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paracetamolo

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There are mainly two therapeutic doses: in small part is eliminated by the kidney, while for the most part it is eliminated always from the kidney, but in the form of inactive metabolites.

Signs and symptoms

Those who take an overdose of paracetamol may remain disappointed by not experiencing any symptoms during the first day. Subsequently, however, the presenting picture is that of acute liver failure. The patient may experience abdominal pain. Histologically, the cellular damage liver is initially centrolobular, so it tends to become confluent.

Diagnosis and treatment

From a clinical point of view, the difficult thing is to decide whether the patient has ingested acetaminophen in such quantities as to require administration of the antidote. The medical history is of great help because if less than 15 grams have been ingested there is little to worry about. If the dose has been exceeded then liver damage is certain and death is almost inevitable. If the history is certain, no further time should be wasted and methionine should be administered immediately orally or intravenously. The side effects of these antidotes are minimal, especially if given within 10 hours of taking acetaminophen. Ancillary measures include gastric lavage, which can be performed within 6 hours.

Source: Vadecum of poisoning therapy by Roy Goulding

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