What Should I do About an Acetaminophen Overdose?

Within 24 hours of taking the drug, the patient had mild anorexia, nausea, vomiting, and sweating; 24-48 hours after taking the drug, the patient was slightly better, but he had pain in the right upper quadrant liver region, and abnormal liver function was found. Significantly increased; liver necrosis, hepatic encephalopathy, myocardial damage and renal failure occurred after 2 to 4 days, jaundice was obvious, and prothrombin time was significantly prolonged.

Acetaminophen poisoning

Paracetamol (acetaminophen) has antipyretic and analgesic effects. The drug is rapidly absorbed from the gastrointestinal tract, and the plasma concentration reaches the highest peak 30 to 120 minutes after oral administration (therapeutic amount). 90% of the drugs are combined with glucuronic acid and sulfate in the liver and excreted from the urine; only 2% to 4% are metabolized by the cytochrome P-450 mixed function oxidase system in the liver, becoming toxic intermediate metabolites and interacting with the grains. Glutathione binding. After the latter is exhausted, unbound metabolites bind to hepatocyte proteins, leading to hepatocyte necrosis. Adults can produce hepatotoxic effects by taking 7.5 g orally once.

Signs and symptoms of acetaminophen poisoning

Potential poisoning can be detected by measuring the plasma concentration of the drug. Repeated determination after several hours can help diagnosis of poisoning.

Paracetamol poisoning treatment

If the patient has an allergic reaction after taking the drug, the medication must be stopped immediately; it should not be taken at the same time as other acetaminophen-containing drugs; alcoholic beverages should be avoided during the medication; patients with liver and kidney dysfunction should be used with caution. Children under 3 years of age and newborns should be avoided due to liver and kidney dysgenesis.

First aid treatment: Whether the treatment of patients with acetaminophen poisoning is related to their prognosis. If handled promptly, the case fatality rate is low. Conversely, delays in handling can easily lead to accidents even in the early stages of poisoning. Actions include:

1. Gastric lavage, sodium diarrhea.

2. Those with conditions can measure the blood drug concentration to estimate the degree of poisoning.

3. The use of N-acetylcysteine, a thiol donor, as early as possible to prevent and cure liver damage caused by acetaminophen has specific effects. The drug can increase the storage of glutathione in liver cells, enable glutathione to bind to the active metabolite of acetaminophen, and prevent it from covalently binding to large molecules of liver cells. It should be used as soon as possible, and try to use acetaminophen within 10 hours after taking it. If it is exceeded, it will be invalid. The drug itself is relatively non-hepatotoxic. Therefore, it should be used decisively in the following situations:

(1) After taking acetaminophen for 4 hours, the plasma drug concentration exceeds 200 mg / L or 12 hours exceeds 50 mg / L.

(2) There is sufficient evidence that patients take acetaminophen in excess. If the patient has been drinking alcohol for a long time, while taking drugs that can induce liver enzymes, starvation or lack of protein, etc., N-acetylcysteine should be applied in time.

Usage: The first dose is 140 mg / kg orally, and then a maintenance dose is given. The dose is 70 mg / kg every 4 hours for 72 hours. The first dose of 150mg / kg can also be injected intravenously in 200ml of 5% glucose solution, and the injection time is not shorter than 15 minutes; then 50mg / kg dissolved in 500ml of glucose solution is intravenously injected for more than 4 hours. Thereafter, intravenous drip was continued with 100 mg / kg in 1000 ml of glucose solution for 16 hours. In this way, the total amount reached 300 mg / kg in 20 hours.

Chinese medicine treatment of acetaminophen poisoning

This kind of drug has the functions of clearing away heat, relieve heat poison, cooling blood and purging fever, and is mainly used for heat constitution and heat syndrome.

1 Scrophularia quinquefolium is the root of Scrophulariaceae and Northern Scrophulariaceae, which contains Scrophularin, Cycloene Ether Terpenoids; It also contains volatile oil, alkaloids, etc .; Pharmacological tests, water extract of Radix Scrophularia, alcohol Infusions and decoctions have the effect of lowering blood pressure; Radix Scrophulariae also has vasodilator and cardiotonic effects; a variety of invasion agents of Scrophularia Scrophularia have sedative and anticonvulsant effects. Chinese medicine believes that its coldness, sweetness and bitterness, nourishing yin and lowering fire, cooling blood and detoxification, are suitable for fever, thirst, hair spots, bone steaming and fever, restlessness at night, spontaneous sweating, night sweats, constipation, and constipation. Sore throat. Dosage: 6-12 grams; but those who have loose stools and wet phlegm should not use it.

