Help with Panadol
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Hey, this thread is made because I am worried for my friend. You see, my friend has headaches and he has seen a specialist but nothing is wrong with him. But he still has these headaches, so he takes panadol to help, but now, soemtimes, he takes 7 panadols at one go just so that it MIGHT help with the headache. I am worried because my mom said that Panadol causes kidney failure. And is Panadol leathal in large doses, say like 20 pills taken at one go?
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a few more and he should be prepared to have his stomach pump....
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20 pills?
it can kill wor.. -
What specialist has he seen?
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not only the kidney, it causes harm to the liver also.
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how much panadol to kill , i wan to try
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dun over rely on panadaol. remember the more u eat, the more reliant u get.
say u need 3 pills dis time to lessen headaches. nxt time 3 wun help, u'll probably need 7 -
as much as you can takeOriginally posted by icyboiz:how much panadol to kill , i wan to try -
20 panadol can't kill you, at most, knock you out only, i know
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Panadol can be lethal at 16 pills at 24 hours, recent years the specs have went down to 8 pills per 24 hours, but bascially if you pop 12 pills per 24 hours you will not die, at 16 you might get a bit high (as in losing consciousness) and at 24 pills bascially you have to wash your stomach or else...
People who took 30 pills at one go killed themselves. So please gauge correctly and do not misuse medicine. It can and will kill. -
tts like committing suicide
ur fren can request for Anarex from doctor -
I think your friend kena black magic.
One of my friend same situation. Always got headache and took panadol everyday until he went to see bomoh.
He was lucky, cos he nearly died from panadol overdose..his liver was swollen. -
JUst asking where you get your info from? Thanks for all the contribution guys! So 20 pills will only get his stomach pumped? Confirm won't die? Cuase I hope this will be a lesson to him.Originally posted by jetabt767400:Panadol can be lethal at 16 pills at 24 hours, recent years the specs have went down to 8 pills per 24 hours, but bascially if you pop 12 pills per 24 hours you will not die, at 16 you might get a bit high (as in losing consciousness) and at 24 pills bascially you have to wash your stomach or else...
People who took 30 pills at one go killed themselves. So please gauge correctly and do not misuse medicine. It can and will kill. -
Try asking for Anarex from Polyclinic Doctor as it contains muscle relaxer. It could be tension headaches, which is treated only by relaxant...
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This one info got from doctor one, cause i asked him the same question, If you can dig up old packing they write 16 in 24hrs, but nowadays only have 8 in 24hrs, because some people really go pop 16 in 24 and they got problems.Originally posted by PlsDunBanMe:JUst asking where you get your info from? Thanks for all the contribution guys! So 20 pills will only get his stomach pumped? Confirm won't die? Cuase I hope this will be a lesson to him.
20 in 24 no gurantees won't die. It has only be assumed that it would cause the symptoms...
Sorry, I not chemistry people so not sure about rest, lols... -
i think it's headache caused by stress or other emotional distress.Originally posted by PlsDunBanMe:Hey, this thread is made because I am worried for my friend. You see, my friend has headaches and he has seen a specialist but nothing is wrong with him. But he still has these headaches, so he takes panadol to help, but now, soemtimes, he takes 7 panadols at one go just so that it MIGHT help with the headache. I am worried because my mom said that Panadol causes kidney failure. And is Panadol leathal in large doses, say like 20 pills taken at one go? -
He has seen the brain specialist, if I'm not wrong, and he has done a CAT scan.Originally posted by Viper`:What specialist has he seen? -
SO who here can confirm 20 pills will not kill him?
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wun immediately die
maybe kou tu bai mo, eyeballs rolled back, face turn purple or something -
My friend ate 30-40 pills a day.Originally posted by PlsDunBanMe:SO who here can confirm 20 pills will not kill him?
Ask him to try nurofen, its a different painkiller to panadol..like aspirin, etc -
And the scan was completely normal?Originally posted by PlsDunBanMe:He has seen the brain specialist, if I'm not wrong, and he has done a CAT scan.
Ask him to seek a second medical opinion, or turn to a psychologist if the problem is mental. He shouldn't go on relying on medication all his life without finding out the cause. -
Actually a simple search on wiki shows that a single dosage of 10 grams would cause toxicity, thats about 20 pills (500mg per pill).
Damn dangerous dah... -
Damn, can't allow him to continue like this...Originally posted by jetabt767400:Actually a simple search on wiki shows that a single dosage of 10 grams would cause toxicity, thats about 20 pills (500mg per pill).
Damn dangerous dah... -
Treatment
That was from Wiki, I have no idea what it is saying, can anyone smart explain?
[edit] Initial measures
The initial treatment for uncomplicated paracetamol overdose, similar to any other overdose, is gastrointestinal decontamination. In addition, the antidote, acetylcysteine plays an important role. Paracetamol absorption from the gastrointestinal tract is complete within 2 hours under normal circumstances, so decontamination is most helpful if performed within this timeframe. Absorption may be somewhat slowed when it is ingested with food. There is considerable room for physician judgement regarding gastrointestinal decontamination, activated carbon administration is the most commonly used procedure, however, gastric lavage may also be considered if the amount ingested is potentially life threatening and the procedure can be performed within 60 minutes of ingestion.[20] Syrup of ipecac has no role in paracetamol overdose because the vomiting it induces delays the effective administration of activated carbon and oral acetylcysteine.
