Medium urgency
-Moderately severe
Paracetamol is the most popular painkiller.
The cause of intoxication may be an accidental intake (more common in childhood) or intentional (suicide attempts).
Symptoms include abdominal pain, nausea, vomiting, sweating, diarrhea, irritability and seizures. Severe intoxication is characterized by liver failure, which can be sudden and sharp.
Diagnosis is made by taking the medical history, performing a full physical examination and a laboratory test (measurement of levels).
Treatment is based on supportive measures with monitoring of vital signs, gastric lavage and decontamination using activated charcoal (early stages) and early use of the antidote N-acetylcysteine.
- Michael J Burns, Scott L Friedman, Anne M Larson. Acetaminophen (paracetamol) poisoning in adults: Pathophysiology, presentation, and diagnosis. UpToDate. Oct 06, 2015.
- Kennon Heard, Richard Dart. Acetaminophen (paracetamol) poisoning in adults: Treatment. UpToDate. Aug 30, 2016.
- Brok J, Buckley N, Gluud C. Interventions for paracetamol (acetaminophen) overdose. Cochrane Database Syst Rev 2006; :CD003328.
- Spiller HA, Winter ML, Klein-Schwartz W, Bangh SA. Efficacy of activated charcoal administered more than four hours after acetaminophen overdose. J Emerg Med 2006; 30:1.
- Schwartz EA, Hayes BD, Sarmiento KF. Development of hepatic failure despite use of intravenous acetylcysteine after a massive ingestion of acetaminophen and diphenhydramine. Ann Emerg Med 2009; 54:421.
- José Ignacio García Sánchez, Jara Llenas García, Virginia Melgar Molero. Intoxicaciones. Manual de diagnóstico y terapéutica médica Hospital Universitario 12 de octubre. 6ª edición. 2007. 1118:1119.
- Indalecio Morán, Jaume Baldirà, Luís Marruecos, Santiago Nogué. Intoxicaciones agudas por paracetamol. Intoxicación clínica. Capítulo 12. Páginas 159-166. Grupo Difusión.
Dr. Elvira Moreno
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