[Paracetamol poisoning--clinical aspects and pharmacokinetics]

The analgesic and antipyretic effect of paracetamol and phenacetin is to be traced back to the same pharmacologic active substance. When no therapeutic doses are applied, paracetamol causes severe lesions of the liver parenchyma with often fatal termination. It is reported on the paracetamol intoxication of a 38-year-old landlady, in whom as a sequel of the intoxication a severe lesion of the liver parenchyma and an acute toxic renal failure developed. The understanding of the paracetamol-conditioned lesions takes the knowledge of the course of the reaction of its biotransformation for granted. Since the pharmacokinetics underlies numerous influence factors, there is no foreseeable correlation between toxicity and doses. It seems that also in therapy paracetamol does not cause less side-effects than phenacetin. The discussed use of paracetamol instead of phenacetin is, therefore, critically to be considered.