acetaminophen (oral, rectal)

Assessment

• Assess overall health status and alcohol usage before administering acetaminophen. Patients who are malnourished or chronically abuse alcohol are at higher risk of developing hepatotoxicity with chronic use of usual doses of this drug.

» Assess amount, frequency, and type of drugs taken in patients self-medicating, especially with OTC drugs. Prolonged use of acetaminophen increases the risk of adverse renal effects. For short-term use, combined doses of acetaminophen and salicylates should not exceed the recommended dose of either drug given alone.

• Assess type, location, and intensity prior to and 30–60 min following administration.

• Assess fever; note presence of associated signs (diaphoresis, tachycardia, and malaise).

• Evaluate hepatic, hematologic, and renal function periodically during prolonged, high-dose therapy.

» May alter results of blood glucose monitoring. May cause falsely ↓ values when measured with glucose oxidase/peroxidase method, but probably not with hexokinase/G6PD method. May also cause falsely ↑ values with certain instruments; see manufacturer's instruction manual.

» Increased serum bilirubin, LDH, AST, ALT, and prothrombin time may indicate hepatotoxicity.

• If overdose occurs, acetylcysteine (Acetadote) is the antidote.