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4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katiha...

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Drug

Treatment Details

Paracetamol (Acetaminophen)

It is the most commonly used antipyretic

Route : Ingestion

Fatal dose : 10 to 20 gms

Fatal Period : 2 to 4 days

Mechanism of action : It is absorbed rapidly fro the GIT and metabolized in the liver. A small part is converted by the liver enzyme into N-acetyl-p-benzoquinoneimine{NABP}. Due to overdose, NABP accumulates and causes centrilobular liver necrosis.

Clinical picture : • In few hrs: patient has anorexia, nausea , vomiting, diaphoresis, hypotension, tachycardia and dyspnoea
• After 1 to 2 days: the discomfort disappears
• After 2 to 4 days: there is vomiting, jaundice, hepatic pain, bleeding, hypoglycemia, confusion, coma, metabolic acidosis and coarse flapping tremors of hands
• Cardiac arrhythmias, hemorrhagic pancreatitis, disseminated intravascular coagulation

Treatment : • Gastric lavage
• Activated charcoal
• Antidote: N-acetyl cysteine is a specific antidote and is most effective if used within 8 hours. It is given orally or i.v. . Methionine is also used as an antidote, although it is less effective
• Symptomatic

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Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?

No, it should be used only after drug sensitivity report

Yes, under guidance of an infectious disease expert

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