Paracetamol (Acetaminophen): mechanisms of action

@article{Anderson2008ParacetamolM,
  title={Paracetamol (Acetaminophen): mechanisms of action},
  author={Brian J. Anderson},
  journal={Pediatric Anesthesia},
  year={2008},
  volume={18}
}
  • B. Anderson
  • Published 1 October 2008
  • Biology, Chemistry
  • Pediatric Anesthesia
Paracetamol has a central analgesic effect that is mediated through activation of descending serotonergic pathways. Debate exists about its primary site of action, which may be inhibition of prostaglandin (PG) synthesis or through an active metabolite influencing cannabinoid receptors. Prostaglandin H2 synthetase (PGHS) is the enzyme responsible for metabolism of arachidonic acid to the unstable PGH2. The two major forms of this enzyme are the constitutive PGHS‐1 and the inducible PGHS‐2. PGHS… 
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TLDR
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There is considerable evidence that the analgesic effect of paracetamol is central and is due to activation of descending serotonergic pathways, but its primary site of action may still be inhibition of PG synthesis.
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