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Paracetamol liver disease — GPhC CRA MCQ

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ModerateRenal and Hepatic ImpairmentParacetamol liver diseaseGPhC CRA

A patient with chronic alcohol-related liver disease asks to buy paracetamol for dental pain. He says he has been taking extra tablets because the pain wakes him at night. He has no current prescription analgesia. What is the most appropriate alternative?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Check the total daily dose and refer for clinical assessment

Paracetamol overdose can cause serious hepatotoxicity, and patients may unintentionally exceed the maximum daily dose through combination products. Chronic liver disease and alcohol use increase the need for careful assessment and safety-netting. Dental pain may require dental or medical assessment rather than escalating analgesics. The pharmacist should clarify intake and refer urgently if overdose is possible.

Reference: BNF; NICE CKS