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Acetaminophen Poisoning

Author: Dana Bartlett, BSN, MSN, MA, CSPI
(Click author's name for bio)

CE: 4 hours Pharmacology: 4 hours
Rated 4.6 out of 5.0 based on 22962 reviews

Course Summary

Acetaminophen poisoning is the most common cause of acute liver failure in the United States and other countries. Liver damage after acetaminophen overdose is common but liver failure and death are rare. There is a highly effective antidote available, N-acetylcysteine, and if treated promptly, patient recovery and survival from acetaminophen toxic overdose is almost assured. A case study that includes a novel triple therapy of N-Acetylcysteine, 4-Methylpyrazole, and hemodialysis is discussed.

Course Format


Course Syllabus

I.       Introduction
II.       Incidence of Acetaminophen Overdose
III.       Acetaminophen: Pharmacology
1.   Dosing
2.   Available Forms
3.   Contraindications
4.   Side Effects
5.   Drug-Drug Interactions
IV.       Acetaminophen Toxicity
1.   Therapeutic Dose and Toxicity
V.       Clinical Presentation of Acetaminophen Poisoning
1.   Phase I
2.   Phase II
3.   Phase III
4.   Phase IV
 VI.      Acetaminophen Overdose and Organ Damage
1.   Liver Damage
2.   Renal Damage
3.   Other Organ Damage
VII.      Acetaminophen Poisoning: High Risk Patients
1.   Alcohol and Acetaminophen Poisoning
2.   Children and Acetaminophen
VIII.     Acute Acetaminophen Overdose
1.   Acetaminophen Ingestion: Dose and Time
2.   Acetaminophen Serum Level
3.   Signs and Symptoms of Acetaminophen Toxicity
 IX.     Initial Care for Acetaminophen Overdose
1.   Gastric Decontamination
2.   Laboratory Studies or Diagnostic Tests
3.   N-acetylcysteine (NAC)
4.   Hemodialysis
5.   Antidotal Therapy: N-Acetylcysteine
6.   NAC: Prevention of Liver Damage
7.   Modes of Administration
8.   Duration of Therapy
 X.     Special Cases of Acetaminophen Poisoning
1.   Chronic Ingestion of Excess Acetaminophen
2.   Pregnancy and Acetaminophen Overdose
3.   Liver Failure and Transplantation
XI.     Case Study: Acetaminophen Poisoning
XII.    Summary


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