Paracetamol Overdose Flashcards
1
Q
What are important points to illicit in the history?
A
When they were taken?
How many?
What dose?
What were they taken with?
2
Q
What are the intial symptoms?
A
None
3
Q
What are later symptoms?
A
Vomiting
RUQ pain
Jaundice
4
Q
What investigations should be done?
A
Bloods
- FBC
- U+Es
- LFTs
- Coag
- paracetamol level
5
Q
Why is paracetamol toxic?
A
Breakdown product is NAPQI which is toxic to hepatocytes
NAPQI is a strong oxidising agent - direct trauma to liver
NAPQI joins with glutathione - depletes levels of glutathione which is an antioxidant
6
Q
How is treatment for paracetamol overdose planned?
A
Graph of plasma paracetamol concentration and time
7
Q
What is the treatment for paracetamol overdose?
A
Acetylcysteine
8
Q
How dose acetylcysteine work?
A
Replenishes glutathione so liver can metabolise NAPQI
