Paracetamol poisoning Treatment in UAE

Overview Of Paracetamol poisoning

Acetaminophen toxicity, also known as paracetamol poisoning, occurs when excessive amounts of acetaminophen are ingested, leading to potentially fatal liver damage. It is a leading cause of acute liver failure and is responsible for numerous emergency department visits and hospitalizations annually.

Symptoms of Paracetamol poisoning

Acetaminophen toxicity progresses through four stages:
Stage I (0.5 to 24 hours): Nausea, vomiting, diaphoresis, and general malaise.
Stage II (24 to 72 hours): Improvement in initial symptoms; however, right upper quadrant abdominal pain may develop due to liver enlargement.
Stage III (72 to 96 hours): Peak liver enzyme abnormalities, jaundice, coagulopathy, hypoglycemia, and possible hepatic encephalopathy.
Stage IV (4 days to 2 weeks): Recovery phase for survivors; liver function may return to normal over time.

Causes of Paracetamol poisoning

Intentional Overdose: Ingestion of large quantities of acetaminophen in a suicide attempt or gesture.
Unintentional Overdose: Accidental consumption of excessive doses, often due to the use of multiple acetaminophen-containing products without realizing their combined effect.

Risk Factors of Paracetamol poisoning

- Chronic Alcohol Use: Induces liver enzymes that increase the production of toxic metabolites. - Malnutrition: Depletes glutathione stores, reducing the body's ability to detoxify harmful metabolites. - Concurrent Use of Enzyme-Inducing Drugs: Medications that enhance liver enzyme activity can increase toxicity risk.

Prevention of Paracetamol poisoning

- Public Education: Raising awareness about the dangers of overdose and the presence of acetaminophen in many over-the-counter and prescription medications. - Regulation of Acetaminophen Content: Limiting the amount of acetaminophen in single doses and combination products. - Clear Labeling: Ensuring that medication labels clearly indicate acetaminophen content to prevent unintentional overdoses.

Prognosis of Paracetamol poisoning

With prompt treatment, especially early administration of NAC, the prognosis is generally favorable. Delayed treatment or massive overdoses can lead to fulminant hepatic failure, necessitating liver transplantation, and may result in death.

Complications of Paracetamol poisoning

- Acute Liver Failure: Severe hepatic dysfunction leading to coagulopathy and encephalopathy. - Renal Failure: Acute kidney injury secondary to liver failure. - Metabolic Acidosis: Due to accumulation of lactic acid and other metabolites.

Related Diseases of Paracetamol poisoning

- Drug-Induced Liver Injury: Liver damage caused by various medications or toxins. - Reye's Syndrome: A rare condition that causes swelling in the liver and brain, often associated with aspirin use in children. - Viral Hepatitis: Inflammation of the liver caused by viral infections, presenting with similar hepatic symptoms. Early recognition and treatment of acetaminophen toxicity are crucial to prevent severe liver damage and other life-threatening complications.

Treatment of Paracetamol poisoning

- **Activated Charcoal**: Administered within 1 to 2 hours of ingestion to reduce acetaminophen absorption. - **N-Acetylcysteine (NAC)**: Serves as a precursor to glutathione, aiding in detoxification; most effective when given within 8 hours of overdose.