Vol 13: Low rates of hepatotoxicity among Asian patients with paracetamol overdose: a review of 1024 cases.Reportar como inadecuado



 Vol 13: Low rates of hepatotoxicity among Asian patients with paracetamol overdose: a review of 1024 cases.


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This article is from BMC Pharmacology & Toxicology, volume 13.AbstractBackground: The metabolism of paracetamol in Asians is thought to differ from Westerners. Detailed clinical features of paracetamol -induced hepatotoxicity among Asians remains largely unreported. Methods: A retrospective review of adult cases with paracetamol overdose over a five-year duration was performed in two of the largest public institutions in this country. Prevalence and predictive factors for hepatotoxicity were determined. Results: Data on 1024 patients median age 23 years, 82.0% female, ethnic groups: Malays 40.8%, Chinese 20.9% , Indian 33.2% were obtained from January 2005 to December 2009. The median amount of paracetamol ingestion was 10.0 IQR 5.0 - 15.0 g and the median serum paracetamol level was 274.80 IQR 70.0 - 640.0 μmol-L at presentation. 75 7.3% patients developed hepatotoxicity. 23- 55 41.8% patients who had ingested  10 g of paracetamol and had a delayed 24 hour administration of N-acetyl cystine NAC developed hepatotoxicity. No patients developed acute liver failure nor suffered any mortality 0%. Independent predictors for hepatotoxicity were identified as Malay OR 2.22, 95% CI = 1.13-4.37 and Chinese OR 3.26, 95% CI = 1.55-6.84 ethnicity, paracetamol dose  10 g OR 2.61, 95% CI = 1.53-4.46, prolonged duration of time from paracetamol ingestion to hospital presentation 24 hours OR 10.71, 95% CI = 3.46-33.15 and prolonged duration of time from paracetamol ingestion to NAC administration 24 hours OR 9.02, 95% CI = 2.97-27.45. Conclusions: Paracetamol-induced hepatotoxicity rates in a multi-ethnic Asian population was low at 7.3%. Mortality and morbidity were non-existent despite high doses of paracetamol ingestion and delayed presentations to hospital.



Autor: Marzilawati, Abd-Rahman; Ngau, Yen-Yew; Mahadeva, Sanjiv

Fuente: https://archive.org/







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