Acetaminophen (Tylenol) Nursing Considerations

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Outline

What is the Generic Name

Acetaminophen

What is the Trade Name for Acetaminophen

Tylenol

What is the Indication for Acetaminophen

Pain, fever

What is the Action of Acetaminophen

Inhibit the synthesis of prostaglandins which play a role in transmission of pain signals and fever response

What is the Therapeutic Class of Acetaminophen

Antipyretic, non-opioid analgesic

What are the Nursing Considerations for Acetaminophen

• Do not exceed 4g of acetaminophen per day to limit risk for liver, renal,
and cardiac damage
• Overdose will lead to hepatotoxicity
• Acetadote is the antidote for overdose
• May increase risk for bleed with warfarin therapy
• May alter blood glucose measurements

Acetaminophen Audio Lecture

[lesson-linker lesson=”424740″ background=”white”]

What Does Acetaminophen (Tylenol) Look Like

acetaminophen nursing considerations
By Katy Warner from Orlando, FL, USA – rapid release (02-18-08), CC BY-SA 2.0, https://commons.wikimedia.org/w/index.php?curid=10764398

 

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Transcript

Hey guys, let’s talk about acetaminophen, better known as Tylenol, also called paracetamol in Europe. This is an oral medication, as you can see here in the picture, but it actually can also be given in the IV form. So, remember that the therapeutic class is what the drug does in the body. And the pharmacologic class is the actual chemical effect. So, acetaminophen is a non-opioid analgesic or pain reliever, and an antipyretic is a fever reducer. It’s pharmacologic class; it’s technically a prostaglandin inhibitor, although we don’t usually refer to it this way. A big thing to note here is that it is not an anti-inflammatory, which is a very common misconception.

 

So, the exact mechanism of acetaminophen isn’t fully understood, but it is thought to be involved in inhibiting the prostaglandin synthesis in the brain. Prostaglandins actually play a role, not only in the transmission of pain signals in the brain, but also in the fever response. So, what do we give it for? Well, pain and fever.

 

So typically, acetaminophen doesn’t cause any side effects, but if someone has a bad reaction, they could be really, really itchy or have a rash. Just like any oral medication, it can cause nausea. And the big thing to note is that acetaminophen has a significant impact on the liver. So, we always want to be on the lookout for any signs of liver toxicity like jaundice or yellowing of the skin.

 

Here are some major nursing considerations for acetaminophen. Because of the risk of the liver, we will set a 24- hour max dose of four grams for anyone taking acetaminophen. A big thing to remember here, both in the hospital and for educating your patients, is that you may also give some combination drugs that have acetaminophen in them like cold medications or things like Percocet or Lortab. So always make sure you’re looking at those drugs too when you’re calculating that max dose.

 

We know that overdose causes hepatotoxicity or significant damage to the liver. So, make sure you look out for that and know that the antidote is a drug called N-acetyl cysteine or NAC. So, I know of a patient who took a whole bottle of Tylenol PM once. She came into the ER, bright yellow with severe nausea and vomiting. She ended up on a NAC drip for three days before she even really started to recover. So, guys, it is a big, big deal.

 

As far as interactions, be aware that acetaminophen can cause increased bleeding risk especially if a patient is also taking warfarin and be aware that it can possibly alter blood glucose measurements.

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pharmacology

Concepts Covered:

  • Pregnancy Risks
  • Medication Administration
  • Prenatal Concepts
  • Labor Complications
  • Newborn Care
  • EENT Disorders
  • Intraoperative Nursing
  • Depressive Disorders
  • Disorders of the Thyroid & Parathyroid Glands
  • Postpartum Complications
  • Bipolar Disorders
  • Psychotic Disorders
  • Anxiety Disorders
  • Postoperative Nursing
  • Cardiac Disorders
  • Central Nervous System Disorders – Brain
  • Peripheral Nervous System Disorders
  • Shock
  • Neurologic and Cognitive Disorders
  • Vascular Disorders
  • Lower GI Disorders
  • Respiratory Disorders
  • Urinary Disorders
  • Substance Abuse Disorders
  • Cardiovascular Disorders
  • Acute & Chronic Renal Disorders
  • Disorders of Pancreas
  • Upper GI Disorders
  • Gastrointestinal Disorders
  • Neurological
  • Noninfectious Respiratory Disorder
  • Immunological Disorders
  • Male Reproductive Disorders
  • Infectious Respiratory Disorder
  • Microbiology
  • Female Reproductive Disorders
  • Emergency Care of the Cardiac Patient
  • Hematologic Disorders
  • Integumentary Disorders
  • Disorders of the Adrenal Gland
  • Liver & Gallbladder Disorders
  • Sexually Transmitted Infections
  • Nervous System
  • Learning Pharmacology
  • Dosage Calculations
  • Concepts of Pharmacology
  • Disorders of the Posterior Pituitary Gland

