Use Of Paracetamol In Children Research Articles

Assessment of Paracetamol Usage Practices and Perceptions among Caregivers for Children Post-COVID-19 in Saudi Arabia: A Cross-Sectional Analysis.

Caregivers often use paracetamol in the management of pediatric illnesses without a clear rationale. This study evaluated the perception and practices of caregivers regarding the use of paracetamol in children in Southwestern Saudi Arabia. This study involved a cross-sectional design involving 373 caregivers of children under twelve. The questionnaire elucidated the reasons, usage frequency, and safe usage practices. Data were analyzed using SPSS, applying Chi-square tests and logistic regression. Most caregivers were in the age range of 31-40 years, and with intermediate education. Paracetamol was mainly used for fever, generalized pain and, diarrhea, with fewer opting for other self-care measures. Caregivers with primary or less education were more likely to perceive paracetamol as safe (AOR = 2.98 (1.3-6.73), p = 0.009) and less inclined to check warning labels (AOR: 0.11 (0.05-0.25), p < 0.001) and expiry dates (AOR: 0.063 (0.027-0.14), p < 0.001). The caregiver's education level significantly influenced the determination of treatment duration (χ2 = 21.58 (4), p < 0.001), dosage (χ2 = 30.70 (4), p < 0.001), and frequency of administration (χ2 = 17.77 (4), p = 0.001). In conclusion, inadequate health literacy can result in a lack of attention towards crucial safety information about pediatric paracetamol use. Hence, counselling initiatives should be undertaken to ensure the safe and effective use of paracetamol in children.

An assessment of parents’ knowledge, awareness and practice regarding paracetamol use in children

Introduction: Paracetamol is an effective antipyretic and analgesic medication also known as acetaminophen and it is over-the-counter medication although it is widely prescribed to treat mild to moderate pain and fever but at same time it could have minor side effects like lowering blood pressure or increasing heart rate or allergic reaction (rash and swelling). Previous studies confirmed that there is a lack of information among the general population about how to take paracetamol and deal with the dosage which includes what is the maximum dose and how many times to take it daily (frequency). Most previous studies were done out of Saudi Arabia and to the best of our knowledge there are a lack of studies on the topic in Saudi Arabia. For that reason, our aim in this study was to assess parents’ knowledge, awareness and practice regarding paracetamol use in children and to evaluate whether doctors and pharmacists in hospitals or pharmacies educate the parents about this medication or not. Methodology: A Descriptive Cross-sectional Study was done via a validated questionnaire on the general population in the Western Region of Saudi Arabia. This study was conducted in July-August 2021. The questionnaire has been used in previous studies and it is validated. The questionnaire is divided into four parts that comprises 32 questions; the first about socio-demographic data, the second part to assess parents’ awareness, the third part to assess parents’ knowledge and the fourth part assessing parents’ practises. Results: The study consisted of 502 participants, 52.4% females and 47.6% males. More than half of the participants (58.8%) do not use paracetamol without doctors’ consultation. Regarding Knowledge score among participants, the mean score was 2.089, out of 6. There is a significant relationship between Knowledge and Mother’s educational level (P= 0.016). On the other hand 48.6% used syrup as their most commonly used form of treatment. Conclusion: This study emphasises the need for increasing caregivers’ education on paracetamol use and its side effects. Overall the knowledge score was unsatisfactory. The study found a significant association between parents who had a university degree and their higher knowledge scores. Although most of the participants would consult their doctors before administering paracetamol, it showed no positive impact on their knowledge and practises towards antipyretics dose and side effects, which indicates a need for campaigns or educational programs on fever management. Keywords: Paracetamol, Acetaminophen, Parents, Children.

Optimisation of acute pain treatment in children in abdominal surgery at the stages of the perioperative period

