Paracetamol: Pallor, nausea, vomiting anorexia and abdominal pain. Liver damage may become apparent 12 to 48 hours after ingestion. Abnormalities of glucose metabolism and metabolic acidosis may occur. In severe poisoning, hepatic failure may progress to encephalopathy, coma and death. Acute renal failure with acute tubular necrosis may develop even in the absence of severe liver damage. Cardiac arrhythmias have been reported.
Codeine phosphate: Overdosage may produce central nervous stimulation, nausea, drowsiness, respiratory depression, cyanosis, coma. Convulsion may occur in infants and children.
Treatment: General: Aspiration or gastric lavage, followed by oral administration of activated charcoal.
Codeine phosphate: If necessary, combined with anticonvulsant therapy and control of respiration. Antidote, 0.4 mg Naloxone hydrochloride may be given intravenously and repeated every 3-4 minutes until normal respiration is restored. Observed the patient for 24 hours.
Paracetamol: Intravenous administration of 300mg of N-acetylcysteine per kg over 20 hour period or oral treatment with 1330 mg N-acetylcysteine per kg over 72 hour period is accepted. Treatment should be started within 8 hours after overdose but is still indicated at least as late as 24 hours after ingestion.