Acetaminophen Drug Study

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Drug Name

Dosages

acetaminophen (N-acetyl-paminophenol) (a seet a min' a fen)

ADULTS • PO or PR • By suppository, 325– 650 mg q 4–6 hr or PO, 1,000 mg tid to qid. Do not exceed 4 g/day.

Suppositories: Abenol (CAN), Acephen Oral: Aceta, Apacet, Atasol (CAN), Genapap, Genebs, Liquiprin, Mapap, Panadol, Tapanol, Tempra, Tylenol Pregnancy Category B Drug classes • Antipyretic • Analgesic (nonopioid)

PEDIATRIC PATIENTS • PO or PR • Doses may be repeated 4–5 times/day; do not exceed five doses in 24 hr; give PO or by suppository. Age

Dosage (mg)

0–3 mo

40

Therapeutic Actions • Antipyretic: Reduces fever by acting directly on the hypothalamic heat-regulating center to cause vasodilation and sweating, which helps dissipate heat. • Analgesic: Site and mechanism of action unclear.

Indications

Adverse effects

• Analgesicantipyretic in patients with aspirin allergy, hemostatic disturbances, bleeding diatheses, upper GI disease, gouty arthritis

• CNS: Headache

• Arthritis and rheumatic disorders involving musculoskeletal pain (but lacks clinically significant antirheumatic and anti-inflammatory effects)

120

2–3 yr

160

4–5 yr

240

6–8 yr

320

9–10 yr

400

11 yr

480

• GI: Hepatic toxicity and failure, jaundice

•

Common cold, flu, other viral and bacterial infections with pain and fever

• GU: Acute kidney failure, renal tubular necrosis

•

Unlabeled use: Prophylactic for children receiving DPT vaccination to reduce incidence of fever and pain

• Hematologic: Methemoglobine mia—cyanosis; hemolytic anemia— hematuria, anuria; neutropenia, leukopenia, pancytopenia, thrombocytopeni a, hypoglycemia

4–11 mo 80 12–23 mo

• CV: Chest pain, dyspnea, myocardial damage when doses of 5–8 g/day are ingested daily for several weeks or when doses of 4 g/day are ingested for 1 yr

•

Hypersen sitivity: Rash, fever

Contraindications

Nursing considerations

• Contraindicated with allergy to acetaminophen.

Assessment • History: Allergy to acetaminophen, impaired hepatic function, chronic alcoholism, pregnancy, lactation • Physical: Skin color, lesions; T; liver evaluation; CBC, LFTs, renal function tests

• Use cautiously with impaired hepatic function, chronic alcoholism, pregnancy, lactation.

Interventions • Do not exceed the recommended dosage. • Consult physician if needed for children < 3 yr; if needed for longer than 10 days; if continued fever, severe or recurrent pain occurs (possible serious illness). • Avoid using multiple preparations containing acetaminophen. Carefully check all OTC products. • Give drug with food if GI upset occurs. • Discontinue drug if hypersensitivity reactions occur. • Treatment of overdose: Monitor serum levels regularly, Nacetylcysteine should be available as a specific antidote; basic life support measures may be necessary.

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Teaching points • Do not exceed recommended dose; do not take for longer than 10 days. • Take the drug only for complaints indicated; it is not an antiinflammatory agent. • Avoid the use of other over-the-counter preparations. They may contain acetaminophen, and serious overdosage can occur. If you need an over-the-counter preparation, consult your health care provider. • Report rash, unusual bleeding or bruising, yellowing of skin or eyes, changes in voiding patterns.

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