Every individual will definitely experience the unpleasant feeling of shivering while the body is hot as blazes. This phenomenon is known as fever which is usually manifested when we are attacked by various invading microorganisms leading to an infection. During the infection, our body will release certain mediators and proteins in response to the toxins of invading microorganisms, where inflammation will set in. These fever-producing mediators are thought to increase the limit set by the thermal regulatory centre in the hypothalamus, eventually leading to heat-producing behaviours such as vessels constriction and shivering to achieve the new thermal set point.

We are exposed to these microorganisms daily as they linger in every corner across the globe. Infection sets in when our immune system is down or when our immune system is unable to recognise the invaders, delaying the activation of the immune response to eliminate them. The virus is the most common organism responsible for the occurrence of fever in most of the case and we will always consume the infamous Panadol whenever we have fever. So, how does Panadol, also known as paracetamol act as the medicine for viral fever?

Paracetamol is categorized under Non-steroidal Anti-inflammatory drug (NSAID) where it is a weak cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) inhibitor. The exact mechanism for paracetamol is still not known to date, but it is postulated to relieve fever by acting directly on the thermal regulatory centre in the hypothalamus. Although paracetamol is placed under the group of NSAID, it only exerts a weak effect on relieving inflammation because it does not act on the COX-1 and COX-2 enzymes peripherally, making it not as effective as other medications under the group.

It does a decent job in relieving pain and fever. When active ingredients of paracetamol bind to the enzyme in the hypothalamus, it will start to inhibit the production of fever-producing mediators which are the prostaglandins, bringing forth the effects such as peripheral dilation of vessels, sweating, and ultimately loss of body heat which is much needed in a fever patient. Since paracetamol does not affect enzymes peripherally, it brings outstanding advantages when compare to other fever relieving medications. It will not stimulate breathing system or the acid-base balance in our body, not to mention, it will also not irritate our stomach which we see in the conventional medications such as aspirin.

Paracetamol is generally well-tolerated and safe unless one has an allergy towards it. Like any other medications, overdosage will cause poisoning which is fatal in severe cases. It is recommended to take this medication in the dose of 1g 4 times daily for an adult whereas for children is recommended with a dose of 500mg 4 times daily. In the case of paracetamol poisoning, patients will experience nausea, vomiting, abdominal pain especially right upper quadrant where the liver is located, blood in urine, hypoglycemia and if left untreated, patients will fall into a coma and subsequently death. Thus, it is important to be aware of this condition as this medication can get easily from any pharmacy in town, so use it with care and also remember not to abuse it.