<Tr> <Th> Prognosis </Th> <Td> Death occurs in ~ 0.1% </Td> </Tr> <Tr> <Th> Frequency </Th> <Td>> 100,000 per year (US) </Td> </Tr> <P> Paracetamol poisoning, also known as acetaminophen poisoning, is caused by excessive use of the medication paracetamol (acetaminophen). Most people have few or non-specific symptoms in the first 24 hours following overdose . This may include feeling tired, abdominal pain, or nausea . This is typically followed by a couple of days without any symptoms after which yellowish skin, blood clotting problems, and confusion occurs . Additional complications may include kidney failure, pancreatitis, low blood sugar, and lactic acidosis . If death does not occur, people tend to recover fully over a couple of weeks . Without treatment some cases will resolve while others will result in death . </P> <P> Paracetamol poisoning can occur accidentally or as an attempt to end one's life . Risk factors for toxicity include alcoholism, malnutrition, and the taking of certain other medications . Liver damage results not from paracetamol itself, but from one of its metabolites, N - acetyl - p - benzoquinone imine (NAPQI). NAPQI decreases the liver's glutathione and directly damages cells in the liver . Diagnosis is based on the blood level of paracetamol at specific times after the medication was taken . These values are often plotted on the Rumack - Matthew nomogram to determine level of concern . </P>

Most serious toxic effect of acute acetaminophen overdose