Why does paracetamol kill you

Other tests that are requested will depend on each individual case and the patient's course. For example, if other medications were taken then their levels may need to be checked.

Immediate management will require resuscitation and stabilisation. If the patient is unstable - such as having low blood pressure - or there is overwhelming liver failure, they will need to be treated on an intensive care unit.

The paracetamol levels will be sent off and once the result is back this is compared with a standard graph - patients who are above a certain line will need treatment. Those below the line may not require treatment. Treatment is with intravenous N-acetylcysteine NAC and is given to all who have high paracetamol levels. If there is any doubt about the time of the overdose or there has been a 'staggered overdose', intravenous NAC is started without delay.

NAC protects the liver and this may be the result of it restoring the glutathione levels. It may also help the liver to combat toxicity. A full treatment course consists of three consecutive bags of the medicine, mixed with intravenous fluid and given over approximately 24 hours. During that period several blood tests may be taken to monitor the liver and kidneys.

It is most effective when given within eight hours of taking the paracetamol overdose. If, however, there is ongoing damage from the paracetamol overdose then the NAC treatment may need to be prolonged. NAC is used in children and also in pregnant women. In pregnant women the paracetamol overdose can affect the liver of the fetus as well and NAC can help prevent this. The main complication following a paracetamol overdose is liver failure.

The patient may need to be referred to the specialist liver unit if the bloods confirm liver failure. Other features which will help the healthcare professionals to decide if the patient needs to go to a specialist unit include: involvement of the brain, abnormal clotting, kidney impairment, low blood pressure hypotension , low blood sugar hypoglycaemia and high blood acid levels. Urgent liver transplantation is the only treatment when overwhelming, irreversible liver failure occurs.

Hawton K et al ; Impact of different pack sizes of paracetamol in the United Kingdom and Ireland on intentional overdoses: a comparative study. Biomed central Paracetamol overdose - revised single line treatment nomogram ; Medicines and Healthcare products Regulatory Agency, Sept Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions.

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The Annual Report of the Child Safeguarding Practice Review Panel, an independent expert panel reviewing serious safeguarding cases, has been published for An antidote to paracetamol poisoning is available which protects the liver but it must be given within 24 hours of overdose.

Many people who have taken an overdose appear to recover and then develop fatal liver failure a few days later. Join thought-provoking conversations, follow other Independent readers and see their replies. Want to bookmark your favourite articles and stories to read or reference later? Start your Independent Premium subscription today. More about Drugs Healthcare Liver Pharmaceuticals. Already subscribed?