However, poison centers and emergency medical centers in some developing countries lack the laboratory resources required for timely reporting of drug concentrations. The serum APAP level that can be reported while treating a patient is key to successfully managing acute APAP overdose. However, the nomogram treatment line indicating NAC therapy differs from country to country. The nomogram utilizes time of ingestion and serum APAP concentration to guide the need for N-acetylcysteine (NAC) treatment. The risk prediction of hepatotoxicity in acute paracetamol (APAP) overdose has relied on the Prescott nomogram since the 1970s. Only dose per weight was moderately correlated with the first concentration (R 2 = 0.410, p 150 mg/kg as the cut-off value for N-acetylcysteine treatment with risk stratification for hepatotoxicity if the patient is ≥14 years and visit the ED within 15 h after an acute paracetamol overdose. One hundred and seventy-two patients were enrolled in the primary analysis median dose was 133.3 mg/kg and 46 (37.8%) had concentration above 100-line in the first test. Subgroups were created based on ingested dose, rate of concentration above 100-line were investigated. Multiple linear regression was performed to determine the effect of ingested dose on paracetamol concentration. The inclusion criteria were single acute paracetamol overdose, presentation within 15 h, and age ≥ 14 years.

Methodsĭata were retrieved from two emergency medical centers retrospectively, between 20. This study aimed to examine whether using an reported dose is safe to predict concentration above the 100-line.

Emergency medical centers in some developing countries lack the resources for timely reporting of paracetamol concentrations, hence treatment depends on reported dose. The United Kingdom guideline for acute paracetamol overdose has recommended the use of ‘100-treatment line’.

Antidote paracetamol overdose