2 Cassia seed Cassia seed is the seed of stewed leaves of Cassia or Cassia, which contains anthracene ester and anthraquinone glycosides, cassia hormone and vitamin A, etc. Pharmacological tests have proven that: Cassia seed can reduce blood pressure and serum cholesterol; Resistant to various pathogenic bacteria and soft stools. Chinese medicine believes that its mild coldness, sweetness and bitterness, clear liver and eyesight, and diuretic and laxative, are suitable for redness and pain in the eyes caused by liver heat or wind-heat in the liver, and shame and tears; Hepatitis, cirrhosis, ascites, and habitual constipation are also effective. Dosage: 3--9 grams, mashed fried clothes.

3 Bone skin Bone skin is the root bark of the Lycium barbarum plant, which contains cinnamic acid, a variety of phenols, betaine and linoleic acid, etc .; Bone skin has a significant antipyretic effect, and its decoction It can lower blood sugar, reduce serum cholesterol and anti-fatty liver, and the infusion of ground bone skin has a significant effect on lowering blood pressure in animals. Chinese medicine believes that its coldness, sweetness, lightness, functional cooling blood, steaming, clearing and reducing lung heat, is suitable for fatigue, hot flashes, night sweats, lung heat, asthma, blood fever, vomiting blood, bleed blood, bloating and evil Sores and tuberculosis and hypertension. Dosage: Generally 3--9 grams.

4 Reed roots Reed roots are underground stems of reeds of the family Poaceae, which contain aragonin, asparagine, and the like. Chinese medicine believes that its coldness, sweetness, functions of clearing heat and refreshing fluids, removing annoyance, vomiting, and diuresis, are suitable for fever injury, fever, thirst, stomach vomiting, nausea, nausea, and treatment of lung heat cough, lung dysentery Wait. Dosage: 9-30 grams for ordinary dry; 15-40 grams for fresh.

5 Forsythia forsythia is a fruit of the genus Forsythia, which contains volatile oil, forsythia phenol, flavonoid glycosides, alkaloids, etc .; pharmacological tests show that forsythia has a broad-spectrum antibacterial effect, and the content of forsythia may be the main inhibitor Bacterial constituents; Forsythia also has anti-inflammatory, antiemetic, diuretic and cardiotonic effects; the flavonoids contained in it can increase the density of capillaries, and thus have hemostatic effects on bleeding caused by capillary rupture and subcutaneous hemorrhage. Chinese medicine believes that it is slightly cold, has a bitter taste, has functions of clearing heat and detoxifying, dispersing and dispersing swelling, and is suitable for warming, erysipelas, spotted rash, ulcer, and allergic purpura. Dosage: Usually 6-9 grams.

6 Peony skin Peony skin is the root bark of the peony plant of the genus Ranunculaceae, which contains paeonol, paeonol glycosides, volatile oils and phytosterols. The pharmacological test proves that peony skin has the effect of lowering blood pressure; it has analgesic, sedative, anti-inflammatory and antipyretic effects; and has a strong inhibitory effect on a variety of pathogenic bacteria. Chinese medicine believes that its coldness, bitterness, astringency, heat-clearing function, cooling blood, and blood, and clearing blood stasis, are suitable for hot human blood, hair spots, pain, vomiting blood, ulcers, bruises and other symptoms. Dosage: 5--9 grams, but those who have spleen and stomach deficiency cold and diarrhea should not use it.

