Acetaminophen (Paracetamol) Poisoning, fatal dose and Management.

Acetaminophen is an over the counter drug, easily available without a prescription, but if taken especially if more than 12g is taken which is potentially fatal. The cause of death or the complication is usually the liver failure, which likely occurs if more than 250mg/kg of paracetamol is taken.

If a patient arrives at the emergency department with paracetamol poisoning and has taken more than 200mg/kg or more than 10g of paracetamol then immediately resuscitate and start acetylcysteine which is the antidote for paracetamol poisoning.

The dose of Acetylcysteine and Method of Administration

Consider Oral acetylcysteine, if the patient is not confused and can easily tolerate the medicine orally, the injectable acetylcysteine may also be given by oral route.
The oral dose is as follows.

Oral Administration of Acetylcysteine

The loading dose is 140mg/kg, after giving the loading dose, wait for four hours and after four hours give the maintenance dose, which is 70mg/kg. Repeat the maintenance dose after every 4 hours and give total seventeen doses, one dose after every four hours (total seventeen doses)
If the patient vomits within one hour of oral administration, repeat the dose.

Intravenous Administration of Acetylcysteine

If a patient is unable to tolerate the oral dose due to repeated vomiting or confusion then give acetylcysteine intravenously according to the following directions;
1. Give loading dose, which is 150mg/kg, mix it with 200ml of dextrose water 5%, and infuse is over the period of one hour.
2. After the loading dose, give 50mg/kg, mixed with 500ml of dextrose 5% and transfuse it over the period of 4 hours,
3. after this add 100mg/kg of acetylcysteine to 1000ml of dextrose 5% and infuse it over the period of sixteen hours.

Monitor vital signs, liver and renal function test, mental status, and urine output.

Comments

Human Parasites, Types of Parasites, and Classification

Parasite: A parasite is a living organism which gets nutrition and protection from another organism where it lives. Parasites enter into the human body through mouth, skin and genitalia. In this article, we will generally discuss the types and classification of parasites. It is important from an academic point of view. Those parasites are harmful, which derives their nutrition and other benefits from the host and host get nothing in return but suffers from some injury. Types of Parasites Ecto-parasite: An ectoparasite lives outside on the surface of the body of the host. Endo-parasite: An endo-parasite lives inside the body of the host, it lives in the blood, tissues, body cavities, digestive tract or other organs. Temporary parasite: A temporary parasite visits its host for a short period of time. Permanent parasite: Permanent parasite lives its whole life in the host. Facultative parasite: A facultative parasite can live both independently and dependently. It lives in the

How to taper off, wean off beta blocker, atenolol, Propranolol, Metoprolol

Beta blockers include, atenolol (Tenormin), propranolol (Inderal ) and metoprolol (Lopressor) and are used to treat high blood pressure, certain cardiac problems, migraine and few other conditions. People usually take atenolol, propranolol or metoprolol for many years as a treatment of high blood pressure or after having an episode of heart attack . Sometimes, it becomes necessary to withdraw these beta blockers due to their potential side effects that trouble the patients or sometimes doctor wants to change the drug and shift the patient to some other anti-hypertensive medicine. No matter whatever the cause is, whenever, a patient who has been using a beta blocker for a long period of time, and he needs to be stopped from further usage of that beta blocker, must not stop taking it. One should taper off the dose of a beta blocker. Now a question arises how to wean off or taper off a beta blocker? The method of tapering off beta blocker varies from individual to individual. Allow you

Difficulty in standing up from a sitting or squatting position, Causes & Solution

People who feel it difficult to stand up from a sitting or squatting position may have problem in one or more of the following structures. 1. Knee joint 2. Muscles of legs, thighs or buttock 3. Muscles of arms 4. Cerebellum Let’s now explain one by one, what kind of problems in above structures may cause difficulty in standing up from a sitting or squatting position. 1. How do problems in knee joints lead to difficulty in standing up? Knee joint is one of the primary and most affected joint that takes part in standing up. Other joints that take part are hip, ankle, knee, elbow, wrist and shoulder joint. Knee joint gets the most strain , and also knee joint is comparatively less supported. That’s why usually it’s the knee joint that starts to cry first because of arthritis. Knee joint arthritis causes long term knee pain , that makes the movement difficult at knee joint. Arthritis also makes the knee joint stiffer and slower and its range of motion also decreases. All these affects coll

MedicoTips.Com

Search This Blog