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Article: Volume 44 Number 5 Page 409 - May 2017

  Dent Update 2017; 44: 409-414  Read article

Pharmacology:  Supra-Therapeutic Oral Paracetamol Overdose in Adults: An Update for the Dental Team

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Abstract: Paracetamol (acetaminophen) is a commonly used analgesic; its 'over the counter' availability, low cost and popularity amongst patients often make it the first choice for dental pain. It is in this that its potential toxicity, made more complicated by the ever extending range of paracetamol-containing products, make the understanding of this medication key to the safe management of patients presenting to surgery with dental pain.

Clinical relevance: The purpose of this article is to supply dental practitioners with the knowledge to manage patients who present having taken an oral supra-therapeutic paracetamol overdose. Consideration is given to those patients who can be treated safely in primary care and to those who require transfer to Accident and Emergency (A&E).

Author notes: Ross Leader, BDS(Hons), MFDS RCPS (Glasg), PgDip ClinEd, Staff Grade in Oral and Maxillofacial Surgery, University Hospital Aintree, Lower Lane, Liverpool, L9 7AL, James Hackett, Fourth Year Medical Student, University of Liverpool School of Medicine, Cedar House, Ashton Street, Liverpool, L69 3GE and Ahmed Al-Naher, MBBS, BSc, MRCP, Clinical Research Fellow CLAHRC NWC, University of Liverpool, Wolfston Centre for Personalized Medicine, 1−5 Brownlow Street, Liverpool, L69 3GL, UK.

Objective: To understand the basic pharmacology of paracetamol and the pathophysiology of overdose with reference to those patients presenting to dental practice, knowing which patients to treat and which to refer to A&E.