Acetaminophen
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Trade Name
Tylenol (primary brand name); also available as generic acetaminophen.
Classification
Analgesic (non-opioid) and antipyretic; not an anti-inflammatory.
Dosage/Route
- * Dosage: Tablets, capsules, or liquid in 325 mg, 500 mg (regular strength), 650 mg (extended-release); IV forms available.
- * Route: Oral (PO), rectal (suppository), or intravenous (IV).
Usual Dosage
- * Adults: 325-1000 mg every 4-6 hours as needed; max 4000 mg/day (4 g) for short-term use (some guidelines suggest 3000 mg/day for chronic use).
- * Children: 10-15 mg/kg/dose every 4-6 hours; max based on weight/age.
Mechanism of Action
Inhibits prostaglandin synthesis in the central nervous system (CNS), reducing pain perception. Acts on the hypothalamus to lower fever (antipyretic effect). Does not have significant peripheral anti-inflammatory action.
Side Effects & Adverse Effects
- * Side Effects: Rare at therapeutic doses; rash or nausea possible.
- * Adverse Effects:
- – Hepatotoxicity (overdose → liver failure; symptoms: nausea, jaundice, confusion).
- – Acute overdose risk at >7.5-10 g/day (adults) or >150 mg/kg (children).
- – Rare: Hypersensitivity reactions (e.g., anaphylaxis).
Nursing Management (Implications & Teachings)
- * Implications:
- – Monitor liver function tests (LFTs) if prolonged use or overdose suspected.
- – Assess for overdose signs (e.g., vomiting, sweating, abdominal pain); antidote is acetylcysteine.
- – Check for hidden acetaminophen in combination drugs (e.g., Percocet).
- * Teachings:
- – Do not exceed 4 g/day; track all sources (OTC meds, combos).
- – Avoid alcohol (increases liver toxicity risk).
- – Take with food if GI upset occurs; report yellow skin/eyes or dark urine.
- – Store safely away from children (overdose risk).
Indication for This Patient
- * Mild to moderate pain (e.g., headache, muscle ache, postoperative pain).
- * Fever reduction in adults and children.
- * Preferred over NSAIDs if anti-inflammatory effect not needed or in patients with bleeding risks.
Time
- * Timing: Every 4-6 hours as needed; avoid more frequent dosing.
- * Onset: Pain relief/fever reduction within 30-60 minutes (PO); peak effect in 1-3 hours.
