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APAP overdose

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Adammmk

Greenlighter
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May 9, 2008
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Hey guys,

About 40 hours ago, I ingested 11 grams of APAP. The tablets had codeine in them and that the only reason why I took alot. (Extremely stupid and ignorant)

I know I know, CWE is the way to go, and I will definatly do that from now on.

About 4 hours after taking the pills, I threw up about 5-6 times.
I did all the research and am currently shitting myself because I know that hepatoxicity is a huge concern, and that most people are asymptomatic for the first 24 hours except for vomiting and nausea. But at the moment, I feel absolutely fine...

Even if I went to the hospital, it is wayy too late for the N-acetylcysteine antidote. What do you rekon I should do? I'm pretty sure that I would have some sort of symptoms this far in if liver failure was a concern...

Thanks for the help
 
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You still need to go to the hospital/doctor and get checked out, get your enzyme levels checked, etc in order to assess the current state of your liver (you almost assuredly have done major, major damage to it.) Even if you havent killed it completely, the state of your liver will dictate whether you can ever have any acetaminophen, alcohol, or other medications that are hard on the liver again (even in CWE as you mentioned above, not all of the APAP is taken out, just a good deal of it).

Some people do have what is called a late presentation of symptoms, making going to the hospital/doctor even more important. If you experience hepatic failure, you will need to get on a transplant list immediately.

Oh, and did I mention GO TO THE DOCTOR
 
Is it possible that when vomiting, I got rid of a small percentage of APAP?
I vomited absolutely everything up....

And Dokomo, If I had done major damage to my liver, would I not feel some sort of pain in my upper right side? I feel 100% normal with no pain and no other symptoms...
 
depends when you consumed the apap. if you puke them before metabolizing in the body, it should be ok
 
Vomiting is an early symptom of post necrotic cirrhosis or acute tylenol overdose. It is also a symptom of a heavy load of hydrocodone. What is your normal opiate tolerance? Did you vomit from the dope or the APAP?

I would be inclined to say that you have not overdosed on tylenol as it usually presents with abdominal cramping, severe dyspepsia in addition to vomiting. You need to go to the hospital and get a liver panel AST/ALT, direct bilrubin. Don't eat anything for a while, rest your liver as it works with digestion. While mucomyst may be out of time range for you right now, steroids could help control inflammation which leads to necrosis. IV fluids can help flush out your system and keep your liver functioning.

BTW-if you think that " I ingested 11 grams of APAP, not knowing that it was wayyy above the maximum of 4 gram" is believable you need to get a grip on that line of BS. No offense, but you knew better.
Nobody on BL ever takes the advice, but you need to see a doctor. I've seen liver failure manifest 72 hours after tylenol overdose. It takes a bit for your hepatic cells to die.
 
it's really not that bad guys
yes, get checked out
NO, don't think you're going to die.

i've done this a bunch of times (flame away, i wasn't ignorant, but i chose to do it to get high. same story) and i have an ok liver.... it hasn't failed yet?


i don't reccommend being retarded like me (dee dee dee) but it probably won't hurt you THAT much from doing it ONCE. just saying.
 
Sonnyluv, It was definatly the APAP that caused the vomiting, as ive had alot more codeine before....

I guess im just confused, because people are saying that I should see a doctor immediatly, yet other than the initial vomiting, i have no other symptoms...surely 41 hours later I should be feeling sick?
 
oc4meee said:
it's really not that bad guys
yes, get checked out
NO, don't think you're going to die.

i've done this a bunch of times (flame away, i wasn't ignorant, but i chose to do it to get high. same story) and i have an ok liver.... it hasn't failed yet?


i don't reccommend being retarded like me (dee dee dee) but it probably won't hurt you THAT much from doing it ONCE. just saying.
Click to expand...

lol....an ok liver...i doubt it.

And yes it is that bad, take a peek at all the medical literature out there for APAP overdoses, an acute dosage of 11g is more than enough to destroy a healthy liver
 
Adammmk said:
Sonnyluv, It was definatly the APAP that caused the vomiting, as ive had alot more codeine before....

I guess im just confused, because people are saying that I should see a doctor immediatly, yet other than the initial vomiting, i have no other symptoms...surely 41 hours later I should be feeling sick?
Click to expand...

Like I said, some people feel sick soon after, some people dont. Its a delayed onset of symptoms as certain conditions in the body deteriorate from the lack of a properly functioning liver.

