Journal Article10.1081/CLT-120002882
Acetaminophen hepatotoxicity: The first 35 years
TL;DR: The lack of enhancement of acetaminophen toxicity by phenytoin and in fact, the potential for reduction of toxicity with that agent is a good example of the evolution of knowledge.
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Abstract: The acetaminophen nomogram including its uses and limitations is discussed as well as the development of the N-acetylcysteine protocol. While it has taken many years to elucidate the genetic variability and true multiplicity of the cytochrome P450 “mixed function oxidase system” many publications early on looked at the enzyme system as a single entity. Numerous articles indicated that barbiturates, anticonvulsants, and others could induce “P450” and add to the toxicity of acetaminophen. It rapidly became apparent that just because “P450” was induced when measured as a whole, not all other substrates would have changed metabolic activity. The role of diet and ethanol induction and inhibition on CYP2E1, the enzyme of greatest interest for acetaminophen is multifaceted. The lack of enhancement of acetaminophen toxicity by phenytoin and in fact, the potential for reduction of toxicity with that agent is a good example of the evolution of our knowledge. Further complicating our understanding is the introductio...
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Citations
Increased acetaminophen related calls to Finnish PIC better reflect acetaminophen sales than serious poisonings
TL;DR: Despite an evident trend between sales and fatalities, the correlation with fatality remains weak due to the small number of fatalities and changes in the chosen indicators for serious poisonings show only a weak association.
Pharmacokinetics, clinical efficacy and safety of acetaminophen (paracetamol) in adult horses with naturally occurring chronic lameness.
M. A. Mercer,Jennifer Davis,Harold C. McKenzie,Christopher R. Byron,Maureen E Kelleher,Thomas E. Cecere,Katie Wilson,Roberto McAlister Council-Troche,Stephen R. Werre +8 more
TL;DR: In this paper , the authors evaluated the pharmacokinetics, safety and efficacy of chronic dosing of acetaminophen in horses with naturally occurring chronic lameness, and found that 30 mg/kg of Acetaminophen produced a transient improvement in subjective lameness and BMIS evaluation.
Quantification of paracetamol and 5-oxoproline in serum by capillary electrophoresis: Implication for clinical toxicology.
Tomáš Hložek,Tomáš Křížek,Petr Tůma,Miroslava Bursová,Pavel Coufal,Radomír Čabala,Radomír Čabala +6 more
TL;DR: A simple, cost effective, and fast capillary electrophoresis method with diode array detection (DAD) for simultaneous measurement of both paracetamol (acetaminophen) and 5‐oxoproline in serum was developed and validated and is highly suitable for clinical toxicology laboratory diagnostic, allowing rapid quantification of acidosis inducing organic acids present in cases of par acetamol overdose.
Paracetamol toxicity: what would be the implications of a change in Australian treatment guidelines?
TL;DR: The present study aims to study the implications for resource utilisation if Australia adopted recent revised UK treatment guidelines for paracetamol poisoning.
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