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Acetaminophen poisoning

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https://www.readbyqxmd.com/read/27889404/adolescent-suicidal-ingestion-national-trends-over-a-decade
#1
David C Sheridan, Robert G Hendrickson, Amber L Lin, Rongwei Fu, B Zane Horowitz
PURPOSE: Suicide attempts by adolescents most commonly involve the overdose of medications. To date, there has been little information on the over-the-counter or prescription medicines that adolescents ingest for self-harm. Identification of medications chosen in suicide attempts may help guide anticipatory guidance to parents by primary care providers and Poison Centers in prevention programs. METHODS: This was a retrospective observational study using the American Association of Poison Control Center's National Poison Data System...
November 23, 2016: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/27788602/can-a-serum-acetaminophen-concentration-obtained-less-than-4-hours-post-ingestion-determine-which-patients-do-not-require-treatment-with-acetylcysteine
#2
Mark C Yarema, Jason P Green, Marco L A Sivilotti, David W Johnson, Alberto Nettel-Aguirre, Charlemaigne Victorino, Daniel A Spyker, Barry H Rumack
CONTEXT: The interpretation of acetaminophen concentrations obtained prior to 4 hours after an acute, single overdose remains unclear. Patient care decisions in the Emergency Department could be accelerated if such concentrations could reliably exclude the need for treatment. OBJECTIVE: To determine the agreement between a serum acetaminophen concentration obtained less than 4 hours after an acute ingestion and the subsequent 4 + hour concentration, and the predictive accuracy of early concentrations for identifying patients with potentially toxic exposures...
October 28, 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27604786/brown-tree-snake-boiga-irregularis-population-density-and-carcass-locations-following-exposure-to-acetaminophen
#3
Joshua B Smith, Kelsey L Turner, James C Beasley, Travis L DeVault, William C Pitt, Olin E Rhodes
Mass aerial delivery of dead mouse baits treated with acetaminophen has been evaluated as a means to reduce brown tree snake (Boiga irregularis) populations over large areas, increasing the likelihood of wide-scale eradication on Guam. Given the high density of snakes in some areas of their invasive range, eradication efforts could result in a resource pulse that may influence food web dynamics and the indirect transport of acetaminophen among trophic levels. We evaluated abundance, habitat type, and snake size (i...
September 7, 2016: Ecotoxicology
https://www.readbyqxmd.com/read/27595368/analysis-of-gastric-lavage-reported-to-a-statewide-poison-control-system
#4
Jimmy Donkor, Patil Armenian, Isaac N Hartman, Rais Vohra
BACKGROUND: As decontamination trends have evolved, gastric lavage (GL) has become a rare procedure. The current information regarding use, outcomes, and complications of GL could help refine indications for this invasive procedure. OBJECTIVES: We sought to determine case type, location, and complications of GL cases reported to a statewide poison control system. METHODS: This is a retrospective review of the California Poison Control System (CPCS) records from 2009 to 2012...
October 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27463118/double-peaked-acetaminophen-concentration-secondary-to-intestinal-trauma
#5
B Alyahya, S Tamur, S Aljenedil, A Larocuque, E Holody, S Gosselin
BackgroundReduced gastrointestinal motility can alter the toxicokinetics of acetaminophen poisoning. We report a case of altered acetaminophen toxicokinetics due to delayed gastrointestinal absorption, likely secondary to intestinal trauma/surgery.  Case ReportA 37-year-old woman ingested an unknown amount of acetaminophen and ethanol then stabbed herself in the abdomen. The initial acetaminophen was 1,285.9 μmol/L and the time of ingestion was not known. Intravenous acetylcysteine protocol was started. She developed an ileus post-surgery for the stab wounds...
2016: Journal of Population Therapeutics and Clinical Pharmacology
https://www.readbyqxmd.com/read/27383404/a-large-case-series-of-acute-pediatric-methotrexate-ingestions-significant-clinical-effects-are-rare
#6
Matthew D Hensley, Vikhyat S Bebarta, Douglas J Borys
OBJECTIVE: Significant adverse effects after acute pediatric methotrexate (MTX) exposures have been limited to parenteral exposures. Treatment recommendations for pediatric MTX exposures do not differentiate between routes of exposure. We report the incidence of significant clinical effects and drug-specific treatments reported in a large series of acute, pediatric MTX ingestions. METHODS: Poison center records of all MTX ingestions by patients younger than 17 years during 2000 to 2005 were collected from 6 poison centers...
July 2, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27350835/results-of-liver-transplantation-in-patients-with-acute-liver-failure-due-to-amanita-phalloides-and-paracetamol-acetaminophen-intoxication
#7
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
https://www.readbyqxmd.com/read/27302828/chemokine-c-c-motif-receptor-2-positive-monocytes-aggravate-the-early-phase-of-acetaminophen-induced-acute-liver-injury
#8
Jana C Mossanen, Oliver Krenkel, Can Ergen, Olivier Govaere, Anke Liepelt, Tobias Puengel, Felix Heymann, Sandra Kalthoff, Eric Lefebvre, Dirk Eulberg, Tom Luedde, Gernot Marx, Christian P Strassburg, Tania Roskams, Christian Trautwein, Frank Tacke
: Acetaminophen (APAP, paracetamol) poisoning is a leading cause of acute liver failure (ALF) in humans and induces hepatocyte necrosis, followed by activation of the innate immune system, further aggravating liver injury. The role of infiltrating monocytes during the early phase of ALF is still ambiguous. Upon experimental APAP overdose in mice, monocyte-derived macrophages (MoMFs) massively accumulated in injured liver within 12-24 hours, whereas the number of tissue-resident macrophages (Kupffer cells) decreased...
