KOLEJ ANTARABANGSA TEKNOLOGI PROFESIONAL,PERLIS

DIPLOMA IN PHARMACY ( PA 8240 ) LAST SEMESTER FINAL PROJECT PRESENTATION (DFG 1023 )

( TO STUDY THE KNOWLEDGE AND THE USAGE OF PANADOL AMONG STUDENT SEMESTER 1&2 IN KATPM )

NAMA : IZATI ABU BAKARIC NUMBER : 900225086110LECTURER : EN.HASMADI HASSAN B. ABD HADIMEMBERS NAME : AHMAD ASIF MOHD AMIN NUR IZZATI OSMAN NOEM NADZRA ISMAIL UMMUL AMIRA BINTI MD NOH

NO. CONTENT PAGE

1. ACKNOWLEDGEMENT 3

2. ABSTRACT 4

3. OBJECTIVES 5

4. INTRODUCTION 6-12

5. METHOD 13

6. RESULT 14-20

7. DISCUSSION 21-22

8. CONCLUSION 23

9. REFERENCE 24

10. APPENDICES 25

ACKNOWLEDGEMENT

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In preparing this research, I get more knowledge and learn about the

drug use in patient. I do some research in internet and get information

about this panadol drug. It’s give many information to help me in doing

this research.

First at all, I was grateful to Allah s.w.t because give me a chance to

complete this research. I also want to say a lot of thank you to my

supervisors Mr. Hasmadi B. Hassan because give me a supports, critics,

advice and motivations to make this result . He also teach me to do a

research about how to get information with people. Without him, my

group will not complete this research successfully.

My sincere appreciation also extends to all my collageous because

their support and help me in finding the information about that drug.

Without them, my research will not be done like this. Not forgetful, I am

also very thankful to my parents for their moral support and advice to

me. Credit to all students semester 1&2 in KATPM fort their support.

ABSTRACT

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This study was conducted to identify the usage of panadol among the student

semester 1&2 community in KATPM. This is because the panadol is most likely to

be use in the wrong way. The objective of this research is to know the knowledge

and the usage of panadol among the student sem 1&2 in KATPM. This study is

conducted by met the students and collect the data. This study also to ensure the

student getting the exact information on panadol usage by distribute some handout

leaflet. They are several types of panadol that I focused in this research such as

common panadol, panadol actifast, panadol soluble, panadol extend and menstrual

panadol.

Panadol contain paracetamol or acetaminophen (in UK). Paracetamol belongs to

a class of drugs called analgesic and antipyretic. In fact, paracetamol prescribed as a

pain relief or pain killer. However, it just for the treatment of mild to moderate pain.

It also use to reduce body temperature or fever. Paracetamol is virtually free of side

effect. Skin rash and other allergic reactions have been described rarely. Prolong use

or overdose of paracetamol may cause hepatic failure. The dose required is 2 tablets

swallowed 3 times a day for adult and children over 12 years.

The main point that highlight in this research is that paracetamol usage pattern

among students. Panadol also the safest drug when taking in recommended dose.

And also the most dangerous drug if overdose. Paracetamol is very danger in

profuse uses. It should not be taken more than 6 times a day. In case of overdosage,

prompt treatment should be given. Panadol misuse also required to their source of

information and their misunderstanding.

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OBJECTIVE

Objectives of this research are :

to dertermine the knowledge of the usage of panadol among the student semester 1&2 in KATPM community.

to determine the pattern of the usage of panadol among the student

to determine whether the usage of panadol is influence by the advertisement.

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INTRODUCTION

What is paracetamol?

Paracetamol (international nonproprietary name) or acetaminophen is a widely used over the counter analgesic (pain reliever) and antipyretic (fever reducer). Paracetamol is part of the class of drugs known as "aniline analgesics".

Particular features of paracetamol : Its analgesic (pain relief) and antipyretic (fever relief) effects. There are virtually no groups of people who should not take it. Interactions with other treatments are not a problem. At the recommended dosage there are virtually no side-effects. It is suitable for small children and the elderly. It can be taken by those sensitive to aspirin. It is well tolerated by patients with peptic ulcers.

Others Paracetamol brand name :Panadol, febrex, milidon, uphamol, paramol, dusil, ifimol, weng heng tablet, panodil, paratab, tapanol, Tylenol.

