![]() ![]() During the first stage the patient may be asymptomatic or may experience mild emesis. There are four stages of acetaminophen toxicity. Initial lab work may show elevated levels of liver enzymes and bilirubin. The most common antidote for acetaminophen is N-acetylcysteine and is most effective in treating an overdose if administered within eight hours. The onset of acute liver failure can appear within two to five days after an individual consumes a large significant of acetaminophen. The symptoms of a Tylenol overdose can occur as early as 12 hours after acetaminophen ingestion, including nausea, vomiting, abdominal pain, extreme fatigue, delirium, dark urine, altered mental status, early onset lactic acidosis, encephalopathy, coagulopathy, and renal failure. If the patient presents within 1 hour of ingestion, alert patients can receive activated charcoal for GI decontamination. Compromised emptying, or co-ingestion with a drug that slows gastric motility can delay peak. Unless in the extended-release form, levels peak at 4. The gastrointestinal (GI) tract absorbs acetaminophen, and the drug reaches therapeutic levels within 2 hours. Overdose is more common in children.ĭespite an excellent safety profile with the recommended dose of four grams per day, acetaminophen toxicity develops at dosing of 7.5 g/day to 10 g/day or 140 mg/kg. In the United States, 56,000 emergency department visits, 2,600 hospitalizations, and 500 deaths per year occur secondary to the use or misuse of acetaminophen. In fact, 23% of the adult American population reported using either OTC or prescription acetaminophen weekly. ![]() As an antipyretic and fever reducer, and an ingredient in over the counter cold, cough and sinus medicines, acetaminophen is a common ingredient in over six hundred different over the counter medications. Tylenol is one of the most ubiquitous pain relievers in the world and toxicity is the second most common cause of liver transplantation in the United States. ![]()
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