Let’s get to the most important point first. If a paracetamol overdose is suspected, hospital treatment should be sought without delay. Ideally within 12 hours of having taken the overdose. Treatment must always be supervised in a hospital.
The recommended dose of paracetamol for a single adult is two standard 500 mg tablets. Researches have reported that the threshold for liver damage to start from a single paracetamol overdose is 15 gms (30 tablets).
An important point my however noted that as per the standard hospital guidelines, they allow an extra cover or safety margin and consider that liver damage could start to occur at a single overdose of 24 standard tablets or 150 mg/kg body weight, (whichever is the smaller). The overdose border or threshold may be lowered in a person on prescription medicines, or someone who is an alcoholic or is undernourished to some extent.
Symptoms: Overdose Of Paracetamol often shows no symptoms within the first 24 hours after the overdose. In some cases although there may be mild nausea and vomiting. If the overdose is large then liver function may start deteriorating leading to either of these; jaundice, confusion, and loss of consciousness. Death due to overdose of Paracetamol is rare but when it occurs it is in majority of cases due to liver failure.
In severe poisoning, hepatic failure may progress to encephalopathy, haemorrhage, hypoglycaemia, cerebral oedema, and like discussed earlier, death. Abnormalities of glucose metabolism and metabolic acidosis may occur. Acute renal failure with acute tubular necrosis, strongly suggested by loin pain, haematuria and proteinuria, may develop even in if there is no severe liver damage. Cardiac arrhythmias and pancreatitis have also been reported as a result of overdose of Paracetamol.
Treatment of a serious paracetamol overdose is done by administration of an antidote, which can defeat and combat the toxic effects of the overdose.
Immediate treatment is essential in case of paracetamol overdose. When a person has had an overdose of paracetamol, and there are no significant early symptoms, patients should still be referred to hospital urgently for immediate medical attention. Symptoms may be limited to nausea or vomiting and may not be severe but the risk of organ damage has already set in so steps should be taken immediately.
Doctors normally consider treating such patients with activated charcoal if the overdose has been taken within 1 hour. Likewise, treatment with N-acetylcysteine may be used up to 24 hours after ingestion of paracetamol. However one must know that the maximum protective effect is obtained up to 8 hours after ingestion. The effectiveness of the antidote diminishes sharply after this time. If vomiting is not a problem, oral methionine may be a suitable substitute for remote areas, outside the hospital.
For a common person with an overdose of paracetamol it is best to visit the doctor and seek immediate advice. If you are someone you know has had an overdose of paracetamol then whether to not symptoms start to surface you should visit the doctor. Earlier the better. Best within one hour of intake of it. And starts getting really dangerous after 24 hours of having taken he overdose. No self medication, no taking cues from people who have experienced this horror before or checking out the net for immediate assistance. Keep it simple. VISIT THE DOCTOR.
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