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Annabelle S. Chidiac, Nicholas Allan Buckley, Firouzeh Noghrehchi, Rose FJ Cairns
INTRODUCTION: Paracetamol is one of the most used medicines worldwide and is the most common important poisoning in high-income countries. In overdose, paracetamol causes dose-dependent hepatotoxicity. Acetylcysteine is an effective antidote, however despite its use hepatotoxicity and many deaths still occur. AREAS COVERED: This review summarizes paracetamol overdose and toxicity (including mechanisms, risk factors, risk assessment, and treatment). In addition, we summarize the epidemiology of paracetamol overdose worldwide. A literature search on PubMed for poisoning epidemiology and mortality from 1 January 2017 to 26 October 2022 was performed to estimate rates of paracetamol overdose, liver injury, and deaths worldwide. EXPERT OPINION: Paracetamol is widely available and yet is substantially more toxic than other analgesics available without prescription. Where data were available, we estimate that paracetamol is involved in 6% of poisonings, 56% of severe acute liver injury and acute liver failure, and 7% of drug-induced liver injury. These estimates are limited by lack of available data from many countries, particularly in Asia, South America, and Africa. Harm reduction from paracetamol is possible through better identification of high-risk overdoses, and better treatment regimens. Large overdoses and those involving modified-release paracetamol are high-risk and can be targeted through legislative change.
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Chidiac, A. S., Buckley, N. A., Noghrehchi, F., & Cairns, R. F. (2023). Paracetamol (acetaminophen) overdose and hepatotoxicity: mechanism, treatment, prevention measures, and estimates of burden of disease. Expert Opinion on Drug Metabolism & Toxicology, 19(5), 297–317. https://doi.org/10.1080/17425255.2023.2223959
Chidiac, Annabelle S., et al. "Paracetamol (acetaminophen) overdose and hepatotoxicity: mechanism, treatment, prevention measures, and estimates of burden of disease." Expert Opinion on Drug Metabolism & Toxicology, vol. 19, no. 5, 2023, pp. 297–317, https://doi.org/10.1080/17425255.2023.2223959.
Chidiac, Annabelle S., Nicholas Allan Buckley, Firouzeh Noghrehchi, and Rose FJ Cairns. "Paracetamol (acetaminophen) overdose and hepatotoxicity: mechanism, treatment, prevention measures, and estimates of burden of disease." Expert Opinion on Drug Metabolism & Toxicology 19, no. 5 (2023): 297–317. https://doi.org/10.1080/17425255.2023.2223959.
Chidiac A. S., Buckley N. A., Noghrehchi F. [и др.] Paracetamol (acetaminophen) overdose and hepatotoxicity: mechanism, treatment, prevention measures, and estimates of burden of disease // Expert Opinion on Drug Metabolism & Toxicology. — 2023. — Vol. 19, № 5. — P. 297–317. — URL: https://doi.org/10.1080/17425255.2023.2223959
@article{chidiac2023paracetamol,
title = {{Paracetamol (acetaminophen) overdose and hepatotoxicity: mechanism, treatment, prevention measures, and estimates of burden of disease}},
author = {Annabelle S. Chidiac and Nicholas Allan Buckley and Firouzeh Noghrehchi and Rose FJ Cairns},
journal = {Expert Opinion on Drug Metabolism \& Toxicology},
year = {2023},
volume = {19},
number = {5},
pages = {297--317},
doi = {10.1080/17425255.2023.2223959},
url = {https://doi.org/10.1080/17425255.2023.2223959}
}TY - JOUR AU - Chidiac, Annabelle S. AU - Buckley, Nicholas Allan AU - Noghrehchi, Firouzeh AU - Cairns, Rose FJ TI - Paracetamol (acetaminophen) overdose and hepatotoxicity: mechanism, treatment, prevention measures, and estimates of burden of disease JO - Expert Opinion on Drug Metabolism & Toxicology VL - 19 IS - 5 SP - 297 EP - 317 PY - 2023 DA - 2023/05/04 DO - 10.1080/17425255.2023.2223959 UR - https://doi.org/10.1080/17425255.2023.2223959 ER -
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