Prompt

DCE long case: late single acute paracetamol overdose with established hepatotoxicity in a man with alcohol use disorder — ANZ acetylcysteine, O'Grady markers, Bernal lactate, psychiatry.

Paracetamol Toxicity — Clinical Case

Name: Paracetamol Toxicity — Clinical Case
Creator: MedVellum
Published: 2026-09-03
Keywords: Paracetamol Toxicity — Clinical Case, Clinical Cases, pharmacological, FRACP DCE, MRCP PACES

References12Show

[1]Prescott LF, Illingworth RN, Critchley JA, Stewart MJ, et al. Intravenous N-acetylcystine: the treatment of choice for paracetamol poisoning Br Med J, 1979.PMID 519312
[3]O'Grady JG, Alexander GJ, Hayllar KM, Williams R Early indicators of prognosis in fulminant hepatic failure Gastroenterology, 1989.PMID 2490426
[4]Keays R, Harrison PM, Wendon JA, Forbes A, et al. Intravenous acetylcysteine in paracetamol induced fulminant hepatic failure: a prospective controlled trial BMJ, 1991.PMID 1954453
[5]Bernal W, Donaldson N, Wyncoll D, Wendon J Blood lactate as an early predictor of outcome in paracetamol-induced acute liver failure: a cohort study Lancet, 2002.PMID 11867109
[6]Craig DG, Bates CM, Davidson JS, Martin KG, et al. Staggered overdose pattern and delay to hospital presentation are associated with adverse outcomes following paracetamol-induced hepatotoxicity Br J Clin Pharmacol, 2012.PMID 22106945
[7]Bateman DN, Dart RC, Dear JW, Prescott LF, et al. Fifty years of paracetamol (acetaminophen) poisoning: the development of risk assessment and treatment 1973-2023 with particular focus on contributions published from Edinburgh and Denver Clinical Toxicology (Philadelphia), 2023.PMID 38197864
[8]Bateman DN, Carroll R, Pettie J, Yamamoto T, et al. Effect of the UK's revised paracetamol poisoning management guidelines on admissions, adverse reactions and costs of treatment Br J Clin Pharmacol, 2014.PMID 24666324
[10]Yarema M, Chopra P, Sivilotti MLA, Johnson D, et al. Anaphylactoid Reactions to Intravenous N-Acetylcysteine during Treatment for Acetaminophen Poisoning J Med Toxicol, 2018.PMID 29423816
[11]Chiew AL, Reith D, Pomerleau A, Wong A, et al. Updated guidelines for the management of paracetamol poisoning in Australia and New Zealand Med J Aust, 2020.PMID 31786822
[12]Chyka PA, Seger D, Krenzelok EP, Vale JA, et al. Position paper: Single-dose activated charcoal Clin Toxicol (Phila), 2005.PMID 15822758
[13]Rumack BH, Peterson RC, Koch GG, Amara IA Acetaminophen overdose. 662 cases with evaluation of oral acetylcysteine treatment Arch Intern Med, 1981.PMID 7469629
[17]Hodgman MJ, Garrard AR A review of acetaminophen poisoning Crit Care Clin, 2012.PMID 22998987

References12Show

[1]Prescott LF, Illingworth RN, Critchley JA, Stewart MJ, et al. Intravenous N-acetylcystine: the treatment of choice for paracetamol poisoning Br Med J, 1979.PMID 519312
[3]O'Grady JG, Alexander GJ, Hayllar KM, Williams R Early indicators of prognosis in fulminant hepatic failure Gastroenterology, 1989.PMID 2490426
[4]Keays R, Harrison PM, Wendon JA, Forbes A, et al. Intravenous acetylcysteine in paracetamol induced fulminant hepatic failure: a prospective controlled trial BMJ, 1991.PMID 1954453
[5]Bernal W, Donaldson N, Wyncoll D, Wendon J Blood lactate as an early predictor of outcome in paracetamol-induced acute liver failure: a cohort study Lancet, 2002.PMID 11867109
[6]Craig DG, Bates CM, Davidson JS, Martin KG, et al. Staggered overdose pattern and delay to hospital presentation are associated with adverse outcomes following paracetamol-induced hepatotoxicity Br J Clin Pharmacol, 2012.PMID 22106945
[7]Bateman DN, Dart RC, Dear JW, Prescott LF, et al. Fifty years of paracetamol (acetaminophen) poisoning: the development of risk assessment and treatment 1973-2023 with particular focus on contributions published from Edinburgh and Denver Clinical Toxicology (Philadelphia), 2023.PMID 38197864
[8]Bateman DN, Carroll R, Pettie J, Yamamoto T, et al. Effect of the UK's revised paracetamol poisoning management guidelines on admissions, adverse reactions and costs of treatment Br J Clin Pharmacol, 2014.PMID 24666324
[10]Yarema M, Chopra P, Sivilotti MLA, Johnson D, et al. Anaphylactoid Reactions to Intravenous N-Acetylcysteine during Treatment for Acetaminophen Poisoning J Med Toxicol, 2018.PMID 29423816
[11]Chiew AL, Reith D, Pomerleau A, Wong A, et al. Updated guidelines for the management of paracetamol poisoning in Australia and New Zealand Med J Aust, 2020.PMID 31786822
[12]Chyka PA, Seger D, Krenzelok EP, Vale JA, et al. Position paper: Single-dose activated charcoal Clin Toxicol (Phila), 2005.PMID 15822758
[13]Rumack BH, Peterson RC, Koch GG, Amara IA Acetaminophen overdose. 662 cases with evaluation of oral acetylcysteine treatment Arch Intern Med, 1981.PMID 7469629
[17]Hodgman MJ, Garrard AR A review of acetaminophen poisoning Crit Care Clin, 2012.PMID 22998987