title: Intravenous paracetamol toxicity in a malnourished child.
abstract: We present a case of intravenous (IV) paracetamol overdose in a nutritionally malnourished child during hospital admission. A ten-fold IV paracetamol dosing error ocurred, with delayed recognition and treatment resulting in transient hepatotoxicity, with a peak alanine transaminase (ALT) of 1378 IU/L in a 3-year-old child. Our case suggests that hepatotoxicity may occur for lower doses of IV paracetamol compared to oral ingestion, especially in the malnourished, and that a dose less than 150 mg/kg of IV paracetamol should be used to define treatment following overdose in a child with potential nutritional deficiencies.
authors: Discipline of Clinical Pharmacology, Clinical Toxicology and Pharmacology, Calvary Mater Newcastle, Newcastle, Australia. ingrid.berling@gmail.com
authors: Ingrid
authors: I
authors: Berling
authors: Michael
authors: M
authors: Anscombe
authors: Geoffrey K
authors: GK
authors: Isbister
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage / Q000506:poisoning*; D000111:Acetylcysteine / Q000627:therapeutic use; D000410:Alanine Transaminase / Q000097:blood; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000633:toxicity*; D001219:Aspartate Aminotransferases / Q000097:blood; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology; D015362:Child Nutrition Disorders / Q000150:complications*; D002675:Child, Preschool; D057210:Delayed Diagnosis / Q000009:adverse effects; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008508:Medication Errors / Q000009:adverse effects
chemical_list: D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000111:Acetylcysteine