Acetaminophen (Paracetamol) toxicity Quiz: Ace Your Exams
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A 42-year-old woman is brought to the emergency department by her husband for worsening confusion and lethargy over the past 24 hours. He found multiple empty bottles of acetaminophen on the kitchen counter. The patient states that she was trying to relieve her headache. Past medical history is significant for major depressive disorder. Her only medication is sertraline. Temperature is 36.9°C (98.4°F), blood pressure is 112/68 mm Hg, pulse is 95/min, respiratory rate is 14/min, and oxygen saturation is 99% on room air. On physical examination, she is drowsy but arousable. Her pupils are 3 mm and reactive. She exhibits asterixis with outstretched arms. Abdominal examination is significant for right upper quadrant (RUQ) abdominal pain. Laboratory evaluation shows AST 4500 U/L, ALT 5300 U/L and prolonged INR. Which of the following is the best next step in management?
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