The spectrum of paracetamol (acetaminophen) overdose: clinical and epidemiological studies

Abstract

SummaryIn a regional survey of paracetamol overdose, 201 patients were admitted to hospital over 12 months. Chronic alcoholism was present in 10% of cases. Over 25% of patients were females aged 20 years or less. Initial blood paracetamol levels were in the toxic range in 16% and histologically severe liver damage eventually found in 20% of those biopsied. This

Correlation of paired plasma and saliva paracetamol levels following deliberate self-poisoning with paracetamol (The Salivary Paracetamol In Toxicology [SPIT] study)

“…In Australasia, risk assessment for patients presenting within 8 hours of acute paracetamol overdose requires only a single timed plasma paracetamol level (16). N-AC is required in only a small minority of these patients (17). If N-AC is commenced within 8 hours of ingestion further blood tests are not required (16).…”

Paracetamol

“…Rosenberg et al (1977) reported 2 patients who ingested paracetamol whilst suffering from infectious mononucleosis and who subsequently developed hepatitis. However, infectious mononucleosis itself may be complicated by hepatitis, and at least one of the patients concerned suffered from Gilbert's disease, a condition in which the metabolism of paracetamol is thought to be abnormal (Douglas et al, 1978). In 2 well documented case reports (Johnson and Tolman, 1977;Bonkowsky, Mudge and McMurtry, 1978) there is no doubt that small doses of paracetamol did cause disturbance of liver function.…”

“…One-hundred-and-sixty deaths are recorded as being due to paracetamol alone and 313 occurred when paracetamol was taken in combination with other drugs. The recorded number of deaths due to paracetamol alone, however, may exceed the real number which can be directly attributed to paracetamol (Hamlyn, 1978;Harvey and Spooner, 1978;Spooner and Harvey, 1978). It is likely that some of the deaths were due to the concomitant ingestion of the respiratory depressant drug, dextropropoxyphene, which can be prescribed in fixed combination with paracetamol.…”

Retinol Binding Proteinuria and Phosphaturia: Markers of Paracetamol-Induced Nephrotoxicity

“…Plasma paracetamol was measured by fluorescence polarization immunoassay (TDx, Abbott Diagnostics, Maidenhead, UK). Random urine samples were collected after an overnight fast for estimation of creatinine (Cr), inorganic phosphate (P0 4 ) and retinol binding protein (RBP) concentrations, together with serum samples taken at the corresponding time. Urine samples were stored at -20°C until the time of analysis.…”