Paracetamol Overdose Flashcards
Define Paracetamol Overdose?
Excessive ingestion of paracetamol causing toxicity
What is the max recommended dose of Paracetamol?
2x500 mg tablets
4x24hrs
What intake of paracetamol overdose can cause hepatic necrosis?
Intake > 12g
What are the risk factors of Paracetamol Overdose?
Chronic Alcohol Abusers
Patients on enzyme-inducing drugs (e.g. anticonvulsants)
Malnourished
Anorexia Nervosa
HIV
Paracetamol Overdose is commonly associated with ingestion of large amounts of alcohol
What is the epidemiology of paracetamol overdose?
Most common intentional drug overdose in the UK
Causes 100 deaths/yr in the UK
What’s important to remember when considering the presenting symptoms of Paracetamol Overdose?
Make sure you ascertain the timing and quantity of overdose and presence of risk factors
What are the presenting symptoms of Paracetamol Overdose in the first 24 hours?
Asymptomatic
Mild nausea/vomiting
Lethargy
Malaise
What are the presenting symptoms of Paracetamol Overdose in the first 24-72 hours?
RUQ pain
Vomiting
What are the presenting symptoms of Paracetamol Overdose after 72+ hours?
Increased confusion (encephalopathy) Jaundice
What are the signs of Paracetamol Overdose on physical examination in the first 24 hours?
No signs
What are the signs of Paracetamol Overdose on physical examination in the 24-72 hours?
Liver enlargement and Tenderness
What are the signs of Paracetamol Overdose on physical examination after 72 hours?
Jaundice
Coagulopathy
Hypoglycaemia
Renal Angle Tenderness
What investigations would you do for Paracetamol Overdose?
Measure Paracetamol Overdose FBC U&Es Glucose LFTs Clotting Screen Lactate ABG
When are peak paracetamol levels?
4 hrs after ingestion
