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Acetaminophen Poisoning

Janet Chen, DO and Jennifer A Meeks, D.O. Reviewed 04/2024
 


BASICS

DESCRIPTION

  • A disorder characterized by hepatic necrosis following large acetaminophen ingestions. Clinical manifestations of acetaminophen toxicity vary with time since ingestion and are genera...

DIAGNOSIS

Signs and symptoms of poisoning develop over the first 24 hours following large ingestions. Symptoms may develop gradually in those with a history of long-term ingestion near supratherapeuti...

TREATMENT

  • Immediately contact a local Poison Control center for recommendations. Call (800) 222-1222 in the United States.

  • N-acetylcysteine (NAC) is a benign prodrug that provides cysteine as a substra...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Evaluate all patients at an accredited health care facility. Evaluate patients with evidence of organ failure, increased LFTs, or coagulopathy for emergency liver...

REFERENCES

1
Chiew  AL, Gluud  C, Brok  J, et al. Interventions for paracetamol (acetaminophen) overdose. Cochrane Database Syst Rev.  2018;(2):CD003328. [View Abstract on ...

ADDITIONAL READING

SEE ALSO

Dart RC, Mullins ME, Matoushek T, et al. Management of Acetaminophen Poisoning in the US and Canada: a consensus statement. JAMA Netw Open. 2023;6...

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

  • Immediately call and notify the local Poison Control Center for management recommendations (800) 222-1222 (USA).

  • Give NAC when plasma acetaminophen concentrations (measured ≥4 hours aft...

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