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paracetamol intoxication

Robert B Flint, Paola Mian, Bart van der Nagel, Nuria Slijkhuis, Birgit C P Koch
BACKGROUND: Acetaminophen (APAP, paracetamol) is the most commonly used drug for pain and fever in both the United States and Europe and is considered safe when used at registered dosages. Nevertheless, differences between specific populations lead to remarkable changes in exposure to potentially toxic metabolites. Furthermore, extended knowledge is required on metabolite formation after intoxication, to optimize antidote treatment. Therefore, the authors aimed to develop and validate a quick and easy analytical method for simultaneous quantification of APAP, APAP-glucuronide, APAP-sulfate, APAP-cysteine, APAP-glutathione, APAP-mercapturate, and protein-derived APAP-cysteine in human plasma by ultraperformance liquid chromatography-electrospray ionization-tandem mass spectrometry...
April 2017: Therapeutic Drug Monitoring
Eman A Abd El-Ghffar, Heba A S El-Nashar, Omayma A Eldahshan, Abdel Nasser B Singab
CONTEXT: In Egypt, the burden of liver diseases is exceptionally high. OBJECTIVE: To investigate the components of the n-hexane extract of Acrocarpus fraxinifolius Arn. (Leguminosae) and its hepatoprotective activity against paracetamol (APAP)-induced hepatotoxicity in rats. MATERIAL AND METHODS: TRACE GC ultra gas chromatogaphic spectrometry was used for extract analysis. Thirty albino rats were divided into six groups (five rats in each)...
December 2017: Pharmaceutical Biology
Maciej Krasnodębski, Michał Grąt, Wacław Hołówko, Łukasz Masior, Karolina M Wronka, Karolina Grąt, Jan Stypułkowski, Waldemar Patkowski, Marek Krawczyk
INTRODUCTION: Amanita phalloides and paracetamol intoxications are responsible for the majority of acute liver failures. AIM: To assess survival outcomes and to analyse risk factors affecting survival in the studied group. MATERIAL AND METHODS: Of 1369 liver transplantations performed in the Department of General, Transplant, and Liver Surgery, Medical University of Warsaw before December 2013, 20 (1.46%) patients with Amanita phalloides (n = 13, 0...
2016: Przegla̜d Gastroenterologiczny
Heiko Mühl
Acetaminophen (APAP, N-acetyl-p-aminophenol, or paracetamol) overdosing is a prevalent cause of acute liver injury. While clinical disease is initiated by overt parenchymal hepatocyte necrosis in response to the analgetic, course of intoxication is substantially influenced by associated activation of innate immunity. This process is supposed to be set in motion by release of danger-associated molecular patterns (DAMPs) from dying hepatocytes and is accompanied by an inflammatory cytokine response. Murine models of APAP-induced liver injury emphasize the complex role that DAMPs and cytokines play in promoting either hepatic pathogenesis or resolution and recovery from intoxication...
2016: Frontiers in Immunology
Ines Elbini Dhouib, Manel Jallouli, Alya Annabi, Najoua Gharbi, Saloua Elfazaa, Mohamed Montassar Lasram
N-acetylcysteine (NAC), a cysteine pro-drug and glutathione precursor has been used in therapeutic practices for several decades, as a mucolytic agent and for the treatment of numerous disorders including paracetamol intoxication. There is a growing interest concerning the beneficial effects of NAC against the early stages of toxicity-induced by pesticides. Nevertheless, the mechanisms underlying the therapeutic and clinical applications of NAC are not fully understood. In this review we aimed to focus on the protective effects of NAC against oxidative stress caused by pesticide in many organs...
April 15, 2016: Life Sciences
Menen E Mund, David Quarcoo, Christoph Gyo, Dörthe Brüggmann, David A Groneberg
Paracetamol is used widely in pediatrics because it has a high drug safety when used in therapeutic dosages. In case of overdose the majority of paracetamol is metabolized to N-acetyl-p-benzoquinone imine (NAPQI), which is responsible for the severe toxic effects. The covalent connection between NAPQI and hepatic proteins leads to hepatocellular damage and possibly to severe liver failure. The antidote for paracetamol is N-acetylcysteine (NAC). It is a precursor of glutathione and aids to fill glutathione stores...
