analgesic misuse Flashcards
Names some analgesics
aspirin
NSAIDS
paracetamol
opiates and opioids
Names some analgesics
aspirin
NSAIDS
paracetamol
opiates and opioids
where is paracetamol absorbed?
small intestine
what is the half life of paracetamol?
2 hours
what effects does paracetamol have?
analgesic and antipyretic
what are possible side effects of paracetamol?
rash
white cell disorders
hepatoxicity
what happens in the case of paracetamol overdose?
available gluthione is exhausted
n acetyl p bendoquinone imine accumulates
hepatocellular necrosis can occur
what can help to reduce hepatocellular damage?
N Acetyl cysteine- NAC, Parvolex- enables production of additional gluthione
what is the risk of NAC?
caries risk of severe allergic reaction
what occurs at phase 1 of paracetamol overdose?
what occurs at phase 2 of paracetamol overdose
24-48 hours
tachycardia
hypotension
upper abdominal pain
what occurs at phase 3 of paracetamol overdose?
3-4 days jaundice bleeding encaphelopathy GI bleeding
what occurs at phase 4 of paracetamol overdose?
4-11 days
recovery, or death depending on severity of damage
what is the definition of a normal toxic dose of paracetamol?
> 10mg/ 24 hours or 150mg/kg
what is the definition of an at risk toxic dose of paracetamol?
7g/24 hours or 75mg/kg
what is a staggered overdose dosage shown to have?
greater morbidity than an intentional one time bollus
What are additional risk factors to hepatoxicity?
undernourished or underweight rifampicin anti virals carbamazepine phenytoin chronic alcohol excess viral hepatitis
what are features of an aspirin overdose?
increased respiratory rate ringing in ears paraesthesia vomiting and nausea drowsiness
What are features of NSAIDS overdose?
enhances features of normal effects
anti platelet effects increase
metabolic effects increase- dizziness, tinnitus, paraesthesia
GI irritation
What are features of opiate overdose?
pupils constricted
drowsiness
confusion/agitation
airway and respiratory depression
where is paracetamol absorbed?
small intestine
what is the half life of paracetamol?
2 hours
what effects does paracetamol have?
analgesic and antipyretic
what are possible side effects of paracetamol?
rash
white cell disorders
hepatoxicity
