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Paracetamol (acetaminophen) poisoning

Nick Buckley1, Michael Eddleston

  • 1Canberra Hospital, Canberra, Australia.

BMJ Clinical Evidence
|May 20, 2009
PubMed

Insights

Paracetamol overdose can cause severe liver damage, but treatments exist. This review evaluates interventions for acute paracetamol poisoning, assessing their effectiveness and safety.

Area of Science:

  • Toxicology
  • Pharmacology
  • Evidence-Based Medicine

Background:

  • Paracetamol overdose is a significant cause of liver damage, with severe hepatotoxicity occurring in at least half of untreated individuals exceeding UK treatment levels.
  • While mortality is low (0.4%), prompt treatment is crucial to prevent liver injury.

Purpose of the Study:

  • To systematically review the effects of various treatments for acute paracetamol poisoning.
  • To evaluate the effectiveness and safety of interventions for paracetamol overdose.

Main Methods:

  • Systematic review of 24 studies, including systematic reviews, RCTs, and observational studies.
  • Searched major databases (Medline, Embase, Cochrane Library) up to March 2006.
  • Included harms alerts from regulatory agencies (FDA, MHRA) and performed GRADE evaluation.

Main Results:

  • Evaluated interventions include activated charcoal, gastric lavage, ipecacuanha, liver transplant, methionine, and N-acetylcysteine.
  • Evidence quality for interventions was assessed using the GRADE system.

Conclusions:

  • This systematic review synthesizes evidence on interventions for acute paracetamol poisoning.
  • Information on the effectiveness and safety of key treatments is presented.
Abstract

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