Dangers of paracetamol in times of COVID-19

With the advent of the so-called "sixth wave of infections" by coronavirus, the demand for certain medicines increased. Among many, paracetamol was one of those involved in this rebound effect.

The arrival of the Ómicron variant and its high rate of infection triggered alarms due to a growing use of said drug. Along with this, the latent danger of overdose in particular cases was evidenced.

Definition and mechanism of action of paracetamol

Also known as acetaminophen, acetaminophen, or by its trade name, Tylenol, it is a pain reliever and fever reducer.

Terms designated to express its action against mild or moderate pain, as well as to counteract fever, mainly in adults.

Broadly speaking, it is a drug that acts at the level of the central nervous system. On the one hand, it is believed that it indirectly blocks the enzymatic action of COX, which is responsible for modulating prostaglandins.

The latter are substances involved in the organic response to pain.

In other words, by inhibiting the appearance of prostaglandins, the reaction to pain is controlled. However, it does not completely reduce inflammation like other medications that ARE anti-inflammatories.

On the other hand, the medical literature states that prostaglandins are involved in thermal regulation directed by the hypothalamus. Being reduced, this structure reduces body heat by dissipating it through a mechanism of peripheral vasodilation.

How much paracetamol can you take?

Various investigations suggest that the consumption limit is 3,000 mg per day for an average adult. However, the FDA (Food and Drug Administration) provides that a maximum dose of 4,000 mg in 24 hours is safe under strict medical criteria.

Of course, it is a figure that will vary depending on the age at whom the treatment is prescribed. For older adults, especially after the age of 60, it is not advisable to even reach 3,000 mg.

In the case of children, the effectiveness of acetaminophen in them is not fully proven. Indeed, the World Health Organization only recommends its use when the fever exceeds 38.5 °C.

If these specifications are negatively incurred, the risk of overdose is high.

Although it is a safe drug to use, complications related to excessive intake are deadly. Essentially, if not treated in time, death is more than guaranteed.

Paracetamol in times of COVID-19

The US National Library of Medicine highlighted a warning that shocked the world. The demand for paracetamol doubled due to the aftermath of Ómicron, translating into a potential danger of overdoses.

Coronavirus disease, in any of its variants, is known to trigger symptoms such as fever, sore throat, headache and malaise. Manifestations that, to a certain extent, can be treated by paracetamol without inconvenience.

The problem lies when the pain experienced becomes intense or inflammatory, for which the spectrum of the medication is not made.

Because of this, self-medication and inadequate intake begin, exceeding the 3,000 to 4,000 mg allowed daily.

According to the government agency, intoxication scenarios are more than likely to occur. When the dose reaches 5,000 to 6,000 mg in less than 24 hours, it is vitally important to go to the Emergency Room immediately.

The same health agency details that people rely on their little knowledge and experience. They rely on believing that it is a safe pharmaceutical drug, ignoring its potential damage to target organs such as the liver and kidneys.

Scale of symptoms present in the intoxication picture

The symptoms present after intoxication are varied, but they do not take long to appear. In less than 12 hours, the first ones appear as malaise, nausea, vomiting, diarrhoea, abdominal pain and heartburn.

When it evolves into a more serious scenario, the liver is the main affected. Liver dysfunction becomes apparent when jaundice, sweating, and stupor accompany the initial symptoms.

The alteration and dysfunction of this organ unleashes, in the long run, convulsive states, coma and finally death if not treated. It is for this reason that acetaminophen or paracetamol cannot be taken lightly.

Paracetamol is metabolized in the liver, meaning that the body needs this organ to take advantage of the drug. In overdose, a non-physiological stress is generated that leads to the establishment of liver damage or failure and that can become total.

What is the prognosis or life expectancy after poisoning?

The faster and more accurate the medical assistance, the proportional will be the patient's recovery. The National Library of Medicine of America recommends a period not exceeding the first 8 hours.

However, the medical community assures that within 4 to 6 hours of implementing the treatment, the chances of success are gigantic. Hence, the identification of early symptoms are accurate and quickly go to the emergency room.

If more than 12 to 24 hours elapse without constant treatment and strict medical surveillance, the horizon darkens. You practically enter a point of no return, since liver failure will be irreversible and subsequently fatal.

To circumvent such a circumstance, the antidote for Tylenol overdose is NAC or N-acetylcysteine. The popular MSD Manual in its respective section, states that it is a drug that prevents liver cell damage.

Basically, it prevents the metabolite of paracetamol, which is found in high concentrations due to overdose, from producing fatal consequences. In conclusion, it facilitates its absorption, metabolism and subsequent excretion through intrinsic mechanisms proven by science.

In parallel, the medical protocol allows the application of supplements such as activated carbon. As a sum, gastric lavage, oxygen placement, laxatives, volumetric expansion with physiological solution, are proven alternatives.