The value of plasma acetaminophen half-life in antidote-treated acetaminophen overdosage
| Autor: | Stig Bondesen, Peter Ott, Frank V. Schiødt, Erik Christensen |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Adult
Male Adolescent medicine.medical_treatment Antidotes digestive system Statistics Nonparametric law.invention Acetylcysteine law Blood plasma medicine Humans Pharmacology (medical) Prospective Studies Antidote Acetaminophen Aged Pharmacology Coma Analysis of Variance Chemotherapy Clinical pharmacology business.industry digestive oral and skin physiology Analgesics Non-Narcotic Liver Failure Acute Middle Aged digestive system diseases stomatognathic diseases Hepatic Encephalopathy Anesthesia Toxicity Female Drug Overdose medicine.symptom business Half-Life medicine.drug |
| Zdroj: | Clinical Pharmacology & Therapeutics. 71:221-225 |
| ISSN: | 0009-9236 |
| DOI: | 10.1067/mcp.2002.121857 |
| Popis: | A plasma acetaminophen (INN, paracetamol) half-life of more than 4 hours has been correlated with hepatotoxicity in acetaminophen overdosing not treated with an antidote. Acetaminophen half-life has not been studied in patients receiving the antidote N -acetylcysteine.Prospectively, 112 patients with acetaminophen overdosage all treated with intravenous N -acetylcysteine were studied. A minimum of 2 plasma acetaminophen values20 micromol/L were available for calculation of acetaminophen half-life, assuming first-order kinetics.Overall, the median acetaminophen half-life was 5.4 hours (range, 0.8-119.7 hours). Forty-eight patients with no or little hepatotoxicity (ALT1000 U/L), 43 patients with hepatotoxicity without encephalopathy, and 21 patients with hepatotoxicity and encephalopathy had acetaminophen half-lives of 3.0 hours (range, 0.8-10.0 hours), 6.4 hours (range, 1.3-19.0 hours), and 18.4 hours (range, 4.6-119.7 hours), respectively (P.001). An acetaminophen half-life4 hours was observed in 71 patients, and 56 of those (79%) had hepatotoxicity (ALT1000 U/L or coma). Thirty-three of 41 patients (81%) with an acetaminophen half-life4 hours had no hepatotoxicity. A receiver operating characteristic curve analysis showed that an acetaminophen half-life of 5.5 hours provided better discrimination; hepatotoxicity was therefore present in 49 of 54 patients with an acetaminophen half-life5.5 hours (positive predictive value, 91%) and in 15 of 58 patients with a half-life below this limit (negative predictive value, 74%) despite treatment with N -acetylcysteine.Acetaminophen half-life correlates well with the degree of liver damage in patients treated with the antidote N-acetylcysteine. Longer half-lives reflect a greater toxic effect on the liver. |
| Databáze: | OpenAIRE |
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