OTC Painkiller Overdose
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TTLWHKR
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It all depends on the size of the person taking the meds. Too much is usually more than two doses of the medication. In some people the recommended dose may be an underdose. :blink: You know the ones...
How much is too much?
Normal: Dose on box - Too Much: 140 mg/kg
Treatment - IMO:
acetaminophen - Long term over use, liver damage
EKG, IV NS KVO, Activated charcoal, O2, draw labs
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Normal: 80mg - Too Much: 130mg/kg
Treatment - IMO:
aspirin - GI bleeding, CVA, coma, hypoglycemia, hypotensive, renal faliure
Monitor BGL, activated charcoal, IV NS w/ Sodium Bicarb push, be prepared to assist w/ resps, draw labs, EKG.. detailed med hx. Check for abd tenderness, rigidity, distension, if present hang another IV, NS or LR titrated to vitals.
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Normal: 100/300/500 - 1000mg - Too Much 1500mg/kg
Treatment - IMO:
ibuprofen - nausea, GI problems, headache, dizziness, or sleepiness, seizures, liver failure
EKG, IV NS, titrated to vitals; possibly phenergan or diazepam, perhaps Narcan if it was a prescription form of Ibuprofen. NG Tube w/ Charcoal b/c of possibility of N/V from meds interaction
I've had an ASA OD patient vomit blood and go into hypovolemic shock and cardiac arrest. Unfortunately, to replace all of her blood with Saline or Ringers, would have been the same as embalming her. The blood in the NG tube was pink in the ER, i.e. it was mostly resuscitative fluids, as she bled out 3/4 of her bodily supply of blood. They couldn't get the blood in fast enough, and she was so far gone, it was a wasted effort. Chances are, she had been using aspirin for too long, and using too much. An autopsy showed massive internal bleeding from perforated ulcers from her esophagus to the ascending colon. Yuckers.
How much is too much?
Normal: Dose on box - Too Much: 140 mg/kg
Treatment - IMO:
acetaminophen - Long term over use, liver damage
EKG, IV NS KVO, Activated charcoal, O2, draw labs
------------------------------
Normal: 80mg - Too Much: 130mg/kg
Treatment - IMO:
aspirin - GI bleeding, CVA, coma, hypoglycemia, hypotensive, renal faliure
Monitor BGL, activated charcoal, IV NS w/ Sodium Bicarb push, be prepared to assist w/ resps, draw labs, EKG.. detailed med hx. Check for abd tenderness, rigidity, distension, if present hang another IV, NS or LR titrated to vitals.
-----------------------------
Normal: 100/300/500 - 1000mg - Too Much 1500mg/kg
Treatment - IMO:
ibuprofen - nausea, GI problems, headache, dizziness, or sleepiness, seizures, liver failure
EKG, IV NS, titrated to vitals; possibly phenergan or diazepam, perhaps Narcan if it was a prescription form of Ibuprofen. NG Tube w/ Charcoal b/c of possibility of N/V from meds interaction
I've had an ASA OD patient vomit blood and go into hypovolemic shock and cardiac arrest. Unfortunately, to replace all of her blood with Saline or Ringers, would have been the same as embalming her. The blood in the NG tube was pink in the ER, i.e. it was mostly resuscitative fluids, as she bled out 3/4 of her bodily supply of blood. They couldn't get the blood in fast enough, and she was so far gone, it was a wasted effort. Chances are, she had been using aspirin for too long, and using too much. An autopsy showed massive internal bleeding from perforated ulcers from her esophagus to the ascending colon. Yuckers.
AnthonyM83
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From Emedicine.com:
Acetaminophen (Tylenol) Toxicity:
"The toxic dose of APAP after a single acute ingestion is 150 mg/kg or approximately 7 g in adults"
Salicylate (Acetylsalicylic Acid, Aspirin, technically also a NSAID) Toxicity:
" * The following 4 categories are helpful for assessing the potential severity and morbidity of an acute, single event, nonenteric-coated, salicylate ingestion:
o Less than 150 mg/kg - Spectrum ranges from no toxicity to mild toxicity
o From 150-300 mg/kg - Mild-to-moderate toxicity
o From 301-500 mg/kg - Serious toxicity
o Greater than 500 mg/kg - Potentially lethal toxicity "
NonSteroidal Anti-inflammatory Drug (Ibuprofen, NSAID) Toxicity:
"Doses of 100 mg/kg or less of ibuprofen, the most widely utilized NSAIDs, generally cause minimal symptoms; life-threatening situations typically occur with ingestions of 400 mg/kg or more"
Acetaminophen (Tylenol) Toxicity:
"The toxic dose of APAP after a single acute ingestion is 150 mg/kg or approximately 7 g in adults"
Salicylate (Acetylsalicylic Acid, Aspirin, technically also a NSAID) Toxicity:
" * The following 4 categories are helpful for assessing the potential severity and morbidity of an acute, single event, nonenteric-coated, salicylate ingestion:
o Less than 150 mg/kg - Spectrum ranges from no toxicity to mild toxicity
o From 150-300 mg/kg - Mild-to-moderate toxicity
o From 301-500 mg/kg - Serious toxicity
o Greater than 500 mg/kg - Potentially lethal toxicity "
NonSteroidal Anti-inflammatory Drug (Ibuprofen, NSAID) Toxicity:
"Doses of 100 mg/kg or less of ibuprofen, the most widely utilized NSAIDs, generally cause minimal symptoms; life-threatening situations typically occur with ingestions of 400 mg/kg or more"
TTLWHKR
Forum Deputy Chief
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I take two prescribed 500mg tablets of Ibuprofin every 8 hours... Hasn't killed me. knock on wood.
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mg per kg..... alex... you'd need to take about 50x your daily dose, or more, before you hit the lethal dose.
APAP OD is a nasty thing. I lost a friend to it.
For APAP, you can give an oral suspension that smells like rotten eggs - supposedly helps.
Jon
APAP OD is a nasty thing. I lost a friend to it.
For APAP, you can give an oral suspension that smells like rotten eggs - supposedly helps.
Jon
Wingnut
EMS Junkie
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My pain management doc told me that anything over 4000mg of tylenol per day would become lethal. (I was taking a lot of percocet) And the only reason they make drugs like oxycontin was because of the tylenol toxicity after a pt has become opoid tolerant. I was getting like 6000 mg of tylenol there for a few days, but I stopped it early enough so that it didn't become a problem.
Thanks for getting the figures up there guys, it's a good home reference too.
Thanks for getting the figures up there guys, it's a good home reference too.