Norpriexia/Norpriexia Forte Overdosage

Symptoms and Signs: Orphenadrine overdosage: Known symptoms with orphenadrine include tachycardia, excitement, confusion and delirium leading to coma. Convulsions, dilated pupils and urinary retention may occur.
Paracetamol overdosage: Toxic symptoms following an overdose with paracetamol include vomiting, abdominal pain, hypotension, sweating, central simulation with exhilaration and convulsions in children, drowsiness, respiratory depression, cyanosis and coma. In adults, hepatotoxicity may occur after ingestion of a single dose of paracetamol 10 to 15 g; a dose of 25 g or more is potentially fatal.
Symptoms during the first two days of acute poisoning by paracetamol do not reflect the potential seriousness of the intoxication. Major manifestations of liver failure such as jaundice, hypoglycemia and metabolic acidosis may take at least three days to develop.
Treatment: Prompt treatment is essential when there are no obvious symptoms.
In cases of overdosage, methods of reducing absorption of ingested medicine are important.
Prompt administration of activated charcoal 50 g in 150 mL of water and 150 mL sorbitol 50% solution by mouth may reduce absorption. It is recommended that intravenous fluids such as normal saline be given concurrently. Gastric lavage is indicated if the patient is unwillingly or unable to drink an activated charcoal/sorbitol mixture.
If the history suggests that paracetamol 150 mg/kg body weight or 15 g total or more has been ingested, administer the following antidote: Intravenous acetylcysteine 20%: Administer acetylcysteine immediately without waiting for positive urine test or plasma level results if 8 hours or less since overdose ingestion. Initial dose 150 mg/kg over 15 minutes, followed by continuous infusion of 50 mg/kg in glucose 5% 500 mL over four hours and 100 mg/kg in glucose 5% 1 l over 16 hours. If more than eight hours have been elapsed since the overdose was taken, the antidote may be less effective. Convulsions and delirium respond to relatively large doses of diazepam, preferably by mouth.
Adequate hydration of the patient is important.