4,772 results match your criteria Toxicity Acetaminophen


Acetaminophen: Is Too Much of a Good Thing Too Much?

Compend Contin Educ Dent 2022 May;43(5):268-273; quiz 274

Associate Principal, Vizient Pharmacy Advisory Solutions, Irving, Texas; Clinical Professor, School of Pharmacy, University of Montana, Missoula, Montana; Clinical Assistant Professor, School of Dentistry, Oregon Health and Sciences University, Portland, Oregon; Adjunct Professor, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia; Fellow, American Society of Health-System Pharmacists; Fellow, American College of Healthcare Executives.

Acetaminophen is a popular, universally used, over-the-counter pain medication contained in more than 600 different products and available in a plethora of dosage forms. Acetaminophen is an important adjunct to manage postoperative dental pain in combination with a nonsteroidal anti-inflammatory drug such as ibuprofen. For the treatment of more severe pain, acetaminophen is often formulated with non-opioid and opioid agents. Read More

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Comparison of Two-Bag Versus Three-Bag N-Acetylcysteine Regimens for Pediatric Acetaminophen Toxicity.

Ann Pharmacother 2022 May 19:10600280221097700. Epub 2022 May 19.

University of Colorado Anschutz Medical Campus, Aurora, CO, USA.

Background: Acetaminophen overdose is a leading cause of liver failure, and a leading cause of pediatric poisoning requiring hospital admission. The antidote, N-acetylcysteine (NAC), is traditionally administered as a three-bag intravenous infusion. Despite its efficacy, NAC is associated with high incidence of nonallergic anaphylactoid reactions (NAARs). Read More

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A critical review on paracetamol removal from different aqueous matrices by Fenton and Fenton-based processes, and their combined methods.

Chemosphere 2022 May 13;303(Pt 1):134883. Epub 2022 May 13.

Departamento de Química, DCNE, Universidad de Guanajuato, Cerro de la Venada s/n, Pueblito de Rocha, Guanajuato, C.P. 36040, Mexico. Electronic address:

Paracetamol (PCT), also known as acetaminophen, is a drug used to treat fever and mild to moderate pain. After consumption by animals and humans, it is excreted through the urine to the sewer systems, wastewater treatment plants, and other aquatic/natural environments. It has been detected in trace amounts in effluents of wastewater plant treatments, sewage sludge, hospital wastewaters, surface waters, and drinking water. Read More

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Urgent need to standardize labelling of acetaminophen-paediatric liquid drug products in Saudi Arabia.

Int J Pediatr Adolesc Med 2022 Mar 23;9(1):62-65. Epub 2021 Sep 23.

Pediatric Emergency Medicine, Department of Emergency Medicine, Maternity & Children Hospital, Qassim, Saudi Arabia.

In this study, dosing instructions in package inserts of all 12 paediatric liquid acetaminophen products registered in pharmacies in the Kingdom of Saudi Arabia were analysed to determine the potential for administering a supratherapeutic dose of acetaminophen. Doses in millilitres were calculated as mg/kg for four age groups: three months old, one year old, six years old, and twelve years old, and based on the 3rd, 50th, and 75th weight percentiles of each age group. Acetaminophen concentrations in the products varied, and only two products included Arabic language instructions. Read More

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L. Polysaccharide Alleviates Oxidative Stress and Protects From Acetaminophen-Induced Hepatotoxicity Activating the Nrf2-ARE Pathway.

Front Pharmacol 2022 29;13:888560. Epub 2022 Apr 29.

Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

The alleviation of oxidative stress is considered an effective treatment for acetaminophen (APAP)-induced acute liver injury (AILI). However, it remains unknow whether the potential antioxidant L. polysaccharide (SCLP) protects against AILI. Read More

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Performance study on adsorptive removal of acetaminophen from wastewater using silica microspheres: Kinetic and isotherm studies.

Chemosphere 2021 Jun 8;272:129896. Epub 2021 Feb 8.

