When you ask a patient if they have a fever, what's their preferred agent to reduce their fever?

In other words, what's their most commonly used antipyretic?

And yes, an antipyretic or antifirate is the terminology we use for medications to reduce fevers. In the United States, everyone

will unitedly say acetaminophen. What they'll probably say is Tylenol, because that's actually

the term that's being used in the same way people

call toothpaste Colgate and that's the accepted term it's just become synonymous

but as it is in the United States the most widely used analgesic and antipyretic is acetaminophen. It was introduced in 1955 and has been going

strong ever since. Now acetaminophen or paracetamol if you're outside the United States is

considered safe at its usual doses of 2 to 4 grams within a 24 hours. But

overdose has become commonly recognized and it began being seen in the literature

in about 1966 and it can cause

both fatal and non-fatal hepatic necrosis. And so with that ladies and

gentlemen I'm Dr. Niket Son Paul, your friendly neighborhood

internist and gastrointestinal and today we're going to be talking about acetaminophen poisoning.

The next topic of our liver series.

So stay tuned and let the music play out. Now a Cita minifophen is available in both an immediate release and a sustained release

formulation.

The dose is usually for children at about 10 to 15 milligrams per kilogram, And in adults you see tablets of about 325 to 1,000 milligrams

per dose, usually given every 4 to 6 hours.

And we typically tell patients not to go above 4 grams.

And if they have liver disease or cirrhosis we tell them to stay

under 2 grams. We know that toxicity is likely to occur with single ingestions

...