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

Dosages ADULTS PO or PR By suppository, 325 650 mg q 46 hr or PO, 1,000 mg tid to qid. Do not exceed 4 g/day. PEDIATRIC PATIENTS PO or PR Doses may be repeated 45 times/day; do not exceed five doses in 24 hr; give PO or by suppository. Age 03 mo Dosage (mg) 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 Analgesicantipyretic in patients with aspirin allergy, hemostatic disturbances, bleeding diatheses, upper GI disease, gouty arthritis Arthritis and rheumatic disorders involving musculoskeletal pain (but lacks clinically significant antirheumatic and anti-inflammatory effects) Common cold, flu, other viral and bacterial infections with pain and fever Unlabeled use: Prophylactic for children receiving DPT vaccination to reduce incidence of fever and pain

Adverse effects CNS: Headache CV: Chest pain, dyspnea, myocardial damage when doses of 58 g/day are ingested daily for several weeks or when doses of 4 g/day are ingested for 1 yr GI: Hepatic toxicity and failure, jaundice GU: Acute kidney failure, renal tubular necrosis Hematologic: Methemoglobine miacyanosis; hemolytic anemia hematuria, anuria; neutropenia, leukopenia, pancytopenia, thrombocytopeni a, hypoglycemia Hypersen sitivity: Rash, fever

Contraindications Contraindicated with allergy to acetaminophen. Use cautiously with impaired hepatic function, chronic alcoholism, pregnancy, lactation.

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

411 mo 80 1223 mo 23 yr 45 yr 68 yr 910 yr 11 yr 120 160 240 320 400 480

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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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