MedlinePlus Medical Encyclopedia: Acetaminophen and codeine

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Acetaminophen and codeine

Contents of this page:
Alternative names Definition Poisonous Ingredient Where Found Symptoms	Home Treatment Before Calling Emergency Poison Control, or a local emergency number What to expect at the emergency room Expectations (prognosis)

Alternative names

Tylenol # 3

Definition Return to top

This poisoning is from an overdose of acetaminophen with codeine.

Poisonous Ingredient Return to top

Acetaminophen
Codeine

Where Found Return to top

Tylenol No. 3

Note: This list may not be all inclusive.

Symptoms Return to top

Respiratory
- Breathing slow and labored (from the codeine)
- Breathing shallow (from the codeine)
- Respiratory arrest (from the codeine)
Eyes, ears, nose, and throat
- Pinpoint pupils (from the codeine)
Skin
- Bluish skin (fingernails and lips)
Gastrointestinal
- Spasms of the stomach and/or intestinal tract
- Vomiting
- Acetaminophen overdose over a certain toxic level leads to liver failure unless the antidote, N-Acetyl-cysteine, is given
Heart and blood vessels
- Low blood pressure (from the codeine)
Nervous system
- Drowsiness (from the codeine)

Home Treatment Return to top

Seek emergency medical care immediately. Both Tylenol and codeine overdoses can be rapidly fatal. DO NOT INDUCE VOMITING.

Before Calling Emergency Return to top

Determine the following information:

The patient's age, weight, and condition
The name of the product (as well as the ingredients and strength, if known)
The time it was swallowed
The amount swallowed
If the medication was prescribed for the patient

Poison Control, or a local emergency number Return to top

See Poison Control Centers for telephone numbers and addresses. Take the container with you to the emergency room.

What to expect at the emergency room Return to top

For swallowed poison
- Placement of a tube down the nose and into the stomach (a nasogastric tube, or an NG tube) to wash out the stomach (gastric lavage).
- Activated charcoal administration.
- Give IV fluids.
- Admission to the hospital.
- For Tylenol, N-Acetyl cysteine is given if the blood Tylenol level is high enough. Without the antidote, the patient has fatal liver failure.
- Treat the symptoms.
- Give a counteracting medication (narcotic antagonist). Multiple doses may be needed.

Expectations (prognosis) Return to top

If an antidote can be given, recovery from an acute overdose often occurs within 24-48 hours.

Update Date: 1/29/2004

Updated by: Cherlin Johnson, M.D., Department of Emergency Medicine, University of Southern California, Los Angeles, CA. Review provided by VeriMed Healthcare Network.

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