At the same time, renal failure and pancreatitis are possible, sometimes without liver failure. Increased ACT activity> 1000 U / L is more likely to result from paracetamol poisoning than with chronic hepatitis or alcoholic liver disease. The activity of aspartate aminotransferase (ACT) and alanylaminotransferase (ALT) may increase, and in severe poisoning, total bilirubin and MHO may occur. The clinical symptoms that go through 4 stages include anorexia, vomiting, nausea, pain in the right hypochondrium. ,, , Acute single overdose with paracetamol Mild poisoning can be asymptomatic, or the symptoms are minimally pronounced within 48 hours from the moment of taking the drug. Chronic overdose is usually caused by taking an unreasonably high amount of a drug to treat pain, rather than deliberate poisoning. Alcohol intake may have a protective effect, since the hepatic enzymes of the P450 system preferably metabolize ethanol and, as a result, cannot produce toxic N-acetyl-b-benzoquinoneimine.įor poisoning, an acute overdose is needed totaling> 150 mg / kg body weight (about 7 g for adults) during the day.Ĭhronic overuse or repeated overdose lead to liver damage in rare cases. However, it is unclear whether the risk actually increases. Theoretically, alcoholic liver disease and reduced nutrition can increase the risk of damage, since the state of the hepatocyte enzyme system causes an increased formation of N-acetyl-b-benzoquinone-imine, and as a result of depletion (which is typical for alcoholics) leads to a decrease in glutathione reserves. As a result, N-acetyl-b-benzoquinoneamine accumulates, causing hepatocyte necrosis, possibly causing damage to other organs (kidney, pancreas). Acute overdose depletes glutathione in the liver. The main toxic metabolite of paracetamol, N-acetyl-b-benzoquinone imine, is produced by the liver cytochrome P450 enzyme system neutralized in the liver with glutathione. In this regard, paracetamol overdose is common. Many prescription drugs also contain paracetamol. Paracetamol is contained in more than 100 over-the-counter drugs, including medicines for children (capsules, tablets and syrups), as well as drugs used for cough and cold.
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