Paracetamol poisoning

Abstract

Paracetamol is a very common and readily available analgesic, alone or in combination with other drugs in some cold and flu products. In dogs, paracetamol at low doses is metabolised to non-toxic metabolites, but these pathways become saturated in overdose, leading to metabolism by other pathways resulting in the production of toxic metabolites. Cats and ferrets lack the enzymes required for the safe metabolism of paracetamol and are therefore susceptible to lower doses. The characteristic picture of severe paracetamol poisoning is methaemoglobinaemia, cyanosis, anaemia and jaundice. Acetylcysteine is the antidote of choice in the management of paracetamol poisoning.