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What is good everybody welcome back to another video with the alpha nurse thank you guys for coming back today we are going to be discussing a very popular and said sedum in offense now depending on where you live where you’re from a acetaminophen may have different trade names however here the us the trade name that’s most popular or the one that a lot of people
Will be familiar with is tylenol but i also added other names that other people may be more familiar with like for toulon or a banal tempra pediatrics things like that alright so how does acetaminophen work so what it does that inhibits the synthesis of priceless prostaglandins that may serve as mediators of pain and fever primarily in the central nervous system
Acetaminophen has no significant anti-inflammatory properties or gi toxicity so let’s kind of break this down a little bit more what exactly are prostaglandins so prostaglandins are basically a group of active lipid compounds called iko iko so noids and they have diverse hormone effects and animals eco solenoids function in like diverse physiological systems
And pathological processes such as inhibiting inflammation allergy fever and other immune responses and also other things like regulating abortion of pregnancy normal childbirth contributes to the perception of pain regulating cell growth etc etc so specifically here what acetaminophen does that it specifically inhibits the synthesis of prostaglandins that could
Serve or may serve and the mediation of pain and fever i wanted to break that down because prostaglandins are their effects are very very diverse in a body so here see the benefit works on one aspect of prostaglandins but they do these hormone like compounds do have other purposes and other aspects and they play other roles in the human body the therapeutic effect
Obviously acetaminophen is classified as an antipyretic and then on opioid so the antipyretic is used for fever and it’s also pain medication but it’s not opioid as the the concentration of acetaminophen isn’t as strong as normal opioids like morphine oxycontin percocet per campe perco don’t actually code on things like that so what are complications acetaminophen
Well they affect different parts of the body so it’s going to break it down within the central nervous system things like agitation which is typically higher in children anxiety fatigue and insomnia can all be observed specifically if it’s administered iv and we’ll talk about the routes of administration and medication administration for acetaminophen later on in
Our presentation within a cardiovascular system we can see things like hypertension or hypotension again if administered iv within this the skin we can see this beautiful word acute and generalized x and emesis postulates stevens-johnson syndrome toxic epidermal necrolysis rash and utak area so for those that maybe don’t know and i’m gonna as long word to a dep
This is basically a rare skin reaction map is in about 90% of cases related to medication administration but it’s characterized by sudden skin eruptions that appear on average like five days after a medication has started steven johnson syndrome is somewhat similar not necessarily in the way is presented but in a way or why individual would obtain this is order
Obviously it’s a skin disorder a rare skin disorder but serious nonetheless it also affects the mucous membranes and it’s usually a reaction to a medication or an infection other systems like fluid and electrolyte so we can see things like hypokalemia again if we’re talking about iv administration and in the gastrointestinal area peto toxicity constipation is a
Little higher in children as well increased liver enzymes nausea and vomiting again are related to iv administration other complications for other different body systems so genital urinary we can see things like renal failure in high doses or chronic use within a blood neutropenia or pancytopenia musculoskeletal muscle spasm trismus again this is all related to iv
Administration and within a respiratory system at alexis’s which is higher in children and dyspnea again this is both of these are related to iv administration so for medication administration i said we were talk about this acetaminophen can be administered by mouth it can be administered iv and it can also be administered directly so we’re going to talk about mouth
Administration first for adults and children above the age of 12 years old you can see what the dosage is which in between ages of one and twelve years old you can see what that dosage is a little bit lower for offense you can see what that dosage is and for neonates you can also see what that dosage is relatively similar to infants but you know nevertheless they’re
Again for iv adults and children greater than thirteen years and fifty kilograms you can see what that what that is one hundred or thousand milligrams every six hours or six hundred and fifty milligrams every four hours that’s what q ch q 6h stands for every six hours for adults and children greater than thirteen years and less than fifty kilograms you can see what
That dosage would be for children between the ages of two to twelve you can see what that would be as well for infants twenty-nine days two years dad dosage is available and neonates from birth to twenty-eight days you can see what that dosage would be as well so if you want to kind of read through this feel free to pause it here and read through it okay and finally
For acetaminophen where you want to get that off the screen finally for acetaminophen it can be administered rectally and in doses are as follow like i said adults and children i forgot the indian children above the age of twelve years you can see what that is with three hundred and twenty five to six hundred and fifty milligrams every four to six hours as needed
For children between the ages of one to twelve years old 10 to 20 milligrams per kilogram per dose every six to four four to six hours for infants 12 to sorry 10 to 20 milligrams per kilogram per dose every four to six hours and for neonates ten to fifteen milligrams per kilogram per dose every six to eight hours as needed so what would be some contraindications
What would be some precautions that you would have to take as a health care vizor or as someone that is taking this as a prescription from a doctor whatever it’s some things you need to be aware of for contraindications if you’re allergic to it and obviously don’t want to take this medication and patients that are allergic to alcohol as pardon me saccharin sugar or
Tartrazine again contraindicated if you’re if you have a large tree or you are allergic to these items and patients with severe hepatic impairment and active liver disease again because of the effect that seed of medicine can have on the liver these patients would be contraindicated for precautions or people you would want to use this drug cautiously and including
