Paracetamol has been used as an analgesic and antipyretic for many years. It is a common pain reliever and fever reducer that is usually bought over the counter without a prescription.
Its toxicity was first noted in the 1960s. It is one of the most common medicines taken by young children in an accidental overdose. Paracetamol is also commonly taken by people in suicide attempts. In UK it is the most common medicine used in suicide attempts and is responsible for approximately 70,000 cases per year. It is also the most common cause of acute liver failure (ALF).
The recommended adult single dose of paracetamol is two standard 500mg tablets. Research have shown that a single paracetamol overdose is 15g which is roughly obtained from 30 tablets is the common threshold for liver damage.
During the first 24 – 48 hrs the patient may appear well. However nausea and vomiting may occur, especially if taken with alcohol.
During the next 48 – 72 hrs, common symptoms are: anorexia, nausea and vomiting, and right subcostal pain.
Death due to paracetamol poisoning occurs about 4 – 18 days later. Death is rare but when it occurs it is due to liver failure.
The initial treatment for paracetamol overdose is gastrointestinal decontamination. The gastrointestinal decontamination is done through stomach pumping. However, this procedure must be performed within 60 minutes of ingestion as paracetamol absorption from the gastrointestinal tract is complete within two hours under normal circumstances. Apart from this, activated charcoal can be used to absorb the paracetamol.
The treatment of serious paracetamol-induced fulminant liver failure is done through the administration of an antidote like N-acetylcysteine which can prevent the toxic effects of the overdose.
The treatment of paracetamol poisoning is essentially done under medical supervision ideally within 12 hours of the overdose. However, the treatment can be beneficial up to 24 hours.
The basic first aid measures that can be taken are:
Written by: healthplus24 team
Date last updated: May 02, 2015
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