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The Clinical Use of the Plasma Acetaminophen Halflife in NAC-treated Acetaminophen Overdose
Journal of the Korean Society of Emergency Medicine ; : 56-60, 2003.
Article in Korean | WPRIM | ID: wpr-97136
ABSTRACT

PURPOSE:

A plasma acetaminophen halflife of more than 4 hours has been correlated with hepatotoxicity in acetaminophen overdosing not treated with an antidote. However, the acetaminophen halflife has not been studied in patients receiving the antidote N-acetylcysteine (NAC).

METHODS:

Ninety-eight (98) patients with acetaminophen overdoses, all of whom were treated with N-acetylcysteine were studied. A minimum of 2 plasma acetaminophen valu e s > 2.0 microgram/ml were available for calculating the acetaminophen halflife, assuming first-order kinetics.

RESULTS:

Overall, the median acetaminophen halflife was 6.2 hours (range, 1.15~103.9 hours). Sixty-two (62) patients with no hepatotoxicity (AST 1,000 U/L) without acute hepatic failure, and 6 patients with hepatotoxicity (AST > 1,000 U/L) with hepatic failure had acetaminophen halflives of 3.7 hours (range, 1.15~23.2 hours), 5.9 hours (range, 1.96~26.2 hours), 6.3 hours (range, 2.19~15.38 hours), and 32.8 hours (range, 5.48~103.9 hours), respectively (p<0.05). A receiver operating characteristic curve analysis showed that an acetaminophen halflife of 5.19 hours provided better discrimination (sensitivity=69.6%, specificity=84.0%, accuracy=80.6%).

CONCLUSION:

The acetaminophen halflife correlates well with the degree of liver damage in patients treated with N-acetylcysteine. Longer halflives reflect a greater toxic effect on the liver.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Plasma / Acetylcysteine / Kinetics / ROC Curve / Liver Failure, Acute / Liver Failure / Discrimination, Psychological / Half-Life / Liver / Acetaminophen Type of study: Prognostic study Limits: Humans Language: Korean Journal: Journal of the Korean Society of Emergency Medicine Year: 2003 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Plasma / Acetylcysteine / Kinetics / ROC Curve / Liver Failure, Acute / Liver Failure / Discrimination, Psychological / Half-Life / Liver / Acetaminophen Type of study: Prognostic study Limits: Humans Language: Korean Journal: Journal of the Korean Society of Emergency Medicine Year: 2003 Type: Article