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September 16, 2025 39 mins

In this episode, we cover everything you need to know about acetaminophen (paracetamol) toxicity — also known as Tylenol overdose. This is one of the most common drug overdoses worldwide and a leading cause of acute liver failure.

We’ll review: Safe and toxic dosing thresholds. Mechanism of action and toxic metabolic pathways (NAPQI, glutathione depletion). The four clinical stages of toxicity. Diagnostic workup and interpretation of acetaminophen levels (Rumack–Matthew nomogram). Management strategies, including NAC (N-acetylcysteine). Indications for liver transplant. Prognosis and outcomes. *Apologies for the audio, microphone didn't turn on!

Timestamps:

0:00 - 6:24 - What Is Acetaminophen, Normal Dosing, Max Doses, 2 grams/day Vs 4 grams/day.

6:25 - 7:41 - Epidemiology, Risk Factors, Liver Failure.

7:42 - 13:37 - Metabolization, Mechanism Of Toxicity, NAPQI, Glutathione

13:38 - 18:19 - 4 Stages Of Toxicity

18:20 - 26:46 - Management, Stabilization, Key Factors, Rumack Matthew Nomogram, Therapies

26:47 - 28:50 - N-Acetyl-Cysteine (NAC)

28:51 - 30:37 - Monitoring, Special Populations (Co-ingestants, Pregnancy, Etc)

30:38 - 32:14 - Liver Transplant, King's College Criteria, Prognosis

32:15 - 38:51 - Key Points, Review, Practice Questions

Link to YouTube Video:

https://www.youtube.com/watch?v=hlXF8GwrT98

📚 Related Resources:

Download our Tylenol Overdose study guides and practice questions: https://www.patreon.com/collection/1443765

Watch next: Playlist Critical Care Medicine

https://youtube.com/playlistlist=PLf5bMa9_tvRiZ85NNUGwk91YpqDWdIGvA&si=jGyrxrOcvQqTldFb

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DISCLAIMER THIS PODCAST DOES NOT PROVIDE MEDICAL ADVICE. The information, including but not limited to, video, text, graphics, images and other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read, watched, or listened to on this video, or any other videos, reports, texts tweets or other sources.

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