Acetaminophen is one of the most widely used analgesics and anti-pyretics around the world1. Because of its safety, acetaminophen is the most common drug used in children for the relief of fever and pain2, 3. It is available in both oral (tablet & liquid) and rectal forms (suppositories). Various research studies have indicated that both forms have potential efficacy for the treatment of fever in children; however, there may be variations in administration, absorption and toxicity4-6. The oral form is the more common and acceptable form of administration among physicians. The rectal forms are often essential for treating febrile children with emesis and in other conditions where oral administration is contraindicated.
There have been several …show more content…
Although, it has been cited in the literature4 that the American Academy of Pediatrics (AAP) has discouraged the use of rectal acetaminophen because of concerns about the toxic effects as well as erratic absorption of the drug; this was not the recommendation for the use of rectal acetaminophen. The AAP did, in fact, publish that certain factors create the potential for inadequate therapeutic effect such as poor absorption and a cumulative toxic effect from excessive or too frequently repeated doses but the recommendation clearly stated that, for parents, rectal acetaminophen therapy should be avoided unless specifically discussed with the health care provider22. There was not a recommendation for discontinuing the use of rectal suppositories in hospitals or by physicians. The reason that parents need specific instructions is because the absorption of the acetaminophen varies depending on where in the rectum it is placed. When the suppository is placed in the distal rectum the drug by passes the liver, whereas with more proximal placement (oral), the drug will go through the first pass of the portal system that is drugs are metabolized in a single passage through the gut wall and (principally) liver, which reduces the bioavailability of the
There have been several …show more content…
Although, it has been cited in the literature4 that the American Academy of Pediatrics (AAP) has discouraged the use of rectal acetaminophen because of concerns about the toxic effects as well as erratic absorption of the drug; this was not the recommendation for the use of rectal acetaminophen. The AAP did, in fact, publish that certain factors create the potential for inadequate therapeutic effect such as poor absorption and a cumulative toxic effect from excessive or too frequently repeated doses but the recommendation clearly stated that, for parents, rectal acetaminophen therapy should be avoided unless specifically discussed with the health care provider22. There was not a recommendation for discontinuing the use of rectal suppositories in hospitals or by physicians. The reason that parents need specific instructions is because the absorption of the acetaminophen varies depending on where in the rectum it is placed. When the suppository is placed in the distal rectum the drug by passes the liver, whereas with more proximal placement (oral), the drug will go through the first pass of the portal system that is drugs are metabolized in a single passage through the gut wall and (principally) liver, which reduces the bioavailability of the