Medically there is no question about it, you need to be seen immediately. As above stated, your vomiting probably indicates that a large portion of the acetaminophen was metabolized. You dont seem to realize the true seriousness of your situation here...
 
you're fine... just give your liver a break for a while, the liver regenerates amazingly... i did the same thing when i fucked up a cwe n ended up swallowing 18 times 400mg of apap... i just threw up loads then got better, but for a while i was thinking bout calling the ER....

just give your liver a break....
 
Thanks for all the advice guys,

Im still extremily confused as to what I should do. Theres the;

"You dont seem to realize the true seriousness of your situation here..."

and right after that,

"You're fine...just give your liver a break"

Anyone able to shine light on this issue?
 
"You should not take more than 4000 mg of acetaminophen a day. Taking more, especially 7000 mg or more, can lead to a severe overdose if not treated."

http://www.nlm.nih.gov/medlineplus/ency/article/002598.htm

"In adults and adolescents, hepatic toxicity may occur following ingestion of greater than 7.5 to 10 g over a period of 8 hours or less.)

http://www.rxlist.com/cgi/generic/apap_od.htm

"In adults, the minimum toxic dose of APAP for a single ingestion is 7.5-10 g."

http://www.emedicine.com/ped/topic7.htm

And heres where someone else died from taking 10g

http://headaches.about.com/cs/medicationsusage/a/acet_death.htm

Hope this "sheds some light" on the fact that you need to see a doctor! If all the "I ate a metric ton of acetaminophen and im fine" people can link you to scientific and medical literature that say "oh you will be fine, just give it a rest for a while, dont go the doctor" then more power to you. Man, this is one for the darwin awards...
 
I was under the impression that some cases of acetaminophen poisoning don't present symptoms until stage 3 of toxicity, which is around 72-90 hours after ingestion. The problem is, if you're at this stage no further treatment can assist you - it's all down to how well your body has been able to manage.

Don't ask me to source this, but I read this in a online document on acetaminophen on wednesday. It was an excellent document and very well sourced, not some bullshit thing.

Therefore, just because you're not presenting symptoms it doesn't mean that you haven't nuked the fuck out of your liver.


I hope to fuck you're alright. Acetaminophen/paracetemol poisoning is a pretty horrible, drawn out way to go.
 
WTF, how can you not want to adhere to the old addage - "better safe then sorry"

It's your life (or quality of) thats at stake and you are on an online forum asking IF you should get help at? I hope you are ok, but I also hope you realise how idiotic this was - and I dont just mean that ridiculous dose of APAP, but you seeking advice on the net and then just listening to the "oh, you will be fine" posts, despite a large amount of evidence (and people) advising you to do the smart/safe thing.....
 
I keep saying it, but anyone taking ANY quantity should also take the same dosage of the amino-acid methionine. It's when you run out of methionine that it screws your body. After 4 days, little can be done. Death is slow and painful so at least the doctor can give pain killers...

Good luck, don't forget a note and make sure your last will and testiment.
 
Don't listen to people saying its fine. It's fine when it's 5 grams and you are freaking out. 11 grams of APAP? GO TO THE FUCKING HOSPITAL.
 
I want all the little stupid brats on this website to shut the fuck up.

HOW DO YOU KNOW HE DOESN'T HAVE LIVER DAMAGE. STOP TELLING HIM HE IS FINE. IS IT SO THAT YOU CAN TLL YOURSELF YOU ARE FINE.

I'M A CRITICAL CARE R.N. THIS IS MY JOB. HE IS NOT FINE. IF YOU DO NOT KNOW WHAT YOU ARE TLAKING ABOUT OR HAVE DONE THE SAME THING YOU SHOULD BE ASHAMED OF YOURSELF FOR TELLING HIM HE IS OKAY.

And Oc4mee, you punk ass little bitch, you need to go get your liver checked out. B/C what you don't know is that liver failure can also be chronic, and that damage to your liver accumulates over time, usually until you are about middleage and then it shuts down on you.

WHERE ARE THE FUCKING MODERATORS?

This forum is turning into a joke. People harm themselves on a daily basis here and there are always some little turds to say that they've done it too and that they are still alive so therefeore there is no harm done.

PHATASS YOU NEED TO GO GET YOUR LIVER CHECKED YOU FUCKING MORON.

THIS IS A FLAME AND YEAH, I'M IN CAPS.
 
Adammmk-
I told you exactly what you need to do 12 hours ago. It was news you did not want to hear. You can be a stupid, irresponsible child and take the advice of losers like phatass and OC4mee and downplay what you have done. Even OC4mee says get it checked out.
grow up and handle your shit. You fucked up!!
 
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