Activated carbon adsorbs paracetamol, reducing its gastrointestinal absorption. Administering activated carbon also poses less risk of aspiration than gastric lavage. Previously there was reluctance to give activated carbon in paracetamol overdose, because of concern that it may also absorb acetylcysteine. Studies have shown that no more than 39% of an oral acetylcysteine is absorbed when they are administered together.[21] Other studies have shown that activated carbon seems to be beneficial to the clinical outcome. It appears the most benefit from activated carbon is gained if it is given with 2 hours of ingestion.[22] However, administering activated carbon later than this can be considered in patients who may have delayed gastric emptying due to co-ingested drugs or following ingestion of sustained or delayed release paracetamol preparations. Activated carbon should also be administered if co-ingested drugs warrant decontamination. There are conflicting recommendations[21][23] regarding whether to change the dosing of oral acetylcysteine after the administration of activated carbon, and even whether the dosing of acetylcysteine needs to be altered at all.
[edit] Acetylcysteine
Acetylcysteine (also called N-Acetylcysteine or NAC) works to reduce paracetamol toxicity by supplying sulfhydryl groups (mainly in the form of glutathione, of which it is a precursor) to react with the toxic NAPQI metabolite so that it does not damage cells and can be safely excreted. (NAC can be bought as a dietary supplement in the United States.)
If the patient presents less than 8 hours after paracetamol overdose, then acetylcysteine significantly reduces the risk of serious hepatotoxicity. If NAC is started more than 8 hours after ingestion, there is a sharp decline in its effectiveness because the cascade of toxic events in the liver has already begun and the risk of acute hepatic necrosis and death increases dramatically. Although acetylcysteine is most effective if given early, it still has beneficial effects if given as late as 48 hours after ingestion.[24] In clinical practice, if the patient presents more than 8 hours after the paracetamol overdose, then activated carbon is probably not useful, and acetylcysteine is started immediately. In earlier presentations the doctor can give carbon as soon as the patient arrives, start giving acetylcysteine, and wait for the paracetamol level from the laboratory.
In United States practice, intravenous (IV) and oral administration are considered to be equally effective. However, IV is the only recommended route in Australasian and British practice.
Oral acetylcysteine is given as a 140 mg/kg loading dose followed by 70 mg/kg every 4 hours for 17 more doses. Oral acetylcysteine may be poorly tolerated due to its unpleasant taste, odor, and its tendency to cause nausea and vomiting. It can be diluted to a 5% solution, from its marketed 10% or 20% solutions, to improve palatability. Where oral acetylcysteine is required, the inhalation formulation of acetylcysteine (Mucomyst) is often given orally. The respiratory formulation can also be diluted and filter sterilized by a hospital pharmacist for IV use, however this is an uncommon practice. If repeat doses of carbon are indicated because of another ingested drug, then subsequent doses of carbon and acetylcysteine should be staggered every two hours.
Intravenous acetylcysteine (Parvolex/Acetadote) is used as a continuous intravenous infusion over 20 hours (total dose 300 mg/kg). Recommended administration involves infusion of a 150 mg/kg loading dose over 15 minutes, followed by 50 mg/kg infusion over 4 hours; the last 100 mg/kg are infused over the remaining 16 hours of the protocol. Intravenous acetylcysteine has the advantage of shortening hospital stay, increasing both doctor and patient convenience, and it allows administration of activated carbon to reduce absorption of both the paracetamol and any co-ingested drugs without concerns about interference with oral acetylcysteine.[25]
Baseline laboratory studies include bilirubin, AST, ALT, and prothrombin time (with INR). Studies are repeated at least daily. Once it has been determined that a potentially toxic overdose has occurred, acetylcysteine is continued for the entire regimen, even after the paracetamol level becomes undetectable in the blood. If hepatic failure develops, acetylcysteine should be continued beyond the standard doses until hepatic function improves or until the patient has a liver transplant.
[edit] Prognosis
The mortality rate from paracetamol overdose increases 2 days after the ingestion, reaches a maximum on day 4, and then gradually decreases. Patients with a poor prognosis are usually identified for likely liver transplantation. Acidemia is the most important single indicator of probable mortality and the need for transplantation. A mortality rate of 95% without transplant was reported in patients who had a documented pH of < 7.30. Other indicators of poor prognosis include renal insufficiency, grade 3 or worse hepatic encephalopathy, a markedly elevated prothrombin time, or a rise in prothrombin time from day 3 to day 4. One study has shown that a factor V level less than 10% of normal indicated a poor prognosis (91% mortality) while a ratio of factor VIII to factor V of less than 30 indicated a good prognosis (100% survival).
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The toxic dose of paracetamol is highly variable. In adults, single doses above 10 grams or 150 mg/kg have a reasonable likelihood of causing toxicity.[12] Toxicity can also occur when multiple smaller doses within 24 hours exceeds these levels, or even with chronic ingestion of doses as low as 4 g/day, and death with as little as 6 g/day.
Another quote from Wiki
I have some Paracetamol tablets at home, 8 of them and 2 panadol extra. Each Paracetamol tablet contains 500mg of acetaminophen, according to the above quote, so my friend has to take 20+ pills of Paracetamol before it causes toxicity?