Tylenol an NSAID?

Nurses General Nursing

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I had a patient today who was a postop and his temp kept rising. His O2 sat was 89-90% on 3L of O2. This was his second surgery, first was an lap-open appy which resulted in pneumonia, this one was a small bowel resection and lysis of adhesions r/t complications from first surgery. Anyway, his temp reached 104.1 within 2 hours despite all efforts with triflow. His BP was 150/100. I paged the doc twice regarding this, he said "Well Tylenol is an NSAID and I dont want to admin that due to risk for bleeding." I asked the nightshift charge nurse if Tylenol is an NSAID and her response was "yes it is, thats why liver patients cant take it." Now, that just doesnt make any sense to me and I found that comment obsurd. What am I missing here?

You are correct and the doc is wrong--Tylenol is NOT an NSAID. I just finished my pharmacology class. Happy to know that I learned something.

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Specializes in Critical Care.
You are correct and the doc is wrong--Tylenol is NOT an NSAID. I just finished my pharmacology class. Happy to know that I learned something.

Well he's half wrong if we want to get technical.

See http://www.ncbi.nlm.nih.gov/pubmed/15662292

It does act in a similar fashion as a COX inhibitor, but the effect is so minimal it's not clinically relevant.

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i think tylenol is the least of this pt's concerns...

and don't think it's your typical post-op temp.

time for some blood cultures.

leslie

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Specializes in NICU,PICU, community ADL assessment.,.

there is a misunderstanding:

on one hand it is an NSAID, because it's a non-steroida anti-inflamatoric.

BUT!!! unlike the ibuprofen,it's based on cox-3 inhibition (regular NSAID's are cox1, cox2 inhibiting.

AND- its metabolism is done in the liver (so it's not good for all the liver diseases and alcohol abuses, etc), unlike the reg NSAIDs, which metabolism takes place in the kidneys (so it's not good for all the kidney problemati patients), and is C/I to the peptic disease- can cause internal bleeding.

so: tylenil (paracetamol)- doesn't cause any bleeding, and is C/I for the pts with liver problems.

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OK, I know this thread is old but the question is still important.

What's the final consensus? Or is it still that partially wrong/right answer?

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Specializes in Telemetry, Case Management.

The final answer is:

Tylenol is NOT an NSAID.

However, it IS contraindicated in liver patients, as Tylenol is metabolized through the liver.

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Well he's half wrong if we want to get technical.

See http://www.ncbi.nlm.nih.gov/pubmed/15662292

It does act in a similar fashion as a COX inhibitor, but the effect is so minimal it's not clinically relevant.

This is what we were taught in our Pharm course as well.

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Specializes in Critical Care.

Tylenol is not an NSAID, it has no significant anti-inflammatory effects and no significant direct effect on blood clotting. If it were to cause hepatotoxicity then it could indirectly affect clotting, but by itself it is not a platelet inhibitor.

Your MD and charge Nurse should definitely know better.

At just a few hours post-op, the temp is most likely related to pulmonary issues, and/or the surgery itself, and/or the medications involved. Where I work, the lab won't even run blood cultures any more for a post-op temp that is

The clearest explanation of the difference between Acetaminophen and NSAIDS:

http://www.hospicenet.org/html/nonprescription.html

(scroll down to "Are Aspirin, Acetaminophen, and Ibuprofen Different?")

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