23
Apr
Management Of Paracetamol Overdose. If the patient is at risk of liver damage see Indications for immediate treatment below immediately give acetylcysteine intravenously see Dosing below. Authors Robin E Ferner 1 James W Dear D Nicholas Bateman. If it has been MORE than 8 hours since the first dose treat the patient as per the 8 hours scenario in the Acute Ingestion. If the patient is unstable - such as having low blood pressure - or there is overwhelming liver failure they will need to be treated on an intensive care unit.
Serum paracetamol levels should be used to assess the need for N-acetylcysteine administration in all patients with deliberate paracetamol self-poisoning regardless of the stated dose. Unless severe maternal toxicity develops paracetamol overdose does not appear to increase the risk for adverse pregnancy outcome. Immediate management will require resuscitation and stabilisation. Management of paracetamol overdose with acetylcysteine depends on the risk of liver damage based on the dose and timing of ingestion. Patients who are malnourished have been fasting take enzyme inducing drugs or regularly drink alcohol to excess are at higher risk of liver damage. How is paracetamol overdose treated.
Cochrane Database Syst Rev 2018.
Buckley NA Whyte IM OConnell DL Dawson AH. Patients who are malnourished have been fasting take enzyme inducing drugs or regularly drink alcohol to excess are at higher risk of liver damage. Paracetamol overdose during pregnancy should be treated with either oral or intravenous NAC according to the regular protocols in order to prevent maternal and potentially fetal toxicity. There is little evidence to guide management in repeated supratherapeutic doses. The efficacy of acetylcysteine decreases subsequent to the first 8 hours following an acute paracetamol overdose with a corresponding stepwise increase in hepatotoxicity with increasing treatment delays between 8 and 16 hours. Potential toxicity should be assessed and a toxicologist consulted when.