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Acetaminophen

QuestionAnswer
Brand Name Tylenol
Generic Name Acetaminophen
Classification Antipyretic (fever reducer) Non-opioid analgesics
Indication PO, Rectal: Treatment of mild pain, fever IV: Treatment of mild to moderate pain, moderate to severe pain with opioid analgesics, fever
Action Inhibits synthesis of prostaglandins Has no significant anti-inflammatory properties or GI toxicity
Therapeutic Effect Analgesia (inability to feel the pain) Antipyresis (fever reducer)
Side Effect CNS: anxiety, headache, fatigue, insomnia CV: Hyper/hypotension GI: Renal failure (high doses/chronic use)
Toxic Effect GI: Hepatotoxicity (Liver damage if overdose) Derm: Acute generalized exanthematous pustulosis, Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis
Assessment Pain: Assess type, location, and intensity prior to and 30–60 min following administration. Fever: Assess fever; note presence of associated signs (diaphoresis, tachycardia, and malaise).
Assessment Assess overall health status and alcohol usage before administering. Pts malnourished or chronically abuse alcohol are at higher risk of developing hepatotoxicity (chemical-driven liver damage) with chronic use of usual doses of this drug.
Assessment Assess amount, frequency, and type of drugs taken in patients self-medicating, especially with OTC drugs. Prolonged use of acetaminophen increases risk of adverse hepatic and renal effects.
Assessment For short-term use, combined doses of acetaminophen and salicylates should not exceed the recommended dose of either drug given alone.
Assessment Do not exceed maximum daily dose of acetaminophen when considering all routes of administration and all combination products containing acetaminophen.ith chronic use of usual doses of this drug.
Assessment Assess for rash periodically during therapy. May cause Stevens-Johnson syndrome.
Assessment Discontinue therapy if rash or if accompanied with fever, general malaise, fatigue, muscle or joint aches, blisters, oral lesions, conjunctivitis, hepatitis, and/or eosinophilia.
Assessment Increased serum bilirubin, LDH, AST, ALT, and prothrombin time may indicate Hepatotoxicity
Overdose antidote Acetylcysteine: when overdosed
Implementation Do not confuse Tylenol with Tylenol PM.
Implementation To prevent fatal medication errors ensure dose in milligrams (mg) and milliliters (mL) is not confused; dosing is based on weight for patients under 50 kg;
Implementation When combined with opioids do not exceed the maximum daily dose of acetaminophen. PO: Administer with a full glass of water. May be taken with food/empty stomach.
Pt/Family Teaching Advise patient to take medication exactly as directed and not to take more than the recommended amount.
Pt/Family Teaching Chronic excessive use of (greater than) >4 g/day (2 g in chronic alcoholics) may lead to hepatotoxicity, renal, or cardiac damage.
Pt/Family Teaching Adults should not take acetaminophen longer than 10 days and children not longer than 5 days unless directed by health care professional.
Pt/Family Teaching Short-term doses of acetaminophen with salicylates or NSAIDs should not exceed recommended daily dose of either drug alone.
Pt/Family Teaching Advise patient to avoid alcohol (3 or more glasses per day increase the risk of liver damage) if taking more than an occasional 1–2 doses
Pt/Family Teaching Advise patient to discontinue acetaminophen and notify health care professional if rash occur
Pt/Family Teaching Caution patient to check labels on all OTC products. Advise patients to avoid taking more than one product containing acetaminophen at a time to prevent toxicity.
Pt/Family Teaching Advise patient to consult health care professional if discomfort or fever is not relieved by routine doses of this drug or if fever is greater than 39.5°C (103°F) or lasts longer than 3 days.
Pt/Family Teaching Inform patients with diabetes that acetaminophen may alter results of blood glucose monitoring
Created by: saramx1005