US EPA

2855330 

Journal Article 

Acetaminophen hepatoxicity 

Broughan, TA; Soloway, RD 

2000 

Yes 

Digestive Diseases and Sciences
ISSN: 0163-2116
EISSN: 1573-2568 

45 

8 

1553-1558 

English 

11007105 

To determine the influence of psychosocial factors in accidental and deliberate acetaminophen overdose, we reviewed the charts of 207 overdose patients, and 48 met our criteria for acetaminophen toxicity. Two patients died. A psychiatric history was present in 75%, and 25% had a previous or subsequent suicide attempt. A substance abuse history was elicited from 46% and 36% of adolescent teenagers had a teen pregnancy. The mean time to starting N-acetylcysteine was 18.5 hr. Delayed N-acetylcysteine administration led to higher transaminase levels. Alcohol abuse was associated with a longer hospital stay. Mean AST was 8,860 IU/liter in the accidental and 3,013 IU/liter in the suicide groups. We concluded that management of acetaminophen toxicity can be optimized by early identification, obtaining a complete drug screen, starting N-acetylcysteine early or whenever toxic acetaminophen levels or elevated transaminases are identified, and referring patients with acetaminophen toxicity to a liver center.