Paracetamol, Ibuprofen and Diclofenac uses in pediatric cases.

1. Paracetamol
Ibuprofen
Diclofenac
.
By Hassan Haval Haji

2. Paracetamol = Acetaminophen
Painkiller
Antipyretic

3. Debatable
COX2 theory
Mechanism of Action

5. Routes of Administration
Orally (Syrup, tablet, chewable tab)
Suppositories
IM
IV infusion

6. Side Effects
Very safe
Allergy (very rare)
Overdose — deliberate or accidental
Hepatonecrosis
and less frequently renal damage
Antidote → N-acetylcysteine (NAC)

7. Painkiller
Antipyretic
Anti-inflammatory
Ibuprofen & Diclofenac
→ Non-Steroidals (NSAIDS)
Non-selective inhibitors of an enzyme called cyclooxygenase (COX), which is
required for the synthesis of prostaglandins via the arachidonic acid pathway.
Mechanism of Action

9. Ibuprofen (Advil)
Routes of Administration
Orally (Syrup, tablet, capsule, chewable tab)
IV infusion
Other indications
PDA IV
CF orally
JIA orally
Profen Syrup 100mg/5ml 30mg/kg ÷3

10. Diclofenac (Voltarin)
Other indications
Perioperative acute pain
Post-traumatic
Routes of Administration
Orally
IV
IM
Suppositories

11. Contraindications (Side Effects)
Asthma Exacerbate bronchospasm
Stomach Increase acidity – ulcers – UGIB, perforation – sepsis
Coagulation defects Some prostaglandins are antithrombotic.
Ductal-dependent CHD, Heart attack
Renal impairment (very common)
Children under 3 months Immature kidney
Children with anemia & jaundice Drug-induced hemolytic anemia

12. Qs