The aim of the study. To improve the quality of perioperative analgesia by combined multimodal use of paracetamol and ketorolac tromethamine in children after abdominal surgery.&#x0D; Materials and methods. 48 children (6-17 years old) with choledochal, pancreatic cysts, hepatic echinococcosis, and abdominal trauma. The study period was from January 2021 to January 2022. Group 1 (main group, n=28): baseline analgesia - 15 min before surgery, intravenous paracetamol administration at 25-30 mg/kg. In order to prevent postoperative pain syndrome 15 minutes before the end of the surgery, we administered ketorolac and tromethamine in a dose of 0.5 mg/kg. Pain relief was repeated 6-8 h later with ketorolac at a dose of 0.5 mg/kg. Group 2 (comparison, n=20), who received 0.2 – 0.3 mg/kg promedol (trimeperidin) in the postoperative period. Both groups received standard endotracheal anaesthesia (propofol + fentanyl + arduan against the background of Low-flow anaesthesia with sevoflurane MAK=1). Systemic haemodynamics, C-reactive protein, and glucose were investigated, and a visual analogue scale was applied at the main stages of the study.&#x0D; Results: Analysis of the parameters of central hemodynamics, parameters of the operational stress response and clinical data showed that in the postoperative period, sufficient analgesic effect was established only in children in group 1 with the preventive combined administration of paracetamol and ketorolac on the operating table, which allows recommending them in the practice of perioperative analgesia during abdominal surgical interventions.&#x0D; Conclusions. Optimised method of preventive (preoperative) use of paracetamol in children at a dose of 25-30 mg/kg during abdominal surgery followed by administration of ketorolac tromethamine (15 minutes before the end of the surgery) increases the degree of nociceptive protection. It ensures high efficiency of postoperative pain relief, which allows to recommend it in the practice of perioperative analgesia for the above abdominal surgical interventions in children

Клинический случай токсического гепатита при применении парацетамола у новорожденного ребенка

Drug-induced liver injury is a rare but life-threatening phenomenon. Paracetamol is referred to as a drug with a direct dose-dependent hepatotoxic eff ect. Th e use paracetamol, even in therapeutic doses, is essentially safe, but requires a sensible approach while prescribing it to the risk groups and “off - label”. Th e use of paracetamol in children is limited at the age of less than 3 months. Signifi cant damage to hepatocytes by paracetamol in children is relatively rare and only occurs in 10% of the cases while taking potentially toxic doses of the drug. We have recorded a clinical case of toxic hepatitis development in a newborn aft er intravenous “off -label” administration of therapeutic doses of paracetamol in order to relieve the pain syndrome. Th is case is indicative of the fact that even therapeutic doses of paracetamol, as well as the predominantly sulfate pathway of drug biotransformation, which is typical for children under 14 years of age, does not rule out the possibility of toxic drug-induced liver damage. Taking into account the described case, there is a need to determine clear indications for “off -label” use of the drug in view of the possible toxic eff ect development.

Is paracetamol responsible for fatal acute liver failure in pediatric patients after hip dysplasia surgery?

It is well known that local complications, such as avascular necrosis and arthrosis can develop after surgery for developmental dysplasia of the hip (DDH). Thus far, systemic complications that may develop in such cases have not been identified in the literature. This study is the first case series to evaluate acute liver failure (ALF) development after DDH surgery in pediatric patients. Six patients, five female and one male, who underwent DDH surgery were selected for this study. Perioperative fasting time, laboratory values, treatments, histopathological evaluations, and prognoses after ALF in these patients were evaluated retrospectively. All the patients were administered paracetamol and sevoflurane in therapeutic doses. The patients were referred postoperatively to our pediatric emergency department after 5 ± 1.67 days (range = 3-7 days) on average. The average perioperative fasting time was 9.3 ± 0.82 hours (range = 8-10 hours). Due to the very high aminotransferases and use of paracetamol, intravenous N-acetylcysteine was administered alongside supportive treatments to all the patients. After liver transplantation, two of three patients with grade 3 encephalopathy, died in the early postoperative period. Histopathological evaluations of the three patients' explants were compatible with toxic hepatitis due to paracetamol. Paracetamol is a commonly used analgesic after pediatric surgery. The therapeutic dose of paracetamol remains uncertain in children who have been fasting for a long time and have been exposed to hepatotoxic drugs due to previous surgery. In conclusion, caution should be exercised in the use of paracetamol in children with DDH who will undergo surgery, and careful perioperative clinical and laboratory monitoring for ALF is essential.

Practical Challenges-Use of Paracetamol in Children and YouthWho are Overweight or Obese: A Narrative Review.

