Prakt. lékáren. 2015; 11(3): 90-92

Paracetamol (acetaminophen) - new data, risk of overdose, intoxication and coping with it

MUDr.Mgr.Jiří Hodis, Ph.D.
Farmakologický ústav 1. LF UK, Univerzita Karlova, Praha

Acetaminophen (paracetamol) is well known and one of the most used analgesics and antipyretic since 1893 with very good toxicity

profile. Nevertheless the toxicity of acetaminophen (in Europe called paracetamol) is not negligible. The review assumes the new facts

about mechanism of action, toxicity, toxicity risk stratification and toxicity therapy protocols with prevention.

Keywords: paracetamol, acetaminophen, toxicity, mechanism of action

Published: May 25, 2015  Show citation

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Hodis J. Paracetamol (acetaminophen) - new data, risk of overdose, intoxication and coping with it. Praktické lékárenství. 2015;11(3):90-92.
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    References

    1. Graham GG, et al. The modern pharmacology of paracetamol: therapeutic actions, mechanism of action, metabolism, toxicity and recent pharmacological findings. Inflammopharmacol 2013; 21: 201-232. Go to original source... Go to PubMed...
    2. Miller RP, et al. Acetaminophen elimination kinetics in neonates, children, and adults. Clin Pharmacol Ther 1976; 19(3): 284-294. Go to original source... Go to PubMed...
    3. Lauterburg BH, et al. The effects of age and glutathione depletion on hepatic glutathione turnover in vivo determined by acetaminophen probe analysis. J Pharmacol Exp Ther 1980; 213(1): 54-58. Go to PubMed...
    4. Andreasen PB, Hutters L. Paracetamol (acetaminophen) clearance in patients with cirrhosis of the liver. Acta Med Scand Suppl 1979; 624: 99-105. Go to original source... Go to PubMed...
    5. Arnman R, Olsson R. Elimination of paracetamol in chronic liver disease. Acta Hepatogastroenterol (Stuttg) 1978; 25(4): 283-286. Go to PubMed...
    6. Forrest JA, et al. Paracetamol metabolism in chronic liver disease. Eur J Clin Pharmacol 1979; 15(6): 427-431. Go to original source... Go to PubMed...
    7. Forrest JA, et al. Antipyrine, paracetamol, and lignocaine elimination in chronic liver disease. Br Med J 1977; 1(6073): 1384-1387. Go to original source... Go to PubMed...
    8. Bosilkovska M, et al. Analgesics in Patients with Hepatic Impairment-Pharmacology and Clinical Implications. Drugs 2012; 72(12): 1645-1669. Go to original source... Go to PubMed...
    9. Ševela K, et al. Akutní intoxikace a léková poškození v intenzivní péči. Praha: Grada 2011: 328 s.
    10. Bennett WM, et al. Drug Prescribing in Renal Failure, 3rd Edition. Philadelphia: American College of Physicians, 1994.
    11. Graham GG, et al. Current concepts of the actions of paracetamol (acetaminophen) and NSAIDs Inflammopharmacology 1999; 7(3): 255-263. Go to original source... Go to PubMed...
    12. Aronoff DM, Oates JA, Boutaud O. New insights into the mechanism of action of acetaminophen: Its clinical pharmacologic characteristics reflect its inhibition of the two prostaglandin H2 synthases. Clinical Pharmacology & Therapeutics 2006; 79(1): 9-19. Go to original source... Go to PubMed...
    13. Simmons DL, et al. Induction of an acetaminophensensitive cyclooxygenase with reduced sensitivity to non-steroid antiinflammatory drugs, Proc. Natl. Acad. Sci. USA 1999; 96: 3275-3280. Go to original source... Go to PubMed...
    14. Willoughby DA, et al. COX-1, COX-2, and COX-3 and the future treatment of chronic inflammatory disease, Lancet 2000; 355: 646-648. Go to original source... Go to PubMed...
    15. Warner TD and Mitchell JA Cyclooxygenases: new forms, new inhibitors, and lessons from the clinic. FASEB J 2004; 18: 790-804. Go to original source... Go to PubMed...