2015: Journal of Occupational Medicine and Toxicology
Ercan Gündüz, Recep Dursun, Yılmaz Zengin, Mustafa İçer, Hasan Mansur Durgun, Ayşe Kanıcı, İbrahim Kaplan, Ulaş Alabalık, Hüseyin Gürbüz, Cahfer Güloğlu
The aim of the present study was to investigate the hepatoprotective and antioxidant effects of Lycium barbarum (LB) extract against paracetamol-induced acute oxidative stress and hepatotoxicity in rats. The subjects were divided into 6 groups of 8 rats each. The rats in the LB group were administered a dose of 100 mg/kg LB extract dissolved in saline via the intraperitoneal route for 7 days. Subsequently, after last dose of LB, PCT was given in a single dose of 1 g/kg diluted in saline via the oral route. Twenty-four hours later, blood samples were drawn from all of the subjects for serum Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Total antioxidant status (TAS) and Total oxidant status (TOS) tests, and liver tissue samples were obtained for histopathological evaluation...
2015: International Journal of Clinical and Experimental Medicine
Y I Mahmoud, A A Mahmoud, G Nassar
Acetaminophen (paracetamol) is a well-tolerated analgesic and antipyretic drug when used at therapeutic doses. Overdoses, however, cause oxidative stress, which leads to acute liver failure. Alpha lipoic acid is an antioxidant that has proven effective for ameliorating many pathological conditions caused by oxidative stress. We evaluated the effect of alpha lipoic acid on the histological and histochemical alterations of liver caused by an acute overdose of acetaminophen in rats. Livers of acetaminophen-intoxicated rats were congested and showed centrilobular necrosis, vacuolar degeneration and inflammatory cell infiltration...
2015: Biotechnic & Histochemistry: Official Publication of the Biological Stain Commission
Yuan Wang, Dan Li, Ni Cheng, Hui Gao, Xiaofeng Xue, Wei Cao, Liping Sun
Fourteen vitex honeys from China were investigated to evaluate its antioxidant and hepatoprotective activity against paracetamol-induced liver damage. All honey samples exhibited high total phenolic content (344-520 mg GAE per kg), total flavonoid content (19-31 mg Rutin per kg), and strong antioxidant activity in DPPH radical scavenging, ferric reducing antioxidant power and Ferrous ion-chelating ability. Nine phenolic acids were detected in vitex honey samples, in which caffeic acid was the main compound...
July 2015: Food & Function
Mohamed Montassar Lasram, Ines Bini Dhouib, Alya Annabi, Saloua El Fazaa, Najoua Gharbi
OBJECTIVE: N-acetylcysteine (NAC), a cysteine pro-drug and glutathione precursor has been used in therapeutic practices for several decades, as a mucolytic agent and for the treatment of numerous disorders including paracetamol intoxication. There is a growing interest concerning the beneficial effects of NAC against the early stages of type-2 diabetes development. Nevertheless, the mechanisms underlying the therapeutic and clinical applications of NAC are not fully understood. In this review we aimed to focus on the protective effects of NAC against insulin resistance...
November 2015: Clinical Biochemistry
Katarzyna Kominek, Agnieszka Pawłowska-Kamieniak, Agnieszka Mroczkowska-Juchkiewicz, Paulina Krawiec, Elżbieta Pac-Kożuchowska
INTRODUCTION: Paracetamol is one of the most commonly used analgesics and antipyretics available without limits as preparations of the OTC group (over the counter drugs). Overdose and poisoning with this drug always brings about the risk of acute hepatic failure. The objective of the study was a retrospective evaluation of patients hospitalized in the Paediatric Clinic during the period 2004-2012 due to poisoning with paracetamol. MATERIAL AND METHODS: The analysis covered 44 patients hospitalized in the Paediatric Clinic during 2004-2012 due to poisoning with paracetamol...
2015: Postȩpy Higieny i Medycyny Doświadczalnej
Patrick Scheiermann, Malte Bachmann, Lorena Härdle, Thomas Pleli, Albrecht Piiper, Bernhard Zwissler, Josef Pfeilschifter, Heiko Mühl
Overdosing of the analgesic acetaminophen (APAP, paracetamol) is a major cause of acute liver injury. Whereas toxicity is initiated by hepatocyte necrosis, course of disease is regulated by mechanisms of innate immunity having the potential to serve in complex manner pathogenic or pro-regenerative functions. Interleukin (IL)-36γ has been identified as novel IL-1-like cytokine produced by and targeting epithelial (-like) tissues. Herein, we investigated IL-36γ in acute liver disease focusing on murine APAP-induced hepatotoxicity...
February 17, 2015: Scientific Reports
Ahmet Sebe, Nezihat Rana Dişel, Ayça Açıkalın Akpınar, Emre Karakoç
OBJECTIVES: The objective of this study was to assess the efficacy of lipid emulsion as antidotal therapy in severe calcium channel blocker (CCB) and β-blocker (BB) intoxications. PATIENTS AND METHODS: This is a retrospective study in which we have summarized data of patients who were admitted to a university-based emergency department in a period of 3 years and were given intravenous lipid emulsion (ILE) to manage cardiogenic shock due to CCB and BB overdose. RESULTS: We identified 15 patients who received ILE therapy for CCB and BB toxicity...
