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Paracetamol: a review with specific focus on the haemodynamic effects of intravenous administration.

Chiam E, Weinberg L, Bellomo R - Heart Lung Vessel (2015)

Bottom Line: The haemodynamic effects of the intravenous paracetamol formulations are largely understudied.It is unknown if mannitol is a contributing factor in the observed hypotension.Understanding the pharmacokinetic and pharmacodymanic properties of intravenous paracetamol may have important clinical implications for vulnerable patients in subgroups where haemodynamic stability is at risk such as those undergoing elective and emergency surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, University of Melbourne, Victoria, Australia.

ABSTRACT
Paracetamol is one of the most commonly used drugs worldwide with non-prescription sales exceeding 25 thousand million doses per year in the United States of America. The haemodynamic effects of the intravenous paracetamol formulations are largely understudied. There is an emerging body of evidence suggesting that intravenous paracetamol may cause iatrogenic hypotension. Little is known as to the mechanisms of this phenomenon or if intravenous paracetamol indeed does cause hypotension. As paracetamol has negligible solubility in aqueous solutions, many of the commercially available intravenous formulations contain mannitol (up to 3.91 g/100 mL paracetamol) as a stabilising ingredient. It is unknown if mannitol is a contributing factor in the observed hypotension. In this review, we outline the development of paracetamol's current intravenous formulations, describe the composition of these formulations, and overview the literature pertaining to the proposed phenomenon of paracetamol-induced altered hypotension. Understanding the pharmacokinetic and pharmacodymanic properties of intravenous paracetamol may have important clinical implications for vulnerable patients in subgroups where haemodynamic stability is at risk such as those undergoing elective and emergency surgery.

No MeSH data available.


Related in: MedlinePlus

Summary of haemodynamic and intravenous paracetamol-specific papers in the current literature.IV = intravenous; NICU = neonatal intensive care unit; ICU = intensive care unit; MCU = medium care unit; MAP = mean arterial pressure; SBP = systolic blood pressure. *Mean infusion time.
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Figure 003: Summary of haemodynamic and intravenous paracetamol-specific papers in the current literature.IV = intravenous; NICU = neonatal intensive care unit; ICU = intensive care unit; MCU = medium care unit; MAP = mean arterial pressure; SBP = systolic blood pressure. *Mean infusion time.


Paracetamol: a review with specific focus on the haemodynamic effects of intravenous administration.

Chiam E, Weinberg L, Bellomo R - Heart Lung Vessel (2015)

Summary of haemodynamic and intravenous paracetamol-specific papers in the current literature.IV = intravenous; NICU = neonatal intensive care unit; ICU = intensive care unit; MCU = medium care unit; MAP = mean arterial pressure; SBP = systolic blood pressure. *Mean infusion time.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4476766&req=5

Figure 003: Summary of haemodynamic and intravenous paracetamol-specific papers in the current literature.IV = intravenous; NICU = neonatal intensive care unit; ICU = intensive care unit; MCU = medium care unit; MAP = mean arterial pressure; SBP = systolic blood pressure. *Mean infusion time.
Bottom Line: The haemodynamic effects of the intravenous paracetamol formulations are largely understudied.It is unknown if mannitol is a contributing factor in the observed hypotension.Understanding the pharmacokinetic and pharmacodymanic properties of intravenous paracetamol may have important clinical implications for vulnerable patients in subgroups where haemodynamic stability is at risk such as those undergoing elective and emergency surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, University of Melbourne, Victoria, Australia.

ABSTRACT
Paracetamol is one of the most commonly used drugs worldwide with non-prescription sales exceeding 25 thousand million doses per year in the United States of America. The haemodynamic effects of the intravenous paracetamol formulations are largely understudied. There is an emerging body of evidence suggesting that intravenous paracetamol may cause iatrogenic hypotension. Little is known as to the mechanisms of this phenomenon or if intravenous paracetamol indeed does cause hypotension. As paracetamol has negligible solubility in aqueous solutions, many of the commercially available intravenous formulations contain mannitol (up to 3.91 g/100 mL paracetamol) as a stabilising ingredient. It is unknown if mannitol is a contributing factor in the observed hypotension. In this review, we outline the development of paracetamol's current intravenous formulations, describe the composition of these formulations, and overview the literature pertaining to the proposed phenomenon of paracetamol-induced altered hypotension. Understanding the pharmacokinetic and pharmacodymanic properties of intravenous paracetamol may have important clinical implications for vulnerable patients in subgroups where haemodynamic stability is at risk such as those undergoing elective and emergency surgery.

No MeSH data available.


Related in: MedlinePlus