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Acetaminophen poisoning

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https://www.readbyqxmd.com/read/29700994/improving-interpretation-of-new-and-old-serum-biomarkers-of-drug-induced-liver-injury-through-mechanistic-modeling
#1
Paul B Watkins
The study by Mason et al. in this issue used mechanistic modeling and simulation to address how both the dose of acetaminophen consumed and the time since ingestion can be estimated from biomarkers measured in a single serum sample in mice. Translation into the clinic would potentially be an advance in the treatment of acetaminophen poisoning. Importantly, this approach could transform the evaluation of liver safety in clinical trials of new drug candidates.
April 26, 2018: CPT: Pharmacometrics & Systems Pharmacology
https://www.readbyqxmd.com/read/29680280/pediatric-oral-formulation-of-dendrimer-n-acetyl-l-cysteine-conjugates-for-the-treatment-of-neuroinflammation
#2
Venkata K Yellepeddi, Raziye Mohammadpour, Siva P Kambhampati, Casey Sayre, Manoj K Mishra, Rangaramanujam M Kannan, Hamidreza Ghandehari
N-acetyl-L-cysteine (NAC) commonly used as an antidote in acetaminophen poisoning has shown promise in the treatment of neurological disorders such as cerebral palsy (CP). However, NAC suffers from drawbacks such as poor oral bioavailability and suboptimal blood-brain-barrier (BBB) permeability limiting its clinical success. It was previously demonstrated that intravenous administration of dendrimer-NAC (D-NAC) conjugates have shown significant promise in the targeted treatment of neuroinflammation, in multiple preclinical models...
April 19, 2018: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/29628190/prognostic-utility-of-initial-lactate-in-patients-with-acute-drug-overdose-a-validation-cohort
#3
Randy Cheung, Robert S Hoffman, David Vlahov, Alex F Manini
STUDY OBJECTIVE: Previous studies have suggested that the initial emergency department (ED) lactate concentration may be an important prognostic indicator for inhospital mortality from acute drug poisoning. We conduct this cohort study to formally validate the prognostic utility of the initial lactate concentration in a larger, distinct patient population with acute drug overdose. METHODS: This observational, prospective, cohort study was conducted during 5 years at 2 urban teaching hospitals...
April 6, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29622340/frequency-of-poison-center-exposures-for-pediatric-accidental-unsupervised-ingestions-of-acetaminophen-after-the-introduction-of-flow-restrictors
#4
Eric P Brass, Kate M Reynolds, Randy I Burnham, Jody L Green
OBJECTIVE: To assess the temporal association of flow restrictor introduction and the rate of accidental unsupervised ingestions (AUIs) of liquid acetaminophen products. STUDY DESIGN: The National Poison Data System was used to identify AUIs of single ingredient acetaminophen in patients aged <12 years reported between 2007 and 2015. Six regional poison centers obtained additional information using a structured telephone survey. RESULTS: Pediatric AUIs involving acetaminophen averaged 30 000 exposures per year between 2007 and 2012...
April 2, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29579890/molecular-adsorbent-recirculating-system-treatment-can-reduce-blood-levels-of-n-acetylcysteine-in-patients-with-acetaminophen-overdose-case-reports
#5
V Lopez-Lopez, J Ros, D Ferreras, J Sanmartin, M Martinez, J A Pons Miñano, F Sanchez-Bueno, R Robles-Campos, P Ramirez-Romero, P Parrilla-Paricio
BACKGROUND: Acetaminophen poisoning continues to be a major cause of liver failure that can lead to liver transplantation. N-acetylcysteine (NAC) is the cornerstone of treatment. Some authors use a Molecular Adsorbent Recirculating System (MARS) system in acetaminophen poisoning. It is reported that the MARS system eliminates acetaminophen more efficiently than conventional dialysis. It is theoretically possible that treatment with MARS administered after NAC will increase the effectiveness of treatment...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29532341/correction-to-anaphylactoid-reactions-to-intravenous-n-acetylcysteine-during-treatment-for-acetaminophen-poisoning
#6
Mark Yarema, Puja Chopra, Marco L A Sivilotti, David Johnson, Alberto Nettel-Aguirre, Benoit Bailey, Charlemaigne Victorino, Sophie Gosselin, Roy Purssell, Margaret Thompson, Daniel Spyker, Barry Rumack
The original article has been corrected. Table 4 in PDF version of this article has been corrected since the original publication of the article because the first column of numbers (under the heading "Female") in the original PDF version was typeset poorly.
March 12, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29522886/medication-errors-with-pediatric-liquid-acetaminophen-after-standardization-of-concentration-and-packaging-improvements
#7
Eric P Brass, Kate M Reynolds, Randy I Burnham, Jody L Green
OBJECTIVE: To assess the impact of the 2011 changes in pediatric single-ingredient liquid acetaminophen product packaging and standardization of the acetaminophen concentration (160 mg/5 mL) on poison control center exposures due to medication errors. METHODS: National Poison Data System (NPDS) data from January 1, 2007, through December 31, 2016, were used to identify medication error exposures involving single-ingredient liquid acetaminophen in children younger than 12 years of age...
