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Paracetamol (acetaminophen) poisoning

¹Wolfson Department of Clinical Pharmacology, University of Newcastle upon Tyne, U.K.

Pharmacology & Therapeutics

|October 1, 1993

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Intentional paracetamol overdose causes significant illness. This review covers paracetamol toxicity mechanisms, clinical effects, and treatments, including antidotes, to reduce harm.

Area of Science:

Toxicology
Pharmacology
Clinical Medicine

Background:

Paracetamol (acetaminophen) overdose is a frequent cause of acute liver injury.
Intentional self-harm leading to paracetamol poisoning presents a significant public health challenge.

Purpose of the Study:

To review the mechanism of paracetamol toxicity.
To outline the clinical manifestations and management strategies for paracetamol poisoning.
To identify research priorities for mitigating paracetamol poisoning morbidity and mortality.

Main Methods:

Literature review of paracetamol toxicity.
Synthesis of clinical data on poisoning effects.
Analysis of current treatment guidelines and antidotal therapies.

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Main Results:

Paracetamol toxicity results from the metabolic pathway producing a reactive intermediate.
Clinical effects range from asymptomatic to severe hepatotoxicity and multi-organ failure.
N-acetylcysteine is the established antidote, most effective when administered early.

Conclusions:

Understanding paracetamol's toxic mechanism is crucial for effective treatment.
Prompt recognition and administration of N-acetylcysteine are key to preventing severe outcomes.
Further research should focus on optimizing antidote protocols and identifying novel therapeutic targets.