Snapshot A 20-year-old woman presents to the emergency department for ingestion of acetaminophen. She reports that she has had suicidal ideation and had ingested an unknown quantity of acetaminophen in an attempt to end her life. An hour later, she began feeling nauseous. She regretted the ingestion and came to the hospital. In the emergency room two hours after ingestion, she has vomited twice. Serum labs reveal no abnormalities. She is given activated charcoal since the ingestion was within four hours of presentation. Introduction Mechanism of action central reversible inhibition of cyclooxygenase (COX) inactivated peripherally Clinical use used as an antipyretic and analgesic especially useful in the pediatric population to avoid a risk of Reye syndrome in children with viral infection not used for inflammation Toxicity massive hepatic necrosis pathogenesis login to view 3 more bullets clinical manifestations login to view 4 more bullets treatment login to view 5 more bullets minimal gastrointestinal irritation