kindly go through topic..its a typical presentation in which sentences are really less

1. ACETAMINOPHEN OVERDOSE
HARIKRISHNA SHEEJA
GROUP#612

2. Paracetamol Overdose
MOST
COMMON
FEW
SYMPTOMS
12g FATAL

3. Characteristics of Acetaminophen
White solid crystals
Lightly soluble in cold water
Greater solubility in hot water
Solubility in organic solvents
Soluble in menthol

4. Acetaminophen’s Pharmaceutical
Classes
Derivative of acetanilide
Analgesic
Non-narcotic
Antipyretic

5. Metabolism

6. Clinical picture

7. After 72-96hrs of ingestion

8. Minimum toxic doses for a single
ingestion, posing significant
risk of severe hepatotoxicity:
Adults: 7.5-10 g
Children: 150 mg/kg; 200 mg/kg in healthy
children aged 1-6 years

9. Serum Acetaminophen Levels
Rumack-Matthew
nomogram

10. Diagnosis
 PCM LEVELS
 BLOOD &URINE
TOXICOLOGY
SCREEN

11. MANAGEMENT
• EMPTY STOMACH TAKEN WITHIN
1 HOUR
• If < 8 hours :
Tx of choice – activated
charcoal 1g/kg

12. If 8-24 hours & suspicious of large overdose
(> 7.5g )

13. If Unknown Time of overdose
 Determine serum acetaminophen
levels
 Determine INR levels, LFT
 Treat with Acetylcysteine if serum
Acetaminophen or transaminases
(ALT, AST) are detected

14. Patient should not take
over 4 grams of
Acetaminophen/day.
Threshold may be lower for
patients with liver disease or
cirrhosis
Increased risk of
hepatotoxicity with chronic
alcohol use
Patient should be careful when
taking numerous products
containing Acetaminophen

15. Reference
http://bestpractice.bmj.com/best-
practice/monograph/337/basics/pathophysiology.html
http://emedicine.medscape.com/article/820200-overview
 http://www.nhs.uk/Conditions/Poisoning/Pages/Symptoms.aspx
Sarawak Handbook of Medical Emergencies 3rd Edition
Oxford Handbook of Clinical Medicine 6th Ed.