Insight On Paracetamol, Amoxycillin, And Their Mechanism Of Action: A Review

Mechanism of Action of Paracetamol

Although the drug was invented about 100 years ago, its mechanism of action has not been distinguished. Such aspects can be attributed to its antipyretic and analgesic properties, the same as NSAIDs. However, they do not have any anti-inflammatory activities. When used to the commended doses, it does not prompt any typical NSAIDS gastrointestinal side effects. Since it does not have any anti-inflammatory elements, paracetamol is not considered part of the NSAIDs. Paracetamol acts like a reducing factor when it comes to ferryl photopryin IX radical cation within the peroxidase site enzymes (Miotke-Wasilczyk, 2021). Previously, it was revealed that Paracetamol has both antipyretic and analgesic properties through acting centrally.

Its inhibitory impacts impact COX1 and COX2 activities, including prostaglandin synthesis, which was very low. Such ideas and concepts were based on the fact that ethanol was reported to decrease the synthesis of prostaglandin, which was ten times as compared to the brain. COX-1 isoforms could not be identified because isoenzyme was only noticed in the 1990s. However, the notion that the COX-1 and 2 reliant on central mechanism of the drug has not stood the taste of time. Generally, Paracetamol is an effectual analgesic specifically when it comes to the administration to pain and other illnesses. Its mechanism of action however is yt to be determined  and is more probably going to involve various pathways of pain. Although its clinical significance is viewed as being equivocal, the drug has the aptitude of exerting impacts virtually organ systems, which calls for more research. However, it is essential to be aware that toxicity may occur even within the recommended dose range in certain patient groups since it affects the metabolism of the body. There have also been various reports that the toxicity of the drug on children is high in regards to formulation.

Amoxicillin mainly consists of the penicillin-binding protein 1 and other binding proteins with higher molecular weight. The proteins are primarily liable for transpeptidase and glycosyltransferase responses which often result in the cross-linking of  D-aspartic acid in the wall cells of the bacteria. Without the action of the penicillin-binding proteins, the bacteria tend to regulate and control the autolytic enzymes (Akhavan et al., 2020). Besides, they are incapable of building and repairing the walls of cells. Such aspects often result in bacteriocidal actions. Generally, amoxicillin acts by constraining the combination of bacterial cell walls. It further prevents the cross-linkage between the linear peptidoglycan polymer chains, which consist of various significant elements of the cell wall of both the gram-negative and positive bacterias. The drug works the same way as penicillin, especially when it comes to its bacterial action against the susceptible bacteria during the stages of active multiplication. It also acts by restricting the cell wall biosynthesis, which results in the death of the bacteria. The administration of amoxicillin may also be an incorporation of the beta-lactamase inhibitors. There are various examples of such types of administration, including sulbactam and clavulanic acid.

The drug is rapidly absorbed after being administered orally and it reaches its peak between 1 and 2 hours of dosing. However, it may take between 24 and 72 hours of regular dosses in order for the symptoms caused by infection begins to fade. The drug is effectively distributed throughout the body tissues and fluids with the exemption of the brain and the spinal cord. It penetrates through the meninges where it is inflamed. It works by synthesizing the cell wall mucopeptides which weakens and further destroys the cell wall of the bacteria. It may be used to treat other infections like lower respiratory tract, and nose and throat infections.

Insight on Amoxycillin

There are various side effects related to the drug Vaxzevria. Based on the research conducted, 68% injection site pain, 58% of individuals reported experiencing headache, 53% reported experiencing fatigue, 44% experienced pyrexia, and 22% reported experiencing nausea. Most of the adverse reactions range from mild to moderate when it comes to severity. They were further resolved within a few days after vaccination. Few cases of thrombosis accompanied by thrombocytopenia have been reported within the first three weeks after being vaccinated. The adverse effects experienced after the second dose were more mild and less frequent

 compared to the first dose. The drug may further result in pain in the joints  especially arms and legs, swelling and redness in the region where the injection has been done, feeling sick especially vomiting and diarrhea and flu-like symptoms like muscle aches, sore throat, running nose and chills.  Some of the rare side effects includes severe allergic reactions, the occurrence of blood clots  that is accompanied by lower levels of platelets, swelling that occur under the skin and the capillary leak syndrome where  the fluid leaks in the body resulting in swelling and decrease in blood pressure.

