小结
定义
病史和体格检查
其他诊断因素
- 恶心和呕吐
- 危险因素
- 右上象限腹痛
- 黄疸
- 肝肿大
- 意识水平改变
- 扑翼样震颤
- 会阴疼痛
危险因素
- 自我伤害史
- 为缓解疼痛而频繁或重复服药的病史
- 谷胱甘肽缺乏
- 肝药酶诱导剂(CYP 450 诱导剂)
诊断性检查
首要检查
- 血清中对乙酰氨基酚浓度
- 肝功能检测
- 凝血酶原时间和 INR
- 血糖
- 尿素、肌酐及电解质
- 静脉或动脉血气检查
- 全血细胞计数
需考虑的检查
- 水杨酸水平
- 尿液分析
- 尿液药物筛查
治疗流程
急性单次过量
累积过量
治疗过量
撰稿人
专家顾问
Johann Grundlingh
Emergency Medicine Consultant
Royal London Hospital
Barts Health NHS Trust
Honorary senior lecturer
Queen Mary University
London
UK
利益声明
JG declares that he has no competing interests.
Clarissa Ribeiro
Senior Clinical Fellow
Newham University Hospital
Barts Health NHS Trust
London
UK
利益声明
CR declares that she has no competing interests.
Acknowledgements
BMJ Best Practice would like to gratefully acknowledge the previous team of expert contributors, whose work has been retained in parts of the content:
Daniel K. Colby, MD
Assistant Professor
Department of Emergency Medicine
UC Davis Health
CA
Alastair Newton, MB ChB, FCEM
Consultant in Emergency Medicine
The Prince Charles Hospital
Brisbane
Australia
利益声明
DKC and AN declare that they have no competing interests.
同行评议者
Ruben Thanacoody
Consultant Physician
Royal Victoria Infirmary
Newcastle upon Tyne Hospitals NHS Foundation Trust
Honorary Clinical Senior Lecturer in Clinical Pharmacology
Newcastle University
Honorary Consultant Clinical Toxicologist
Public Health England
Director
National Poisons Information Service (Newcastle unit)
Newcastle upon Tyne
UK
利益声明
RT was an investigator in the Scottish and Newcastle Antiemetic Pre-treatment for paracetamol poisoning (SNAP) study. RT declares that he has no other competing interests.
编辑
Annabel Sidwell
Section Editor, BMJ Best Practice
利益声明
AS declares that she has no competing interests.
Tannaz Aliabadi-Oglesby
Lead Section Editor, BMJ Best Practice
利益声明
TAO declares that she has no competing interests.
Rachel Wheeler
Lead Section Editor, BMJ Best Practice
利益声明
RW declares that she has no competing interests.
Susan Mayor
Lead Section Editor, BMJ Best Practice
利益声明
SM works as a freelance medical journalist and editor, video editorial director and presenter, and communications trainer. In this capacity, she has been paid, and continues to be paid, by a wide range of organisations for providing these skills on a professional basis. These include: NHS organisations, including the National Institute for Health and Care Excellence, NHS Choices, NHS Kidney Care, and others; publishers and medical education companies, including the BMJ Group, the Lancet group, Medscape, and others; professional organisations, including the British Thoracic Oncology Group, the European Society for Medical Oncology, the National Confidential Enquiry into Patient Outcome and Death, and others; charities and patients’ organisations, including the Roy Castle Lung Cancer Foundation and others; pharmaceutical companies, including Bayer, Boehringer Ingelheim, Novartis, and others; and communications agencies, including Publicis, Red Healthcare and others. She has no stock options or shares in any pharmaceutical or healthcare companies; however, she invests in a personal pension, which may invest in these types of companies. She is managing director of Susan Mayor Limited, the company name under which she provides medical writing and communications services.
Julie Costello
Comorbidities Editor, BMJ Best Practice
利益声明
JC declares that she has no competing interests.
Adam Mitchell
Drug Editor, BMJ Best Practice
利益声明
AM declares that he has no competing interests.
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