Posted by: OD | 2004/11/08

Overdose - Mypaid (Taken Saturday)

Hi Doc,
My girlfriend drank a handful of Mypaid. Can you please advise if an overdose of Mypaid is dangerous or not? If no side affects have been experienced is there still a chance that things can go wrong because I was told that paracetamol takes a while to work. These tables also contain Ibuprofen. She took between 12 to 20. I apologise if this is the wrong site but can't pose question to Cyberdoc, it won't take it.

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Our expert says:
Expert ImageCyberShrink

Whenever you are in any doubt about an overdose, take the person to the nearest Casualty Dept for a checkup. Remember also that such drugs can interact unhelpfully with any other medicines she might have been taking.
and much depends on the amount of each drug in the pills she took, how many pills she took, whether she vomited up any of them, and so on.
Paracetamol may not make her drowsy, but can cause significant liver damage, so it could be a good idea to have a blood test done at casualty, of her liver function. Ibuprofen is in some ways like aspirin, and can cause severe stomach irritation and indigestion, even possible stomach bleeding, among other problems.
Then I notice that Lucia has very helpfully quoted a listing of side-effects and risks.
Notice that this official quote from Lucia emphasizes that the damage may grow in the days after the OD, so it is still worth getting her to casualty for a proper checkup.
Do your best to persuade her to do this ; she is an adult, which gives her the right to be very foolish if she insists, but ot would be a really bad idea for her not to have a checkup, and she shouldn't see it as doing anyone else a favour, to look after herself properly.

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Our users say:
Posted by: OD | 2004/11/08

Thank you again, I will take her asap, the problem is however that she is quite a distance from me and probably won't want to go. She refused on Saturday evening and I didn't push it. Spoke to a chemist and he said if she didn't show symptoms in the first 12 hours she was okay. She did have the heart arrythmia though already on Saturday evening and I do now remember that she complained of being nauseas. It has now been over 24 hrs and I hope that she will be okay.

Reply to OD
Posted by: El-Jo | 2004/11/08

It sounds as if taking her to do the doctor, as soon as possible, might be a very good idea.

Reply to El-Jo
Posted by: Chelle | 2004/11/08

I think you should take her to the doctor, better to play it safe.
Also, she should be referred to someone to help her overcome the issue that has lead her to take an overdose.

Reply to Chelle
Posted by: OD | 2004/11/08

Thank you Lucia. I am now very worried about her, she went to work this morning as though nothing has happened. Do I go fetch her and take her to the doctor? She hasn't shown any symptoms as yet. Has some pain in kidney area though, could this be it and the heart arrythmias.

Reply to OD
Posted by: Lucia | 2004/11/08

High OD - hope this helps:

Ibuprofen - The most likely symptoms of overdosage are epigastric pains and nausea. Treatment is symptomatic and supportive.
Paracetamol - Symptoms of paracetamol overdosage in the first 24 hours are pallor, nausea, vomiting, anorexia, and abdominal pain. Liver damage may become apparent 12 to 48 hours after ingestion.
Abnormalities of glucose metabolism and metabolic acidosis may occur.
Acute renal failure with acute tubular necrosis may develop even in the absence of severe liver damage. Cardiac arrhythmias have been reported.
Symptoms during the first 2 days of acute poisoning do not reflect the potential seriousness of the overdosage. Nausea, vomiting, anorexia and abdominal pain may persist for a week or more. Liver injury may be manifested on the second day, (or later) initially by elevation of serum transaminase and lactic dehydrogenase activity, increased serum bilirubin concentration and prolongation of prothrombin time. The liver damage may progress to encephalopathy, coma and death. Cerebral oedema and nonspecific myocardial depression have also occurred.
In the event of overdosage consult a doctor or take the patient to the nearest hospital immediately. Specialized treatment is essential as soon as possible.
Prompt treatment is essential. Any patient who has ingested about 7,5 g of paracetamol in the preceding 4 hours should undergo gastric lavage. Specific therapy with an antidote such as acetylcysteine or methionine may be necessary. If decided upon, acetylcysteine should be administered IV as soon as possible.
Acetylcysteine: Acetylcysteine should be administered as soon as possible, preferably within 8 hours of overdosage.
IV: An initial dose of 150 mg/kg in 200 mL glucose injection, given intravenously over 15 minutes, followed by an intravenous infusion of 50 mg/kg in 500 mL of glucose injection over the next 4 hours, and then 100 mg/kg in 1000 mL over the next 16 hours. The volume of intravenous fluids should be modified for children.
Orally: 140 mg/kg as a 5% solution initially, followed by a 70 mg/kg solution every 4 hours for 17 doses. Acetylcysteine is effective if administered within 8 hours of overdosage.

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