Paracetemol overdose

Question 1

What is the leading result of paraecetemol overdoese

Answer 1

Fulminant liver fail

Question 2

What are the presentations of PO

Answer 2

Acute RUQ pain

Sever N+V

Question 3

What are the two phases of Paraceteoml metabolism

Answer 3

Phase 2 Conjugation = Excretion (Gluconosidation)

Phase 1 Conjugation = Toxic (CYP450) then enters Phae 2

Question 4

What is the pathology of Paracetemol overdose

Answer 4

High Phase 2 saturation
Sent to Phase 1 to compensate
HIgh Phase 1 saturation = Depleted Gluthiamine
High NAPQ1 levels = toxic in liver

Question 5

What causes high levels of NAPQ1 in paracetemol overdose

Answer 5

Depleted Gluthiamine due to high Phase 2 Conjugation

Question 6

How is PO treated

Answer 6

Activated charcoal <1hr ingestion

N-Acetyl Cysteine (Remove NAPQ1)

Question 7

Why is N acetyl cysteine used in treating paracetemol overdoe

Answer 7

Increase availability of gluthialol

Excrete NAPQ1