Be Vigilant About Acetaminophen (Tylenol) Toxicity - Page 3

A question for all, my facility recently changed the standard for max Tylenol dosing from 4 G/24 hrs to 3 G/24 hrs supposedly based on new federal guidelines. I don't think it is a bad idea, but has anybody else heard of this or made this change where you work?

I have heard of the 3g recommendation, but at my hospital, it's still 4g. It amazes me how many nurses don't even really know what class of drug tylenol is. I was giving report to another RN who was precepting a new grad. The pt had previously complained of pain and was ordered a one time dose of percocet, but refused the med because of the narcotic. In the evening, pt was complaining of pain again, so I called and got an order for tylenol, which the pt took with good results. The new grad listening to report jumped in to chastise me for ordering tylenol for this pt. Why? Because the pt had a hx of GI Bleed. For a second, I just stared at her, but after a moment, it hit me, so I asked her, "Do you think tylenol is an NSAID?" Her reply was that it is an NSAID and that it was irresponsible of me to get it ordered for this pt. Her tone and attitude left me wanting to share a few choice words with her, but I took a deep breath and told her, "No, tylenol is not an NSAID; you are welcome to look it up, which you probably should, since you obviously don't know what class of drug it is, but I'll just let you know that I'm right."
The scary thing for me was that this wasn't the first time I had had another RN tell me that tylenol is an NSAID.

heard of it, think the pharm is talking about it, and I think it is actually 2600 for the elderly, which would work out to 2 doses of tylenol arthritis...

The only big change for us has been tweaking scheduled and prn orders to get under 3 G. Kind of an issue with the narc/Tylenol combo drugs that people seem to like so much.