ACETAMINOPHEN (PARACETAMOL) ABUSE IN NIGERIA

Paracetamol is the most commonly abused over the counter analgesic in Nigeria. Often times people take more than the prescribed dose (overdose) and claim that the normal dose doesn't give the therapeutic effect.

Cases have also been reported of people using Paracetamol as meat tenderizer in Nigeria, the long term effect of paracetamol abuse may result in liver problem.

In this blog post we will try to show why you shouldn't take paracetamol more than the prescribed dose and the dosage regimen.

Acetaminophen (also known as Paracetamol) is a commonly used over-the-counter pain reliever and fever reducer. It is widely available and considered safe when taken at recommended doses. However, the abuse of this medication can have serious consequences.

Pharmacology of Acetaminophen:

Acetaminophen is a weak inhibitor of the cyclooxygenase (COX) enzymes, which are responsible for the production of prostaglandins, molecules that play a role in pain and inflammation. Acetaminophen is believed to work mainly in the central nervous system by blocking the synthesis of prostaglandins in the brain. This makes it effective in relieving pain and reducing fever.

Pharmacokinetics of Acetaminophen:

When taken orally, acetaminophen is rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It is metabolized mainly in the liver, where it is conjugated with glucuronic acid or sulfate before being excreted in the urine. A small fraction of acetaminophen is metabolized by the cytochrome P450 system to form a reactive intermediate, N-acetyl-p-benzoquinone imine (NAPQI). NAPQI is normally detoxified by conjugation with glutathione, but in cases of overdose, the glutathione supply becomes depleted, and NAPQI can bind to cellular proteins, leading to hepatotoxicity and potentially fatal liver damage.

The Effect of Overdose:

Taking more than the recommended dose of acetaminophen can result in liver damage and other serious health problems. The risk of liver damage increases with the amount of acetaminophen consumed, and with repeated doses over time. Overdose can occur accidentally or intentionally, and symptoms may not appear for several hours or even days after ingestion. Symptoms of acetaminophen overdose include nausea, vomiting, abdominal pain, and loss of appetite. In severe cases, overdose can cause liver failure, coma, and even death.

Binding of Glucuronic Acid in the Liver:

The binding of glucuronic acid in the liver is a crucial step in the metabolism of acetaminophen. When taken at recommended doses, the liver can easily conjugate acetaminophen with glucuronic acid, allowing for safe excretion in the urine. However, when taken in excess, the liver's ability to conjugate acetaminophen with glucuronic acid becomes overwhelmed, leading to the formation of toxic metabolites, such as NAPQI.

In conclusion, acetaminophen is a safe and effective pain reliever and fever reducer when used as directed. However, abuse of this medication can result in serious health problems, particularly liver damage. It is important to always follow the recommended dosage instructions and to seek medical attention if you suspect an overdose. Remember, "the dose makes the poison."

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