Analgesic abuse

Last updated: Thursday, 28, October, 2010
ConsequencesAppropriate Tests

Creatinine, urea, electrolytes.

Urine microscopy and culture.

Renal failure - chronic

Hypertension

Hyponatraemia

Renal papillary necrosis

Urine microscopy and culture; collect any solid material passed in urine and submit (in formalin) for histopathological assessment (sloughed papilla).

Renal tubular acidosis

Renal tubulo-interstitial disorders

Urinary tract tumour, especially

  • Renal pelvis

Urine cytology. FNAB, lesion biopsy, as appropriate.

Hepatotoxicity 

Typically follows an acute overdose, but may result from prolonged use of smaller doses of paracetamol-containing analgesics, particularly in patients with pre-existing liver disease. Paracetamol; AST, ALT, GGT.

See Hepatic failure