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Outcomes from massive paracetamol overdose: a retrospective observational study
Author(s) -
Marks Daniel J. B.,
Dargan Paul I.,
Archer John R. H.,
Davies Charlotte L.,
Dines Alison M.,
Wood David M.,
Greene Shaun L.
Publication year - 2017
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.13214
Subject(s) - medicine , acetaminophen , acute kidney injury , acetaminophen overdose , drug overdose , coagulopathy , retrospective cohort study , odds ratio , creatinine , anesthesia , nomogram , acetylcysteine , poison control , emergency medicine , biochemistry , chemistry , antioxidant
This article is commented on by Bateman DN and Dear JW. Should we treat very large paracetamol overdose differently? Br J Clin Pharmacol 2017; 83: 1163-5. https://doi.org/10.1111/bcp.13279 AIMS: Treatment of paracetamol (acetaminophen) overdose with acetylcysteine is standardized, with dose determined only by patient weight. The validity of this approach for massive overdoses has been questioned. We systematically compared outcomes in massive and non-massive overdoses, to guide whether alternative treatment strategies should be considered, and whether the ratio between measured timed paracetamol concentrations (APAP pl ) and treatment nomogram thresholds at those time points (APAP t ) provides a useful assessment tool.