The symptoms of acetaminophen overdose can be divided into four phases:
Phase 1 (0-24 hours): Patients may experience nausea, vomiting, anorexia, malaise, and pallor. Phase 2 (24-72 hours): Although gastrointestinal symptoms may improve, signs of hepatic damage (e.g., right upper quadrant pain, elevated liver enzymes) begin to appear. Phase 3 (72-96 hours): This is the critical period where liver failure, coagulopathy, hypoglycemia, and encephalopathy can develop, potentially leading to hepatic failure. Phase 4 (4 days to 2 weeks): Recovery phase, if the patient survives the acute hepatic failure, liver function generally improves.
