Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e
Chapter 184. Acetaminophen
Sections: Epidemiology, Pharmacology, Clinical Features, Diagnosis, Treatment, Treatment Guidelines, Disposition and Follow-Up, Special Considerations, References.
Topics Discussed: acetaminophen; acetaminophen overdose.
or paracetamol) is the most popular over-the-counter analgesic and
is one of the most common toxic exposures reported to poison centers.
Acetaminophen is available as a sole agent or combined with a variety
of other medications prepared in many different forms, such as tablets,
capsules, gels, and liquids. Poisonings often occur because of the
erroneous belief that this medication is benign or because the victim
was unaware that acetaminophen was an ingredient in the ingested
preparation. During 2008, the American Association of Poison Control
Centers received reports of 71,328 exposures to acetaminophen combinations
and 80,845 exposures to acetaminophen alone.1 There
were 53 deaths attributed to isolated ingestion of acetaminophen
combinations and 69 deaths attributed to isolated acetaminophen
ingestions.1 The potential of an acetaminophen
overdose is indicated by the observation that acetaminophen (alone
and in combination) accounts for about 15% of the observed
fatalities seen with isolated ingestions of the top 25 categories
associated with a fatal outcome.1 Combining ED,
hospital, and poisoning databases, an estimated 450 deaths occur
each year in the U.S...."
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