Should a Lower Treatment Line Be Used When Treating Paracetamol Poisoning in Patients with Chronic Alcoholism?

@article{Dargan2002ShouldAL,
  title={Should a Lower Treatment Line Be Used When Treating Paracetamol Poisoning in Patients with Chronic Alcoholism?},
  author={Paul I Dargan and Alison Linda Jones},
  journal={Drug Safety},
  year={2002},
  volume={25},
  pages={625-632}
}
The widespread practice of using a lower plasma paracetamol (acetaminophen) concentration threshold for the treatment of paracetamol poisoning in patients with chronic alcoholism has been introduced on the basis of anecdotal case reports.In animals, acute alcohol loading inhibits toxic metabolic activation of paracetamol whilst chronic alcohol administration results in cytochrome P450 (CYP) 2E1 induction with increased toxic metabolic activation of paracetamol by CYP2E1 and increased… 
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Comment on "Acute ethanol coingestion confers a lower risk of hepatotoxicity after deliberate acetaminophen overdose".

TLDR
Investigation into the effect of acute ethanol coingestion on risk of hepatotoxicity among patients admitted to hospital for N-acetylcysteine (NAC) therapy after deliberate acetaminophen overdose finds an apparent protective effect, but further work is required to establish mechanisms by which ethanol might confer protection against hepatot toxicity.

Over-the-Counter Pain Management Gone Awry

TLDR
It is essential for all health care providers to be familiar with the etiology and progression of this poisoning, as well as the necessary steps in treatment, to provide the highest level of care for this often-treatable condition.

Management of paracetamol poisoning.

Treating acetaminophen overdose: thresholds, costs and uncertainties

The United Kingdom's Medicines and Healthcare Products Regulatory Agency (MHRA) modified the indications for N-acetylcysteine therapy of acetaminophen (paracetamol) overdose in September 2012. The

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