Acetaminophen poisoning
Acetaminophen (Paracetamol) intoxication is a life-threatening condition leading potentially to hepatic failure. Acetaminophen has antipyretic and analgesic effect, it does not have anti-inflammatory effect. It is widely used by the general public in the form of over-the-counter medicines. Due to large number of different types and easy availability of drugs containing acetaminophen on the Czech market, accidental or intentional ingestion of a toxic dose may occur. One of these situations is shown by our algorithm.
Review
Interactive virtual scenario of "Acetaminophen intoxication" concisely, understandably and entertainingly summarizes problematic of this clinical state from anamnesis and the first aid, up till liver transplantation and supplementary treatment of acute liver failure. The reader is guided step by step through the series of decisive points of this life-threatening condition, has the opportunity to learn from accompanying explanation text, as well as from his own mistakes if the incorrect answer is chosen. Authors gave emphasis on the brevity and comprehensibility of the algorithm, while maintaining all essential and important information. The resulting learning programme is not only instructive, but also inspires the reader to study deeper about the topics, which were mentioned marginally. Studying medicine by this interactive form is undoubtedly more effective and more interesting than the classical teaching methods, therefore I strongly recommend it and I congratulate the authors on their success.
Sources
ZADÁK, Zdeněk and Eduard HAVEL, 2017. Intenzivní medicína na principech vnitřního lékařství. 2., doplněné a přepracované vydání. Praha: Grada Publishing. ISBN 978-80-271-0282-2.
SEN, Sambit, et. al., 2004. Pathophysiological effects of albumin dialysis in acute‐on‐chronic liver failure: A randomized controlled study. Liver Transplantation. 10(9), 1109-1119. DOI: 10.1002/lt.20236. ISSN 1527-6473.
ČESKÁ HEPATOLOGICKÁ SPOLEČNOST. Doporučený postup ČHS: Diagnostika a léčba jaterní encefalopatie, Česká hepatologická společnost [online]. [cit. 2020-03-23]. Available at: https://www.ces-hep.cz/file/324/doporuceny-postup-chs-jaterni-encefalopatie.pdf
TRUNEČKA, Pavel. Indikace k transplantaci jater: Doporučený postup. Institut klinické a experimentální medicíny [online]. [cit. 2020-03-23]. Available at: https://www.ikem.cz/UserFiles/Image/1450363289Indikace_k_transplanatci_jater_-_doporu%C4%8Den%C3%BD_postup.pdf
RUMACK, B. H., et. al., 1981. Acetaminophen overdose: 662 cases with evaluation of oral acetylcysteine treatment. Archives of Internal Medicine. 141(3), 380-385. DOI: 10.1001/archinte.141.3.380. ISSN 00039926. Available at: http://archinte.ama-assn.org/cgi/doi/10.1001/archinte.141.3.380
NATIONAL POISONS CENTRE, Acetaminophen. Toxinz.com [online]. [cit. 2020-04-30]. Available at: https://www.toxinz.com/Demo/11/TjAyQkUwMS9hY2V0YW1pbm9waGVu
TOXIKOLOGICKÉ INFORMAČNÍ STŘEDISKO, Dávkování N-acetylcysteinu i.v. - 2 infuze, Toxikologické informační středisko [online]. [cit. 2020-04-30]. Available at: https://www.tis-cz.cz/index.php/informace-pro-odborniky/davkovani-n-acetylcysteinu-2-infuze
