This document discusses the treatment and post-mortem changes of paracetamol poisoning. It outlines the common causes of paracetamol poisoning including suicidal attempts and accidental ingestion. The treatment options described include stomach washing, activated charcoal, antiemetics, supportive care, antidotal therapy like methionine and N-acetylcysteine, and potentially liver transplantation for fulminant liver failure. The post-mortem changes mentioned are jaundice, enlarged liver, liver necrosis, and cerebral edema.

1. PARACETAMOL POISONING
TREATMENT & PM CHANGES
NUR IZZATUL NAJWA BINTI
SHARUPUDDIN
082015100036

2. LEARNING OBJECTIVES
AT THE END OF THESE SEMINAR, ALL OF US
MUST :
• BEING AN EXPERT IN THE TREATMENT AND
POST MORTEM CHANGES OF PARACETAMOL
POISONING.

3. PARACETAMOL
• SUICIDAL ATTEMPT
• UNCONTROLLED PAIN
• POISONING
• ACCIDENTAL

4. TREATMENT
STOMACH WASH
• Useful for <1 hour presentation
ACTIVATED CHARCOAL
• For adsorption, administered earlier to 4 hours post ingestion
ANTI EMETIC
• If the patient is vomiting repeteadly (eg: metaclopramide or ondansetron)
SUPPORTIVE MEASURES
10-20% dextrose for hypoglycemia
Vitamin K is PT is elevated
H2 antagonist to prevent upper GI hemorrhage

5. ANTIDOTAL THERAPY
• Methionine (oral)
• N- acetylcysteine ( NAC )
• Indication :
• PL estimated between 4-12 hours post- ingestion lies above
nomogram line
• PCM ingested is more than 100mg/kg
• Likehood exist for PCM- induced hepatic failure

6. LIVER TRANSPLANTATION
• When fulminant liver failure develops

7. TREATMENT

8. PM CHANGES
JAUNDICE ENLARGED LIVER
LIVER WITH
CENTRILOBULAR
NECROSIS
CEREBRAL
OEDEMA

9. SUMMARY
• BEING AN EXPERT IN THE TREATMENT AND
POST MORTEM CHANGES OF PARACETAMOL
POISONING.