Paracetamol - serum

Last updated: Friday, 04, June, 2010

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Item Process
Specimen

5 mL blood in plain tube collected, ideally 4 hours after ingestion of the paracetamol.

A second specimen collected at least 2 hours later can be used to measure paracetamol half-life.

Method

Spectrophotometry, chromatography, or immunoassay.

Reference Interval

Toxic range: >1,300 µmol/L (195 mg/L) 4 hours after ingestion of paracetamol.

Paracetamol half-life:
<4 hours: low probability of liver damage
>12 hours: hepatic coma likely.

Application

Assessment of toxic overdose.

Interpretation

See Figure 2. Risk of liver damage.

Toxicity is more likely and occurs at lower plasma levels in patients with pre-existing liver disease.

Calculation of half-life (from two specimens) is also a useful guide to hepatotoxicity as prolongation of half-life is a good predictor of the risk of development of acute hepatocellular damage.

Reference

Dargan PI and Jones AL. Trends Pharmacol Sci 2003; 24(4): 154-157.