Is it possible to poison with paracetamol
Paracetamol consists of the main active ingredient - acetaminophen. It is a constituent of more than 200 medicines, including in a variety of children's - syrups, capsules, tablets, suppositories. These are anti-flu and pain medications.
Due to its prevalence, overdose with this drug is common. What doses are acceptable when poisoning may occur, symptoms of such intoxication, and how to cleanse the body of this medication? Let's discuss this.
When can I get poisoned?
Paracetamol poisoning can occur in several cases:
- when taking large doses once;
- with long-term use of the drug;
- with increased sensitivity to it.
Medical professionals known paracetamol antidote - N-acetylcysteine. It must be taken in the first 8 hours after ingestion exceeding the maximum dose of paracetamol.
What doses of paracetamol are permissible
Before starting treatment, be sure to study the drug, specify the dosage! Paracetamol is taken orally, washed down with plenty of liquid.
A single dose for adults is 500 mg with a person’s weight up to 40 kg, and 1 gram with a weight over 40 kg. The number of doses per day - a maximum of 4. The maximum daily dose - 4 grams for an adult, 90 mg per kg of weight for children. Duration of treatment is 5-7 days.
The lethal dose is calculated and amounts to more than 150 mg per pound of weight for an adult.
Is it possible to poison with paracetamol, observing the maximum daily dose? Yes, its toxic effect, up to poisoning, may also occur when taking an acceptable dosage of the drug. This is observed in alcoholism, hepatitis, fasting, hereditary liver diseases, joint use of such drugs as: Rifampicin, Isoniazid, anticonvulsants.
What is harmful paracetamol
Once in the stomach, paracetamol is rapidly absorbed and enters the blood. The main breakdown of the drug into metabolites occurs in the liver cells, which are excreted in the urine. The decay period is 1.5–2 hours, but due to the long-lasting properties of this drug, absorption and cleavage also continue in the small intestine.
The main metabolite is N-acetyl-b-benzoquinoneimine, which is formed in the liver and has a toxic effect. It is neutralized by glutamine in the liver. With the depletion of reserves and glutamine deficiency, the metabolite accumulates, which has a toxic effect on the liver, kidneys and pancreas. Depletion of glutamine is observed when taking paracetamol more than 10 grams.
Poisoning is possible at any age. But in children, paracetamol poisoning rarely leads to liver failure, as they are resistant to toxic effects.
Symptoms of paracetamol poisoning
Symptoms of paracetamol poisoning after 10-24 hours:
- nausea and vomiting;
- severe pain in the right hypochondrium;
- aversion to food;
- malaise and general weakness.
Symptoms of paracetamol poisoning after 36 hours:
- decrease in temperature and blood pressure;
- pronounced pains in the abdomen;
- acute renal failure;
- hypoglycemia - lowering blood glucose levels;
- thrombocytopenia - a decrease in the level of platelets in the blood;
- increased sweating;
- delirium, convulsions, coma;
- hepatic failure with jaundice.
When these symptoms of paracetamol poisoning appear, emergency hospitalization of the victim is necessary.
Clinical picture with paracetamol poisoning
There are 4 stages of the course of poisoning.
The first stage. Time after reception from 1 to 24 hours.
- mild poisoning - no symptoms;
- the average degree of poisoning is nausea, vomiting, sweating, anorexia, pallor of the skin, laboratory values are within normal limits;
- severe poisoning - symptoms of damage to the liver, heart and pancreas, consciousness is not disturbed, easy inhibition.
Second stage Time after reception from 24 hours to 3-4 days. Manifested by pain in the right hypochondrium, the size of the liver increases.
If the poisoning comes from a moderate amount of the drug, then the symptoms do not progress and the patient recovers!
If the poisoning comes from an overdose of the drug, then all the symptoms increase. The liver is affected, the level of AST, ALT increases to 1000 IU / l, bilirubin.
The third stage. The time after administration is 3-5 days.
With a moderate degree of poisoning - reverse the development of symptoms and recovery!
With a severe degree of poisoning, toxic damage to the liver and AST, ALT values above 10,000 IU / l increase, high bilirubin levels, consciousness is disturbed, sugar levels decrease, jaundice appears, renal failure, a sharp decrease in blood pressure, body temperature.
Fourth stage. The time after taking a high dose of the medicine is more than 5 days.
Irreversible hepatic failure with a fatal outcome.
Treatment with paracetamol poisoning
It is necessary to call the ambulance crew and immediately begin to provide emergency assistance in case of poisoning with paracetamol before the arrival of the doctors.
- Gastric lavage, within one and a half hours after taking the drug.
- Tablets of activated charcoal for 8 hours after taking the drug in a dosage of 1 gram per kilogram of weight.
- The introduction of the antidote N-acetylcysteine within 8 hours after taking the drugs.
- Mechanical ventilation to accelerate the breakdown and elimination of paracetamol metabolites.
- The introduction of methionine 2.5 grams inside with an interval of 4 hours three times to protect the liver cells.
- Diet number 5. Animal squirrels, fats are excluded from the diet. The basis of the diet is easily digestible carbohydrates (fruit and berry juices, compotes, jelly, infusion of dried apricots, prunes and dried apricots).
- With a decrease in the level of sugar - the introduction of glucose solution intravenously.
- In case of heart failure - taking heart gliclazide.
- In severe cases, surgical treatment may be necessary - liver transplantation, kidney removal.
Prevention of paracetamol poisoning
By following all the rules you can prevent poisoning:
- Keep medications out of the reach of children.
- When taking the drug pay attention to the dosage and correctly calculate the daily dose of paracetamol.
- Avoid joint use of nonsteroidal anti-inflammatory drugs (Nurofen, acetylsalicylic acid, Ortofen, Ibuprofen, Metamizole sodium, Analgin), as they enhance the effect of paracetamol.
- Strong waiver of alcohol while taking paracetamol.
- When taking paracetamol for more than 3 days in a row, add methionine to the treatment.
In most cases, such poisoning due to the ability of the liver to regenerate, the presence of antidote and maintenance therapy and with timely treatment ends with recovery.
If irreversible liver failure requires emergency liver transplantation, the prognosis is extremely poor.
If you take an acceptable dosage of the drug, taking into account the peculiarities of the state of health, then it will not bring any harm to your health!