Tylenol Liver Damage (cont.)
How can overdose be avoided in children?
The dosing of acetaminophen for children, as previously mentioned, depends on
their weight and age. To avoid overdose in children, follow the same procedures
for them as suggested above for adults. Beyond that, two adults should
independently determine the dose of acetaminophen for a child. If there is
disagreement about the recommended dose, consult a pharmacist or physician.
These precautions are not excessive when you consider that in one experimental
mock situation, only 30% of adults correctly calculated the dose of
acetaminophen for their child. If a baby-sitter is caring for a sick child,
parents should carefully write out the dose and schedule for the administration
of the drug. The fact is that each year, in children with high fevers who were
given repetitive doses of acetaminophen, deaths have occurred due to accidental
overdose and the resulting liver damage.
What are the symptoms and signs of acetaminophen-induced liver damage?
Three clinical stages (phases) of acetaminophen-induced liver injury have
been described.
During the first phase, that is, the initial 12 to 24 hours or
so after ingestion, the patient experiences
nausea and vomiting.
For the next
perhaps 12 to 24 hours, which is the second phase or the so-called inactive
(latent) phase, the patient feels well.
In the third phase, which begins about
48 to as late as 72 hours after the ingestion of acetaminophen, liver blood test
abnormalities begin to appear. Most notably, extremely high (abnormal) levels of
the liver blood tests, AST and ALT, are common with this type of liver
injury. The outcome (prognosis) of the liver injury can be predicted fairly
accurately on the basis of the patient's clinical exam and blood tests. For
example, at one extreme, if the patient develops severe acid buildup in the
blood, kidney failure, bleeding disorders, or coma, then death is almost
certain. Only a liver transplant can possibly save such a patient.
Next: What should be done if acetaminophen toxicity is suspected? »
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