Paracetamol poisoning

Paracetamol poisoning, also recognized as acetaminophen poisoning, is a potentially serious condition caused by the ingestion of an excessive amount of the over-the-counter medication paracetamol (known as acetaminophen in North America). Paracetamol is a common medication used for the treatment of mild to moderate pain and fever. It is generally safe at recommended doses, but excessive intake can lead to severe liver damage and other serious health complications.

Paracetamol metabolism

Signs and Symptoms

In the initial 24 hours following a paracetamol overdose, individuals typically experience mild and often nonspecific symptoms, which can include fatigue, nausea, and abdominal pain. These initial symptoms can mislead both the individual and healthcare professionals due to their common and non-severe nature.

After a symptom-free period of a couple of days, more serious signs begin to emerge. These are linked to liver failure and may include jaundice (yellowing of the skin and the whites of the eyes), coagulation issues leading to bleeding, and cognitive changes such as confusion. If left untreated, other severe complications may develop, such as kidney failure, pancreatitis, low blood sugar (hypoglycemia), and lactic acidosis - a condition characterized by the buildup of lactic acid in the bloodstream, which can result in organ failure.

Prognosis

If treatment is not promptly initiated, death due to hepatic failure can occur anywhere from 4 to 18 days following the overdose. However, with appropriate treatment, individuals tend to recover fully over a period of a few weeks.

Treatment

Immediate medical attention is required in cases of suspected paracetamol poisoning. Treatment generally involves the administration of a medication called N-acetylcysteine, which can minimize liver damage if administered promptly.

Prevention

Education on the proper use of paracetamol, including recommended dosages and the dangers of overdose, is a crucial preventative measure.

See Also

• Paracetamol (Acetaminophen)
• Liver Failure
• Poisoning

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