The present controversy over prescribing nimesulide in children
because of its adverse effects switched back the Pediatricians to
paracetamol. As per the National Essential Drug List of Government of
India(1), paracetamol is in the priority 1 i.e., drugs selected
by ³76% pediatricians. But, the different concentration of paracetamol
in the available brands in drops and syrup may expose the children
towards more adverse effects because of overdosing. Under dosing may
lead to improper desired clinical response.
The clinical response to usual recom-mended dose of
a drug can vary considerably, even when the dose is administered
relative to a patient’s body weight, surface area and stage of
maturation(2). Because of these practically all formulations available
in the market should have uniform concentration in drops/syrups.
Presently, the available brands are having different concentrations
e.g., Calpol120 mg/ 5 mL (Wellcome), Cofamol 250 mg/5 mL (CFL),
Crocin 125 mg/5 mL (Gsk), Pacemo 150 mg/5 mL(Ashok Pharma), Pacimol
125 mg/5mL (IPCA), Ultragin 125 mg/5 mL (Wyeth Ledrle), Lotemp 250
mg/5 mL (Raptakos), similarly most of the drops contain 150 mg/mL
paracetamol but some of the brand (T-98) contain 100 mg/mL of
paracetamol(3,4), Nelson Textbook of Pediatrics recommends 120 mg/2.5
mL in syrups and 100 mg of paracetamol in 1 mL in the drop
preparations(2) .
Clinical Pharmacology is concerned with the
integration of a drugs pharmacokinetic and pharmacodynamic profile to
optimize drug therapy. Rational prescribing of drugs depends on a
fundamental understanding of a drug’s pharmacokinetic and pharmaco-dynamic
profile. The ability to estimate a drug’s pharmacokinetic parameters
accurately permits the determination of the dose and dose interval to
achieve a defined target concen-tration, desired pharmacologic effect,
or both. It depends largely on the composition and formulations of the
drug available in the market with trade names(1).
Ajay Gaur,
Assistant Professor, Pediatrics,
G.R. Medical College, Gwalior,
India
E-mail:
[email protected]