March 6, 2018: Academic Pediatrics
https://www.readbyqxmd.com/read/29473717/interventions-for-paracetamol-acetaminophen-overdose
#8
REVIEW
Angela L Chiew, Christian Gluud, Jesper Brok, Nick A Buckley
BACKGROUND: Paracetamol (acetaminophen) is the most widely used non-prescription analgesic in the world. Paracetamol is commonly taken in overdose either deliberately or unintentionally. In high-income countries, paracetamol toxicity is a common cause of acute liver injury. There are various interventions to treat paracetamol poisoning, depending on the clinical status of the person. These interventions include inhibiting the absorption of paracetamol from the gastrointestinal tract (decontamination), removal of paracetamol from the vascular system, and antidotes to prevent the formation of, or to detoxify, metabolites...
February 23, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29423816/anaphylactoid-reactions-to-intravenous-n-acetylcysteine-during-treatment-for-acetaminophen-poisoning
#9
Mark Yarema, Puja Chopra, Marco L A Sivilotti, David Johnson, Alberto Nettel-Aguirre, Benoit Bailey, Charlemaigne Victorino, Sophie Gosselin, Roy Purssell, Margaret Thompson, Daniel Spyker, Barry Rumack
BACKGROUND: Anaphylactoid reactions to intravenous (IV) N-acetylcysteine (NAC) are well-recognized adverse events during treatment for acetaminophen (APAP) poisoning. Uncertainty exists regarding their incidence, severity, risk factors, and management. We sought to determine the incidence, risk factors, and treatment of anaphylactoid reactions to IV NAC in a large, national cohort of patients admitted to hospital for acetaminophen overdose. METHODS: This retrospective medical record review included all patients initiated on the 21-h IV NAC protocol for acetaminophen poisoning in 34 Canadian hospitals between February 1980 and November 2005...
February 8, 2018: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/29388410/-high-anion-gap-metabolic-acidosis-pyroglutamic-acidosis-induced-by-chronic-acetaminophen-use
#10
J Tchougang Nono, V Mistretta, I Noirot, J L Canivet, P Damas
Acetaminophen is the most consumable analgesic in the world in the form of medical prescription or self-medication. It is one of the active ingredients most often involved in voluntary poisoning. Lethal dose of acetaminophen classically induces acute hepatic failure on hepatic necrosis. Chronic intake of sub-lethal doses (i.e. near recommended therapeutic doses) of acetaminophen in the presence of certain risk factors may be responsible for another much less recognized pathological manifestation: severe metabolic acidosis with an increased anion gap due to the accumulation of 5-oxoproline or pyroglutamic acid...
January 2018: Revue Médicale de Liège
https://www.readbyqxmd.com/read/29357777/outcomes-and-costs-of-patients-admitted-to-the-intensive-care-unit-due-to-accidental-or-intentional-poisoning
#11
Shannon M Fernando, Peter M Reardon, Ian M Ball, Sasha van Katwyk, Kednapa Thavorn, Peter Tanuseputro, Erin Rosenberg, Kwadwo Kyeremanteng
INTRODUCTION: Acute poisoning represents a major cause of morbidity and mortality, and many of these patients are admitted to the intensive care unit (ICU). However, little is known regarding ICU costs of acute poisoning. METHODS: This was a retrospective matched database analysis of patients admitted to the ICU with acute poisoning from 2011 to 2014. It was performed in 2 ICUs within a single tertiary care hospital system. All patient information, outcomes, and costs were stored in the hospital data warehouse...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29327353/increased-risk-of-congestive-heart-failure-in-patients-with-acetaminophen-poisoning-a-nationwide-cohort-study
#12
Wei-Sheng Chung, Cheng-Li Lin
Acetaminophen poisoning increases cytochrome P450 2E1 expression and reactive oxygen species production, which may lead to maladaptive myocardial remodeling and congestive heart failure (CHF). We conducted a nationwide cohort study to investigate the incidence and risk of CHF in patients with acetaminophen poisoning. We identified a cohort of adult patients with newly diagnosed acetaminophen poisoning in the inpatient claims of the Taiwan National Health Insurance Research Database for the 1998-2011 period...
May 2018: Journal of Applied Toxicology: JAT
https://www.readbyqxmd.com/read/29322813/opioid-drug-poisonings-in-ohio-adolescents-and-young-adults-2002-2014
#13
Sarah Caupp, Janine Steffan, Junxin Shi, Krista K Wheeler, Henry A Spiller, Marcel J Casavant, Henry Xiang
CONTEXT: Opioids represent a drug class that adolescents and young adults intentionally misuse and abuse. When taken on their own or with other substances in this manner, opioids pose an increased risk of overdose and potential death. OBJECTIVE: To determine trends of opioid drug poisonings among adolescents and young adults in Ohio from 2002 to 2014 using Poison Control Center (PCC) data. METHODS: Data were obtained from Ohio PCCs from 2002 to 2014 for opioid drug poisonings amongst 10-29 year olds...
