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Acetaminophen (APAP) is the most common drug overdose in pregnancy. Available data regarding APAP overdose in pregnancy is limited to case reports and a small prospective case series. APAP has been demonstrated to cross the placenta and in toxic doses may harm the fetal and maternal hepatocytes.
Successful treatment of APAP overdose during pregnancy requires supportive care, early administration of IV NAC and a multidisciplinary team of specialists (intensivists, toxicologists, obstetricians and neonatologists) to optimize maternal-fetal outcome.
Maternal treatment of paracetamol overdose should be as for the non-pregnant patient. There is evidence linking a delay in treating a pregnant patient with N-acetylcysteine (NAC) with increased fetotoxic effects.
Most patients with APAP overdose have minimal or nonspecific symptoms such as malaise, abdominal pain or nausea, and vomiting at presentation. A detailed medication history can help ascertain total APAP exposure but can be challenging in patients with polydrug overdose or advanced encephalopathy.
7 maj 2024 · Acetaminophen poisoning is among the most common causes of medication-related poisoning and death. It may occur following an acute ingestion or through repeated ingestions of supratherapeutic amounts.
29 lut 2024 · N-acetylcysteine (NAC) is the mainstay of therapy for acetaminophen toxicity. NAC has FDA approval for treating potentially hepatotoxic doses of acetaminophen (APAP) and is almost 100% effective if given within 8 hours post-ingestion.
18 cze 2020 · Overdose may occur after an acute single ingestion of a large amount of paracetamol or paracetamol-containing medication, or repeated ingestion of an amount exceeding recommended dosage. Patients are often asymptomatic or have only mild gastrointestinal symptoms at initial presentation.
