4,5 At that time the biochemical mechanisms underlying paracetamol toxicity were unknown, and thus treatment was entirely symptomatic. The first documented cases of organ toxicity from paracetamol were in Scotland in 1966. 3 The precise psychosocial factors behind this increase are unclear, but by the early 1970s admissions to hospital from patients deliberately ingesting aspirin and paracetamol had become a regular, problematic medical emergency. The profile of the epidemiology of poisoning changed over the next 40 years with poisoning becoming a common reason for emergency admission to hospital. 1,2 At that time presentations with poisoning, either accidental or from self-harm, were unusual in Europe. Introduction Paracetamol was introduced into clinical medicine in the 1950s as an antipyretic analgesic. We offer suggestions for improvements in the way NAC may be administered and outline new developments that should have major impacts on the way we manage paracetamol poisoning in the near future. This article examines the history of the development of NAC and recent developments in its use.

The development of antidotes followed within 10 years, and by 1980 acetylcysteine (NAC) was acknowledged as the optimal therapy available.

Paracetamol poisoning was first reported in 1966.

Acetaminophen overdose antidote