Paracetamol poisoning

Flushing, fever, stomatitis, nausea, vomiting, rhinorrhoea, bronchospasm,
anaphyloid reactions, rashes

Rarely blurred vision, bradycardia, syncope, thrombocytopenia,  convulsions,
Rarely respiratory or cardiac arrest

Special precautions-

Asthmatic patients, history of bronchospasms,
Peptic ulceration,
Pregnancy and lactation

Indications-
Paracetamol poisoning

Dosage-
Adult-
Administer loading dose of 140mg/kg followed by maintenance doses of 70mg.kg every
4 hr for a total of 17 doses
Repeat dose if the patient vomits within 1 hr of admin.
Continue therapy until paracetamol levels are not detectable and there is no evidence of hepatoxicity

Child-
After gastric lavage or induction of emesis with Ipecac syrup admin loading dose of
140mg/kg followed by maintenance doses of 70mg/kg  every 4 hr for a total of 17 doses
1st maintenance dose is given after 4hr after the loading dose
Repeat dose if the patient vomits within 1 hr of admin.
Continue therapy until paracetamol levels are not detectable and thereis no evidence of hepatoxicity

Intravenous-
Adult-
Initially 150mg/kg in 200ml of infusion  fluid given over 15  minutes followed by 50mg/kg
of infusion given  over the next 4 hr then 100mg/kg in i L infusion fluid over the next 12 hours

Child-
Child > 20kg. initially 150mg/kg in 100ml of  fluid given over 15 minutes followed by 50mg/kg
in 250ml of infusion given over next 4 hr then 100mg/kg in 500ml of infusion fluid over the  next
16hr

Child < 20kg - adjust  adult dose volume based on child age and weight to avoid fluid overload

Use with caution during pregnancy and lactation