Study Plan Lessons

Prostaglandins in Pregnancy
Rh Immune Globulin in Pregnancy
Lung Surfactant for Newborns
Eye Prophylaxis for Newborn
Phytonadione (Vitamin K) for Newborn
Hepatitis B Vaccine for Newborns
Ibuprofen (Motrin) Nursing Considerations
Lidocaine (Xylocaine) Nursing Considerations
Antidepressants
Levothyroxine (Synthroid)
Betamethasone and Dexamethasone in Pregnancy
Sedatives-Hypnotics
Opioid Analgesics in Pregnancy
Meds for Postpartum Hemorrhage (PPH)
Uterine Stimulants (Oxytocin, Pitocin) Nursing Considerations
Tocolytics
Mood Stabilizers
Magnesium Sulfate in Pregnancy
Antipsychotics
Antianxiety Meds
Magnesium Sulfate (MgSO4) Nursing Considerations
Meperidine (Demerol) Nursing Considerations
Morphine (MS Contin) Nursing Considerations
Phenobarbital (Luminal) Nursing Considerations
Pentobarbital (Nembutal) Nursing Considerations
Neostigmine (Prostigmin) Nursing Considerations
Meropenem (Merrem) Nursing Considerations
Selegiline (Eldepyrl) Nursing Considerations
Norepinephrine (Levophed) Nursing Considerations
Vasopressin (Pitressin) Nursing Considerations
Nitroglycerin (Nitrostat) Nursing Considerations
Nitroprusside (Nitropress) Nursing Considerations
Hydralazine (Apresoline) Nursing Considerations
Methylprednisolone (Solu-Medrol) Nursing Considerations
Fluticasone (Flonase) Nursing Considerations
Propofol (Diprivan) Nursing Considerations
Phenazopyridine (Pyridium) Nursing Considerations
Iodine Nursing Considerations
Oxycodone (OxyContin) Nursing Considerations
Nalbuphine (Nubain) Nursing Considerations
Methadone (Methadose) Nursing Considerations
Hydromorphone (Dilaudid) Nursing Considerations
Hydrocodone-Acetaminophen (Vicodin, Lortab) Nursing Considerations
Butorphanol (Stadol) Nursing Considerations
Oxytocin (Pitocin) Nursing Considerations
Methylergonovine (Methergine) Nursing Considerations
Terbutaline (Brethine) Nursing Considerations
Naproxen (Aleve) Nursing Considerations
Ketorolac (Toradol) Nursing Considerations
Indomethacin (Indocin) Nursing Considerations
Lithium (Lithonate) Nursing Considerations
Calcium Acetate (PhosLo) Nursing Considerations
Propylthiouracil (PTU) Nursing Considerations
Glucagon (GlucaGen) Nursing Considerations
Pantoprazole (Protonix) Nursing Considerations
Omeprazole (Prilosec) Nursing Considerations
Sucralfate (Carafate) Nursing Considerations
Pancrelipase (Pancreaze) Nursing Considerations
Ondansetron (Zofran) Nursing Considerations
Metoclopramide (Reglan) Nursing Considerations
Loperamide (Imodium) Nursing Considerations
Lactulose (Generlac) Nursing Considerations
Mannitol (Osmitrol) Nursing Considerations
Spironolactone (Aldactone) Nursing Considerations
Hydrochlorothiazide (Hydrodiuril) Nursing Considerations
Salmeterol (Serevent) Nursing Considerations
Montelukast (Singulair) Nursing Considerations
Guaifenesin (Mucinex) Nursing Considerations
Dopamine (Inotropin) Nursing Considerations
Methylphenidate (Concerta) Nursing Considerations
Olanzapine (Zyprexa) Nursing Considerations
Quetiapine (Seroquel) Nursing Considerations
Haloperidol (Haldol) Nursing Considerations
Tetracycline (Panmycin) Nursing Considerations
Trimethoprim-Sulfamethoxazole (Bactrim) Nursing Considerations
Amoxicillin (Amoxil) Nursing Considerations
Vancomycin (Vancocin) Nursing Considerations
Levofloxacin (Levaquin) Nursing Considerations
Rifampin (Rifadin) Nursing Considerations
Nystatin (Mycostatin) Nursing Considerations
Isoniazid (Niazid) Nursing Considerations
Metronidazole (Flagyl) Nursing Considerations
Verapamil (Calan) Nursing Considerations
Nifedipine (Procardia) Nursing Considerations
Losartan (Cozaar) Nursing Considerations
Lisinopril (Prinivil) Nursing Considerations
Propranolol (Inderal) Nursing Considerations
Metoprolol (Toprol XL) Nursing Considerations
Ranitidine (Zantac) Nursing Considerations
Promethazine (Phenergan) Nursing Considerations
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin – Intermediate Acting (NPH) Nursing Considerations
Insulin – Short Acting (Regular) Nursing Considerations
