SWIM is curious if it is safe to plug higher amounts of APAP because absorption of APAP in the rectum is much lower and slower than the oral route. SWIM looked at some studies and found that it generally takes a much higher doses of APAP to reach therapeutic levels and since opioid absorption does not change whether it is taken orally or rectally you can get a higher dose. For example, since SWIM weighs about 80 kg swim would need 2800 mg of APAP to reach therapeutic levels based off a conservative dosing of 35mg/kg, that would result in taking roughly 8 pills of Percocet rather than 3 if taken orally based off the 1000 mg oral limit for APAP.
Serum paracetamol concentrations in adult volunteers following rectal administration
M. E. Stocker1 and J. E. Montgomery
+ Author Affiliations
Department of Anaesthesia, South Devon Healthcare Trust, Torquay, Devon TQ2 7AA, UK 1Present address: Department of Anaesthesia, Royal Devon and Exeter Hospital, Exeter EX2 5DW, UK
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Abstract
Paracetamol is usually given in adults at a dose of 10–20 mg kg–1 orally or rectally. Work in children suggests that doses of 40 mg kg–1 are needed to provide therapeutic concentrations when this drug is used by the rectal route. We have investigated the dose of rectal paracetamol needed to achieve serum concentrations within the accepted therapeutic range of 10–20 µg ml–1 in adults. Ten healthy adult volunteers received increasing doses of rectal paracetamol (15, 25, 35, and 45 mg kg–1). Following suppository administration, serum paracetamol concentrations were measured half hourly to 4 h then hourly to 8 h. Sustained concentrations within our therapeutic range were achieved with 35 and 45 mg kg–1. Maximum measured concentrations were 12.5 (10–16), 16.5 (14–20), and 20 (17.5–23) µg ml–1, median (inter‐quartile range) after 25, 35, and 45 mg kg–1, respectively. We conclude that doses of 35–45 mg kg–1 of rectal paracetamol are needed to achieve sustained therapeutic plasma concentrations in healthy adult volunteers.
Br J Anaesth 2001; 87: 638–40
http://bja.oxfordjournals.org/content/87/4/638.full
Serum paracetamol concentrations in adult volunteers following rectal administration
M. E. Stocker1 and J. E. Montgomery
+ Author Affiliations
Department of Anaesthesia, South Devon Healthcare Trust, Torquay, Devon TQ2 7AA, UK 1Present address: Department of Anaesthesia, Royal Devon and Exeter Hospital, Exeter EX2 5DW, UK
Next Section
Abstract
Paracetamol is usually given in adults at a dose of 10–20 mg kg–1 orally or rectally. Work in children suggests that doses of 40 mg kg–1 are needed to provide therapeutic concentrations when this drug is used by the rectal route. We have investigated the dose of rectal paracetamol needed to achieve serum concentrations within the accepted therapeutic range of 10–20 µg ml–1 in adults. Ten healthy adult volunteers received increasing doses of rectal paracetamol (15, 25, 35, and 45 mg kg–1). Following suppository administration, serum paracetamol concentrations were measured half hourly to 4 h then hourly to 8 h. Sustained concentrations within our therapeutic range were achieved with 35 and 45 mg kg–1. Maximum measured concentrations were 12.5 (10–16), 16.5 (14–20), and 20 (17.5–23) µg ml–1, median (inter‐quartile range) after 25, 35, and 45 mg kg–1, respectively. We conclude that doses of 35–45 mg kg–1 of rectal paracetamol are needed to achieve sustained therapeutic plasma concentrations in healthy adult volunteers.
Br J Anaesth 2001; 87: 638–40
http://bja.oxfordjournals.org/content/87/4/638.full
