Acetaminophen toxicity is the most frequent cause of emergency calls to poison control centers and of acute liver failure in the U.S. Contributing factors include medication errors, OTC availability, and inadequate patient education. Overdose must be treated as quickly as possible to avoid acute liver failure or death. Patients who receive N-acetylcysteine treatment within the first 8 hours of overdose have a very positive prognosis with less than a 5% chance of developing liver toxicity. Delays in treatment beyond 10 hours lead to a poorer prognosis. Pharmacists need to be aware of the recommended doses for acetaminophen use, signs and symptoms of acute liver injury, and emergency treatment protocols.
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