7 Anemarrhena anemarrhena is the rhizome of an lily family Anemarrhena anemarrhenae, which contains a variety of saponins and saponins, and also contains two flavonoids, mangiferin, and the like. The test proves that Zhimu has obvious antipyretic effect, and has obvious curative effect on epidemic hemorrhagic fever, Japanese encephalitis and tuberculosis hot flashes. Chinese medicine believes that its coldness, sweetness and bitterness, functions of clearing heat and purging fire, nourishing yin and moisturizing, are suitable for lung heat cough, asthma or yin deficiency cough, irritability and thirst, bone steaming torture, unfavorable urination, and dry stool disease. Dosage: Usually 6--9 grams, but those with kidney yang deficiency, weak two-foot veins, and fecal diarrhea should not use it.

8. Isatis indigotica Isatis root is the root of Cymbidium grandiflora and Cymbidium grandiflora, which contains Isatis indigoside, cyanine B, B-sitosterol, etc .; Isatis root has a significant antiviral effect. It has inhibitory effect on a variety of pathogenic bacteria and has Leptospira effect. Clinical use of Banlangen decoction for oral or intramuscular injection has a significant effect on the treatment of Japanese encephalitis; it has certain effects on acute and chronic hepatitis, which can alleviate or resolve symptoms and promote improvement of liver function; use Banlangen to treat viral skin diseases such as Herpes simplex, shingles, pityriasis rosea, and flat warts all have varying degrees of therapeutic effect. Chinese medicine believes that its coldness, bitterness, heat-clearing and detoxification, cooling blood, and pharyngeal throat are applicable to influenza encephalitis, Japanese encephalitis, pneumonia, erysipelas, fever-induced freckles, fire eyes, and herpes. Dosage:-Normally 5-9 grams; but those with spleen and stomach deficiency should not be used.

9 Honeysuckle Honeysuckle is a flower bud of the honeysuckle family, which contains chlorogenic acid, inositol, and flavonoids; pharmacological tests have proven that honeysuckle has anti-inflammatory and antipyretic effects, and is effective against influenza viruses and various pathogenic bacteria and skin pathogenic fungi Both have inhibitory effects, reflecting the heat-clearing and detoxifying effects of honeysuckle. Chinese medicine believes that its coldness, sweetness, function of clearing heat, and detoxification are suitable for fever, fever, blood rash, sores, carbuncle, and bloating. Dosage: Generally 6-12 grams; however, those who are cold and diarrhea and sore and pus have no fever should not be used.

10 Prunella vulgaris is a flower or whole grass of the labiata plant Prunella vulgaris, which contains triterpenoid saponin and its aglycon oleanolic acid, volatile oil and vitamins, potassium chloride, etc .; pharmacological research proves that: Prunella vulgaris Both have the effect of lowering blood pressure; its decoction has different degrees of inhibition on some common skin fungi, and it also inhibits a variety of pathogenic bacteria. Chinese medicine believes that its coldness, bitterness and astringency, functions of clearing liver and fire, dispersing depression, and lowering blood pressure, are suitable for redness and pain in the eyes caused by liver inflammation, eye pain, shame, tears, headache, dizziness, etc .; used for phlegm Fire stagnation caused by pimple, pimple and so on. Dosage: Generally about 9 grams.

11 Gardenia gardenia is the fruit of the Rubiaceae plant, which contains a variety of bitterin glycosides, also contains mannitol, ursolic acid, etc. Gardenia gardenia has a beneficial effect on bile or increases bile secretion; at the same time, gardenia gardenia has cooling and sedation , Analgesic and anticonvulsant effects; there are antimicrobial effects, and it has inhibitory effects on a variety of pathogenic bacteria and a variety of skin pathogenic fungi. Chinese medicine believes that its coldness, bitterness, function of purging fire and removing annoyance, clearing away heat and dampness, cooling blood and detoxifying, are suitable for fever, fever, insomnia, jaundice, red eyes, bleed blood, heat sore and so on. Dosage: 3-9 grams.

12 Taraxacum Taraxacum is a rooted whole plant of the family Asteraceae taraxacum, containing taraxol, choline, inulin, and fruit acid, etc .; its decoction has anti-pathogenic microorganism effect; it also has liver-protecting, choleretic, and improves human immune functions Role. Chinese medicine believes that its coldness, sweetness, bitterness, heat clearing and detoxification, swelling and dispersal, are applicable to acute mastitis, lymphadenitis, acromitis, gastritis, hepatitis, cholecystitis, urinary tract infections, etc. Dosage: 9-15 grams, smashed for external application, can be used for palate, rash, bloated, etc.

