Acute paracetamol poisonings received at the Oran University Hospital

Abstract

Introduction: Paracetamol is the most commonly used drug worldwide for its analgesic/antipyretic effect and especially a non-prescription access in pharmacies. Acute Paracetamol poisoning remains problematic for clinicians because of its insidious progression to fulminant hepatitis and even death. This work proposes to draw up the epidemiological profile of acute Paracetamol poisonings. Materials and Methods: A retrospective descriptive study has been carried out over 8 years on cases of acute Paracetamol poisoning received at the Pharmacology Toxicology department of University Hospital of Oran (UHO). Data were collected using a pre-established fact sheet. Toxicological analysis was carried out by colorimetric and enzyme immunoassay method. Results and Discussion: A total of 400 cases were recorded, mainly from emergency departments of UHO (85 %). These are suicide attempts in 82 % of cases, observed especially in adolescents (69 %), and accidental poisoning in 12 % of cases, predominant in small children (89 %). Half of the patients were admitted asymptomatic in the first 24 h of intoxication. Digestive and neurological disorders were the most described (18.75 % and 20.5 %). The quantitative determination of Paracetamol showed that 16 cases had a high risk of developing liver injury and required antidote therapy, based on N-acetylcysteine. The evolution was mostly favorable (84 %) but 8 patients had liver damage and 5 deaths were recorded. Conclusion: Although it seems benign, acute Paracetamol poisoning is serious and requires adequate care making clinicians collaborate with toxicologists. The general population must be made aware of the dangers of Paracetamol. The pharmacist must provide the necessary information concerning the recommended doses and the toxicity.

Keywords

• Paracetamol
• Acute poisoning
• Hepatoxicity
• N-Acetylcysteine
• Toxicological analysis
• Rumack-Matthew nomogram