Brief Answer: Measure Serum Paracetamol conc & LFT. NAC therapy. Detailed Answer: Hello, I have gone through your query and understand your concern. You have taken 5000 mg of paracetamol in 27 hours. Currently, the maximum recommended daily dose of paracetamol is 4 g for adults. You have taken above the maximum recommended dose. Thus you are at the risk of paracetamol toxicity. If you are alcoholic, the risk of toxicity is more. One good thing is you have taken paracetamol over a spread of time. This allows your liver to metabolize the paracetamol which you have taken at regular interval. Usual half life of paracetamol is 2 hours. In high doses, the paracetamol cause liver damage. There are often no symptoms in the first 24 hours following overdose, although there may be mild nausea and vomiting. Thus better to measure serum paracetamol concentration. Because the serum paracetamol concentration is the basis for diagnosis and treatment, even in the absence of symptoms, because of the delay in onset of clinical manifestations of liver toxicity. In addition, please do Liver function tests. If you are my patient, i will initially measure 4th hourly Serum paracetamol concentration and liver function tests. Then if these are with in normal limits, i would keep you under observation for 48 hours as inpatient to watch for any toxicity. If the paracetamol concentration is high, i would start N -acetylcysteine (NAC) therapy. Thus do not delay, consult your ER and get checked the investigations mentioned. Hope this helps. Please write back for further queries. Wishing you good health.

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