An adolescent is brought to the emergency department by a parent ...

[LCritchfi]

An adolescent is brought to the emergency department by a parent who reports that the patient took a whole bottle of extended-release acetaminophen tablets somewhere between 8 and 10 hours ago.
 
  The nurse will anticipate administering which of the following?
  a. Acetylcysteine (Mucomyst)
  b. Activated charcoal
  c. Hemodialysis
  d. Respiratory support

Question 2

A patient who is taking acetaminophen for pain wants to know why it does not cause gastrointestinal upset, as do other over-the-counter pain medications. The nurse will explain that this is most likely because of which property of acetaminophen?
 
  a. It does not inhibit cyclooxygenase.
  b. It has minimal effects at peripheral sites.
  c. It is more similar to opioids than to nonsteroidal anti-inflammatory drugs (NSAIDs).
  d. It is selective for cyclooxygenase-2.

[Zebsrer]

Answer to Question 1

ANS: A
The nurse should anticipate giving acetylcysteine, because it is the specific antidote for acetaminophen overdose. It is 100 effective when given within 8 to 10 hours after ingestion and may still have some benefit after this interval. Activated charcoal is effective only if given before the medication is absorbed, so it must be given much sooner. Hemodialysis is not indicated. Respiratory support is used for ASA overdose.

Answer to Question 2

ANS: B
The differences between the effects of acetaminophen and aspirin are thought to result from selective inhibition of cyclooxygenase; acetaminophen has only minimal effects on cyclooxygenase at peripheral sites, which may explain why acetaminophen does not have adverse GI, renal, and antiplatelet effects. Acetaminophen is a selective COX inhibitor. It is not more similar to opioids than NSAIDs. It is not selective for COX-2.

[LCritchfi]

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[Zebsrer]

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