Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Delayed toxic acetaminophen level after initial four hour nontoxic level

T V Tighe1, F G Walter

  • 1Valley Medical Center, University of California, San Francisco, School of Medicine, Department of Emergency Medicine, Fresno 93702.

Journal of Toxicology. Clinical Toxicology
|January 1, 1994
PubMed
Summary
This summary is machine-generated.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Crotalus morulus (Viperidae: Crotalinae) envenoming and treatment with F(ab')<sub>2</sub> antivenom.

Toxicon : official journal of the International Society on Toxinology·2022
Same author

Metabolic effects of metaproterenol overdose: hypokalemia, hyperglycemia and hyperlactatemia.

Veterinary and human toxicology·2001
Same author

Continuous intravenous flumazenil infusion for benzodiazepine poisoning.

Veterinary and human toxicology·2000
Same author

Continuous intravenous midazolam infusion for Centruroides exilicauda scorpion envenomation.

Annals of emergency medicine·1999
Same author

Envenomations.

Critical care clinics·1999
Same author

Recurrent and persistent coagulopathy following pit viper envenomation.

Archives of internal medicine·1999
Same journal

Ingestion of high-dose buprenorphine by a 4 year-old child.

Journal of toxicology. Clinical toxicology·2005
Same journal

A reassessment of topical organic phosphorus insecticide exposures and permanent paralysis.

Journal of toxicology. Clinical toxicology·2005
Same journal

Methamphetamine toxicity secondary to intravaginal body stuffing.

Journal of toxicology. Clinical toxicology·2005
Same journal

Duodenal perforation after ibuprofen overdose.

Journal of toxicology. Clinical toxicology·2005
Same journal

Delayed dystonia following pimozide overdose in a child.

Journal of toxicology. Clinical toxicology·2005
Same journal

Pattern of acute poisonings in Mashhad, Iran 1993-2000.

Journal of toxicology. Clinical toxicology·2005
See all related articles

A delayed toxic acetaminophen level can occur even after an initial nontoxic reading, especially with co-ingestions. This case highlights the importance of considering delayed acetaminophen peaks in poisoning management.

Area of Science:

  • Toxicology
  • Emergency Medicine
  • Pharmacokinetics

Background:

  • Acetaminophen poisoning management typically relies on single serum levels at 4+ hours post-ingestion.
  • Co-ingestions may necessitate repeat acetaminophen level monitoring.
  • Delayed gastric emptying from co-ingestants can alter drug absorption profiles.

Observation:

  • A 20-year-old female ingested a significant amount of acetaminophen (13g) along with propoxyphene napsylate and naproxen sodium.
  • Initial acetaminophen level at 4.5 hours was 83.5 mg/L (nontoxic).
  • A subsequent acetaminophen level at 6.75 hours revealed a toxic concentration of 124.6 mg/L.

Findings:

  • This case represents the first reported instance of a delayed toxic acetaminophen level following an initial nontoxic measurement.

Related Experiment Videos

  • The patient received N-acetylcysteine treatment and experienced a full recovery without complications.
  • The findings suggest that co-ingestions, particularly those delaying gastric emptying, can lead to a delayed peak acetaminophen concentration.

    • Implications:

    • Clinicians should consider the possibility of delayed acetaminophen peak levels in cases of overdose, especially with co-ingestions.
    • Repeat acetaminophen level monitoring may be crucial in specific poisoning scenarios to ensure accurate assessment of toxicity.
    • This underscores the complexity of acetaminophen pharmacokinetics in mixed overdoses and informs clinical decision-making for antidotal therapy.