eli5 How does paracetamol work?
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At a simple level: Body produces something called prostaglandins which cause swelling/pain/fever in response to infection or injury. Paracetamol ( Tylenol) weakly blocks the production of these prostaglandins 🙂
Brain scans suggest it affects your perception of pain. It decreases connections in the pain of your brain that creates a pain sensation.
A way to think about it is to compare the pain of hitting your toe at work vs hitting your toe at 3am on the way to the toilet. The pain stimulus is the same but the perception is different. Panadol is similar.
It has other effects but they all seem fairly mild compared with its effect on the brain
My understanding is that paracetamol reduces pain & fever, and is safe to use. We have known this for a long time, but we never quite figured out how it works. Only that it does.
I checked [HealthDirect](https://www.healthdirect.gov.au/paracetamol) which seems to support this.
> “Paracetamol has been in general use for more than 50 years, but the way it works to reduce pain and fever is not fully understood.”
I have a chemistry background, but never did any bio or pharmaceutical studies. So someone else would have to chime in with more info.
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We don’t know exactly yet.
Regarding other painkillers like Ibuprofen/Naproxene/Asprine/Metamizol (so called NSAID/NSAR), they all influence one of your bodies enzymes (as you requested an Eli5: A tiny chemical tool that will produce or modify something), called cyclooxigenase (COX). This enzyme produces substances that will cause fever, pain etc. because these symptoms are a warning sign to your body that something is wrong.
A really basic explanation lacking many things: NSARs will reduce the activity of COX and therefore will inhibit the production of substances that cause fever, pain etc..
Paracetamol however, is different. There are multiple theories, but the one that’s taught in medical school mostly is, that paracetamol modifies the way your brain will perceive pain.
eli5: Your brain will think about pain as less terrible and less alarming when it’s under the influence of paracetamol, either because the pain information is received less & later and/or the understand of „pain“ is changed.
Btw: Changing the perception of pain is the major effect of all opioids. They are several magnitudes more efficient then paracetamol but also far more dangerous.
We do not actually know yet in detail, but there are multiple mechanisms of action discussed.
1. A Inhibition of an enzyme called COX. It Transform Arachidonic acid into Prostaglandins (and other products) which are proinflammatoric. Opposite to other NSAIDs there might be a third Isoform of this enzyme involved ; COX-3. To this day there is no proof to this theory.
2. Paracetamol may form a metabolte called “AM404”.
It’s basically Paracetamol bound to an Arachidonic acid.
This metabolite shows similarities to the endogenic Ligand of Cannaboid Receptors which is called Anandamide. So there may be a pain relieving effect from activating the Cannabinoid system.
The top answers here are incorrect. We actually don’t know how paracetamol works. It is not a cox inhibitor like aspirin.
Op here!
I’m not sure who to trust much since everyone is saying different things.
Isn’t it just Tylenol but in the UK?
Like you’re 5? Magic pill make booboo go away
Like you’re 50? Still don’t know. Perhaps magic
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