What happens in an overdose of paracetamol in children?

The article was professionally consulted by Pharmacist, Dr. Phan Quynh Lan - Director of Pharmacy Department of Vinmec Health System - Head of Pharmacy Department, Vinmec Times City International Hospital. Pharmacist Lan has many years of experience in the field of Clinical Pharmacy, used to be a lecturer in Clinical Pharmacy at Hanoi University of Pharmacy.

Paracetamol is a common pain reliever and fever reducer and is believed to be quite safe, even for children. However, when using the drug for children, it is necessary to have a doctor's prescription and advice because paracetamol overdose will lead to dangerous complications, even death.

Paracetamol (acetaminophen) is an active ingredient that helps relieve pain and reduce fever, used to treat symptoms such as headache, muscle pain, arthritis, backache, toothache, cold and fever... pain for mild cases of arthritis but not for more severe inflammatory conditions such as myositis.
The drug is used for both adults, children and pregnant women. However, pregnant women and young children when taking paracetamol need to have a doctor's prescription, not to buy drugs on their own, to avoid unwanted effects when taking paracetamol overdose.
The drug is not recommended in cases of inflammatory pain because it has no anti-inflammatory effect.
When using paracetamol can cause some of the following allergic reactions:
Allergies, skin rash Pain in the mouth, fever, difficulty breathing Nausea, weight loss, loss of appetite Jaundice, yellow eyes When any symptoms occur If you have any symptoms while taking the drug, you should stop using it and see a doctor immediately

Paracetamol for children is usually made in the form of powder packs, syrups and suppositories, with concentrations of 80 mg, 150 mg, 250 mg and 300mg:
Powder sachets often have the scent of fruits. tree, has a sweet taste that is very suitable for children's preferences, children will not be afraid to use it. It is very convenient when the child has a fever, just mix the medicine with cold boiling water to give it to the child to drink. The syrup form has many different flavors, making it easier for children to take the medicine and the antipyretic effect is similar to the powder package. Anal tablets are used when the child has a fever that cannot be taken, has vomiting, convulsions or when the child is asleep and parents do not want to wake him up. The usual dose of paracetamol is 10-15 mg/kg for a single oral dose and not more than 60 mg/kg in a day. Drink no more than 4-6 times a day, the interval between times is at least 4 hours. When giving paracetamol to children, it is necessary to observe a safe distance between two doses, otherwise the child will overdose on paracetamol.
When the child has a fever above 38.5 degrees Celsius (measure the thermometer in the armpit), medicine should be used to reduce the fever. Particularly, young children with liver disease, jaundice due to biliary obstruction... are not allowed to use the drug at home.
When using the drug, if the child shows signs of fatigue, gastrointestinal disorders (such as diarrhea, vomiting), blue skin, lethargy, it is necessary to stop the drug immediately and take the child to the doctor for monitoring and treatment. timely.

Overdose of paracetamol in children can cause paracetamol poisoning. The reason is because:
Many people see that the child's fever is not getting better, so they give paracetamol many times in a short time to reduce the fever. Taking more than one medicine containing paracetamol at the same time Using the medicine for a long time. Take too high a dose. Symptoms of paracetamol overdose in children:
Case 1: (Within 24 hours after overdose) The child refuses to breastfeed, anorexia, nausea, vomiting, abdominal pain. After an overdose of the drug causes coma, body weakness.
Case 2: (Within 24 - 72 hours after overdose) When paracetamol poisoning is severe, the child will initially be agitated and delirious. This is followed by central nervous system depression such as hypothermia, fatigue, rapid and shallow breathing; rapid, weak, irregular pulse, low blood pressure and circulatory failure.
Case 3: (Within 72h-96h) Following a rapid increase in liver enzymes, the child is at risk of liver and kidney damage, respiratory failure, circulatory failure, even death when not intervened in time. time

Doctors recommend parents if the child has a fever lasting more than 3 days, taking antipyretic drugs does not work, or is allergic to the medicine, has a fever of 40-41 degrees, they need to take the child to the hospital to be checked. check. Parents should keep medicines out of the sight and reach of children, and store them in a locked cabinet.
Women who are pregnant or breast-feeding, must consult a doctor or pharmacist when using this medicine, because some drugs can enter breast milk and cause poisoning in nursing infants.
Only use medicine as prescribed by the doctor, do not arbitrarily buy more medicine for children. When using drugs, it is necessary to carefully read the ingredients of the drug to avoid using many types with the same active ingredient. These ingredients are usually listed at the top of the drug label, so read the instructions for use carefully before taking and take the correct dose according to the recommendations on the label and the instructions of your doctor/pharmacist.
Use the dosing device that comes with each medicine, such as a dropper, cup, spoon, spoon... Do not use other measuring devices such as a daily spoon in the kitchen because may give the wrong dose of medication. Never drink liquid medicine directly from the bottle or bottle.
Test the drug 3 times before use. For any medication, this practice is always necessary. First, check that the outer packaging is intact. Second, check the label on the inner package to make sure you're taking the correct medication. Third, check the color, shape, size and taste of the medicine. When you notice anything unusual, stop taking the medicinal product.
Shake the liquid paracetamol vial before use. Chewable tablets should be chewed properly before swallowing. Your hands must be dry before handling paracetamol disintegrating tablets.
When your child has symptoms of Paracetamol overdose or has worsening symptoms such as: red or swollen skin in the painful area, rash, headache, nausea or vomiting, call 911 or seek immediate medical attention. Immediately go to the hospital for treatment as soon as possible.
As a key area of ​​Vinmec Health System, Pediatrics Department always brings satisfaction to customers and is highly appreciated by industry experts with:
Gathering a team of leading pediatricians and doctors : consists of leading experts with high professional qualifications (professors, associate professors, doctorates, masters), experienced, worked at major hospitals such as Bach Mai, 108.. Doctors All doctors are well-trained, professional, conscientious, knowledgeable about young psychology. In addition to domestic pediatric specialists, the Department of Pediatrics also has the participation of foreign experts (Japan, Singapore, Australia, USA) who are always pioneers in applying the latest and most effective treatment regimens. . Comprehensive services: In the field of Pediatrics, Vinmec provides a series of continuous medical examination and treatment services from Newborn to Pediatric and Vaccine,... according to international standards to help parents take care of their baby's health from birth to childhood. from birth to adulthood Advanced techniques: Vinmec has successfully deployed many specialized techniques to make the treatment of difficult diseases in Pediatrics more effective: neurosurgery - craniofacial surgery, stem cell transplantation. blood in cancer treatment. Professional care: In addition to understanding children's psychology, Vinmec also pays special attention to the children's play space, helping them to play comfortably and get used to the hospital's environment, cooperate in treatment, improve the efficiency of medical treatment.