NAPBQI or N-acetyl-p-benzoquinone imine, is a

toxic byproduct produced during the xenobiotic

metabolism of the analgesic paracetamol.

When the glutathione pathway is overwhelmed

by too much acetaminophen's metabolite,
NAPQI. Then, this toxic compound accumulates
in the liver and causes damage.

Nausea & Vomiting – toxins build up inside the

body.

Anemia- depletion of erythrocytes by causing

alteration of red blood cell counts, hemoglobin
and hematocrit or PCV

Acetylcysteine is an effective antidote to

prevent or limit liver injury in patients with
potentially toxic acetaminophen levels or
evidence of liver injury.

Liver function tests (also known as a liver panel)

are blood tests that measure different enzymes,
proteins, and other substances made by the
liver. These tests check the overall health of
your liver.
Functions of Liver

1. Removes pathogens
2. Removes metabolites
3. Degrade hormones
4. Form protein
5. Absorptions of fat soluble, vitamins, fats

Vitamins D- absorption of calcium

Hypokalcemia - due to lack of vitamin D

 Seizure precautions
 Assess for tetany( bronchospasm) ,
paresthesia, arrythmia

Transfusion

 Monitor Vital signs (every 15mins)

 BT form
 Check for data with other nurse (serial
number, exp date, name, blood type,
time)
 Dry warmer the Blood
 Stay with patient during transfusion
(stop when there is allergic reaction or
irritability; administer Plain NSS)
 Make sure the line is patent (gauge 18)
