Intentional Death Caused by the Overdose of Nonprescription Drugs: An Autopsy Case of Acetaminophen Poisoning

Korean J Leg Med 2020;44:134-139

Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Korea,

Department of Pathology, Seoul National University College of Medicine, Seoul, Korea,

Department of Forensic Medicine, Seoul National University College of Medicine, Seoul, Korea,

Institute of Forensic and Anthropological Science, Seoul National University College of Medicine, Seoul, Korea

E-mail: tttrack@naver.com

Acetaminophen or paracetamol (N-acetyl-para-aminophenol [APAP]) is a safe and effective antipyretic and analgesic drug and is a representative nonprescription drug. However, APAP is one of the most common nonprescription drugs used for intentional overdose or suicide, thereby resulting in hundreds of deaths annually in the United States. Moreover, the misuse of nonprescription drugs is a cause of increasing concern in Korea with the revision of the Pharmaceutical Affairs Law in 2012. Generally, the mortality rate of APAP overdose is extremely low due to the well-established treatment guidelines and availability of antidotes. However, it should not be overlooked because of the high number of either accidental or intentional APAP overdose cases recorded every day. To achieve a good prognosis, individuals with APAP overdose must be immediately identified and brought to the hospital. Herein, we report an autopsy case of an individual with APAP overdose who died due to acute liver injury.

Key Words: Nonprescription drugs; Acetaminophen; Drug-induced acute liver injury; Suicide; KIDS KAERS database (KIDS-KD)