Acute & emergency · UKMLA & AKT

Paracetamol overdose

A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise paracetamol overdose — the full SA Note notes add investigations, management, complications and 10 practice questions.

Key high-yield points

  • Overdose saturates glucuronidation/sulphation → more paracetamol shunted via CYP2E1 → excess NAPQI overwhelms hepatic glutathione → covalent binding to hepatocytes → centrilobular necrosis
  • N-acetylcysteine (NAC) works as a glutathione precursor - most effective before glutathione is fully depleted

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