1= 98.97(± 0.02%), P2= 99.96(± 0.03%) and P3= 99.91(±0.02%). Dissolution were performed at multiple point intervals such as 5 min, 10 min, 20 min, 30 min and 45 min. At 45 minutes the percentage of drug release for P1, P2 and P3 were found to be 98.7%, 99.8% and 98.9%. For the determination of model independent approaches brand P2 were selected as reference formulation. Similarity factor (f2), dissimilarity factor (f1) for brand P1, and P3 were found to be 73.5, 5 and 79.5, 3. All selected brands were subjected to model dependent approaches. In this study all tablets of selected brands P1, P2 and P3 followed First order and weibull model as the r2 values for first order were (0.9897), (0.9893) and (0.9837) and for weibull model r2 values were found to be (0.9937), (0.9953) and (0.9915).
 Conclusion: In this study successful application of Pharmacopeial and non Pharmacopeial tests on three different selected brands in Karachi, Pakistan were carried out however further work is recommended on large sample. Results were found to be in limit in accordance to the United States Pharmacopeia. Invitro multiple points interval dissolution studies were conducted at phosphate buffer pH 5.8 the data were subjected to several kinetic models by the application of Dissolution Data (DD solver) an add in program in Excel to determine release kinetics. Study demonstrated that all selected brands of Paracetamol 500 mg tablets followed first order kinetics and weibull model.

A Directly Compressible Pregelatinised Sago Starch: A New Excipient in the Pharmaceutical Tablet Formulations.

An excipient intended for direct compression in pharmaceutical tableting must show important features of flowability and compactibility. This study investigated pregelatinised sago starch as an excipient for direct compression tablets. Pregelatinised sago starch was prepared and characterised. Its powder bulk properties and performance in the tablet formulations with paracetamol as a model drug were compared against two commercial, directly compressible excipients, namely Avicel® PH 101 and Spress® B820. The results showed that pregelatinisation did not affect the chemical structure of sago starch, but its degree of crystallinity reduced, and X-ray diffraction pattern changed from C-type to A-type. Powder bulk properties of pregelatinised sago starch and Spress® B820 were comparable, exhibiting better flowability but lower compactibility than Avicel® PH 101. In the formulation of paracetamol tablets, pregelatinised sago starch and Spress® B820 performed equally well, followed by Avicel® PH 101 as indicated in Formulations 3, 2 and 1, respectively.

Efficacy of Preoperative Piroxicam, Diclofenac, Paracetamol With Tramadol and Placebo Tablets for Relief of Postoperative Pain After the Removal of Impacted Mandibular Third Molars: A Randomised Controlled Trial.

AimWe aimed to analyze the influence of preoperative piroxicam, diclofenac, paracetamol, tramadol, and placebo tablets as measured in the time required for rescue analgesia for postoperative pain relief after the extraction of impacted mandibular third molar.Materials & methodsForty-four patients who needed extraction of impacted mandibular third molar were arbitrarily categorized into four groups namely, piroxicam, diclofenac, paracetamol with tramadol, and placebo. The test medicine was given one hour preoperatively before the surgical removal. The pain was assessed using visual analog scale (VAS) and verbal rating scale (VRS) scores preoperatively and at the third and 24th hours. The time required for escape analgesia was measured. ResultsThe mean VAS and VRS scores showed significant differences across the groups after 24 hours. The mean score was lowest for the patients taking piroxicam (1.30+1.95) and highest for patients taking tramadol + paracetamol (4.50+2.59). As far as escape analgesia is concerned piroxicam group was by far superior.ConclusionThe pain scores and the rescue analgesic requirement suggested that piroxicam analgesic significantly reduced pain; moreover, it is a safe as well as an efficacious substitute to the conventional non-steroidal anti-inflammatory drugs (NSAIDs) for mandibular third molar impactions.

Konvansiyonel Fizik Tedavi Alan Fibromiyalji Hastalarında Balneoterapinin Katkısı

Purpose: This study aims to investigate the role of additional balneotherapy in fibromyalgia patients receiving conventional physical therapy.
 Materials and Methods: 107 female patients diagnosed with fibromyalgia for the first time were studied in two groups. Group 1 included those patients receiving Transcutaneous Electrical Nerve Stimulation, physical therapy modalities including superficial hot and therapeutic ultrasound. Group 2 consisted of patients applied balneotherapy in addition to therapeutic modalities given to the first group. All patients went through a 10-session treatment program. Evaluation was based on Fibromyalgia Impact Questionnaire (FIQ), Visual Analogue Scale (VAS), Pittsburgh Sleep Quality Index (PSQI), Quality of Life Short Form-36 (SF-36) before and after the treatment. The total amount of paracetamol tablets consumed was also recorded.
 Results: In both groups, there was significant improvement in post-treatment pain VAS, FIQ and PSQI scores compared to prior to treatment, but they were more pronounced after the balneotherapy. With balneotherapy, drug consumption was also significantly lower and patients expressed better general health and social function scores of SF-36.
 Conclusion: In the treatment of fibromyalgia, combination of balneotherapy with the conventional physical modalities can be considered as an effective treatment option as it positively contributes to the patients' pain, functional status, quality of life and sleep, and drug consumption.