Worldwide, > 380 million children and adolescents are overweight or obese, including 41 million children aged < 5 years. Obesity can change the pharmacokinetic properties of drugs by altering their distribution, metabolism, and elimination. Thus, children who are overweight or obese are at increased risk for receiving inappropriate doses of commonly used drugs, which can result in treatment failure, adverse events, and/or drug toxicity. This review analyzes available data on paracetamol dosing for pain and fever in children and adolescents who are overweight or obese to identify gaps and challenges in optimal dosing strategies. Literature searches using Medline, Embase, and ClinicalTrials.gov were conducted to identify English-language articles reporting paracetamol pharmacokinetics, dosing practices, and guidelines in children and adolescents who are overweight or obese. Of 24 relevant studies identified, 20 were specific to overweight/obese individuals and 15 were specific to children and/or adolescents. Data on paracetamol pharmacokinetics in children and adolescents who are overweight or obese are lacking, and there is no high-quality evidence to guide paracetamol prescribing practices in these patients. Adult data have been extrapolated to pediatric populations; however, extrapolation does not address differences in paracetamol metabolism in adults versus children; the efficacy and safety effects of such differences are unknown. Given the growing worldwide prevalence of obesity in children and adolescents and the likelihood that paracetamol use in this population will increase accordingly, obesity-specific pediatric dosing guidelines for paracetamol are urgently needed. High-quality research is necessary to inform such guidelines.

SYMPTOMATIC THERAPY OF ACUTE RESPIRATORY INFECTIONS AND FLU IN CHILDREN

The article discusses approaches to therapy of acute respiratory infection (ARI) and flu. Some peculiarities of application of various non-steroid anti-inflammatory drugs in children are discussed. Data on effectiveness of paracetamol use in children with ARI and flu symptoms are provided.

Paracetamol-associated acute liver failure in Australian and New Zealand children: high rate of medication errors

BackgroundIn children, paracetamol overdose due to deliberate self-poisoning, accidental exposure or medication errors can lead to paediatric acute liver failure and death. In Australia and New Zealand, the nature of...

An evolving curse on paracetamol use in children

An evolving curse on paracetamol use in children

P242 Managing Etiology Questions With Grade

BackgroundCurrently the GRADE approach only considers the development of recommendations for treatment and diagnosis related clinical questions.ObjectivesTo develop a proposal using GRADE to formulate recommendations for aetiology questions.MethodsThe exposure to...

Proposed MHRA changes to UK children's paracetamol dosing recommendations: modelling study

Paracetamol is the most commonly administered medicine to children. A recent study highlighted the risk of overdose of paracetamol using British National Formulary for Children (BNFC) age-based dosing guidelines. This current study assesses the safety of changes to the UK paracetamol product dosing system proposed by the Medicines and Healthcare products Regulatory Authority (MHRA) which include a larger number of narrower age bands and a single dose per age band. Theoretical comparison of the proposed MHRA dosing system with the product dosing instructions of a commonly prescribed form of paracetamol in the UK. United Kingdom Participants Proposed MHRA dosing recommendations and current product dosing instructions were compared using a previously validated model. For both dosing recommendations, single and cumulative daily doses of paracetamol for boys and girls at the 9th, 50th and 91st centiles for weight were calculated for 3 month, 1 year, 6 year and 12 year age groups. With the current product dosing instructions, underweight children are at risk of receiving approximately two times the recommended single and cumulative daily dose of paracetamol, particularly at age 1 year and 6 years. This risk is negligible when the same model is applied to the proposed MHRA dosing system, whereby underweight, average weight and overweight children at all ages receive doses marginally above or within the recommended dose range or limit. The proposed MHRA dosing recommendations for paracetamol use in children are effective at reducing the risk of paracetamol overdose in children of all ages, when compared with current product dosing instructions.

Paracetamol use in children: is it as safe as we think?

AbstractThe authors explain why they think paracetamol, one of the commonest drugs prescribed, should be used with caution in young children. Copyright © 2011 Wiley Interface Ltd

Promoting Safe Use of Paracetamol in Children

ABSTRACTParacetamol is one of the most widely used analgesics and the most common medicine given to children in Australia. Its safety and efficacy when appropriately used is well established and its effects in acute overdose are well known to health professionals. However, gaps in knowledge of parents/carers of young children about its safe use are less recognised and may lead to unintentional misuse and harm. This paper aims to help bridge this knowledge gap and promote safe use of paracetamol in children. By using illustrative cases to highlight this problem, discussing the relevant literature, providing a parent/carer counselling checklist and resources for health professionals.

Paracetamol: overused in childhood fever

Paracetamol has a mild beneficial effect on the symptoms of viral illness in childhood; however, there are good reasons for limiting the use of paracetamol in children.