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Some case reports have described loss of pregnancy following high-dose ingestion of APAP (up to 29 g) within a day of hospital presentation and others have described successful fetus delivery following ingestion of 15 g and aggressive NAC rescue therapy.48 Should either APAP therapeutic misadventure or intentional overdose be suspected, aggressive antidote intervention with NAC should be of the utmost priority since the benefit of therapy may outweigh the risks of untreated APAP toxicity.1,47 Although more studies retrospectively investigating pregnant women would be helpful, for now the judicious use of APAP should be advised as APAP remains the most common drug overdose in pregnancy.46 Clinical manifestations Identification of APAP overdose is critical, as significant morbidity and mortality may be prevented with early therapy

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If dry mouth worsens on the same days as fatigue or dizziness , dehydration is likely the primary driver and aggressive hydration is your highest-priority intervention

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