![]() ![]() A follow-up study of serum bile acids and liver histology. Liver function and structure in survivors of acetaminophen poisoning. Hamlyn AN, Douglas AP, James OF, Lesna M, Watson AJ.Pharmacological considerations and clinical management. Intravenous N-acetylcystine: the treatment of choice for paracetamol poisoning. Prescott LF, Illingworth RN, Critchley JA, Stewart MJ, Adam RD, Proudfoot AT.Josephs DS, Christian MS, Saunders JR, Stanesby P, Woodbridge K.Acetaminophen-induced hepatic necrosis and renal failure. Acute liver necrosis following overdose of paracetamol. A fixed drug eruption due to paracetamol. Acetaminophen sensitivity and fixed dermatitis. The pain cocktail as an adjunctive agent in the treatment of spine pain patients. Analgesic efficacy and plasma concentration of three analgesics in pain after lower third molar removal. Review of the comparative analgesic efficacy of salicylates, acetaminophen, and pyrazolones. A comparative evaluation of marketed analgesic drugs. Moertel CG, Ahmann DL, Taylor WF, Schwartau N.A model to evaluate mild analgesics in oral surgery outpatients. Evaluation of acetaminophen and aspirin in the relief of preoperative dental pain. Korberly BH, Schreiber GF, Kilkuts A, Orkand RK, Segal H.Acetaminophen versus propoxyphene hydrochloride for relief of pain in episiotomy patients. Hopkinson JH, 3rd, Bartlett FH, Jr, Steffens AO, McGlumphy TH, Macht EL, Smith M.Efficacy, disposition and pharmacodynamics of aspirin, acetaminophen and choline salicylate in young febrile children. Wilson JT, Brown RD, Bocchini JA, Jr, Kearns GL.A comparison of the antipyretic effect of acetaminophen and aspirin. Tarlin L, Landrigan P, Babineau R, Alpert JJ. ![]() The comparative antipyretic effect of N-acetyl-p-aminophenol and acetylsalicylic acid. Study of antipyretic therapy in current use. Nonsteroidal anti-inflammatory drugs (first of two parts). Anti-inflammatory drugs in rheumatic diseases. Inhibition of prostaglandin synthetase in brain explains the anti-pyretic activity of paracetamol (4-acetamidophenol). Modern views on the pathogenesis of fever and the mode of action of antipyretic drugs. Evidence that acetaminophen and N-hydroxyacetaminophen form a common arylating intermediate, N-acetyl-p-benzoquinoneimine. Corcoran GB, Mitchell JR, Vaishnav YN, Horning EC.Acetaminophen-induced hepatic injury: protective role of glutathione in man and rationale for therapy. Mitchell JR, Thorgeirsson SS, Potter WZ, Jollow DJ, Keiser H.Clinical pharmacokinetics of paracetamol. Pharmacokinetics of paracetamol (acetaminophen) after intravenous and oral administration. Kinetics of acetaminophen absorption and gastric emptying in man. Clements JA, Heading RC, Nimmo WS, Prescott LF.Links to PubMed are also available for Selected References. Get a printable copy (PDF file) of the complete article (2.3M), or click on a page image below to browse page by page. Full textįull text is available as a scanned copy of the original print version. Appropriate antidotal therapy markedly reduces the severity of the initial damage. They and those who survive the third phase recover with no residual injury to the liver. Most patients do not progress beyond the first or second phase. Acetaminophen poisoning follows an acute overdose and, if untreated, is manifested clinically by an initial phase of nonspecific signs and symptoms, a latent period in which the liver transaminase levels rise and then, 3 to 5 days after the ingestion, signs of more serious hepatic dysfunction. Long-term therapeutic use of acetaminophen does not appear to be associated with liver damage, although some case reports suggest the possibility. Such damage is unlikely to occur unless the plasma concentration of acetaminophen peaks above 150 micrograms/mL-a level far in excess of the 5 to 20 micrograms/mL achieved with therapeutic doses of the drug. In the case of an acetaminophen overdose the hepatic stores of glutathione seem to become depleted, leaving the toxic intermediate free to damage liver tissue. An intermediate compound in a minor metabolic pathway, however, is toxic it is normally inactivated by glutathione. The drug is metabolized mainly in the liver, and the several end products have no harmful effects. Acetaminophen is an effective analgesic and antipyretic agent with few adverse effects when used in recommended dosages. ![]()
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