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Acetaminophen Overdose

 Syn. Acetaminophen poisoning

Signs & Symptoms

 Exposure to Carbon tetrachloride (negative symptom)
Ref: Epocrates [ https://online.epocrates.com/diseases/33732/Acetaminophen-overdose]
Exposure to Industrial chemicals (negative symptom)
Ref: Epocrates [ https://online.epocrates.com/diseases/33732/Acetaminophen-overdose]
Exposure to anesthetic agents (negative symptom)
Ref: Epocrates [ https://online.epocrates.com/diseases/33732/Acetaminophen-overdose]
Exposure to mushrooms (negative symptom)
Ref: Epocrates [ https://online.epocrates.com/diseases/33732/Acetaminophen-overdose]

Physical Examination

 Pharyngitis (negative symptom)
Ref: Epocrates [ https://online.epocrates.com/diseases/33732/Acetaminophen-overdose]
Sustained hypotension (negative symptom)
Ref: Epocrates [ https://online.epocrates.com/diseases/33732/Acetaminophen-overdose]
Right upper quadrant tenderness
Ref: Epocrates [ https://online.epocrates.com/diseases/33732/Acetaminophen-overdose]

Lab / Serology

 Positive Hepatitis A IgM (negative symptom)
Ref: Epocrates [ https://online.epocrates.com/diseases/33732/Acetaminophen-overdose]
Glutathione deficiency
Ref: Epocrates [ Https://online.epocrates.com/diseases/33732/Acetaminophen-overdose]
positive HBc ag (negative symptom)
Ref: Epocrates [ https://online.epocrates.com/diseases/33732/Acetaminophen-overdose]

Imagin Study

 Decreased arterial PH
Note: Used to monitor severity of hepatic failure
Ref: Epocrates [ https://online.epocrates.com/diseases/33732/Acetaminophen-overdose]
ELEVATED arterial lactate level
Note: Used to monitor severity of hepatic failure
Ref: Epocrates [ https://online.epocrates.com/diseases/33732/Acetaminophen-overdose]

Complication

 Renal injury
Ref: Uptodate [ Acetaminophen (paracetamol) poisoning in adults: Pathophysiology, presentation, and diagnosis] Epocrates [ https://online.epocrates.com/diseases/33732/Acetaminophen-overdose]
Acute liver failure
Note: The most common cause of acute liver failure (ALF) in the United States
Ref: Epocrates [ https://online.epocrates.com/diseases/33732/Acetaminophen-overdose]
Coma
Note: West Haven classification system Grade 4
Ref: Epocrates [ https://online.epocrates.com/diseases/33732/Acetaminophen-overdose]

Risk Factors

 Age greater than 40
Ref: Uptodate [ Acetaminophen (paracetamol) poisoning in adults: Pathophysiology, presentation, and diagnosis]

Cause

Other