Is it possible to poison with paracetamol
Paracetamol consists of the main active substance - acetaminophen. It is a component of more than 200 medicines, including a lot of children's syrups, capsules, tablets, suppositories. These are anti-influenza and pain medications.
Because of its prevalence, there are often overdoses of this drug. What are its doses, when can poisoning occur, the symptoms of such intoxication, and how to cleanse the body of this medicine? Let's discuss this.
When can I get poisoned?
Paracetamol poisoning can occur in several cases:
- when receiving large doses once;
- with prolonged use of the drug;
- with increased sensitivity to it.
Medical workers know the antidote of paracetamol - N-acetylcysteine. It must be taken within the first 8 hours after ingestion of a paracetamol dose that exceeds the maximum.
What doses of paracetamol are acceptable
Before starting treatment, be sure to study the drug, specify the dosage! Paracetamol is taken orally, washed down with plenty of fluids.
A single dose for adults is 500 mg with a person weighing up to 40 kg, and 1 gram at a weight of more than 40 kg. The number of receptions per day is a maximum of 4. The maximum daily dose is 4 grams for an adult, 90 mg per kg of weight for children. Duration of treatment 5-7 days.
The lethal dose is calculated and is more than 150 mg per kilogram of weight for an adult.
Is it possible to poison with paracetamol while observing the maximum daily dose? Yes, its toxic effect, up to poisoning, can occur even when taking an acceptable dosage of the drug. This is observed with alcoholism, hepatitis, starvation, hereditary liver diseases, joint intake of such drugs as: Rifampicin, Isoniazid, anticonvulsants.
What is harmful is paracetamol
Getting into the stomach, paracetamol is quickly absorbed and enters the blood. The main splitting 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 because of the long-term properties of this drug, absorption and cleavage continue even in the small intestine.
The main metabolite is N-acetyl-b-benzoquinonimine, which is formed in the liver and has a toxic effect. It neutralizes glutamine in the liver. With the depletion of reserves and glutamine deficiency, a metabolite accumulates, which acts toxicly on the liver, kidneys, and pancreas. Depletion of glutamine stores 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;
- expressed abdominal pain;
- acute renal insufficiency;
- hypoglycaemia - lowering blood glucose;
- thrombocytopenia - a decrease in the level of platelets in the blood;
- increased sweating;
- delirium, convulsions, coma;
- hepatic failure with jaundice.
When such symptoms of paracetamol poisoning appear, emergency hospitalization of the victim is necessary.
The clinical picture of paracetamol poisoning
There are 4 stages of poisoning.
The first stage. Time after taking 1 to 24 hours.
- slight degree of poisoning - no symptoms;
- average degree of poisoning - nausea, vomiting, sweating, anorexia, pale skin, laboratory indicators within the limits of the norm;
- severe poisoning - symptoms of damage to the liver, heart and pancreas, consciousness is not disturbed, slight inhibition.
The second stage. Time after taking from 24 hours to 3-4 days. It appears painful in the right hypochondrium, the size of the liver increases.
If the poisoning has occurred from a moderate amount of the drug, the symptoms do not progress, and the patient recovers!
If the poisoning has occurred from an overdose of the drug, then all the symptoms are growing. The liver is damaged, the level of AST, ALT is increased to 1000 IU / l, bilirubin.
The third stage. The time after taking is 3-5 days.
With a moderate degree of poisoning - the reverse development of symptoms and recovery!
With a severe degree of poisoning, toxic damage to the liver and ASTs, ALT above 10,000 IU / L, high bilirubin level, deterioration of consciousness, a decrease in the level of sugar, jaundice, kidney failure, a sharp decrease in blood pressure, body temperature.
The fourth stage. Time after taking a high dose of the drug for more than 5 days.
Irreversible hepatic failure with fatal outcome.
Treatment of paracetamol poisoning
It is necessary to call an ambulance and immediately begin to provide emergency assistance with paracetamol poisoning before the arrival of doctors.
- Gastric lavage, within an hour and a half after taking the drug.
- Tablets of activated carbon within 8 hours after taking the drug at a dosage of 1 gram per kilogram of weight.
- Administration of the antidote N-acetylcysteine within 8 hours after taking the drugs.
- Artificial ventilation of the lungs to accelerate the cleavage and excretion of metabolites of paracetamol.
- The introduction of methionine 2.5 grams inside with an interval of 4 hours three times to protect the liver cells.
- Diet number 5. From the diet, animal proteins and fats are excluded. The basis of the diet is easily digestible carbohydrates (berry and fruit juices, compotes, kissels, infusions of dried apricots, prunes and dried apricots).
- With a decrease in the level of sugar - the introduction of glucose solution intravenously.
- With heart failure - the reception of cardiac glycazides.
- In severe cases, surgical treatment may be needed - liver transplantation, kidney removal.
Prevention of poisoning with paracetamol
Observing all the rules can prevent poisoning:
- Keep medicinal products 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 intake of non-steroidal anti-inflammatory drugs (Nurofen, acetylsalicylic acid, Orthofen, Ibuprofen, Metamizol sodium, Analgin), as they enhance the effect of paracetamol.
- Categorical refusal of alcohol during the reception of 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 results in recovery.
With irreversible hepatic insufficiency, an emergency liver transplantation is necessary, the prognosis is extremely unfavorable.
If you take an acceptable dosage of the drug, taking into account the peculiarities of your health, it will not cause any harm to your health!