Non-narcotic analgesics. Problems of overdosage

Area of Science:

• Toxicology
• Hepatology
• Nephrology

Background:

• Paracetamol (acetaminophen) poisoning is a significant cause of acute liver failure (ALF) in the UK.
• Adults are primarily affected by severe and fatal paracetamol poisoning cases.
• Fulminant hepatic failure and acute renal failure are potential severe complications.

Purpose of the Study:

• To review the clinical presentation, prediction, and management of paracetamol poisoning.
• To discuss the complications of paracetamol overdose, including hepatic and renal failure.
• To contrast paracetamol poisoning with aspirin poisoning management.

Main Methods:

• Review of clinical data and treatment protocols for paracetamol and aspirin poisoning.
• Analysis of diagnostic indicators for liver damage, such as plasma paracetamol concentration.
• Evaluation of therapeutic interventions, including gastric lavage and N-acetylcysteine administration.

Main Results:

• Plasma paracetamol levels at 4 hours post-ingestion accurately predict liver damage.
• Peak liver function disturbance occurs 2-4 days post-overdose, with potential for fulminant hepatic failure.
• Acute renal failure can occur 24-72 hours after overdose, often with severe liver damage.

Conclusions:

• Prompt measurement of plasma paracetamol and timely administration of N-acetylcysteine are crucial for managing paracetamol poisoning.
• Hepatic and renal complications require conventional management.
• Aspirin poisoning presents with mixed acid-base disturbances and requires different management strategies.