Paracetamol is widely used for pain and fever reduction, but the way it works is not fully understood.
It helps reduce pain by inhibiting prostaglandin production in the brain and targets the hypothalamus to regulate body temperature.
Despite its widespread use and reputation as a "safe" drug, paracetamol poisoning remains underreported, with many countries, especially in Asia, South America, and Africa, lacking comprehensive data on its impact.
Paracetamol is metabolized mainly in the liver, where it is converted into harmless substances, but a small percentage is converted into the toxic compound N-acetyl- p-benzoquinone imine (NAPQI)
In the event of an overdose, the liver's ability to neutralize NAPQI is overwhelmed, leading to liver cell death and liver failure.
Paracetamol poisoning symptoms, such as abdominal pain, jaundice, and confusion, often appear only after significant liver damage has occurred, making early detection difficult.
N-acetylcysteine (NAC) serves as the antidote by replenishing the liver’s glutathione levels, which helps neutralize the toxic NAPQI, and can be effective even if administered up to 24 hours after the overdose.
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