Sign Out
Symptoms: In the first 24 hours: nausea, vomiting, abdominal pain, diaphoresis and pallor. Liver function tests may be normal.
In 24 to 36 hours: right upper quadrant pain and elevation of liver function test (e.g. ALT, AST, bilirubin, PT).
In 72 to 96 hours: fulminant hepatic failure, encephalopathy, AST and ALT levels of more than 10,000 units/L, abnormal PT appear.
Young children who received paracetamol dosages exceeding those recommended (10 - 15 mg/kg per dose with a maximum of 5 doses per day) appear to be less likely to develop hepatotoxic effects than adults.
Treatment: If the overdose has been taken within 1 hour, treatment with activated charcoal may reduce paracetamol absorption should be considered. Plasma or serum paracetamol concentrations should be determined as soon as possible, but no sooner than 4 hours after ingestion (to ensure that peak concentrations have occurred).
After ingestion more than 24 hours, treatment with N-acetylcysteine with an oral or IV loading dose is effective in adults and pediatric patients.
