pspressman
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« on: September 19, 2008, 12:54:49 PM » |
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Acetaminophen in liver disease
Many folks are nervous about giving Tylenol to patients who have liver disease. In recommended doses, there is no evidence that tylenol increases hepatotoxicity in patients with chronic liver disease. Of course, tylenol can cause liver damage-- it's frequently a drug of choice in suicidal patients. However, the risk of severe liver damage is still less than 10% in overdose situations. While acetaminophin is eliminated slowly in patients with chronic liver disease, this does not seem to cause accumulation of the drug or byproducts.
Dr. Cox: Did you actually just page me to find out how much Tylenol to give to Mrs. Lensner?
J.D.: I was worried that it could exacerbate the patient's...
Dr. Cox: It's Regular-Strength Tylenol. Here's what you do. Get her to open her mouth, take and handful, and throw it at her. Whatever sticks, that's the correct dosage.
- Scrubs
OK, that's a little harsh-- you can get a patient to overdose if you forget to include doses of acetaminophen included in say, Vicodin in addition to prescribed Tylenol. But again, if the overall dose of Tylenol is within recommended limits, don't sweat it in patients with chronic liver disease. More in the paper below. A caveat-- not much is included about acute liver disease.
Benson GD, Koff RS, Tolman KG. The therapeutic use of acetaminophen in patients with liver disease. Am J Ther. 2005 Mar- Apr; 12(2): 133-41
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