Hydrocodone and acetaminophen overdose

Definition:
This poisoning is from an overdose of acetaminophen and hydrocodone.

Alternative Names:
Lorcet; Lortab; Vicodin

Poisonous Ingredient:
  • Acetaminophen
  • Hydrocodone (oral narcotic)


Where Found:
  • Lortab
  • Lorcet
  • Vicodin
Note: This list may not be all inclusive.

Symptoms:
  • Respiratory
  • Eyes, ears, nose, and throat
    • Pinpoint pupils (from the hydrocodone)
  • Skin
  • Gastrointestinal
    • Spasms of the stomach and/or intestinal tract
    • Vomiting
    • Acetaminophen overdose over a certain toxic level leads to liver failure, unless the antidote, N-Acetyl-cysteine, is given
  • Heart and blood vessels
  • Nervous system


Home Treatment:
DO NOT INDUCE VOMITING. Seek emergency medical care immediately.

Before Calling Emergency:
Determine the following:
  • The patient's age, weight, and condition
  • The name of the product (ingredients and strengths, if known)
  • The time it was swallowed
  • The amount swallowed
  • It the medication was prescribed for the patient


Poison Control, or a local emergency number:
See Poison Control centers for telephone numbers and addresses. Take the container with you to the emergency room.

What to expect at the emergency room:
Some or all of the following procedures may be performed:
  • For swallowed poison
    • Placement of a tube down the nose and into the stomach (a nasogastric tube, or an NG tube) to wash out the stomach (gastric lavage).
    • Activated charcoal administration.
    • Give IV fluids.
    • Admission to the hospital.
    • For Tylenol, N-Acetyl cysteine is given if the blood Tylenol level is high enough. Without the antidote, the patient has fatal liver failure.
    • Treat the symptoms.
    • Give a counteracting medication (narcotic antagonist). Multiple doses may be needed.


Expectations (prognosis):
If an antidote can be given, recovery from an acute overdose occurs within 24 to 48 hours for hydrocodone, and within 3 to 4 days for acetaminophen.


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