Symptoms of overdosage may vary from CNS depression to stimulation. Other signs and symptoms may include dizziness, tinnitus, ataxia, blurred vision, dry mouth, flushing and gastrointestinal symptoms. Acute hypertension or cardiovascular collapse with accompanying hypotension may occur. Treatment is symptomatic and supportive. The stomach should be emptied by aspiration and lavage. Convulsion may be controlled with diazepam given intravenously. Symptoms that may occur within 24 hours of overdosage of Paracetamol include nausea, vomiting, lethargy and sweating. Abdominal pain may be the first indication of liver damage. Hepatic failure, encephalopathy, coma and death may result. Toxicity following overdosage with paracetamol has been attributed to the metabolite, N-acetyl-p-benzoquinoneimine by mixed function oxidase enzyme in the liver and kidney. Acetylcysteine or methionine, are used as antidotes in paracetamol overdosage.
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