Tylenol IV

[Adri_RN]

Ok, so the other day I receive a post op on our floor with an order for Tylenol 500 mg IV q8h x2. I thought the doc had written the order by mistake.... IV? So I call him to clarify, and he tells me yes, administer it via IVPB. Pharmacy mixed it and sent it up to the floor. Per the pharmacist it was recently approved by the FDA and has been in use for a short time. Have any of you had to administer it yet and what are your thoughts on it?

Thanks for your input :)

[RKpianoman, APRN]

I haven't seen it, but I'm still in nursing school. Found the following article on it; looks interesting:

http://www.medscape.com/viewarticle/731994

[AirforceRN, RN]

I believe the Brits have been using IV acetaminophen for some time...I haven't used it before but anything that can decrease my suppository count can only be good in my books.

[xtxrn, ASN, RN]

I haven't seen it, but I'm still in nursing school. Found the following article on it; looks interesting:

http://www.medscape.com/viewarticle/731994

Wow- never even thought of it ever being IV...if it works (and doesn't destroy the liver in the long haul), sounds good :) The dose is more than the newer recommended limits.

[Anna Flaxis, BSN, RN]

IV paracetamol (acetaminophen) has been in use in the UK for some time now, I believe.

[JemJ]

I had to give it the other day - but it comes in a bottle and it's name starts with an "O". (Sorry - can't remember the full name) You give it over 15 to 30 min and from what I understand, b/c it is in IV form, it helps decrease the need for narcotics.

[wooh, BSN, RN]

We got an email recently saying our pain team has gotten the pharmacy to start carrying it. I'm looking forward to seeing how it works.

(Although NOTHING will beat my excitement over finding out there's aspirin suppositories. It is amazing how hard it is to get a kid to take baby aspirin when they have Kawasaki. And I just find it ridiculous crushing it and mixing it with syrup. When we were kids, we LOVED baby aspirin. It was a treat!!! Now I can just say, "we could do it rectally instead of fighting!")

[xtxrn, ASN, RN]

We got an email recently saying our pain team has gotten the pharmacy to start carrying it. I'm looking forward to seeing how it works.

(Although NOTHING will beat my excitement over finding out there's aspirin suppositories. It is amazing how hard it is to get a kid to take baby aspirin when they have Kawasaki. And I just find it ridiculous crushing it and mixing it with syrup. When we were kids, we LOVED baby aspirin. It was a treat!!! Now I can just say, "we could do it rectally instead of fighting!")

LOL.... I remember that too- and if there were orange candies that were sort of like SweeTarts, that was a HUGE deal :yeah: I wonder if the non-nursey sorts loved the flavor

[carolmaccas66, BSN, RN]

We use it here all the time. It is called Perfalgan and comes in little glass bottles, which you spike with a little spiggot and a line, to get the IV running. You just give it over about 20 minutes for adults, it's 10mg/ml, in a 100mls (1000mg).

It is expensive, but great for wee patients, and those who have dysphagia, or who may have had craniofacial diseases/surgery and who can't eat/drink. I reckon it works better than oral paracetamol cos it's fast and efficient.

It's great stuff and the doctors would love to use IV paracetamol all the time, but here they get told off if they do as using it blows the budget.

[pumpkin455]

I have seen it come on the scene in the last 3 months. I work in Ortho and a bunch of our surgeons have deemed it "the miracle drug". We typically give 1000 mg Q6 x 24 hours post op- so that puts pts right at their 4G limit for 24 hours.

Also one thing we have learned is that- per our pharmacy, the only IV fluid it is compatible with is normal saline, otherwise it must have its own tubing.

Not so sure I'm convinced of its effectiveness yet, I really think Toradol is the way to go for a non-narcotic pain med.

[CCRNDiva, BSN, RN]

We're using it in our hospital now, but has been in use in Europe for some time now. It provides good pain relief without causing respiratory depression and sedation while decreasing the need for narcotics.

[xtxrn, ASN, RN]

We use it here all the time. It is called Perfalgan and comes in little glass bottles, which you spike with a little spiggot and a line, to get the IV running. You just give it over about 20 minutes for adults, it's 10mg/ml, in a 100mls (1000mg).

It is expensive, but great for wee patients, and those who have dysphagia, or who may have had craniofacial diseases/surgery and who can't eat/drink. I reckon it works better than oral paracetamol cos it's fast and efficient.

It's great stuff and the doctors would love to use IV paracetamol all the time, but here they get told off if they do as using it blows the budget.

Have you had any issues with it masking infections that would normally be caught with an increased temp? :)