Advanced search
Publication Cover
Clinical Toxicology Volume 48, 2010 - Issue 2
Submit an article Journal homepage
666
Views
25
CrossRef citations to date
0
Altmetric
Brief Communication

Massive acetaminophen ingestion with early metabolic acidosis and coma: treatment with IV NAC and continuous venovenous hemodiafiltration

Timothy J. Wiegand Department of Medicine and Emergency Medicine, Maine Medical Center and Northern New England Poison Center, Portland, ME, USACorrespondence[email protected]
,
Mary Margaretten Department of Rheumatology, University of California – San Francisco, San Francisco, CA, USA
&
Kent R. Olson San Francisco General Hospital, San Francisco Division, California Poison Control System & the University of California – San Francisco, San Francisco, CA, USA
Pages 156-159 | Received 01 Dec 2009, Accepted 02 Dec 2009, Published online: 03 Mar 2010

References

  • Roth B, Woo O, Blanc P. Early metabolic acidosis and coma after acetaminophen ingestion. Ann Emerg Med 1999; 33(4):452–456.
  • Gray TA, Buckley BM, Vale JA. Hyperlactataemia and metabolic acidosis following paracetamol overdose. Q J Med 1987; 65:811–821.
  • Pitt J, Hauser S. Transient 5-oxoprolinuria and high anion gap metabolic acidosis: clinical and biochemical findings in eleven subjects. Clin Chem 1998; 4(1):497–1503.
  • Koulouris Z, Tierney MG, Jones G. Metabolic acidosis and coma following a severe acetaminophen overdose. Ann Pharmacother 1999; 33(11): 1191–1194.
  • Ramsey RR, Rashed MS, Nelson SD. In vitro effects of acetaminophen metabolites and analogs on the respiration of mouse liver mitochondria. Arch Biochem Biophys 1989; 273:449–457.
  • Esterline RL, Ray SD, Ji S. Reversible and irreversible inhibition of hepatic mitochondrial respiration by acetaminophen and its toxic metabolite, N‐acetyl-p-benzoquinoneimine (NAPQI). Biochem Pharmacol 1989; 38:2387–2390.
  • Landin JS, Cohen SD, Khairallah EA. Identification of a 54-kDa mitochondrial acetaminophen-binding protein as aldehyde dehydrogenase. Toxicol Appl Pharmacol 1996; 14(1):299–307.
  • Widdop B, Medd RK, Braithwaite RA, Rees AJ, Goulding R. Experimental drug intoxication: treatment with charcoal haemoperfusion. Arch Toxicol 1975; 34(1):27–36.
  • Higgins RM, Goldsmith DJ, MacDiarmid-Gordon A, Venning MC, Ackrill P. Treating paracetamol overdose by charcoal haemoperfusion and long-hours high-flux dialysis. Q J Med 1996; 89(4):297–306.
  • Wiegand T. Another Routine APAP OD? Not Quite but Just How Many More Letters can follow APAPNAPQIINCVVHD. North American Congress on Clinical Toxicology, Intensive Care Symposium Case Discussion, San Francisco, CA; 2006.
  • Farid NR, Glynn JP, Kerr DN. Haemodialysis in paracetamol self-poisoning. Lancet 1972; 2(7774):396–398.
  • Oie S, Lowenthal DT, Briggs WA, Levy G. Effect of hemodialysis on kinetics of acetaminophen elimination by anephric patients. Clin Pharmacol Ther 1975; 18(06):680–686.
  • Lee CS, Wang LH, Marbury TC, Cade JR. Hemodialysis for acetaminophen detoxification. Clin Toxicol 1981; 18(4):431–439.
  • Lowenthal DT, Oie S, Van Stone JC, Briggs WA, Levy G. Pharmacokinetics of acetaminophen elimination by anephric patients. J Pharmacol Exp Ther 1976; 196(3):570–578.
  • Pond SM, Tong TG, Kaysen GA, Menke DJ, Galinsky RE, Roberts SM, Levy G. Massive intoxication with acetaminophen and propoxyphene: unexpected survival and unusual pharmacokinetics of acetaminophen. J Toxicol Clin Toxicol 1982; 19(1):1–16.
  • Wu ML, Tsai WJ, Deng JF, Yang CC. Hemodialysis as adjunctive therapy for severe acetaminophen poisoning: a case report. Zhonghua Yi Xue Za Zhi (Taipei) 1999; 62(12):907–913.
  • Prescott LF, Roscoe P, Wright N, Brown SS. Plasma-paracetamol half-life and hepatic necrosis in patients with paracetamol overdosage. Lancet 1971; 1(7698):519–522.
  • Slattery JT, Levy G. Acetaminophen kinetics in acutely poisoned patients. Clin Pharmacol Ther 1979; 25(2):184–195.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Order Reprints Request Corporate Permissions

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

Request Academic Permissions

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.

Related research

People also read lists articles that other readers of this article have read.

Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine.

Cited by lists all citing articles based on Crossref citations.
Articles with the Crossref icon will open in a new tab.