Acetaminophen Research Today is a free monthly online journal that collates and summarizes the latest research about Acetaminophen, including details on paracetamol, pain relief, side effects, toxicity. | ||||||
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Hepatic tolerance of repeated intravenous paracetamol administration in neonates.Allegaert K, Rayyan M, De Rijdt T, Van Beek F, Naulaers G Neonatal Intensive Care Unit, University Hosptials Leuven, Leuven, Belgium. allegaert@uz.kuleuven.ac.be INTRODUCTION: An intravenous (i.v.) formulation of paracetamol is available, but reports on its hepatic tolerance in neonates are limited. We therefore assessed hepatic tolerance of i.v. paracetamol in neonates. METHODS: In a single centre retrospective study, clinical data and hepatic enzyme profiles (ALT, AST, gammaGT) were collected in neonates treated with i.v. paracetamol between January 1, 2006 and October 1, 2007. Hepatic enzyme profiles were retrieved from 2 days before until 2 days after i.v. paracetamol administration. Mann-Whitney U-test was used to compare hepatic enzymes before, during, and after i.v. treatment. Correlations (Spearman rank) of hepatic enzymes with duration of treatment during i.v. administration were investigated. RESULTS: In 189 cases, 2360 administrations {postmenstrual age 38 (range 30-55) weeks, postnatal age 5 (1-182) days} were documented and 1132 hepatic enzyme observations were available in 149/189 cases. There was no significant increase in ALT, AST, or gammaGT when pretreatment observations (n = 310) were compared with observations during (n = 649) or during with after (n = 173) treatment, nor was there a significant increase during administration. CONCLUSIONS: This retrospective study on hepatic tolerance provides evidence on safety aspects of i.v. paracetamol in neonates. Future studies should focus on dose-findings and pharmacodynamics of this formulation in neonates. Published 3 April 2008 in Paediatr Anaesth, 18(5): 388-92. Articles on Acetaminophen published 2 April 2008: Aspirin, NSAID, and acetaminophen use and the risk of endometrial cancer. Cancer Res, 68(7): 2507-13. To date, no prospective studies have explored the relationship between the use of aspirin, other nonsteroidal anti-inflammatory medications (NSAID), and acetaminophen and endometrial adenocarcinoma. Of the 82,971 women enrolled in a prospective cohort study, 747 developed medical record-confirmed invasive endometrial cancer over a 24-year period. Use of aspirin was ascertained from 1980 to 2004, and for other NSAIDs and acetaminophen, from 1990 to 2004. Cox regression models calculated ... [Abstract] [Full-text] Articles on Acetaminophen published 5 March 2008: Paracetamol (acetaminophen) pharmacodynamics: interpreting the plasma concentration. Arch Dis Child, 93(3): 241-7. Interpretation of analgesic and antipyretic responses documented after paracetamol administration is confused because response is not directly related to concentration in the blood, but rather to an effect compartment. The effect compartment does not have real measurable concentrations, but concentrations equate approximately to those observed in the cerebrospinal fluid. A time delay exists before drug reaches the effect compartment, and the equilibration half-time between the central and ... [Abstract] [Full-text] Articles on Acetaminophen published 29 February 2008: A randomized controlled trial comparing acetaminophen plus ibuprofen versus acetaminophen plus codeine plus caffeine after outpatient general surgery. J Am Coll Surg, 206(3): 472-9. BACKGROUND: Narcotics are used extensively in outpatient general surgery but are often poorly tolerated with variable efficacy. Acetaminophen combined with NSAIDs is a possible alternative. The objective of this study was to compare the efficacy of acetaminophen, codeine, and caffeine (Tylenol No. 3) with acetaminophen and ibuprofen for management of pain after outpatient general surgery procedures. STUDY DESIGN: A double-blind randomized controlled trial was performed in patients undergoing ... [Abstract] [Full-text] Articles on Acetaminophen published 26 February 2008: Survey of cases of paracetamol overdose in the UK referred to National Poisons Information Service (NPIS) consultants. Emerg Med J, 25(3): 140-3. BACKGROUND: Paracetamol is the most common means of drug overdose in the UK. Guidance on management is available to junior doctors through TOXBASE, the online resource managed by the UK National Poisons Information Service (NPIS) and in poster form. TOXBASE is supported by NPIS units and further by a UK national rota of clinical toxicologists. A study was undertaken to examine reasons why calls about paracetamol are referred to consultants to better understand issues in managing this common ... [Abstract] [Full-text] Articles on Acetaminophen published 25 February 2008: Acute acetaminophen overdose is associated with dose-dependent hypokalaemia: a prospective study of 331 patients. Basic Clin Pharmacol Toxicol, 102(3): 325-8. Hypokalaemia is a recognized complication of acute acetaminophen overdose. It is unclear whether this might be a pharmacological effect of acetaminophen, or due to association with confounding factors. The present study sought to better characterize the relationship between acetaminophen concentrations and risk of hypokalaemia. A prospective study of patients received N-acetylcysteine treatment within 15 hr of acute acetaminophen ingestion. Serum potassium concentrations were determined before ... [Abstract] [Full-text] Articles on Acetaminophen published 1 February 2008: Acetaminophen (paracetamol) is a selective cyclooxygenase-2 inhibitor in man. FASEB J, 22(2): 383-90. For more than three decades, acetaminophen (INN, paracetamol) has been claimed to be devoid of significant inhibition of peripheral prostanoids. Meanwhile, attempts to explain its action by inhibition of a central cyclooxygenase (COX)-3 have been rejected. The fact that acetaminophen acts functionally as a selective COX-2 inhibitor led us to investigate the hypothesis of whether it works via preferential COX-2 blockade. Ex vivo COX inhibition and pharmacokinetics of acetaminophen were assessed ... [Abstract] [Full-text] Development of an HPLC-MS/MS method for the selective determination of paracetamol metabolites in mouse urine. Anal Biochem, 374(1): 106-11. An HPLC-MS/MS method has been developed for the selective quantitative analysis of paracetamol and its two major metabolites. The use of tandem MS enabled the detection and quantitation of metabolites in small sample sizes with high sensitivity and selectivity. Isocratic elution using acetonitrile and water containing formic acid combined with electrospray-tandem MS enabled the separation and accurate quantitation of each analyte and the internal standard 3-acetamidophenol. The on-column limits ... [Abstract] [Full-text] Articles on Acetaminophen published 29 January 2008: Acetaminophen use during pregnancy: effects on risk for congenital abnormalities. Am J Obstet Gynecol, 198(2): 178.e1-7. OBJECTIVE: We evaluated if acetaminophen, one of the most frequently used drugs among pregnant women is associated with an increased prevalence of congenital abnormalities. STUDY DESIGN: We selected 88,142 pregnant women and their liveborn singletons from the Danish National Birth Cohort who had information on acetaminophen use during the first trimester of pregnancy. We used the National Hospital Registry to identify 3784 (4.3%) children from the cohort diagnosed with 5847 congenital ... [Abstract] [Full-text] © 2004-2008 Acetaminophen Research Today. 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