Abstract
Paracetamol (acetaminophen) has been one of the most popular analgesics and antipyretics since the 1980s, which can be used even by people who cannot tolerate other analgesics. lt thus became one of the most widely used medicines ever. Every coin has two sides, the flip side of paracetamol is that an overdose leads to damage of the liver or kidneys. ln the developed world, paracetamol intoxication is one of the most common causes of acute liver failure.
Although the hepatotoxicity of paracetamol is becoming known to people, overdose cases in the Czech Republic are increasing according to inquiries to the Toxicology lnformation Center (TIC). ln 2020-2022, TIC provided a total of 1,712 consultations for paracetamol overdose patients, which represented 6.5% of all drug inquiries. An amount greater than 200 mg/kg of body weight, or more than 10 g, is considered as a toxic dose.
An effective, safe, and inexpensive treatment is the antidote N-acetylcysteine. Recommendations for its dosage vary.
The indication is also determined by the level of paracetamol in the serum, collected no earlier than 4 hours after taking the tablets. The main message of this work is to describe the current recommended procedure for paracetamol intoxication.
With early therapy, N-acetylcysteine is a highly effective antidote, and both hepatocellular and renal lesions are reversible.