Paracetamol: Friend or Foe

1
Paracetamol Friend or Foe

• Annie Moulden (Paediatrician)
• Mike South (Paediatrician)
• Soula Zambetis (Senior Clinical Pharmacist)
• Royal Childrens Hospital, Melbourne

2
Paracetamol Friend or Foe

• This Clinical Practice Review meeting was
  triggered by the recent report of a death of a
  child in NSW from paracetamol toxicity when the
  drug was given with therapeutic intent.
• A summary of the NSW Coroner findings can be read
  at
• www.rch.org.au/genmed/media/NSW-Coroner-on-paracet
  amol.pps

3
Paracetamol quotes

• Ive been giving her Panadol but it isnt
  working - I cant get her temperature down
• Could you write him up for a routine paracetemol
  order just in case

4
Paracetamol - history
1893 paracetamol discovered in patients urine
by doctors working on phenacetin (toxic) 1948
established that paracetamol was a metabolite
phenacetin and the major active agent. 1956
1st commercial UK tablet (prescription
only) 1963 Listed in British Pharmacopoeia as
OTC 2000 gt US 3.3 billion a year
worldwide (? 50 billion doses)
Lim, Cranswick, Skull South 2002 In a recent
community survey of Victorian primary aged
children 37 (564/1534) took paracetamol in last
2 weeks.
5
RCH Usage

• Most commonly prescribed drug
• Monthly figures
• 630 x 100 mL (240 mg/5 mL) bottles 63 Litres /
  Month
• 230 x 24 pk, 500 mg tabs 5520 tabs / Month