Rumack Matthew Nomogram with treatment line added at 150 A person's history of taking<unk>  is somewhat accurate for the diagnosis. The most effective way to diagnose poisoning is by obtaining a blood<unk>  level. A drug nomogram developed in 1975, called the Rumack-Matthew nomogram, estimates the risk of toxicity based on the serum concentration of<unk>  at a given number of hours after ingestion. To determine the risk of potential hepatotoxicity, the<unk>  level is traced along the nomogram. Use of a timed serum<unk>  level plotted on the nomogram appears to be the best marker indicating the potential for liver injury. A<unk>  level drawn in the first four hours after ingestion may underestimate the amount in the system because<unk>  may still be in the process of being absorbed from the gastrointestinal tract. Therefore, a serum level taken before 4 hours is not recommended. Clinical or biochemical evidence of liver toxicity may develop in one to four days, although, in severe cases, it may be evident in 12 hours. Right-upper-quadrant tenderness may be present and can aid in diagnosis. Laboratory studies may show evidence of liver necrosis with elevated AST, ALT, bilirubin, and prolonged coagulation times, particularly an elevated prothrombin time. After<unk>  overdose, when AST and ALT exceed 1000 IU/L,<unk> -induced hepatotoxicity can be diagnosed. In some cases, the AST and ALT levels can exceed 10,000 IU/L. Detection in body fluids<unk>  may be quantified in blood, plasma, or urine as a diagnostic tool in clinical poisoning situations or to aid in the medicolegal investigation of suspicious deaths. The concentration in serum after a typical dose of<unk>  usually peaks below 30 mg/l, which equals 200 μmol/L. Levels of 30–300 mg/L (200–2000 μmol/L) are often observed in overdose patients. Postmortem blood levels have ranged from 50 to 400 mg/L in persons dying due to acute overdosage. Automated colorimetric techniques, gas chromatography and liquid chromatography are currently in use for the laboratory analysis of the drug in physiological specimens.
Paracetamol poisoning
Alcoholism
Carbamate poisoning
Viral hepatitis
Salicylate poisoning
Gastroenteritis
Cyanide poisoning
Secondary poisoning