Accuracy in the Alteration of Acetaminophen Suppositories

This is the authors' abstract. We don't add key points for this paper.

In Brief Many pediatric anesthesiologists divide acetaminophen suppositories to achieve an approximate dose. In this three-part study we first surveyed pediatric anesthesiologists regarding their attitudes and frequency of this clinical practice. Second, acetaminophen suppositories were divided for analysis of acetaminophen content. Finally, the accuracy of pediatric anesthesiologists in dividing suppositories was assessed. The survey indicated 50% of anesthesiologists believed acetaminophen was nonuniform and 62% believed the alteration of suppositories was inaccurate. The laboratory investigation revealed uniform distribution of acetaminophen but poor accuracy in achieving the target dose. The findings suggest using only intact suppositories for improved accuracy. IMPLICATIONS: Contrary to popular belief, our study found acetaminophen to be uniformly distributed in 80 mg, 120 mg, and 325 mg suppositories. However, the difficulty of accurately altering rectal acetaminophen suppositories makes for a compelling argument to restrict their use to intact samples or to have suppositories custom-tailored by the hospital pharmacy.