However, in large overdoses these pathways become saturated, and more acetaminophen is converted by CYP2E1 into the toxic metabolite N-acetyl-p-benzoquinone imine (NAPQI). Acetaminophen is metabolized by glucuronidation primarily to nontoxic metabolites. Toxicity develops at 150 mg/kg or >7.5 g/day. However, acetaminophen is thought to inhibit COX receptors in the CNS selectively. The therapeutic antipyretic mechanism of action is not well understood. 2 According to the United States Acute Liver Failure Study Group registry, 42% of all cases of acute liver failure in the United States are attributable to acetaminophen overdose. 1 Each year in the United States, acetaminophen overdoses are estimated to result in 56,000 emergency department visits, 2,600 hospital admissions, and 500 deaths.

Acetaminophen toxicity is one of the most common causes of liver toxicity in the United States.Īcetaminophen ingestions are the most common cases called into poison centers in the United States, accounting for more than 100,000 calls per year.

Paracetamol overdose antidote