The Test Sample
What is being tested?
Acetaminophen is one of the most common pain relievers (analgesics) and fever reducers (antipyretics) available over the counter. It is generally regarded as safe. However, it is also the most common cause of toxic hepatitis in North America and Europe and one of the most common poisonings from either accidental or intentional overdose.
Acetaminophen is primarily processed (metabolized) by the liver. In therapeutic doses, the liver is able to process the drug safely without any harmful effects. When a large dose is ingested and/or when doses exceed the recommended amount over a period of time, however, the liver may be overwhelmed and may not process the excessive amount of drug. As a result, a toxic intermediate form of the drug can build up in the liver and cause damage to liver cells. If treatment is not given soon enough, liver failure may result.
For this reason, acetaminophen can be harmful or even fatal if not taken correctly and children in particular are at risk if caregivers do not follow dosing instructions carefully. Often, people do not realize that acetaminophen is one of the ingredients in many combination medications such as cold and flu preparations. If two or more of these medications are taken together, levels of acetaminophen may exceed safe limits.
Acetaminophen preparations come in varying strengths and several different forms, including tablets, capsules and liquid.
- For adults, the typical maximum daily limit for acetaminophen is 4000 milligrams (mg). Consuming more than 4000 mg in a 24-hour period is considered an overdose, while ingesting more than 7000 mg can lead to a severe overdose reaction unless treated promptly.
- For children, the amount that is considered an overdose depends on their age and body weight. (For more on this, see the MayoClinic webpage Acetaminophen and children: Why dose matters.)
If it is known or suspected that someone has ingested an overdose of acetaminophen, it is recommended to take the person to the emergency room. If a health practitioner determines that an overdose has occurred, treatment may include an antidote, N-acetylcysteine (NAC), which can help minimize damage to the liver, especially if given within 8 to 12 hours after an overdose. Though NAC is ideally administered within this timeframe, people who seek treatment more than 12 hours after ingestion may still be given the antidote.
Until recently, NAC for people who visit healthcare providers later than 24 hours after acetaminophen ingestion was not the standard of care for acetaminophen overdose management in the United States. However, study data from England suggest that NAC may be beneficial for acetaminophen-induced liver failure more than 24 hours after ingestion.
How is the sample collected for testing?
A blood sample is obtained by inserting a needle into a vein in the arm.
NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.
Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.
Is any test preparation needed to ensure the quality of the sample?
No test preparation is needed.