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Massive Acetaminophen Overdose.

Thor S Stead1, Jae Yun Jeong2, Latha Ganti3,4,5

  • 1Emergency Medicine, Alpert Medical School of Brown University, Providence, USA.

Cureus
|August 22, 2020
PubMed
Summary
This summary is machine-generated.

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Acetaminophen (APAP) overdose can be fatal. Prompt N-acetylcysteine (NAC) and hemodialysis are crucial for massive APAP poisoning in unresponsive patients.

Area of Science:

  • Toxicology
  • Emergency Medicine
  • Pharmacology

Background:

  • Acetaminophen (APAP) is a widely available over-the-counter medication.
  • Intentional overdoses can lead to severe hepatotoxicity and fatalities.
  • Physicians must remain vigilant regarding APAP's ubiquity and overdose potential.

Observation:

  • This case details a fatal intentional APAP overdose.
  • The patient presented unresponsive, complicating clinical assessment and management.
  • Plasma APAP levels were significantly elevated, indicating a massive ingestion.

Findings:

  • Massive APAP overdose (> 300 µg/ml plasma at four hours post-ingestion) requires aggressive intervention.
  • Prompt administration of N-acetylcysteine (NAC) is the cornerstone of treatment.
Keywords:
acetaminophenpoisoningtoxicology

Related Experiment Videos

  • Early hemodialysis is indicated in severe cases to enhance toxin removal.

    • Implications:

    • Highlights the critical need for timely recognition and management of APAP overdose.
    • Emphasizes the importance of considering APAP toxicity even in unresponsive patients.
    • Reinforces the established treatment protocols for massive acetaminophen poisoning.