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Acetaminophen

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acute-paracetamol-toxicity

 
lifeinthefastlane.com
about 5 years ago
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Acetaminophen Toxicity

This week Dr. Welniak is back with a great video on APAP overdose and the rule of 150s!  
emin5.com
about 5 years ago
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Paucis Verbis: Acetaminophen toxicity

Paucis Verbis: Acetaminophen toxicity  
academiclifeinem.com
about 5 years ago
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22

SGEM#87: Let Your Back Bone Slide (Paracetamol for Low-Back Pain)

Guest Skeptics: Dr. Pal Ager-Wick is from Norway. Consultant at Legevakten in Drammen, which is a GP run ED handling most things except major trauma. Keen interest in everything evidence based especially ultrasound. Pal is bringing Matt and Mike from the Ultrasound podcast to Norway.  
thesgem.com
about 5 years ago
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11

Rectal Acetaminophen dosing is higher than you think

Though 15mg/kg for acetaminophen are firmly ingrained in your brain, remember that initial and subsequent dosing for the rectal suppository is higher.  
pemcincinnati.com
about 5 years ago
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30

Paracetamol should remain the first line option for persistent pain

Persistent pain in older people is a serious problem that is often undermanaged.1 Osteoarthritis disproportionately affects older people, yet they are often under-represented in trials. Furthermore, their response to analgesics may differ from that of younger patients owing to altered pharmacokinetics and pharmacodynamics.2  
feeds.bmj.com
about 5 years ago
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105

Acetaminophen Pathway (therapeutic doses), Pharmacokinetics

Acetaminophen (N-acetyl-p-aminophenol, APAP, or paracetamol, PARA) is widely used for its analgesic and antipyretic properties in many over-the-counter formulations in both adults and children [Articles:21054454, 23719833]. APAP can be synthesized in the body through O-dealkylation of the prodrug phenacetin, a pain-killer that was withdrawn from the market due to nephrotoxicity and carcinogenesis [Article:7002186]. At the therapeutic adult dose of 1-2 g/day, oral APAP is indicated for fever and mild to moderate acute pain conditions [Article:23719833]. Administration of acetaminophen via intravenous route has become increasingly widespread and has been used as a safe and effective antipyretic and analgesic agent [Article:25521845]. Maximum recommended therapeutic dose of APAP is 4 g/day in adults and 50-75 mg/kg/day in children. Consumption of a single dose greater than 7 g in an adult and 150 mg/kg in a child is considered potentially toxic to the liver and kidneys due to the highly active metabolite N-acetyl-p-benzoquinone imine (NAPQI)[Article:22998987].  
pharmgkb.org
about 5 years ago
Www.bmj
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Paracetamol induced liver failure varies widely across Europe, study finds

The rate of acute liver failure induced by paracetamol is much higher in some European countries than in others, with no clear reason for the variation, a study has found. Paracetamol overdose was found to account for one in six cases of acute liver failure that lead to registration for transplantation.  
feeds.bmj.com
about 5 years ago
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Pregnant women are advised to seek medical advice if they need paracetamol for more than one day

Pregnant women are being advised to see their doctor if they need to take paracetamol for more than a day, after researchers found in an animal study that prolonged use of the analgesic reduced the production of testosterone.1  
feeds.bmj.com
about 5 years ago
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Paracetamol induced liver failure varies widely across Europe, study finds

The rate of acute liver failure induced by paracetamol is much higher in some European countries than in others, with no clear reason for the variation, a study has found. Paracetamol overdose was found to account for one in six cases of acute liver failure that lead to registration for transplantation.  
feeds.bmj.com
about 5 years ago
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11

Pregnant women are advised to seek medical advice if they need paracetamol for more than one day

Pregnant women are being advised to see their doctor if they need to take paracetamol for more than a day, after researchers found in an animal study that prolonged use of the analgesic reduced the production of testosterone.1  
feeds.bmj.com
about 5 years ago
Sinaiem dark
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burning-up

62 y/o M PMH of hep C cirrhosis, HTN, and anemia presents with fever to 101.6 and diffuse abdominal pain. Your patient has jaundice and abdominal distension and tenderness with shifting fluid wave. You work him up with labs, including a tap to rule out SBP. Can you safely use tylenol to control his fever?  
sinaiem.org
about 5 years ago
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Acetaminophen & Salicylate Toxicity with Dr. Bosse

