Serimol Overdosage

Symptoms: Symptoms of paracetamol overdosage in the first 24 hours are pallor, nausea, vomiting, loss of appetite and abdominal pain. Liver damage (pain, tenderness, and/or swelling in the upper abdominal area) may become more apparent 12 to 48 hours after ingestion. Abnormalities of glucose metabolism and metabolic acidosis may occur. In severe poisoning, hepatic failure may progress to encephalopathy, coma, and death. Acute renal failure with acute tubular necrosis may develop even in the absence of severe liver damage. Cardiac arrhythmias have been reported.
Treatment: Prompt treatment is essential in the management of paracetamol overdosage. Any patient who has ingested 7.5 g or more of paracetamol in the preceding 4 hours should undergo gastric lavage. The plasma or serum paracetamol concentration should be determined as soon as possible, but no sooner than 4 hours after ingestion. Acetylcysteine should be administered as soon as possible after ingestion of an overdose has been reported. Instituting haemoperfusion to remove paracetamol from the circulation may be beneficial if acetylcysteine administration cannot be instituted within 24 hours following ingestion. Supportive treatment including maintaining fluid and electrolyte balance, correcting hypoglycaemia should also be instituted.