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Acetaminophen misconceptions
Author(s) -
Rumack Barry H.
Publication year - 2004
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.20300
Subject(s) - acetaminophen , glucuronidation , medicine , cyp2e1 , pharmacokinetics , hepatology , pharmacology , intensive care medicine , chemistry , metabolism , enzyme , biochemistry , cytochrome p450 , microsome
Abstract Examination of the pharmacokinetics of acetaminophen can decrease misconceptions involved in clinical evaluation. Enzyme patterns and acetaminophen levels must be related to time and known metabolic phenomena. A careful look at ethanol and nutrition, especially fasting demonstrates that therapeutic doses of acetaminophen do not place patients at a greater risk in either of these instances. An overdose of acetaminophen in a chronic alcohol abuser may result in more severe hepatotoxicity than in the nonalcoholic. CYP2E1 and glutathione must be evaluated simultaneously rather than in isolation. Glucuronidation capacity in humans is not a factor except in massively overdosed patients. (H EPATOLOGY 2004;40:10–15.)