Acetaminophen-related Hepatotoxicity

被引：235

作者：

Bunchorntavakul, Chalermrat ^{[1
,2
]}

Reddy, K. Rajender ^{[1
]}

机构：

[1] Univ Penn, Hosp Univ Penn, Dept Med, Div Gastroenterol & Hepatol, Philadelphia, PA 19104 USA

[2] Rangsit Univ, Coll Med, Rajavithi Hosp, Div Gastroenterol & Hepatol,Dept Med, Bangkok 10400, Thailand

来源：

CLINICS IN LIVER DISEASE | 2013年 / 17卷 / 04期

关键词：

Acetaminophen; Hepatotoxicity; Overdose; Drug-induced liver injury; Acute liver failure; N-acetylcysteine; Liver transplantation; ACUTE LIVER-FAILURE; ORAL N-ACETYLCYSTEINE; FULMINANT HEPATIC-FAILURE; ASSESSMENT SOFA SCORE; ACTIVATED-CHARCOAL; PARACETAMOL OVERDOSE; PROTEIN ADDUCTS; GASTRIC LAVAGE; DOUBLE-BLIND; RISK-FACTOR;

D O I：

10.1016/j.cld.2013.07.005

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Acetaminophen (APAP) is the leading worldwide cause of drug overdose and acute liver failure (ALF). Single overdose ingestion and therapeutic misadventure may cause hepatotoxicity. Several factors, such as concomitant alcohol use or abuse, concurrent medications, genetic factors, and nutritional status, can influence the susceptibility and severity of APAP hepatotoxicity. Early manifestations of APAP hepatotoxicity are nonspecific, but require prompt recognition by physicians. Patients with repeated overdose tend to present late, and in such hepatotoxicity may have already evolved. N-acetylcysteine is a very effective antidote when giving within 8 hours, and is also recommended after a presentation of hepatotoxicity and ALF. The prognosis of patients with APAP-induced ALF is better than other causes of ALF. Liver transplantation should be offered to those who are unlikely to survive.

引用

页码：587 / +

页数：22

共 123 条

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