PARACETAMOL OD

Question 1

what does the recommended therapeutic dose of paracetamol depend on?

Answer 1

ADULTS = max dose in 24 hrs is 4 grams

Question 2

What is an ACUTE paracetamol overdose?

Answer 2

EXCESSIVE INGESTION over a period of less than one hour in the context of self harm

Question 3

What is STAGGERED paracetamol overdose

Answer 3

Excessive ingestion over more than one hour in the context of TREATING PAIN (therapeutic overdose)
- this can also occur with the intent of self-harm

Question 4

What is the typical presentation of therapeutic paracetamol excess

Answer 4

• most pts are asymptomatic or only have mild GI symptoms at initial presentation
• Untreated excess ingestion may cause varying degrees of liver injury

Question 5

What are the common signs of excess within the first 24 hours ?

Answer 5

• nausea and vomiting
• general abdominal pain

Question 6

What are the signs of ACUTE liver injury

Answer 6

• abdominal pain
• jaundice - sign of acute liver injury
• hepatomegaly (enlargement of liver)

Question 7

What are the high risk groups for a glutathione deficiency?(4)

Answer 7

these patients are at a higher risk of liver injury, secondary to paracetamol excess.
Patients at risk include:
- Malnourishment (eating disorder)
- Psychiatric disorders
- chronic disease (HIV, Cystic fibrosis, liver disease)
- alcohol-use disorder

Question 8

What is the REVERSIBLE DRUG called for a paracetamol overdose?

Answer 8

ACETYLCYSTEINE