Acetaminophen
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Brand Name | Tylenol
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Generic Name | Acetaminophen
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Classification | Antipyretic (fever reducer)
Non-opioid analgesics
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Indication | PO, Rectal: Treatment of mild pain, fever
IV: Treatment of mild to moderate pain, moderate to severe pain with opioid analgesics, fever
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Action | Inhibits synthesis of prostaglandins
Has no significant anti-inflammatory properties or GI toxicity
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Therapeutic Effect | Analgesia (inability to feel the pain)
Antipyresis (fever reducer)
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Side Effect | CNS: anxiety, headache, fatigue, insomnia
CV: Hyper/hypotension
GI: Renal failure (high doses/chronic use)
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Toxic Effect | GI: Hepatotoxicity (Liver damage if overdose)
Derm: Acute generalized exanthematous pustulosis, Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis
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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).
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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.
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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.
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Assessment | For short-term use, combined doses of acetaminophen and salicylates should not exceed the recommended dose of either drug given alone.
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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.
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Assessment | Assess for rash periodically during therapy. May cause Stevens-Johnson syndrome.
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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.
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Assessment | Increased serum bilirubin, LDH, AST, ALT, and prothrombin time may indicate Hepatotoxicity
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Overdose antidote | Acetylcysteine: when overdosed
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Implementation | Do not confuse Tylenol with Tylenol PM.
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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;
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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.
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Pt/Family Teaching | Advise patient to take medication exactly as directed and not to take more than the recommended amount.
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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.
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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.
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Pt/Family Teaching | Short-term doses of acetaminophen with salicylates or NSAIDs should not exceed recommended daily dose of either drug alone.
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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
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Pt/Family Teaching | Advise patient to discontinue acetaminophen and notify health care professional if rash occur
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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.
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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.
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Pt/Family Teaching | Inform patients with diabetes that acetaminophen may alter results of blood glucose monitoring
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