@article{ref1,
title="Paracetamol overdose in the newborn and infant: a life-threatening event",
journal="European journal of clinical pharmacology",
year="2021",
author="Cuzzolin, Laura and Locci, Cristian and Antonucci, Roberto and Capobianco, Giampiero",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="PURPOSE: Paracetamol is the only drug recommended to treat fever in neonates. At recommended doses, paracetamol has not been associated with liver injury in  neonates, while hepatotoxicity may occur after intake of a single high dose or  multiple excessive doses. The aim of this narrative review is to critically analyze  and summarize the available literature on newborns and infants exposed to  supratherapeutic doses of paracetamol, with special focus on their clinical  features, outcome, and management. <br><br>METHODS: The PubMed, SCOPUS, and Google Scholar  search engines were used to collect data, without time limitation. The following  keywords were used: paracetamol/acetaminophen, overdose, hepatotoxicity,  N-acetylcysteine, newborn, infant. <br><br>RESULTS: The literature search identified a total  of 27 case reports, a number of review articles, and few other relevant  publications. Neonatal poisoning from paracetamol resulted from transplacental drug  transfer after maternal overdose in some published cases, while it was the  consequence of medication errors in other cases. Newborns and infants who have  received a single overdose and have paracetamol concentrations below the  Rumack-Matthew nomogram limits are at low risk of serious hepatic damage, while  those who have recently ingested more than one supratherapeutic dose of paracetamol  should be managed with caution. The treatment of choice for paracetamol poisoning is  N-acetylcysteine, a specific antidote which reduces paracetamol hepatotoxic effects. N-Acetylcysteine should be given according to specific regimens through weight-based  dosing tables. <br><br>CONCLUSIONS: Caution should be used when paracetamol is administered  to the newborn. In the event of an overdose, careful patient monitoring and  personalization of post-overdose procedures are recommended.<p /> <p>Language: en</p>",
language="en",
issn="0031-6970",
doi="10.1007/s00228-020-03077-7",
url="http://dx.doi.org/10.1007/s00228-020-03077-7"
}