Generic Name: Paracetamol, Acetaminophen
Brand Name: Biogesic, Panadol, Tylenol
Classification: Non-narcotic analgesic, Antipyretic


  1. Control of pain due to headache, earache, dysmenorrhea, arthralgia, myalgia, musculoskeletal pain, arthritis, immunizations, teething, tonsillectomy
  2. O reduce fever in viral and bacterial infections.
  3. As a substitute for aspirin in upper GI disease, bleeding disorders, clients in anticoagulant therapy and gouty arthritis


  1. Decreases fever by a hypothalamic effect leading to sweating and vasodilation
  2. Inhibits pyrogen effect on the hypothalamic-heat-regulating centers
  3. Inhibits CNS prostaglandin synthesis with minimal impact on peripheral prostaglandin synthesis
  4. It does not cause ulceration of the GI tract and causes no anticoagulant action.


  1. Renal Insufficiency
  2. Anemia

Special Concerns

  1. Liver toxicity (hepatocyte necrosis) may occur with doses not far beyond labeled dosing.
  2. If three or more alcoholic drinks per day are consumed, consult a physician prior to use.


  1. Minimal GI upset.
  2. Methemoglobinemia
  3. Hemolytic Anemia
  4. Neutropenia
  5. Thrombocytopenia
  6. Pancytopenia
  7. Leukopenia
  8. Urticaria
  9. CNS stimulation
  10. Hypoglycemic coma
  11. Jaundice
  12. Glissitis
  13. Drowsiness
  14. Liver Damage


Per Orem: 325-650mg q4h up to a maximum of 1 gram q6h.

Suppositories: 650mg q4h not to exceed 4 grams a day for up to 10 days.

Nursing Considerations

  1. Do not exceed 4gm/24hr. In adults and 75mg/kg/day in children.
  2. Do not take for >5days for pain in children, ten days for pain in adults, or more than three days for fever in adults.
  3. Extended-Release tablets are not to be chewed.
  4. Monitor CBC, liver, and renal functions.
  5. Assess for fecal occult blood and nephritis.
  6. Avoid using OTC drugs with Acetaminophen.
  7. Take with food or milk to minimize GI upset.
  8. Report N&V. cyanosis, shortness of breath, and abdominal pain as these are signs of toxicity.
  9. Report paleness, weakness, and heartbeat skips
  10. Report abdominal pain, jaundice, dark urine, itchiness, or clay-colored stools.
  11. Phenmacetin may cause urine to become dark brown or wine-colored.
  12. Report pain that persists for more than 3-5 days
  13. Avoid alcohol.
  14. This drug is not for regular use with any form of liver disease.
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