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ArticlesCritical Care

Multiplying the serum aminotransferase by the acetaminophen concentration to predict toxicity following overdose

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Pages 793-799 | Received 22 Jun 2010, Accepted 10 Sep 2010, Published online: 08 Oct 2010

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Angela L. Chiew & Geoffrey K. Isbister. (2023) Advances in the understanding of acetaminophen toxicity mechanisms: a clinical toxicology perspective. Expert Opinion on Drug Metabolism & Toxicology 0:0, pages 1-16.
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Annabelle S Chidiac, Nicholas A Buckley, Firouzeh Noghrehchi & Rose Cairns. (2023) Paracetamol (acetaminophen) overdose and hepatotoxicity: mechanism, treatment, prevention measures, and estimates of burden of disease. Expert Opinion on Drug Metabolism & Toxicology 19:5, pages 297-317.
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Chun En Yau, Haoyang Chen, Bryant Po-Yuen Lim, Mingwei Ng, R. Ponampalam, Daniel Yan Zheng Lim, Yip Han Chin & Andrew Fu Wah Ho. (2023) Performance of the paracetamol-aminotransferase multiplication product in risk stratification after paracetamol (acetaminophen) poisoning: a systematic review and meta-analysis. Clinical Toxicology 61:1, pages 1-11.
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Ari B. Filip, Sarah E. Berg, Michael E. Mullins & Evan S. Schwarz. (2022) Fomepizole as an adjunctive therapy for acetaminophen poisoning: cases reported to the toxicology investigators consortium (ToxIC) database 2015–2020. Clinical Toxicology 60:9, pages 1006-1011.
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Stephanie L. Link, Garrett Rampon, Stephen Osmon, Anthony J. Scalzo & Barry H. Rumack. (2022) Reply to Comments on Fomepizole as an adjunct in acetylcysteine treated acetaminophen overdose patients: a case series. Clinical Toxicology 60:5, pages 668-669.
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Sanjay Mohan, Sarah Mahonski & Robert S. Hoffman. (2022) Comment on Fomepizole as an adjunct in acetylcysteine treated acetaminophen overdose patients: a case series. Clinical Toxicology 60:5, pages 666-666.
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Jacob A. Lebin & Anita Mudan. (2022) Comment on Fomepizole as an adjunct in acetylcysteine treated acetaminophen overdose patients: a case series. Clinical Toxicology 60:5, pages 665-665.
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Stephanie L. Link, Garrett Rampon, Stephen Osmon, Anthony J. Scalzo & Barry H. Rumack. (2022) Fomepizole as an adjunct in acetylcysteine treated acetaminophen overdose patients: a case series. Clinical Toxicology 60:4, pages 472-477.
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Yvonne Gloor, Domitille Schvartz & Caroline F.Samer. (2019) Old problem, new solutions: biomarker discovery for acetaminophen liver toxicity. Expert Opinion on Drug Metabolism & Toxicology 15:8, pages 659-669.
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Harry Egan, Geoffrey K. Isbister, Jennifer Robinson, Michael Downes, Betty S. Chan, Elia Vecellio & Angela L. Chiew. (2019) Retrospective evaluation of repeated supratherapeutic ingestion (RSTI) of paracetamol. Clinical Toxicology 57:8, pages 703-711.
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Adam Mutsaers, Jason P. Green, Marco L. A. Sivilotti, Mark C. Yarema, Dylan Tucker, David W. Johnson, Daniel A. Spyker & Barry H. Rumack. (2019) Changing nomogram risk zone classification with serial testing after acute acetaminophen overdose: a retrospective database analysis. Clinical Toxicology 57:6, pages 380-386.
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Anselm Wong, Marco L. A. Sivilotti, Naren Gunja, Richard McNulty & Andis Graudins. (2018) Accuracy of the paracetamol-aminotransferase product to predict hepatotoxicity in paracetamol overdose treated with a 2-bag acetylcysteine regimen. Clinical Toxicology 56:3, pages 182-188.
