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Acetaminophen versus dantrolene as antipyretic
- Julian P Stone (11 July 2007)
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Julian P Stone, Anaesthetic Consultant
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Anaesthetic Department Great Western Hospital Swindon Wilts SN3 6BB 5/7/7 Editor I should like to comment on the case discussed by Moon and Cros about the use of dantrolene in the management of Ecstasy (3,4- methylenedioxymetamphetamine,MDMA) induced hyperthermia [1]. Although the dantolene given to the patient almost certainly reduced the muscle rigidity, it is not clear how the effect of it on the temperature can be separated from that of the acetaminophen 1 gram per rectum since only a short time elapsed after the acetaminophen administration before the dantrolene was given. Rectal acetaminophen has variable absorption but its peak plasma level certainly is longer than 45 min. Beck and colleagues found that peak plasma levels were 4.2 hours and 3.6 hours after 20mg/kg and 40 mg/kg rectal acetaminophen respectively [2]. Intravenous acetaminophen is becoming increasingly available and will produce quicker and more predictable peak plasma levels as well as being less expensive. Dr Julian P Stone drjpstone@hotmail.com 1. Moon J,Cros J. Br J Anaesth2007;99:146 2. Beck DH,Schenk MR,Hagemann K,Doepfmer UR,Kox WJ.Anesth Analg 2000;90:431-6 Conflict of Interest:None declared |
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