Solvent-exfoliated Cu-TCPP nanosheets: Electrochemistry and sensing application in simultaneous determination of 4-aminophenol and acetaminophen

The design and preparation of 2D metal-organic frameworks (MOFs) can effectively improve the performance of electrochemical sensing. In this work, a series of Cu-TCPP nanosheets (TCPP: Tetrakis(4-carboxyphenyl)porphyrin) are prepared through ultrasonic exfoliation of bulk Cu-TCPP in different solvents, including ethanol absolute (EtOH), N,N-dimethylformamide (DMF), N-methyl-2-pyrrolidone (NMP), and ultrapure water (H2O). The exfoliation ability of DMF is higher than EtOH, H2O, and NMP, and the exfoliated Cu-TCPP nanosheets in DMF (Cu-TCPP-DMF) are more uniform and thinner due to their approximate surface energy. Then, the electrochemistry of different Cu-TCPP nanosheets is studied. Cu-TCPP-DMF modified glassy carbon electrode (Cu-TCPP-DMF/GCE) features higher redox activity, larger electrochemical response area, faster electron transfer ability, and higher enhancement effects toward the oxidation of 4-aminophenol (4-AP) and acetaminophen (AC). The corresponding electrochemical reaction mechanisms are explored. Using Cu-TCPP-DMF as sensing material, a platform for simultaneous measurement of 4-AP and AC is successfully developed with the determination limit of 2.6 and 1.9 nM. The wonderful recoveries are also obtained when the sensor is used to determine 4-AP and AC in urine, river water and commercial paracetamol tablet. This work is in favor of constructing a novel 2D MOFs based electrochemical sensing system with superior performance.

Electrochemical determination of paracetamol at Cu doped ZnO/Nanoparticle with TX-100-surfactant MCPE: A cyclic voltammetric technique

Zinc oxide nanoparticles (ZnO/NPs) and Copper doped ZnO nanoparticles (Cu-ZnO/NPs) were prepared using the co-precipitation method and their characterizations were done with X-ray diffraction (XRD), Scanning electron microscope (SEM) and Energy dispersive spectroscopy (EDS) techniques. The prepared Cu-ZnO/NPs were used for the modification of the carbon paste electrode (CPE), the Cetyl Trimethyl Ammonium Bromide (CTAB) and Triton-X 100 (TX-100) surfactants were immobilization on the surface of Cu-ZnO/MCPE, the TX-100 modified electrode improved the more redox property with increasing the peak current for Paracetamol (PA) compare to Cu-ZnO/CTAB/MCPE. From the pH study confirms that the equal number of electrons and protons transfer mechanism involved at the MCPE. The cyclic voltammetry (CV) technique demonstrated the oxidation of both PA and Adrenaline (AD) was found to be adsorption controlled. The electrochemical response of PA and AD was linear in the µM concentration range and the limit of detection and limit of quantification was found to be 4.6 µM and 16.2 µM for PA and 3.9 µM and 13.2 µM for AD respectively, the effect of interference study was examined by using the differential pulse voltammetric technique (DPV), the Cu-ZnO/TX-100/MCPE shows an excellent selectivity towards PA in presence of different AD concentration. In present study commercial PA tablet also studied.

Comparison of outcome of compression dressing for two days Vs seven days after varicose surgery.

Incompetence of the great saphenous vein (GSV) is a global issue and the most prevalent cause of chronic venous disease of the leg. Clinical manifestations range from moderate to severe, including tiredness, heaviness, and irritation, as well as hyperpigmentation and leg ulcers. A study was conducted to address this controversy,1 i.e. to determine the outcome of compression dressing after varicose vein surgery in terms of postoperative pain, on the Surgical floor, of Mayo Hospital, Lahore, from October 1, 2020, to April 1, 2021. A total of 60 patients with Primary varicose veins were enrolled in this study, fulfilling the inclusion criteria after obtaining approval from the ethical committee of the hospital. The patients were divided in two groups. Group A wore compression dressing for two days after surgery and Group B wore compression dressing for seven days after surgery. All the patients received 1gm Paracetamol I/V eight hourly followed by tablet Paracetamol 500mg P/O eight hourly. Then the outcome of compression dressing was analysed in the form of mean postoperative pain. The mean pain score was assessed on one week. Data were entered in SSPS v23.0. Stratification of pain score was done against age, gender, and grades of varicose veins. A comparison of the two groups was done by applying a t-test. A p-value of ≤ 0.05 was considered significant. Prescribing compression stockings for longer than two days after Trendelenburg's procedure leads to reduced pain and improved physical function during the first week after treatment.

