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Acetaminophen Overdose: Risks & Treatment

Acetaminophen, also known as paracetamol, is used as an analgesic and antipyretic, with a therapeutic dose of 10-20 mg/kg. Toxic doses can lead to severe hepatotoxicity, with adults at risk from 7.5-10 g and children from 150 mg/kg. Treatment for overdose includes basic life support, decontamination, and the antidote N-acetylcysteine, which is most effective when administered within 8 hours of ingestion.

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18 views22 pages

Acetaminophen Overdose: Risks & Treatment

Acetaminophen, also known as paracetamol, is used as an analgesic and antipyretic, with a therapeutic dose of 10-20 mg/kg. Toxic doses can lead to severe hepatotoxicity, with adults at risk from 7.5-10 g and children from 150 mg/kg. Treatment for overdose includes basic life support, decontamination, and the antidote N-acetylcysteine, which is most effective when administered within 8 hours of ingestion.

Uploaded by

alaqtashsami64
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd

Acetaminophen

(paracetamol)
Therapeutic uses
• Analgesic antipyretic.
• Therapeutic dose: 10 – 20mg/kg
or up to 2.6gm/24 hours.
• Minimum toxic doses of acetaminophen
for a single ingestion, posing significant
risk of severe hepatotoxicity, are as
follows:
• Adults: 7.5-10 g
• Children: 150 mg/kg
Common paracetamol preparations
acetaminophen
Mechanism of action Prostaglandin synthesis
accidental
Circumstances of poisoning suicidal
g 10

Toxokinetics and pathophysiology

Cytochrome Toxic intermediate


GIT liver oxidase NAPQI metabolite

Conjugated with glutathione Binds to hepatic cells

Inactive metabolite Centrilobular hepatic necrosis


Clinical picture
LABORATORY INVESTIGATIONS
Assessment of severity of acetaminophen overdose is achieved using
RumackMattew nomogram

1. The measured serum acetaminophen


level at 4 hours or longer following
an acute ingestion predicts the
possibility of hepatic injury and it
determines the need to treat a patient
using its specific antidote.
2-Aspartate and Alanine transaminase
plasma levels.
3-Coagulation profile
4-Glucose level
5-Bilirubin level
6-Renal function tests
7-Acid- base status and electrolytes
Treatment
Initial treatment :
• Basic life support (ABCs)
• Decontamination by emesis, gastric lavage and
activated charcoal (within 1-2 hr of ingestion)
• The antidote for acetaminophen poisoning is
N- acetylcysteine (NAC) ( which works
primarily
via refilling hepatic glutathione stores ).
• Most effective when initiated within 8 hr of
ingestion
• There is no demonstrated benefit to giving
NAC before the 4 hr post-ingestion mark.
• NAC is available in oral and intravenous
forms, and both forms are equally
efficacious
Patients who develop hepatic failure in spite
of NAC therapy may be candidates for liver
transplantation
N-acetyl cystien
THANK YOU

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