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Interés clínico de la semivida de eliminación del paracetamol como complemento al nomograma de Rumack en la valoración de la intoxicación por paracetamol. / [Clinical value of estimated half-life in paracetamol poisoning as a complement to Rumack's nomogram].
Med Clin (Barc) ; 129(13): 501-3, 2007 Oct 13.
Artigo em Espanhol | MEDLINE | ID: mdl-17980119
RESUMEN

BACKGROUND AND OBJECTIVE:

Rumack's nomogram is usually used to indicate the treatment with N-acetilcysteine in the paracetamol poisoning, but it has several limitations. Paracetamol half-life elimination (t1/2) is approximately of 2 h with therapeutic doses and it increases to more than 4 h in patients with hepatotoxicity. The aim of this study was to determine the usefulness of estimated paracetamol t1/2 as greater than or inferior to 4 h by using a simple ratio in relation to the development of hepatotoxicity.

PATIENTS AND METHOD:

21 patients with paracetamol overdose were admitted to Son Dureta Hospital (Palma de Mallorca) and Clínic Hospital (Barcelona) over 13 months. The estimated t1/2 is calculated using the quotient between 2 plasma paracetamol concentrations separated by 2 or more hours.

RESULTS:

We found a significant difference (p < 0.005) between the group with hepatotoxicity (n = 3; t1/2 = 8,5 h; range: 3,6 - 8,7 h); and without hepatotoxicity (n = 18; t1/2 = 2,4 h; (range: 1,6 - 4,3 h). We observed an agreement between positive ratio and a t1/2 > 4 h, and negative ratio with t1/2 < 4 h, bearing in mind that the quotient is obtained through mathematical equations.

CONCLUSIONS:

Rumack's nomogram should be complemented with t1/2 estimation in all cases of paracetamol poisoning, especially with those patients for whom we are not able to determine the time of ingestion at presentation or if there has been a multiple-timepoint ingestion.
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Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Nomogramas / Doença Hepática Induzida por Substâncias e Drogas / Acetaminofen Tipo de estudo: Guia de prática clínica Aspecto clínico: Etiologia / Predição / Prognóstico Limite: Adulto / Feminino / Humanos / Masculino Idioma: Espanhol Revista: Med Clin (Barc) Ano de publicação: 2007 Tipo de documento: Artigo