December 9, 2022

Paracetamol, also known as acetaminophen, is used as an antipyretic drug to treat fever. It is also commonly used as an analgesic to relieve mild pains like headache. In adults, the dose of paracetamol is 500 to 1,000 milligrams every four to six hours. The maximum dose is four grams in any 24-hour period. The drug is available in 500mg tablet and in injectable form in hospital setting in persons who cannot take the drug by mouth. The blood level attained through oral or injection is the same.
Paracetamol is not used to prevent fever or pain, it is used only as needed. If not used as prescribed, prolonged and frequent use of paracetamol can cause heart, liver, or kidney damage.
Decongestants are used for stuffy nose, but observe precautions because these drugs can have adverse effects. For example, cardiovascular complications may be associated with phenylpropanolamine (PPA). One of its effects is constriction of blood vessels, leading to further elevation of blood pressure in hypertensive patients. Irregular heart rhythm (arrhythmia) and bleeding in the brain (hemorrhagic stroke) are other adverse effects associated with the use of PPA.
Stocking up on several tablets of paracetamol or acetaminophen and other medications and self-medication may delay much-needed medical attention.
Consider these when you use over-the-counter drugs: the side effects of the drugs; drug interactions; dosage and dose adjustment in the presence of medical conditions that affect processing and elimination of the drug; contraindications like allergy, liver disease, heart disease, and impaired kidney function; and drug combinations: Paracetamol may already be part of a drug combination that you also take. For example, paracetamol is combined with tramadol, another analgesic.
Paracetamol is also commonly combined with decongestants.
Is it influenza (flu) or is it Covid-19? Is it influenza plus Covid-19?
The symptoms overlap including cough, headache, body pains, fever. The way to differentiate between the two is through viral testing.
Influenza weakens one’s immune system, and bacterial infection can set in. The most common complication of flu is bacterial pneumonia. SARS-CoV-2 itself can cause lung damage through an inflammatory process.
Oseltamivir (Tamiflu by Roche Company) is an oral drug used for pre-exposure and post-exposure prophylaxis against influenza. Its dose is adjusted if a person has liver or kidney function impairment.
Updates on SARS-CoV-2 and Covid-19 include the following:
– Early studies indicate that compared to the Delta variant, Omicron causes less severe disease. Omicron, however, has a high transmissibility and immune evasion that can lead to a high number of people who will get infected and seek admission to hospitals. Infections are usually mild in fully vaccinated and/or boosted persons, but may be severe and fatal among those who are unvaccinated.
– Early data on Omicron show that the severity of infection increases with age, in the presence of co-morbid conditions, and in unvaccinated persons.
Omicron can infect and reproduce in the upper airways (bronchus/bronchi) faster and better than the Delta variant but causes less severe infection of the lungs.
Initial studies show that waning of vaccine effectiveness against symptomatic infection occurs faster with Omicron than with Delta, but vaccine effectiveness conferred by the vaccines against severe disease is sustained during Omicron infection, especially after a booster dose. The risk of hospitalization is lower for Omicron cases after two and three doses of vaccine, with 77 to 85 percent reduction in the risk of hospitalization after three doses, as compared to unvaccinated Omicron cases.
– Booster doses maintain and optimize vaccine effectiveness against severe disease, particularly among persons at high risk of serious illness.
The Omicron variant appears to have no effect on the diagnostic accuracy of routinely used PCR and antigen detection rapid diagnostic tests.
Of the drugs that are currently being used in the treatment of Covid-19, corticosteroids and interleukin-6 receptor blockers are expected to remain effective in treating severe Omicron disease. Initial studies, however, show that some of the monoclonal antibodies developed against SARS-CoV-2 have reduced ability to neutralize Omicron and only sotrovimab is anticipated to be active against the variant.
Outpatient treatment of high risk Omicron cases may include the use of oral nirmatrelvir/ritonavir (Paxlovid) given within five days of symptom onset reduces the risk of hospitalization or death by 88 percent, oral molnupiravir given within five days of symptom onset, intravenous remdesivir given within seven days of symptoms, and intravenous sotrovimab given within 10 days of onset. Drug interactions, efficacy, ease of delivery, safety in pregnancy and children are some of the factors considered in their use.

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