Paracetamol is an antipyretic and an analgesic medicine, a mandatory addition to any homeopathic medicine. It is the first choice for pregnant women, nursing mothers and babies with a very good safety profile. However, if paracetamol is used improperly, paracetamol may also be dangerous.
When paracetamol is administered at therapeutic doses, 90-93% of the preparation is metabolised to an inactive metabolite that is excreted in the urine. About 5% is metabolised to a toxic compound (benzoquinone), which damages the liver (hepatotoxicity).
Taking the therapeutic dose and in healthy patients the toxic benzoquinone is processed into the liver to a non-toxic substance.
The therapeutic dose of paracetamol in adults is 4g. for 24h. (1 tablet Paracetamol is 500mg, the maximum dose is 8 tablets per day). For children, the dose is 15 mg per kilogram of body weight over 4-6 hours to a maximum daily dose of 75 mg / kg.
After taking paracetamol at a dose above 150 mg / kg (about 7 g) in adults, toxic effects develop. In chronic alcoholics and patients with hepatic impairment (cirrhosis, hepatitis), the risk of hepatotoxicity increases repeatedly. The liver does not manage to deactivate the toxic benzoquinone that begins to damage it.
Acute paracetamol poisoning occurs in 4 phases.
– The first 24 hours. after overdose symptoms such as nausea, vomiting, increased liver enzymes develop. Often in adults this phase is asymptomatic.
– The second phase (up to 72hrs) is latent. Vomiting stops and apparent improvement occurs. A liver enlargement was observed during the review
– The third stage (up to 96 hours) occurs with liver failure. Characterized by necrosis, jaundice, nausea, upper right stomach pain
– The fourth phase (4-14 days) – recovery. After the fifth day of poisoning, recovery of liver function begins.
Treatment. It starts by washing the stomach with activated charcoal and administering a specific antidote (acetylcysteine – a cough medicine).