ReviewBMC pharmacology & toxicology2012
Low rates of hepatotoxicity among Asian patients with paracetamol overdose: a review of 1024 cases.
Review in BMC pharmacology & toxicology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 42 citations in OpenAlex.
- Silymarin Protects against Acute Liver Injury Induced by Acetaminophen by Downregulating the Expression and Activity of the CYP2E1 Enzyme.Molecules (Basel, Switzerland) · 2022Article
- Successful management of delayed presentation of massive paracetamol overdose in a resource-limited setting: A case report from Nepal.Clinical case reports · 2022Article
- Facile Electrochemical Sensor for Sensitive and Selective Determination of Guaifenesin, Phenylephrine and Paracetamol on Electrochemically Pretreated Pencil Graphite Electrode.Micromachines · 2022Article
- Probiotics: Evolving as a Potential Therapeutic Option against Acetaminophen-Induced Hepatotoxicity.Biomedicines · 2022Review
- Sensitivity of dose-estimations for acute acetaminophen overdose in predicting hepatotoxicity risk using the Rumack-Matthew Nomogram.Pharmacology research & perspectives · 2022Article
- Epidemiological differences of common liver conditions between Asia and the West.JGH open : an open access journal of gastroenterology and hepatology · 2020Review
- Characteristics and Outcomes of Acetaminophen Overdose and Hepatotoxicity in Thailand.Journal of clinical and translational hepatology · 2019Article
- Characterisation and outcomes of adult patients with paracetamol overdose presenting to a tertiary hospital in Singapore.Singapore medical journal · 2017Article
- Endogenous Antioxidant and LOX-Mediated Systems Contribute to the Hepatoprotective Activity of Aqueous Partition of Methanol Extract ofFrontiers in pharmacology · 2017Article
- Acetaminophen-Induced Hepatotoxicity: a Comprehensive Update.Journal of clinical and translational hepatology · 2016Review
- PharmGKB summary: pathways of acetaminophen metabolism at the therapeutic versus toxic doses.Pharmacogenetics and genomics · 2015Article
- Pharmacogenomics of acetaminophen in pediatric populations: a moving target.Frontiers in genetics · 2014Review
- Pharmacogenetics of analgesic drugs.British journal of pain · 2013Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe metabolism of paracetamol in Asians is thought to differ from Westerners. Detailed clinical features of paracetamol -induced hepatotoxicity among Asians remains largely unreported.
methodsA 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.
resultsData 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).
conclusionsParacetamol-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.
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