Pharmacology of Paracetamol

Pharmacokinetics:Paracetamol is readily absorbed from the gastrointestinal tract with peak plasma concentrations occurring about 10 to 60 minutes after oral administration. Paracetamol is distributed into most body tissues. Plasma protein binding is negligible at usual therapeutic doses but increases with increasing doses. The elimination half-life varies from about 1 to 3 hours. Paracetamol is metabolised extensively in the liver and excreted in the urine mainly as inactive glucuronide and sulfate conjugates. Less than 5% is excreted unchanged. The metabolites of paracetamol include a minor hydroxylated intermediate which has hepatotoxic activity. This intermediate metabolite is detoxified by conjugation with glutathione, however, it can accumulate following paracetamol overdosage (more than 150mg/kg or 10g total paracetamol ingested) and if left untreated can cause irreversible liver damage. Paracetamol is metabolised differently by premature infants, newborns, infants and young children compared to adults, the sulfate conjugate being predominant.

Bioavailability Peak plasma Plasma half- Active Elimination

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level life metabolites

constant 80% 40 to 60 minutes 2 to 3 hours None Predominantly extrarenal

Bioavailability is significantly lower when the drug is administered rectally.

Pharmacodynamics/Mechanism of action :

Paracetamol is a p-aminophenol derivative that exhibits analgesic and antipyretic activity. It does not possess anti-inflammatory activity. Paracetamol is thought to produce analgesia through a central inhibition of prostaglandin synthesis.

Indications

It is commonly used for the relief of headaches, and other minor aches and pains. In combination with opioid analgesics, paracetamol can also be used in the management of more severe pain such as post surgical pain and providing palliative care in advanced cancer patients. The onset of analgesia is approximately 11 minutes after oral administration of paracetamol, and its half life is 1–4 hour.

Contraindications

Paracetamol is contraindicated for use in patients with known hypersensitivity or idiosyncratic reaction to paracetamol (or any of the other ingredients in the product)

Precautions

Paracetamol should be used with caution in patients with: impaired hepatic function impaired renal function

Use in pregnancy :Category A: Paracetamol has been taken by a large number of pregnant women and women of childbearing age without any proven increase in the frequency of malformations or other direct or indirect harmful effects on the foetus having been observed.

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Lactation :Paracetamol is excreted in small amounts (< 0.2%) in breast milk. Maternal ingestion of paracetamol in usual analgesic doses does not appear to present a risk to the breastfed infants.

Interaction with other medicines

The following interactions with paracetamol have been noted: Metoclopramide and domperidone may increase the absorption of paracetamol from the

gut. Paracetamol absorption is decreased by substances that decrease gastric emptying, e.g.

propantheline, antidepressants with anticholinergic properties, and narcotic analgesics Paracetamol may increase chloramphenicol concentrations The risk of paracetamol toxicity may be increased in patients receiving other potentially

hepatotoxic drugs or drugs that induce liver microsomal enzymes such as alcohol and anticonvulsant agents

Paracetamol excretion may be affected and plasma concentrations altered when given with probenecid

Cholestyramine reduces the absorption of paracetamol from the gut. It should not be taken within an hour of taking paracetamol or the effect of the paracetamol will be reduced.

Anticoagulant drugs (warfarin) - dosage may require reduction if paracetamol and anticoagulants are taken for a prolonged period of time.

Adverse reactions

Side effects of paracetamol are rare and usually mild, although haematological reactions have been reported. Skin rashes and hypersensitivity reactions occur occasionally.

Overdosage with paracetamol if left untreated can result in severe, sometimes fatal liver damage and rarely, acute renal tubular necrosis.

Dosage

Common Panadol : 500mg PCMPanadol actifast : 500mg PCMPanadol soluble : 500mg PCMPanadol extend : 665mg PCMMenstrual panadol : 500mg PCM

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Adults :The recommended dosage of paracetamol in adults is :

two 500mg tablets (i.e. 1gm paracetamol) every four to six hours, not exceeding 8 tablets (4gms) in any 24 hour period (1).

Children :Children's dosages vary with the age of the child and the type of product, therefore the instructions on the pack should always be followed.

In general,

children's dosages are based on a single dose of 10mg paracetamol per kilogram bodyweight, which can be repeated 4-6 hourly, not exceeding four doses per 24 hours.

On a doctor's recommendation only,

paracetamol may be given to a 2 month old child following immunisation as a single dose of 60mg (i.e. 2.5mL paracetamol liquid (oral suspension) at a strength 120mg per 5 mL).

