Acetaminophen (Paracetamol) Overdose – Emergency Medicine | Lecturio

Acetaminophen (Paracetamol) Overdose – Emergency Medicine | Lecturio

[Music] all right so we’re gonna talk a little bit about acetaminophen overdose which is actually a common and disturbing problem in the United States acetaminophen is also known as paracetamol and other settings and it’s a readily available over-the-counter drug that has high lethality potential and produces very minimum minimal symptoms at least in the initial phase so the way acetaminophen works or the way that toxicity works I should say is that the liver metabolizes the acetaminophen into a compound called na pqi which is highly toxic now in normal doses of acetaminophen your na pqi is combined in the body with files that produces a non toxic metabolite which is then eliminated however in overdoses your file stores are depleted and the toxic metabolite accumulates now the main effect of acetaminophen is liver injury so in high doses acetaminophen can actually cause fulminant liver failure and it’s one of the leading causes of liver transplantation and young people the antidote for this is called nak or an asset eel cysteine and basically what it does is it detoxifies na p qi and decreases the production of it it’s a very very effective antidote but it has to be given early it should be initiated within eight hours of the ingestion so this is very important you can’t wait around to see if the patient is gonna have manifestations of liver failure you need to initiate treatment based on your clinical suspicion so there’s a nomogram that helps guide our decision about whether to give nak to patients with acetaminophen overdoses note that the nomogram doesn’t start until four hours after the ingestion so it takes four hours for GI absorption to be complete meaning we don’t check a level until four hours after the ingestion after that point depending on what level we get we can differentiate between high risk of toxicity and low risk of toxicity and if the patient is above that threshold for toxicity we want to go ahead and treat them all right so obviously I couldn’t cover every possible poisoning so I tried to give you some essential principles it’s really important to know your toxic drums so that you can recognize what drug class your patient might have been exposed to and narrow your differential diagnosis otherwise you’re going to be left trying to figure out the individual properties of lots of different drugs which is not really realistic you want to make sure you externally decontaminate your patient in order to protect you both yourself and them you want to provide aggressive supportive care with a real focus on the ABCs you want to recognize any potential high toxicity or high lethality ingestion x’ and get help you want to consider GI contempt decontamination especially in patients with a high risk of morbidity or mortality from their toxic ingestion but remember to always protect their airway when you do that and then you want to be aware of antidotes and use them when they’re available and indicated [Music] you


  1. Ahmed Yasin Adaan says:

    Thanks *lecturio* try to minimise minutes its good like this clip

  2. Biomed Master says:

    It's sooooo crazy that people are not informed they only should take a max of 4 grams a day…

  3. JAMUNA CB says:

    Is this affect pregnancy??

  4. Ivars Matisons says:


  5. gary smallwood says:


  6. Ranaaahh says:

    I drank 4 tablets in a day

    Please help I don’t want to die

  7. christian jose says:

    I'm for suicide method i hope this things works

  8. PanadolSZN says:

    can you be my lecturer?

  9. Excluded says:

    I chewed 10 paracetamol, vomited, felt so terrible and no appetite, I survived.

  10. RenrakS says:

    I took 10g in 2 hours and i puked for the next 2 days

  11. Alex Edits says:


  12. Tarrina__C says:

    I am open to help as many people as possible. Drop any social media below. I WILL help you through this I don’t care what it takes or if it takes years. I’ve been there and now want to help others that are currently in the place I was.

  13. lil moon says:

    I just tried to kill myself 🙂

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