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

Paracetamol (Acetaminophen)

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