For children under 3 months, on a doctor's advice only,

the dosage is 10mg paracetamol per kilogram body weight (5mg/kg if jaundiced).

For a child 3 months to 1 year of age,

a dose of between 60mg and 120mg (i.e. 2.5mL to 5mL of paracetamol liquid (oral suspension) at a strength of 120mg/5mL) may be repeated every 4-6 hours to a maximum of 4 doses in 24 hours.

For a child 1 to 5 years of age,

120mg to 250mg (i.e. 5mL to 10mL of paracetamol liquid (oral suspension) at a strength of 120mg/5mL) may be repeated every 4-6 hours to a maximum of 4 doses in 24 hours.

For a child 6 to 12 years of age,

250mg to 500 mg (i.e. 5mL to 10mL paracetamol liquid (oral suspension) at a strength of 250mg/5mL) may be repeated every 4-6 hours to a maximum of 4 doses in 24 hours.

These dosages have been found to be effective, well tolerated and safe in OTC usage and there are no circumstances in which they should be exceeded. If this dosage is not proving effective, then a pharmacist or doctor should be consulted for further advice.

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Paracetamol poisonings

Toxicity stems from its saturable metabolism. In therapeutic doses, 60-90% is conjugated to inactive sulphates and glucuronides. Saturation of the sulphation path after OD diverts an increased fraction to the reactive/toxic species NABQI (N-acetyl-benzoquinoneimine) whose detoxification rapidly depletes hepatic glutathione stores.

Presentation/symptoms : Apart from mild nausea, vomiting and anorexia, patients presenting within 24 hrs of

ingestion are generally asymptomatic. Hepatic necrosis becomes apparent at 24-36 hrs with right subchondral pain/tenderness,

reappearance of vomiting and neuroglycopenia. Encephalopathy deepens over the next 72 hrs.

Complications : The predictable consequences of liver failure i.e. metabolic acidosis, hypoglycaemia,

cerebral oedema, cardiac arrhythmias and GI bleeding. 10% of patients develop renal impairment from acute tubular necrosis which occasionally

is seen in the absence of hepatic failure. Very rarely patients with G6PD deficiency develop methaemoglobinaemia and

haemolysis.

Prognostic features : Untreated, the fatal dose in adults is usually >10g but may be lower in chronic alcoholics

or subjects with underlying liver disease. A patient of 20s at 24 hrs indicates significant hepatocellular damage and the more rapid

the rise in patient thereafter the poorer the prognosis. Patients developing hepatic failure. A poor prognosis is suggested by: (1) arterial pH

<7.3; (2) prothrombin time >100s; (3) creatinine of >300 mol/l. They should be considered for early liver transplantation.

Management : Ipecac/gastric lavage within 4 hrs of ingestion. Paracetamol levels checked at 4hrs. Compare to treatment curve (200mg/1 or 1.32mmol/l

at 4h joined to with 6mg/1 or 0.04mmol/l at 24h. Some 60% of patients above the line develop severe liver damage i.e. AST >1000.

Patients on or above the line should be given IV N-acetylcysteine*

* up to 10% have a rash, bronchospasm or hypotension during the IVI (acts as a mast cell releaser). Stopping and giving chlorpheniramine IV usually allows the IVI to be safely restarted.

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Treatment :

The aim is to remove the paracetamol from the body and replacing glutathione. Treatment of overdose consists of skilled hospital management of the patient, including where necessary the administration of an antidote.

1. n-acetylcysteine. N-acetylcysteine is administered intravenously. The antidote restores the liver's capacity to produce glutathione for combination

with the benzoquinoneimine. It appears to have further protective effects on the liver.

Acetylcysteine , also acts as a precursor for glutathione, helping the body regenerate enough to prevent damage to the liver,

2. Activated charcoal Activated Carbon, also called activated charcoal or activated coal is a form of

carbon that has been processed to make it extremely porous and thus to have a very large surface area available for adsorption or chemical reactions.

It can be used to decrease absorption of paracetamol if the patient presents for treatment soon after the overdose.

The administration of antidote within 12 hours of overdose is highly effective and is able to remove the risk of liver injury. Antidote therapy is also very effective up to 24 hours and there is evidence for benefit from antidote administration up to 48 hours following overdose.

