Melo, Monica Tan

Paracetamol
DRUG ORDER
(Generic
name, Dosage,
Route,
Frequency,
etc.)
1.
Paraceta
mol
(250mg/5ml)
3ml q4h for
fever
2.
Paraceta
mol 145mg IV
q4h for T >
38oC

PHARMACOLOGI
C ACTION OF
DRUG
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 AND
CONTRAINDICATIONS

ADVERSE EFFECTS
OF THE DRUG

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 antiinflammatory 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

CNS: Headache
CV: Chest pain,
dyspnea, myocardial
damage when doses
of 58 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
anemiahematuria,
anuria; neutropenia,
leucopenia,
pancytopenia,
thrombocytopenia,
hypoglycemia
Hypersensitivity:
Rash, fever

Contraindications
- Contraindicated with
allergy to acetaminophen.
- Use cautiously with
impaired hepatic function,
chronic alcoholism,
pregnancy, lactation.

DESIRED ACTION
ON THE CLIENT

Fever reduction

NURSING
RESPONSIBILITIES /
PRECAUTIONS
- Monitor liver
function studies;
may cause hepatic
toxicity at doses
>4g/day
- Monitor renal
function studies;
albumin indicates
nephritis
- Monitor blood
studies, especially
CBC and pro-time if
patient is on longterm therapy.
- Check I&O ratio;
decreasing output
may indicate renal
failure.
- Assess for fever and
pain
- Assess
hepatotoxicity: dark
urine, clay-colored
stools
- Assess allergic
reactions: rash,
urticaria