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Effect of acute paracetamol overdose on changes in serum and urine electrolytes
N Pakravan1, D N Bateman, J Goddard
1NPIS Edinburgh, Edinburgh, UK. dr_p_n@yahoo.com
Aims:
To investigate the effects of acute paracetamol overdose on renal function, serum and urine electrolyte excretion in man.
Methods:
Two studies were performed in patients admitted with paracetamol overdose: a retrospective study examining changes in serum electrolytes, and a prospective study evaluating changes in serum and urine electrolytes. A control group with SSRI overdose was included in the prospective study.
Results:
There was a significant dose-dependent relationship between admission (4 h) paracetamol concentration and fall in serum potassium in the retrospective study (P < 0.01) and a significant positive relationship between serum paracetamol at 4 h and fractional excretion of potassium at 12 h postingestion (P < 0.01) in the prospective study. No changes were seen in the control group. No cases developed renal failure.
Conclusions:
Paracetamol overdose is associated with dose-related hypokalaemia, and kaliuresis of short duration (<24 h), suggesting a specific renal effect of paracetamol in overdose perhaps via cyclo-oxygenase inhibition. This effect seems distinct from any nephrotoxic effect of paracetamol.
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