Methhionine :

1. Methionine is an antidote that can be used to treat paracetamol overdosage, although the standard antidote is n-acetylcysteine, given intravenously.

2. The effectiveness of methionine when combined in tablets with paracetamol to try to render an overdose harmless is unknown - clinical trials involving overdoses obviously cannot be carried out.

3. All but a very small number of overdoses are taken with the intention of causing self harm. Paracetamol/methionine combinations would probably be avoided by people who intend to take a drug overdose to commit suicide or cause self harm.

4. Paracetamol/methionine combinations are of no benefit to people who use paracetamol normally. Methionine neither increases the effectiveness of paracetamol nor its safety in normal doses.

5. Methionine occurs naturally in foods but animal experiments show that at higher doses it may have side-effects including nausea; vomiting; drowsiness; enlargement of the spleen,

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kidney, and liver; and possible vitamin deficiency. In people who have methionine intolerance, methionine supplementation may lead to increased risk of cardiovascular disease. Methionine may also stimulate the growth of certain common pre-existing cancer tumours.

History of paracetamol

The first observations about the analgesic and antipyretic properties of paracetamol were made back in the late nineteenth century when alternative compounds were being sought to reduce fever in the treatment of infections.

The antipyretics commonly used at the time consisted of preparations of natural compounds such as cinchona bark, from which quinine is derived, or galenicals based on willow bark, the earliest source of salicylate. Cinchona bark became in short supply and cheaper, synthetic substitutes were needed.

Two alternatives that were developed included acetanilide in 1886 and phenacetin in 1887, both of which had the advantage over quinine of possessing both antipyretic and analgesic properties.

In 1893, another compound, now known as paracetamol, was noted also to have a prompt analgesic and antipyretic action. In 1895, further work on this compound indicated that paracetamol might be present in the urine of patients who had taken phenacetin and in 1889, paracetamol was also shown to be a urinary metabolite of acetanilide.

However, it was not until 1948 that Brodie and Axelrod established that paracetamol was a major metabolite of both phenacetin and acetanilide. This, and other work, led to the belief that the clinical effect of these two drugs was entirely due to rapid conversion in the body to paracetamol. This belief was supported by the observation that the analgesic and antipyretic effects of paracetamol were of the same order as those of its parent compound. Some years later, it was shown that phenacetin had both effects in its own right and that paracetamol formation was not essential for its pharmacological action. However, because a very high proportion is converted to paracetamol during first passage through the liver, phenacetin itself exerts a direct analgesic effect only at very high doses.

The work of Brodie and Axelrod led to the introduction of 500 mg tablets of paracetamol in the United Kingdom in 1956, primarily as a prescription product. In 1963, paracetamol was added to the British Pharmacopoeia and its popularity as an over-the-counter analgesic increased rapidly.

Subsequently, it also became an ingredient of compound analgesics, being combined with such centrally-acting compounds as codeine, dihydrocodeine and dextropropoxyphene, as well as with oral decongestants in a variety of formulations for the relief of the symptoms of the common cold, influenza and sinusitis.

Paracetamol is now the most widely accepted antipyretic and analgesic in the UK.

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METHOD

In my research, I have to collect information about the Panadol drug that contains paracetamol as an active ingredient among student semester 1&2 in KATPM, Kangar, Perlis.

I have to meet about 50 student semester 1&2 in KATPM to get information. I had interview and ask them to fill the survey form that contains suitable and easily question. I also give them an attachment of leaflet about the general information of the knowledge of panadol as their own references after the interview.

The data that included for the interview with student are:

1. Personal Information i) Agesii) Genderiii) Occupationiv) Educationv) Maritial statusvi) Living area (topography)

2. Their basic knowledgement about Panadoli) Attend/concerning to panadol or notii) Content of panadoliii) Strength of panadoliv) Risk on taking panadol (safe/danger)v) Proper doses taking of panadolvi) Does know about other medicines which contains in Paracetamolvii) The source of information they attained

3. Their knowledge and the way they usage the Panadol Their knowledge of Panadol

i) Types of panadol related to the common symptoms ii) Either have take Panadol mix together related to the common symptoms

The way they use the Panadoli) Either have take Panadol or not

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ii) Symptoms that related to panadol useiii) Either have take several panadol mix together iv) Dose takenv) Panadol side effect

RESULT

1.) Personal information

This research has been done about 50 student in KATPM semester 1&2 where is 32 person are female and 18 are male. Their personal information have been collected to know their gender, age, occupation, living area, origin, marital status and their educational status.