Regarding the nursing interventions, there are various factors that nurses should consider before administering the drug to the patient. The first consideration is that they should avoid prescribing the medication to patients who experience a severe allergic reaction to any medical ingredient found in the vaccine. They should further prevent it when the patient experiences an allergic reaction after administering the first dose. The second consideration is avoiding administering the drug to patients who have experienced blood clots and low blood platelets in the past.

Metformin should be stored at room temperature and away from light and excess heat. Individuals should further note that the unneeded medicine should be disposed of away from children, pets and other individuals who can easily consume them. Metformin should, however, not be flushed down the toilet. Instead, the medicine take-back program is the best way of disposing of them. Individuals should talk to their pharmacist or further contact their recycling department to learn about various take-back programs located in society. They can further view the FDA Safe Disposal of Medicine websites for additional information if they are unable to access any take-back programs.

Additionally, in order to protect children from poisoning, one should ensure that the lock safety caps are placed and place the medication in a safe location, especially one which is away from their sight. The shell life of metformin is about 12 months. Patients should also read the information on the template attached to the medicine. In case of any questions, one should ask their doctor. Patients should also follow the meal plan that the doctor offers, which plays a significant role in helping to control the condition. It is further necessary for medicine to work effectively. Metformin should be left packaged in its own storage container to prevent contaminating the drug. It is essential for patients to have a conversation with the doctor or the pharmacists inorder to determine if their dosage needs to be reduced. The medicine should not be administered among patients who have clinical and laboratory evidence of the hepatic disease. Patients should avoid excessive consumption of alcohol during medication since it will impact the lactate metabolism. The drug is highly diazybale which is the reason why hemodialysis is strongly recommended to fix the acidosis and eradicate the accumulation of metformin.

The first consideration is that nurses should be able to teach their patients about various drug interactions of the drugs. Secondly, they should tell the patient about the significance of establishing a daily routine to assist in maintaining the hormone levels. Levothyroxine should be taken on an empty stomach with water one hour before eating. Substances like coffee have been proven to interfere with the absorption of the drug. Thirdly, they should be aware that the drug tends to be incompatible with various medications and thus should be consumed alone. Medicines which bind Levothyroxine and decrease the biovilatlly consist of elements including calcium supplements, bile acids and magnesium. In addition, consuming the drug with anticoagulants may significantly increase its impact. With medications like anti-acids, the nurse must advise the patient to allow for 4 to 6 hours to pass before swallowing the following medicines. Although patients are often traditionally instructed to take the drug the first thing in the morning on an empty stomach, a randomized study demonstrated that taking it at bedtime often leads to better absorption. Such schedules may significantly change and can be helpful to patients who take the medications in the morning. For discharge and home care, nurses should advice their patients to comply to the medication since not taking the drug may decrease the effectiveness of the drug and further cause the disease to re-occur. There is also the need for nurse to caution the patient against being exposed to extreme cold temperature until their conditions significantly improves. The patient should go for the follow-up visits to ensure that the drugs is effective and does its role.

References

Akhavan, B., Khanna, N., & Vijhani, P. (2020, August 27). Amoxicillin - StatPearls - NCBI bookshelf. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK482250/

Miotke-Wasilczyk, M., Józefowicz, M., Strankowska, J., & Kwela, J. (2021). The role of hydrogen bonding in paracetamol–solvent and paracetamol–hydrogel matrix interactions. Materials, 14(8), 1842. https://doi.org/10.3390/ma14081842