Dr. George Bosse gives a thorough review of acetaminophen and salicylic acid pharmacokinetics followed by presenting symptoms, pathology and treatments for t...  
youtube.com
about 5 years ago
Sinaiem dark
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3894

This recent meta-analysis in the BMJ found that paracetamol (acetaminophen) was no better than placebo for the treatment of low back pain.  Low back pain (LBP) is an increasingly common condition, for which patients often present to the ED.  Treatment options are limited with NSAIDs and acetaminophen being two commonly prescribed medications for pain.  This recent meta-analysis in the BMJ found that paracetamol (acetaminophen) was no better than placebo for low back pain.  It included two trials including 1692 patients evaluated paracetamol on immediate pain reduction and found no difference compared to placebo (weighted mean difference 1.4, 95% CI -1.3 to 4.1).  One trial (1652 patients) found no effect on pain (-0.5, -2.9-1.9), disability (0.4, -1.7-2.5), or quality of life measured on a 12-item survey.  Patients received doses in the range of 3900-4000 mg/day and followed patients for up to 12 weeks.  
sinaiem.org
about 5 years ago
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Oral non-steroidal anti-inflammatory drugs compared with other oral pain killers for sprains, strains and bruises | Cochrane

Strains, sprains and bruises are common soft tissue injuries, and people with these injuries often require pain relief. This is usually in the form of a tablet taken orally (swallowed). Many different types of oral painkillers are available to treat such injuries, but we do not know whether any of these are any better than any of the others. We sought to identify if there were any differences in people's pain, swelling or function when these injuries were treated with oral non-steroidal anti-inflammatory drugs (NSAIDs) compared with paracetamol, opioids (e.g. codeine), complementary or alternative medicines (CAM), or any combinations of these. We also looked for adverse effects that could occur as a result of using these medicines.  
cochrane.org
about 5 years ago
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Paracetamol (acetaminophen) for prevention or treatment of pain in newborns | Cochrane

Background: Newborn infants have the ability to experience pain. Newborns treated in neonatal intensive care units are exposed to numerous painful procedures. Healthy newborns are exposed to pain if the birth process consists of assisted vaginal birth by vacuum extraction or by forceps and during blood sampling for newborn screening tests.  
cochrane.org
about 5 years ago
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Amitriptyline for neuropathic pain in adults | Cochrane

Neuropathic pain is pain coming from damaged nerves, and can have a variety of different names. Some of the more common are painful diabetic neuropathy, postherpetic neuralgia, or post-stroke pain. It is different from pain messages that are carried along healthy nerves from damaged tissue (for example, a fall, or cut, or arthritic knee). Neuropathic pain is treated by different medicines to those used for pain from damaged tissue. Medicines such as paracetamol or ibuprofen are not usually effective in neuropathic pain, while medicines that are sometimes used to treat depression or epilepsy can be very effective in some people with neuropathic pain.  
cochrane.org
almost 5 years ago
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Milnacipran for neuropathic pain in adults | Cochrane

Neuropathic pain is pain coming from damaged nerves. It is different from pain messages that are carried along healthy nerves from damaged tissue (for example, a fall, or cut, or arthritic knee). Neuropathic pain is treated by different medicines to those used for pain from damaged tissue. Medicines such as paracetamol or ibuprofen are not usually effective in neuropathic pain, while medicines that are sometimes used to treat depression or epilepsy can be very effective in some people with neuropathic pain.  
cochrane.org
almost 5 years ago
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Where are we now with paracetamol?

When a doctor recommends a new medicine there are questions that a patient would hope to have answered. Will the treatment work for my clinical problem? Are there side effects? How many tablets do I take? Paracetamol was introduced into UK medical practice in 1956. It is the most widely used and prescribed drug in the UK and is generally considered to be effective and safe in therapeutic doses. In recent years, however, studies have raised questions regarding its efficacy and safety.1 2 Where are we with regard to the patient’s three questions?  
feeds.bmj.com
almost 5 years ago
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17

Where are we now with paracetamol?

When a doctor recommends a new medicine there are questions that a patient would hope to have answered. Will the treatment work for my clinical problem? Are there side effects? How many tablets do I take? Paracetamol was introduced into UK medical practice in 1956. It is the most widely used and prescribed drug in the UK and is generally considered to be effective and safe in therapeutic doses. In recent years, however, studies have raised questions regarding its efficacy and safety.1 2 Where are we with regard to the patient’s three questions?  
feeds.bmj.com
almost 5 years ago