title: Intravenous paracetamol as an antipyretic and analgesic medication: the significance of drug metabolism.
abstract: One prospective, open-label, non-randomized study was conducted in 100 patients to define the antipyretic and analgesic effect of a new intravenous formulation of 1 g of paracetamol; 71 received paracetamol for the management of fever and 29 received paracetamol for pain relief after abdominal surgery or for neoplastic pain. Serial follow-up measurements of core temperature and of pain intensity were done for 6 h. Additional rescue medications were recorded for 5 days. Blood was sampled for the measurement of free paracetamol (APAP) and of glucuronide-APAP and N-sulfate-APAP by an HPLC assay. Defervescence, defined as core temperature below or equal to 37.1°C, was achieved in 52 patients (73.2%) within a median time of 3 h. Patients failing to become afebrile with the first dose of paracetamol became afebrile when administered other agents as rescue medications. Analgesia was achieved in 25 patients (86.4%) within a median time of 2 h. Serum levels of glucuronide-APAP were greater among non-responders to paracetamol. The presented results suggest that the intravenous formulation of paracetamol is clinically effective depending on drug metabolism.
authors.affiliation: Fourth Department of Internal Medicine, University of Athens, Medical School, Greece.
authors.forename: Evangelos J
authors.initials: EJ
authors.lastname: Giamarellos-Bourboulis
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Spyridaki
authors.forename: Athina
authors.initials: A
authors.lastname: Savva
authors.forename: Marianna
authors.initials: M
authors.lastname: Georgitsi
authors.forename: Thomas
authors.initials: T
authors.lastname: Tsaganos
authors.forename: Maria
authors.initials: M
authors.lastname: Mouktaroudi
authors.forename: Maria
authors.initials: M
authors.lastname: Raftogiannis
authors.forename: Anastasia
authors.initials: A
authors.lastname: Antonopoulou
authors.forename: Vassilios
authors.initials: V
authors.lastname: Papaziogas
authors.forename: Fotini
authors.initials: F
authors.lastname: Baziaka
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Sereti
authors.forename: Petros
authors.initials: P
authors.lastname: Christopoulos
authors.forename: Androniki
authors.initials: A
authors.lastname: Marioli
authors.forename: Theodora
authors.initials: T
authors.lastname: Kanni
authors.forename: Panagiota
authors.initials: P
authors.lastname: Maravitsa
authors.forename: Ilianna
authors.initials: I
authors.lastname: Pantelidou
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Leventogiannis
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Tsiaoussis
authors.forename: Korina
authors.initials: K
authors.lastname: Lymberopoulou
authors.forename: Ioannis M
authors.initials: IM
authors.lastname: Koutelidakis
mesh_terms: D015746:Abdominal Pain / Q000188:drug therapy*; D000082:Acetaminophen / Q000008:administration & dosage* / Q000097:blood / Q000378:metabolism* / Q000493:pharmacokinetics; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005334:Fever / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007239:Infections / Q000150:complications; D007262:Infusions, Intravenous; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D010148:Intractable Pain / Q000188:drug therapy*; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015850:Interleukin-6; D000082:Acetaminophen