Injectable paracetamol

RE: Injectable paracetamol

David Mills — Thu, 18 Feb 2016 19:13:09 GMT

[quote user="Anthony Dennison"]a cute pain[/quote]

Sounds like a girlfriend.

RE: Injectable paracetamol

Anthony Dennison — Thu, 18 Feb 2016 09:24:16 GMT

[quote user="mariette asselbergs"] A junior doctor friend told me that they use it in the NHS too and is as effective as morphine.[/quote]

There is a human paper comparing morphine and paracetamol showing that paracetamol was as effective as morphine for a cute pain over the first 60 minutes with fewer side effects, or something like that.

I know this because I once read a case report on my certAVP that used it as a reference to justify why the only analgesia given to a dog with a broken leg was a single dose of i/v paracetamol...

RE: Injectable paracetamol

mariette asselbergs — Wed, 17 Feb 2016 16:24:04 GMT

Thanks everybody for sharing this info. I think it would be justifiable under the cascade as alternative for using controled drugs, NSAIDs and oral drugs in vomiting patients.

Mariette

RE: Injectable paracetamol

Virginia Campbell — Wed, 17 Feb 2016 15:14:04 GMT

[quote user="Charlie G"]generic - comes in 100ml bottles designed for human infusions. Pretty sure we get it from the wholesaler. [/quote]

Same here.

RE: Injectable paracetamol

Rob Loxley — Wed, 17 Feb 2016 13:42:07 GMT

You can get Perflagan from the cheap human medical suppliers for <£3/bottle.

RE: Injectable paracetamol

Charlie G — Wed, 17 Feb 2016 09:22:16 GMT

We use either Perfalgan or generic - comes in 100ml bottles designed for human infusions. Pretty sure we get it from the wholesaler.

RE: Injectable paracetamol

Joyce Whitehead — Wed, 17 Feb 2016 08:37:20 GMT

Those of you using it - is it a generic and do you get it from your usual wholesaler? I've had a few cases in the past I feel it might have helped as an addition to licensed drugs, but at the time couldn't source it from the wholesaler.

RE: Injectable paracetamol

Virginia Campbell — Tue, 16 Feb 2016 23:36:26 GMT

Yes it's really nice for pyrexic miserable dogs - I think a more potent anti pyretic than NSAIDs and I feel safer using it in the acute phase when I'm still afraid of the post-pyretic diarrhoea kicking in. Also safer to use if they're dehydrated and you want something to make them happier while you're running the fluids in as fast as you dare. I've used it in pups, and recently in an adult dog with a severe arthritis flare and diarrhoea (various opiates made her dopey and anorexic even at unheroic doses) and another with cellulitis. I've also used it for a day or two in old labradors with big arthritic elbows that are already on trocoxil but come in with acute 5/5 elbow lameness and suspected septic joint along with the IV abs. My husband got IV paracetamol when he was admitted to hospital for 3 days with bad cat bites in his hand and it helped to relieve the pain. I really, really wish cat-safe paracetamol existed- think of all those pyrexic kitties we could use it on!

RE: Injectable paracetamol

Stephen Courtney — Tue, 16 Feb 2016 23:20:45 GMT

[quote user="Clive Ansell"]

Going back to that old devil the cascade again - why would one use injectable paracetamol off label, when there are a whole range of tried and tested, safe and efficacious licenced analgesics?

[/quote]

we use it at times as part of multimodal analgesia. Paracetamol has its place in canine medicine, for instance a severe pancreatitis case that is being weaned off opiates, and dogs that can't tolerate the usual products.

Remember it isn't an NSAID proper just has similar indictations, and doesn't have the side effects associated with them. So if that is an issue in any one case, then that is why you use it. Pretty costly though, so not a casual choice.

RE: Injectable paracetamol

John Flynn — Tue, 16 Feb 2016 19:41:18 GMT

I find it invaluable for bringing down the temperature of a severely pyrexic dog and use it slow iv or SC. It's about 2euro for a 100ml bottle I think (no preservative, not sure of rate of decreased efficacy after puncture of vial)

I really don't think it's as effective as morphine for pain though!

Indeed I'm a bit skeptical whether at 10mg/kg in a dog it has any measurably useful analgesic effects given in addition to morphine etc. I did use it for a while when it was trendy peri-operatively for ortho cases and did not notice any obvious benefit. They certainly won't benefit from the placebo effect that humans get for musculoskeletal pain. I believe it is meant to be more effective against visceral pain perhaps?

Some hopsitals won't give NSAIDs to fracture patients for a week or more as they're concerned re reduced healing, they give paracetamol instead apparently.

RE: Injectable paracetamol

Charlie G — Tue, 16 Feb 2016 18:12:12 GMT

We use it pretty frequently peri-op (generally orthopaedic/spinal etc), at a dose of 10mg/kg and then followed up q12h as necessary. Find it useful for dogs on steroids or where NSAIDs are contraindicated as an adjunct injectable if opioids +/- ketamine CRI aren't enough - does seem to smooth the GA in painful patients.

RE: Injectable paracetamol

Clive Ansell — Tue, 16 Feb 2016 17:21:46 GMT

Going back to that old devil the cascade again - why would one use injectable paracetamol off label, when there are a whole range of tried and tested, safe and efficacious licenced analgesics?

RE: Injectable paracetamol

skatealexia — Tue, 16 Feb 2016 16:47:00 GMT

They used it all the time at the university of liverpool in orthopedic and spinal cases