November 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27180426/serum-antioxidant-parameters-in-patients-poisoned-by-different-xenobiotics
#9
COMPARATIVE STUDY
Piotr Hydzik, Mirosław Krośniak, Renata Francik, Ewa Gomółka, Ebru Derici Ebru, Paweł Zagrodzki
There is a great diversity of the acute drugs overdose cases in clinical toxicology. Clinical situation is complicated by the coexistence of factors predisposing to the development of adverse drug reactions (chronic use of drugs, polypharmacy, alcohol or drugs dependence, nutritional disorders) and by the presence of chronic organ damage, especially the liver and the kidney. The aim of this study was to evaluate whether there are sensitive plasma markers belonging to the antioxidant system in patients exposed to various xenobiotics...
March 2016: Acta Poloniae Pharmaceutica
https://www.readbyqxmd.com/read/27123589/counterfeit-norco-poisoning-outbreak-san-francisco-bay-area-california-march-25-april-5-2016
#10
Kathy T Vo, Xander M R van Wijk, Kara L Lynch, Alan H B Wu, Craig G Smollin
On March 28, 2016, two patients were evaluated at the Contra Costa Regional Medical Center emergency department (ED) in Contra Costa County, California, for nausea, vomiting, central nervous system depression, and respiratory depression, 30 minutes after ingesting what appeared to be Norco, a prescription opioid pain medication that contains acetaminophen and hydrocodone. The patients purchased the drug from a friend a few days earlier. The two cases of drug intoxication were reported to a Contra Costa County Health Department public health official who subsequently notified the California State Health Department...
2016: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/27118496/massive-acetaminophen-overdose-effect-of-hemodialysis-on-acetaminophen-and-acetylcysteine-kinetics
#11
Marc Ghannoum, Sara Kazim, Ami M Grunbaum, Eric Villeneuve, Sophie Gosselin
CONTEXT: Early onset acidosis from mitochondrial toxicity can be observed in massive acetaminophen poisoning prior to the development of hepatotoxicity. In this context, the efficacy of acetylcysteine to reverse mitochondrial toxicity remains unclear and hemodialysis may offer prompt correction of acidosis. Unfortunately, toxicokinetics of acetaminophen and acetylcysteine during extracorporeal treatments hemodialysis have seldom been described. CASE DETAILS: An 18-year-old woman presented to the emergency department 60 minutes after ingestion of 100 g of acetaminophen, and unknown amounts of ibuprofen and ethanol...
July 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27117657/routine-biological-tests-in-self-poisoning-patients-results-from-an-observational-prospective-multicenter-study
#12
Thomas Reydel, Jean-Christophe Callahan, Laurent Verley, Christelle Teiten, Christophe Andreotti, Yann Erick Claessens, David Missud, Erwan L'Her, Gael Le Roux, Nicolas Lerolle
CONTEXT: Routine biological tests are frequently ordered in self-poisoning patients, but their clinical relevance is poorly studied. MATERIALS AND METHODS: This is a prospective multicentric observational study conducted in the emergency departments and intensive care units of 5 university and nonuniversity French hospitals. Adult self-poisoning patients without severely altered vital status on admission were prospectively included. RESULTS: Routine biological test (serum electrolytes and creatinine, liver enzymes, bilirubin, blood cell count, prothrombin time) ordering and results were analyzed...
August 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27049274/deliberate-drug-poisonings-admitted-to-an-emergency-department-in-paris-area-a-descriptive-study-and-assessment-of-risk-factors-for-intensive-care-admission
#13
S Beaune, P Juvin, A Beauchet, E Casalino, B Megarbane
OBJECTIVE: Each year, approximately 165,000 poisonings are managed in the emergency departments (ED) in France. We performed a descriptive analysis of self-poisoned patients admitted to a university hospital ED in the Paris metropolitan area (France) aimed at investigating their outcome and the risk factors for transfer to the intensive care unit (ICU). PATIENTS AND METHODS: We retrospectively reviewed patients' records and performed multivariate logistic regression analysis to identify risk factors for ICU admission...
2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27017358/-a-prospective-study-on-suicide-attempts-by-self-poisoning-in-adolescents-symptoms-and-complications
#14
J Le Vaillant, L Pellerin, J Brouard, D Nimal-Cuvillon
AIM: Biological complications in adolescents' self-poisoning are not currently evaluated. The aim of this study was to describe the toxicological characteristics of suicide attempts, the ingested substances, and their complications to better prevent the risks associated with deliberate self-poisoning. MATERIALS AND METHODS: This was a descriptive, prospective, single-center study. It took place in the pediatric emergency, hospitalization, and intensive care unit of the Caen University Hospital...