Integrated Bioprocessing Laboratory, School of Bioengineering, SRM Institute of Science and Technology (SRM IST), Kattankulathur, Tamil Nadu, 603 203, India. Electronic address:

Owing to the global industrialization, a new generation of pharmaceutical pollutants with high toxicity and persistency have been detected. In the present study, silica microspheres, a promising adsorbent has been employed to investigate the extent of removal of prevalent therapeutic acetaminophen, an emerging micropollutant, from wastewater in isolated batch experiments. The BET surface area of the adsorbent was 105. Read More

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[Mechanism of Tibetan medicine Ershiwuwei Songshi Pills against liver injury induced by acetaminophen in mice based on Keap1/Nrf2 and TLR4/NF-κB p65 signaling pathways].

Zhongguo Zhong Yao Za Zhi 2022 Apr;47(8):2049-2055

College of Life Science and Engineering,Southwest Jiaotong University Chengdu 610031,China.

The present study investigated the mechanism of the Tibetan medicine Ershiwuwei Songshi Pills(ESP) against the liver injury induced by acetaminophen(APAP) in mice based on the kelch-like ECH-associated protein 1(Keap1)/nuclear transcription factor E2 related factor 2(Nrf2) and Toll-like receptor 4(TLR4)/nuclear factor-kappa B(NF-κB) p65 signaling pathways. Kunming mice were randomly divided into a blank control group, a model group, an N-acetyl-L-cysteine(NAC) group, and high-(400 mg·kg~(-1)), medium-(200 mg·kg~(-1)), and low-dose(100 mg·kg~(-1)) ESP groups. After 14 days of continuous administration, except for those in the control group, the mice were intraperitoneally injected with 200 mg·kg~(-1) APAP. Read More

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Management of Pharmacologic Adverse Effects in Advanced Liver Disease.

Clin Drug Investig 2022 May 6. Epub 2022 May 6.

Unidad de Gestión del Aparato Digestivo, Hospital Universitario Virgen de la Victoria, Málaga, Spain.

As a consequence of the altered hepatic architecture in advanced liver disease, drug metabolism is modified by changes in pharmacokinetic and pharmacodynamic properties, leading to the appearance of adverse effects and drug interactions and increasing the risk of over- or underdosing of medications. However, there are no tests that accurately determine the degree of impairment of liver metabolic function; therefore, general recommendations are established based on the degree of hepatic extraction, degree of hepatic metabolism, and degree of protein binding. Although the hepatic toxicity of some frequently used drugs, such as acetaminophen, is well known, many health care professionals are unaware or not fully aware of the deleterious effects that other drugs can have on patients with advanced liver injury, as is the case for nonsteroidal anti-inflammatory drugs. Read More

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The role of Iron in lipid peroxidation and protein nitration during acetaminophen-induced liver injury in mice.

Toxicol Appl Pharmacol 2022 Jun 2;445:116043. Epub 2022 May 2.

Department of Pharmacology, Toxicology and Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA. Electronic address:

Acetaminophen (APAP) hepatotoxicity, a leading cause of acute liver failure in western countries, is characterized by mitochondrial superoxide and peroxynitrite formation. However, the role of iron, especially as facilitator of lipid peroxidation (LPO), has been controversial. Our aim was to determine the mechanism by which iron promotes cell death in this context. Read More

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Fomepizole as an adjunctive therapy for acetaminophen poisoning: cases reported to the toxicology investigators consortium (ToxIC) database 2015-2020.

Clin Toxicol (Phila) 2022 May 5:1-6. Epub 2022 May 5.

American College of Medical Toxicology, Phoenix, AZ, USA.

Introduction: Fomepizole inhibits formation of toxic acetaminophen (APAP) metabolites and may prevent or reverse mitochondrial toxicity. Given these mechanisms, it may be beneficial in patients with severe APAP toxicity. Current patterns of use for this indication are not well-studied. Read More

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Protective Effect of the Hydroalcoholic Extract of Pelargonium Graveolens L. on Rats with Acetaminophen- Induced Nephrotoxicity.

Iran J Kidney Dis 2022 Mar;16(2):108-114

Clinical Research Development Unit of Shahid Beheshti hospital, Hamadan University of Medical Sciences, Hamadan, Iran.

Introduction: Geranium has various antioxidant, anti-inflammatory, and anti-microbial effects. Prescribing glutathione probably enhances the protective mechanisms of nephrons against oxidative stresses. This study aimed to evaluate the protective effect of geranium on acetaminophen-induced nephrotoxic rats. Read More

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Prevalence, severity, duration and resolution of cholestasis after acute liver failure.

