Paracetamol overdose

Paracetamol overdose is a medical condition resulting from the excessive intake of the pain-relieving and fever-reducing medication paracetamol (also known as acetaminophen). This condition is a common cause of drug poisoning worldwide and can lead to severe liver damage and potentially fatal liver failure. Paracetamol overdose can occur accidentally or as an act of self-harm.

Causes

The primary cause of a paracetamol overdose is the ingestion of a paracetamol dose exceeding the recommended safe amount. For adults, the maximum recommended dose within a 24-hour period is generally 4,000 milligrams (mg), but lower limits may be advised for certain individuals, including those with pre-existing liver conditions or those who consume alcohol regularly.

Symptoms

Symptoms of paracetamol overdose may initially be absent or non-specific and can include nausea, vomiting, sweating, and general malaise. As the condition progresses, more severe symptoms related to liver damage, such as jaundice (yellowing of the skin and eyes), abdominal pain, and confusion, may develop. In severe cases, liver failure may occur, necessitating liver transplantation.

Diagnosis

Diagnosis of paracetamol overdose involves a medical history assessment, physical examination, and laboratory tests. Blood tests are crucial for measuring the level of paracetamol in the bloodstream and assessing liver function. The Rumack-Matthew nomogram is a tool used by healthcare professionals to determine the risk of liver damage based on the timing of the overdose and the blood levels of paracetamol.

Treatment

Treatment for paracetamol overdose is most effective when initiated within a few hours of ingestion. The antidote for paracetamol poisoning is N-acetylcysteine (NAC), which works by replenishing glutathione, a substance that helps to detoxify the liver. NAC can be administered orally or intravenously and is most effective when given within 8 to 10 hours of overdose. In cases of severe liver damage, a liver transplant may be necessary.

Prevention

Prevention of paracetamol overdose involves the responsible use of paracetamol, including adherence to recommended dosages and caution when using multiple products containing paracetamol. Public education on the risks associated with paracetamol overdose and the importance of reading medication labels is also crucial.

See also

• Drug poisoning
• Liver failure
• N-acetylcysteine