    16. Chandrasekharan NV, et al. COX-3, a cyclooxygenase-1 variant inhibited by acetaminophen and other analgesic/antipyretic drugs: cloning, structure and expression. Proc Nat Acad Sci.2002; 99: 13926-13931. Go to original source... Go to PubMed...
    17. Jaeschke H, et al. Oxidant stress, mitochondria, and cell death mechanisms in drug-induced liver injury: Lessons learned from acetaminophen hepatotoxicity. Drug Metabolism Reviews 2012; 44(1): 88-106. Go to original source... Go to PubMed...
    18. Ray SD, et al. Protection of acetaminophen-induced hepatocellular apoptosis and necrosis by cholesteryl hemisuccinate pretreatment. J. Pharmacol. Exp. Ther. 1996; 279: 1470-1483.
    19. Gujral JS et al. Mode of cell death after acetaminophen overdose in mice: Apoptosis or oncotic necrosis? Toxicol. Sci. 2002; 67: 322-328. Go to original source... Go to PubMed...
    20. Cheung V. et al. Medication Overuse Headache. Curr Neurol Neurosci Rep 2015; 15: 509. Go to original source... Go to PubMed...
    21. Michaut A, et al. Acetaminophen-induced liver injury in obesity and nonalcoholic fatty liver disease. Liver Int 2014; 34: e171-e179. Go to original source... Go to PubMed...
    22. Myers RP, et al. Hospitalizations for acetaminophen overdose: a Canadian population-based study from 1995 to 2004. BMC Public Health 2007; 7: 143. Go to original source... Go to PubMed...
    23. Rumack BH, et al. Acetaminophen overdose. 662 cases with evaluation of oral acetylcysteine treatment. Arch Intern Med 1981; 141: 380-385 Go to original source... Go to PubMed...
    24. Lancaster EM, et al. Acetaminophen hepatotoxicity: an updated review. Arch Toxicol 2015; 89: 193-199. Go to original source... Go to PubMed...
    25. Bjornsson ES. Drug-induced liver injury: an overview over the most critical compounds. Arch Toxicol. 2015; 89(3): 327-334. Go to original source... Go to PubMed...
    26. Prescott LF, et al. Successful treatment of severe paracetamol overdosage with cysteamine. Lancet 1974; 1: 588-592. Go to original source... Go to PubMed...
    27. Yarema MC, et al. Comparison of the 20-Hour Intravenous and 72-Hour Oral Acetylcysteine Protocols for the Treatment of Acute Acetaminophen Poisoning. Ann Emerg Med. 2009; 54: 606-614. Go to original source... Go to PubMed...
    28. Yip L, et al. Intravenous administration of oral N-acetylcysteine. Crit Care Med 1998; 26: 40-43. Go to original source... Go to PubMed...
    29. Gosselin S, et al. Extracorporal treatment for acetaminophen poisoning: recommendation form the EXTRIP workgroup. Clin Toxicol 2014; (8): 856-867. Go to original source... Go to PubMed...
    30. Michna E, et al. Removal of opioid/acetaminophen combination prescription pain medications: assessing the evidence for hepatotoxicity and consequences of removal of these medications. Pain Med 2010; 11: 369-378. Go to original source... Go to PubMed...
    31. Blieden M, et al. A perspective on the epidemiology of acetaminophen exposure and toxicity in the United States. Expert Rev Clin Pharmacol 2014; 7: 341-348. Go to original source... Go to PubMed...
    32. Mehrpour O, Ballali-Mood M. Why Not Formulate an Acetaminophen Tablet Containing N-Acetylcysteine to Prevent Poisoning? J. Med. Toxicol. 2011; 7: 95-96. Go to original source... Go to PubMed...
    33. Olson H, et al. Concordance of the toxicity of pharmaceuticals in humans and in animals. Regul Toxicol Pharmacol 2000; 32: 56-67. Go to original source... Go to PubMed...
    34. Bessems JGM and Vermeulen NP. Paracetamol (Acetaminophen) induced toxicity: Molecular end biochemical mechanisms, Analogues and Protective Approaches. Clinical Review in Toxicology 2001; 31(1): 55-138. Go to original source... Go to PubMed...

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