Acetaminophen overdose resident survival guide
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Chetan Lokhande, M.B.B.S [2]
Definition
Acetaaminophen is widely used as a pain medication in the U.S . An overdose normally occurs when somebody ingests it accidentally or intentionally above the normal recommended dose . It one of the most common poisoning in the U.S and worldwide . The main reason of this being that is is easily available and people think that it is a very safe medication . It is available in the U.S market under the following brand names .
- Tylenol
- Anacin-3
- Liquiprin
- Percocet
- Tempra
- Cold and flu medicines.
- Aceta
- Actimin
- Apacet
- Aspirin Free Anacin
- Atasol
- Banesin
- Dapa
- Datril Extra-Strength
- Feverall
- Fibi
- Genapap
- Genebs,
- Panadol
Common dosage forms and strengths
- Suppository: 120 mg, 125 mg, 325 mg, 650 mg
- Chewable tablets: 80 mg
- Regular strength: 325 mg
- Extra strength: 500 mg
- Liquid: 160 mg/teaspoon
- Drops: 100 mg / mL, 120 mg / 2.5 mL
mg = milligrams
Maximum advisable dosage is 4000 mg of acetaminophen a day . A severe overdose can happen if taken more than 7000 mg / day .
Causes/Pathophysiology
After ingestion of an excessive amount of acetaminophen a toxic metabolite called N-acetyl-p-benzoquinonimine (NAPQI) is formed in excess and hence the normal pathways of conjugating by glutathione are saturated . This results in glutathione depletion which leads to liver injury .
Management
Most of the patients who have an overdose of acetaminophen are asymptomatic . A few however who are symptomatic show symptoms only after 12 hrs of ingestion.