Several medical conditions associated with acetaminophen overdose have been the focus of many clinical studies. Theses studies have been conducted to gain a better understanding of the affects that acetaminophen has on the human body in larger than recommended doses. McLaughlin and his associates note that, "heavy use of analgesics, particularly over-the-counter (OTC) products, has long been associated with chronic renal failure, including acetaminophen." A 2002 study pointed out that, "most instances of hepatotoxicity due to paracetamol in the United Kingdom and Australia are the result of large overdoses of the drug taken with suicidal or parasuicidal intent. In contrast, serious hepatotoxicity at recommended or near-recommended doses for therapeutic purposes has been reported, mainly from the United States and in association with chronic alcohol use, leading to the widely held belief that chronic alcoholics are predisposed to paracetamol-related toxicity at relatively low doses." Paracetamol is more commonly known as acetaminophen in the United States.
Hypokalemia is also a recognized complication of acute acetaminophen overdose which may lead to cardiac arrhythmia's as well as fatigue and muscle weakness. Hypokalemia is defined as low potassium levels within the blood. Mild hypokalemia is often not associated with signs and symptoms. In 2005 the Southern Medical Journal reported that acetaminophen is the most common drug overdose in pregnancy. Acetaminophen has been demonstrated to cross the placenta and in toxic doses may harm the fetal and maternal hepatocytes (liver cells) and may cause fetal hepatic necrosis, abnormal liver cell death.
A study published in 2009 reported that acetaminophen was the number 1 cause of emergency department visits among children related to unintentional medication overdoses. Of the 6,028 visits, 289 were related to acetaminophen compared to the 211 visits due to opioid (i.e. codeine, morphine, hydrocodone) overdoses.
McLaughlin, J., Lipworth, L., Chow, W., &Blot, W. (1998, September). Analgesic use and chronic renal failure: a critical review of the epidemiologic literature. Kidney International, 54(3), 679-686. Retrieved September 8, 2009, from MEDLINE database.
Riordan, S., & Williams, R. (2002, April). Alcohol exposure and paracetamol-induced hepatotoxicity. Addiction Biology, 7(2), 191-206. Retrieved September 8, 2009, from MEDLINE database.
Waring, W., Stephen, A., Malkowska, A., & Robinson, O. (2008, March 28). Acute acetaminophen overdose is associated with dose-dependent hypokalaemia: a prospective study of 331 patients. Basic & Clinical Pharmacology & Toxicology, 102(3), 325-328. Retrieved September 8, 2009, from MEDLINE database.
Wilkes, J., Clark, L., & Herrera, J. (2005, November). Acetaminophen overdose in pregnancy. Southern Medical Journal, 98(11), 1118-1122. Retrieved September 8, 2009, from MEDLINE database.
Tuesday, September 29, 2009
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I never realized that acetaminophen caused more ER vists than opioids that is crazy to me. Excellent informative post...
ReplyDeleteIt's hard to believe that an easily obtainable medication such as acetaminophen contibuted in more ER visits than opioid's.
ReplyDeleteI wonder if there are actually more opioid overdoses that go unreported (ER Visits) because of the illegal nature of the drug itself.
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ReplyDeleteThe opioid overdoses that were reported are related to prescription opioids only. Therefore, no "street" drug related opioids are considered in these statistics. However, I do wonder how many of these opioid drug related overdoses are due to illegally obtained prescriptions or those shared with people other than the patient.
ReplyDeleteI had no idea that Acetaminophen was the most common drug overdose in pregnancies. Most consumers are highly uneducated about the dangers of any over the counter medication. Most people don't bother reading warning labels or directions.
ReplyDeleteAlso, I agree with one of the above bloggers. Drug overdose due to an illegal substance might not be as commonly reported as an overdose resulting from the use of an over the counter medication so the actual statistic is questionable.
I always knew there was a reason I did not take any of these witch pills.
ReplyDeleteI wonder how many people taking Vicodin either RX'd to them or those who abuse it realize that each tablet may contain up to 750 mg of Acetaminophen?
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