Chronic Misuse of Paracetamol in OCD Without Hepatic Injury: A Case Report and Literature Review

AimsParacetamol is a commonly used antipyretic and analgesic over the counter medication. In acute or chronic overuse it is associated with dose-dependent hepatic injury. There is a narrow therapeutic margin and that consistent use of as little as 7.5 g/day may be hazardous. Unintentional overdose with paracetamol is the most common cause of acute liver failure in the United Kingdom Here we present an unusual case of a 60-year-old lady with a reported chronic history of self-medicating with an above daily recommended dose of paracetamol without evidence of hepatic injury.MethodsA 60-year-old Caucasian lady known to psychiatric services for 20 years with Recurrent Depressive disorder, Obsessive Compulsive Disorder (OCD), Dependent Personality Disorder with Borderline personality traits. She reported consuming 32 tablets of paracetamol (16gm per day) every day for the past 11 years. She experienced obsessions of fear that if she did not take a particular number of paracetamols in a day then her friends will come to harm and her anxiety was relieved by the compulsion of consuming supratherapeutic doses of paracetamol. There was no evidence of misuse of any other medications other than paracetamol. Her blood investigations revealed liver function tests within normal limits and ultrasound of the liver was unremarkable.ResultsA literature search of “paracetamol or acetaminophen” and “no liver or hepatic” and “damage or injury” found only one case report. The case reported that studies of paracetamol metabolism were performed in a 58-year-old female with rheumatoid arthritis who had consumed 15–20 g paracetamol daily for 5 years without developing liver damage and data were compared with results in seven normal volunteers. The report concluded that a combination of slow paracetamol absorption, enhanced detoxication of paracetamol (by sulphation) and reduced metabolism to potentially cytotoxic metabolites may have reduced the risk of liver damage in this patient.ConclusionIn OCD, misusing medications can be an uncommon presentation of compulsive acts to relieve anxiety. The diagnostic dilemma of factitious illness is probable, however supratherapeutic use of paracetamol without physical harm is rare but possible.

Towards a holistic view of tablet quality, an extensive study on paracetamol tablets with nuclear magnetic resonance using similarity calculations, differential NMR and hierarchical cluster analysis

The 1H NMR spectra obtained from 56 different paracetamol tablets were thoroughly investigated to analyse and quantify besides paracetamol, the excipients and eventual minor components present in the formulations. In the NMR spectra the amide-iminol tautomerism of paracetamol was observed, with the iminol form present at a quantity of only 0.80% of the amide form. Furthermore, seventeen different components of the tablets were identified, ranging from major excipients like starch and polyvinylpyrrolidone (PVP) to minor components like different parabens, sorbate and triacetin. The similarity from all spectra in relation to each of the other spectra was calculated and based on the similarity table a hierarchical cluster analysis (HCA) was performed. Each of the components of the DMSO extracts of the tablets was quantified, providing a component table, which also was used for HCA. The quantitative analysis of paracetamol was determined to have a precision of 0.2% using the residual solvent signals as internal standard. The HCA of the similarity data and the component table were compared with the HCAs obtained by analysis of the crude NMR data. This clearly shows the limitations of multivariate data analysis and the strength of similarity calculations combined with differential NMR, especially in relation to the analysis of trace components. In fact, the spectrum is not a series of unrelated variables, but a superposition of a limited number of component spectra, and the quantities of these components were determined.

Effect of Varying Parameters on the Properties of Effervescent Paracetamol Tablets for Paediatrics

Aims: This study was aimed to determine the effect of varying parameters on the properties of effervescent paracetamol tablets for paediatrics.
 Study Design: This analytical study was carried out on effervescent paracetamol tablets formulated with differing formulation parameters.
 Place and Duration of Study: This study was carried out in the Faculty of Pharmacy, Delta State University and Abraka from April 2017 to November, 2017.
 Methodology: Different formulations of effervescent paracetamol tablets were produced through wet granulation method using varied concentrations of citric acid (15, 20 and 25 %) and sodium bicarbonate (15, 20 and 25 %) as the major effervescent ingredients. The powder blends were evaluated for angle of repose, tapped and bulk density to determine its flow property. The prepared tablets were further evaluated using the unofficial test for hardness, friability and thickness as well as the official tests for weight uniformity, disintegration time, carbon dioxide (CO2) content, water content and pH.
 Results: Angle of repose ranged from 23.96 ± 1.97o - 28.84 ± 0.91o, Hausner’s ratio ranged from 1.16 ± 0.02 – 1.25 ± 0.02 while Carr’s index ranged from 14 ± 1.73 - 20 ± 1.15. All the granules had good flow properties while granules for F3 was the optimized formulation. Friability values were from 0.38 - 0.39 %. Tablets disintegrated between 3 ± 43.06 to 5 ± 16.3 min. The effervescence time in all formulations was between 3 to 5 mins with batch F3 giving the best effervescence time.
 Conclusion: Granules made with Formulation F3 had the optimized flow characteristics. Effervescent paracetamol tablets containing 25% each of citric acid and sodium bicarbonate had the most desired properties as increase in both the concentration of the citric acid and sodium bicarbonate led to a decrease in the disintegration and effervescence time.