Paracetamol overdose and poisoning Flashcards
What organs are affected by paracetamol toxicity?
liver and kidneys
How long does it take for liver toxicity to occcur with paracetamol overdose?
24-48 hours are when proper symptoms appear
How long do you have to wait to do paracetamol plasma blood levels?
4 hours from ingestion
Which types of patients are at particular risk of liver damage?
Regular ethanol consumption (21M, 14F)
Regular use of enzyme inducing drugs (carbamazepine, phenytoin, phenobarbitol, rifampicin)
Conditions causing glutathione depletion (malnutrition, HIV, eating disorders, cystic fibrosis)
When would you start NAC?
8 hours after ingestion (how long natural glutathione lasts)
Start immediately if >150mg/kg ingested over 1 hour
What other blood tests would you do in paracetamol overdose?
FBC, clotting, electrolytes, glucose, LFT, ABG (bicarb)
When would you give charcoal?
if they present within an hour of ingestion
What are some common SE of NAC?
vomiting, flushing
What do you treat paracetamol overdose with?
N-acetylcystine
methionine as alternative
monitor ALT/AST and INR
What are the symptoms of CO poisoning?
viral infection symptoms
convulsions
coma
cardiac arrest
What is the treatment of CO?
remove from environment
high flow O
