More than 100 over-the-counter medicines for adults and children contain acetaminophen, reports "The Merck Manual for Healthcare Professionals." Many combination prescription medications also contain acetaminophen. Although acetaminophen typically proves safe when taken in recommended dosages, an overdose can cause severe, potentially fatal liver damage. Recognizing the symptoms of acetaminophen overdose and seeking immediate medical treatment may limit liver damage.
Early Nausea and Vomiting
In the first 24 hours after an acetaminophen overdose, nausea and vomiting are the predominant symptoms, reports "The Merck Manual for Healthcare Professionals." Patients who have inadvertently overdosed or the parents of children who have consumed too much acetaminophen often do not identify these symptoms as related to a medication overdose, frequently leading to a delay in treatment.
Excessive Sweating
Patients may exhibit profuse sweating in the early stages after an acetaminophen overdose. Parents may misidentify this symptom as evidence of a fever and give a child suffering from unrecognized acetaminophen poisoning additional doses of the medication, notes the American Academy of Pediatrics.
Right Upper Abdominal Pain
Approximately 24 hours after ingestion of an acetaminophen overdose, nausea and vomiting gradually subside and right upper abdominal pain develops. This pain arises from the liver as toxic byproducts of acetaminophen accumulate in the organ and cause tissue damage. The right upper abdomen proves tender to pressure. Blood tests typically reveal significantly elevated liver enzyme levels, indicating liver cell damage.
Recurrent Nausea and Vomiting
On approximately the third to the fifth day after an acetaminophen overdose, nausea and vomiting recur as liver failure emerges, reports the American Academy of Pediatrics. Patients are profoundly ill at this stage of acetaminophen poisoning.
Yellow Skin Discoloration
As liver failure evolves, patients with acetaminophen poisoning often develop yellow skin discoloration known as jaundice, notes the National Library of Medicine encyclopedia, MedlinePlus. The liver normally incorporates the yellow chemical bilirubin into the bile. With liver failure, however, bilirubin builds up in the blood and causes yellow staining of the skin and whites of the eyes.
Dark Urine
Excess bilirubin in the bloodstream associated with acetaminophen-induced liver failure spills into the urine, causing a deep yellow to brown appearance. In some patients, kidney failure develops along with liver failure. In these patients, a severe reduction in urine production may occur.
Confusion, Drowsiness and Coma
Severe acetaminophen-induced liver failure can lead to a buildup of several toxic chemicals in the blood, which may adversely affect brain function. Common symptoms include confusion, drowsiness, decreased alertness and difficulty arousing a response from the patient, reports "The Merck Manual for Healthcare Professionals." The severity of a patient's brain-related symptoms typically reflects the degree of liver failure. This condition, known as hepatic encephalopathy, may progress to coma in patients with profound liver failure.
