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Tylenol (Acetaminophen)

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SIMPLE EXPLANATION

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What is it and what does it do?

 

Tylenol (acetaminophen) is a pain-relieving agent used to treat mild pain and fever. It has no anti-inflammatory properties and is therefore NOT an NSAID (Non-Steroidal Anti-Inflammatory Drug). Ofirmive is acetaminophen in IV form.

DETAILED EXPLANATION

 

Action: analgesic action is achieved by inhibiting prostaglandin synthesis, which may block

             peripheral impulses of pain; antipyretic action is achieved by inhibiting prostaglandin

             synthesis in the hypothalamus, which is the heat-regulating center of the central nervous

             system; does not possess anti-inflammatory properties.

 

Availability: prescription (IV); over the counter (PO, RECT).

 

Avoid: alcohol due to liver damage.

 

Black Box Warning: hepatotoxicity.

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Class (Chemical): non-salicylate; para-aminophenol derivative.

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Class (Functional): non-opioid analgesic; antipyretic.

 

Contraindications: hypersensitivity to acetaminophen, phenacetin aspartame, saccharin, or

                                 tartrazine.

 

Dose: Adult/Child Over 12yrs PO/RECT: 325-650mg every 4-6hrs, max 4g/day

          Over 50kg IV: 1000mg every 6hrs, 650mg every 4hrs

          Less Than 50kg IV: 15mg/kg every 6hrs, 12.5mg/kg every 4hrs

          Child Over 2yrs Less Than 50kg: 15mg/kg every 6hrs, 12.5mg/kg every 4hrs

 

Interactions: NSAIDs and salicylates will increase renal adverse reactions; nitric oxide 

                       and/or prilocaine will increase methemoglobinemia; warfarin will increase 

                       hypoprothrombinemia; alcohol, barbiturates, carbamazepine, hydantoins, rifampin,

                       rifabutin, isoniazid, dasatinib, and mipomersen will increase hepatotoxicity; 

                       colestipol and cholestyramine will decrease absorption of acetaminophen;

                       acetaminophen may decrease effects of lamotrigine and/or zidovudine; St John’s

                       wort will increase hepatotoxicity.

 

Labs: increase in liver function test, potassium, bilirubin, LDH, prothrombin time; decrease in

           hemoglobin, hematocrit, white blood cells, red blood cells, platelets, albumin, magnesium,

           phosphate.

 

Notes: do not confuse 2x 350mg with 650mg extended release.

 

Off-Label Use: acetaminophen may be used to treat migraines.

 

Precautions: anemia; breastfeeding; chronic alcoholism; geriatric patients; pregnancy; renal

                      and/or hepatic disease.

 

Report to Provider: bleeding; bruising; fever; malaise; sore throat; worsening pain.

 

Routes: IV; PO; RECT.

 

Side Effects: agitation in children; headache (IV); fatigue; anxiety (IV); dyspnea (IV);

                      atelectasis in children; hypertension (IV); hypotension (IV); nausea; vomiting;

                      abdominal pain; hepatotoxicity; hepatic seizure; GI bleeding; renal failure;

                      leukopenia; neutropenia; hemolytic anemia; thrombocytopenia; pancytopenia; rash;

                      urticaria; pain at IV site; Stevens-Johnson syndrome; toxic epidermal necrolysis;

                      cyanosis (toxicity); anemia (toxicity); jaundice; CNS stimulation; delirium

                      followed by vascular collapse; seizures; death.

 

Uses: relief of mild to moderate pain; fever; arthralgia; dental pain; dysmenorrhea; headache;

          myalgia; osteoarthritis.

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Reference: Mosby's Nursing Drug Reference

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