Paracetamol overdose

Presentations Appropriate Tests
 

Paracetamol level.

Time since ingestion must be known to assess significance of levels - see Figure 2.

Final assessment of likely drug toxicity should not be made while the patient is still in the absorptive phase (ie, while levels are still increasing).

Once absorption is complete, a second level, taken 3-4 hours after the first, enables half-life to be calculated. If increased, this is another indicator of toxicity.

Hepatotoxicity

Aspartate aminotransferase, Alanine aminotransferase, Lactate dehydrogenase, Bilirubin, Glucose, Ammonia, INR.

See also Drug overdose.

Nephrotoxicity

Urea urine, Creatinine urine, Protein urine.

See Hepatic failure

Metabolic acidosis

Organic acids urine (pyroglutamate).

See Acidosis