Buscopan Venus Overdosage

Symptoms: Signs of overdose of Hyoscine-N-butylbromide may include pallor, nausea, vomiting, anorexia and abdominal pain. Patients may then experience a temporary subjective improvement but mild abdominal pain possibly indicative of liver damage may persist.
A single dose of paracetamol of approximately 6 g or more in adults or 140 mg/kg in children may cause hepatocellular necrosis. This may lead to complete irreversible necrosis and subsequently to hepatocellular insufficiency, metabolic acidosis and encephalopathy, which may in turn progress to coma and death.
Concurrent rises in liver transaminases (AST, ALT), lactate dehydrogenase and bilirubin and an increase in prothrombin time, occurring 12 - 48 hours after ingestion, have been observed. Clinical symptoms of liver damage are normally apparent after 2 days and reach a maximum after 4 - 6 days.
Acute renal failure with acute tubular necrosis may develop even in the absence of severe liver damage. Other non-hepatic symptoms such as myocardial abnormalities and pancreatitis have also been reported to occur after paracetamol overdosage.
Treatment: If required, parasympathomimetic drugs should be administered. Ophthalmological advice should be sought urgently in cases of glaucoma. Cardiovascular complications should be treated according to usual therapeutic principles. In case of respiratory paralysis: intubation, artificial respiration should be considered. Catherisation may be required for urinary retention. In addition, appropriate supportive measures should be used as required.
Where paracetamol intoxication is suspected, intravenous administration of SH group donators such as N-acetylcysteine within the first 10 hours after ingestion is indicated. Although N-acetylcysteine is most effective if initiated within this period, it can still offer some degree of protection if given as late as 48 hours after ingestion; in this case, it is taken for longer. The plasma concentration of paracetamol can be decreased by dialysis. Determinations of the plasma concentration of paracetamol are recommended.
Further measures will depend on the severity, nature and course of clinical symptoms of paracetamol intoxication and should follow standard intensive care protocols.