Following an acute overdosage, toxicity may result from
hydrocodone or acetaminophen. SIGNS AND SYMPTOMS Toxicity from
hydrocodone poisoning includes the opioid triad of loss of
consciousness, pinpoint pupils, and respiratory depression
(Cheyne-Stokes respiration, cyanosis, decrease in respiratory
rate and/or tidal volume). Convulsions may occur. The toxic dose
of acetaminophen for adults is 10 grams. In adults, hepatic
toxicity has rarely been reported with acute overdoses of less
than 10 grams, or fatalities with less than 15 grams. Early
symptoms following a potentially hepatotoxic overdose of
acetaminophen may include diaphoresis, general malaise, nausea,
and vomiting. Clinical and laboratory evidence of hepatic
toxicity may not be apparent until 48 to 72 hours post-
ingestion. Other signs and symptoms of overdose of this product
include bradycardia, cold and clammy skin, extreme somnolence
progressing to stupor or coma, hypoglycemic coma, hypotension,
renal tubular necrosis, skeletal muscle flaccidity, th