Author, LLC is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
  • Target Audience: Pharmacist
  • Credits: 1.5
  • Activity Release Date: 2/22/2022
  • Activity Expiration Date: 2/22/2025
  • Activity Type: Knowledge
  • UAN: 0669-0000-22-043-H08-P
  • Topic: Pain Management/Opioids
  • CeBroker Number: 20-955984
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Course Summary
The leading cause of acute liver failure in the United States and other developed countries is the intentional or accidental overdose of the common over-the-counter medication acetaminophen. An overdose of acetaminophen not only causes liver damage but, in rare instances, can cause renal and other organ system damage as well. Healthcare teams that are prepared with the appropriate knowledge and skill to recognize acetaminophen poisoning and provide the appropriate diagnostic and treatment steps can help to save a person from significant physical harm. After a chronic overdose, the toxic dose of acetaminophen depends on how long the patient has been taking the drug and the presence of risk factors. The use of the Rumack-Matthew nomogram helps to determine whether acute acetaminophen ingestion can be expected to be toxic or non-toxic. In chronic acetaminophen use, a serum level should be measured to determine the need for treatment. The standard treatment for acetaminophen overdose is N-acetylcysteine, and if patients are treated appropriately and promptly, the prognosis is typically good. Hemodialysis may be used as a treatment option and in severe cases liver transplantation may be needed.

Course Objectives
  • Describe the pharmacology of acetaminophen
  • Identify the prevalence and circumstances that give rise to acetaminophen poisoning
  • Describe the criteria for diagnosing acetaminophen poisoning
  • Describe treatment guidelines for acetaminophen overdose

I. Introduction

II. Acetaminophen Use and Incidence of Overdose

III. Acetaminophen Pharmacology

IV. Acetaminophen Dosing and Available Forms

1. Acetaminophen Dosing
2. Available Forms of Acetaminophen
3. Contraindications
4. Adverse Effects
5. Drug-Drug/Drug-Disease Interactions

V. Acetaminophen Toxicity

Therapeutic Dose and Potential Toxicity

VI. Clinical Presentation of Acetaminophen Poisoning

1. Phase I
2. Phase II
3. Phase III
4. Phase IV

VII. Acetaminophen Overdose and Organ Damage

1. Liver Damage
2. Renal Damage
3. Other Organ Damage

VIII. Acute Acetaminophen Overdose

1. Acetaminophen Toxic Dose and Time of Ingestion
2. Measuring Acetaminophen Serum Levels
3. Signs and Symptoms of Acetaminophen Toxicity

IX. Initial Treatment for Acetaminophen Overdose

1. Gastric Decontamination
2. Antidotal Therapy: N-Acetylcysteine
3. Modes of Administration
4. Hemodialysis

X. The Roles of Pharmacists and Pharmacy Technicians in Preventing Acetaminophen Overdose

XI. Summary

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Faculty Planner Disclosure
The following individuals were involved in the development of this activity: Susan DePasquale, MSN, PMHNP-BC, Amanda Mayer, PharmD, and Jeff Goldberg, PharmD, BCPP. There are no financial relationships relevant to this activity to report or disclose by any of the individuals involved in the development of this activity.

Unlabeled Use Disclosures
The information provided in this course is general in nature and it is solely designed to provide participants with continuing education credit(s). This course and materials are not meant to substitute for the independent, professional judgment of any participant regarding that participant’s professional practice, including but not limited to patient assessment, diagnosis, treatment and/or health management. Medical and pharmacy practices, rules, and laws vary from state to state, and this course does not cover the laws of each state; therefore, participants must consult the laws of their state as they relate to their professional practice. Healthcare professionals, including pharmacists and pharmacy technicians, must consult with their employer, healthcare facility, hospital, or other organization, for guidelines, protocols, and procedures they are to follow. The information provided in this course does not replace those guidelines, protocols, and procedures but is for academic purposes only, and this course’s limited purpose is for the completion of continuing education credits. Participants are advised and acknowledge that information related to medications, their administration, dosing, contraindications, adverse reactions, interactions, warnings, precautions, or accepted uses are constantly changing, and any person taking this course understands that such person must make an independent review of medication information prior to any patient assessment, diagnosis, treatment and/or health management. Any discussion of off-label use of any medication, device, or procedure is informational only and such uses are not endorsed hereby. Nothing contained in this course represents the opinions, views, judgments, or conclusions of LLC. LLC is not liable or responsible to any person for any inaccuracy, error, or omission with respect to this course, or course material.
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