Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/22242
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dc.contributor.authorChiew, Angela L-
dc.contributor.authorReith, David-
dc.contributor.authorPomerleau, Adam-
dc.contributor.authorWong, Anselm-
dc.contributor.authorIsoardi, Katherine Z-
dc.contributor.authorSoderstrom, Jessamine-
dc.contributor.authorBuckley, Nicholas A-
dc.date2019-12-01-
dc.date.accessioned2019-12-12T23:08:25Z-
dc.date.available2019-12-12T23:08:25Z-
dc.date.issued2020-
dc.identifier.citationMedical Journal of Australia 2020; 212(4): 175-183-
dc.identifier.urihttp://ahro.austin.org.au/austinjspui/handle/1/22242-
dc.description.abstractParacetamol is a common agent taken in deliberate self-poisoning and in accidental overdose in adults and children. Paracetamol poisoning is the commonest cause of severe acute liver injury. Since the publication of the previous guidelines in 2015, several studies have changed practice. A working group of experts in the area, with representation from all Poisons Information Centres of Australia and New Zealand, were brought together to produce an updated evidence-based guidance. The optimal management of most patients with paracetamol overdose is usually straightforward. Patients who present early should be given activated charcoal. Patients at risk of hepatotoxicity should receive intravenous acetylcysteine. The paracetamol nomogram is used to assess the need for treatment in acute immediate release paracetamol ingestions with a known time of ingestion. Cases that require different management include modified release paracetamol overdoses, large or massive overdoses, accidental liquid ingestion in children, and repeated supratherapeutic ingestions. The new guidelines recommend a two-bag acetylcysteine infusion regimen (200 mg/kg over 4 h, then 100 mg/kg over 16 h). This has similar efficacy but significantly reduced adverse reactions compared with the previous three-bag regimen. Massive paracetamol overdoses that result in high paracetamol concentrations more than double the nomogram line should be managed with an increased dose of acetylcysteine. All potentially toxic modified release paracetamol ingestions (≥ 10 g or ≥ 200 mg/kg, whichever is less) should receive a full course of acetylcysteine. Patients ingesting ≥ 30 g or ≥ 500 mg/kg should receive increased doses of acetylcysteine.-
dc.language.isoeng-
dc.subjectChemical and drug induced liver injury-
dc.subjectDrug overdose-
dc.subjectGuidelines as topic-
dc.subjectToxicology-
dc.titleUpdated guidelines for the management of paracetamol poisoning in Australia and New Zealand.-
dc.typeJournal Article-
dc.identifier.journaltitleMedical Journal of Australia-
dc.identifier.affiliationUniversity of Sydney, Sydney, NSWen
dc.identifier.affiliationUniversity of Otago, Dunedin, New Zealand-
dc.identifier.affiliationQueensland Poisons Information Centre, Queensland Children's Hospital, Brisbane, QLDen
dc.identifier.affiliationRoyal Perth Hospital, Perth, WAen
dc.identifier.affiliationWestern Australia Poisons Information Centre, Sir Charles Gairdner Hospital, Perth, WAen
dc.identifier.affiliationPrince of Wales Hospital and Community Health Services, Sydney, NSWen
dc.identifier.affiliationNSW Poisons Information Centre, Children's Hospital at Westmead, Sydney, NSWen
dc.identifier.affiliationVictorian Poisons Information Centre, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationMonash Health, Monash University, Melbourne, VICen
dc.identifier.affiliationPrincess Alexandra Hospital, Brisbane, QLDen
dc.identifier.doi10.5694/mja2.50428-
dc.identifier.orcid0000-0002-0079-5056-
dc.identifier.orcid0000-0002-6817-7289-
dc.identifier.pubmedid31786822-
dc.type.austinJournal Article-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.fulltextNo Fulltext-
item.cerifentitytypePublications-
item.grantfulltextnone-
item.languageiso639-1en-
item.openairetypeJournal Article-
crisitem.author.deptToxicology-
crisitem.author.deptEmergency-
crisitem.author.deptVictorian Poisons Information Centre-
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