All about paracetamol and its dangers

The known medical elements are still few, but explanations on the death of Naomi Musenga begin to be made public.

The prosecutor in charge of the file pointed to the AFP having been able to evoke with several members of the family of the young woman "the medical elements obtained, which explain the death of Naomi Musenga as being the consequence of a paracetamol intoxication absorbed by self-medication over several days". "The evolutionary destruction of the cells of his liver brought a failure of all his organs leading quickly to his death" added the prosecutor.

The Doliprane, composed of paracetamol, arrives at the top of the drugs the more consumed in France. How to take it safely? The point with Professor Bruno Mégarbane, head of department of toxicological medical resuscitation at Lariboisière hospital, Paris.

• What are the doses of paracetamol not to be exceeded?

3 to 4 g per day, due to 1 g per maximum hold. A delay of 6 to 8 hours is to be respected between each catch. It should be noted that several over-the-counter medications in community pharmacies contain paracetamol (especially in combination with codeine or vasoconstrictors).

• What happens in the body when over-consumption of paracetamol occurs

If paracetamol is taken at the recommended daily doses, everything goes well. " The molecule is metabolized by the liver and eliminated, explains the Pr Megarbane. On the other hand, if it is consumed in excess, the drug follows another pathway of metabolism which results in a toxic intermediate This intermediate will accumulate in the liver and cause the destruction of liver cells. "

If nothing is done, the liver can no longer perform its functions:

– It no longer manages to filter the toxins that come from the intestine and let them reach the brain, which is disrupted. The intoxicated person declares hepatic encephalitis.
– Then, he no longer succeeds in synthesizing coagulation factors and exposes the patient to a risk of mbadive haemorrhage.

• What are the symptoms of paracetamol poisoning?

The symptoms appear at a distance (a few days) from the time taken, while the product of toxic degradation accumulates in the liver. " The first symptoms are possibly stomach ache and nausea, the doctor points out. Then, in cases of hepatic encephalitis, the person has neurological signs, drowsiness, confusion …"

• What are the risks if no treatment is given?

Without management, the major consequence of overdose with paracetamol is toxic hepatitis: few cells are destroyed, which is without clinical impact. But if more liver cells are killed, it is possible to die from a paracetamol overdose: paracetamol has a dose-dependent toxicity.

• What are the dangerous doses?

They depend on the abilities of the liver of each. "The more a liver is sick, the more dangerous paracetamol is" notes Professor Megarbane. It is not possible to give threshold values, but the scientific literature reports cases of hepatitis and death (in patients with liver disease) from 8 g / day (equivalent to one box). ). But beyond the dose as such, it is the setting mode that is very important for the prognosis. "Starting with 15 g of paracetamol / day, consumed in a single dose, the risk of death, still without management, is estimated at about 1%, but repeated doses at normal doses may to the same process, and even more risky: if the drug is taken in doses of 1g, but 15 times in a row over 24 or 48 hours, the risk of dying jumps to 20%. " [19659003] The liver is better able to "cash out" a high single dose of paracetamol because it uses detoxification mechanisms, which are difficult when the doses are repeated

• What to do in case of overdose? [19659006] Medical advice is required even in the absence of any symptoms Problems always appear at least 24 hours after the start of the shots

  There is an antidote for paracetamol. " Doctors will evaluate liver injury or risk of hepatitis o-toxicity to come, thanks to biological measures, indicates the resuscitator. They give the antidote neither necessary. "If the damage to the liver is already very severe at the time of the care, the patient is placed on a list of hyper-urgent transplantation.

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  Paracetamol, a bestseller in pharmacy Chronicle published on 12/07/2018 in The Health Magazine

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