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Acetaminophen Poisoning

Luis T. Garcia, MD and Ken Polezoes, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • A disorder characterized by hepatic necrosis following large ingestions of acetaminophen. Symptoms may vary from an asymptomatic presentation to nausea, vomiting, diaphoresis, malais...

DIAGNOSIS

  • May initially present as asymptomatic with history of ingestion in the last 8 hours. Signs and symptoms of poisoning are related to liver toxicity and develop over the first 24 hours followi...

TREATMENT

  • Contact a regional/local poison control center for recommendations; in the United States: (800) 222-1222

  • NAC should be given when plasma acetaminophen concentrations measured ≥4 hours after i...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

  • All patients should be evaluated at a health care facility.

  • Patients with evidence of organ failure, increased LFTs, or coagulopathy should be evaluated for ELT (e...

REFERENCES

1
1 Brok J, Buckley N, Gluud C. Interventions for paracetamol (acetaminophen) overdose. Cochrane Database Syst Rev.  2006;(2):CD003328.  [View Abstract]
2
2 Spiller HA, Winter ML, Klein-...

ADDITIONAL READING

  • Major JM, Zhou EH, Wong HL, et al. Trends in rates of acetaminophen-related adverse events in the United States. Pharmacoepidemiol Drug Saf.  2016;25(5):590–598.  [View Abstra...

SEE ALSO

Algorithm: Acetaminophen Poisoning, Treatment 

CODES

ICD10

  • T39.1X4A Poisoning by 4-Aminophenol derivatives, undetermined, init

  • K71.10 Toxic liver disease with hepatic necrosis, without coma

  • T39.1X1A Poisoning by 4-Aminophenol derivatives, accidental,...

CLINICAL PEARLS

  • Contact a regional poison control center for management recommendations; in the United States: (800) 222-1222

  • NAC should be given when plasma acetaminophen concentrations measured ≥4 ho...

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