Acetaminophen poisoning

1. Toxic dosage in:

    1. adults: 7.5 gr

    2. children: 150 mg/kg

2. check:

    1. AST, ALT, ALKP, PT, PTT, INR, BUN, Cr, VBG, Ca, P

    2. if AST/ALT >1000 ⇒ check them q6h

    3. if AST/ALT< 500 ⇒ check them daily

3. N-acetylcysteine 150 mg/kg in 1 hour then 50 mg/kg in 4 hours then 100 mg/kg in 16 hours IV

    or  N-acetylcysteine 140 mg/kg PO stat then 70 mg/kg PO q4h for 17 days

4. H.D if serum level AST/ALT >1000 or comatose or severe acidosis

5. Liver transplantation if pH< 7.3, PT>100 or Cr>3.3