Immediate management of drug overdose relies upon the patient account of what was ingested and how much.
Paracetamol (acetaminophen) is involved in around 40% of intentional overdose episodes, and remains the leading cause
of acute liver failure in many countries including the United Kingdom. In recent years, consumers have had increasing
access to medications supplied by international retailers via the internet, which may have different proprietary or generic
names than in the country of purchase. We describe a patient that presented to hospital after intentional overdose
involving ‘acetaminophen’ purchased via the internet. The patient had difficulty recalling the drug name, which was
inadvertently attributed to ‘Advil’, a proprietary non-steroidal anti-inflammatory drug. The error was later recognised
when the drug packaging became available, but the diagnosis of paracetamol overdose and initiation of acetylcysteine
antidote were delayed. This case illustrates the benefit of routinely measuring paracetamol concentrations in all patients
with suspected poisoning, although this is not universally accepted in practice. Moreover, it highlights the importance of
the internet as a source of medications for intentional overdose, and emphasises the need for harmonisation of
international drug names to improve patient safety.
Keywords: Acetaminophen, analgesic, drug name, drug nomenclature, drug safety, generic drug, paracetamol, proprietary
Rights & PermissionsPrintExport