Acute poisoning: analgesics - clinical features and management

Analgesics, particularly paracetamol, aspirin and ibuprofen, are the most common subject of enquiry to NPIS (London); paracetamol alone is involved in more than 16 per cent of emergency telephone enquiries. These three drugs are all available without prescription in varying strengths and are found in combination with a number of other drugs, for example, decongestants, other analgesics, caffeine. Some compound analgesics are available on prescription containing opioids and aspirin or paracetamol (Box I). Although over the counter (OTC) use of these drugs is generally safe and effective, it is inevitable that they will be taken in overdose and thus be a cause of frequent referral to A&F, departments.