is a derivative of aniline
, which is a deadly poison which acts by killing the liver
. Aniline is treated to add a hydroxyl in the para position
. Then the p-hydroxy-aniline is treated in an addition reaction to add a ketone (O=C-CH3) to it; the ketone carbon adds to the nitrogen, replacing one of the hydrogens. In the liver
, the terminal methyl group is cleaved.
Acetaminophen is relatively harmless in those with functioning livers when taken at safe doses. However, the drug should not be taken by those with liver disorders. Overdosage tends to cause acute liver failure, and what basically amounts to a slow, painful death.
For some reason, acetaminophen is often the drug of choice for teenagers making desperate cries for attention by supposedly attempting suicide. Most of the time, they don't actually intend to commit suicide and are only wanting attention, and they mistakingly figure that overdosing on acetaminophen is not going to hurt them. Instances of this nature typically spike in America around the late Spring, where princes and princesses of high school are suddenly beginning to realize that their reign is about to end, and/or their girlfriends or boyfriends really don't care about them for anything other than status symbols, money, and cheap sex.
As with most drugs, people mistakenly assume that if one or two is good, fifty must be better, because they have some severe symptoms this time.
A patient presenting to a medical facility as a possible overdose can expect an NG tube (nasogastric tube) to be inserted, with a lavage of activated charcoal pumped down it. An acetaminophen level will be drawn, along with a full toxscreen, and a battery of other tests. In the case of an acetaminophen overdose, the patient can expect to be admitted to the hospital on suicide precautions, to receive IV hydration therapy, and will be given acetylcysteine (Mucomyst).
Acetylcysteine is used because it is a precursor to glutathione, which is necessary to metabolize the acetaminophen into relatively harmless byproducts.