Adult dose: Initial IV dose: 150mg/kg in 200ml 5% glucose over 15-60 mins. Maintenance dose: IV, 50mg/kg in 500ml of 5% glucose over 4hrs followed by 100mg/kg in 1liter of 5% glucose over 16hrs (total dose over 21hrs: 300mg/kg)Children: Initial IV dose: 150mg/kg in 5ml/kg 5% glucose over 15-60 mins. Maintenance dose: IV, 50mg/kg in 10ml/kg of 5% glucose over 4hrs followed by 100mg/kg in 20ml/kg of 5% glucose over 16hrs.
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About 90% paracetamol is metabolized via phase II pathways by sulphation and glucuronidation while approximately 10% is oxidized via phase I using the cytochrome oxi- dases. The main product of this phase I metabo- lism is a chemically reactive quinoneimine toxic metabolite that reacts with glutathione to form a non-toxic metabolite excreted in the urine. In case of overdosage quinoneimine toxic metabolite accumulates. This consumes and depletes of glutathione and in its absence quinoneimine toxic
metabolite reacts with nucleophilic sites on critical cellular proteins, interfering with cell function and initiating hepatocellular necrosis. N- acetylcysteine [NAC] replenishes hepatic gluta- thione stores, facilitating quinoneimine toxic metabolite detoxification. NAC therapy is most effective if administered within 8-10 hours of ingestion
These are basically due to rapid IV administration that results in histamine release. They include flushing, urticaria, itching and anaphylactic reactions.