Newpamol Overdosage

There is a risk of poisoning, particularly in elderly subjects, in patients with liver disease, in cases of chronic alcoholism, in patient with chronic malnutrition and in patients receiving enzyme inducers. Overdosing may be fatal in these cases. Symptoms generally appear within the first 24 hours and comprise: nausea, vomiting, anorexia, pallor and abdominal pain. Overdose, 7.5 g or more of paracetamol in a single administration in adults or 140 mg/kg of body weight in a single administration in children, causes hepatic cytolysis likely to induce complete and irreversible necrosis, resulting in hepatocellular insufficiency, metabolic acidosis and encephalopathy which may lead to comma and death. Simultaneously, increased levels of hepatic transaminases (AST, ALT) lactate dehydrogenase and bilirubin damage are usually evident initially after two days.
Emergency Measures: Immediate hospitalisation.
Before beginning treatment, take a blood sample for plasma paracetamol assay, as soon possible after the overdose. The treatment inducers includes administration of the antidote, N-acetylcysteine (NAC) by the i.v. or oral route if possible before than 10th hour. NAC can, however; give some degree of protection even after 10 hours but in these case prolonged treatment is given.
Symptomatic treatment.
Hepatic test must be carried out at the beginning of treatment and repeated 24 every hours. In most cases, hepatic transaminases return in to normal in one to two weeks with full return of normal liver function. In very rare cases, however, liver transplantation may be necessary.