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 :)

[K+MgSO4, BSN]

We have been using it for years here in Oz & UK and ireland. There is some caution when using it IV. Our pain service did some research on my ward and they found that it can cause tempoary derangement of LFTS and should really be prescribed TDS when IV.

[Robublind]

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.

Its called OFIRMEV. I haven't seen it yet.

[MaryAnn_RN]

UK nurse here - we've been using it for some time and it appears to be very effective.

[dee122381]

Crazy, just a couple of years in nursing school, we heard horror stories of nursing students pushing IV Tylenol. Everyone knows you don't give Tylenol IV!!! But I guess now (in the US), it can be given IVPB. Just goes to show how healthcare is an ever-changing field...

[ChristineN, BSN, RN]

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

On a post-op floor would IV Tylenol really be masking temps anymore than the Percocet and Vicoden that these pts are already receiving, both of which contain Tylenol?

[ShortStackRN]

We give IV paracetamol a good bit in my facility. It's hung just like albumin and you must be sure it's vented tubing. It's basically a fast drip. We use it mostly for unresolved fever or fever related to blood transfusion reactions.

[Ocelot]

I've used OFIRMEV in our ER. It works great when the patient has a high temp, with vomiting and diarrhea. The IVPB decreased their fever and the PT was overall in a better state.

[TigerGalLE, BSN, RN]

We use it in my ICU often. Works great to get those high fevers down on patients who have gut issues with decreased absorption. Sure beats a cooling blanket.

[RNGrammie]

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.

The new MDD of acetaminophen is 3 grams/24hr.

[shygoofyone]

We were told on a Friday that we would start using it on our post-op orthos. Orfirmev, I believe. We give it over 15mins, at 400ml/hour. Since there's no compatibility studies available, we will only run it in as a piggyback with NS. The amount of pain control is unbelievable! Having seen our post-op orthos require less and less narcotics, and having received the IV tylenol last week after having my gallbladder removed-it's amazing!

[luvazsun, RN]

So, if I understand correctly, you administered a medication you knew nothing about? I do hope you only neglected to write in your post that you spoke with the pharmacy about the drug, how it should be infused, and any side effects you should be alert too, not that you just did it because it was ordered.

[kessadawn, BSN, RN]

We just started using it in my pediatric hospital, but we don't push it, we run it over a pump for like 20 or 30 minutes.