Paracetamol Overdose

Question 1

who may benefit from activated charcoal in cases of paracetamol overdose?

Answer 1

minority of patients who present within 1 hr

can help reduce absorption of the drug

Question 2

when is acetylcysteine used in paracetamol overdose?

Answer 2

if there is a staggered overdose or there is doubt over what time paracetamol was ingested (regardless of concentration)
if the plasma paracetamol concentration is on or above a single treatment line

Question 3

what is the treatment line in paracetamol overdose?

Answer 3

line connecting points on time/plasma concentration graph

line connecting 100mg/L at 4 hrs and 15mg/L at 15 hrs

Question 4

how is acetylcysteine used in paracetamol overdose?

Answer 4

infused over 1 hr

Question 5

risks of using acetylcysteine?

Answer 5

can cause anaphylactic like reaction (non-IgE mediated mast cell release)
should stop infusion if this occurs

Question 6

blood tests in paracetamol overdose?

Answer 6

serum paracetamol concentration
LFTs
prothrombin time and INR
blood glucose