Unintentional overdose of paracetamol as a problem of modern times - a case report

Pożarowska Kinga, Brzuszkiewicz Kinga, Rudziński Gracjan, Orczykowski Maciej, Rosińska Agata, Tchórz Michał. Unintentional overdose of paracetamol as a problem of modern times - a case report. Journal of Education, Health and Sport. 2022;12(8):687-706. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2022.12.08.070 https://apcz.umk.pl/JEHS/article/view/JEHS.2022.12.08.070 https://zenodo.org/record/7014260 The journal has had 40 points in Ministry of Education and Science of Poland parametric evaluation. Annex to the announcement of the Minister of Education and Science of December 21, 2021. No. 32343. Has a Journal's Unique Identifier: 201159. Scientific disciplines assigned: Physical Culture Sciences (Field of Medical sciences and health sciences); Health Sciences (Field of Medical Sciences and Health Sciences). Punkty Ministerialne z 2019 - aktualny rok 40 punktów. Załącznik do komunikatu Ministra Edukacji i Nauki z dnia 21 grudnia 2021 r. Lp. 32343. Posiada Unikatowy Identyfikator Czasopisma: 201159. Przypisane dyscypliny naukowe: Nauki o kulturze fizycznej (Dziedzina nauk medycznych i nauk o zdrowiu); Nauki o zdrowiu (Dziedzina nauk medycznych i nauk o zdrowiu). © The Authors 2022; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 05.08.2022. Revised: 07.08.2022. Accepted: 20.08.2022. Unintentional overdose of paracetamol as a problem of modern times - a case report Kinga Pożarowska 1, https://orcid.org/0000-0003-0691-0155, kpozarowska@gmail.com Kinga Brzuszkiewicz 1, https://orcid.org/0000-0003-3941-027X, kinga.brzuszkiewicz@gmail.com Gracjan Rudziński 1, https://orcid.org/0000-0001-8911-9144, gracjanrudzinski@gmail.com Maciej Orczykowski 1, https://orcid.org/0000-0002-2319-3082, morczykowski7@gmail.com Agata Rosińska 1, https://orcid.org/0000-0003-0308-656X, agataros1996@gmail.com Michał Tchórz 2, https://orcid.org/0000-0002-1308-099X, michaltchorz@umlub.pl 1 Students’ Research Group at the Department of Toxicology, Medical University of Lublin 2 Department of Toxicology, Medical University of Lublin Adres do korespondencji: Michał Tchórz Department of Toxicology, Medical University of Lublin al Kraśnicka 100, 20-718 Lublin, 81-537-40-80 ABSTRACT INTRODUCTION Paracetamol is one of the most widely used analgesics and antipyretics in the world. An overdose of this drug can occur after a single ingestion of a large amount of paracetamol or after repeated ingestion of smaller amounts that eventually exceed the recommended total dose and can result in liver damage. It is believed that the maximum daily dose of paracetamol for an adult is 4g. MATERIALS AND METHOD Patient information was collected from hospital records available in the clinical toxicology department. In addition, we conducted a literature review on paracetamol using PubMed. CASE REPORT A patient, 16 years old, was admitted from a district hospital to the Clinical Toxicology and Cardiology Department in Lublin for paracetamol intoxication and suspected intoxication with a psychoactive substance. The patient's history revealed that he had taken a total of 20 paracetamol 500mg (10g) tablets in short intervals of 2 h for abdominal pain. The patient was treated with a full dose of antidote (ACC), and the drug infusion was continued at a maintenance dose. Despite the treatment administered, increasing features of liver damage were observed (INR 2.78, AST 6273 U/l, ALT 8854 U/l, bilirubin 3.83 mg/dl).The patient was consulted to qualify for a possible liver transplant. With intensive treatment maintained, a downward trend in liver damage parameters was achieved. The patient was discharged from the Department in good general condition, without complaints. CONCLUSION Due to the increasing number of paracetamol overdoses (intentional or accidental), strategies should be implemented to raise awareness and prevent this-educating patients, encouraging label/leaflet reading, reducing the amount of paracetamol in packages, more visible warnings on packages. KEYWORDS: paracetamol; acetaminophen; paracetamol overdose; acetaminophen overdos