Analgesic abuse

Consequences

Appropriate Tests

 

Creatinine, Urea, Electrolytes (serum).

MCS urine (microscopy and culture).

Renal failure - chronic

 

Hypertension

 

Hyponatraemia

 

Renal papillary necrosis

MCS urine; collect any solid material passed in urine and submit (in formalin) for histopathological assessment (sloughed papilla).

Renal tubular acidosis

 

Renal tubulo-interstitial disorders

 

Urinary tract tumour, especially

  • Renal pelvis

Urine cytology. Fine needle aspiration biopsy, lesion biopsy, as appropriate.

Hepatotoxicity

Typically follows an acute overdose, but may result from prolonged use of smaller doses of paracetamol-containing analgesics, particularly in patients with pre-existing liver disease. Paracetamol level. Aspartate aminotransferase, Alanine aminotransferase, Gamma glutamyltransferase.

See Hepatic failure.