Overdosed prescription of paracetamol (acetaminophen) in a teaching hospital.

B Charpiat, A Henry, G Leboucher, M Tod, B Allenet

Joseph-Fourier University-Grenoble 1, CNRS, TIMC-IMAG UMR 5525, Themas, Domaine de la Merci, 38706 La Tronche cedex, France. bruno.charpiat@chu-lyon.fr

Annales pharmaceutiques françaises 2012 Jul

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Paracetamol is the most commonly used analgesic and antipyretic. Reviews of hospital use of paracetamol are scarce. Little is known about the appropriateness of the dose of paracetamol prescribed for hospitalized adults. The aim of this study was to report on the nature and the frequency of the overdosed prescription of paracetamol observed in adult patients over a 4.5-year period in a teaching hospital. Prescription analysis by pharmacists was performed once a week in six medical and three surgical departments and daily in a post-emergency unit. In cases of prescription error, the pharmacist notified the physician through an electronic alert when a computerized prescription order entry system was available or otherwise by face-to-face discussion. For each drug-related problem detected, the pharmacists recorded relevant details in a database. From October 2006 to April 2011, 44,404 prescriptions were reviewed and 480 alerts related to the overdosed prescription of paracetamol were made (1% of analyzed prescriptions). The extent of errors of dosage was within the intervals [90-120 mg/kg/d] and greater than 120 mg/kg/d for 87 and 11 patients respectively, who were prescribed a single non-combination paracetamol containing product. Sixty alerts concerned co-prescription of at least two paracetamol containing products with similar frequency for computerized (1.4/1000) or handwritten (1.2/1000) prescriptions. Prescriptions of paracetamol for hospitalized adults frequently exceed the recommended dosage. These results highlight the need for increased awareness of unintentional paracetamol overdose and support the initiation of an educational program aimed at physicians and nurses. Copyright © 2012. Published by Elsevier Masson SAS.

Citation

B Charpiat, A Henry, G Leboucher, M Tod, B Allenet. Overdosed prescription of paracetamol (acetaminophen) in a teaching hospital. Annales pharmaceutiques françaises. 2012 Jul;70(4):213-8