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Metformin (Glucophage) Nursing Considerations
Sertraline (Zoloft) Nursing Considerations
Paroxetine (Paxil) Nursing Considerations
Phenytoin (Dilantin) Nursing Considerations
Heparin (Hep-Lock) Nursing Considerations
Lamotrigine (Lamictal) Nursing Considerations
Levetiracetam (Keppra) Nursing Considerations
Streptokinase (Streptase) Nursing Considerations
Procainamide (Pronestyl) Nursing Considerations
Warfarin (Coumadin) Nursing Considerations
Midazolam (Versed) Nursing Considerations
Lorazepam (Ativan) Nursing Considerations
Glipizide (Glucotrol) Nursing Considerations
Gentamicin (Garamycin) Nursing Considerations
Gabapentin (Neurontin) Nursing Considerations
Furosemide (Lasix) Nursing Considerations
Fluoxetine (Prozac) Nursing Considerations
Ferrous Sulfate (Iron) Nursing Considerations
Fentanyl (Duragesic) Nursing Considerations
Famotidine (Pepcid) Nursing Considerations
Escitalopram (Lexapro) Nursing Considerations
Erythromycin (Erythrocin) Nursing Considerations
Epoetin (Epogen) Nursing Considerations
Epinephrine (EpiPen) Nursing Considerations
Enoxaparin (Lovenox) Nursing Considerations
Enalapril (Vasotec) Nursing Considerations
Dobutamine (Dobutrex) Nursing Considerations
Divalproex (Depakote) Nursing Considerations
Diphenoxylate-Atropine (Lomotil) Nursing Considerations
Diphenhydramine (Benadryl) Nursing Considerations
Diltiazem (Cardizem) Nursing Considerations
Digoxin (Lanoxin) Nursing Considerations
Diazepam (Valium) Nursing Considerations
Dexamethasone (Decadron) Nursing Considerations
Cyclosporine (Sandimmune) Nursing Considerations
Cortisone (Cortone) Nursing Considerations
Codeine (Paveral) Nursing Considerations
Clopidogrel (Plavix) Nursing Considerations
Clindamycin (Cleocin) Nursing Considerations
Ciprofloxacin (Cipro) Nursing Considerations
Cimetidine (Tagamet) Nursing Considerations
Chlorpromazine (Thorazine) Nursing Considerations
Cephalexin (Keflex) Nursing Considerations
Celecoxib (Celebrex) Nursing Considerations
Cefdinir (Omnicef) Nursing Considerations
Cefaclor (Ceclor) Nursing Considerations
Carbidopa-Levodopa (Sinemet) Nursing Considerations
Carbamazepine (Tegretol) Nursing Considerations
Captopril (Capoten) Nursing Considerations
Calcium Carbonate (Tums) Nursing Considerations
Buspirone (Buspar) Nursing Considerations
Bupropion (Wellbutrin) Nursing Considerations
Bismuth Subsalicylate (Pepto-Bismol) Nursing Considerations
Bisacodyl (Dulcolax) Nursing Considerations
Benztropine (Cogentin) Nursing Considerations
Azithromycin (Zithromax) Nursing Considerations
Atropine (Atropen) Nursing Considerations
Atorvastatin (Lipitor) Nursing Considerations
Atenolol (Tenormin) Nursing Considerations
ASA (Aspirin) Nursing Considerations
Ampicillin (Omnipen) Nursing Considerations
Amlodipine (Norvasc) Nursing Considerations
Amiodarone (Pacerone) Nursing Considerations
Alteplase (tPA, Activase) Nursing Considerations
Alprazolam (Xanax) Nursing Considerations
Alendronate (Fosamax) Nursing Considerations
Albuterol (Ventolin) Nursing Considerations
Adenosine (Adenocard) Nursing Considerations
Acyclovir (Zovirax) Nursing Considerations
Acetaminophen (Tylenol) Nursing Considerations
Parasympathomimetics (Cholinergics) Nursing Considerations
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
The SOCK Method – Overview
The SOCK Method – O
The SOCK Method – C
The SOCK Method – K
The SOCK Method – S
Complex Calculations (Dosage Calculations/Med Math)
IV Infusions (Solutions)
Injectable Medications
Oral Medications
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Basics of Calculations
Pharmacokinetics
Pharmacodynamics
Disease Specific Medications
Vasopressin
TCAs
SSRIs
Proton Pump Inhibitors
Anti-Infective – Penicillins and Cephalosporins
Parasympatholytics (Anticholinergics) Nursing Considerations
NSAIDs
Nitro Compounds
MAOIs
Magnesium Sulfate
Insulin
HMG-CoA Reductase Inhibitors (Statins)
Hydralazine
Histamine 2 Receptor Blockers
Histamine 1 Receptor Blockers
Epoetin Alfa
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Corticosteroids
Cardiac Glycosides