March 2015: Postgraduate Medicine
Marcus Vinicius Henriques Brito, Felipe D'Almeida Costa, Diego Matos de Vasconcelos, Lauro Augusto Veloso Costa, Edson Yuzur Yasojima, Renan Kleber Costa Teixeira, Vitor Nagai Yamaki
PURPOSE: To investigate the copaiba oil on the hepatic damage induced by acetaminophen, comparing against corn oil. METHODS: Fifty four rats were distributed into nine study groups (N=6): control group, that didn't receive the acetaminophen; Acetaminophen Group, that only received the acetaminophen; Prophylactic Copaiba Group 1, that received copaiba oil two hours before the acetaminophen; Prophylactic Copaiba Group 7, that received copaiba oil seven days, once by day, before the acetaminophen; Therapy Copaiba Group, that received the copaiba oil two hours after the acetaminophen, the corn's groups were similar than copaiba oil groups; and N-Acetyl-Cysteine Group, that received the N-Acetyl-Cysteine two hours after the acetaminophen...
December 2014: Acta Cirúrgica Brasileira
F Saliba, D Samuel
Since the early 1960s, several authors reported on the use of some experimental artificial liver devices in order to support patients with either acute liver failure (ALF) or end-stage chronic liver disease. In the 1980s, liver transplantation became an established real treatment replacing the whole liver with a major survival benefit. In the 1990s, the concept of albumin dialysis appeared as a new revolution in the concept of dialysis with the great capacity of removal of toxins, drugs and molecules strongly bound to albumin...
February 2015: Minerva Medica
Bandari Uma Mahesh, Shweta Shrivastava, Rajeswara Rao Pragada, V G M Naidu, Ramakrishna Sistla
Paracetamol (PCM) hepatotoxicity is related to reactive oxygen species (ROS) formation and excessive oxidative stress; natural antioxidant compounds have been tested as an alternative therapy. This study evaluated the hepatoprotective activity of an alcoholic extract of Boswellia ovalifoliolata (BO) bark against PCM-induced hepatotoxicity. BO extract also demonstrated antioxidant activity in vitro, as well as scavenger activity against 2, 2-diphenyl-1-picrylhydrazyl. Administration of PCM caused a significant increase in the release of transaminases, alkaline phosphatase, and lactate dehydrogenase in serum...
September 2014: Chinese Journal of Natural Medicines
Patrick Emeka Aba, Ikenna Emmanuel Ozioko, Ngozi Dorathy Udem, Samuel Chukwuneke Udem
BACKGROUND: This study investigated the acute toxicity effect of aqueous stem bark extract of Lophira lanceolata and the activities of liver enzymes and other markers of organ damage in rats pretreated with aqueous stem bark extract of L. lanceolata extract and subsequently intoxicated with paracetamol (PCM). METHODS: A total of 30 rats were used to determine the acute toxicity of aqueous extract of L. lanceolata stem. They were divided into six groups consisting of five rats each...
December 2014: Journal of Complementary & Integrative Medicine
A Koppen, A van Riel, I de Vries, J Meulenbelt
Treatment of paracetamol intoxication consists of administration of N-acetylcysteine, preferably shortly after paracetamol ingestion. In most countries, the decision to treat patients with N-acetylcysteine depends on the paracetamol plasma concentration. In the literature, different arguments are given regarding when to treat paracetamol overdose. Some authors do not recommend treatment with N-acetylcysteine at low paracetamol plasma concentrations since unnecessary adverse effects may be induced. But no treatment with N-acetylcysteine at higher paracetamol plasma concentrations may lead to unnecessary severe morbidity and mortality...
June 2014: Netherlands Journal of Medicine
Cüneyt Kayaalp, Veysel Ersan, Sezai Yılmaz
BACKGROUND/AIMS: To present the causes of acute liver failure in Turkey. MATERIALS AND METHODS: [corrected] International and national medical research databanks were searched for publications related to acute liver failure and originating from Turkey. Patients in the databank of acute liver failure of our center were also added to this literature search. Patients were evaluated for age, gender, etiology, treatment modality, and outcomes. RESULTS: A total of 308 patients were analyzed...
February 2014: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
R Vargha, G Mostafa, G Burda, M Hermon, G Trittenwein, J Golej
No abstract text is available yet for this article.
May 21, 2014: Klinische Pädiatrie
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