January 11, 2018: Clinical Toxicology
https://www.readbyqxmd.com/read/29322714/novel-regimens-in-the-treatment-of-paracetamol-acetaminophen-poisoning
#14
R Dilip Kumar, Umalakshmi Premnath
No abstract text is available yet for this article.
November 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29310687/long-term-mortality-of-acetaminophen-poisoning-a-nationwide-population-based-cohort-study-with-10-year-follow-up-in-taiwan
#15
Hung-Sheng Huang, Chung-Han Ho, Shih-Feng Weng, Chien-Chin Hsu, Jhi-Joung Wang, Shih-Bin Su, Hung-Jung Lin, Chien-Cheng Huang
BACKGROUND: The long-term mortality of acetaminophen (APAP) poisoning has not yet been well studied; hence, we conducted this study to gain understanding of this issue. METHODS: We conducted a nationwide population-based cohort study by identifying 3235 participants with APAP poisoning and 9705 participants without APAP poisoning in Taiwan between 2003 and 2012 in the Nationwide Poisoning Database and Longitudinal Health Insurance Database 2000. Participants with APAP poisoning and control subjects were compared for the risk of all-cause mortality by follow-up until 2013...
January 8, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29302859/acetaminophen-poisoning-may-increase-coronary-artery-disease-risk-a-nationwide-cohort-study
#16
Yu-Ting Chung, Che-Yi Chou, Wen-Chen Tsai, Wei-Kung Chen, Cheng-Li Lin, Wei-Sheng Chung
The purpose of this nationwide cohort study was to investigate the incidence and risk of coronary artery disease (CAD) in patients with acetaminophen (APAP) poisoning. We identified the patients with APAP poisoning and randomly selected comparison patients according to a 1:4 ratio, matching them by age, sex, and the index year using data from the National Health Insurance Research Database from 2000 to 2010. We traced both cohorts until a diagnosis of CAD, loss to follow-up, or the end of 2011. In total, 2723 patients with APAP poisoning and 10,892 comparison patients have followed...
January 4, 2018: Cardiovascular Toxicology
https://www.readbyqxmd.com/read/29227521/pediatric-poisonings-the-risk-of-over-the-counter-pharmaceuticals
#17
Elizabeth Quaal Hines
Every week in the United States, 56% of children younger than age 18 years and 82% of adults take at least one medication. Nonprescription medications, including acetaminophen and ibuprofen, are among the most commonly used pharmaceuticals across all age groups. Use of nonprescription medications, traditionally available over-the-counter, has become ubiquitous. Unfortunately, with such abundant use there is an associated risk for therapeutic misuse, intentional misuse, and even abuse. [Pediatr Ann. 2017;46(12):e454-e458...
December 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/29227519/pediatric-poisoning-by-ingestion-developmental-overview-and-synopsis-of-national-trends
#18
Vincent R Lee, Michael Connolly, Diane P Calello
The American Association of Poison Control Centers' National Poison Data Surveillance System provides real-time toxico-surveillance and epidemiologic trends, and pediatric ingestions comprise most of those reports. The sequences in social and physical developmental milestones from young childhood to adolescence reveal the vulnerability of these age groups to a wide variety of potential poisonous ingestions. Most pediatric ingestions are exploratory. Some common agents associated with pediatric fatalities include disc batteries, laundry detergent "pods," opioid analgesics, acetaminophen, benzodiazepines, and amphetamines...
December 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/29186557/analgesic-related-medication-errors-reported-to-us-poison-control-centers
#19
Madhulika Eluri, Henry A Spiller, Marcel J Casavant, Thitphalak Chounthirath, Kristen A Conner, Gary A Smith
Objective: This study investigates the characteristics and trends of medication errors involving analgesic medications. Design and Methods: A retrospective analysis was conducted of analgesic-related medication errors reported to the National Poison Data System (NPDS) from 2000 through 2012. Results: From 2000 through 2012, the NPDS received 533,763 reports of analgesic-related medication errors, averaging 41,059 medication errors annually...
November 23, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29068170/antidote-availability-in-saudi-arabia-hospitals-in-the-riyadh-province
#20
Abdullah AlTamimi, Nidal K Malhis, Najla M Khojah, Saleh A Manea, Abdulrahman AlTamimi, Sami Ayed AlShammary
Inadequate antidote stocking is a global problem in hospitals. Insufficient supplies and delays in the administration of antidotes could lead to death and additional potentially negative clinical consequences. Our objective was to determine the availability of antidotes in hospitals listed on the Saudi Ministry of Health website in the Riyadh Province and to evaluate the leading poison in Saudi Arabia. A cross-sectional study was conducted using questionnaires. The questionnaires were distributed to pharmacist directors and emergency room-treating physicians in 17 public hospitals throughout the Riyadh Province...
February 2018: Basic & Clinical Pharmacology & Toxicology
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