Acetaminophen toxicity is the most common cause of acute liver failure in the United States and Europe. Although much is known about the metabolism of acetaminophen, many questions remain regarding the pathogenesis of liver injury. In this study, we examined the role of lipopolysaccharide-binding protein (LBP), a protein important in mediating cellular response to lipopolysaccharides, by using ...

OBJECTIVE To compare the performance of ibuprofen vs codeine for postoperative pain management after tonsillectomy as measured by need for emergency department (ED) treatment for pain and/or dehydration. STUDY DESIGN Retrospective case series with chart review. SETTING Tertiary children's hospital. SUBJECTS AND METHODS Consecutive series of patients who underwent tonsillectomy with or wit...

Analgesics, known to be hepatotoxic drugs, are frequently prescribed to patients with liver cirrhosis who are prone to drug-induced liver injury. No guidelines are available regarding the prescription of analgesics in these patients. Therefore, we aimed to evaluate the prescription pattern of most frequently used analgesics in patients with cirrhosis. We assessed the prescription pattern of ace...

Acetaminophen induces the mitochondrial permeability transition (MPT) in hepatocytes. Reactive oxygen species (ROS) trigger the MPT and play an important role in AAP-induced hepatocellular injury. Because iron is a catalyst for ROS formation, our aim was to investigate the role of chelatable iron in MPT-dependent acetaminophen toxicity to mouse hepatocytes. Hepatocytes were isolated from fasted...

A case is presented of a serious, potentially life-threatening intravenous acetaminophen overdose in a 3month-old (40 weeks’ post menstrual age), 2.3 kg baby girl. The neonate was scheduled for urgent laser therapy for retinopathy of prematurity. Instead of an intended intravenous Hartmann’s solution bolus of 10 ml·kg, the neonate received a 17 ml bolus of correctly labelled intravenous 1% acet...

Acetaminophen, an effective and popular over-the-counter pain reliever (e.g., Tylenol®), has recently been shown to blunt individuals’ reactivity to a range of negative stimuli beyond physical pain. Because past psychological and neuroimaging research has linked reduced sensitivity to negative reactions to similarly diminished sensitivity to positive reactions, we conducted two experiments test...

An Update of N-acetylcysteine Treatment for Acute Acetaminophen Toxicity in Children. Marzullo L. Curr Opin Pediatr. 2005;17(2):239–245 Acetaminophen Toxicity in Children. American Academy of Pediatrics. Committee on Drugs. Pediatrics. 2001; 108(4):1020–1024 Clinical Report—Fever and Antipyretic Use in Children. Section on Clinical Pharmacology and Therapeutics; Committee on Drugs, Sullivan JE,...

BACKGROUND Although it is known that acetaminophen causes oxidative injury in the liver, it is not known whether it causes oxidative stress in the respiratory tract. If so, this widely used analgesic may potentiate the adverse effects of oxidant air pollutants. OBJECTIVES The goal of this study was to determine if acetaminophen induces respiratory tract oxidative stress and/or potentiates the...

We read with interest the article by Nicolai et al. who described four children with Dravet syndrome treated with valproic acid (VPA) and topiramate (TPM), who all developed transient hepatic injury shortly after introduction of acetaminophen in therapeutic dosage. Based on the time interval between fever, administration of acetaminophen, epileptic status and liver enzyme disturbances, the auth...

CONTEXT Osteoarthritis (OA) is often treated with nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, or specific inhibitors of cyclooxygenase 2 (COX-2). OBJECTIVE To assess the relative therapeutic efficacy of rofecoxib, celecoxib, and acetaminophen in adults with OA. DESIGN AND SETTING Randomized, parallel-group, double-blind trial, conducted from June 1999 to February 2000, in ...