Evaluation of cut-off values in acute paracetamol overdose following the United Kingdom guidelines

The United Kingdom guideline for acute paracetamol overdose has recommended the use of '100-treatment line'. Emergency medical centers in some developing countries lack the resources for timely reporting of paracetamol concentrations, hence treatment depends on reported dose. This study ai...

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Bibliographic Details
Published in:BMC pharmacology & toxicology 2022-01, Vol.23 (1), p.5-5, Article 5
Main Authors: Jeong, Hyun Ho, Cha, Kyungman, Choi, Kyoung Ho, So, Byung Hak
Format: Article
Language:English
Subjects:
Acetaminophen
Acetylcysteine
Activated carbon
Activated charcoal
Adolescent
Alcohol
Analgesics
Analgesics, Non-Narcotic
Analysis
Antidote
Charcoal
Chemical and Drug Induced Liver Injury - drug therapy
Developing countries
Dosage
Drug dosages
Drug Overdose - drug therapy
Drugs
Emergency medical services
Health care facilities
Hepatotoxicity
Humans
Ingestion
LDCs
Medical centers
Medical laboratories
Overdose
Paracetamol
Patients
Poisoning
Poisons
Regression analysis
Retrospective Studies
Risk factors
Subgroups
United Kingdom
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Summary:The United Kingdom guideline for acute paracetamol overdose has recommended the use of '100-treatment line'. Emergency medical centers in some developing countries lack the resources for timely reporting of paracetamol concentrations, hence treatment depends on reported dose. This study aimed to examine whether using an reported dose is safe to predict concentration above the 100-line. Data were retrieved from two emergency medical centers retrospectively, between 2010 and 2017. The inclusion criteria were single acute paracetamol overdose, presentation within 15 h, and age ≥ 14 years. Multiple linear regression was performed to determine the effect of ingested dose on paracetamol concentration. Subgroups were created based on ingested dose, rate of concentration above 100-line were investigated. One hundred and seventy-two patients were enrolled in the primary analysis; median dose was 133.3 mg/kg and 46 (37.8%) had concentration above 100-line in the first test. Only dose per weight was moderately correlated with the first concentration (R  = 0.410, p  150 mg/kg as the cut-off value for N-acetylcysteine treatment with risk stratification for hepatotoxicity if the patient is ≥14 years and visit the ED within 15 h after an acute paracetamol overdose.
ISSN:2050-6511
2050-6511
DOI:10.1186/s40360-021-00547-1