Fri12November0729PM 1

A 74-year-old woman is admitted to the Emergency department with a fractured neck of femur. She is known to be a chronic alcoholic. She weighs 49 kg.

Following a fascia iliaca block you are asked to prescribe an intravenous paracetamol regimen.

Which one of the following regimens is the most appropriate for this patient?

(Please select 1 option)

7.5 mg/kg with a maximum daily dose of 30 mg/kg

15 mg/kg with a maximum daily dose of 60 mg/kg (not exceeding 2 g) Incorrect answer selected

15 mg/kg with a maximum daily dose of 60 mg/kg (not exceeding 3 g) This is the correct answer

1 g with a maximum daily dose not exceeding 4 g

1 g with a maximum daily dose not exceeding 3 g

Explanation

Intravenous paracetamol (Perfalgan�) is formulated as a 10 mg/ml solution and manufactured by Bristol-Myers Squib Pharmaceuticals Limited.

There is a risk of accidental overdose of paracetamol if it is not prescribed carefully, according to age, weight and comorbitities of the patient. The upper safe limit for each single dose and in each 24 hour period should not be exceeded.

Patient weight Dose per administration Maximum daily dose

=10 kg 7.5 mg/kg 30 mg/kg

10 kg to =33 kg 15 mg/kg 60 mg/kg (not exceeding 2 g)

33 kg to =50 kg 15 mg/kg 60 mg/kg (not exceeding 3 g)

50 kg with additional risk factors for hepatotoxicity 1g 3 g

50 kg with no additional risk factors for hepatotoxicity 1g 4 g

In adults with hepatocellular insufficiency, chronic alcoholism, chronic malnutrition (low reserves of hepatic glutathione) or dehydration, the maximum daily dose should not exceed 3 g.

Reference:

Medicines and Healthcare products Regulatory Agency (MHRA). Intravenous paracetamol (Perfalgan�): risk of accidental overdose, especially in infants and neonates.

Safe Anaesthesia Liaison Group. Intravenous Paracetamol.

Answer Statistics

1

6%

2

21%

3

55%

4

5%

5

14%

Times answered: 252