Eur J Clin Pharmacol (2017) 73:1103–1110 DOI 10.1007/s00228-017-2277-4 PHARMACOKINETICS AND DISPOSITION Pharmacokinetic modelling of modified acetylcysteine infusion regimens used in the treatment of paracetamol poisoning 1,2 3 1,4 Anselm Wong & Cornelia Landersdorfer & Andis Graudins Received: 30 March 2017 /Accepted: 2 June 2017 /Published online: 17 June 2017 Springer-Verlag GmbH Germany 2017 Abstract using the two-bag compared to the 1-h loading dose of the Purpose Paracetamol overdose is common and is treated with three-bag regimen. When administering an abbreviated 12-h acetylcysteine to prevent the development of hepatotoxicity. acetylcysteine regimen, circulating acetylcysteine is detect- N-acetyl-p-benzoquinone imine (NAPQI) is the toxic metab- able for 8 h after cessation of the infusion. This may provide olite of paracetamol overdose. We aimed to assess the expect- a continued hepatoprotective effect if NAPQI is still being ed acetylcysteine concentration time profiles following deliv- generated after the infusion is ceased. ery of modified acetylcysteine regimens proposed for those at Conclusion This pharmacokinetic simulation study is an im- high and low risk of hepatotoxicity. In addition, we will de- portant step in determining plasma acetylcysteine concentra- termine acetylcysteine concentrations post-cessation of abbre- tions that are likely to be achieved using various modified viated infusions. treatment
European Journal of Clinical Pharmacology – Springer Journals
Published: Jun 17, 2017
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