Paracetamol: what benefits and what dangers?
The death of Naomi Musenga is linked to an overdose of paracetamol. The opportunity to take stock of the proper use and the risks of this ubiquitous drug in our medicine cabinets, but not so trivial.
The known medical elements are still few, but explanations for the death of Naomi Musenga are beginning to be made public.
The prosecutor in charge of the case stressed to AFP that he was able to discuss with several members of the young woman's family "the medical elements obtained, which explain the death of Naomi Musenga as being the consequence of poisoning with paracetamol absorbed by self-medication over several days". "The progressive destruction of his liver cells led to a failure of all his organs, quickly leading to his death ," added the prosecutor.
Doliprane, composed of paracetamol, tops the list of the most widely consumed drugs in France. How to take it safely? Update with Professor Bruno Mégarbane, head of the toxicological medical resuscitation department at Lariboisière hospital in Paris.
What are the doses of paracetamol not to exceed?
3 to 4 g per day, at a rate of 1 g per maximum intake. A delay of 6 to 8 hours is to be respected between each dose. Note that several over-the-counter medications in community pharmacies contain paracetamol (particularly combined with codeine or vasoconstrictors).
What happens in the body in case of overconsumption of paracetamol?
If nothing is done, the liver can no longer fulfill its functions:
- It can no longer filter the toxins that come from the intestine and let them reach the brain, which is disturbed. The intoxicated person declares hepatic encephalitis.
- Then, it no longer succeeds in synthesizing coagulation factors and exposes the patient to a risk of massive bleeding.
What are the symptoms of paracetamol poisoning?
Symptoms appear some time (a few days) from the intake(s), while the toxic degradation product accumulates in the liver. “ The first symptoms are possibly stomach aches and nausea, underlines the doctor. Then, in the event of hepatic encephalitis, the person presents neurological signs, drowsiness, confusion…”
What are the risks if no treatment is given?
Without treatment, the major consequence of a paracetamol overdose is toxic hepatitis: few cells are destroyed, which has no clinical repercussions. But if more liver cells are killed, it is possible to die from a paracetamol overdose: paracetamol has a dose-dependent toxicity.
What are the dangerous doses?
- what are the side effects of paracetamol?
They depend on the capacity of the liver of each. "The more a liver is sick, the more paracetamol is dangerous" , notes Professor Mégar bane. It is not possible to give threshold values, but the scientific literature reports cases of hepatitis and death (in people with liver disease) from 8 g/day (i.e. the equivalent of a can ). But beyond the dose as such, it is the method of taking that is very important for the prognosis. "From 15 g of paracetamol / day, consumed in a single dose, the risk of death, still without treatment, is estimated at around 1%. But the fact of repeatedly taking normal doses can quite lead the same process, and even in a riskier way: if the drug is taken in doses of 1g, but 15 times in a row over 24 or 48 hours, the risk of dying jumps to 20%.
The liver is better able to "catch" a large single dose of paracetamol, because it uses detoxification mechanisms. These mechanisms are challenged when the holds are repeated.
What to do in case of overdose?
It is necessary to take medical advice, even in the absence of any symptoms. The problems always appear at least 24 hours after the start of the doses.
There is an antidote to paracetamol. “ Doctors will assess liver damage or the risk of hepatotoxicity to come, using biological measurements, indicates the resuscitator. They administer the antidote that is not necessary. ” If the damage to the liver is already very severe at the time of admission, the patient is placed on a hyper-urgent transplant list.
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