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Related Concept Videos

Phase II Reactions: Acetylation Reactions01:24

Phase II Reactions: Acetylation Reactions

168
Acetylation, a phase II biotransformation reaction, introduces an acetyl group to drugs or their metabolites. Acetyltransferase enzymes facilitate this reaction, which resembles α-amino acid conjugation due to the addition of a functional group to the drug molecule.
The substrates for acetylation are typically drugs or their metabolites with an amino, sulfonamide, or hydrazine functional group. Acetylation can occur at several points in the drug molecule, including primary, secondary, and...
168
Acute Pancreatitis II: Clinical Manifestations and Management01:30

Acute Pancreatitis II: Clinical Manifestations and Management

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Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
84
Acute Pancreatitis I: Introduction01:27

Acute Pancreatitis I: Introduction

324
Pancreatitis is inflammation of the pancreas, an organ located behind the stomach. It can be either acute or chronic.
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
324
Acetals and Thioacetals as Protecting Groups for Aldehydes and Ketones01:24

Acetals and Thioacetals as Protecting Groups for Aldehydes and Ketones

4.0K
Acetals are formed by reacting two equivalents of alcohol with carbonyl compounds like aldehydes or ketones. Acetals are unaffected by bases, nucleophiles, oxidizing agents, and reducing agents. They serve as protecting groups for aldehydes and ketones. Acetals can be easily formed and also easily removed via mild acid hydrolysis.
In the presence of multiple functional groups, when selective reduction of one group over the other is desired, groups like aldehydes and ketones that form acetals...
4.0K
Acute Respiratory Failure-V01:29

Acute Respiratory Failure-V

117
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
117
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

60
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
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Related Experiment Video

Updated: May 29, 2025

Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen
09:44

Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen

Published on: November 27, 2019

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Acute Liver Failure: Is Acetaminophen the Only Culprit?

Scott D McLaughlin1, Jason Z Amaral2, Joshua Thomas3

  • 1Department of Internal Medicine, Advocate Lutheran General Hospital, Park Ridge, USA.

Cureus
|February 7, 2025
PubMed
Summary
This summary is machine-generated.

Epstein-Barr virus hepatitis complicated a teen's acetaminophen overdose, making it resistant to standard treatment. Fomepizole addition improved outcomes, suggesting its potential role in managing severe pediatric drug-induced liver injury.

Keywords:
acetaminophen toxicitydrug-induced liver injury (dili)ebv liver dysfunctionebv-associated hepatitisepstein-barr virus (ebv)fomepizole for acetaminophen toxicityfomepizole pediatricsinfectious mononucleosis complicationspediatric acute liver failure (alf)pediatric hepatotoxicity

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Area of Science:

  • Hepatology
  • Virology
  • Pediatric Toxicology

Background:

  • Epstein-Barr virus (EBV) can cause hepatitis, potentially altering liver metabolism and increasing susceptibility to drug toxicity.
  • Acetaminophen overdose is a leading cause of acute liver failure in children.

Observation:

  • A 16-year-old female with acute EBV infection developed severe acetaminophen toxicity despite appropriate initial management.
  • Her condition was refractory to N-acetylcysteine treatment.

Findings:

  • Fomepizole was added to N-acetylcysteine, leading to clinical improvement and resolution of liver injury.
  • Fomepizole may have reduced toxic metabolite (NAPQI) formation by inhibiting CYP2E1 and suppressed inflammation.

Implications:

  • This case highlights the challenges in managing pediatric acute liver failure with coexisting viral hepatitis.
  • Fomepizole shows promise as an adjunctive therapy for N-acetylcysteine-refractory acetaminophen toxicity in pediatric patients with viral hepatitis.