Author/Editor		Markota, Andrej; Kirbiš, Simona; Strdin Košir, Alenka; Marinšek, Martin; Sinkovič, Andreja
Title		Prikaz treh primerov zastrupitve s paracetamolom
Translated title		Paracetamol intoxication - a case series
Type		članek
Source		In: Gričar M, Vajd R, editors. Urgentna medicina: izbrana poglavja 2011. Zbornik 18. mednarodni simpozij o urgentni medicini; 2011 jun 15-18; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Publication year		2011
Volume		str. 246-8
Language		slo
Abstract		Introduction: Paracetamol is a widely available mild analgetic and antipiretic agent. It may cause liver failure in cases of overdose. Paracetamol is often used in suicide attempts. Case series: In a 2-month period three patients with suicidal attempt paracetamol intoxication were treated in Medical Intensive Care Unit, University Medical Centre Maribor. All patients bought a readily available over-the-counter analgetic with the intention of committiong suicide by paracetamol, 1 of them took only paracetamol. In two cases gastric lavage was performed, all of the patients received activated charchoal and antidote N-acetyl cystein. Blood levels of paracetamol 12 hours after ingestion were 53, 86 and 132 mg/L, respectfully. Acute liver failure developed in one patient. Intubation and mechanical ventilation was required in one patient. The same patient developed bronchoesophageal fistula and recurring pneumonia, requiring surgical treatment. All of the patients were discharged home after medical and psychiatric treatment. Conclusion: Three patients were admitted for suicidal paracetamol intoxication over a 2 month period. All of them ingested paracetamol because of its availability and lethality. In order to treat paracetamol intoxication effectively one needs to provide rapid supportive treatment and specific measures (N-acetyl cystein).
Summary		Uvod: Paracetamol je blag analgetik in antipiretik, ki je dostopen v splošni prodaji. Paracetamol je toksičen za jetra in povzroča akutno jetrno odpoved. Pogosto je uporabljen pri poskusih samomora. Prikaz primerov: V obdobju dveh mesecev smo na Oddelku za intenzivno interno medicino obravnavali 3 bolnike zaradi zastrupitve s paracetamolom v samomorilne namene. Vsi trije so paracetamol kupili z namenom samomora, ena bolnica je zaužila samo paracetamol. Pri dveh bolnikih je bilo opravljeno izpiranje želodca, vsi so prejeli aktivno olje in antidot N-acetilcistein. 12 ur po zaužitju so bile koncentracije paracetamola 53, 86 in 132 mg/L. Pri eni bolnici se je razvila akutna jetrna odpoved, ki se je po zdravljenju popravila. V dveh primerih smo opazovali prehoden porast transaminaz. Pri eni bolnici je bila zaradi motnje zavesti potrebna intubacija in mehanska ventilacija. Zaradi bronhoezofagealne fistule in recidivnih pljučnic je bilo potrebno dolgotrajno bolnišnično zdravljenje. Zaključek: V dveh mesecih smo na Oddelku za intenzivno interno medicino obravnavali 3 bolnike, zastrupljene s paracetamolom v samomorilne namene. Paracetamol so izbrali zaradi enostavne dostopnosti. Zdravljenje zastrupitve s paracetamolom je učinkovito, če je izvedeno hitro in obsega simptomatske in specifične ukrepe kot je dajanje antidota N-acetilcisteina.
Descriptors		ACETAMINOPHEN OVERDOSE SUICIDE INTENSIVE CARE