Document Detail


Medicine, poison, and mystic potion: a personal perspective on paracetamol Louis Roche lecture, Stockholm, 2009.
MedLine Citation:
PMID:  20199128     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Paracetamol poisoning has been a clinical problem for over 40 years. This article reflects the content of the Louis Roche lecture given on this topic in 2009. HISTORICAL CONTEXT: Initially key work illustrated the relationship between plasma paracetamol concentration and risk of liver injury facilitating the development of antidote strategies. Much of this work was done in the Edinburgh clinical toxicology unit. DISCUSSION: The antidote most widely used, acetylcysteine, was developed in Edinburgh and subsequently shown to be associated with adverse effects. Studies on this aspect and on key problems remaining in patient management are described. These include the identification of patients at greatest risk of toxicity, in order that they may be targeted for appropriate early intervention. More recent work suggests that the inflammatory response to paracetamol-induced liver injury may offer new targets for drug therapy in this major poisoning. CONCLUSION: Paracetamol poisoning remains a challenging problem, but new approaches to treatment seem possible based on recent experimental studies in animals and humans.
Authors:
D Nicholas Bateman; James Dear
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Publication Detail:
Type:  Historical Article; Journal Article    
Journal Detail:
Title:  Clinical toxicology (Philadelphia, Pa.)     Volume:  48     ISSN:  1556-9519     ISO Abbreviation:  Clin Toxicol (Phila)     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-03-04     Completed Date:  2010-03-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101241654     Medline TA:  Clin Toxicol (Phila)     Country:  England    
Other Details:
Languages:  eng     Pagination:  97-103     Citation Subset:  AIM; IM    
Affiliation:
Royal Infirmary of Edinburgh, Edinburgh, UK. nick.bateman@luht.scot.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Acetaminophen / history,  pharmacokinetics,  poisoning*
Acetylcysteine / adverse effects,  pharmacology,  therapeutic use
Analgesics, Non-Narcotic / history,  pharmacokinetics,  poisoning*
Animals
Antidotes / adverse effects,  pharmacology,  therapeutic use
Drug-Induced Liver Injury / etiology*,  history
History, 19th Century
History, 20th Century
History, 21st Century
Humans
Risk Factors
Chemical
Reg. No./Substance:
0/Analgesics, Non-Narcotic; 0/Antidotes; 103-90-2/Acetaminophen; 616-91-1/Acetylcysteine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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