Couple of comments:
1. Simply doubling the total daily therapeutic dose of acetaminophen,
whether PO or PR route for more than 48 hours has been shown to produce
hepatotoxicity. [ > 140 mg/kg/day]. A one time dose is probably going to
be OK but not on a "round the clock" basis.
2. I think fever is not a bad thing unless the patient is prone to
febrile seizures and we as providers should not feed into this "fever
phobia" that exists out there by over-emphasizing antipyretics & fever
3. The analgesic nephropathy[interstitial nephritis] was more of an
issue I thought with chronic dosing with "tylenol with codeine" in the
NEJM article and not regular acetaminophen.
> -----Original Message-----
> From: Mark Hostetler [SMTP:[log in to unmask]]
> Sent: Thursday, February 19, 1998 6:09 PM
> To: Multiple recipients of list PED-EM-L
> Subject: Rectal Tylenol
> Are there any group thoughts on rectal tylenol at the higher dose
> of 30-40mg/kg?
> Specifically regarding frequency, or infrequency, at these higher
> As with many others we are deluged with kids with extremely high temps
> (41.8'C) - I wonder regarding the pros (higher serum levels - perhaps
> "therapeutic levels") and cons of those higher doses (?hepatic
> consequences, chronic toxicity).
> Mark Hostetler
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