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    Group 3 provided answers to questions asked by Group 5 about a case study involving acetaminophen (Tylenol) overdose. [1] Acetaminophen overdose can cause life-threatening liver damage and failure. Clinical manifestations of toxicity include nausea, vomiting, and abdominal pain within 24-72 hours, potentially progressing to liver and multiple organ failure. [2] Liver enzymes AST and ALT are the most sensitive markers for injury. [3] Toxicity may also impact the heart by causing oxidative stress and myocardial necrosis, potentially leading to heart failure. [4] The standard treatment is oral or intravenous N-acetylcysteine administration, with activated charcoal recommended within 1 hour of ingestion

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    Group 3 provided answers to questions asked by Group 5 about a case study involving acetaminophen (Tylenol) overdose. [1] Acetaminophen overdose can cause life-threatening liver damage and failure. Clinical manifestations of toxicity include nausea, vomiting, and abdominal pain within 24-72 hours, potentially progressing to liver and multiple organ failure. [2] Liver enzymes AST and ALT are the most sensitive markers for injury. [3] Toxicity may also impact the heart by causing oxidative stress and myocardial necrosis, potentially leading to heart failure. [4] The standard treatment is oral or intravenous N-acetylcysteine administration, with activated charcoal recommended within 1 hour of ingestion

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    4 views3 pages

    Group 3 Answers - Acetaminophen

    Uploaded by

    ACan
    Group 3 provided answers to questions asked by Group 5 about a case study involving acetaminophen (Tylenol) overdose. [1] Acetaminophen overdose can cause life-threatening liver damage and failure. Clinical manifestations of toxicity include nausea, vomiting, and abdominal pain within 24-72 hours, potentially progressing to liver and multiple organ failure. [2] Liver enzymes AST and ALT are the most sensitive markers for injury. [3] Toxicity may also impact the heart by causing oxidative stress and myocardial necrosis, potentially leading to heart failure. [4] The standard treatment is oral or intravenous N-acetylcysteine administration, with activated charcoal recommended within 1 hour of ingestion

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    of 3

    1

    GROUP 3 ANSWERS TO GROUP 5 PRESENTATION

    1. In the case study, patient is admitted to the hospital because of acetaminophen (Tylenol)
    overdose. Overdoses of acetaminophen can precipitate life-threatening abnormalities in which
    organ? Explain.

    Over many years, it has been used countless times by many people, and it has proven to be a safe
    and effective medication. However, if taken in excess amounts (overdose, whether on purpose or by
    accident), acetaminophen can cause life-threatening illness.

    Acetaminophen in overdose can seriously damage the liver. If the damage is severe, a liver
    transplant may be necessary in order to save someone’s life. Acetaminophen is primarily metabolized
    by the liver. Too much acetaminophen can overwhelm the way the liver normally functions.

    2. What are clinical manifestations of acetaminophen toxicity?

    Stage Time of Post Description


    Ingestion
    1 0-24 hours Anorexia, nausea, vomiting
    2 24-72 hours Right upper quadrant abdominal pain (common)
    AST, ALT, and, if poisoning is severe, bilirubin and PT
    (usually reported as the INR) sometimes elevated.

    3 72-96 hours Vomiting and symptoms of liver failure


    Peaking of AST, ALT, bilirubin, and INR
    Sometimes renal failure and pancreatitis

    4 More than 5 days Resolution of hepatotoxicity or progression to


    multiple organ failure (sometimes fatal)

    3. Which tests are the most sensitive marker of injury caused by acetaminophen poisoning?

    a. INR

    b. AST and ALT

    c. Bun and Creatinine

    d. Alkaline phosphatase

    4. In the case study, Explain the impact of Acetaminophen toxicity on Heart.

    Toxic effects of acetaminophen in overdose leading to myocardial necrosis may


    contribute to heart failure. Furthermore, oxidative stress from acetaminophen overdose
    may contribute to heart failure as well.
    2

    5. The standard treatment for acetaminophen overdose is administration of N-


    acetylcysteine given orally or intravenously. When is the addition of activated charcoal
    recommended?

    As with any ingestion, assessing for other potential life-threatening co-ingestants is very
    important. Administer activated charcoal (AC) if the patient has a stable mental and clinical
    status, patent airway, and presents to the emergency department within 1 hour of ingestion.
    3

    References:

    KhabazianZadeh, F., Kazemi, T., Nakhaee, S., Ng, P. C., & Mehrpour, O. (2019, December).
    Acetaminophen poisoning-induced heart injury: A case-based review. Daru : journal of Faculty of
    Pharmacy, Tehran University of Medical Sciences.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6895290/#:~:text=Toxic%20effects%20of%20ace
    taminophen%20in,failure%20as%20well%20%5B38%5D

    O’Malley, G. F., & O’Malley, R. (2023, June 21). Acetaminophen poisoning - injuries; poisoning. Merck
    Manuals Professional Edition. https://www.merckmanuals.com/en-ca/professional/injuries-
    poisoning/poisoning/acetaminophen-poisoning#v8343420

    Susan E Farrell, M. (2023, June 14). Acetaminophen toxicity treatment & management. Approach
    Considerations, Gastric Decontamination, Oral N-Acetylcysteine.
    https://emedicine.medscape.com/article/820200-
    treatment#:~:text=As%20with%20any%20ingestion%2C%20assessing,within%201%20hour%20of
    %20ingestion

    WebMD. (n.d.). Tylenol poisoning (acetometophen overdose). WebMD.


    https://www.webmd.com/a-to-z-guides/tylenol-acetaminophen-poisoning

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