Acetaminophen prevention

Acetaminophen is thought to work within the central nervous system to inhibit the synthesis of prostaglandins, agents that enhance pain sensations. Acetaminophen prevents prostaglandin synthesis by blocking the action of central cyclooxygenase. Acetaminophen is well... 

Acetaminophen, which depletes hepatic glutathione, does not potentiate the toxicity of methyl parathion in mice. A possible mechanism of action may be competition between acetaminophen and methyl parathion for mixed function oxidases and subsequent prevention of activation of methyl parathion to methyl paraoxon (Costa and Murphy 1984). Diethyl maleate, an agent that depletes cytosolic glutathione and is not an enzyme inducer, potentiates toxicity of methyl parathion in mice (Mirer et al. 1977). 

Centers for Disease Control and Prevention (CDC). Fatalities associated with ingestion of diethylene glycol-contaminated glycerin used to manufacture acetaminophen syrup—Haiti, November 1995-June 1996 MMWR Morb Mortal Wkly Rep 1996 45 649-50. 

Non-steroidal anti-inflammatory agents, aspirin, and acetaminophen have been suggested for use in the prevention of different cancers, especially hereditary non-polyposis colon cancer.14 While there have been observational studies linked to a reduction of ovarian carcinoma risk, evidence is still lacking. Potential... 

Watch for infusion reactions with rituximab and alemtuzumab. Premedicate with acetaminophen and diphenhydramine to prevent these reactions. 

Acetaminophen and NSAID around the clock for fever and chills add meperidine if chills are severe clindamycin or cefazolin to prevent infection. 

In addition to their beneficial effects, some medications may actually cause cellular injury and disease. An example of this phenomenon involves nonsteroidal anti-inflammatory drugs (NSAIDS). These drugs include aspirin (a derivative of salicylic acid), ibuprofen (arylpropionic acid, Advil ), and acetaminophen (para-aminophenol derivative, Tylenol ). Because of their beneficial pharmacological effects, consumption of these agents has increased significantly in recent years. NSAIDS have the ability to treat fever, pain, acute inflammation, and chronic inflammatory diseases such as arthritis. They are also used prophylactically to prevent heart disease, stroke, and colon cancer. 

Pain management should begin with nonnarcotic analgesics such as acetaminophen or a nonsteroidal antiinflammatory drug administered on a scheduled basis before meals to prevent postprandial exacerbation of... 

Nakae, D. et al., Liposome-encapsulated superoxide dismutase prevents liver necrosis induced by acetaminophen, Am. J. Pathol., 136, 787, 1990. 

Researchers have found that the substitution of two methyl groups on the benzene ring in the acetaminophen molecule results in the formation of an analog that is essentially resistant to the metabolic reactions that result in the formation of N-acetyl-p-henzo-quinone imine and, hence, prevent toxic reactions involved with the use of acetaminophen. Researchers believe that the presence of the methyl groups interferes with enzyme actions that, in the first step of the reaction by which N-acetyl-p-benzo-quinone imine is produced, convert hydrogen atoms on the benzene rings in acetaminophen to hydroxyl groups. 

Acetaminophen is similar to salicylates in that it is a useful analgesic for mild to moderate pain, with equal efficacy to aspirin, and like aspirin, it is antipyretic. However, acetaminophen exerts little if any effects on platelet aggregation and is not antiinflammatory. Thus, it is not useful for patients with arthritis or other inflammatory diseases. It is also not useful as an antithrombotic agent in the prevention of myocardial infarction or transient ischemic attacks. Acetaminophen does not produce the gastric ulceration that can occur with aspirin and is useful in patients who are salicylate sensitive or who have a history of ulcers or other gastric ulcerations. 

A minor asymptomatic increase in liver aminotransferase is seen in 10 to 20% of patients, whereas fatal hepatitis is seen in fewer than 1% of isoniazid recipients. Risk factors for hepatitis include underlying liver disease, advanced age, pregnancy, and combination therapy with acetaminophen. Early recognition and prompt discontinuation of the drug is recommended to prevent further damage to the liver. 

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