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Anselm Wong & Andis Graudins. (2017) Risk prediction of hepatotoxicity in paracetamol poisoning. Clinical Toxicology 55:8, pages 879-892.
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Anselm Wong, Marco L. A. Sivilotti & Andis Graudins. (2017) Accuracy of the paracetamol-aminotransferase multiplication product to predict hepatotoxicity in modified-release paracetamol overdose. Clinical Toxicology 55:5, pages 346-351.
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Mark C. Yarema, Jason P. Green, Marco L. A. Sivilotti, David W. Johnson, Alberto Nettel-Aguirre, Charlemaigne Victorino, Daniel A. Spyker & Barry H. Rumack. (2017) Can a serum acetaminophen concentration obtained less than 4 hours post-ingestion determine which patients do not require treatment with acetylcysteine?. Clinical Toxicology 55:2, pages 102-108.
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David G. Cairney, Hannah K. S. Beckwith, Khalid Al-Hourani, Michael Eddleston, D. Nicholas Bateman & James W. Dear. (2016) Plasma paracetamol concentration at hospital presentation has a dose-dependent relationship with liver injury despite prompt treatment with intravenous acetylcysteine. Clinical Toxicology 54:5, pages 405-410.
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Morgan Riggan, Mireille Sayegh, Wayne Choi & Robert S. Hoffman. (2015) Letter in response to: External validation of the paracetamol-aminotransferase multiplication product to predict hepatotoxicity from paracetamol overdose. Clinical Toxicology 53:10, pages 1155-1156.
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R. Mason Curtis & Marco L. A. Sivilotti. (2015) A descriptive analysis of aspartate and alanine aminotransferase rise and fall following acetaminophen overdose. Clinical Toxicology 53:9, pages 849-855.
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Anselm Wong, Marco L. A. Sivilotti, Paul I. Dargan, David M. Wood & Shaun L. Greene. (2015) External validation of the paracetamol-aminotransferase multiplication product to predict hepatotoxicity from paracetamol overdose. Clinical Toxicology 53:8, pages 807-814.
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M. J. Hodgman. (2014) Seeking a role, Psi and APAP×AT as acetaminophen risk assessment tools. Clinical Toxicology 52:5, pages 451-453.
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M. L. A. Sivilotti, D. N. Juurlink, J. S. Garland, I. Lenga, R. Poley, L. N. Hanly & M. Thompson. (2013) Antidote removal during haemodialysis for massive acetaminophen overdose. Clinical Toxicology 51:9, pages 855-863.
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Jonathan G Stine & James H Lewis. (2011) Drug-induced liver injury: a summary of recent advances. Expert Opinion on Drug Metabolism & Toxicology 7:7, pages 875-890.
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Mitchell R. McGill & Steven C. Curry. (2023) The Evolution of Circulating Biomarkers for Use in Acetaminophen/Paracetamol-Induced Liver Injury in Humans: A Scoping Review. Livers 3:4, pages 569-596.
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Ari B. Filip & Michael E. Mullins. (2022) Fomepizole should be used more liberally in paracetamol overdose. British Journal of Clinical Pharmacology 89:2, pages 594-598.
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Kannan Sridharan, Muna Al Jufairi, Eman Al Ansari, Reem Al Marzooq, Zakariya Hubail, Sadeq Jaafar Radhi Hasan & Abdulraoof Al Madhoob. (2021) Intravenous acetaminophen (at 15 mg/kg/dose every 6 hours) in critically ill preterm neonates with patent ductus arteriosus: A prospective study. Journal of Clinical Pharmacy and Therapeutics 46:4, pages 1010-1019.
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Mark C. Yarema, David W. Johnson, Marco L.A. Sivilotti, Alberto Nettel‐Aguirre, Chris DeWitt, Sophie Gosselin, Nancy Murphy, Charlemagne Victorino, Benoit Bailey, Kathryn Dong, Elizabeth Haney, Roy Purssell, Margaret Thompson, Jason A. Lord, Daniel A. Spyker & Barry H. Rumack. (2021) Predicting mortality from acetaminophen poisoning shortly after hospital presentation. British Journal of Clinical Pharmacology 87:8, pages 3332-3343.