BMJ Open Gastroenterol 2022 Apr;9(1)

Department of Intensive Care, Austin Hospital, Heidelberg, Victoria, Australia.

Objective: Persistent cholestasis may follow acute liver failure (ALF), but its course remains unknown. We aimed to describe the prevalence, onset, severity, duration and resolution of post-ALF cholestasis.

Design: Cohort of 127 adult patients with ALF at a liver transplantation centre identified using electronic databases. Read More

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The Roles of Antidotes in Emergency Situations.

Emerg Med Clin North Am 2022 May 5;40(2):381-394. Epub 2022 Apr 5.

Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, 1391 Speer Boulevard, Suite 600, Denver, CO 80204, USA. Electronic address:

Management of the acutely poisoned patient requires supportive care and timely administration of antidotes to minimize ongoing toxicity and mortality. New applications for old antidotes include utilization of methylene blue and hydroxocobalamin in vasoplegia. Fomepizole is also being evaluated as a potential adjunct in acetaminophen toxicity. Read More

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6'--Caffeoylarbutin from Que Zui tea ameliorates acetaminophen-induced liver injury enhancing antioxidant ability and regulating the PI3K signaling pathway.

Food Funct 2022 May 10;13(9):5299-5316. Epub 2022 May 10.

Faculty of Food Science and Engineering, Kunming University of Science and Technology, Kunming, 650500, China.

Que Zui tea (QT), a traditional herbal tea in China, has a significant hepatoprotective effect. 6'--Caffeoylarbutin (CA) is the most abundant chemical compound in the QT. However, the hepatoprotective effect of CA has not been investigated. Read More

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Electrogenerated chemiluminescence of a Ru(bpy) /arginine system: a specific and sensitive detection of acetaminophen.

RSC Adv 2022 Jan 24;12(5):3157-3164. Epub 2022 Jan 24.

Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, Department of Pharmacy, School of Medicine, Hunan Normal University Changsha 410013 Hunan China

Ru(bpy)Cl/TPrA is a prominent and widely used ECL system in analytical science. However, the co-reactant TPrA restricts the variety of applications because of its toxicity, volatility, and high cost. Here, we use arginine (Arg) as an alternative co-reactant for Ru(bpy) by taking advantage of its low cost, non-toxicity, and biocompatibility. Read More

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January 2022

Disruption of peroxisome proliferator-activated receptor α in hepatocytes protects against acetaminophen-induced liver injury by activating the IL-6/STAT3 pathway.

Int J Biol Sci 2022 6;18(6):2317-2328. Epub 2022 Mar 6.

Department of Infectious Diseases, Peking University First Hospital, Beijing, 100034, China.

Peroxisome proliferator-activated receptor α (PPARα) is a ligand-activated transcription factor abundantly expressed in liver. PPARα activator has been previously reported to protect against acetaminophen-induced hepatotoxicity, but fenofibrate, a lipid-lowering drug that activates PPARα, has a common side-effect causing liver injury. Thus, the exact effect of liver PPARα on drug-induced liver injury remains obscure. Read More

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Molecular pathogenesis of acetaminophen-induced liver injury and its treatment options.

J Zhejiang Univ Sci B 2022 Apr;23(4):265-285

State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.

Acetaminophen, also known as -acetyl--aminophenol (APAP), is commonly used as an antipyretic and analgesic agent. APAP overdose can induce hepatic toxicity, known as acetaminophen-induced liver injury (AILI). However, therapeutic doses of APAP can also induce AILI in patients with excessive alcohol intake or who are fasting. Read More

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Hepatoprotective Effects of Crude Stem Bark Extracts and Solvent Fractions of against Acetaminophen-Induced Liver Injury in Rats.

Can J Gastroenterol Hepatol 2022 29;2022:1449286. Epub 2022 Mar 29.

Department of Pharmacology and Clinical Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Oromia, Ethiopia.

