Management of Paracetamol (Acetaminophen) Intoxication

Year 2022, Volume: 4 Issue: 1, 17 - 22, 30.04.2022

Funda Yılmaz

https://doi.org/10.51262/ejtox.1098185

Abstract

Acetaminophen intoxication is one of the most frequent causes of poisoning caused by medical treatment and deaths. Acetaminophen intoxication happens when it is taken in a single high dose or several times above the treatment dose. The approach to the patient with acetaminophen intoxication includes stabilization, decontamination and n-acetyl cysteine (the specific antidot of acetaminophen). In this article, it is aimed to review the approach to patients with paracetamol poisoning in the emergency department with current medical literature.

Keywords

Paracetamol, acetaminophen, intoxication, emergency

Parasetamol (Asetaminofen) Zehirlenmesinin Yönetimi

Abstract

Asetaminofen zehirlenmesi tedaviye bağlı zehirlenmeler ve ölümlerin en sık görülen nedenlerinden biridir. Asetaminofen zehirlenmesi tek doz fazla miktarda alım ya da tedavi dozunun üzerinde tekrarlayan alımlarla gerçekleşmektedir. Asetaminofen zehirlenmesi olan hastaya yaklaşım stabilizasyon, dekontaminasyon ve spesifik antidot olan N-asetilsistein tedavilerini içerir. Bu makalede parasetamol zehirlenmeli hastalara acil serviste yaklaşımın güncel tıbbi literatür bilgileri eşliğinde derlenmesi amaçlandı.

Keywords

Parasetamol, asetaminofen, zehirlenme, acil

References

• Oliver LH, Lewis SN. Acetaminophen. In Judith E. Tintinalli, Editor. Emergency Medicine. 9th ed. New York: McGraw-Hill; 2010. p.1246-52.
• Hendrickson RG, Bizovi KE. Acetaminophene. In Flomenbaum NE, Goldfrank LR, Hoffman RS, Howland MA, Lewin NA, et al Editors. Goldfrank’s Toxicologic Emergencies. 8th ed. New York: McGraw-Hill; 2006. p.333-43. 3.
• Rumack BH, Matthew H. Acetaminophen poisoning and toxicity. Pediatrics 1975; 55: 871-6.
• Prior MJ, Cooper K, Cummins P, Bowen D: Acetaminophen availability increases in Canada with no increase in the incidence of reports of inpatient hospitalizations with acetaminophen overdose and acute liver toxicity. Am J Ther 2004, 11:443-45.
• Satar S. Clinical toxicology in the emergency service. 2009.
• Gülen B, Taşlıdere B. Parasetamol (Asetaminofen) Zehirlenmesi. In: Kekeç Z, editor. Acil Tıp Pratiğinde Klinik Toksikoloji, 1. Baskı. Ankara: EMA Tıp kitapevi yayıncılık; 2020.p.248-249.
• Hendrickson RG, McKeown NJ. In: Walls RM, Hockberger RS, Gausche-Hill M, editors. Rosen Acil Tıp Kavramlar ve Klinik Uygulama, 9.Baskı. İstanbul: Yeditepe Üniversitesi Yayınevi; 2019.p.1852-1857.
• Fontana RJ. Acute liver failure including acetaminophen overdose. Med Clin North Am. 2008;92(4):761-94.
• Chun LJ, Tong MJ, Busuttil RW, Hiatt JR. Acetaminophen hepatotoxicity and acute liver failure. J Clin Gastroenterol. 2009;43(4):342-9.
• Ozkaya O, Genc G, Bek K, Sullu Y. A case of acetaminophen (paracetamol) causing renal failure without liver damage in a child and review of literature. Ren Fail. 2010;32(9):1125-7.
• Igarashi H, Ito T, Yoshinaga M, Oono T, Sakai H, Takayanagi R. Acetaminophen-induced acute pancreatitis. A case report. JOP. 2009;10(5):550-3.
• Wolf SJ, Heard K, Sloan EP, Jagoda AS. Clinical policy: critical issues in the management of patients presenting to the emergency department with acetaminophen overdose. Ann Emerg Med. 2007;50(3):292-313.
• Daly FF, Fountain JS, Murray L, Graudins A, Buckley NA. Guidelines for the management of paracetamol poisoning in Australia and New Zealand—explanation and elaboration. A consensus statement from clinical toxicologists consulting to the Australasian poisons information centres. Med J Aust. 2008;188(5):296-301.
• Bateman DN, Dear JW, Thomas SHL. New regimens for intravenous acetylcysteine: where are we now? Clin Toxicol (Phila). 2016;54(2):75-8.
• Chiew AL, Isbister GK, Duffull SB, Buckley NA. Evidence for the changing regimens of acetylcysteine. Br J Clin Pharmacol. 2016;81(3):471-81.
• Klein-Schwartz W, Doyon S. Intravenous acetylcysteine for the treatment of acetaminophen overdose. Expert Opin Pharmacother. 2011;12(1):119-30.
• Wightman RS, Nelson LS. Asetaminofen. In Judith E. Tintinalli, Editor. Emergency Medicine. 9th ed. New York: McGraw-Hill; 2010. p.1252-1258.
• Kennon Heard, Richard Dart. Acetaminofen (paracetamol) poisoning in adults: Treatment. Available from: https://www.uptodate.com/contents/acetaminophen-paracetamol-poisoning-in-adults-treatment (Acces date: 04.04.2022)
• Speeg KV Jr, Mitchell MC, Maldonado AL. Additiveprotection of cimetidineand N- acetylcysteine treatment against acetaninophen-induced hepaticnecrosis in therat. J Pharmacol ExpTher. 1985;234:550.
• Al-Mustafa ZH, Al- Ali AK, Qaw FS, Abdul- Cader Z. Cimetidine enhances the hepatoprotectiveaction of N-asetilcisteine in micetreated with toxicdoses of paracetamol. Toxicology.1997;121:223.
• Küçükardalı Y, Cihan U, Acar HV, et al. Comparison of the therapeutic efficacy of 4- methylpyrazole and N-acetylcisteine on acetaminophen hepatotoxicity in rats. Curr Med Res Opin. 2002;18:78.
• Hamlyn AN, Lesna M, Record CO, et al. Methionine and cysteamine in paracetamol overdose, prospective controlled trial of early therapy. J Int Med Res. 1981;9:226.
• Marbury TC, Wang LH, Lee CS. Hemodialysis of acetaminophen in uremicpatients. Int J Artif Organs. 1980;3:263.