andersenpa Posted July 5, 2012 Share Posted July 5, 2012 We have this on our hospital formulary; it is restricted to PACU right now. I am writing a request for expanding use to postop analgesia in ICU. I saw a few mentions of it in the ketorolac thread...who is using it? ER folks? Inpatient PAs? Mike Jones (you are a specialty unto yourself here, sir.....) I am interested in hearing your experiences. Link to comment Share on other sites More sharing options...
chiaroscuro27 Posted July 5, 2012 Share Posted July 5, 2012 Ditto. I'd like to know all the particulars: dosing, efficacy, SE's, etc Link to comment Share on other sites More sharing options...
jmj11 Posted July 5, 2012 Share Posted July 5, 2012 I've never used it. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 5, 2012 Moderator Share Posted July 5, 2012 never used it. would love to give it to a drug seeker who refuses to leave without a shot. them: I demand a shot me: ok them(20 min later) what was that? me: 500 dollar tylenol. have a nice day(hands d/c paperwork) Link to comment Share on other sites More sharing options...
ATCLATEMTB Posted July 5, 2012 Share Posted July 5, 2012 I use it on almost all of my post-op thoracotomy patients. I do check a CMP on all pre-op labs, and obviously not give if even a whiff of liver issues pop up. I typically give Acetaminophen 1grm IV Q6 hrs x 6 doses. With a follow-up order for no oral sources of acetaminophen for 36 hours. I have had pretty good results, only once have I dc'd it due to liver enzyme elevations. I should note we also use OnQ pain caths, and usually a spinal narc- if not an infected pleural space. Had brief interaction with one of the reps about 3 wks ago, had some information and study data....nothing that was really that interesting. Link to comment Share on other sites More sharing options...
coloradopa Posted July 5, 2012 Share Posted July 5, 2012 We have this on our hospital formulary; it is restricted to PACU right now.I am writing a request for expanding use to postop analgesia in ICU. I saw a few mentions of it in the ketorolac thread...who is using it? ER folks? Inpatient PAs? Mike Jones (you are a specialty unto yourself here, sir.....) I am interested in hearing your experiences. We use it in the ICUs. In our hospital it's restricted to ICU and pain medicine. Seems to work pretty well. I usually give q8hr x 3. We have also been going away from APAP in other formulations. Link to comment Share on other sites More sharing options...
cjancay Posted July 6, 2012 Share Posted July 6, 2012 Haven't used it but we've been using IV Ibuprofen frequently postop due to the toradol shortage. Works quite well for patients who prefer not to use or do not require opioids and are still npo. The surgeons are even ok with recent GI surgery. I guess the IV formulation has far less risk of GI bleed than the oral form. Link to comment Share on other sites More sharing options...
Nakasoner Posted November 3, 2014 Share Posted November 3, 2014 I used it for post-op Neurosurgery, mostly spine cases. It was one NSx's preference. 1g IV q8h for 3 days. Of course, I couldn't use Norco/Vic/Percs at the same time. We'd use either PCA or oral morphine elixir and then add up the morphine equivalent dosing over 24hrs and then convert to PO meds. The other NSx I worked with didn't use IV acetaminophen and would just do PCA and then transition to Percocet or Norco., which was simpler. Link to comment Share on other sites More sharing options...
andersenpa Posted November 3, 2014 Author Share Posted November 3, 2014 We've been using it now for over a year (got P&T approval mentioned in the OP) We will be looking at before and after opioid use as well as other metrics (ICU LOS, delirium, mortality, etc) Link to comment Share on other sites More sharing options...
ohiovolffemtp Posted March 14, 2018 Share Posted March 14, 2018 resurrection post: IV tylenol (Ofirmev) is now off patent and is much cheaper. Starting to use it more (had been using tylenol suppositories) in my NPO patients. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted March 14, 2018 Moderator Share Posted March 14, 2018 On 7/5/2012 at 0:49 PM, EMEDPA said: never used it. would love to give it to a drug seeker who refuses to leave without a shot. them: I demand a shot me: ok them(20 min later) what was that? me: 500 dollar tylenol. have a nice day(hands d/c paperwork) THIS IS HOW I USE IT Link to comment Share on other sites More sharing options...
surgblumm Posted March 14, 2018 Share Posted March 14, 2018 Nice work Eric. I never heard of this nor did it so I guess I am a caveman. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted March 14, 2018 Share Posted March 14, 2018 On 7/5/2012 at 2:49 PM, EMEDPA said: never used it. would love to give it to a drug seeker who refuses to leave without a shot. them: I demand a shot me: ok them(20 min later) what was that? me: 500 dollar tylenol. have a nice day(hands d/c paperwork) I about snorted morning coffee reading this because I immediately thought the same thing. I try so hard not to be cynical and you guys can't even let me get out the door this morning without a high five. All this being said, I wonder if the bioavailability is greater, faster, than it would be if able to give po? Comparison would be glucocorticoids. What about just sticking a suppository up the rear torpedo tube if they're not taking p.o.? BTW, what's the cost if anyone should know? Link to comment Share on other sites More sharing options...
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