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Did you know that taking the right medicine can be deadly? Unravel the mystery of acetaminophen poisoning!
Acetaminophen, also known as paracetamol, is a commonly used antipyretic and analgesic drug by many people. However, this seemingly safe drug hides potentially fatal dangers. According to research, poisoning cases are occurring more and more frequently, especially in the United States and the United Kingdom, and acetaminophen poisoning has become one of the leading causes of acute liver failure.
After an overdose of acetaminophen, the first symptoms are usually not obvious, and some people may not even notice the changes in their bodies.
Symptoms of poisoning usually go through three stages. In the early stages, patients may have only non-specific symptoms such as mild general weakness, abdominal discomfort, or nausea, which may be mistaken for ordinary discomfort. However, within the next 24 to 72 hours, the liver begins to be severely damaged, manifested by abnormal increases in liver function indicators and even pain in the right upper quadrant. If it enters the third stage, significant liver failure may occur, with clinical manifestations such as impaired coagulation, hypoglycemia, acute renal failure and other complications.
The basic mechanism of this toxic reaction involves drug metabolism. When the intake of acetaminophen exceeds the metabolic carrying capacity of the liver, a large amount of the toxic metabolite N-acetyl-p-benzoquinone imine (NAPQI) will be produced. This substance causes severe damage to liver cells and reduces the body’s antioxidant capacity. Glutathione is excessively consumed, causing cell death and liver necrosis.
Severity of liver injury is generally related to dose and individual response.
The risk of acetaminophen poisoning is related to many factors. Chronic alcoholism, malnutrition, and concurrent use of other hepatotoxic drugs are all factors that affect the chance of poisoning. Especially in terms of epidemiology, the UK reports that it has become the drug with the most people sent to the hospital due to overdose, while the United States reports more than 100,000 poisoning cases every year, especially for young children, it is very easy to cause accidental overdose. Serious health problems due to overdose.
How to diagnose and treat acetaminophen poisoning?
Diagnosis usually relies on measuring the concentration of acetaminophen in the blood. Doctors will use the Rumack-Matthew plot to assess a patient's risk of liver damage. This chart provides a guide to help medical professionals determine the need and urgency of treatment. The timing of blood collection and concentration readings are both critical, and testing usually needs to be performed within a certain period of time after administration to obtain accurate results.
Early treatment is crucial to avoid liver failure, with a mortality rate of only 0.1%.
In terms of treatment, the antidote for acetaminophen is acetyl cysteine (NAC), which promotes the synthesis of glutathione, neutralizes NAPQI, and protects liver cells from damage. Studies have shown that starting acetylcysteine within 8 hours of taking it can significantly reduce the risk of liver toxicity. If delayed beyond this time, effectiveness decreases dramatically and the risk of liver necrosis increases significantly.
To be honest, this situation is chilling, because just one day's dosage is too high, but it may be necessary to face the test of life and death. Because of this, the medical community emphasizes the rational use of drugs to avoid irreversible consequences caused by casual self-administration of drugs.
How to prevent acetaminophen poisoning?
In many countries, sales of acetaminophen are restricted in an effort to reduce overdoses. For example, the UK limits over-the-counter acetaminophen dosage to 32 pills, while Ireland's limit is 24 pills. This move indeed has a significant effect on reducing the mortality rate from poisoning. In addition, regular medication safety education to the public can help increase people’s awareness and reduce accidental poisonings.
Authorities need to balance access to medicines with safety, which is a challenge.
Furthermore, medical institutions are also exploring other potential alternatives, by developing new drugs to reduce liver toxicity, or combining drugs to reduce side effects. These are all directions for future improvement.
While we use every medicine conveniently, we really need to think carefully about whether these commonly taken cold and painkillers may also have hidden dangers?
