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Acetaminophen

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Abstract

Acetaminophen prevails as one of the most popular and broadly used over-the-counter analgesic and antipyretic medications for more than half a century in the United States. Paracetamol (acetaminophen’s recommended international nonproprietary name) is the most commonly used analgesic worldwide. Although acetaminophen’s exact mechanism of action remains unclear, its analgesic properties are most likely due to activation of descending serotonergic pathways in the central nervous system. Acetaminophen is the recommended first step in pharmacological treatment for almost any pain and/or as part of multimodal management for postoperative pain in adults and children. In spite of its well-established safety profile with limited side-effects, acetaminophen overuse can result in liver injury and is therefore contraindicated in patients with severe hepatic impairment and/or active liver disease. Compared to the oral formulation, intravenous acetaminophen has been found to demonstrate a faster onset and shorter time to reach higher mean cerebrospinal fluid concentrations, but whether these differences translate into significant clinical benefits has not yet been determined. Administration of intravenous acetaminophen is recommended as appropriate when a patient is unable to tolerate the oral route.

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Brennan, K., Liu, H. (2023). Acetaminophen. In: Li, J., Jiang, W., Vadivelu, N. (eds) First Aid Perioperative Ultrasound. Springer, Cham. https://doi.org/10.1007/978-3-031-21291-8_7

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  • DOI: https://doi.org/10.1007/978-3-031-21291-8_7

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