Acetaminophen Poisoning and Treatment

Course overview

The leading cause of acute liver failure in the United States and other developed countries is the intentional or accidental overdose of the common over-the-counter medication acetaminophen. An overdose of acetaminophen not only causes liver damage but, in rare instances, can cause renal and other organ system damage as well. Healthcare teams that are prepared with the appropriate knowledge and skill to recognize acetaminophen poisoning and provide the appropriate diagnostic and treatment steps can help to save a person from significant physical harm. After a chronic overdose, the toxic dose of acetaminophen depends on how long the patient has been taking the drug and the presence of risk factors. The use of the Rumack-Matthew nomogram helps to determine whether acute acetaminophen ingestion can be expected to be toxic or non-toxic. In chronic acetaminophen use, a serum level should be measured to determine the need for treatment. The standard treatment for acetaminophen overdose is N-acetylcysteine, and if patients are treated appropriately and promptly, the prognosis is typically good. Hemodialysis may be used as a treatment option and in severe cases liver transplantation may be needed.