Western medicine treatment of acetaminophen poisoning

Early administration of thiol-containing compounds to replace glutathione combined with drug intermediate metabolites can significantly reduce liver damage. Methionine and cysteamine (cysteamine) both detoxify. At present, acetylcysteine (acetylcysteine) is mainly used. Within 16 to 24 hours after taking the poison, the sputum easy-cleaning 20% aqueous solution can be administered orally or through a nasal feeding tube. The first dose is 140 mg / kg, and the subsequent dose is 70 mg / kg every 4 hours. A total of 17 times (68 hours) are required. ). The antidote has side effects such as nausea and vomiting, which are generally tolerated by patients, but cannot be taken at the same time as medicinal carbon, which can absorb sputum and is easy to clean. If the medicine has been taken for more than 24 hours, supportive therapy is the main method, and Yitan Jing can no longer detoxify.

The above information is for reference only, please consult your doctor for details.

Paracetamol poisoning diet health care

Patients have no special dietary contraindications and can eat normally.

Diet side:

1. 2000 grams of live loach, put it in clean water for 1 day, and make it clear the intestinal waste. Put it in the drying box to dry or bake the next day, and bake it at the end. Take 10 grams once a day with warm water for 15 days as a course of treatment. It has the benefits of warming the qi and detoxifying.

2. Yinchen and plantain are each 100 grams (or plantain 20 grams), add 1000 ml of water, cook 800 ml, 200 ml per serving, add 20 grams of sugar, 2 to 3 times a day. Conducive to dampness and heat.

3. Yin Chen 30 ~ 60 grams, japonica rice 50 ~ 100 grams, the right amount of sugar. First wash Yin Chen, decoction, remove dregs. After adding rice, add an appropriate amount of water. When the porridge is about to be cooked, add an appropriate amount of sugar and cook for 1 to 2 minutes. Take 2 to 3 times a day, 7 to 10 days as a course of treatment. It has the effects of clearing away dampness and heat, and removing jaundice. For acute infectious jaundice hepatitis.

4. 50 grams of jujube, add 500 ml of water, simmer for 1 hour, add an appropriate amount of sugar. Take 1 time daily. It is suitable for acute and chronic hepatitis, and has the effect of reducing transaminase.

5. 30 grams of Chinese wolfberry, 1 hen, 1250 grams of broth, 10 grams of cooking wine. Open the hen in the anus of the chicken, dig out the internal organs, and wash; wash the wolfberry into the chicken belly, then put it in the bowl (the chicken belly is up), put onion and ginger, pour clear soup, add salt and cooking wine , Pepper noodles, steam out for 2 hours, remove ginger, scallion, adjust the salty Serve. 2 times a day, eating meat and soup, have liver protection and essence, nourishing yin and eyesight. It is suitable for patients with chronic hepatitis, early cirrhosis, and anemia.

6. 100 ~ 150 grams of fresh celery, washed, smashed to get juice, add honey stew, once a day. It has the effect of clearing heat and detoxifying and nourishing liver.

The above information is for reference only, please consult your doctor for details.

Prevention of paracetamol poisoning

If the patient develops an allergic reaction after taking the drug, the drug should be stopped immediately; it should not be taken at the same time as other drugs containing acetaminophen; avoid drinking alcoholic beverages while taking the drug; use with caution in patients with liver and kidney dysfunction, children under 3 years old and newborn Children should be avoided due to liver and kidney dysgenesis.

Pathological causes of acetaminophen poisoning

It is mainly caused by overdose or accidental ingestion of acetaminophen drugs by patients.

Diagnosis of acetaminophen poisoning

It is mainly distinguished from drug poisoning that causes gastrointestinal reactions.

Inspection method for acetaminophen poisoning

In case of symptoms of poisoning, measures such as vomiting, gastric lavage, catharsis, enema and infusion should be given immediately. Routine examination should be performed after the condition is stable.

Acetaminophen poisoning complications

It can cause nausea, vomiting, sweating, abdominal pain and paleness. Excessive dose can cause liver damage. In severe cases, it can cause coma and even death.