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D Nicholas Bateman

, Robert D Jefferson

, Simon HL Thomas

, John P Thompson

, and J Allister Vale

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date: 11 August 2020

This chapter deals with analgesics, the most frequent drugs ingested in self-harm episodes in the UK. This is because they are widely available for sale, both in pharmacies and other retail outlets, and are widely prescribed. Paracetamol is the commonest single cause of poisoning seen in the UK, and of acute liver failure in Europe and North America. The frequency of salicylate poisoning has declined as the overdose rate from paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) has increased. Opioids are potentially very hazardous when taken in overdose. They are also widely used as drugs of misuse. Since naloxone is a short-acting drug its use is always potentially hazardous for clinicians who do not appreciate complexities of serious opioid poisoning and the potential for rapid clinical decline in patients who are not adequately monitored. The opioids methadone and dextropropoxyphene (withdrawn in UK) have additional toxicity due to their effects on myocardial ion channels.

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