Drug Name
Generic Name: acetaminophen (N-acetyl-p-aminophenol)
Brand Name:
- Suppositories: Abenol (CAN), Acephen
- Oral: Aceta, Apacet, Atasol (CAN), Genapap, Genebs, Liquiprin, Mapap, Panadol, Tapanol, Tempra,Tylenol
Classification: Antipyretic, Analgesic (nonopioid)
Pregnancy Category B
Dosages
ADULTS
- PO or PR
- By suppository, 325–650 mg q 4–6 hr or PO, 1,000 mg tid to qid. Do not exceed 4 g/day.
PEDIATRIC PATIENTS
- PO or PR
- Doses may be repeated 4–5 times/day; do not exceed five doses in 24 hr; give PO or by suppository.
| Age | Dosage (mg) |
| 0–3 mo | 40 |
| 4–11 mo | 80 |
| 12–23 mo | 120 |
| 2–3 yr | 160 |
| 4–5 yr | 240 |
| 6–8 yr | 320 |
| 9–10 yr | 400 |
| 11 yr | 480 |
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
- Analgesic-antipyretic 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 5–8 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: Methemoglobinemia—cyanosis; hemolytic anemia—hematuria, anuria; neutropenia, leukopenia, pancytopenia, thrombocytopenia, hypoglycemia
- Hypersensitivity: 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, N-acetylcysteine should be available as a specific antidote; basic life support measures may be necessary.
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 anti-inflammatory 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.