Abstract
When taken at the recommended doses, the common analgesic and antipyretic drug paracetamol is regarded as safe by the majority of medical professionals. In cases of overdose or continuous use, it has been documented to result in liver damage. In this paper, the effects of paracetamol on the liver are summarized based on a survey of the most recent academic publications. The study focuses on the clinical symptoms of paracetamol-induced liver injury as well as the mechanisms of paracetamol-induced liver injury and risk factors for liver injury. The results imply that excessive or extended paracetamol usage may result in the buildup of hazardous metabolites that cause oxidative stress and liver cell death. Those who are malnourished, have a history of alcoholism, or have pre-existing liver illness are more likely to suffer from liver damage. In extreme situations, it can potentially result in death due to liver failure. The research ends with suggestions on how paracetamol should be used safely to reduce the risk of liver damage, including avoiding overdose and prolonged usage and obtaining medical help if you have any symptoms of liver damage.
1. Introduction
The over-the-counter drug paracetamol, usually referred to as acetaminophen, is frequently used to treat fever and pain. When taken as directed, it is usually regarded as safe and is both readily and affordably available. Regarding paracetamol’s potential negative effects on the liver, particularly in cases of overdose or extended use, worries have been raised. Paracetamol can induce liver damage that ranges from modest abnormalities in liver enzymes to acute liver failure and, in extreme situations, can be fatal. High doses or continuous usage of paracetamol may be too much for the liver to handle, which plays a critical role in the metabolism and removal of the drug (Chia et al., 2020). An overview of the most recent research on the effects of paracetamol on the liver is given in this paper, along with information on the mechanisms of liver damage, risk factors for liver damage, clinical signs, and methods for therapy and prevention.
2. Findings
2.1. Liver damage
When taken at the recommended doses, the common analgesic and antipyretic drug paracetamol is regarded as safe by the majority of medical professionals. In cases of overdose or continuous use, it has been documented to result in liver damage. High doses or continuous usage of paracetamol may be too much for the liver to handle, which plays a critical role in the metabolism and removal of the drug (Alchin et al., 2022). This may result in the buildup of harmful compounds that damage liver cells and induce oxidative stress. Those who are malnourished, have a history of drinking excessively, or have pre-existing liver illness are more likely to suffer from liver damage. Jaundice, nausea, vomiting, and abdominal discomfort are some of the clinical signs of paracetamol-induced liver damage. In extreme circumstances, it may result in liver failure and even death. Avoiding overdose and prolonged usage, seeking medical assistance if suffering any symptoms of liver injury, and early intervention with antidotes such N-acetylcysteine are some of the prevention and management measures for paracetamol-induced liver injury (Alchin et al., 2022). Although paracetamol is generally safe when used in the authorized quantities, the risk of liver damage highlights the significance of using this commonly used medicine safely and responsibly.
2.2. Solution
The usual dosage of paracetamol is 1-2 tablets (500-1000 mg) every 4-6 hours as needed, with a daily maximum of 4 grams. The risk of liver damage rises when the recommended dose is exceeded. Avoid using paracetamol for an extended period of time because doing so increases the risk of liver damage and the accumulation of harmful metabolites. It is advised to consume paracetamol for no longer than 10 days straight if you are not under medical care (Jasat et al., 2022). Long-term alcohol consumption raises the possibility of liver damage from paracetamol. A history of alcohol abuse should be taken into consideration before using paracetamol or mixing it with alcohol. Those who already have liver disease or are taking other drugs that influence liver function need to have their liver function periodically checked for any signs of damage. If there is any reason to suspect liver damage, liver function tests should be carried out.
3. Discussion
When taken in accordance with authorized dosages, paracetamol (acetaminophen), a common analgesic and antipyretic, is usually regarded as safe. However, excessive or improper usage of it can harm the liver and potentially result in death from acute liver failure. High doses or continuous usage of paracetamol can overwhelm the liver’s ability to process and eliminate the drug, which is critical to its metabolism and disposal. Paracetamol’s toxic byproducts can harm the liver by inducing oxidative stress and the death of liver cells. (Rotundo & Pyrsopoulos, 2020). Those with pre-existing liver illness, continuous alcohol use, or those who are malnourished have an increased risk of liver damage. The amount taken, how long it is used for, and each person’s vulnerability are a few of the elements that affect how toxic paracetamol is to the liver. Usually, 1-2 pills (500-1000 mg) every 4-6 hours as needed, up to a daily maximum of 4 grams, constitute the recommended paracetamol dosage. A liver damage is more likely when the recommended dose is exceeded. (Ullah et al., 2022) The accumulation of hazardous metabolites and increased risk of liver damage are both caused by prolonged paracetamol usage. Use of paracetamol without a doctor’s supervision is advised to be limited to no more than 10 days in a row.
4. Conclusion
In conclusion, paracetamol is a commonly used drug that, when used improperly, can harm the liver. Paracetamol must be metabolized and eliminated by the liver, which can become overburdened by excessive doses or extended use. The harmful byproducts of paracetamol can result in oxidative stress and liver cell death, which can harm the liver and, in extreme situations, induce liver failure and even death.
5. Recommendations
It is advised that healthcare professionals inform patients about the safe and responsible use of paracetamol in light of the report’s results about the effects of paracetamol on the liver. This should contain instructions on suggested dosages, the daily intake cap, and the length of use. Also, patients should be instructed not to mix alcohol and paracetamol and to get help right once if they experience any liver damage symptoms.
References
Alchin, J., Dhar, A., Siddiqui, K., & Christo, P. J. (2022). Why paracetamol (acetaminophen) is a suitable first choice for treating mild to moderate acute pain in adults with liver, kidney or cardiovascular disease, gastrointestinal disorders, asthma, or who are older. Current medical research and opinion, 38(5), 811–825. https://doi.org/10.1080/03007995.2022.2049551
Chia, P. Y., Thein, T. L., Ong, S. W. X., Lye, D. C., & Leo, Y. S. (2020). Severe dengue and liver involvement: an overview and review of the literature. Expert review of anti-infective therapy, 18(3), 181–189. https://doi.org/10.1080/14787210.2020.1720652
Jasat, H., Thompson, J., Sonneborn, O., Dayment, J., & Miller, C. (2022). Prolonged use of paracetamol and the prescribing patterns on rehabilitation facilities. Journal of clinical nursing, 31(23-24), 3605–3616. https://doi.org/10.1111/jocn.16188
Rotundo, L., & Pyrsopoulos, N. (2020). Liver injury induced by paracetamol and challenges associated with intentional and unintentional use. World journal of hepatology, 12(4), 125–136. https://doi.org/10.4254/wjh.v12.i4.125
Ullah, H., Khan, A., Bibi, T., Ahmad, S., Shehzad, O., Ali, H., Seo, E. K., & Khan, S. (2022). Comprehensive in vivo and in silico approaches to explore the hepatoprotective activity of poncirin against paracetamol toxicity. Naunyn-Schmiedeberg’s archives of pharmacology, 395(2), 195–215. https://doi.org/10.1007/s00210-021-02192-1
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