Case Report-Acetaminophen Poisoning

Paracetamol is most common analgesic drug used all over the world. It is also single most commonly taken drug in over doses that leads to hospitalisation. paracetamol is rapidly absorbed from small intestine. Twenty Five percent of ingested dose undergoes first pass metabolism in gut wall. In normal conditions N-Acetyl-P-Benzoquinone imine (NAPQI) immediately bound by intracellular glutathione and eliminated in urine as mercapturic adducts. With increased paracetamol doses, greater production of NAPQI may deplete glutathione stores. When glutathione depletion reaches a critical level NAPQI binds to other proteins causing damage to hepatocytes, which may lead to hepatic injury. A 21 year old female presented to the casualty in SreeBalaji Medical College and Hospital with intoxicated state with ingestion of total amount of 7 g of acetaminophen in order to attempt suicide. She was brought to our hospital after half an hour from the time of consuming acetaminophen. The chief complaints were lower abdomen pain and nausea with giddiness and disorientation. Acute acetaminophen poisoning is a most common poisoning in our country due to its easy availability and cheap price. Acetaminophen is one of the drug frequently used for suicide. Activated charcoal seems the best choice to reduce absorption. NAC should be given to patients with overdose. Our patient treatment was successful with NAC.