Patients with hepatic and renal disease a grand that we did just mention that you want to contraindicate that will the medication be contraindicated in people with impairments however for diseases you would have to be cautious about whether or not you would want to prescribe or if your doctor would prescribe the medication for those people other precautions would
Include alcoholism chronic malnutrition severe hypovolemia or severe renal impairment again because there’s a lot of side effects and adverse effects of acetaminophen as this chronic alcohol abuse again because of the effect that alcohol has on the liver now nutrition and pregnant women if it’s clearly needed and this is related to iv administration so what are
Interactions that you we have to look out for so chronic high dose see them in a film which is greater than two milligrams a day may increase the risk of bleeding with warfarin which is an anticoagulant capetto toxicity is increased when combined with other hepatotoxic substances a prominent one obviously is alcohol and concurrent useful drugs like i so i still an
Azide and rifampin which are both perky losses anti-biotics rightfully butan which is another anti biotic here’s some other drugs barbiturates carbamazepine all of these drugs if were if taken concurrently wit acetaminophen may increase the risk of acetaminophen induced liver damage and decrease its effects so that’s something that we would have to be aware of other
Interactions include concurrent use of acetaminophen with other nsaids so these may increase the risk of adverse renal effects so you definitely want to avoid this i see the benefit with propranolol which is a beta blocker will result in decrease metabolism and increase effects of both of the drugs and acetaminophen may decrease the effects of lamotrigine which is
The anticonvulsant and i do not know how to pronounce that word but that is an antiviral medication used to treat hiv so for my nurses out there what are some things we should be looking out for so what we want to make sure we do is make sure that we assess overall health status and alcohol users before administering acetaminophen patients who are malnourished or
Chronically abuse or who chronically abuse alcohol are at a higher risk of developing hepatotoxicity which is what we discussed earlier with chronic use of usual doses of the drug that’s a very important thing to look out for you also want to assess the amount the frequency and the type of drugs that the patients are taking if they’re self-medicating especially if
You’re taking over-the-counter drugs the reason why is because prolonged use of acetaminophen increases the risk of adverse hepatic and renal effects so again harping on the fact that increases adverse hepatic liver kidney effects for short-term use combined dosage of acetaminophen and other salads cichlid should not exceed the recommended dose of either of either
Drug giving alone i mean we do not want to exceed maximum daily dose of acetaminophen when we are considering all of administration and all combination products containing acetaminophen third we want to assess for rats periodically during the therapy again one of the side effects of acetaminophen was stevens-johnson syndrome so that’s something you want to look
Out for if we see a rash want to discontinue the therapy so this is like any reddening of the skin blisters and in detachments skin peeling anything like that or if it’s accompanied with a fever general tiredness fatigue muscle joints muscle or joint aches blisters or lesions conjunctivitis hepatitis anything like that for pain we want to assess pain obviously the
Type the location the intensity prior to and 30 to about 30 to 60 minutes after administration for fever again we want to assess fever we want to know any presence of associative signs of fevers for diaphoresis tachycardia and malaise things of that nature for labs when i evaluate hepatic panels hematologic and renal function periodically and during the high-dose
Therapy one thing i didn’t write this one down you want to look out for blood glucose monitoring acetaminophen may cause falsely low values when measured so that’s just something or it may even cause falsely hiding values what certain instruments so it’s something that we would have to be aware of if the patient is diabetic or anything of that case and lastly if
We also want to look out for elevated like i was saying before in regards to if i hepatic panels want to look out for elevated signs of ast alt aldh serum bilirubin these are all things related to a liver if blood work comes back in these levels are relatively high that could be a sign of liver issues and that’s something that you want to be aware and take the
Necessary precautions to to fix for client education so there’s a couple of things that i have here that are important to know that we need to make sure we are teaching our patients so the first thing is we want to advise the patient to take medication exactly as directed and to not take more than the recommended amount chronic excessive use which is greater than
Four grams a day again may lead to a patou toxicity reno or cardiac damage there’s a reason why we are making sure that the patient is taking a recommended amount we want to advise the patient to avoid alcohol they’re taking more than an occasional one or two doses i want a visor patient to discontinue and notify healthcare professional rash occurs inform diabetic
Patients that see the benefit may alter results of blood glucose monitoring things that i mentioned within a nursing intervention here caution patients to check labels on all over-the-counter products because you want to avoid elevated or drugs that it may have acetaminophen in it that can lead to toxicity that can lead to liver damage we know we know damaged renal
Issues we’re gonna advise the patient took installed healthcare professional if this comfort or fever is not relieved by the drug acetaminophen and for pediatric patients want to vitalize parents and caregivers to check concentrations of liquid preparations overall the desire outcome is to rule to relieve pain mild to moderate pain and if you’re taking it for fevers
You want a reduction of the fever so those are the main outcomes that we want to see and that is the end i want to thank you all for learning please like comment and subscribe for more content for more videos it’s the avro nurse and i will see you guys in the next one peace
Transcribed from video
Acetaminophen (Tylenol) | DRUG CARD FOR NURSING,PA,PT,MD STUDENTS. By John Azike JrliveBroadcastDetails{isLiveNowfalsestartTimestamp2020-07-07T040010+0000endTimestamp2020-07-07T041944+0000}
