Paracetamol Toxicity

Overview

Paracetamol or acetaminophen is one of the most widely used over the counter medication as analgesics and antipyretics. It is very safe to use in the proper dosage but taking more than 150mg/kg in 24 hours for 2 consecutive days might lead to paracetamol toxicity.

Signs and Symptoms

Initially there are no symptoms, Loss of appetite, Nausea and vomiting, Lethargy, Abdominal pain (right upper quadrant), Jaundice, Liver tenderness, Altered mental status

Common Causes

Acute deliberate self-poisoning, Accidental paediatric exposure when medication is stored in an easily accessible place by children, Inadvertent repeated supratherapeutic ingestion by patients to resolve the fever or pain

Risk Factors

Liver disease

Investigation Techniques

Full blood count, Urine assessment (urinalysis), Blood paracetamol levels, Glucose, Liver function test, Serum electrolytes, INR, Arterial blood gases

Treatment and Prevention

Gastrointestinal decontamination by giving activated charcoal , Antidote (N-acetylcysteine) administration either orally or intravenously