@article{ref1,
title="Potentially fatal paracetamol overdose and successful treatment with 3 days of intravenous N-acetylcysteine regime--a case report",
journal="Annals of the Academy of Medicine, Singapore",
year="2006",
author="Sule, Ashish-A and Dessmon-Y-H TAI,  and Tze, Choong-Charn and Deepa, Balakrishnan and Melvin-Khee-Shing LEOW,  and Leow, Melvin",
volume="",
number="",
pages="108-111",
abstract="&lt;p&gt;&lt;b&gt;INTRODUCTION&lt;/b&gt;Paracetamol overdose is the most common drug overdose worldwide. To our knowledge, the maximum number of paracetamol tablets ingested reported in the literature is 45 g.&lt;/p&gt;&lt;p&gt;&lt;b&gt;CLINICAL PICTURE&lt;/b&gt;We describe a 21-year-old patient who acutely ingested 120 tablets, each 500 mg paracetamol (i.e., 60 g equivalent to 1200 mg/kg body weight) in a suicidal attempt. Our patient also drank 2 bottles of codeine-based cough syrup equivalent to 360 mg of codeine. At 6 hours post ingestion, her serum paracetamol level was 207 mg/L. The poor prognostic factors for paracetamol overdose in our patient included massive paracetamol ingestion (confirmed by blood levels), codeine co-ingestion and elevated serum amylase (189 U/L).&lt;/p&gt;&lt;p&gt;&lt;b&gt;TREATMENT&lt;/b&gt;She was treated with a 3-day modified regimen of intravenous N-acetylcysteine.&lt;/p&gt;&lt;p&gt;&lt;b&gt;OUTCOME&lt;/b&gt;The liver function tests and the prothrombin time remained normal over the second and third day of admission and the patient was discharged without complications on the fifth day.&lt;/p&gt;&lt;p&gt;&lt;b&gt;CONCLUSION&lt;/b&gt;From this experience we feel that in very severe paracetamol poisoning, a modified regime of intravenous N- acetylcysteine for 3 days is safe and efficacious.&lt;/p&gt;<p /><p>Language: en</p>",
language="en",
issn="0304-4602",
doi="",
url="http://dx.doi.org/"
}