title: Effect of acute paracetamol overdose on changes in serum and urine electrolytes.
abstract: OBJECTIVE
  To investigate the effects of acute paracetamol overdose on renal function, serum and urine electrolyte excretion in man.
  
  
  METHODS
  Two studies were performed in patients admitted with paracetamol overdose: a retrospective study examining changes in serum electrolytes, and a prospective study evaluating changes in serum and urine electrolytes. A control group with SSRI overdose was included in the prospective study.
  
  
  RESULTS
  There was a significant dose-dependent relationship between admission (4 h) paracetamol concentration and fall in serum potassium in the retrospective study (P < 0.01) and a significant positive relationship between serum paracetamol at 4 h and fractional excretion of potassium at 12 h postingestion (P < 0.01) in the prospective study. No changes were seen in the control group. No cases developed renal failure.
  
  
  CONCLUSIONS
  Paracetamol overdose is associated with dose-related hypokalaemia, and kaliuresis of short duration (<24 h), suggesting a specific renal effect of paracetamol in overdose perhaps via cyclo-oxygenase inhibition. This effect seems distinct from any nephrotoxic effect of paracetamol.
authors.affiliation: NPIS Edinburgh, Edinburgh, UK. dr_p_n@yahoo.com
authors.forename: N
authors.initials: N
authors.lastname: Pakravan
authors.forename: D N
authors.initials: DN
authors.lastname: Bateman
authors.forename: J
authors.initials: J
authors.lastname: Goddard
mesh_terms: D000082:Acetaminophen / Q000097:blood / Q000506:poisoning* / Q000652:urine; D000293:Adolescent; D000328:Adult; D062787:Drug Overdose; D004573:Electrolytes / Q000097:blood* / Q000652:urine*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies
chemical_list: D004573:Electrolytes; D000082:Acetaminophen