PARACETAMOL TOXICITY

السلام عليكم ورحمة الله وبركاته

هنتكلم النهارده عن التسمم عن طريق الباراسيتامول اللي موجود في ادويه كتيير سوار شرب او اقراص او لبوس واللي ممكن يحصل تسمم منه عن طريق الخطأ كتيير جدا

PARACETAMOL TOXICITY

 Therapeutic dose :- 2.6 gm/day-

 Toxic dose :- for children : 3gm-

                        For adult : 7.5 gm

♦ Acute liver toxicity occur after ingestion of more than 15 gm in adults but you should know that chronic use of paracetamol cause hepatotoxicity

P.S

Using enzyme Inducer drugs as barbiturates, phenytoin & Alcohol with paracetamol cause more hepatotoxicity

- Symptoms divided in phases according to time

  ● phase I :- 1^st few hours  Nausea, Vomiting,
                     Drowsiness,Excessive sweating

  ● phase II :- from 24-72 hours  liver damage &
                     liver enzyme Increase

  ● phase III :- from 72-96 hours  hypoglycemia,
                       jaundice, liver Kidney & heart problems

  ● phase IV :- 7-10 days  excessive liver damage,
                       sepsis, death…..

-Treatment :-

 1- Decontamination "still after 4 hours of digestion" by

     ▪ Gastric lavage

     ▪ Charcoal

     ▪ Emetic

     ▪ cathartic

 2- Antidotes

     ▪ N-acetyl cystein :- it is glutathione precursor that increase

       glutathione leading to decrease hepatotoxicity

       Dose :-

                oral by loading dose 140 mg/kg then 70mg/kg every 4 hours

                IV dose 300mg/kg

     ▪ methionine as it increase glutathione synthesis

3- Haemodialysis :- if renal failure occur & persist more thane 48 hrs