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Iwona Popiolek, Piotr Hydzik, Pawel Jagielski, Monika Zrodlowska, Karol Mystek & Grzegorz Porebski. (2021) Risk Factors for Hepatotoxicity Due to Paracetamol Overdose in Adults. Medicina 57:8, pages 752.
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Angela L. Chiew & Nicholas A. Buckley. (2021) Acetaminophen Poisoning. Critical Care Clinics 37:3, pages 543-561.
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Richard L. Lambert. 2021. Pediatric Critical Care. Pediatric Critical Care 1289 1314 .
Angela L. Chiew, Laura P. James, Geoffrey K. Isbister, John W. Pickering, Kylie McArdle, Betty S.H. Chan & Nicholas A. Buckley. (2020) Early acetaminophen-protein adducts predict hepatotoxicity following overdose (ATOM-5). Journal of Hepatology 72:3, pages 450-462.
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D. Nicholas Bateman & James W. Dear. (2019) Acetylcysteine in paracetamol poisoning: a perspective of 45 years of use. Toxicology Research 8:4, pages 489-498.
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Mark Real, Michele S. Barnhill, Cory Higley, Jessica Rosenberg & James H. Lewis. (2018) Drug-Induced Liver Injury: Highlights of the Recent Literature. Drug Safety 42:3, pages 365-387.
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Anselm Wong, Richard McNulty, David Taylor, Marco Sivilotti, Shaun Greene, Naren Gunja, Zeff Koutsogiannis & Andis Graudins. (2019) The NACSTOP Trial: A Multicenter, Cluster‐Controlled Trial of Early Cessation of Acetylcysteine in Acetaminophen Overdose. Hepatology 69:2, pages 774-784.
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Diego Castanares-Zapatero, Valérie Dinant, Ilaria Ruggiano, Harold Willem, Pierre-François Laterre & Philippe Hantson. (2018) Pattern of Paracetamol Poisoning: Influence on Outcome and Complications. Toxics 6:4, pages 58.
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Anselm Wong, Cornelia Landersdorfer & Andis Graudins. (2017) Pharmacokinetic modelling of modified acetylcysteine infusion regimens used in the treatment of paracetamol poisoning. European Journal of Clinical Pharmacology 73:9, pages 1103-1110.
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ADB Vliegenthart, RA Kimmitt, JH Seymour, NZ Homer, JI Clarke, M Eddleston, A Gray, DM Wood, PI Dargan, JG Cooper, DJ Antoine, DJ Webb, SC Lewis, DN Bateman & JW Dear. (2016) Circulating acetaminophen metabolites are toxicokinetic biomarkers of acute liver injury. Clinical Pharmacology & Therapeutics 101:4, pages 531-540.
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Scott N. Lucyk, Mark C. Yarema, Marco L.A. Sivilotti, David W. Johnson, Alberto Nettel-Aguirre, Charlemaigne Victorino, Benoit Bailey, Richard C. Dart, Kennon Heard, Daniel A. Spyker & Barry H. Rumack. (2016) Outcomes of Patients With Premature Discontinuation of the 21-h Intravenous N-Acetylcysteine Protocol After Acute Acetaminophen Overdose. The Journal of Emergency Medicine 50:4, pages 629-637.
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D. Nicholas Bateman. (2015) Changing the Management of Paracetamol Poisoning. Clinical Therapeutics 37:9, pages 2135-2141.
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Frédéric Baud, Philippe Hantson & Hafedh ThabetP. Wallemacq & P. Hantson. 2013. Intoxications aiguës. Intoxications aiguës 25 40 .
David Tonoli, Emmanuel Varesio & Gérard Hopfgartner. (2012) Quantification of acetaminophen and two of its metabolites in human plasma by ultra-high performance liquid chromatography–low and high resolution tandem mass spectrometry. Journal of Chromatography B 904, pages 42-50.
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