Treatment of Paracetamol Toxicity

  Although clinical evidence of hepatotoxicity may be delayed for 24 to 72 hours, NAC therapy is most effective if started within 8 hours of ingestion. Because this patient reported the ingestion within 30 minutes, there is time for a serum APAP level, activated charcoal decontamination, and then NAC therapy. If time is an issue, NAC treatment should be initiated without delay. Emesis should not be induced because of the possible delay in therapy. After medical stabilization, assessment of suicide potential is important. SECTION II: CLINICAL