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

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...

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Detalles Bibliográficos
Autores principales: Chiam, Elizabeth, Weinberg, Laurence, Bellomo, Rinaldo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: EDIMES Edizioni Internazionali Srl 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4476766/
https://www.ncbi.nlm.nih.gov/pubmed/26157738
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author Chiam, Elizabeth
Weinberg, Laurence
Bellomo, Rinaldo
author_facet Chiam, Elizabeth
Weinberg, Laurence
Bellomo, Rinaldo
author_sort Chiam, Elizabeth
collection PubMed
description 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.
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spelling pubmed-44767662015-07-08 Paracetamol: a review with specific focus on the haemodynamic effects of intravenous administration Chiam, Elizabeth Weinberg, Laurence Bellomo, Rinaldo Heart Lung Vessel Review-Article 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. EDIMES Edizioni Internazionali Srl 2015 /pmc/articles/PMC4476766/ /pubmed/26157738 Text en Copyright © 2015, Heart, Lung and Vessels http://creativecommons.org/licenses/by-nc/3.0/ This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review-Article
Chiam, Elizabeth
Weinberg, Laurence
Bellomo, Rinaldo
Paracetamol: a review with specific focus on the haemodynamic effects of intravenous administration
title Paracetamol: a review with specific focus on the haemodynamic effects of intravenous administration
title_full Paracetamol: a review with specific focus on the haemodynamic effects of intravenous administration
title_fullStr Paracetamol: a review with specific focus on the haemodynamic effects of intravenous administration
title_full_unstemmed Paracetamol: a review with specific focus on the haemodynamic effects of intravenous administration
title_short Paracetamol: a review with specific focus on the haemodynamic effects of intravenous administration
title_sort paracetamol: a review with specific focus on the haemodynamic effects of intravenous administration
topic Review-Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4476766/
https://www.ncbi.nlm.nih.gov/pubmed/26157738
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