May 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/26899513/outcomes-of-patients-with-premature-discontinuation-of-the-21-h-intravenous-n-acetylcysteine-protocol-after-acute-acetaminophen-overdose
#15
Scott N Lucyk, Mark C Yarema, Marco L A Sivilotti, David W Johnson, Alberto Nettel-Aguirre, Charlemaigne Victorino, Benoit Bailey, Richard C Dart, Kennon Heard, Daniel A Spyker, Barry H Rumack
BACKGROUND: The minimum recommended treatment duration for i.v. N-acetylcysteine (NAC) after an acute, single acetaminophen (APAP) overdose is 21 h. Some have questioned whether shorter courses may be sufficient in carefully selected cases. OBJECTIVE: We sought to describe the incidence of hepatotoxicity in a cohort of acute APAP overdose patients who received <21 h of i.v. NAC for any reason. METHODS: We performed a secondary analysis of a large multicenter retrospective cohort of patients hospitalized for APAP poisoning...
April 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26823936/medication-overdoses-at-a-public-emergency-department-in-santiago-chile
#16
Pablo Aguilera, Marcela Garrido, Eli Lessard, Julian Swanson, William K Mallon, Fernando Saldias, Carlos Basaure, Barbara Lara, Stuart P Swadron
INTRODUCTION: While a nationwide poison control registry exists in Chile, reporting to the center is sporadic and happens at the discretion of the treating physician or by patients' self-report. Moreover, individual hospitals do not monitor accidental or intentional poisoning in a systematic manner. The goal of this study was to identify all cases of intentional medication overdose (MO) that occurred over two years at a large public hospital in Santiago, Chile, and examine its epidemiologic profile...
January 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26818907/relating-calls-to-us-poison-centers-for-potential-exposures-to-medications-to-centers-for-disease-control-and-prevention-reporting-of-influenza-like-illness
#17
Gillian A Beauchamp, Nathanael J McKeown, Sergio Rodriguez, Daniel A Spyker
CONTEXT: The Centers for Disease Control (CDC) monitors influenza like illness (ILI) and the National Poison Data System (NPDS) warehouses call data uploaded by US poison centers regarding reported exposures to medication. OBJECTIVE: We examined the relationship between calls to poison centers regarding reported exposures to medications commonly used to treat ILI and weekly reports of ILI. MATERIALS AND METHODS: The CDC reports ILI, by age group, for each of 10 Health and Human Services (HHS) regions...
March 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/26706992/acetaminophen-paracetamol-induced-acute-liver-failure-a-social-problem-in-an-era-of-increasing-tendency-to-self-treatment
#18
Tadeusz Wróblewski, Konrad Kobryń, Sławomir Kozieł, Urszula Ołdakowska-Jedynak, Jarosław Pinkas, Roman Danielewicz, Bogna Ziarkiewicz-Wróblewska, Marek Krawczyk
INTRODUCTION: The widespread availability of medication without prescription, so-called over the counter (OTC), and the rapid development of health consciousness of Poles is associated with broad access to medical information in the mass media. This causes patients to recognize their own disease, cancel doctor's appointments, and begin self-treatment. This time and money-saving behavior, often signaled by pain, usually leads to the treatment of symptoms alone, without seeking the cause of the disease...
2015: Annals of Agricultural and Environmental Medicine: AAEM
https://www.readbyqxmd.com/read/26653695/acetaminophen-overdose-associated-with-double-serum-concentration-peaks
#19
Cristian Papazoglu, Jonathan R Ang, Michael Mandel, Prasanta Basak, Stephen Jesmajian
Acetaminophen is the most commonly used analgesic-antipyretic medication in the United States. Acetaminophen overdose, a frequent cause of drug toxicity, has been recognized as the leading cause of fatal and non-fatal hepatic necrosis. N-Acetylcysteine is the recommended antidote for acetaminophen poisoning. Despite evidence on the efficacy of N-acetylcysteine for prevention of hepatic injury, controversy persists about the optimal duration of the therapy. Here, we describe the case of a 65-year-old male with acetaminophen overdose and opioid co-ingestion who developed a second peak in acetaminophen serum levels after completing the recommended 21-hour intravenous N-acetylcysteine protocol and when the standard criteria for monitoring drug levels was achieved...
2015: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/26635443/chromatography-as-method-for-analytical-confirmation-of-paracetamol-in-postmortem-material-together-with-psychoactive-substances
#20
REVIEW
Jasmina Biscevic-Tokic, Nedim Tokic, Elma Ibrahimpasic
INTRODUCTION: Paracetamol (Acetaminophen) in addition to aspirin is the most commonly used analgesic and antipyretic medication by millions of patients worldwide. It is an example that paracetamol as medicine that in the world is provided without a doctor's prescription, can lead to death. Today paracetamol became an integral part of a heroin mixture and is very popular at the street market. The main reason for this is that it can be obtained without a prescription, it is cheap, and by most people well tolerated without side effects...
October 2015: Acta Informatica Medica: AIM
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