Health # How Paracetamol destroys Your Liver .

Hello my steemian friends.
Welcome to the new episode in the Health series

If you have missed my latest health topics you can check them here-
What Energy Drinks Do To Your Health??
What it feels like Being in a Depression ??? A 5 min read on This psychological disorder!
Medicine #5 What is cancer? why is it considered so Deadly??
Marijuana!!! Our friend or An Enemy??? What science and medicine say about it???

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Which drug do you take when you develop a fever or a headache or a common cold? What is the drug the doctor prescibe you in these condition?.....It is paracetamol isnt it?

Paracetamol/acetaminophen is one of the commonest drug used all over the world as analgesic(painkiller) and Antipyretic(in fever). It is sold in the brand name of Tylenol, Panadol,calpol,Acet,Atasol etc.
But have you ever wondered how much harm it can do to your health? What it can do to your liver?

Despite being used all over the world as the safest antipyretic and analgesic drug it is one of the most common cause of drug overdose and poisoning.

In Uk about 50% of emergency admission in poisioning are due to paracetamol overdose and 200 people die per year due to it .
In US about 1,00,000 people get admitted due to paracetamol overdose.

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How it affects your liver?

When you take paracetamol it is absorbed through stomach and small intestine and released into the bloodstream. It reaches its maximum plasma conentration after one hour. Then it gets metabolized in the liver, mostly by glucoronidation and sulfuration . small amount is metabolized by Cytochrome p450(CYP2E1) into a toxic product known as NAPQI(N-acetyl para benzo quinoneimine).

Fig.-Metabolism of paracetamol

In normal dose of paracetamol there is small amount of NAPQI in the blood which is neutralized by glutathione . But in case of overdose and prolonged use of paracetamol large amount of this toxic metabolite NAPQI is produced which can not be neutralized by limited quantity of glutathione.

The maximum dose of paracetamol for adult is 2 to 4 gm per day and for children it is 1gm.
More than 250 mg/kg/day is likely to be hepatotoxic and more than 12gm is fatal.

The acumulated NAPQI reacts with cell membrane proteins and nucleic acid and causes liver cell damage and ultimately death. In medical term it is known as acute necrosis of liver.

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What are the symptom you get?

• Initially within 24 hours - Nausea and vomiting, abdominal pain,paleness, weakness, increased sweating
• After 24 hours-Liver necrosis starts , there will be pain around right upper abdomen , jaundice, decreased urination,
  Hepatic encephalopathy, acute renal failure may develop after 48 to 72 hours
• If not treated - coma and death

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Who are at the risk of developing liver damage?

• Alcohol intake- Alcohol increases activity of the enzyme CYP450 and thus increases the level of NAPQI
• Enzyme inducing drugs like- Rifampicin, Phenobarbitone, phenytoin also increase the activity of the enzyme CYP450 and thus increases the level of NAPQI
• some are genetically susceptible, they have inborn high activity of CYP450 enzyme
• Malnourished, HIV patient

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What should you do to prevent it?

• Do not take paracetamol and other painkillers till you can tolerate the pain and when there is only a little rise in temperature
• Do not take drugs without medical advice
• Consult the medical professionals before taking paracetamol if you have impending liver damage,renal failure or if you other diseases.
• Immediately refer to a hospitalif you develop any sign of overdose

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That is it for today. Hope you all got it.

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References-

research.uk
BMJ
wikipedia
sepia
patient.info

Images- [1], [2]

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