Severe thrombocytopenia after paracetamol overdose

Article Abstract:

Blood platelets play a critical role in the clotting of blood in normal and disease states. Administration of high doses of some drugs has been reported to cause a drastic reduction in the number of platelets (thrombocytopenia). Two case reports are described in which patients voluntarily took extremely large overdoses of the analgesic drug paracetamol (acetaminophen), and were subsequently hospitalized. Both patients exhibited a variety of abnormalities in their blood chemistry, most notably a decrease in platelet concentration. This decrease was most marked two days after the overdose. Jaundice was present in both cases, as was a variable degree of disorientation and mental confusion (hepatic encephalopathy; impaired central nervous system function resulting from liver failure). Both patients required extensive platelet transfusions, as well as supportive therapy, and were well enough to be released within three to five weeks after overdose. In cases of paracetamol overdose, platelet levels should be checked immediately. The clotting failure that can result from thrombocytopenia can be life-threatening, but is easily treatable by platelet transfusion. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Case studies, Thrombocytopenia, Medication abuse, Prescription drug abuse

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Paracetamol suppositories: a comparative study

Article Abstract:

Standard treatment for fever in children is oral administration of acetaminophen (called paracetamol in UK and Ireland). This method of treatment is not always effective when the child is vomiting or semi-alert, and the development of aspirin-containing and acetaminophen-containing suppositories has helped solved the problem. The pharmacokinetics (biological behavior) of acetaminophen suppositories made in two different formulas (water-soluble vs fat-soluble) are described. Twenty-eight children between two months and eight years of age, recovering from cardiac surgery, were given the drug (18 received the water-soluble base and 10 received the fat-soluble base) on the first day after the operation. Blood levels of the drugs and their effects on body temperature were compared. The highest blood concentrations of acetaminophen and the greatest reduction in temperature were recorded with the fat-soluble base. Acetaminophen suppositories are an acceptable alternative to aspirin suppositories (which may have adverse side effects such as Reye's syndrome) and oral medication in reducing fever in children. (Consumer Summary produced by Reliance Medical Information, Inc.)

Fever in children, Childhood fever, Dosage and administration

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The advantages of using suppositories

Article Abstract:

Giving medication via suppositories is useful when patients cannot swallow, are continually sick or have sore mouths. However, there are cultural barriers to using suppositories and the British do not like them, plus nurses are embarrassed about administering them. However, once patients have been told more about suppositories they are often more willing to use them. The nurse should explain the benefits, ask about medical problems which may cause problems, such as haemorrhoids, explain how they are inserted and remind them how long they have to remain in place.

Management, Usage, Rectum, Medication by, Rectal medication, Suppositories

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