Paracetamol abuse

Paracetamol is mainly used as an analgesic as an alternative to salicylates and is characterized by toxicity, which should not be overlooked. Toxic doses vary from person to person, so many have determined that the amount needed to induce liver damage is 15 grams, while the fatal risk requires 25 grams.

During the first day, symptoms are nonspecific: pallor, vomiting, nausea, and sweating. Then liver damage appears, eventually progressing to hepatomegaly, jaundice, hypoglycemia, and encephalopathy.

What are the principles of therapy?

Induction of vomiting, gastric lavage and activated charcoal if action is taken within 6 hours of ingestion.
Methionine, specific antidote or N-acetyl-cysteine
Silymarin
Vitamin K

Source: Medical Guard Handbook edited by Piercarlo Salari (Mediserve)

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