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Tylenol (Acetaminophen)
SIMPLE EXPLANATION
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.
Class (Chemical): non-salicylate; para-aminophenol derivative.
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.
Reference: Mosby's Nursing Drug Reference