Lam (Boraginaceae) is widely used in Ethiopian folk medicine for the treatment of different types of liver disorders. Thus, this study aimed to investigate the hepatoprotective effects of an aqueous (CAAE), 80% methanol extracts of stem bark (CAME), and the solvent fractions of the methanol extract against acetaminophen (APAP)-induced liver injury in rats. Acute toxicity test and APAP-induced lethality test were done on mice of either sex, while APAP dose selection test was done on female rats. Read More

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Paracetamol (Acetaminophen) and its Effect on the Developing Mouse Brain.

Front Toxicol 2022 22;4:867748. Epub 2022 Mar 22.

Department of Pharmaceutical Biosciences, Molecular Neuropharmacology, Biomedical Center, Uppsala University, Uppsala, Sweden.

Paracetamol, or acetaminophen (AAP), is the most commonly used analgesic during pregnancy and early life. While therapeutic doses of AAP are considered harmless during these periods, recent findings in both humans and rodents suggest a link between developmental exposure to AAP and behavioral consequences later in life. The aim of this study is to evaluate the impact of neonatal exposure to clinically relevant doses of AAP on adult spontaneous behavior, habituation, memory, learning, and cognitive flexibility later in life using a mouse model. Read More

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A Comparison of Mesenchymal Stem Cell-derived Hepatocyte-like Cells and HepG2 Cells for Use in Drug-Induced Liver Injury Studies.

Altern Lab Anim 2022 Apr 5:2611929221091269. Epub 2022 Apr 5.

Department of Obstetrics & Gynaecology, 63735University of Colombo, Faculty of Medicine, Colombo, Sri Lanka.

Liver cell lines obtained from hepatomas, for example, HepG2 cells, are commonly used in drug toxicity studies. However, functional hepatocyte-like cells derived from mesenchymal stem cells (MSCs) could be a better option for use in the study of drug metabolism and toxicity. Overdose of acetaminophen (APAP) and excess alcohol consumption are common causes of liver damage. Read More

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Factors that influence how adults select oral over-the-counter analgesics: A systematic review.

J Am Pharm Assoc (2003) 2022 Mar 14. Epub 2022 Mar 14.

Background: Oral over-the-counter (OTC) analgesics such as acetaminophen, aspirin, ibuprofen, and naproxen sodium are widely used to treat pain. Although generally considered safe, inappropriate use can lead to injury.

Objective: This study aimed to explore patient attitudes, beliefs, and perceptions about the efficacy and potential risks of oral OTC analgesics and to identify factors that adult patients use to make decisions about these medications. Read More

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Egyptian perspectives on potential risk of paracetamol/acetaminophen-induced toxicities: Lessons learnt during COVID-19 pandemic.

Toxicol Rep 2022 29;9:541-548. Epub 2022 Mar 29.

Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

Paracetamol/Acetaminophen was widely used as a first-line antipyretic and analgesic for COVID-19 patients without giving any attention to the potential risk of related toxicities. A survey was conducted on 176 Egyptians using an online survey portal to assess their knowledge, and attitude regarding potential risk of paracetamol toxicities and whether COVID-19 pandemic affected their practices regarding safe use of paracetamol. The self-administered questionnaire was developed by the researchers and was validated by expert opinions. Read More

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Orientin reverses acetaminophen-induced acute liver failure by inhibiting oxidative stress and mitochondrial dysfunction.

J Pharmacol Sci 2022 May 3;149(1):11-19. Epub 2022 Feb 3.

Department of Nephrology, The First Hospital of Jilin University, Changchun, 130021, China; Department of Gastroenterology, The First Hospital of Jilin University, Changchun, 130021, China. Electronic address:

Oxidative stress, as an important pathogenic factor, plays a critical role in acetaminophen (APAP) overdose-induced acute liver failure (ALF). Thus, an antioxidative strategy may be a good way to alleviate APAP-induced liver damage. Previous research has reported that Orientin (Ori) possesses antioxidant, anti-inflammatory and anticancer effects. Read More

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Pediatric Acute Liver Failure: A Clinicopathological Perspective.

Pediatr Dev Pathol 2022 Mar 31:10935266211067893. Epub 2022 Mar 31.

Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.

Pediatric acute liver failure (PALF) is a life-threatening disorder characterized by acute hepatocellular injury occurring in children without recognized underlying liver disease. The clinicopathologic evaluation of PALF requires a different approach from that in adults. The diagnostic considerations differ depending on the age, personal and family history, geographical region, and clinical presentation. Read More

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Urolithin A protects against acetaminophen-induced liver injury in mice via sustained activation of Nrf2.

