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Acetaminophen toxicity

Long-Term Care Nursing Advisor, October 6, 2006

Acetaminophen toxicity is often asymptomatic. The resident may have anorexia and mild nausea that progresses to vomiting. However, these signs are seldom associated with acetaminophen ingestion. Several days later, the resident develops right upper quadrant tenderness, jaundice, and other signs of liver involvement. By this time, damage may be extensive.

Acetylcysteine is the antidote for acetaminophen overdose, and is most effective if given up to eight hours after ingestion occurs, although it can and should be administered anytime. Acetylcysteine may be given orally or IV. Use of emetics is not usually recommended, although activated charcoal may be used for recent overdosage. The resident should be hospitalized if toxicity is suspected.

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