nonnarcotic analgesic antipyretic: acetaminophen

Question 1

indications/moa for acetaminophen

Answer 1

• antipyretic: acts on hypothalamus, increasing vasodilation and sweating (reducing fever)
• analgesic: moa unknown, decreases minor pain

Question 2

acetaminophen ae

Answer 2

• hepatotoxicity and renal failure

- hypersensitivity reactions– rash/fever

Question 3

acetaminophen cautions/contraindications

Answer 3

• impaired hepatic and renal function

- caution in pregnancy and lactation (increases risk for ADHD in child)

Question 4

acetaminophen implications

Answer 4

• educate to not exceed recommended daily dose (4g)
• if have etoh abuse, no more than 2g a day
• notify hcp at any sign of rash or fever

Question 5

acetaminophen toxicity

Answer 5

• when gluthione is depleted, neurotoxins accumulate in the blood damaging the liver
• fatal toxicity >20g
• can cause acute renal failure

Question 6

s/s of acetaminophen toxicity

Answer 6

• early (12-24 hours): anorexia, n/v, diaphoresis

- later: jaundice, vomiting, cns stimulation, vascular collapse, coma, death

Question 7

how to know/expect an acetaminophen overdose

Answer 7

obtain serum levels within 4 hours, blood levels will be >3000 mcg/ml

Question 8

treating acetaminophen toxicity

Answer 8

• if detected with in 4 hours: gastric lavage and activated charcoal
• antidote: acetylcysteine- provides cysteine (requried for synthesis of glutathione, which bonds with the toxic metabolite and decreases heatotoxicity)