Tylenol Liver Damage (cont.)
What should be done if acetaminophen toxicity is suspected?
A physician should evaluate the individual immediately. Remember that
bringing the bottles of acetaminophen and all of the person's other medications
to the emergency room is always useful. The risk that an acetaminophen overdose
will cause liver injury correlates with the blood level of acetaminophen
relative to the time the drug was taken. Physicians, therefore, are able to
estimate the patient's probability of developing liver injury after an overdose.
To make this determination, they obtain the patient's history of acetaminophen
ingestion and measure the blood level of the drug. With this information, the
doctor then can refer to a table (nomogram) that provides an estimate of the
risk of developing liver injury. The accuracy of this estimate, however, depends
on the reliability of the time of ingestion and whether the acetaminophen was
taken over a period of time or all at once.
With suspected
acetaminophen overdose, the doctors usually will pump (gavage) the patient's
stomach to remove pill fragments. In reality, many individuals who overdose with
acetaminophen in a suicide attempt will have taken other pills in addition. Some
doctors, therefore, will consider treating the patient with activated charcoal,
which binds (and thereby inactivates) many medications. However, this treatment
is controversial because of a concern that the activated charcoal may also bind
the antidote for acetaminophen overdose.
Patients who are
thought to be at a high-risk or even only at a possible risk of developing
acetaminophen liver injury should be given the antidote, N-acetyl cysteine
(Mucomyst) orally (or intravenously in Europe). This drug works by indirectly
replenishing glutathione. The glutathione, as you recall, detoxifies the toxic
metabolite of the acetaminophen. The N-acetyl cysteine is most effective when
administered within 12 to 16 hours after the acetaminophen was taken. Most
physicians however, will administer N-acetyl cysteine even if the patient is
first seen beyond this 16 hour period. Thus, a British study showed that
patients already with liver failure who then received the N-acetyl cysteine were
more likely to survive than patients who did not receive the antidote. Moreover,
the survival occurred in these patients regardless of the time of initial
administration of N-acetyl cysteine. Finally, people who recover from
acetaminophen-induced liver damage are left, fortunately, with no residual or
ongoing (chronic) liver disease.
Next: Acetaminophen (Tylenol) Liver Damage At A Glance »
- acetaminophen, Tylenol and Others - Describes the medication acetaminophen (Tylenol) a drug used to relieve pain and reduce fever. Article includes descriptions, uses, drug interactions, and side effects.
- Liver Blood Tests - Learn about liver blood tests used to detect liver damage disease such as fatty liver, cirrhosis, hepatitis, Tylenol liver damage, and more. This includes measuring the aminotransferases enzymes (AST and ALT levels)
- Abdominal Pain - Learn about abdominal pain (pain in the stomach / abdomen) including causes, symptoms, how abdominal pain is diagnosed, and how abdominal pain is treated.
Latest Medical News
Interactive Slideshows
Health News Feed