Symptoms, caused by the presence of paracetamol: during the first 24 hours the pallor of the skin, nausea, vomiting, anorexia, abdominal pain,disturbance of glucose metabolism, metabolic acidosis. Symptoms of liver dysfunction may appear 12-48 hours after an overdose. In severe overdose, renal failure with progressive encephalopathy, coma, death; acute renal failure with tubular necrosis (including in the absence of severe liver damage); arrhythmia, pancreatitis.
Symptoms due to the presence of acetylsalicylic acid: with the lungs intoxication - nausea, vomiting, dizziness, tinnitus, impaired vision, severe headache; with severe intoxication - hyperventilation of the lungs of the central genesis (dyspnea, choking, cyanosis, cold sticky sweat, respiratory paralysis), respiratory acidosis. The greatest risk of developing chronic intoxication is noted in children and the elderly with more than 100 mg / kg / day for several days.
Symptoms due to the presence of caffeine: gastralgia, agitation, anxiety, agitation, motor anxiety, confusion, delirium, dehydration, tachycardia, arrhythmia, hyperthermia, frequent urination, headache, increased tactile or pain sensitivity,tremor or muscle twitching; nausea and vomiting, sometimes with blood; ringing in the ears, epileptic seizures (with acute overdose - tonic-clonic).
Treatment: constant monitoring of the acid-base state and electrolyte balance. Depending on the state of metabolism - the introduction of sodium bicarbonate, sodium citrate or sodium lactate. Increasing alkalinity increases the excretion of acetylsalicylic acid due to alkalinization of urine. Gastric lavage in the first 4 hours, provocation of vomiting, intake of activated carbon, laxative drugs, administration of donators SH-groups and precursors of the synthesis of glutathione methionine for 8-9 hours after an overdose and acetylcysteine - for 8 hours.