This medicine is available only under a restricted distribution program called the Opioid Analgesic REMS (Risk Evaluation and Mitigation Strategy) program. Although rare, use of acetaminophen has been reported to lead to liver transplantation and death, usually at high doses and when multiple acetaminophen-containing products have been used. But acetaminophen may cause other unwanted effects when taken in large doses, including liver damage. It does not become habit-forming when taken for a long time. Loading dose: 140 mg/kg IV infused over 1 hr (dilute in 500 mL D5W), THEN Maintenance dose: 70 mg/kg IV q4h for at least 12 doses (dilute each dose in 250 mL of D5W and infuse over minimum. Since this medicine is only used for short-term relief of pain, mental and physical dependence will probably not occur.Īcetaminophen is used to relieve pain and reduce fever in patients. Physical dependence may lead to side effects when you suddenly stop taking the medicine. Mental dependence (addiction) is not likely to occur when narcotics are used for this purpose. When tramadol is used for a long time, it may become habit-forming (causing mental or physical dependence). It acts in the central nervous system (CNS) to relieve pain. Tramadol belongs to the group of medicines called opioid analgesics (narcotics). Calculates PO/IV NAC dosing for acetaminophen overdose (and nomogram to determine toxic 4 hour level).
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