Decolgen FX Overdosage

Symptoms: Toxic symptoms include vomiting, abdominal pain, hypotension, and sweating. The most serious adverse effect of acute overdosage of paracetamol is a dose-dependent, potentially fatal hepatic necrosis in adults, hepatotoxicity may occur after ingestion of a single dose 10 to 15 g of paracetamol; a dose of 25 g or more is potentially fatal. Symptoms during the first 2 days of acute poisoning by paracetamol do not reflect the potential seriousness of the intoxication. Major manifestations of liver failure such as jaundice, hypoglycemia, and metabolic acidosis may take at least 3 days to develop.
Treatment: Treatment in case of overdosage and methods of reducing the absorption of ingested drug are important. Gastric lavage is essential even if several hours have elapsed. Prompt administration of 50 g activated charcoal and 500 mL iced mannitol 25% by mouth, may reduce absorption. If the history suggest that 15 g paracetamol or more has been ingested, administer one of the following antidotes: Acetylcysteine 20% IV: administer intravenously, 20% acetylcysteine immediately without waiting for positive urine test or plasma level results, initial dose of 150 mg/kg over 15 minutes, followed by continuous infusion of 50 mg/kg in 500m mL 5% glucose over 4 hours and 100 mg/kg in 1 L 5% glucose over 16 hours.
Oral Methionine: 2.5 g immediately followed by three further doses of 2.5 g at four-hourly intervals. For 3 years old child, 1 g oral methionine every four hours for four doses has been used.
Oral Acetylcysteine 5%: 140 mg/kg as a loading dose, then 70 mg/kg every 4 hours for a total 17 maintenance doses. If patients vomit within one hour of administration of any dose, repeat dose. If more than one hour have elapsed since the overdosage was taken, the antidote may be ineffective.