![]() Therapeutic excess (any of the following):.Self-harm - all patients (irrespective of reported ingested dose or timing, clinical judgement required if historical).Patient should undergo a further hospital medical assessment if: The standard local protocol is acetylcysteine IV in two infusions with the option to extending depending on biochemical criteria. In some scenarios the paracetamol level can be plotted against a single treatment line on the paracetamol treatment nomogram. Management of a patient suffering from a paracetamol overdose is dependent on the presentation scenario and time from ingestion. It may also be effective up to and possibly beyond 24 hours. It has near 100% efficacy in preventing paracetamol-induced hepatotoxicity if given within the first 8 hours from ingestion of overdose. A cetylcysteine IV (N-acetylcysteine, Parvolex ®, NAC) is the treatment of choice. In overdose the potential risk of a patient having significant liver damage is directly proportional to the amount of paracetamol ingested. TOXBASE (password required) should continue to be used as a clinical decision support resource in conjunction with the National Poisons Information Service (NPIS, 03). While the MHRA has not yet approved its use, TOXBASE now lists the regime as a recognised treatment period. The same dose of N-acetylcysteine is administered in this regime but over a 12-hour ( not 21-hour) treatment period. All rights reserved.This guideline reflects the local NHSGGC policy on acetylcysteine use in adult paracetamol overdoses and is based on the Scottish and Newcastle Anti-emetic Pre-treatment for Paracetamol Poisoning (SNAP) regime. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.Ĭopyright © EBSCO Publishing. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. It is neither intended nor implied to be a substitute for professional medical advice. Please be aware that this information is provided to supplement the care provided by your physician. Accessed September 3, 2015.ĮBSCO Medical Review Board Monica Zangwill, MD, MPH : McNeil Consumer Healthcare announces plans for new dosing instructions for Tylenol products. DynaMed Plus Systematic Literature Surveillance ![]()
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