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Paracetamol [a], or acetaminophen [b], is a non-opioid analgesic and antipyretic agent used to treat fever and mild to moderate pain. [13] [14] [15] It is a widely used over-the-counter medication. Common brand names include Tylenol and Panadol. Paracetamol relieves pain in both acute mild migraine and episodic tension headache.
An equianalgesic chart is a conversion chart that lists equivalent doses of analgesics (drugs used to relieve pain). Equianalgesic charts are used for calculation of an equivalent dose (a dose which would offer an equal amount of analgesia) between different analgesics. [1]
The Rumack–Matthew nomogram, also known as the acetaminophen nomogram, is an acetaminophen toxicity nomogram. It plots serum concentration of acetaminophen against the time since ingestion, in order to predict possible liver toxicity and allow a clinician to decide whether to proceed with N-Acetylcysteine (NAC) treatment.
The Tylenol murderer was never found, (though later James Lewis was a prime suspect [10]) and a US$100,000 reward offered by Johnson & Johnson remained unclaimed as of 2023. [11] [12] [13] Before the poisonings, Tylenol brands held around 35% of the US market for acetaminophen and in the immediate aftermath, fell to 8%.
[20] [74] Oral acetylcysteine is given as a 140 mg/kg loading dose followed by 70 mg/kg every four hours for 17 more doses, and if the patient vomits within 1 hour of dose, the dose must be repeated. [ 75 ] [ 76 ] Oral acetylcysteine may be poorly tolerated due to its unpleasant taste, odor, and its tendency to cause nausea and vomiting. [ 72 ]
The panel also cited concerns of liver damage from their paracetamol component, which is also the main ingredient in commonly used nonprescription drugs such as Tylenol. [21] Each year, paracetamol overdose is linked to about 400 deaths and 42,000 hospitalizations.
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