Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/22448
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dc.contributor.authorWong, Anselm Y-
dc.contributor.authorHeard, Kennon-
dc.contributor.authorGraudins, Andis-
dc.contributor.authorDart, Richard-
dc.contributor.authorSivilotti, Marco L A-
dc.date2020-01-14-
dc.date.accessioned2020-01-20T05:24:55Z-
dc.date.available2020-01-20T05:24:55Z-
dc.date.issued2020-04-
dc.identifier.citationJournal of Medical Toxicology 2020; 16(2): 188-194-
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/22448-
dc.description.abstractAcetaminophen protein adducts in the circulation are a specific biomarker of acetaminophen oxidation, and may be a more sensitive measure of impending hepatic injury following overdose than alanine transaminase (ALT). We performed an exploratory analytical substudy of adducts during a clinical trial (NACSTOP) of abbreviated (12-hour) versus control (20-hour) acetylcysteine to identify any signal of diminished antidotal effectiveness with shortened therapy. We measured adducts at 0, 12, and 20 hours from a convenience sample of subjects enrolled in the cluster-controlled NACSTOP trial evaluating a 12-hour ("abbreviated"; 200 mg/kg over 4 hours, 50 mg/kg over 8 hours) vs 20-hour acetylcysteine regimen ("control"; 200 mg/kg over 4 hours, 100 mg/kg over 16 hours). Adducts were assayed using high-performance liquid chromatography/mass spectrometry. Median ALT 20 hours after the initiation of acetylcysteine was 12 U/L (IQR 8,14) in the abbreviated 12-hour regimen group (N = 8), compared with the control group 16 U/L (IQR 11,21; N = 21) (p = 0.46). Adduct concentrations were similarly low in both groups: abbreviated [(0.005 μmol/L, IQR (0,0.14)] and control [(0.005 μmol/L, IQR (0,0.05)] (p = 0.61). There were minimal to no acetaminophen protein adducts detected. These findings further support discontinuing acetylcysteine when acetaminophen concentrations are low and liver function tests normal after 12 hours of treatment.-
dc.language.isoeng-
dc.subjectAcetaminophen-
dc.subjectAcetylcysteine-
dc.subjectNAC-
dc.subjectParacetamol-
dc.subjectPoisoning-
dc.titleAdducts Post Acetaminophen Overdose Treated with a 12-Hour vs 20-Hour Acetylcysteine Infusion.-
dc.typeJournal Article-
dc.identifier.journaltitleJournal of medical toxicology-
dc.identifier.affiliationSection of Medical Pharmacology and Toxicology, Department of Emergency Medicine, University of Colorado, Aurora, CO, USAen
dc.identifier.affiliationAustin Toxicology Service, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationDepartments of Emergency Medicine, and of Biomedical & Molecular Sciences, Queen's University, Kingston, Ontario, Canadaen
dc.identifier.affiliationVictorian Poisons Information Centre, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationRocky Mountain Poison and Drug Center, Denver Health and Hospitals, Denver, CO, USAen
dc.identifier.affiliationMonash Toxicology Service, Monash Health, School of Clinical Sciences, Department of Medicine, Monash University, Melbourne, Victoria, Australiaen
dc.identifier.affiliationRocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, CO, USAen
dc.identifier.affiliationSchool of Clinical Sciences, Department of Medicine, Monash University, Melbourne, Victoria, Australiaen
dc.identifier.affiliationCentre for Integrated Critical Care, University of Melbourne, Melbourne, Victoria, Australiaen
dc.identifier.doi10.1007/s13181-020-00757-9-
dc.identifier.orcid0000-0002-6817-7289-
dc.identifier.pubmedid31939054-
dc.type.austinJournal Article-
local.name.researcherGraudins, Andis
item.languageiso639-1en-
item.cerifentitytypePublications-
item.grantfulltextnone-
item.fulltextNo Fulltext-
item.openairetypeJournal Article-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
crisitem.author.deptToxicology-
crisitem.author.deptEmergency-
crisitem.author.deptVictorian Poisons Information Centre-
crisitem.author.deptVictorian Poisons Information Centre-
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