Paracetamol OD

Question 1

What criteria is used for liver transplant?

Answer 1

King’s College Criteria

Question 2

Outline the types of King’s College Criteria.

Answer 2

One for paracetamol OD, one for non-paracetamol OD

Question 3

Outline the KC Criteria for Paracetamol OD.

Answer 3

• Arterial pH<7.3

or

• INR 6.5< AND Cr 300< AND encephalopathy

Question 4

What is a paracetamol OD?

Answer 4

Greater than 4g in 24 hours

Question 5

What may cause paracetamol OD?

Answer 5

• Accidental
• Self-harm
• Therapeutic

Question 6

How does paracetamol OD present?

Answer 6

• N&V
• RUQ Pain
• Risk of self-harm, dementia etc.

May have: jaundice, hepatomegaly, asterixis

Question 7

What blood test is used for paracetamol OD?

Answer 7

Salicylate level

Question 8

What must always be checked with paracetamol OD?

Answer 8

• Alcohol

- Other drugs that may have been taken

Question 9

What other bloods are done in paracetamol OD?

Answer 9

• Full profile with clotting

- ABG (lactic acidosis)

Question 10

How is paracetamol OD treated?

Answer 10

• N-acetylcysteine within 8 hours of first paracetamol exposure

Question 11

What is vital to take in the history?

Answer 11

• How much paracetamol and when?

- Anything else taken?

Question 12

What may be given in very acute settings for paracetamol OD?

Answer 12

Activated charcoal

Question 13

When can activated charcoal be given in paracetamol OD?

Answer 13

Within an hour

Question 14

What is the main complication of paracetamol OD?

Answer 14

Acute liver failure and coagulopathy