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Signs and Symptoms of Overdose: Following overdose, symptoms of paracetamol poisoning often appear within 24-48 hours, but may be delayed beyond this time.
Symptoms: Poisoning is more likely to occur in the presence of alcohol. Liver damage (hepatocellular necrosis) and impairment of liver function may occur and may progress to hepatic coma. Clinical indications of liver damage may not manifest until 2-4 days following overdose.
Hypokalemia and metabolic acidosis (including lactic acidosis) may also develop in the setting of acute and/or chronic overdose.
There have been isolated reports of acute renal failure following paracetamol overdose.
Management of overdose: The cytotoxic effects can be lessened by intravenous administration of sulfhydryl compounds such as cysteamine or N-acetylcysteine, if possible within eight hours of ingestion of the overdose.
