Related Experiment Video
Updated: Jan 12, 2026

Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen
Published on: November 27, 2019
Treatment of Acute Paracetamol Overdose: A Comprehensive Overview
Arjen Koppen1, Paola Mian2,3,4, Marieke G G Sturkenboom2,4
1Dutch Poisons Information Center, University Medical Center Utrecht, Utrecht, the Netherlands.
Purpose:
Given its widespread availability, paracetamol (acetaminophen and p-aminophenol) is frequently ingested in overdose, making paracetamol poisoning one of the most common drug-induced poisonings worldwide.
Methods:
A comprehensive overview of recent developments in the treatment of acute paracetamol poisoning is presented, with the aim of improving clinicians' understanding of the diagnosis and treatment of patients with paracetamol poisoning.
Results:
Paracetamol's pharmacokinetics and toxicokinetics are examined, along with its toxicity (doses and early concentrations); massive overdose or high-risk ingestion; treatment of specific populations such as children, pregnant women, and patients with obesity; prognostic markers of paracetamol toxicity; gastrointestinal decontamination; renal replacement therapy; antidotal therapy with acetylcysteine dosing regimens; adverse reactions; and acetylcysteine alternatives or adjunctive therapies.
Conclusions:
Although paracetamol poisoning seems straightforward in terms of risk assessment and treatment, the developments in its diagnosis and treatment reveal that this field is constantly evolving. Multiple factors must be considered in patients with paracetamol poisoning, making its treatment challenging. This comprehensive overview aims to address these challenges.
Related Concept Videos
Prevention of Further Absorption of Poison
Anticholinesterase Agents: Poisoning and Treatment
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is...
Acute Pancreatitis II: Clinical Manifestations and Management
Enhanced Elimination of Poison
Antidotes serve a crucial role in counteracting the effects of poison by inhibiting enzymes responsible for producing harmful drug metabolites. In some cases, these toxic metabolites can be neutralized by endogenous cosubstrates, which are maintained at specific concentrations to prevent interaction with cellular macromolecules and subsequent cell death.
Renal excretion is the...
Acute Kidney Injury V: Interprofessional Care
Antidotes
Specific antidotes operate by inhibiting the enzymes that control biochemical pathways, reducing the production of harmful metabolites.
An example of an antidote is atropine, which counteracts the detrimental effects of cholinesterase inhibitors. It achieves this by deactivating muscarinic receptors,...

