What is the recommended dose of paracetamol (acetaminophen) for a pediatric patient weighing 16.5 kg, given a concentration of 250 mg/5 mL?

Paracetamol Dosing for a 16.5 kg Pediatric Patient

For a 16.5 kg pediatric patient, the recommended dose of paracetamol (acetaminophen) at a concentration of 250 mg/5 mL is 5 mL (250 mg) every 4 hours, not to exceed 5 doses in a 24-hour period. 1

Weight-Based Dosing Calculation

• For children weighing 16.5 kg, the appropriate dose falls within the 2-4 year age category which recommends 5 mL (160 mg) every 4 hours 1
• This dose provides approximately 10 mg/kg of paracetamol, which is within the safe therapeutic range for pediatric patients 2
• The maximum daily dose should not exceed 5 doses in a 24-hour period (total of 25 mL or 1250 mg per day) 1

Administration Guidelines

• Measure the dose accurately using the measuring device provided with the medication 1
• Administer the medication orally, and ensure the child has swallowed the full dose 1
• Wait at least 4 hours between doses to prevent potential toxicity 1
• Do not exceed the recommended daily maximum of 5 doses in 24 hours 1

Safety Considerations

• Paracetamol is metabolized primarily in the liver, with toxic intermediate compounds normally inactivated by glutathione 3
• Liver damage is unlikely to occur with therapeutic doses, but can result from overdose when plasma concentrations exceed 150 micrograms/mL 3
• Unintentional overdoses can occur when caregivers attempt to achieve better symptom relief by giving additional doses 4
• Up to half of acetaminophen overdoses are unintentional, often related to incorrect dosing or combination with other acetaminophen-containing products 4

Common Pitfalls to Avoid

• Avoid using adult formulations for children, as this increases the risk of dosing errors 5
• Do not administer additional doses before the 4-hour interval has elapsed, even if symptoms persist 1
• Be aware that paracetamol may be present in combination medications, which could lead to unintentional overdosing 4
• Do not use kitchen teaspoons for measurement as they are inaccurate; always use the provided measuring device 1

When to Seek Medical Attention

• If the child's symptoms worsen or do not improve after 2-3 doses 1
• If there are signs of potential overdose: nausea, vomiting, abdominal pain, or loss of appetite 6
• If the child accidentally receives more than the recommended dose 6

Remember that accurate weight-based dosing is essential for safe and effective paracetamol administration in pediatric patients 5.