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.
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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