Subject Amount

Gender 36% (male) 64% (female)

Age 98% (17-24 year) 2% (25-40years)

Occupation 100% Full time study

Living area City : 32% Town : 22% Rural area : 46%

Hometown City : 32% Town : 22% Rural area : 46%

Marital status 100% Single

Educational level 100% Ipt student (still study)

Table 1 :

Percentage of living area among student KATPM sem 1&2

Graph 1 :

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2. ) Basic Knowledge

I was regulate all the data above into graph to perform more clearly, based on the questions provide in my form.( 50student )

The percentage of ‘yes’ and ‘no’ for those question provide in form

Graph 2 :

Question 1 : Have you ever heard about panadol ?Question 2 : Do you know content of panadol is paracetamol (PCM) ?Question 3 : Do you know the strength of PCM in panadol ?Question 4 : Do you know that panadol is among the safest drug when taking not over dosage?Question 5 : Do you know that panadol is among the dangerous drug when taking overdosage ?Question 6 : Do you know all the panadol types in market are containing PCM ?Question 7 : Do you know the proper dose should be taken for Panadol ? Question 8 : Do you know the others drug that contain PCM ?

Question 9 : where does student getting their source of information about panadol?Reading 19 ( 20% )

57%Advertisement / media 24 ( 26% )Friends / family 10 ( 11% )Doctors 15 ( 16% )

43%Pharmacists 25 ( 27% )

Table 2

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3. ) Panadol usage

Tendency to take panadol according to symptoms ( 50 person )

Tendency of student to take panadol according to symptoms in list.

Types of panadol/symptoms

Common panadol

Panadol activefast

Panadol soluble

Panadol extend

Menstrual panadol

Not related

Flu 10 (22%) 6 (12%) 28 (56%) 0 (0%) 0 (0%) 6 (12%)Fever 22 (44%) 20 (40%) 6 (12%) 0 (0%) 0 (0%) 2 (4%)

Dizziness 17 (34%) 19 (38%) 4 (8%) 0 (0%) 0 (0%) 10 (20%)Headache 17 (34%) 28 (56%) 4 (8%) 1 (2%) 0 (0%) 0 (100%)

Muscle pain 1 (2%) 0 (0%) 2 (4%) 37 (74%) 0 (0%) 10 (20%)Period pain 0 (0%) 0 (0%) 1 (2%) 0 (0%) 30 (60%) 19 (38%)Toothache 4 (8%) 0 (0%) 0 (0%) 2 (4%) 0 (0%) 44 (88%)Joint pain 0 (0%) 0 (0%) 2 (4%) 36 (72%) 1 (2%) 12 (24%)

Table 3

The graph on tendency of use panadol among student (50 student)

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Graph 3

Refer to the result, there were approximately 26 students who have taken some panadol together during their treatment. And 24 student do not combined these panadol together.

Percentage on tendency of student to combined the panadol together (over 50student)

Pie chart 1

In this part, there is only 1 student do not use panadol. According to this student, she told that she never use panadol and incase the symptoms in list fall on, she gonna use only 2 tablet of panadol activefast towards flu only. She will not use another types of panadol for another symptoms.

Usage of panadol among student

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Pie chart 2

Usage of panadol according to the illness in list (49 student)

Usage of panadol among student according to disease

Types of panadol/illness

Common panadol

Panadol activefast

Panadol soluble

Panadol extend

Menstrual panadol

Not related

Flu 11 (22%) 6 (12%) 28 (58%) 0 (0%) 0 (0%) 4 (8%)Fever 22 (46%) 20 (40%) 5 (10%) 0 (0%) 0 (0%) 2 (4%)

Dizziness 17 (35%) 19 (41%) 4 (8%) 0 (0%) 0 (0%) 8 (16%)Headache 12 (24%) 28 (58%) 4 (8%) 1 (2%) 0 (0%) 4 (8%)

Muscle pain 1 (2%) 0 (0%) 3 (6%) 37 (76%) 0 (0%) 8 (16%)Period pain 0 (0%) 0 (0%) 2 (4%) 0 (0%) 30 (61%) 17 (35%)Toothache 7 (14%) 0 (0%) 1 (2%) 2 (4%) 1 (2%) 38 (78%)Joint pain 0 (0%) 0 (0%) 2 (4%) 36 (74%) 1 (2%) 10 (20%)

Table 4

The graph on usage of panadol among student

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Graph 4

Percentage of student use to combined the panadol together (49student)

Pie chart 3

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The percentage of student that taken several types of Panadol combined together.