Int J Biol Sci 2022 28;18(5):2146-2162. Epub 2022 Feb 28.

Key Laboratory of Molecular Target & Clinical Pharmacology and the State & NMPA Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences& The Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou511436, China.

Acetaminophen overdose is a leading cause of acute live failure worldwide. N-acetylcysteine (NAC), as the only antidote, is limited due to its narrow therapeutic time window. Here we demonstrated that Urolithin A (UA), a metabolite of ellagitannin natural products in the gastrointestinal flora, protected against acetaminophen-induced liver injury (AILI) and is superior to NAC in terms of dosage and therapeutical time window. Read More

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Acetaminophen pharmacokinetics in geese.

J Am Vet Med Assoc 2022 Mar 24:1-8. Epub 2022 Mar 24.

Department of Veterinary Sciences, University of Pisa, Pisa, Italy.

Objective: To evaluate the pharmacokinetics of acetaminophen (APAP) after single-dose IV and PO in the goose; to quantify APAP and its main metabolites in goose muscle, heart, lung, liver, and kidney; and to perform a histopathologic evaluation of goose stomach, duodenum, liver, and kidney tissues for potential signs of toxicity.

Animals: 24 geese.

Procedures: Geese were randomly divided into 3 groups (n = 8). Read More

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Epitranscriptomic Reprogramming Is Required to Prevent Stress and Damage from Acetaminophen.

Genes (Basel) 2022 02 25;13(3). Epub 2022 Feb 25.

The RNA Institute, University at Albany, Albany, NY 12222, USA.

Epitranscriptomic marks, in the form of enzyme catalyzed RNA modifications, play important gene regulatory roles in response to environmental and physiological conditions. However, little is known with respect to how acute toxic doses of pharmaceuticals influence the epitranscriptome. Here we define how acetaminophen (APAP) induces epitranscriptomic reprogramming and how the writer Alkylation Repair Homolog 8 (Alkbh8) plays a key gene regulatory role in the response. Read More

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February 2022

Macrophage Migration Inhibitory Factor as a Potential Biomarker in Acetaminophen Overdose: A Pilot Study.

Toxicol Commun 2022 5;6(1):1-5. Epub 2022 Jan 5.

Division of Medical Toxicology, Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, Elmhurst Hospital Center, New York, NY.

Introduction: Acetaminophen overdose is a leading cause of liver failure in the United States. Macrophage migration inhibitory factor (MIF) is a cytokine that is released early and promotes acetaminophen toxicity in preclinical models. This cytokine could prove a useful biomarker in emergency department (ED) patients immediately following an acute acetaminophen overdose. Read More

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January 2022

3,4-dihydroxyphenylethyl alcohol glycoside reduces acetaminophen-induced acute liver failure in mice by inhibiting hepatocyte ferroptosis and pyroptosis.

PeerJ 2022 14;10:e13082. Epub 2022 Mar 14.

Tianjin Medical University, Tianjin, China.

APAP is one of the most commonly used antipyretic and pain medications, but excessive use can cause liver toxicity and damage. 3,4-dihydroxyphenylethyl alcohol glycoside (DAG) is a component isolated from known to have anti-apoptotic, anti-oxidation and anti-inflammatory effects. However, the effects of DAG on acute liver failure (ALF) are largely unknown. Read More

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Optimization of gradient reversed phase high performance liquid chromatography analysis of acetaminophen oxidation metabolites using linear and non-linear retention model.

J Chromatogr A 2022 Apr 10;1669:462956. Epub 2022 Mar 10.

University of Pardubice, Faculty of Chemical Technology, Department of Analytical Chemistry, Studentska 573, Pardubice CZ-53210, Czech Republic. Electronic address:

Acetaminophen (paracetamol, APAP) is one of the most widely used drugs worldwide. Unfortunately, its overdose, which is caused by predominant oxidation of APAP, can lead to acute liver injury. In liver, oxidized APAP is conjugated with glutathione, leading to APAP-glutathione conjugate, which is metabolized to APAP-cysteine and APAP-N-acetylcysteine conjugates. Read More

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