Archives of Internal Medicine: “A total of 14 411 patients (60.7%) were exposed to acetaminophen, of whom 955 (6.6%) exceeded the 4 g per day maximum recommended dose. In addition, 22.3% of patients who were 65 years or older and 17.6% of patients with chronic liver diseases exceeded the recommended limit of 3 g per day.†Arch Intern Med. Published online November 12, 2012
Not surprising at all. Any pharmacist that’s worked in a hospital setting can tell you that an average patient profile is riddled with potential excess acetaminophen dosing. We used to have order sets for post-op patients that contained acetaminophen 650mg Q 4 hrs prn pain/temp plus Darvocet N-100 2 tablets Q 4 hrs prn pain plus Vicodin 1-2 Q 4 hrs prn pain thrown in for good measure. When pharmacy would object to these order sets the hospital would simply say that no one would ever give all of those to one patient. It’s common sense after all. You’d be surprised what people will do.
Medscape has expanded information on the article if you don’t have credentials to read the full Archives article.