Types of Panadol combine together Amount

1. Panadol + ActiveFast 4 (8%)

2. Panadol + Soluble 5 (9%)

3. ActiveFast + Soluble 7 (14%)

4. ActiveFast + Extend 6 (12%)

5. ActiveFast + Menstrual 3 (6%)

6. Panadol + ActiveFast + Soluble 1 (2%)

7. ActiveFast + Soluble + Extend 1 (2%)

Table 5

Otherwise, several student take 1 or 2 tablet at once for their own treatment.

The amount of tablet to be taken at once (1 tablet)

Types of panadol/symptoms

panadol Activefast Soluble Extend menstrual

Flu 10 5 10 0 0Fever 8 7 5 0 0

Dizziness 11 11 4 0 0Headache 10 12 3 0 0

Muscle pain 0 0 3 13 0Period pain 0 0 1 0 8Toothache 3 0 1 0 1Joint pain 0 0 2 14 1

Table 6

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The amount of tablet to be taken at once (2 tablet)

Types of panadol/symptoms

panadol Activefast Soluble Extend menstrual

Flu 1 1 18 0 0Fever 16 10 0 0 0

Dizziness 4 11 0 0 0Headache 3 15 1 1 0

Muscle pain 1 0 0 24 0Period pain 0 0 1 0 22Toothache 4 0 0 2 0Joint pain 1 0 0 24 0

Table 7

DISCUSSION

From the research that I conducted, some of students do not gave their cooperated on my form that I contribute. Some of them have info beyond my expectations. This is maybe because they believe that this study is not interesting and not necessary. Refer to the interview, I know that most of them know very well about panadol. Nearly 98% of student use panadol in daily life. This is because panadol is the safest drug and it price quite cheap. Panadol also was stated under OTC drug, by means its can be get at anywhere and can be purchase anybody. Panadol is widely sell in small shops, supermarket and even in pharmacy.

However, about 24% student don’t know about the panadol content is paracetamol and also about the strength. This is because they do not concern about their drug. They just take it as long as the medication works. The result show the tendency to take panadol usage is same goes to the usage of panadol. This is because the pattern of the usage of panadol is depending on their knowledge.

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Refer to the usage of panadol in table 3, shows that 56% of student use panadol soluble for flu symptoms and 6% says not related. This result proves that most of the student usage is influence by advertisement. This is because panadol soluble is supposed to be use to treat same illness as another panadol. Flu symptom is not in paracetamol indication. There is another drug use to treat flu. However, panadol soluble and also another types of panadol can be use to relief mild to moderate pain related to cold and flu. Such as noseache. But not to treat flu. For fever symptoms, 44% of student use common panadol, 40% student use panadol actifast, and nobody use panadol extend and panadol menstrual. This mightly because student already familiar to use common panadol and panadol actifast due to their environment. Such as their family or their member influence to use it just for treat fever. While nobody use panadol extend to relief fever, because the influence of advertisement. The tv commercial show that panadol extend can be use to muscle and joint pain. So that, they become worry to use panadol extend to relief their fever and they don’t know that panadol extend also can relief fever as another panadol. Same goes to menstrual panadol that can use to treat fever.

I also found that, 41% of student use panadol actifast due to dizziness symptoms and about 8% said not related. Same goes to flu symptoms, dizziness also not including in paracetamol indication. Most of student use the wrong way to treat their dizziness because they do not know the panadol or paracetamol indication. They also thought the panadol is a magic bullet to treat no matter what kind of illness. This reason can be related to their living area or hometown which is 46% of student comes from rural area. In my opinion, living area can influence their knowledge where is student who lives in rural area less of information regarding to their exposure on it.

As I refer to the result, 58% students use panadol actifast and 24% use common panadol to treat their headache. This result show that most of them knew very well about the treatment that should be taken for relieve their headache. Perhaps, they were getting information and instruction from the pharmacist advice.

For muscle pain illness show 76% student use panadol extend and no one use actifast panadol for muscle pain. This result clearly proves that bad influence of advertisement interfere the pattern of usage panadol among student. The advertisement plays as role model among the student, that why no one use panadol actifast require to muscle pain. They mention that panadol extend only can be used for muscle pain.

