Acute renal failure may also occur during this stage. During Stage III (72 to 96 hours after ingestion) nausea, vomiting, and malaise return and patients may also exhibit jaundice and confusion. There may also be hepatomegaly on physical exam. However, patients generally are asymptomatic during Stage II although they may develop some right upper quadrant pain and tenderness. Laboratory evidence of hepatotoxicity usually becomes evident by Stage II (24 to 72 hours after acute ingestion). There is a broad spectrum of overdose presentation depending on whether the intoxication is acute or chronic, the amount of acetaminophen ingested, and time since ingestion. In Stage 1 (0.5-24 hours after ingestion) patients may complain of nausea, vomiting, lethargy and general malaise. It is also the most common cause of acute liver failure (ALF) in the United States, accounting for 50% of all ALF cases. This activity reviews the evaluation and treatment of common overdoses, and highlights the role of the interprofessional team in evaluating and treating patients that have experienced an overdose.Īcetaminophen: Acetaminophen overdose is the most commonly reported overdose in both the UK and in the United States. This activity will focus on updating the health team on sixteen of the most common overdose presentations and their corresponding antidotes. Identifying the ingestion and prompt administration of the correct antidote can prevent significant morbidity and mortality for many patients. While for many overdoses and intoxications the treatment involves supportive care and treatment of the sequelae there are specific antidotes available for a variety of substances. In the United States in 2015 antidotes for various overdoses were used 184,742 times. With more than 2.4 million toxic exposures each year, poisoning is the second most common cause of injury-related morbidity and mortality in the United States. Overdoses and accidental ingestions or exposures are common throughout the world.
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