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The Rumack–Matthew nomogram, also known as the acetaminophen nomogram, is an acetaminophen toxicity nomogram. It plots serum concentration of acetaminophen against the time since ingestion, in order to predict possible liver toxicity and allow a clinician to decide whether to proceed with N-Acetylcysteine (NAC) treatment.
Treatment may include activated charcoal if the person seeks medical help soon after the overdose. [1] Attempting to force the person to vomit is not recommended. [6] If there is a potential for toxicity, the antidote acetylcysteine is recommended. [1] The medication is generally given for at least 24 hours. [6]
NAPQI, also known as NAPBQI or N-acetyl-p-benzoquinone imine, is a toxic byproduct produced during the xenobiotic metabolism of the analgesic paracetamol (acetaminophen). [1] It is normally produced only in small amounts, and then almost immediately detoxified in the liver.
N-acetylcysteine, also known as Acetylcysteine and NAC, is a medication that is used to treat paracetamol (acetaminophen) overdose and to loosen thick mucus in individuals with chronic bronchopulmonary disorders, such as pneumonia and bronchitis. [9]
Paracetamol, [a] or acetaminophen, [b] is a non-opioid analgesic and antipyretic agent used to treat fever and mild to moderate pain. [13] [14] [15] It is a widely available over-the-counter drug sold under various brand names, including Tylenol and Panadol.
More than 107,600 Americans died from drug overdoses last year, the highest annual death toll on record. Fentanyl continues to drive the majority of overdose deaths.
Short-term use of acetaminophen as directed is one of the only medications recommended for treating pain and fever in women who are pregnant. [12] There is no established association with teratogenicity or elevated occurrence of birth defects and the usage of acetaminophen at any point during a pregnancy. [ 12 ]
In contrast, paracetamol (acetaminophen) is regarded as being safe and well tolerated during pregnancy, but Leffers et al. released a study in 2010, indicating that there may be associated male infertility in the unborn. [92] [93] Doses should be taken as prescribed, due to risk of liver toxicity with overdoses. [94]