Furthermore, I also got the result on period pain which is 61% students use menstrual panadol to relief pain during menstruation. From this result, I believe that most of them were properly prescribed by their pharmacist before take this panadol. However, in small quantity student also maybe got recommendation from their friend prior use this drug.

In spite, a great number of students do not use panadol regarding toothache. 78% student do not use any panadol for treat their toothache. This might due to the pharmacist or doctors that cannot expose widely the usage of panadol that use for tootache too.

I found that 74% student use panadol extend for treat their joint pain and nobody use common panadol and actifast panadol related to joint pain. This way of usage due to market, which is perform to establish most likely such panadol for joint pain. In fact, all these types of panadol are just containing same ingredient.

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The most information I got is how the students taking panadol whether they take panadol alone or in combination. As the result, I found that 52% student was combined together several types of these panadol at once. For the students that combined these panadol, they were actually takes the drug for medication indeed as they were really got sick. As the student takes these panadol together, it is no other than to treat for their illness. 52% student that take combined panadol is really achieved dangerous level which is can lead to pandol poisoning that can cause fatal liver damage.

All these discussion about is just directly from my own opinion that I elaborate to make an assumption for every data and explained why the result came that way. As a pharmacy student, I also have some suggestion to increase the knowledge of panadol among the student such as make such activities like organize several exhibition and advertising in the college related to panadol. Plus, pharmacy club also need to give attachment by distribute various pamphlet on panadol by comparing the exact information and misunderstood info to bring out the fact. These is used to show them the proper way of usage of panadol which is can minimize the panadol toxicity or poisoning.

CONCLUSION

The conclusion that I found from this research is the knowledge and the usage of panadol among the student community in KATPM semester 1&2 is widely use. The usage of panadol in this community is very familiar because of panadol in listed under the over the counter drug. Commonly these panadol is used ordinarily for headache, dizziness, flu, toothache, muscle pain and joint pain. 98% of them know about panadol and for sure use it in their daily life. However, they don’t know panadol content is paracetamol and the panadol strength. Only 76% students recognize about paracetamol containing. Most of them also do not know about the others drugs that contain PCM. While the source of information they obtained is about 57% from advertisement, media, family members and from their reading. 43% more are from their pharmacist and doctors. The research proved that a part of them don’t know the dose should be taken in proper way.

Most of them have use panadol as incorrect way due to their flu symptoms and dizziness symptoms. They also thought that such as panadol extend is only can be use to treat muscle and joint pain.

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So as the result I can conclude from this research that although they were many types of panadol which is contain same ingredient that is PCM but most of student in KATPM do not realize it. They do not know the actual content which is provide to treat the same kinds of illness.Panadol combinations would probably be avoided by student to minimize suffering panadol poisoning and fatal liver damage.

REFERENCES

1.) Supervisor: -Mr. Hasmadi bin Hassan B.Pharms (Hons) USM,R.Ph,MMPS

2. ) The Subjects: - 50 students semester 1&2 in KATPM.

3. ) Research from the Internet:- http://en.wikipedia.org/wiki/Paracetamol- http://www-clinpharm.medschl.cam.ac.uk/pages/teaching/topics/poison/poison11.html- http://www.pharmweb.net/pwmirror/pwy/paracetamol/pharmwebpicdosage.html- http://www.pharmweb.net/pwmirror/pwy/paracetamol/pharmwebpic5.html

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- http://www.pharmweb.net/pwmirror/pwy/paracetamol/pharmwebpicf.html- http://www.pharmweb.net/pwmirror/pwy/paracetamol/pharmwebpic2.htmlhttp://webcache.googleusercontent.com/search?q=cache:08O6DzqAbWAJ:www.tga.gov.au/npmeds/pi-paracetamol.rtf+core+paracetamol+product+information&cd=1&hl=en&ct=clnk&gl=my

4. ) - British Pharmacoepia Codex

5. ) The leaflet:- Leaflet Paracetamol Tablet

APPENDICES

Bil. Title Page

1. Survey form 26

2. Basic information leaflet 27

3. Panadol pamphlet 28

4. Panadol Actifast pamphlet 29

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5. Panadol extend pamphlet 30

6. Panadol soluble pamphlet 31

7. Panadol menstrual pamphlet 32

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